American Journal of Transplantation最新文献

{"title":"The Current State of Simultaneous Heart Liver Transplantation in the United States.","authors":"Ahmad Anouti,Ali H Dakroub,Hussein Krayem,Lauren E Matevish,Hamza Dahshi,Sara Hassan,Arjmand R Mufti,Parsia A Vagefi,Maryjane Farr,Matthias Peltz,Lisa B VanWagner,Thomas G Cotter,William M Lee,Madhukar S Patel","doi":"10.1016/j.ajt.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.07.001","url":null,"abstract":"Simultaneous heart liver transplantation (SHLT) has expanded in recent years, bolstered by increases in congenital heart disease (CHD) indications and improvements in organ preservation. We performed a contemporary analysis of patients undergoing SHLT for CHD vs non-CHD, further exploring the impact of machine perfusion (MP). Patients undergoing SHLT between 2010-2024 were retrospectively identified using the UNOS database, assessing a primary outcome of patient survival and secondary outcome of MP utilization. 535 patients underwent SHLT, 224(41.9%) with CHD indication and 311(58.1%) non-CHD. CHD recipients had significantly lower one-(72.9% vs. 89.4%,p<0.01) and five-year survival (66.1% vs. 81.4%,p<0.01) compared to non-CHD recipients. CHD indication was independently associated with a two-fold increased mortality risk, compared to a non-CHD diagnosis (HR:2.31, 95%CI:[1.53,3.47]). Decision tree boosting demonstrated a 2.9% higher relative mortality likelihood after SHLT for recipients with CHD. From 2022-2024, SHLT MP utilization for CHD increased; among 111 patients, 18.0% received a MP liver, 8.1% a MP heart, and 10.8% MP heart and MP liver. In this analysis of modern SHLT cases, patients with CHD had suboptimal outcomes; several donor and recipient factors also impacted mortality. Awareness of these factors can guide pre-transplant optimization, donor/recipient matching, and strategic MP use to improve survival.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"13 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578682","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 Malik and Patel, managing recurrence after liver transplant for colorectal liver metastasis.","authors":"Matthew M Byrne, Koji Tomiyama, Roberto Hernandez-Alejandro","doi":"10.1016/j.ajt.2025.06.031","DOIUrl":"10.1016/j.ajt.2025.06.031","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566856","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":"STAR 2025 innate working group: the potential role of innate allorecognition in kidney allograft damage.","authors":"Olivier Thaunat,Fadi G Lakkis,Vasilis Kosmoliaptsis,Carrie Schinstock,Anat Tambur,Sebastiaan Heidt,Maarten Naesens","doi":"10.1016/j.ajt.2025.06.030","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.06.030","url":null,"abstract":"In solid organ transplantation, the alloimmune response is traditionally attributed to the action of alloreactive T cells that recognize mismatched human leukocyte antigens (HLA), and by antibody formation and antibody-mediated rejection. However, recent evidence indicates that these paradigms of involvement of the adaptive immune system in organ transplant rejection don't explain all cases of graft inflammation, and that innate cell allorecognition plays a role. This review, conducted by the innate team of the Sensitization in Transplantation Assessment of Risk (STAR) workgroup, summarizes the concepts and empirical evidence supporting innate allorecognition. The focus is on NK cell activation via missing self and monocyte activation through SIRPα-CD47 pathway and SIRPα gene polymorphisms. A consensus definition of genetic missing self is proposed, necessitating both donor and recipient HLA class I genotyping, and evaluation of recipient inhibitory killer-cell immunoglobulin-like receptor (KIR) genotype. While in vitro studies and preclinical validations corroborate the potential of innate allorecognition concepts, further research is required to establish clinical utility. This article delineates future research directions to bridge the gap between theoretical promise and practical application in clinical transplantation.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"9 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578717","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 \"Kidney graft directly implanted on endovascular stent in external iliac artery: a preliminary experience\".","authors":"Emilien Seizilles de Mazancourt,Xavier Matillon,Matthieu Arsicot","doi":"10.1016/j.ajt.2025.06.033","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.06.033","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"20 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568441","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":"West Nile Virus and Other Nationally Notifiable Arboviral Diseases - United States, 2023.","authors":"Marcus Pereira","doi":"10.1016/j.ajt.2025.06.032","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.06.032","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574555","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":"Liver transplantation for hepatitis D virus/hepatitis B virus coinfection in Italy: An intention-to-treat analysis of long-term outcomes","authors":"Roberta Angelico ,&nbsp;Silvia Trapani ,&nbsp;Tommaso Maria Manzia ,&nbsp;Ilaria Lenci ,&nbsp;Paolo Grossi ,&nbsp;Andrea Ricci ,&nbsp;Patrizia Burra ,&nbsp;Enzo Andorno ,&nbsp;Salvatore Agnes ,&nbsp;Sherrie Bhoori ,&nbsp;Umberto Baccarani ,&nbsp;Luca S. Belli ,&nbsp;Paola Carrai ,&nbsp;Lucio Caccamo ,&nbsp;Amedeo Carraro ,&nbsp;Matteo Cescon ,&nbsp;Michele Colledan ,&nbsp;Umberto Cillo ,&nbsp;Luciano De Carlis ,&nbsp;Nicola De Maria ,&nbsp;Mario Angelico","doi":"10.1016/j.ajt.2025.03.003","DOIUrl":"10.1016/j.ajt.2025.03.003","url":null,"abstract":"<div><div>Patients with hepatitis D virus (HDV)/hepatitis B virus (HBV)-related end-stage liver disease