American Journal of Transplantation最新文献_第3页

Multiplex bead immunoassay in ABO-A2-incompatible kidney transplantation. abo - a2不相容肾移植的多重头免疫分析。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-09 DOI: 10.1016/j.ajt.2025.04.003

Anne M Halpin,Cathi Murphey,Bruce Motyka,Caishun Li,Jean Pearcey,Maria Ellis,I Esme Dijke,Simon Urschel,Adam Bingaman,Tess Van Ong,Matthias Kapturczak,Todd L Lowary,Christopher W Cairo,Lori J West

{"title":"Multiplex bead immunoassay in ABO-A2-incompatible kidney transplantation.","authors":"Anne M Halpin,Cathi Murphey,Bruce Motyka,Caishun Li,Jean Pearcey,Maria Ellis,I Esme Dijke,Simon Urschel,Adam Bingaman,Tess Van Ong,Matthias Kapturczak,Todd L Lowary,Christopher W Cairo,Lori J West","doi":"10.1016/j.ajt.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.003","url":null,"abstract":"Kidney transplantation from ABO-A2 donors into ABO-O and -B recipients can alleviate inequitable transplant access created by ABO demographics. ABO-A2-incompatible eligibility is determined by anti-A hemagglutination titres. However, titres do not distinguish antibodies specific for A-II glycans, the sole A-antigen subtype in vascular endothelium, from other anti-A antibodies. We examined whether reliance on anti-A titres unnecessarily limited ABO-A2-incompatible transplants for candidates with low anti-A-II levels. We created a single-antigen-bead immunoassay for ABO antibodies, confirmed the specificity and reproducibility, and demonstrated the ability to detect anti-A and -B glycan-subtype-specific antibodies in healthy control sera. We then measured subtype-specific anti-A antibodies in original sera from ABO-B and -O candidates who had been previously evaluated for ABO-A2-incompatible eligibility. Anti-A-II levels in candidates who had been deemed ineligible (anti-A titres >4) were compared to eligible candidates (anti-A titres ≤4) who had subsequently received ABO-A2-incompatible kidneys. Of 141 candidates, 75(53%) were ineligible; 66(47%) were eligible and received ABO-A2 kidneys. Re-testing original sera, 55%(41/75) of ineligible candidates had anti-A-II levels comparable to eligible candidates. Anti-A titres did not reflect anti-A-II levels. Our ABO antibody assay reproducibly measures graft-specific anti-A-II antibodies, providing information beyond anti-A titres that may increase transplant access for ABO-B and -O candidates.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"50 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824819","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}

引用次数: 0

Can Mouse Kidney Transplant Models Inform Mechanisms of Injury and Acceptance in Clinical Kidney Transplantation? 小鼠肾移植模型能否为临床肾移植损伤和接受机制提供信息？

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-08 DOI: 10.1016/j.ajt.2025.04.001

Zheng Jenny Zhang,Federica Casiraghi,Griffith Boord Perkins,William M Baldwin,Robert L Fairchild

{"title":"Can Mouse Kidney Transplant Models Inform Mechanisms of Injury and Acceptance in Clinical Kidney Transplantation?","authors":"Zheng Jenny Zhang,Federica Casiraghi,Griffith Boord Perkins,William M Baldwin,Robert L Fairchild","doi":"10.1016/j.ajt.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.001","url":null,"abstract":"Despite standard of care immunosuppression, acute rejection remains commonly observed in kidney transplants and leads to chronic graft injury and failure in many transplanted patients. Mechanisms underlying acute and chronic kidney graft injury are incompletely understood, undermining development and implementation of therapeutic strategies to improve outcomes. This compels use of preclinical kidney transplant models to identify components and mechanisms mediating acute and chronic graft injury. Mouse models have been instrumental in establishing basic principles of alloimmune responses and rejection of heart allografts. There is increasing use of mouse models to extend these studies to kidney transplantation, but the relevance of the findings to clinical kidney transplants remains under scrutiny. Here, we discuss strengths and weaknesses of mouse models of kidney allograft responses and injury. Although obvious weaknesses arise when considering relevance to clinical kidney transplants, there are new models that recapitulate many features of kidney graft injury in the clinical scenario and have much to contribute to understanding innate and donor alloantigen-specific mechanisms underlying kidney allograft injury. As in most preclinical studies, the pertinent use of kidney allogeneic transplants in mice comes down to judicious choice of test questions and choice of appropriate donors and recipients for the chosen model.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"17 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822623","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}

