American Journal of Transplantation最新文献

{"title":"Undiagnosed lymphoma detected during routine histocompatibility crossmatch: 3 case reports.","authors":"Taba Kheradmand, Sam Ho","doi":"10.1016/j.ajt.2025.02.018","DOIUrl":"10.1016/j.ajt.2025.02.018","url":null,"abstract":"<p><p>Unexpected transmission of donor-derived diseases, including infections and malignancies, through organ transplantation are occasionally observed and reported. Subclinical, or otherwise undiagnosed, hematological malignancies in potential donors are rare events and typically not identifiable via standard donor evaluation or laboratory testing. Flow cytometric crossmatching is a specialized assay routinely performed in clinical histocompatibility laboratories for the evaluation of immunological compatibility between recipients and organ donors through the detection of donor-specific antibodies. Here, we report 3 unusual cases of undiagnosed hematological malignancies in the organ donors that were identified during routine pretransplant flow cytometric crossmatching evaluation through abnormalities observed in the lymphocyte staining profile, size, and relative cell events that effectively prevented potential transmission of such donor-derived malignancies to the immunocompromised recipients.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612867","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":"Posttransplant lymphoproliferative disorder - it's best to face this growing challenge at the start.","authors":"Christopher D Blosser, Lianna J Marks, Vikas R Dharnidharka","doi":"10.1016/j.ajt.2025.03.006","DOIUrl":"10.1016/j.ajt.2025.03.006","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595851","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":"Recipient toll-like receptor 4 determines the outcome of ischemia-reperfusion injury in steatotic liver transplantation in mice.","authors":"Kosuke Tanaka, Yoichiro Uchida, Kentaro Kadono, Shoichi Kageyama, Hiroshi Kawamoto, Masaaki Ito, Yuki Kidoguchi, Kenichi Saga, Hidenobu Kojima, Hirofumi Hirao, Kojiro Nakamura, Kojiro Taura, Hiroaki Terajima, Takeshi Watanabe, Etsuro Hatano","doi":"10.1016/j.ajt.2025.03.005","DOIUrl":"10.1016/j.ajt.2025.03.005","url":null,"abstract":"<p><p>Toll-like receptor 4 (TLR4) plays a crucial role in ischemia-reperfusion injury (IRI) after liver transplantation (LT). However, the role of TLR4 in the context of steatotic grafts remains unclear. In this study, we developed a mouse model to explore IRI mechanisms in steatotic LT using TLR4 knockout mice as recipients. We successfully transplanted steatotic grafts with approximately 35% macrosteatosis and 5 hours of cold storage. Compared to normal LT, steatotic LT resulted in significantly higher serum level of alanine aminotransferase and high mobility group box 1 (HMGB1), higher transcriptional expression of inflammatory markers (C-X-C motif chemokine ligand 2, caspase-1, and caspase-11), and increased infiltration of CD11b-positive cells, correlating with lower survival. Serum HMGB1 and cleaved caspase-3 activation peaked earlier than serum alanine aminotransferase, with cold-stored steatotic grafts releasing more HMGB1. Notably, TLR4 knockout recipients demonstrated improved survival, attenuated inflammatory response, and reduced apoptosis. These findings suggest that TLR4 deficiency in recipients ameliorates IRI in steatotic LT, highlighting the importance of recipient immune modulation in mitigating steatotic graft injury.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595856","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":"Real-world evidence regarding cancer, mortality, and graft failure risk with de novo belatacept use among kidney transplant recipients in the United States.","authors":"Shyfuddin Ahmed, Ruth M Pfeiffer, Karena Volesky-Avellaneda, Christopher D Blosser, Jon J Snyder, Ajay K Israni, Charles F Lynch, Baozhen Qiao, Judy R Rees, Fiona Zwald, Kelly J Yu, Eric A Engels","doi":"10.1016/j.ajt.2025.03.004","DOIUrl":"10.1016/j.ajt.2025.03.004","url":null,"abstract":"<p><p>Belatacept is a selective T cell costimulation blocker used in maintenance immunosuppression for kidney transplant recipients (KTRs), but evidence on cancer risk and other outcomes is limited. This retrospective cohort study used linked US transplant and cancer registry data on KTRs treated with belatacept (N = 1514) or tacrolimus (N = 7570) as initial maintenance therapy. We used multivariable Cox regression models to compare the incidence of invasive cancer, cutaneous