American Journal of Transplantation最新文献_第7页

Kidney Storage at Sub-Zero Temperature is Safe for Porcine Kidney Auto-Transplantation: A World First In-Vivo Study. 零下温度下的肾脏储存对猪肾脏自体移植是安全的：世界上第一个体内研究。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-09 DOI: 10.1016/j.ajt.2025.08.033

Francisco Calderon Novoa,Tun-Pang Chu,Kaitlin Lees,Sujani Ganesh,Laura Martinez-Arenas,Nicola Sariye Pollman,Catherine Parmentier,Masataka Kawamura,Christian Hobeika,Samrat Ray,Emmanuel Nogueira,Rohan John,Aakriti Gupta,Photis Loizides,Tom Allen,Trevor Reichman,Lisa Robinson,Markus Selzner

{"title":"Kidney Storage at Sub-Zero Temperature is Safe for Porcine Kidney Auto-Transplantation: A World First In-Vivo Study.","authors":"Francisco Calderon Novoa,Tun-Pang Chu,Kaitlin Lees,Sujani Ganesh,Laura Martinez-Arenas,Nicola Sariye Pollman,Catherine Parmentier,Masataka Kawamura,Christian Hobeika,Samrat Ray,Emmanuel Nogueira,Rohan John,Aakriti Gupta,Photis Loizides,Tom Allen,Trevor Reichman,Lisa Robinson,Markus Selzner","doi":"10.1016/j.ajt.2025.08.033","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.08.033","url":null,"abstract":"Organ shortage continues to limit kidney transplantation worldwide. Sub-zero storage may harbor the potential for extending cold ischemic times, improving organ sharing, and optimizing graft allocation. However, sub-zero storage remains challenging, limited by possible freeze-thaw damage. We conducted a porcine auto-transplant model to assess kidney function and injury after brief (5 h) or prolonged (24-48 h) sub-zero storage of grafts, comparing it to classic static cold storage. There was no mortality in the cohort, and subjects were followed for 7 days. Creatinine, BUN and potassium peak levels and curves were comparable between groups in both brief and prolonged experiments (P > .05). Histological analysis revealed no evidence suggesting ice crystals had formed, as well as similar injury profiles, suggesting that the sub-zero preservation process was successful. Creatinine clearance, fractional excretion of sodium, NGAL urinary and serum levels tended to favor sub-zero preservation in the 24 h SCS experiments, without statistical significance. While further research is needed to optimize storage protocols and explore the impact of colder temperatures, this study provides promising evidence regarding safety and feasibility of sub-zero storage as a method for extending preservation times. Future studies will focus on enhancing preservation solutions for improved outcomes.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"35 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035744","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

Kidney Transplantation in Patients with Severe Aplastic Anemia: A Case Series of Four Patients Bridging to Tolerance or Hematologic Recovery. 严重再生障碍性贫血患者的肾移植：4例患者耐受或血液恢复的病例系列。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-09 DOI: 10.1016/j.ajt.2025.09.002

Seunghyeok Choi,Hanbi Lee,Hye-Eun Yoon,Silvia Park,Byung Ha Chung

{"title":"Kidney Transplantation in Patients with Severe Aplastic Anemia: A Case Series of Four Patients Bridging to Tolerance or Hematologic Recovery.","authors":"Seunghyeok Choi,Hanbi Lee,Hye-Eun Yoon,Silvia Park,Byung Ha Chung","doi":"10.1016/j.ajt.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.09.002","url":null,"abstract":"Severe aplastic anemia (SAA) is a bone marrow failure syndrome characterized by pancytopenia and hypocellular marrow. When accompanied by end-stage kidney disease (ESKD), it presents a significant therapeutic challenge. While allogeneic hematopoietic stem cell transplantation (HSCT) is the definitive treatment for SAA and kidney transplantation (KT) is the optimal therapy for ESKD, the ideal sequencing and strategy for performing both procedures remain unclear. We report successful outcomes in four patients with concurrent SAA and ESKD managed using a KT-first approach. All patients demonstrated immediate graft function without surgical complications, and no episodes of acute rejection were observed within the first year post-transplant. Two patients subsequently underwent HSCT from the same donor used for KT, approximately three months after KT. Both achieved hematologic remission and were eventually able to discontinue all immunosuppressive medications. Remarkably, the other two patients experienced spontaneous hematologic improvement and no longer required HSCT. These findings suggest that the KT-first approach is both feasible and safe, serving not only as a bridge to curative HSCT but also, in select cases, as a potential standalone therapy for SAA. This case series provides preliminary evidence supporting the role of the KT-first strategy in patients with coexisting SAA and ESKD.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"51 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035740","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

