American Journal of Transplantation最新文献_第6页

Implications of the New NIH Policy on Animal Research for Transplant Science. 美国国立卫生研究院新政策对移植科学动物研究的影响。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-16 DOI: 10.1016/j.ajt.2025.09.006

Mandy L Ford,Paolo Cravedi

引用次数: 0

Changes in characteristics of recovered U.S. deceased donor kidneys lead to large changes in KDRI-to-KDPI scaling over time. 美国已故供者肾脏的特征变化导致kdri - kdpi随时间的变化。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-15 DOI: 10.1016/j.ajt.2025.09.008

Miko E Yu,Syed Ali Husain,Lindsey M Maclay,Jesse D Schold,Sumit Mohan

{"title":"Changes in characteristics of recovered U.S. deceased donor kidneys lead to large changes in KDRI-to-KDPI scaling over time.","authors":"Miko E Yu,Syed Ali Husain,Lindsey M Maclay,Jesse D Schold,Sumit Mohan","doi":"10.1016/j.ajt.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.09.008","url":null,"abstract":"The Kidney Donor Risk Index (KDRI) was introduced into the US kidney allocation system in 2014 as an estimate of the relative risk of post-transplant deceased donor kidney allograft failure in an adult recipient. It is scaled annually relative to the prior year's cohort of donors and converted to a percentile score known as the Kidney Donor Profile Index (KDPI), with higher scores suggesting shorter estimated function. This retrospective cohort study examined all deceased donor kidneys recovered for transplantation from 2016-2023 (N=187,817) to examine the extent to which the KDRI of organs with equivalent KDPI percentage score is changing. Median KDRI stayed constant or trended upwards annually-KDPI 50% kidneys in 2018 were KDRI 1.2 (0.96-1.56) compared to KDRI 1.4 (1.06-1.79) in 2023. The change in KDPI for identical donors ranged from 8% to 14%. KDPI 84% kidneys in 2023 had a KDRI of 1.97, which were KDPI 92% kidneys in 2016. The new KDRI equation, modeled without donor race and hepatitis C factors, showed greater clustering of KDRI values, consistent with a lower number of variables. Although kidneys may be represented by the same percentile score, the underlying drift of the KDRI may result in very different estimated longevity.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"1 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077730","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 Right Liver Donation from Donors Aged 45 and Older: Outcomes for Both Donors and Recipients. 45岁及以上供者活体右肝捐赠：供者和受者的结果

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-12 DOI: 10.1016/j.ajt.2025.09.005

Sang-Hoon Kim,Dong-Hwan Jung,Shin Hwang,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Gil-Chun Park,Young-In Yoon,Ji Hoon Kim,Woo-Hyoung Kang,Eun-Kyoung Jwa,Byeong-Gon Na,Sung Min Kim,I-Ji Jeong,Hyo Jung Ko,Minha Choi,Dae Hyeon Won,Ji Hoon Kang,Sung-Gyu Lee

{"title":"Living Right Liver Donation from Donors Aged 45 and Older: Outcomes for Both Donors and Recipients.","authors":"Sang-Hoon Kim,Dong-Hwan Jung,Shin Hwang,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Gil-Chun Park,Young-In Yoon,Ji Hoon Kim,Woo-Hyoung Kang,Eun-Kyoung Jwa,Byeong-Gon Na,Sung Min Kim,I-Ji Jeong,Hyo Jung Ko,Minha Choi,Dae Hyeon Won,Ji Hoon Kang,Sung-Gyu Lee","doi":"10.1016/j.ajt.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.09.005","url":null,"abstract":"This study evaluated the safety of living-donor liver transplantation (LDLT) using right lobe (RL) grafts from older donors (ODs; age ≥45 years) compared to younger donors (YDs; age <45 years). A total of 4,415 donor-recipient pairs were retrospectively analyzed, including ODs (N=238) and YDs (N=4,177). Donor complication rates, including overall (4.5% vs. 1.3%, p=0.01) and major (2.8% vs. 0.4%, p=0.02) complications were significantly lower in the OD group, indicating no increased surgical risk for ODs. However, recipients of OD group showed significantly higher incidence of biliary stricture (10.1% vs. 6.0%; p=0.01) and 1-year graft failure (11.3% vs. 5.5%; p<0.001), and poorer graft survival (5-year: 77.6% vs. 85.0%; p=0.004) compared with YD group. Furthermore, among patients with MELD scores ≥20, recipients of OD group showed significantly poorer graft survival (5-year: 68.5% vs. 82.2%; p=0.02). These outcomes remained consistent after propensity score matching. Multivariable Cox proportional hazards regression identified using OD grafts as a significant risk factor for recipient graft survival. LDLT using RL from ODs increased risks of biliary stricture and early graft failure in recipients, particularly in MELD scores ≥20, without compromising donor safety. Careful donor-recipient matching is critical when considering ODs in LDLT.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"32 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059038","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