引用次数: 0

Underrecognition of deceased-donor kidney out-of-sequence allocation due to increasing use of free text coding. 由于越来越多地使用自由文本编码，对已故供体肾脏乱序分配的识别不足。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-08 DOI: 10.1016/j.ajt.2025.04.002

Emma G Tucker,Miko E Yu,Joel T Adler,David C Cron,Prateek V Sahni,Jesse D Schold,Sumit Mohan,Syed Ali Husain

{"title":"Underrecognition of deceased-donor kidney out-of-sequence allocation due to increasing use of free text coding.","authors":"Emma G Tucker,Miko E Yu,Joel T Adler,David C Cron,Prateek V Sahni,Jesse D Schold,Sumit Mohan,Syed Ali Husain","doi":"10.1016/j.ajt.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.002","url":null,"abstract":"Out-of-sequence (OOS) allocation, the process by which organ procurement organizations (OPOs) can deviate from standard rank lists of potential recipients to expeditiously allocate deceased-donor kidneys, is rising in the U.S. We aimed to determine whether current OPO reporting practices obscure the extent of OOS allocation. Using match-run data for all U.S. deceased-donor kidney transplants from 2021-2023, we defined \"miscoded\" OOS (mOOS) allocation transplants as those with use of the 799 or 898 OPO-initiated refusal codes (\"other, specify\") with free text responses clearly indicating OOS allocation, and compared these to \"explicit\" OOS (eOOS) allocation, wherein OOS transplants are appropriately coded using refusal codes 861-863. We found that the prevalence of mOOS allocation increased from 2021 (122 transplants) to 2023 (430 transplants) and accounted for 12% of all OOS transplants by 2023. Organs allocated via mOOS had a lower median KDPI than those allocated via eOOS (51% vs 55%, p <0.01). While an increasing number of OPOs used mOOS throughout the study period, the practice remained concentrated overall, with 5 \"high-frequency\" OPOs performing 66% of mOOS allocations in 2023. These findings highlight the need for stricter oversight of organ allocation and underscore the responsibility of the OPTN to ensure proper data reporting.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"37 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822626","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}

引用次数: 0

Normothermic Regional Perfusion Performed by a US Organ Procurement Organization for Non-thoracic Organ Donors. 由美国器官采购组织为非胸部器官供体进行的常温区域灌注。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-08 DOI: 10.1016/j.ajt.2025.04.005

Marty T Sellers,Jill Grandas,Matthew T Warhoover,John D Poland,Deana C Clapper

{"title":"Normothermic Regional Perfusion Performed by a US Organ Procurement Organization for Non-thoracic Organ Donors.","authors":"Marty T Sellers,Jill Grandas,Matthew T Warhoover,John D Poland,Deana C Clapper","doi":"10.1016/j.ajt.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.005","url":null,"abstract":"Normothermic regional perfusion (NRP) has potential to increase the number and quality of transplanted organs. Most reports showing advantages of NRP have been from transplant centers, but not all centers perform NRP. These advantages could be broadened if organ procurement organizations (OPOs) also performed NRP. We report donation and transplantation outcomes of our first 90 OPO-based NRP non-thoracic donors, divided into 3 eras (n=30 each). Comparisons were made with DCD-direct procurement (DP; n=270) and donation after brain death (DBD; n=729) donors. NRP donor median age was 53 years, compared to DP (48 years, p=0.004) and DBD (44 years, p<0.001) donors. NRP liver utilization (69%, 18 accepting centers) was superior to DP (17%, p<0.001) and not significantly different from DBD utilization (79%, p=0.27) on multivariate analysis. By era, NRP liver utilization progressively increased: 53%, 70%, 83% (p=0.04). NRP kidney use rate (71%) was higher than in DP (60%, p=0.02) and not significantly different from DBD (76%, p=0.15), especially among older donors. NRP kidney DGF incidence (29%) was lower than in DP (47%, p=0.001) and not significantly different from DBD (32%, p=0.53) donors. OPO-based NRP can provide more livers and kidneys to multiple transplant centers and improve outcomes from non-thoracic organ donors.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"108 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822668","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}

