American Journal of Transplantation最新文献

{"title":"T regulatory cell therapy: The price of specificity","authors":"Moritz Muckenhuber, Thomas Wekerle","doi":"10.1016/j.ajt.2023.08.005","DOIUrl":"10.1016/j.ajt.2023.08.005","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 1824-1825"},"PeriodicalIF":8.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523006287/pdfft?md5=01392ecf1e544ad585807ee50ec56ab1&pid=1-s2.0-S1600613523006287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476448","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}

{"title":"Characteristics and Outcomes Among Adults Aged ≥60 Years Hospitalized with Laboratory-Confirmed Respiratory Syncytial Virus — RSV-NET, 12 States, July 2022–June 2023","authors":"Fiona P. Havers ,&nbsp;Michael Whitaker ,&nbsp;Michael Melgar ,&nbsp;Bhoomija Chatwani ,&nbsp;Shua J. Chai ,&nbsp;Nisha B. Alden ,&nbsp;James Meek ,&nbsp;Kyle P. Openo ,&nbsp;Patricia A. Ryan ,&nbsp;Sue Kim ,&nbsp;Ruth Lynfield ,&nbsp;Yomei P. Shaw ,&nbsp;Grant Barney ,&nbsp;Brenda L. Tesini ,&nbsp;Melissa Sutton ,&nbsp;H. Keipp Talbot ,&nbsp;Kristen P. Olsen ,&nbsp;Monica E. Patton","doi":"10.1016/j.ajt.2023.10.010","DOIUrl":"10.1016/j.ajt.2023.10.010","url":null,"abstract":"<div><p>Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. In May 2023, two RSV vaccines were approved for prevention of RSV lower respiratory tract disease in adults aged ≥60 years. In June 2023, CDC recommended RSV vaccination for adults aged ≥60 years, using shared clinical decision-making. Using data from the Respiratory Syncytial Virus–Associated Hospitalization Surveillance Network, a population-based hospitalization surveillance system operating in 12 states, this analysis examined characteristics (including age, underlying medical conditions, and clinical outcomes) of 3,218 adults aged ≥60 years who were hospitalized with laboratory-confirmed RSV infection during July 2022–June 2023. Among a random sample of 1,634 older adult patients with RSV-associated hospitalization, 54.1% were aged ≥75 years, and the most common underlying medical conditions were obesity, chronic obstructive pulmonary disease, congestive heart failure, and diabetes. Severe outcomes occurred in 18.5% (95% CI = 15.9%–21.2%) of hospitalized patients aged ≥60 years. Overall, 17.0% (95% CI = 14.5%–19.7%) of patients with RSV infection were admitted to an intensive care unit, 4.8% (95% CI = 3.5%–6.3%) required mechanical ventilation, and 4.7% (95% CI = 3.6%–6.1%) died; 17.2% (95% CI = 14.9%–19.8%) of all cases occurred in long-term care facility residents. These data highlight the importance of prioritizing those at highest risk for severe RSV disease and suggest that clinicians and patients consider age (particularly age ≥75 years), long-term care facility residence, and underlying medical conditions, including chronic obstructive pulmonary disease and congestive heart failure, in shared clinical decision-making when offering RSV vaccine to adults aged ≥60 years.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 2000-2007"},"PeriodicalIF":8.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523008006/pdfft?md5=3472452094960511e550d6daafb72e06&pid=1-s2.0-S1600613523008006-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49671853","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}

{"title":"Novel 4-way simultaneous liver paired exchange: Is it generalizable?","authors":"Dhiraj Agrawal,&nbsp;Kishore Kumar Ariga,&nbsp;Sanjiv Saigal","doi":"10.1016/j.ajt.2023.08.008","DOIUrl":"10.1016/j.ajt.2023.08.008","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 2013-2014"},"PeriodicalIF":8.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10182269","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":"Theseus and the search for an antibody-mediated rejection molecular state in lung transplant biopsies","authors":"Daniel R. Calabrese,&nbsp;John R. Greenland","doi":"10.1016/j.ajt.2023.08.003","DOIUrl":"10.1016/j.ajt.2023.08.003","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 1826-1827"},"PeriodicalIF":8.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523006263/pdfft?md5=668fb79227513ff9f1109edd63a7076c&pid=1-s2.0-S1600613523006263-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10064821","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}