Increasing the acceptance of thoraco-abdominal normothermic regional perfusion in DCD heart donation: A case for collaborative donor research. 提高DCD心脏捐献胸腹常温区域灌注的接受度：一个合作供者研究案例。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-11 DOI: 10.1016/j.ajt.2025.07.2483

John O Louca,Alex Manara,Ashish Shah,Kelly Schlendorf,Brian Lima,Jacob Schroder,Sarah Casalinova,Carmelo Milano,Kiran Khush,Helen Luikart,Owais Dar,Mailen Konicoff,Marian Urban,John Um,Anthony Castleberry,Jordan R H Hoffman,Michael T Cain,Katharina Fetten,Dan Meyer,Addison Xu,Francisco Gonzalez-Vilchez,Beatriz Domínguez-Gil,Mario Royo-Villanova,Iris Garrido,Janne Brouckaert,Filip Rega,Katrien Vandendriessche,Vincent Tchana-Sato,Marius Berman,Nicole Asemota,Sanjay Sinha,Stephen Pettit,Simon Messer,Marco Öchsner,Antonio Rubino,Jayan Parameshwar,Sai Bhagra,Stephen Large,

{"title":"Increasing the acceptance of thoraco-abdominal normothermic regional perfusion in DCD heart donation: A case for collaborative donor research.","authors":"John O Louca,Alex Manara,Ashish Shah,Kelly Schlendorf,Brian Lima,Jacob Schroder,Sarah Casalinova,Carmelo Milano,Kiran Khush,Helen Luikart,Owais Dar,Mailen Konicoff,Marian Urban,John Um,Anthony Castleberry,Jordan R H Hoffman,Michael T Cain,Katharina Fetten,Dan Meyer,Addison Xu,Francisco Gonzalez-Vilchez,Beatriz Domínguez-Gil,Mario Royo-Villanova,Iris Garrido,Janne Brouckaert,Filip Rega,Katrien Vandendriessche,Vincent Tchana-Sato,Marius Berman,Nicole Asemota,Sanjay Sinha,Stephen Pettit,Simon Messer,Marco Öchsner,Antonio Rubino,Jayan Parameshwar,Sai Bhagra,Stephen Large, ","doi":"10.1016/j.ajt.2025.07.2483","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.07.2483","url":null,"abstract":"Donation after circulatory death (DCD) transplantation offers an effective and safe method of increasing the number of heart transplants performed. The DCD heart is ischaemic at the time of retrieval and therefore requires reperfusion. This may take place in the donor - known as thoracoabdominal normothermic regional perfusion (taNRP) or outside of the donor, known as direct procurement and preservation (DPP). There is a growing body of evidence that taNRP is associated with better utilisation of thoracic and abdominal organs from the donor and with superior recipient outcomes. taNRP offers a cheaper alternative to organ recovery than DPP. In addition, taNRP can also be used in paediatric transplantation. However, there are still concerns regarding the ethical acceptability of taNRP. These concerns centre around the possible restoration of brain blood flow during taNRP through collaterals to the vertebrobasilar system. Early studies have demonstrated no brain blood flow or perfusion, but these are limited by small numbers. Further work, with significantly more cases, will need transatlantic collaboration to definitively establish the absence of brain blood flow or perfusion. We have a moral responsibility to both donors and recipients to expedite this work.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"62 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056643","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