引用次数: 0

Association of the Initial Implementation of Continuous Distribution Allocation Policy with Outcomes for Lung Transplant Candidates by Blood Type. 连续分配政策的初步实施与血型肺移植候选者预后的关系。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-08 DOI: 10.1016/j.ajt.2025.04.004

Jesse D Schold,Jordan R H Hoffman,Sumit Mohan,Alice L Gray,Rocio Lopez,Susana Arrigain,Deena Brosi,Ryan LaVanchy,S Ali Husain,Miko Yu,Elizabeth A Pomfret

{"title":"Association of the Initial Implementation of Continuous Distribution Allocation Policy with Outcomes for Lung Transplant Candidates by Blood Type.","authors":"Jesse D Schold,Jordan R H Hoffman,Sumit Mohan,Alice L Gray,Rocio Lopez,Susana Arrigain,Deena Brosi,Ryan LaVanchy,S Ali Husain,Miko Yu,Elizabeth A Pomfret","doi":"10.1016/j.ajt.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.004","url":null,"abstract":"On 3/9/2023, allocation of donor lungs in the US changed to continuous distribution(CD). Initial implementation of policy was flawed due to a programming error affecting priority of candidates by blood type. While this issue was identified and addressed, the impact of initial policy implementation on blood type O candidates has not been rigorously evaluated. We used SRTR data to evaluate candidate(n=4,738) and recipient(n=4,437) outcomes following CD policy. Using cumulative incidence plots accounting for competing risks and multivariable Cox models, incidence of transplantation pre-policy was similar by blood type (8-month incidence 81.0% vs. 80.5% for blood types-A,B,AB and blood type-O respectively,p=0.57). Following CD policy, blood type-O candidates had lower incidence of transplantation relative to other blood types (8-month incidences 86.3% vs 92.1% respectively,p<0.001) with a significantly lower adjusted hazard ratio(AHR) for transplantation (AHR=0.67,95% C.I. 0.54-0.82). Blood type-O candidates were more likely Hispanic and 'Other' race and had higher rates of waitlist removal or death following CD (6.0% vs 2.9%,p=0.003). Among transplants performed prior to CD, 48% were blood type-O recipients compared to 40% post-CD, representing 138 fewer blood type-O transplants than expected. Type-O blood candidates had significant decline in prognosis relative to other blood groups following initial implementation of CD policy.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"60 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822669","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}

引用次数: 0

Microvascular inflammation in kidney allografts: New directions for patient management. 同种异体肾移植的微血管炎症：患者管理的新方向。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-04-06 DOI: 10.1016/j.ajt.2025.03.031

Georg A Böhmig, Alexandre Loupy, Marta Sablik, Maarten Naesens

{"title":"Microvascular inflammation in kidney allografts: New directions for patient management.","authors":"Georg A Böhmig, Alexandre Loupy, Marta Sablik, Maarten Naesens","doi":"10.1016/j.ajt.2025.03.031","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.03.031","url":null,"abstract":"<p><p>Microvascular inflammation (MVI) is a key histological feature of immune-mediated injury at the capillary interface of renal allografts, characterized by immune cell infiltration into glomerular and peritubular capillaries. While traditionally associated with antibody-mediated rejection (AMR), many MVI cases lack detectable donor-specific antibodies (DSA), suggesting the involvement of antibody-independent immune mechanisms or alternative triggers, such as viral infections or ischemia-reperfusion injury. The Banff 2022 scheme introduced a subcategory, \"MVI, DSA-negative, C4d-negative\", within an overarching AMR/MVI category. This subcategory -similar to AMR- was shown to carry a significant risk of graft failure. Its recognition marks a major advancement, offering a robust framework for investigating the pathophysiology of MVI, which may involve a wide array of overlapping triggers. Emerging evidence from transcriptome analyses highlights natural killer (NK) cells as possible effectors, regardless of DSA status. Therapies targeting NK cells, particularly the anti-CD38 antibody felzartamab, have shown promising reductions in MVI and molecular injury. Notably, the U.S. Food and Drug Administration has approved an MVI-based primary endpoint for a phase 3 trial evaluating this approach, representing a critical step toward the development of new therapeutics. Recognizing MVI as a multifaceted histological phenotype -driven by diverse triggers- may signal a paradigm shift in transplant medicine.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810040","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}

