American Journal of Transplantation最新文献_第5页

Letter to the editor: Addressing oncological surveillance in gender-affirming care for transgender and gender diverse liver transplant patients 致编辑的信：在变性和性别多元化肝移植患者的性别确认护理中解决肿瘤监测问题。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.07.006

引用次数: 0

Partial bladder transplantation with en bloc kidney transplant—long-term, 17 years, the outcome of a “bladder patch technique” 膀胱部分移植与整体肾移植--"膀胱补片技术 "17 年的长期疗效。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.07.007

Yoko Shirai , Kenichiro Miura , Mari Suzuki , Ikumi Moriyama , Maki Yoshino , Toshio Takagi , Tomoaki Kato , Motoshi Hattori

{"title":"Partial bladder transplantation with en bloc kidney transplant—long-term, 17 years, the outcome of a “bladder patch technique”","authors":"Yoko Shirai , Kenichiro Miura , Mari Suzuki , Ikumi Moriyama , Maki Yoshino , Toshio Takagi , Tomoaki Kato , Motoshi Hattori","doi":"10.1016/j.ajt.2024.07.007","DOIUrl":"10.1016/j.ajt.2024.07.007","url":null,"abstract":"<div><div>A transplant of a portion of the bladder with an en bloc kidney from a 2-year-old donor was previously reported in a 12-month-old girl due to her extremely small bladder. Bilateral kidneys were transplanted en bloc with their ureters connected to a patch of the donor bladder (bladder patch technique). The long-term outcomes and complications of this technique have not been documented. Here, we report a long-term, 17-year follow-up of this patient with an evaluation of whole bladder functions at 18 years of age. The patient has had no episodes of urinary tract infections. Cystoscopy showed a viable transplanted bladder with a well-perfused mucosa. We observed that the native bladder has stretched over time, forming more than half of the bladder wall. Urodynamic studies showed preserved bladder compliance at 43 mL/cmH<sub>2</sub>O, and native bladder contractility was preserved. Prolonged voiding time and postvoid residual urine were also observed. These findings were suggestive of detrusor underactivity. No reﬂux across the donor ureterovesical junctions was observed. The recipient was instructed to continue timed voiding and double voiding to empty the bladder. In conclusion, en bloc kidney transplantation with a bladder patch is a feasible and safe option for kidney transplant recipients with a small bladder capacity.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 11","pages":"Pages 2121-2124"},"PeriodicalIF":8.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602951","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

Living donor liver transplant in Colombia, with a proposal to reduce geographic disparity in Latin America 哥伦比亚的活体肝移植，建议缩小拉丁美洲的地域差距。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.07.022

Andres Gomez-Aldana, Rosselli Diego

引用次数: 0

Why partial heart transplantation could be regulated as organ transplantation 为什么可以将部分心脏移植作为器官移植来管理。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.06.003

{"title":"Why partial heart transplantation could be regulated as organ transplantation","authors":"","doi":"10.1016/j.ajt.2024.06.003","DOIUrl":"10.1016/j.ajt.2024.06.003","url":null,"abstract":"<div><div>Partial heart transplant (PHT) is a recent clinical innovation involving the transplantation of a segment of the heart (valves) directly from the deceased donor into the recipient patient. This procedure holds out the possibility of significant benefit, especially for pediatric patients because these grafts show growth potential after transplant, reducing or eliminating the current need for repeat procedures. The clinical process for donation and transplant of partial heart (PH) grafts generally follows an organ clinical pathway; however, the Food and Drug Administration has recently stated its intent to regulate PH as tissues, raising a host of regulatory considerations. PHT requires donor testing and eligibility determinations within a short, clinically viable timeframe and, similar to organ transplant, involves donor-recipient matching. Waitlist allocation policies that are a regulatory focus of the Organ Procurement and Transplantation Network including equity and efficiency may become relevant. Oversight of PHT by the Organ Procurement and Transplantation Network could be accomplished through interpretation of the vascular composite allograft definition or through designation by the US Department of Health and Human Services of PH grafts as organs. While some clinical questions remain unanswered, it is important to carefully address these regulatory considerations to support the emergence of this innovation and ensure the continued trust of the donating public and the patients who may benefit from PHT.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 11","pages":"Pages 1941-1949"},"PeriodicalIF":8.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Organ Procurement Organization-level variation in A1/A2 subtyping of deceased donors 已故捐献者 A1/A2 亚型的 OPO 水平差异。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.07.008

Shivani S. Bisen , Laura B. Zeiser , Darren E. Stewart , Bonnie E. Lonze , Dorry L. Segev , Allan B. Massie

引用次数: 0

Clinical and molecular spectrum of v-lesion V 形细胞瘤的临床和分子谱。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.07.025

Anna Buxeda , Marta Crespo , Betty Chamoun , Javier Gimeno , Irina B. Torres , Dolores Redondo-Pachón , Marta Riera , Carla Burballa , Julio Pascual , Michael Mengel , Benjamin A. Adam , María José Pérez-Sáez

