American Journal of Transplantation最新文献

{"title":"Effects of race-neutral estimated glomerular filtration rate policies on access to kidney transplantation.","authors":"Nicholas Hartman,Mona Doshi,Silas P Norman,Jonathan H Segal,Claudia Dahlerus,Vahakn B Shahinian","doi":"10.1016/j.ajt.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.09.022","url":null,"abstract":"Motivated by potential inequities in access to transplantation stemming from the inclusion of Black race coefficients in estimated Glomerular Filtration Rate (eGFR) formulas, the United States Organ Procurement and Transplant Network (OPTN) implemented policies in 2022 and 2023 mandating the use of race-neutral eGFR formulas and the modification of waiting times for Black patients. We evaluated the impact of these policies on access to kidney transplantation using national registry data and supplementary OPTN data describing all waiting time modifications. The policy effects were assessed through segmented regression and difference-in-difference frameworks. There were no meaningful changes from the first mandate in the odds of a preemptively waitlisted patient being Black. The second mandate was associated with 3.8 [95% Confidence Interval: (2.7, 4.9), p-value < 0.001] additional deceased donor transplants per one-hundred person-years among the overall Black population, but 6.0 [95% Confidence Interval: (4.7, 7.3), p-value < 0.001] fewer deceased donor transplants per one-hundred person-years among the Black patients who did not receive waiting time modifications. There was evidence that the OPTN's second mandate had a positive impact on deceased donor transplant rates in the overall Black population but a negative impact on Black patients who did not receive additional waiting time.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"20 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215554","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 questions not addressed: Who should be performing the virtual crossmatch, how should it be classified, and how to obtain reimbursement?","authors":"H. Cliff Sullivan ,&nbsp;Andrés Jaramillo ,&nbsp;Sujata Gaitonde ,&nbsp;Cathi Murphey ,&nbsp;Soumya Pandey ,&nbsp;Chang Liu ,&nbsp;Peter Jindra ,&nbsp;Luis G. Hidalgo ,&nbsp;Eric T. Weimer ,&nbsp;Caroline R. Alquist ,&nbsp;Gerald P. Morris ,&nbsp;Robert A. Bray","doi":"10.1016/j.ajt.2025.03.020","DOIUrl":"10.1016/j.ajt.2025.03.020","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2260-2261"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690532","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":"Evaluation of the stability of organ procurement organization performance metrics","authors":"Rocio Lopez ,&nbsp;Sumit Mohan ,&nbsp;James R. Rodrigue ,&nbsp;Susana Arrigain ,&nbsp;Deena Brosi ,&nbsp;Ryan Lavanchy ,&nbsp;David Zingmond ,&nbsp;Bruce Kaplan ,&nbsp;Elizabeth A. Pomfret ,&nbsp;Jesse D. Schold","doi":"10.1016/j.ajt.2025.05.024","DOIUrl":"10.1016/j.ajt.2025.05.024","url":null,"abstract":"<div><div>In 2020, the Centers for Medicare and Medicaid Services updated the organ procurement<span><span> organization (OPO) conditions for coverage, redefining deceased donor potential as all inpatient deaths among patients aged ≤75 years with a primary cause of death consistent with organ donation, also called CALC (cause, age [years], and location consistent with donation). This study evaluates CALC performance metrics using 2018-2021 data from the Centers for Disease Control (CDC) mortality data (currently used by the Centers for Medicare and Medicaid Services) and the Agency for Healthcare Research and Quality’s State Inpatient Databases. We analyzed yearly performance variability, compared data sources, and examined the impact of CALC vs CALC-adjusted, which excludes donors with potential contraindications. There was significant year-to-year variability in </span>CDC<span> CALC tiers, with up to 40% of OPOs changing tiers annually. Between 20% and 43% of OPOs changed CALC performance tiers using State Inpatient Databases compared to CDC. Additionally, although CALC and CALC-adjusted rates were correlated, 11% to 29% of OPOs changed performance tiers with adjustment. These differences identify opportunities for potential changes to create more stable and consistent OPO performance measures. Future research to refine these metrics to ensure they support the goal of continuing improvement in OPO performance to maximize organ donation and transplant rates is important.