Applying Patient Reported Outcome Measurements to Improve Transplant Therapeutics. 应用患者报告的结果测量来改善移植治疗。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-09 DOI: 10.1016/j.ajt.2025.08.034

Roslyn B Mannon

引用次数: 0

Reply to: Liver Transplantation in Patients with Active Invasive Candida Infection: One Size Does Not Fit All. 回复：活动性侵袭性念珠菌感染患者的肝移植：一种方法不适合所有患者。

IF 8.2 2区医学

American Journal of Transplantation Pub Date : 2025-09-09 DOI: 10.1016/j.ajt.2025.08.032

Julian Allgeier, Christian M Lange

引用次数: 0

PD-L1 on ex-vivo Expanded Toll-like-receptor-Bregs Prevents Allograft Rejection by Breg Viability Promotion, CD4+T Effector Cell Suppression, and Tregs Induction. 体外扩增toll样受体- bregs上的PD-L1通过促进Breg活力、抑制CD4+T效应细胞和诱导Tregs来预防同种异体移植排斥。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-07 DOI: 10.1016/j.ajt.2025.08.031

Minxue Liao,Jing Liu,Kang Mi Lee,Katsuhiro Tomofuji,Naoki Tanimine,Caroline Markmann,Kevin Deng,Rudy Matheson,Matthew Yu,Olivia Bourgeois,Liang Wei,Anil Kharga,Heidi Yeh,Christian Leguern,Shaoping Deng,Ji Lei,Thiago J Borges,Leonardo V Riella,Gaoping Zhao,James F Markmann

{"title":"PD-L1 on ex-vivo Expanded Toll-like-receptor-Bregs Prevents Allograft Rejection by Breg Viability Promotion, CD4+T Effector Cell Suppression, and Tregs Induction.","authors":"Minxue Liao,Jing Liu,Kang Mi Lee,Katsuhiro Tomofuji,Naoki Tanimine,Caroline Markmann,Kevin Deng,Rudy Matheson,Matthew Yu,Olivia Bourgeois,Liang Wei,Anil Kharga,Heidi Yeh,Christian Leguern,Shaoping Deng,Ji Lei,Thiago J Borges,Leonardo V Riella,Gaoping Zhao,James F Markmann","doi":"10.1016/j.ajt.2025.08.031","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.08.031","url":null,"abstract":"Achieving immune tolerance is a key goal in organ transplantation, as it eliminates the need for long-term immunosuppression. Regulatory B cells (Bregs) present a promising strategy for inducing tolerance. Our previous findings demonstrate that the adoptive transfer of ex vivo-expanded murine splenic B regulatory cells, referred to as TLR-Bregs (TLR9/TLR4 stimulation), induces tolerance to allografts. Here, we identify that circulating T cells increase PD-1 expression following TLR-Bregs cellular therapy. To investigate whether PD-L1-PD-1 signaling is involved in tolerance induction by TLR-Bregs, we generate TLR-Bregs from wild-type (WT) or PD-L1-deficient (-/-, KO) B6 splenocytes and assess their regulatory functions. Our findings reveal that TLR-Bregs express high levels of PD-L1 and extend graft survival via a PD-L1-dependent mechanism. Mechanistically, PD-L1 enhances the activation and survival of TLR-Bregs; PD-L1 is required for TLR-Bregs to induce PD-1 expression and an optimal inhibition of effector CD4+T cells while promoting the formation of functional Foxp3hiCCR7hiCTLA4hiTregs. This study highlights the foundational role of PD-L1 in inducing tolerance by ex-vivo-expanded TLR-Bregs.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"32 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025555","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

Evolving Landscape of Thrombotic Microangiopathy in Kidney Transplant Recipients in the post C5 inhibitor Era. 后C5抑制剂时代肾移植受者血栓性微血管病变的演变景观

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-09-05 DOI: 10.1016/j.ajt.2025.08.019