{"title":"Clinical and molecular spectrum of v-lesion","authors":"Anna Buxeda , Marta Crespo , Betty Chamoun , Javier Gimeno , Irina B. Torres , Dolores Redondo-Pachón , Marta Riera , Carla Burballa , Julio Pascual , Michael Mengel , Benjamin A. Adam , María José Pérez-Sáez","doi":"10.1016/j.ajt.2024.07.025","DOIUrl":"10.1016/j.ajt.2024.07.025","url":null,"abstract":"<div><div>Isolated v-lesion presents diagnostic stratification and clinical challenges. We characterized allograft outcomes for this entity based on posttransplant time (early: ≤1 month vs late: >1 month) and compared its molecular phenotype with other v+ rejection forms. Using the NanoString B-HOT panel, we analyzed 92 archival formalin-fixed paraffin-embedded tissue kidney biopsies from 3 centers: isolated v-lesion (n = 23), antibody-mediated rejection (ABMR) v+ (n = 26), T cell–mediated rejection (TCMR) v+ (n = 10), mixed rejection v+ (n = 23), and normal tissue (n = 10). Six gene sets (ABMR, DSAST, ENDAT, TCMR, early/acute injury, late injury) were assessed. Early isolated v-lesions had the poorest 1-year death-censored graft survival compared with late isolated v-lesions or other rejections (<em>P</em> = .034). Gene set analysis showed lower TCMR-related gene expression in isolated v+ groups than TCMR and mixed rejection (<em>P</em> < .001). Both early- and late isolated v-lesions had lower ABMR-related gene expression than ABMR, mixed rejection, and TCMR (<em>P</em> ≤ .022). Late isolated v-lesions showed reduced DSAST and ENDAT gene expression versus ABMR (<em>P</em> ≤ .046) and decreased early/acute injury gene expression than early isolated v+, ABMR, TCMR, and mixed rejection (<em>P</em> ≤ .026). In conclusion, isolated v-lesions exhibit distinct gene expression patterns versus other rejection v+ forms. Early isolated v+ is associated with poorer prognosis and increased early/acute injury gene expression than late isolated v+, suggesting distinct etiologies.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 11","pages":"Pages 2007-2021"},"PeriodicalIF":8.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858383","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

Tissue-resident regulatory T cells as transient, tissue-agnostic immunomodulatory populations 组织驻留调节性 T 细胞是瞬时的组织识别性免疫调节群体。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.09.013

Sagar P. Bapat, James M. Gardner

引用次数: 0

Pediatric cardiac xenotransplantation and stakeholder engagement 小儿心脏异种移植与利益相关者的参与。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.06.020

引用次数: 0

Allostimulation leads to emergence of a human B cell population with increased expression of HLA class I antigen presentation–associated molecules and the immunoglobulin receptor FcRL5 异体刺激导致人类 B 细胞群的出现，其 HLA I 类抗原呈递相关分子和免疫球蛋白受体 FcRL5 的表达量增加。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.06.014

{"title":"Allostimulation leads to emergence of a human B cell population with increased expression of HLA class I antigen presentation–associated molecules and the immunoglobulin receptor FcRL5","authors":"","doi":"10.1016/j.ajt.2024.06.014","DOIUrl":"10.1016/j.ajt.2024.06.014","url":null,"abstract":"<div><div>In the extensive literature characterizing lymphocyte contributions to transplant-related pathologies including allograft rejection and graft-versus-host disease, T cell–focused investigation has outpaced investigation of B cells. Most B cell–related reports describe regulatory and antibody-producing functions, with less focus on the potential role of antigen-presenting capacity. Using in vitro human mixed lymphocyte reactions (MLRs) to model allostimulation, we analyzed responder B cells using transcriptional analysis, flow cytometry, and microscopy. We observed emergence of an activated responder B cell subpopulation phenotypically similar to that described in individuals with graft-versus-host disease or allograft rejection. This population had markedly increased expression of FcRL5 (Fc receptor like 5) and molecules associated with human leukocyte antigen class I antigen presentation. Consistent with this phenotype, these cells demonstrated increased internalization of irradiated cell debris and dextran macromolecules. The proportion of this subpopulation within MLR responders also correlated with emergence of activated, cytotoxic CD8<sup>+</sup> T cells. B cells of similar profile were quite infrequent in unstimulated blood from healthy individuals but readily identifiable in disaggregated human splenocytes and increased in both cases upon allostimulation. Further characterization of the emergence and function of this subpopulation could potentially contribute to identification of novel biomarkers and targeted therapeutics relevant to curbing transplant-related pathology.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 11","pages":"Pages 1968-1978"},"PeriodicalIF":8.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589082","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

Sowing “seeds of trust”: How trust in normothermic regional perfusion is built in a continuum of care 播下 "信任的种子"：如何在持续护理中建立对常温区域灌注的信任。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-11-01 DOI: 10.1016/j.ajt.2024.05.017

{"title":"Sowing “seeds of trust”: How trust in normothermic regional perfusion is built in a continuum of care","authors":"","doi":"10.1016/j.ajt.2024.05.017","DOIUrl":"10.1016/j.ajt.2024.05.017","url":null,"abstract":"<div><div>Normothermic regional perfusion (NRP) is a promising technology to improve organ transplantation outcomes by reversing ischemic injury caused by controlled donation after circulatory determination of death. However, it has not yet been implemented in Canada due to ethical questions. These issues must be resolved to preserve public trust in organ donation and transplantation. This qualitative, constructivist grounded theory study sought to understand how those most impacted by NRP perceived the ethical implications. We interviewed 29 participants across stakeholder groups of donor families, organ recipients, donation and transplantation system leaders, and care providers. The interview protocol included a short presentation about the purpose of NRP and procedures in abdomen versus chest and abdomen NRP, followed by questions probing potential violations of the dead donor rule and concerns regarding brain reperfusion. The results present a grounded theory placing NRP within a trust-building continuum of care for the donor, their family, and organ recipients. Stakeholders consistently described both forms of NRP as an ethical intervention, but their rationales were predicated on assumptions that neurologic criteria for death had been met following circulatory death determination. Empirical validation of these assumptions will help ground the implementation of NRP in a trust-preserving way.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 11","pages":"Pages 2045-2054"},"PeriodicalIF":8.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0