</span></span></div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2151-2160"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130737","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":"Letter in reference to “Neoadjuvant Pemigatinib as a Bridge to Living Donor Liver Transplantation for Intrahepatic Cholangiocarcinoma with FGFR2 Rearrangement”","authors":"Xin Yuan ,&nbsp;Kunlin Xie","doi":"10.1016/j.ajt.2025.05.030","DOIUrl":"10.1016/j.ajt.2025.05.030","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2252-2253"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232777","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":"Potential targeting of urokinase-type plasminogen activator receptor–formyl peptide receptor signaling to prevent recurrence in posttransplant primary podocytopathies","authors":"Deborah Mattinzoli ,&nbsp;Masami Ikehata ,&nbsp;Daniele D’Alonzo ,&nbsp;Maria De Fenza ,&nbsp;Alberto Diana ,&nbsp;Min Li ,&nbsp;Silvia Armelloni ,&nbsp;Antonella Tosoni ,&nbsp;Alessandro Del Gobbo ,&nbsp;Federica Collino ,&nbsp;Antonio Mastrangelo ,&nbsp;William Morello ,&nbsp;Francesca Zanoni ,&nbsp;Gaia Bianchi ,&nbsp;Carlo Alfieri ,&nbsp;Piergiorgio Messa ,&nbsp;Manuela Nebuloni ,&nbsp;Giovanni Montini ,&nbsp;Luca Del Giacco ,&nbsp;Vincenzo Pavone ,&nbsp;Giuseppe Castellano","doi":"10.1016/j.ajt.2025.06.010","DOIUrl":"10.1016/j.ajt.2025.06.010","url":null,"abstract":"<div><div>Primary podocytopathies are a group of disorders characterized by nephrotic syndrome and frequent progression to kidney failure, with high rates of posttransplant recurrence. Increased expression of the urokinase-type plasminogen activator receptor (uPAR) has been associated with podocyte dysfunction in primary podocytopathies. uPAR can interact with formyl peptide receptors (FPRs) in podocytes, but the relevance of this signaling pathway in these diseases remains unclear. We retrospectively evaluated uPAR-FPR expression in renal biopsies from patients with primary podocytopathies with recurrent disease after transplantation. Upregulation of uPAR-FPR signaling was consistently observed in podocytes from kidney biopsies of patients with primary podocytopathies and in cultured podocytes exposed to sera from patients with recurrent disease. Pharmacologic inhibition of uPAR-FPR interactions with UPARANT restored podocyte plasticity, reversing cytoskeletal alterations and protecting against damage. This treatment also led to significant functional recovery in an in vitro glomerular filtration barrier model. Finally, targeting uPAR-FPR crosstalk in a zebrafish model of podocytopathy reversed podocyte foot process effacement and reduced glomerular loss of high-molecular weight dextran, effectively alleviating the disease phenotype. Our data indicate that pharmacologic targeting of the uPAR-FPR axis protects podocytes from damage and may preserve renal function in primary podocytopathies, potentially reducing recurrence after transplantation.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2104-2113"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289831","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 Letter in reference to “Neoadjuvant pemigatinib as a bridge to living donor liver transplantation for intrahepatic cholangiocarcinoma with FGFR2 rearrangement”","authors":"Matthew M. Byrne ,&nbsp;Richard F. Dunne ,&nbsp;Roberto Hernandez-Alejandro ,&nbsp;Koji Tomiyama","doi":"10.1016/j.ajt.2025.06.019","DOIUrl":"10.1016/j.ajt.2025.06.019","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2254-2255"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335478","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":"Corrigendum to ‘Inflammatory and hypoxic stress-induced islet exosomes released during isolation are associated with poor transplant outcomes in islet autotransplantation’ [American Journal of Transplantation. Volume 24, Issue 6, June 2024, Pages 967–982]","authors":"Prathab Balaji Saravanan ,&nbsp;Jagan Kalivarathan ,&nbsp;Kaeden McClintock ,&nbsp;Shujauddin