Léo Drapeau,Jean Paraire,Mehdi Maanaoui,Viviane Gnemmi,François Provôt,Rémi Lenain,Christophe Masset,Christine Kandel-Aznar,Clarisse Kerleau,Karine Autain-Renaudin,Fadi Fakhouri,Marie Frimat,Simon Ville

{"title":"Evolving Landscape of Thrombotic Microangiopathy in Kidney Transplant Recipients in the post C5 inhibitor Era.","authors":"Léo Drapeau,Jean Paraire,Mehdi Maanaoui,Viviane Gnemmi,François Provôt,Rémi Lenain,Christophe Masset,Christine Kandel-Aznar,Clarisse Kerleau,Karine Autain-Renaudin,Fadi Fakhouri,Marie Frimat,Simon Ville","doi":"10.1016/j.ajt.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.08.019","url":null,"abstract":"A comprehensive analysis was performed on all consecutive biopsy-proven Thrombotic Microangiopathy (TMA) complicating kidney transplantation in the post C5 inhibitor era (from 2009) to identify pathological profiles, determine causes and establish risk factor associated with death-censored graft survival, in two French center. Pathological criteria were assessed according to the TMA Banff Working Group, followed by an unbiased analysis to identify distinct subgroups. 119 cases were identified, 8(6.7%) primary TMA, and 23(19.3%) antibody-mediated rejection. In 98 cases (82.4%), more than one potential trigger was involved. Latent class analysis identified two groups: acute TMA pattern (n= 79(66.4%)) enriched for fibrin thrombi in glomerular capillaries and arterioles and mesangiolysis, and chronic active TMA pattern (n= 40 (33.6%)) enriched for collapsed capillaries. Both had similar presentation, were not indicative of specific causes but had different outcome. In multivariate analysis, grade 3 hypertension, low hemoglobin levels, proteinuria, baseline serum creatinine and the value of a Banff-based chronicity index (ct + ci + 2xcg +cv) were associated with poorer death-censored graft survival, while fibrin thrombi in glomerular capillaries were associated with a better outcome. KT-TMA is a severe condition in which the pathological pattern may reflect the disease stage, rather than the often intricate underlying mechanism.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"18 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008714","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

Frailty in lung transplant recipients is associated with anemia and telomere dysfunction but independent of epigenetic age 肺移植受者的虚弱与贫血和端粒功能障碍有关，但与表观遗传年龄无关。

IF 8.2 2区医学

American Journal of Transplantation Pub Date : 2025-09-01 DOI: 10.1016/j.ajt.2025.05.002

Bhavya Kapse , Rashmi Prava Mohanty , Michael Wax , Ying Gao , Lily Tran , Paul J. Wolters , Matteo Pellegrini , Jonathan P. Singer , John R. Greenland

{"title":"Frailty in lung transplant recipients is associated with anemia and telomere dysfunction but independent of epigenetic age","authors":"Bhavya Kapse , Rashmi Prava Mohanty , Michael Wax , Ying Gao , Lily Tran , Paul J. Wolters , Matteo Pellegrini , Jonathan P. Singer , John R. Greenland","doi":"10.1016/j.ajt.2025.05.002","DOIUrl":"10.1016/j.ajt.2025.05.002","url":null,"abstract":"<div><div>Frailty is a syndrome of vulnerability to stressors linked to worse outcomes before and after lung transplantation. However, the biological basis of this association is unknown. Biological correlates of aging include epigenetic reprograming, chronic inflammation, telomere dysfunction, and anemia. We hypothesized that these aging-associated biological processes would be associated with frailty in lung transplant recipients. In a nested case-control study, we compared 43 lung transplant recipients who were frail pretransplant and posttransplant with 43 nonfrail matched controls. We quantified peripheral blood leukocyte epigenetic aging (Horvath) and longevity (GrimAge) clocks, telomere length, cytokine profiles, and hemoglobin before transplant. Epigenetic clocks were correlated with age but not frailty. However, we observed hypermethylation of multiple gene pathways, including hedgehog signaling and angiogenesis, and associated decreased levels of plasma cytokines in frail recipients. Frailty was also associated with telomere dysfunction and anemia. Overall, telomere dysfunction and anemia of chronic disease were most linked to frailty in this cohort, whereas epigenetic aging and chronic inflammation were not. Understanding the heterogeneity of aging syndromes may help target interventions in frail lung transplant recipients.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 9","pages":"Pages 1916-1925"},"PeriodicalIF":8.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921086","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 impact of the Banff v-lesion on rejection classification and outcomes: Insights from a multicenter study Banff v型病变对排斥分类和结局的影响：来自多中心研究的见解。