squamous cell carcinoma, posttransplant lymphoproliferative disorder (PTLD), death, and graft failure/retransplantation (GF/RT) between belatacept and tacrolimus users. Overall, cancer incidence was 10.1 and 12.6 per 1000 person-years in belatacept and tacrolimus users, respectively. We did not find increased risk with belatacept for cancer overall (adjusted hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.53-1.30), individual cancer types, or cutaneous squamous cell carcinoma. Belatacept was associated with increased risk of death (adjusted HR, 1.22; 95% CI, 1.04-1.43) but lower risk of GF/RT >4 years after transplantation (adjusted HR, 0.54; 95% CI, 0.35-0.83). PTLD risk was increased among Epstein-Barr virus-seropositive KTRs (adjusted HR, 1.96; 95% CI, 1.03-3.73). This study provides reassurance that belatacept does not increase cancer risk among KTRs, and there was a long-term protective association for GF/RT. However, we found evidence suggesting a potentially increased risk of PTLD and death with belatacept use.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595854","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":"Approach to kidney transplant candidates with hereditary transthyretin (TTR) amyloidosis and TTR variants: case reports and mini-review.","authors":"Yasar Caliskan, Deana Mikhalkova, Baris Afsar, Rengin Elsurer Afsar, Fadee Abu Al Rub, Krista L Lentine","doi":"10.1016/j.ajt.2025.03.002","DOIUrl":"10.1016/j.ajt.2025.03.002","url":null,"abstract":"<p><p>Evaluating kidney transplant candidates with transthyretin (TTR) variants requires a multidisciplinary approach, considering clinical, genetic, and psychosocial factors. Hereditary transthyretin amyloidosis, an autosomal dominant disorder, can affect cardiovascular and renal allograft health, complicating transplant candidacy. We present 2 cases of Black women with end-stage kidney disease of unknown etiology, identified with the pathogenic Val142Ile TTR variant during transplant evaluation. Cardiac assessments, including technetium-99m pyrophosphate scintigraphy and biopsy, ruled out cardiac amyloidosis, enabling transplant eligibility. This highlights the growing role of genetic testing in kidney transplant clinics and the need for collaboration among nephrologists, cardiologists, and genetic counselors for optimal patient management.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583997","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":"Acquired immune tolerance 2.0.","authors":"Qizhi Tang","doi":"10.1016/j.ajt.2025.02.020","DOIUrl":"10.1016/j.ajt.2025.02.020","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583996","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 HDV/HBV Coinfection In Italy: An Intention-To-Treat Analysis Of Long-Term Outcomes.","authors":"Roberta Angelico, Silvia Trapani, Tommaso Maria Manzia, Ilaria Lenci, Paolo Grossi, Andrea Ricci, Patrizia Burra, Enzo Andorno, Salvatore Agnes, Sherrie Bhoori, Umberto Baccarani, Luca S Belli, Paola Carrai, Lucio Caccamo, Amedeo Carraro, Matteo Cescon, Michele Colledan, Umberto Cillo, Luciano De Carlis, Nicola De Maria, Paolo De Simone, Fabrizio di Benedetto, Maria Francesca Donato, Giuseppe Maria Ettorre, Flaminia Ferri, Alfonso Galeota Lanza, Davide Ghinolfi, Antonio Grieco, Salvatore Gruttadauria, Simona Marenco, Silvia Martini, Vincenzo Mazzaferro, Adriano Pellicelli, Domenico Pinelli, Maria Rendina, Mario Rizzetto, Renato Romagnoli, Massimo Rossi, Francesco Paolo Russo, Laura Schiadà, Francesco Tandoi, Pierluigi Toniutto, Laura Turco, Giovanni Vennarecci, Mauro Viganò, Marco Vivarelli, Giuseppe Tisone, Giuseppe Feltrin, Alessandra Nardi, Mario Angelico","doi":"10.1016/j.ajt.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.03.003","url":null,"abstract":"<p><p>Patients with HDV/HBV-related end-stage liver disease candidates for liver transplantation(LT) have traditionally been regarded as a special population, although their outcomes are controversial. A intention-to-treat(ITT) analysis of long-term outcomes of HDV/HBV-coinfected patients waitlisted for LT in Italy, between 2011-2020, was performed and compared to HBV-monoinfected LT candidates. Out of 1,731 HBV-infected LT candidates, 1,237(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 less hepatocellular carcinoma (HCC:26% vs 65.8%,P<0.0001) compared to 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%;P<0.0001). ITT-multivariable analysis identified the presence of HCC, advanced recipient age, and high-MELD-Na scores as mortality risk factors. Five-years after LT, 99.1% of HDV/HBV-coinfected patients received oral nucleos(t)ide analogues, with immunoglobulins against HBsAg(HBIg) 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 favourable outcomes compared to 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 don't represent a risky population and may be considered for simpler long-term antiviral prophylactic strategies.