Mohammed ,&nbsp;Elijah Burch ,&nbsp;Christiane Morecock ,&nbsp;Jinze Liu ,&nbsp;Aamir Khan ,&nbsp;Marlon F. Levy ,&nbsp;Mazhar A. Kanak","doi":"10.1016/j.ajt.2025.05.026","DOIUrl":"10.1016/j.ajt.2025.05.026","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2263-2264"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504574","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":"Virtual crossmatching: Principles, practices, and the path forward—An American Society for Histocompatibility and Immunogenetics/College of American Pathologists collaborative","authors":"H. Cliff Sullivan ,&nbsp;Andrés Jaramillo ,&nbsp;Sujata Gaitonde ,&nbsp;Cathi Murphey ,&nbsp;Soumya Pandey ,&nbsp;Chang Liu ,&nbsp;Peter Jindra ,&nbsp;Luis G. Hidalgo ,&nbsp;Eric T. Weimer ,&nbsp;Caroline R. Alquist ,&nbsp;Gerald P. Morris ,&nbsp;Robert A. Bray","doi":"10.1016/j.ajt.2025.06.018","DOIUrl":"10.1016/j.ajt.2025.06.018","url":null,"abstract":"<div><div>Donor-specific anti-human leukocyte antigen (HLA) antibodies are a significant barrier to solid organ transplant<span> and can lead to poor outcomes in the posttransplant setting. Physical crossmatch (PXM), including complement-dependent cytotoxicity crossmatch and flow cytometric crossmatch, has substantially reduced the incidence of hyperacute rejection and, for years, has been the gold standard for compatibility assessment before transplant. However, the advent of solid-phase anti-HLA antibody testing and molecular HLA typing has allowed the introduction and rise of virtual crossmatch (VXM). With a high negative predictive value, VXM has proven to be more sensitive than PXM in detecting donor-specific anti-HLA antibodies. Recent regulations by the Centers for Medicare &amp; Medicaid Services now recognize VXM as a suitable alternative to PXM in pretransplant compatibility assessment. As VXM gains acceptance, it is imperative that we understand its complexities, such as its definition, application, advantages, and disadvantages. In this review, we examine the principles underlying VXM, including both generally accepted concepts and areas under debate. Furthermore, we highlight current applications and discuss opportunities for future improvement.</span></div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2048-2056"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370259","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":"Is Organ Transplant the Next Medical Expertise Catastrophe?","authors":"Lara C. Pullen PhD","doi":"10.1016/j.ajt.2025.08.014","DOIUrl":"10.1016/j.ajt.2025.08.014","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2031-2033"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899277","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":"Fatal acute respiratory distress syndrome caused by donor-derived human metapneumovirus after lung transplantation","authors":"Solenne Hulot ,&nbsp;Vincent Prunet ,&nbsp;Benjamin Coiffard ,&nbsp;Christine Zandotti ,&nbsp;Céline Boschi ,&nbsp;Xavier Benoit D’Journo ,&nbsp;Sami Hraiech ,&nbsp;Martine Reynaud-Gaubert ,&nbsp;Philippe Colson ,&nbsp;Nadim Cassir","doi":"10.1016/j.ajt.2025.05.020","DOIUrl":"10.1016/j.ajt.2025.05.020","url":null,"abstract":"<div><div><span>Respiratory viral infections, including </span>human metapneumovirus<span><span> (hMPV), are increasingly recognized as a significant cause of morbidity and mortality in lung transplant<span> recipients (LTRs). We present a case of hMPV pneumonia in a bilateral LTR, likely transmitted by the donor, resulting in severe acute respiratory distress syndrome and leading to death. Next-generation sequencing of hPMV genomes was performed from both the recipient’s </span></span>bronchoalveolar lavage and the organ conservation liquid and strongly supported the presence of donor-derived infection. There is still limited reported evidence to support systematic viral testing of donor respiratory specimens. This case highlights the need to better assess and control the risk of donor-derived respiratory viral infections in LTRs.</span></div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 10","pages":"Pages 2239-2243"},"PeriodicalIF":8.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097702","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}