IF 8.2 2区医学

American Journal of Transplantation Pub Date : 2025-09-01 DOI: 10.1016/j.ajt.2025.04.023

Karolien Wellekens , Maarten Coemans , Priyanka Koshy , Thibaut Vaulet , Evert Cleenders , Tim Debyser , Steffi De Pelsmaeker , Valérie Dubois , Marie-Paule Emonds , Dirk Kuypers , Angelica Pagliazzi , Maud Rabeyrin , Aleksandar Senev , Irina Scheffner , Thomas Vanhoutte , Olivier Thaunat , Candice Roufosse , Wilfried Gwinner , Maarten Naesens

{"title":"The impact of the Banff v-lesion on rejection classification and outcomes: Insights from a multicenter study","authors":"Karolien Wellekens , Maarten Coemans , Priyanka Koshy , Thibaut Vaulet , Evert Cleenders , Tim Debyser , Steffi De Pelsmaeker , Valérie Dubois , Marie-Paule Emonds , Dirk Kuypers , Angelica Pagliazzi , Maud Rabeyrin , Aleksandar Senev , Irina Scheffner , Thomas Vanhoutte , Olivier Thaunat , Candice Roufosse , Wilfried Gwinner , Maarten Naesens","doi":"10.1016/j.ajt.2025.04.023","DOIUrl":"10.1016/j.ajt.2025.04.023","url":null,"abstract":"<div><div>According to the Banff classification, intimal arteritis<span><span> (v-lesion) contributes to diagnosing T cell–mediated rejection (TCMR) and antibody-mediated rejection (AMR) and signifies more severe TCMR. This multicenter cohort study (N = 5323 </span>kidney transplants<span><span>, N = 16 774 posttransplant biopsies) evaluated the impact of v-lesions (N = 707 v-positive biopsies in N = 534 transplants) on biopsy classification and outcomes. The first v-positive biopsy of each transplant was categorized by additional Banff TCMR/(p)AMR-MVI criteria: 166 (31.1%) isolated v, 87 (16.3%) borderline changes with v, 66 (12.4%) TCMR grade I (TCMR-I) with v, 148 (27.7%) (p)AMR-MVI ((probable) AMR/DSAnegC4dneg MVI) with v, and 67 (12.5%) TCMR-I + (p)AMR-MVI with v. Cases with additional TCMR/(p)AMR-MVI criteria were more often indication biopsies, had lower eGFR, and were more frequently HLA-DSA positive than isolated v. While borderline changes with v had borderline higher 10-year </span>graft failure rates than isolated v, TCMR-I, (p)AMR-MVI, and TCMR-I + (p)AMR-MVI with v were associated with significantly worse outcomes, although variably treated. Matching N = 534 v-positive cases to v-negative controls showed no significant impact of v-lesions on outcomes. These findings question the role of isolated v-lesions in rejection diagnosis and emphasize the greater prognostic value of additional TCMR and (p)AMR-MVI criteria. Reconsideration of v-lesions in the Banff classification may be appropriate.</span></span></div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 9","pages":"Pages 1940-1953"},"PeriodicalIF":8.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921084","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

Comparable short-term survival in dual organ heart transplant recipients with and without HIV: A call for increased access to organ donation for people living with HIV HIV阳性和HIV阴性双器官心脏移植受者的短期生存率比较：呼吁增加HIV感染者获得器官捐赠的机会。

IF 8.2 2区医学

American Journal of Transplantation Pub Date : 2025-09-01 DOI: 10.1016/j.ajt.2025.05.004

Elena M. Donald, Jaya Batra, Ersilia M. DeFilippis, Jayant K. Raikhelkar, Dor Lotan, Kevin J. Clerkin, Gabriel Sayer, Nir Uriel