candidates for liver transplantation (LT) have traditionally been regarded as a special population, although their outcomes are controversial. An intention-to-treat (ITT) analysis of long-term outcomes of HDV/HBV-coinfected patients waitlisted for LT in Italy, between 2011 and 2020, was performed and compared with HBV-monoinfected LT candidates. Of 1731 HBV-infected LT candidates, 1237 (71.5%) had HBV monoinfection and 494 (28.5%) HDV/HBV coinfection. At listing, HDV/HBV-coinfected patients were significantly younger, listed mainly for decompensated cirrhosis, and with fewer hepatocellular carcinoma (HCC) cases; (26% vs 65.8%; <em>P</em> &lt;.0001) compared with HBV-monoinfected patients. HDV/HBV-coinfected patients showed better 5-year ITT survival (83.2%; 95% CI: 79.4%-83.4%, vs 71.6%; 95% CI: 68.8%-74.2%; <em>P</em> &lt; .0001). ITT-multivariable analysis identified the presence of HCC, advanced recipient age, and high model for end-stage liver disease-Na scores as mortality risk factors. Five years after LT, 99.1% of HDV/HBV-coinfected patients received oral nucleos(t)ide analogs, with immunoglobulins against antigen of the hepatitis B virus in 91.8% of cases. HBV and HDV viral recurrences were 1.1% and 0.2%, respectively, whereas recurrent or de novo HCC were 8.9% and 0.3%, respectively. In Italy, HDV/HBV-coinfected patients waitlisted for LT showed more favorable outcomes compared with HBV-monoinfected patients, both before and after LT. These excellent results, from the largest cohort reported so far, suggest that HDV/HBV-coinfected LT recipients do not represent a risky population and may be considered for simpler long-term antiviral prophylactic strategies.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 7","pages":"Pages 1502-1514"},"PeriodicalIF":8.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583999","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 operational tolerance induction finally safe and feasible for some kidney transplant recipients: A breakthrough to a new horizon?","authors":"Edward K. Geissler ,&nbsp;Birgit Sawitzki","doi":"10.1016/j.ajt.2025.02.013","DOIUrl":"10.1016/j.ajt.2025.02.013","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 7","pages":"Pages 1386-1387"},"PeriodicalIF":8.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490113","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":"Can mouse kidney transplant models inform mechanisms of injury and acceptance in clinical kidney transplantation?","authors":"Zheng Jenny Zhang ,&nbsp;Federica Casiraghi ,&nbsp;Griffith Boord Perkins ,&nbsp;William M. Baldwin 3rd ,&nbsp;Robert L. Fairchild","doi":"10.1016/j.ajt.2025.04.001","DOIUrl":"10.1016/j.ajt.2025.04.001","url":null,"abstract":"<div><div>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 the development and implementation of therapeutic strategies to improve outcomes. This compels the 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 the 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 the strengths and weaknesses of mouse models of kidney allograft responses and injury. Although obvious weaknesses arise when considering the 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 the judicious choice of test questions and the choice of appropriate donors and recipients for the chosen model.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 7","pages":"Pages 1391-1398"},"PeriodicalIF":8.9,"publicationDate":"2025-07-01","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}

{"title":"Acute retroperitoneal bleeding 1 month after kidney transplantation","authors":"Mahnoor Zia ,&nbsp;Charudatta Bavare ,&nbsp;Luan Troung ,&nbsp;Mark J. Hobeika","doi":"10.1016/j.ajt.2025.02.008","DOIUrl":"10.1016/j.ajt.2025.02.008","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 7","pages":"Pages 1579-1581"},"PeriodicalIF":8.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517197","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":"Impact of repeat human leukocyte antigen mismatches on kidney graft survival: A contemporary Collaborative Transplant Study analysis","authors":"Lissa Pipeleers ,&nbsp;Christian Unterrainer ,&nbsp;Marie-Paule Emonds ,&nbsp;Karl Martin Wissing ,&nbsp;Thuong Hien Tran","doi":"10.1016/j.ajt.2024.12.014","DOIUrl":"10.1016/j.ajt.2024.12.014","url":null,"abstract":"<div><div>Repeat human leukocyte antigen (HLA) mismatches (RMM) have been historically associated with an increased risk of graft loss after repeat kidney transplantation, in particular HLA-DR RMM in sensitized recipients. As routine use of sensitive assays can at present prevent the transplantation of RMM in hosts with donor-specific antibodies, we hypothesized that RMM would no longer be associated with graft loss. We performed a registry analysis of the Collaborative Transplant Study database including 6711 patients who received a second kidney transplant (KT) between 2010 and 2021, with at least 1 HLA-A, HLA-B, or HLA-DR mismatch. No increased risk for graft loss was observed for the second KT with a class I RMM, regardless of sensitization status. For the second KT with a HLA-DR RMM, the hazard ratio for graft loss in the first year after transplantation was 1.61 (95% CI 1.16-2.23; <em>P</em> = .004) compared to recipients without an RMM and increased to 2.21 (95% CI 1.24-3.63: <em>P</em> = .002) in sensitized recipients (latest complement-dependent cytotoxicity panel reactive antibodies &gt;0%). Our observations suggest that class I RMM do not need to be systematically avoided. In contrast, HLA-DR RMM still had a negative impact on graft survival in this contemporary cohort, despite the widespread availability of Luminex.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 7","pages":"Pages 1481-1490"},"PeriodicalIF":8.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880827","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}