American Journal of Transplantation最新文献

{"title":"The Banff 2024 Kidney Meeting Report: Rejection as a spectrum of phenotypes and focus on differential diagnostic reasoning.","authors":"Maarten Naesens, Candice Roufosse, Lynn D Cornell, Mark Haas, Roslyn B Mannon, Marjan Afrouzian, Enver Akalin, Nada Alachkar, Mariam P Alexander, Serena M Bagnasco, Ibrahim Batal, Georg A Böhmig, Peter Boor, Verena Broecker, Anthony Chang, Marian Clahsen-Van Groningen, Shana M Coley, Robert B Colvin, Darshana Dadhania, Cinthia B Drachenberg, Michelle Elias, Alton B Farris, Agnes B Fogo, Kevin Fowler, Ian W Gibson, Valentin Goutaudier, Edmund Huang, Syed A Husain, Annette M Jackson, Jesper Kers, Željko Kikić, Nicolas Kozakowski, Vanderlene Kung, Helen Liapis, Kevin Louis, Thangamani Muthukumar, Brian Nankivell, Desley A H Neil, Marion Rabant, Parmjeet Randhawa, Leonardo V Riella, Ivy Rosales, Virginie Royal, Ruth Sapir-Pichhadze, Thomas Schachtner, Carrie Schinstock, Surya V Seshan, Adnan Sharif, Kim Solez, Olivier Thaunat, Dominique Van Midden, Pedro Ventura-Aguiar, Michelle Willicombe, Carmen Lefaucheur, Alexandre Loupy, Michael Mengel","doi":"10.1016/j.ajt.2026.01.018","DOIUrl":"https://doi.org/10.1016/j.ajt.2026.01.018","url":null,"abstract":"<p><p>The XVIIth Banff meeting for transplant pathology was held in Paris, France, from September 16, 2024 to September 20, 2024, hosted by the Paris Institute for Transplantation & Organ Regeneration. The Banff 2024 meeting resulted in no changes to the Banff kidney classification. Important outputs of the meeting were a reaffirmation of the clinical usefulness of the clinical reasoning framework and flowchart for cases with microvascular inflammation/antibody-mediated rejection introduced at the Banff 2022 meeting and the introduction of a similar flowchart for tubulointerstitial inflammation and intimal arteritis (v lesion). The meeting highlighted the complexity of the immunologic processes (alloimmune and others) that lead to allograft inflammation and the need to strengthen the Banff system for differential diagnostic reasoning. Guidance is put in place for cases with incomplete/mixed phenotypes, which acknowledges the limits of our understanding. A proposal for potential future implementation of activity and chronicity indices was discussed, as well as digital and biopsy-based molecular tools that have the potential to help transform the classification into a probabilistic tool reflective of the underlying immunologic processes. Finally, guidelines for reporting of glomerular disease in the posttransplant setting were developed.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-level cancer trends among solid organ transplant recipients in the United States during 1995-2021.","authors":"Eric A Engels,David Castenson,Qianlai Luo,Meredith S Shiels,Ajay Israni,Jie Li,Margaret M Madeleine,Karen Pawlish,Daniela Ramirez Aguilar,Yun Zeng,Ruth M Pfieffer","doi":"10.1016/j.ajt.2026.02.036","DOIUrl":"https://doi.org/10.1016/j.ajt.2026.02.036","url":null,"abstract":"Solid organ transplant recipients (SOTRs) experience elevated cancer risk from immunosuppression and underlying medical conditions. Medical management has improved over time, and SOTRs are living longer. We used registry data covering 693,718 SOTRs in the United States (US) to evaluate population-level cancer trends during 1995-2021. Compared with SOTRs in 1995-2003, those in 2013-2021 were living at older ages and were followed at a longer time since their transplant. Based on 65,081 cancers, cancer incidence in SOTRs was higher during 2013-2021 than 1995-2003 (unadjusted incidence rate ratio [IRR] 1.29, 95% confidence interval [95%CI] 1.26-1.32). However, cancer incidence was lower in 2013-2021 after adjustment for age (IRR 0.93, 95%CI 0.91-0.95) and multivariable adjustment (0.93, 0.90-0.96). Results for the six most common cancer types showed varying trends during 1995-2021. Overall cancer incidence was higher in SOTRs than in the US general population during 1995-2021 and, most recently, in 2013-2021 (standardized incidence ratio 1.66, 95%CI 1.64-1.67). In conclusion, after accounting for age, there was an encouraging decline in cancer incidence among US SOTRs during 1995-2021. However, incidence remained elevated compared with the general population in 2013-2021. Measures are needed to reduce the cancer burden as SOTRs live longer after transplantation and the population ages.