Ischemia-Free Liver Transplantation As a Novel Approach to Improve Survival and Clinical Outcomes in the Acute-on-Chronic Liver Failure Scenario. 无缺血肝移植是改善急性慢性肝衰竭患者生存和临床结果的新途径。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-11 DOI: 10.1016/j.ajt.2025.08.011

Yunhua Tang,Jiahao Li,Meiting Qin,Zhiying Liu,Jun Kang,Jinbo Huang,Honghui Chen,Tielong Wang,Maogen Chen,Weiqiang Ju,Dongping Wang,Huadi Chen,Zhiyong Guo,Xiaoshun He,Qiang Zhao

{"title":"Ischemia-Free Liver Transplantation As a Novel Approach to Improve Survival and Clinical Outcomes in the Acute-on-Chronic Liver Failure Scenario.","authors":"Yunhua Tang,Jiahao Li,Meiting Qin,Zhiying Liu,Jun Kang,Jinbo Huang,Honghui Chen,Tielong Wang,Maogen Chen,Weiqiang Ju,Dongping Wang,Huadi Chen,Zhiyong Guo,Xiaoshun He,Qiang Zhao","doi":"10.1016/j.ajt.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.08.011","url":null,"abstract":"Acute-on-chronic liver failure (ACLF) is a life-threatening condition with high mortality. Ischemia-free liver transplantation (IFLT), a novel clinical approach avoiding ischemia-reperfusion injury, may offer significant benefits for ACLF patients. This study included 30 ACLF patients undergoing IFLT and 97 ACLF patients undergoing conventional liver transplantation (CLT). After propensity score matching (PSM), the IFLT group comprised 28 patients, while the CLT group had 51 patients. In the PSM cohort, Kaplan-Meier analysis confirmed IFLT improved patient and graft survival for ACLF patients (log rank P=0.018 and 0.018, respectively). The IFLT group demonstrated better six-month patient survival rates (100% vs 74.5%, P=0.009) and lower post-reperfusion syndrome, shorter operative time, reduced intraoperative blood loss, less blood products use. Furthermore, ACLF patients receiving IFLT experienced fewer early allograft dysfunction, reduced intensive care unit stays, earlier extubation, faster consciousness recovery, shorter time to first flatus. Accelerated recovery of liver, circulatory, respiratory, coagulation functions were observed in the IFLT group, along with fewer acute kidney injury. Notably, ACLF patients receiving ECD livers in the IFLT group achieved better survival and clinical outcomes. Consequently, IFLT enhanced the survival rates and promoted the recovery of remote organs in ACLF patients, and improved clinical prognoses for those receiving ECD livers.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"3 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056648","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

Off-Label Use of Alemtuzumab, Belatacept, and Rapamycin in Kidney Transplantation - Long-Term Real-World Experience. 阿仑单抗、贝拉他普和雷帕霉素在肾移植中的适应症外使用-长期真实世界经验。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-11 DOI: 10.1016/j.ajt.2025.09.004

Kateryna Krynychka,Goni Katz-Greenberg,Jennifer S Byrns,Brian I Shaw,Nrupen A Bhavsar,Ursula Rogers,Annette M Jackson,Matthew J Ellis,Xunrong Luo,Allan D Kirk