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-06","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":"Development of a natural language processing algorithm to extract social determinants of health from clinician notes.","authors":"Hamed Zaribafzadeh, Jacqueline B Henson, Norine W Chan, Ursula Rogers, Wendy Webster, Tyler Schappe, Fan Li, Roland A Matsouaka, Allan D Kirk, Ricardo Henao, Lisa M McElroy","doi":"10.1016/j.ajt.2025.02.019","DOIUrl":"10.1016/j.ajt.2025.02.019","url":null,"abstract":"<p><p>Disparities in access to the organ transplant waitlist are well-documented, but research into modifiable factors has been limited due to a lack of access to organized prewaitlisting data. This study aimed to develop a natural language processing (NLP) algorithm to extract social determinants of health (SDOH) from free-text notes and quantify the association of SDOH with access to the transplant waitlist. We collected 261 802 clinician notes from 11 111 adults referred for kidney or liver transplants between 2016 and 2022 at the Duke University Health System. An SDOH ontology and a rule-based NLP algorithm were created to extract and organize terms. Education, transportation, and age were the most frequent terms identified. Negative sentiment and refer were the most negatively associated features with listing in both kidney and liver transplant patients. Income and employment for the kidney, and judgment and positive sentiment for liver were the most positively associated features with the listing. This study suggests that the integration of NLP tools into the transplant clinical workflow could help improve collection and organization of SDOH and inform center-level efforts at resource allocation, potentially improving access to the transplant waitlist and posttransplant outcomes.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583998","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":"ABO-A antibody induction in mice is T cell-dependent, estrogen-independent, and modulated by CD22.","authors":"Ibrahim Adam, Bruce Motyka, Jean Pearcey, Kesheng Tao, Peter J Cowan, Lori J West","doi":"10.1016/j.ajt.2025.03.001","DOIUrl":"10.1016/j.ajt.2025.03.001","url":null,"abstract":"<p><p>ABO antibodies pose barriers in transplantation but remain poorly studied. We investigated anti-A natural antibodies (nAbs) and induced antibodies (iAbs) in wild-type (WT), CD19KO, and CD22KO mice in the context of major histocompatibility complex-syngeneic or major histocompatibility complex-allogeneic stimulation by ABO-A blood cell membranes (BCM) from A-transgenic mice, or xenogeneic human (Hu-A) BCM. CD19KO mice failed to produce anti-A nAbs and iAbs. Syngeneic A-transgenic-BCM failed to stimulate anti-A iAbs in WT mice, in contrast to allogeneic A-transgenic-BCM and xenogeneic Hu-A-BCM. Hu-A-BCM failed to stimulate anti-A iAbs in CD4-T cell-depleted or CD4KO mice, reversed with CD4-T cell reconstitution. Although anti-A nAbs were absent in estrogen-receptor-α-deficient mice, anti-A iAbs were easily stimulated. Anti-A nAbs were higher in CD22KO than in WT mice, with pubertal females producing higher levels than males. Anti-A iAbs were stimulated in CD22KO mice by syngeneic A-transgenic-BCM or by Hu-A-BCM after CD4T cell depletion. We conclude that anti-A nAbs and iAbs are produced by B1a-cells. In WT mice, stimulation of anti-A iAbs requires exposure to nonself A-antigen together with foreign proteins and is T cell dependent. Without CD22-mediated inhibition, anti-A iAb stimulation does not require foreign protein and is T cell-independent. Anti-A iAbs are estrogen-independent, whereas anti-A nAbs are estrogen-dependent and could be elicited by estrogen in males.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583995","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":"Stepping stones: Hepatitis C virus infection and pediatric kidney transplantation.","authors":"Sharon Bartosh, Chris Callaghan","doi":"10.1016/j.ajt.2025.02.017","DOIUrl":"10.1016/j.ajt.2025.02.017","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539658","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}