引用次数: 0

Substantial weight loss resulting in a large panniculus may incur additional pretransplant costs. 大量的体重下降导致的大鼻窦可能会招致额外的移植前费用。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-04-05 DOI: 10.1016/j.ajt.2025.03.016

Christoph Troppmann, Richard V Perez

引用次数: 0

Longitudinal Assessment of the Effect of Invasive Fungal Infections on Transplant Success in Kidney Transplant Recipients. 侵袭性真菌感染对肾移植受者移植成功影响的纵向评估。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-04-03 DOI: 10.1016/j.ajt.2025.03.030

Lucy X Li, Jiashu Xue, Teresa Po-Yu Chiang, Na Lu, Darin Ostrander, Sean X Zhang, John W Baddley, Shmuel Shoham, Daniel C Brennan, Christine M Durand, William A Werbel, Kieren A Marr, Robin K Avery, Nitipong Permpalung

{"title":"Longitudinal Assessment of the Effect of Invasive Fungal Infections on Transplant Success in Kidney Transplant Recipients.","authors":"Lucy X Li, Jiashu Xue, Teresa Po-Yu Chiang, Na Lu, Darin Ostrander, Sean X Zhang, John W Baddley, Shmuel Shoham, Daniel C Brennan, Christine M Durand, William A Werbel, Kieren A Marr, Robin K Avery, Nitipong Permpalung","doi":"10.1016/j.ajt.2025.03.030","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.03.030","url":null,"abstract":"<p><p>Invasive fungal infections (IFIs) significantly impact morbidity and mortality in kidney transplant recipients (KTR), but their effect on allograft function remains poorly defined. This retrospective study examined adult KTRs transplanted at Johns Hopkins from 2012 to 2018, with follow-up through 2023. The association of IFIs with a composite outcome of graft failure and mortality was assessed using negative binomial regression. The association of IFI exposure on composite outcome was quantified by matching using a stochastic extension stratification method followed by Cox regression. Among 1453 KTRs, 79 were diagnosed with proven/probable IFIs, predominantly invasive candidiasis (46.8%). KTRs with IFIs had worse outcome-free survival with higher composite outcome rates [53/79 (67.1%) vs. 411/1338 (30.7%), p<0.001]. The composite outcome incidence rate was 4.61-fold higher when IFIs occurred in the first 6 months post-transplant and decreased to 2.13-fold higher after 36 months (p<0.001). IFI exposure was associated with 3.45-fold increased hazard of composite outcome (95% CI 1.54-7.70; p<0.01) and a 3.23-fold increased hazard of all-cause mortality (95% CI 1.53-6.83; p<0.01). The association of IFIs with increased risk of poor kidney transplant outcomes, particularly in the early post-transplant period, highlights the need for improved strategies for early IFI detection and management in KTRs.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787419","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}

引用次数: 0

Long-term outcomes of induction immunosuppression for kidney transplant recipients with HIV who have average immunologic risk: An inverse probability treatment weighting analysis 免疫风险一般的 HIV 肾移植受者接受诱导免疫抑制的长期疗效：反概率治疗加权分析。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-04-01 DOI: 10.1016/j.ajt.2024.11.004

Rasha El Rifai , Kaushik Bhunia , Lauren Fontana , Kurtis J. Swanson , Scott Jackson , Byron H. Smith , Samy M. Riad