{"title":"Off-Label Use of Alemtuzumab, Belatacept, and Rapamycin in Kidney Transplantation - Long-Term Real-World Experience.","authors":"Kateryna Krynychka,Goni Katz-Greenberg,Jennifer S Byrns,Brian I Shaw,Nrupen A Bhavsar,Ursula Rogers,Annette M Jackson,Matthew J Ellis,Xunrong Luo,Allan D Kirk","doi":"10.1016/j.ajt.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.09.004","url":null,"abstract":"Conventional immunosuppressive regimens in kidney transplantation continue to pose significant challenges, largely due to their reliance on calcineurin inhibitors (CNI) and corticosteroids. These challenges have driven the search for alternative regimens to minimize toxicity and preserve long-term graft function. In this study, we present real-world data utilizing a CNI-free regimen that makes use of the synergistic effects of costimulation blockade and mTOR inhibition. We retrospectively analyzed 106 kidney recipients from 2016 to 2024 who received alemtuzumab induction, followed by de novo belatacept and sirolimus maintenance therapy (ABR regimen). Patient and graft survival were 100% at one year and 96 and 97% respectively at 5 years. At 3 and 5 years, median GFR was 64mL/min/1.73m2 (IQR 54-75) and 62mL/min/1.73m2 (54-74), respectively. The rate of rejection in the first year was 6.6%. Ninety-six patients (91%) avoided treatment with CNIs during the follow-up period. Alemtuzumab and belatacept were well tolerated, but 44% of patients discontinued sirolimus, typically due to sirolimus-related side-effects remedied with conversion to mycophenolate and prednisone. These results inform and support the study of the ABR protocol, or similar costimulation blockade-based regimens, in pursuit of non-CNI-based therapies for kidney transplant recipients.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"47 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056646","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

2025 Report of the STAR Working Group on Donor Derived Cell Free DNA: Establishing Analytical Validity as the Basis for Appropriate and Effective Clinical Utilization. 2025年STAR供体来源细胞游离DNA工作组报告：建立分析有效性作为适当和有效临床应用的基础。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-10 DOI: 10.1016/j.ajt.2025.08.036

Nicole M Valenzuela,James Lan,Kelley M K Hitchman,Ursula Amstutz,Roy D Bloom,Deborah J Levine,Michael Mengel,Roslyn B Mannon

{"title":"2025 Report of the STAR Working Group on Donor Derived Cell Free DNA: Establishing Analytical Validity as the Basis for Appropriate and Effective Clinical Utilization.","authors":"Nicole M Valenzuela,James Lan,Kelley M K Hitchman,Ursula Amstutz,Roy D Bloom,Deborah J Levine,Michael Mengel,Roslyn B Mannon","doi":"10.1016/j.ajt.2025.08.036","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.08.036","url":null,"abstract":"A working group under the Sensitization in Transplant: Assessment of Risk (STAR) initiative was established in 2023 to develop guidelines for analytic and clinical validity of lab-based testing for donor-derived cell-free DNA (dd-cfDNA). Measurement of dd-cfDNA as a minimal invasive marker of allograft injury has become more widely used over the last few years. To date, various technical and quantitation methods have hindered standardized and interpretation of the results, leading to variability in understanding how to best utilize cfDNA in transplantation. Kits are being formulated for local laboratory testing, but we lack an organized framework for laboratory quality assurance. Further, threshold values and methods of measurement have changed over time, indicating that assay sensitivity and clinical relevance are still being refined. Harmonization and reproducibility will be critical as the field moves forward to local laboratory-based testing. The goal of this work group was to review and analyze technical and biological variables, and clinical settings that could contribute to disparities in results, which will ultimately influence clinical validity and utility. High-quality, standardized de-centralized dd-cfDNA testing is the essential pre-requisite for conducting real-world evidence generating multicenter studies to establish the appropriate context of use for this promising assay.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"77 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043585","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

Advancements in Imaging Modalities for Post-Kidney Transplant Monitoring: A Focus on Contrast-Enhanced Ultrasound. 肾移植后监测成像方式的进展：以对比增强超声为重点。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-10 DOI: 10.1016/j.ajt.2025.08.035

Sylvain Bodard,Theodore T Pierce,Madeleine Sertic,Marie-Camille Lafargue,Anthony E Samir,Leonardo V Riella