{"title":"Comparable short-term survival in dual organ heart transplant recipients with and without HIV: A call for increased access to organ donation for people living with HIV","authors":"Elena M. Donald, Jaya Batra, Ersilia M. DeFilippis, Jayant K. Raikhelkar, Dor Lotan, Kevin J. Clerkin, Gabriel Sayer, Nir Uriel","doi":"10.1016/j.ajt.2025.05.004","DOIUrl":"10.1016/j.ajt.2025.05.004","url":null,"abstract":"<div><div><span>Access to organ transplantation<span><span> for individuals with HIV is expanding, yet the outcomes of patients with HIV requiring multiorgan transplants are not well-defined. Adult individuals with HIV in the United Network for Organ Sharing registry and who received heart transplantation between 2010 and 2023 were included. The primary outcome was patient survival. During the study period, 175 patients with HIV were transplanted. Twenty-six (14.8%) underwent dual organ transplantation (20 heart/kidney, 4 heart/lung, and 2 heart/liver) at 23 centers. Median age at the time of heart transplantation was 56 years (interquartile range 47-60); the majority were male (n = 18, 69%), and 46% identified as Black (n = 12). </span>Dilated cardiomyopathy<span> was the most common etiology of heart failure (n = 13, 50%). All patients received organs from donors without HIV. The probability of surviving at least 1 year was 87.6% (95% CI, 81.0%-92.0%) for single-organ recipients and 82.9% for dual organ recipients (95% CI, 60.0%-93.4%). There was no difference in overall survival between matched controls with HIV and matched controls without HIV among dual organ recipients (log-rank </span></span></span><em>P</em> value = .8). Over the last decade, only a small number of individuals with HIV with end-stage heart failure have undergone dual organ transplantation with encouraging short-term outcomes.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 9","pages":"Pages 1996-2007"},"PeriodicalIF":8.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932493","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

Complex donor anatomy does not influence early donor or recipient outcomes after robotic donor hepatectomy at a high-volume center 在高容量中心，复杂的供体解剖结构不影响机器人供肝切除术后早期供体或受体的结果。

IF 8.2 2区医学

American Journal of Transplantation Pub Date : 2025-09-01 DOI: 10.1016/j.ajt.2025.04.017

Kamal S. Yadav, Nikhitha Shetty, Fysal Valappil, Akash Selvathangam, Suchet Chaudhary, Ankur Gupta, Prashant Bhangui, Arvinder S. Soin

{"title":"Complex donor anatomy does not influence early donor or recipient outcomes after robotic donor hepatectomy at a high-volume center","authors":"Kamal S. Yadav, Nikhitha Shetty, Fysal Valappil, Akash Selvathangam, Suchet Chaudhary, Ankur Gupta, Prashant Bhangui, Arvinder S. Soin","doi":"10.1016/j.ajt.2025.04.017","DOIUrl":"10.1016/j.ajt.2025.04.017","url":null,"abstract":"<div><div><span><span><span>With evolving expertise, criteria to select donors for living robotic donor hepatectomy (RDH) have expanded. We studied the comparative donor and recipient outcomes in RDHs with standard grafts and complex grafts. We performed 360 right lobe RDH (RRDH) of 4296 living donor </span>liver transplantations, with 280 having >6 months follow-up. The first 53 cases were excluded as we used a different (cut-suture) technique for </span>hepatic duct<span> division. The subsequent 227 RRDHs were then divided into donors with standard (group S, n = 76) and complex grafts (group C, n = 151). Three donors in each group were converted to open midline incision. In groups S and C, 1 (1.3%) and 3 (1.9%) donors developed biliary complications (</span></span><em>P</em><span> = .741). Both recipient groups had similar early and late postoperative complications. Group C recipients had a nonsignificant higher incidence of late biliary complications (3 [3.9%] vs 17 [11.2%]; odds ratio, 3.09; 95% confidence interval, 0.88-10.88; </span><em>P</em> = .067). Early (<30 days) recipient mortality was similar with 4 (6.6%) in group S and 11 (7.3%) in group C (<em>P</em> = .755), all sepsis-related. The outcomes were similar among donors and recipients with both standard and complex grafts. With experience, RDH can be safely offered to “all-comer” donors and has the potential to become standard of care.</div></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 9","pages":"Pages 1987-1995"},"PeriodicalIF":8.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897320","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