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"406 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to addressing center-level confounding and temporal bias in induction therapy cost-effectiveness analysis.","authors":"David Axelrod, Krista L Lentine, Mark A Schnitzler","doi":"10.1016/j.ajt.2026.02.032","DOIUrl":"10.1016/j.ajt.2026.02.032","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147352980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Consensus on the Use of Immune Checkpoint Inhibitors in the Liver Transplant Setting: Guidance from the Liver Transplant Committee of the Italian Association for the Study of the Liver (AISF).","authors":"Francesca Romana Ponziani,Valerio Giannelli,Giuseppe Marrone,Silvia Martini,Maria Cristina Morelli,Duilio Pagano,Gianluca Svegliati Baroni,Giacomo Germani,Patrizia Burra,Pierluigi Toniutto, ","doi":"10.1016/j.ajt.2026.02.024","DOIUrl":"https://doi.org/10.1016/j.ajt.2026.02.024","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for advanced hepatocellular carcinoma (HCC), increasing opportunities for downstaging and conversion to liver transplant (LT) eligibility. However, the use of ICIs in the LT setting raises challenges regarding the optimal timing and duration of treatment, safety, and assessment of tumor response. Moreover, the use of ICIs for HCC recurrence after LT is associated with an increased risk of acute cellular rejection and potential graft failure. This manuscript presents expert consensus guidance developed by a panel of nine LT experts from the Permanent Transplant Commission of the Italian Association for the Study of the Liver (AISF) and conducted based on the modified Delphi method. Fifteen clinically relevant questions were developed through an iterative process involving structured literature review, clinical experience, and identification of practice gaps. Each question was assigned to one to two panel members with topic-specific expertise, who were responsible for performing a targeted literature review, drafting the evidence summary, and proposing a recommendation. Statements receiving >75% agreement in two rounds of voting were considered approved and presented in this paper. Until prospective data become available, this guidance aims to assist clinical decision-making within the evolving field of LT oncology.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"31 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional increases in incidence of coccidioidomycosis (Valley fever)-Arizona, 2005-2022.","authors":"Marcus R Pereira","doi":"10.1016/j.ajt.2026.03.002","DOIUrl":"10.1016/j.ajt.2026.03.002","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The trouble with tribbles: donor eosinophils propagate lung ischemia-reperfusion injury.","authors":"Daniel R Calabrese,John R Greenland","doi":"10.1016/j.ajt.2026.02.035","DOIUrl":"https://doi.org/10.1016/j.ajt.2026.02.035","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"130 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of in-situ split procurement and ex-situ hyper-reduction under dual hypothermic oxygenated perfusion for neonatal liver transplantation.","authors":"Stefania Camagni,Marco Maria Pascale,Flavia Neri,Marta Tassan Mangina,Angela Pogliaghi,Michela Bravi,Domenico Pinelli","doi":"10.1016/j.ajt.2026.02.031","DOIUrl":"https://doi.org/10.1016/j.ajt.2026.02.031","url":null,"abstract":"Hypothermic oxygenated machine perfusion may provide a platform for graft manipulation in pediatric liver transplantation. We present an innovative strategy-in-situ liver splitting followed by ex-situ left lateral segment (LLS) hyper-reduction during dual hypothermic oxygenated perfusion (DHOPE)-resulting in successful transplantation in a 2.7-kg neonate with fulminant hepatic failure. This report demonstrates the feasibility of LLS reduction under DHOPE and suggests potential advantages of this approach to graft manipulation, unlocking perspectives for pediatric liver transplantation.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"227 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147351086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary carboxymethylcellulose metabolite promotes heart allograft rejection through induction of pro-inflammatory macrophages via lysophosphatidic acid.","authors":"Xinyi Ma,Yang Xu,Yeqi Nian,Rongshen Luo,Tianran Chen,Keke Su,Teng Li,Chunlin Shen,Baiyi Xie,Helong Dai,Jie Zhao,Yunhan Ma","doi":"10.1016/j.ajt.2026.02.030","DOIUrl":"https://doi.org/10.1016/j.ajt.2026.02.030","url":null,"abstract":"Carboxymethylcellulose (CMC), a common food emulsifier, induces microbiota dysbiosis and systemic inflammation; however, its impact on transplant immunity remains unclear. Allogenic heart rejection was observed in CMC-fed recipient mice, with increased abundance of lysophosphatidic acid (LPA)-producing bacteria and increased serum LPA concentration. CMC-induced transplant rejection was caused by the gut microbiota, as confirmed by fecal microbiota transplantation and gut microbiota depletion. Furthermore, LPA-treated macrophages demonstrated a pro-inflammatory ability to accelerate allograft rejection in cytotoxic T lymphocyte-associated protein 4 immunoglobulin-induced allograft