{"title":"Advancements in Imaging Modalities for Post-Kidney Transplant Monitoring: A Focus on Contrast-Enhanced Ultrasound.","authors":"Sylvain Bodard,Theodore T Pierce,Madeleine Sertic,Marie-Camille Lafargue,Anthony E Samir,Leonardo V Riella","doi":"10.1016/j.ajt.2025.08.035","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.08.035","url":null,"abstract":"Early and accurate detection of post-transplant complications is critical for preserving graft function and optimizing long-term outcomes. While conventional ultrasound is widely used in transplant monitoring, its limitations in assessing microvascular perfusion and early complications have prompted growing interest in Contrast-Enhanced Ultrasound (CEUS). CEUS provides real-time, non-nephrotoxic imaging of microvascular perfusion, making it well-suited for kidney transplant patients. We conducted a systematic review of 19 studies evaluating the use of CEUS in kidney transplant monitoring, focusing on its diagnostic accuracy, comparison with conventional US, and its role in detecting vascular complications, rejection, and perfusion abnormalities. CEUS demonstrated high diagnostic performance, with sensitivity up to 90% and specificity up to 95% for detecting vascular complications, such as transplant renal artery stenosis and transplant renal artery or vein thrombosis. CEUS also showed utility in the early detection of acute tubular necrosis and rejection. However, significant variability was noted in CEUS parameters across studies, largely due to differences in imaging software and methodology, highlighting the need for standardization. Despite its potential, the absence of standardized reference values for CEUS parameters remains a barrier to widespread clinical adoption. Further research is needed to establish these benchmarks and optimize CEUS integration into routine transplant surveillance.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"61 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043584","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

More than just the surgeon: the collective moral injury in the liver transplant team. 不仅仅是外科医生：肝移植团队的集体道德伤害。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-10 DOI: 10.1016/j.ajt.2025.09.001

Alexandra Shingina,Kinza Tareen,Seth Waits

引用次数: 0

Trends and recipient outcomes in multiorgan transplantation in the United States 2013-2023. 2013-2023年美国多器官移植趋势和受体结局

IF 8.2 2区医学

American Journal of Transplantation Pub Date : 2025-09-10 DOI: 10.1016/j.ajt.2025.08.037

Mason Lai, Elizabeth C Verna, Tomoaki Kato, Charles E McCulloch, Sandy Feng, Jennifer C Lai, Jin Ge, Giuseppe Cullaro

{"title":"Trends and recipient outcomes in multiorgan transplantation in the United States 2013-2023.","authors":"Mason Lai, Elizabeth C Verna, Tomoaki Kato, Charles E McCulloch, Sandy Feng, Jennifer C Lai, Jin Ge, Giuseppe Cullaro","doi":"10.1016/j.ajt.2025.08.037","DOIUrl":"10.1016/j.ajt.2025.08.037","url":null,"abstract":"<p><p>Multiorgan transplantation (MOT) in the United States is increasing, but data on the epidemiology and posttransplant outcomes are lacking. Using the Scientific Registry of Transplant Recipients database, we examined annual transplant volume, mortality, and graft failure in adult recipients who received a liver, heart, lung, and/or kidney transplant between 2013 and 2023. A total of 380 938 transplant recipients were included in the present study. MOT volume for the liver, heart, lung, and kidney increased between 2013 and 2023. Relative to liver transplantation alone, liver-kidney (adjusted hazard ratio [aHR], 1.22; 95% confidence interval [CI], 1.16-1.29), liver-heart (aHR, 1.82; 95% CI, 1.38-2.40), and liver-lung transplantation (aHR, 2.63; 95% CI, 2.01-3.44) were associated with increased mortality. Relative to heart transplantation alone, heart-liver (aHR, 1.49; 95% CI, 1.17-1.90) and heart-lung (aHR, 2.52; 95% CI, 2.15-2.96) were associated with increased mortality. Relative to lung transplantation alone, lung-heart transplantation (aHR, 1.25; 95% CI, 1.05-1.49) was associated with increased mortality. Compared with kidney transplantation alone, the combinations of kidney-liver (aHR, 1.94; 95% CI, 1.77-2.12), kidney-heart (aHR, 2.35; 95% CI, 1.96-2.83), and kidney-lung (aHR, 6.03; 95% CI, 3.39-10.70) transplantation were associated with increased mortality. Many combinations of MOT are associated with increased mortality and graft failure rates. As MOT increases, a sensible allocation policy is needed for patients with multiorgan failure to ensure equitable distribution of these scarce resources.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051465","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