{"title":"Long-term outcomes of induction immunosuppression for kidney transplant recipients with HIV who have average immunologic risk: An inverse probability treatment weighting analysis","authors":"Rasha El Rifai , Kaushik Bhunia , Lauren Fontana , Kurtis J. Swanson , Scott Jackson , Byron H. Smith , Samy M. Riad","doi":"10.1016/j.ajt.2024.11.004","DOIUrl":"10.1016/j.ajt.2024.11.004","url":null,"abstract":"<div><div>We analyzed the Scientific Registry of Transplant Recipients (2004-2022) for primary kidney transplant recipients with HIV who had average immunologic risk and were discharged on tacrolimus/mycophenolate mofetil (with or without corticosteroids). Recipients were grouped by induction type: rabbit antithymocyte globulin (r-ATG, n = 688) and human interleukin-2 receptor antagonist (IL2Ra, n = 467). Kaplan-Meier curves were generated to examine recipient and graft survival by induction type. We used mixed Cox proportional hazard models to determine associations between induction type and outcomes of interest, with adjustments for recipient and donor factors and transplant center as a random effect. Regression with propensity score weighting reduced selection bias from nonrandom induction allocation. The unadjusted 10-year survival rate was 57% for those receiving r-ATG and 64% for those receiving IL2Ra (<em>P</em> < .001). Adjusted risk of death was significantly lower for IL2Ra induction than r-ATG induction with Cox multivariable (hazard ratio, 0.65; 95% CI, 0.47-0.91; <em>P</em> = .01) and inverse probability treatment weighting (hazard ratio, 0.38; 95% CI, 0.29-0.50; <em>P</em> < .01) models. Death-censored kidney graft survival did not differ by induction type in either model. The 1-year rejection rate was 10.1% and 11.6% for r-ATG and IL2Ra recipients, respectively (<em>P</em> = .52). Overall, IL2Ra conferred better long-term survival than r-ATG without increased risk of graft loss.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 4","pages":"Pages 756-766"},"PeriodicalIF":8.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613044","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}

引用次数: 0

The concept of immunothrombosis in pancreas transplantation 胰腺移植中免疫血栓的概念。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-04-01 DOI: 10.1016/j.ajt.2024.11.025

Christophe Masset , Nicolas Drillaud , Catherine Ternisien , Nicolas Degauque , Nathalie Gerard , Sarah Bruneau , Julien Branchereau , Gilles Blancho , Benoit Mesnard , Sophie Brouard , Magali Giral , Diego Cantarovich , Jacques Dantal

{"title":"The concept of immunothrombosis in pancreas transplantation","authors":"Christophe Masset , Nicolas Drillaud , Catherine Ternisien , Nicolas Degauque , Nathalie Gerard , Sarah Bruneau , Julien Branchereau , Gilles Blancho , Benoit Mesnard , Sophie Brouard , Magali Giral , Diego Cantarovich , Jacques Dantal","doi":"10.1016/j.ajt.2024.11.025","DOIUrl":"10.1016/j.ajt.2024.11.025","url":null,"abstract":"<div><div>Early failure of a pancreatic allograft due to complete thrombosis has an incidence of approximately 10% and is the main cause of comorbidity in pancreas transplantation. Although several risk factors have been identified, the exact mechanisms leading to this serious complication are still unclear. In this review, we define the roles of the individual components involved during sterile <em>immunothrombosis</em>—namely endothelial cells, platelets, and innate immune cells. Further, we review the published evidence linking the main risk factors for pancreatic thrombosis to cellular activation and vascular modifications. We also explore the unique features of the pancreas itself: the vessel endothelium, specific vascularization, and relationship to other organs—notably the spleen and adipose tissue. Finally, we summarize the therapeutic possibilities for the prevention of pancreatic thrombosis depending on the different mechanisms such as anticoagulation, anti-inflammatory molecules, endothelium protectors, antagonism of damage-associated molecular patterns, and use of machine perfusion.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 4","pages":"Pages 650-668"},"PeriodicalIF":8.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870601","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}

引用次数: 0