survival by upregulating glycolysis. Conversely, the administrated of a glycolysis inhibitor resulted in allograft survival and abrogated the detrimental effect of LPA. Mass spectrometry and single-cell RNA sequencing confirmed that human transplant rejection patients showed significantly elevated serum LPA levels and LPAR6 expression in graft-infiltrate macrophages. Mechanistically, LPA preferentially promoted LPAR6 expression, which interacted with Rho-associated protein kinase 2 to activate the mTOR/HIF-1α pathway, thereby enhancing glycolysis and inducing pro-inflammatory macrophage polarization. Treatment with Ki16425, an LPAR antagonist, prolonged allograft survival in CMC-fed recipients. Our findings reveal a major detrimental effect of CMC on macrophage physiology and suggest that controlling LPAR6 expression or glycolysis in macrophage may improve allograft survival in transplant recipients.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"30 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical and psychosocial issues with in situ and ex situ perfusion technology for organ transplantation: A scoping review","authors":"Jaden Blazier ,&nbsp;Emma K. Massey ,&nbsp;Esther W. de Bekker-Grob ,&nbsp;Maartje Schermer ,&nbsp;Robert C. Minnee ,&nbsp;Jeroen de Jonge ,&nbsp;Eline M. Bunnik","doi":"10.1016/j.ajt.2025.10.011","DOIUrl":"10.1016/j.ajt.2025.10.011","url":null,"abstract":"<div><div>Perfusion technology is increasingly used to assess and/or enhance organ viability by circulating blood or blood substitutes through organs, improving transplant outcomes. Both ex situ and in situ techniques present distinct ethical issues that must be considered during implementation. Perspectives of stakeholders can illuminate key concerns. This scoping review maps the literature on ethical and psychosocial issues related to perfusion technology, comparing techniques. We searched Embase, Medline, CINAHL, PsycINFO, and Google Scholar for articles discussing these issues, without date limits. We included peer-reviewed articles in English, using thematic analysis to extract and synthesize themes. 141 articles were included, and 9 themes were identified. 89% of articles discussed in situ normothermic regional perfusion (67% in-depth), with a focus on in situ thoracoabdominal normothermic regional perfusion and determination of death. Ex situ machine perfusion appeared in 61% of articles (16% in-depth) with the theme of justice/allocation highlighted due to machine perfusion’s potential to exacerbate or ameliorate inequities in transplant access. To clarify debated issues and inform policy, both techniques require further qualitative research and ethical analysis, particularly regarding allocation, dignity, informed consent, and the moral status of ex situ organs.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"26 3","pages":"Pages 550-575"},"PeriodicalIF":8.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organ procurement organizations should develop policy regarding surrogate consent for normothermic regional perfusion","authors":"Nicholas B. Murphy ,&nbsp;Matthew J. Weiss ,&nbsp;Stephen Beed ,&nbsp;Stéphanie Chartier-Plante ,&nbsp;Prosanto Chaudhury ,&nbsp;Jed Adam Gross ,&nbsp;Andrew Healey ,&nbsp;George Isac ,&nbsp;Andreas Kramer ,&nbsp;Marat Slessarev ,&nbsp;Charles Weijer","doi":"10.1016/j.ajt.2025.10.014","DOIUrl":"10.1016/j.ajt.2025.10.014","url":null,"abstract":"<div><div>Normothermic regional perfusion (NRP) is a postmortem technique that restores oxygenated blood flow to transplantable organs in situ after death determination in donation after circulatory death to improve organ viability and function. Although observational evidence strongly suggests NRP is superior to conventional rapid organ recovery, it has generated ethical controversy internationally. While much of the debate revolves around NRP’s compatibility with the dead donor rule, an unresolved ethical question facing organ procurement organizations is whether, in addition to general consent (or “authorization”) to organ donation, specific consent to NRP should be sought from surrogate decision makers. As NRP practice continues to evolve and as more jurisdictions consider NRP adoption, developing policy governing NRP consent or notification practices should be a priority for organ procurement organizations. In this <em>Personal Viewpoint</em> article, we outline arguments for and against a consent requirement. We conclude that ongoing ethical controversy and unresolved empirical questions concerning the potential for the resumption of intracranial blood flow during NRP support a cautious, consent-based approach at this stage of NRP’s adoption.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"26 3","pages":"Pages 449-454"},"PeriodicalIF":8.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}