{"title":"Disulfide-HMGB1 signals through TLR4 and TLR9 to induce inflammatory macrophages capable of innate-adaptive crosstalk in human liver transplantation","authors":"Allyson Q. Terry ,&nbsp;Hidenobu Kojima ,&nbsp;Rebecca A. Sosa ,&nbsp;Fady M. Kaldas ,&nbsp;Jackson L. Chin ,&nbsp;Ying Zheng ,&nbsp;Bita V. Naini ,&nbsp;Daisuke Noguchi ,&nbsp;Jessica Nevarez-Mejia ,&nbsp;Yi-Ping Jin ,&nbsp;Ronald W. Busuttil ,&nbsp;Aaron S. Meyer ,&nbsp;David W. Gjertson ,&nbsp;Jerzy W. Kupiec-Weglinski ,&nbsp;Elaine F. Reed","doi":"10.1016/j.ajt.2023.08.002","DOIUrl":"10.1016/j.ajt.2023.08.002","url":null,"abstract":"<div><p>Ischemia-reperfusion injury (IRI) during orthotopic liver transplantation (OLT) contributes to graft rejection and poor clinical outcomes. The disulfide form of high mobility group box 1 (diS-HMGB1), an intracellular protein released during OLT-IRI, induces pro-inflammatory macrophages. How diS-HMGB1 differentiates human monocytes into macrophages capable of activating adaptive immunity remains unknown. We investigated if diS-HMGB1 binds toll-like receptor (TLR) 4 and TLR9 to differentiate monocytes into pro-inflammatory macrophages that activate adaptive immunity and promote graft injury and dysfunction. Assessment of 106 clinical liver tissue and longitudinal blood samples revealed that OLT recipients were more likely to experience IRI and graft dysfunction with increased diS-HMGB1 released during reperfusion. Increased diS-HMGB1 concentration also correlated with TLR4/TLR9 activation, polarization of monocytes into pro-inflammatory macrophages, and production of anti-donor antibodies. <em>In vitro</em>, healthy volunteer monocytes stimulated with purified diS-HMGB1 had increased inflammatory cytokine secretion, antigen presentation machinery, and reactive oxygen species production. TLR4 inhibition primarily impeded cytokine/chemokine and costimulatory molecule programs, whereas TLR9 inhibition decreased HLA-DR and reactive oxygen species production. diS-HMGB1–polarized macrophages also showed increased capacity to present antigens and activate T memory cells. In murine OLT, diS-HMGB1 treatment potentiated ischemia-reperfusion–mediated hepatocellular injury, accompanied by increased serum alanine transaminase levels. This translational study identifies the diS-HMGB1/TLR4/TLR9 axis as potential therapeutic targets in OLT-IRI recipients.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 1858-1871"},"PeriodicalIF":8.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523006251/pdfft?md5=9eb0aa14d9dc7ed542930f0c9e024f1f&pid=1-s2.0-S1600613523006251-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10516786","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}

{"title":"Successful cryopreservation of functional kidney allografts using vitrification and nanorewarming","authors":"Charles G. Rickert MD, PhD,&nbsp;James M. Gardner MD, PhD","doi":"10.1016/j.ajt.2023.10.024","DOIUrl":"10.1016/j.ajt.2023.10.024","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 1822-1823"},"PeriodicalIF":8.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523008262/pdfft?md5=bd39ec60e8d08f41f3f0768abb167ada&pid=1-s2.0-S1600613523008262-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71418808","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}

{"title":"Body surface area compared to body weight dosing of valganciclovir is associated with increased toxicity in pediatric solid organ transplantation recipients","authors":"Salih Demirhan ,&nbsp;Flor M. Munoz ,&nbsp;Kristen G. Valencia Deray ,&nbsp;Claire E. Bocchini ,&nbsp;Lara Danziger-Isakov ,&nbsp;Samantha Blum ,&nbsp;Tanvi S. Sharma ,&nbsp;Gilad Sherman ,&nbsp;Juri Boguniewicz ,&nbsp;Samantha Bacon ,&nbsp;Monica I. Ardura ,&nbsp;Gabriela M. Maron ,&nbsp;Jose Ferrolino ,&nbsp;Marc Foca ,&nbsp;Betsy C. Herold","doi":"10.1016/j.ajt.2023.07.013","DOIUrl":"10.1016/j.ajt.2023.07.013","url":null,"abstract":"<div><p><span><span>Optimal dosing of valganciclovir (VGCV) for </span>cytomegalovirus<span><span> (CMV) prevention in pediatric </span>solid organ transplantation<span> recipients (SOTR) is controversial. Dosing calculated based on body surface area (BSA) and creatinine clearance is recommended but simplified body weight (BW) dosing is often prescribed. We conducted a retrospective 6-center study to compare safety and efficacy of these strategies in the first-year posttransplant There were 100 (24.2%) pediatric SOTR treated with BSA and 312 (75.7%) with BW dosing. CMV DNAemia was documented in 31.0% vs 23.4% (</span></span></span><em>P</em> = .1) at any time during the first year and breakthrough DNAemia in 16% vs 12.2% (<em>P</em> = .3) of pediatric SOTR receiving BSA vs BW dosing, respectively. However, neutropenia (50% vs 29.3%, <em>P</em><span> &lt;.001), lymphopenia (51% vs 15.0%, </span><em>P</em><span> &lt;.001), and acute kidney injury<span> causing treatment modification (8.0% vs 1.8%, </span></span><em>P</em><span> &lt;.001) were documented more frequently during prophylaxis in pediatric SOTR receiving BSA vs BW dosing. The adjusted odds ratio of VGCV-attributed toxicities comparing BSA and BW dosing was 2.3 (95% confidence interval [CI], 1.4-3.7] for neutropenia, 7.0 (95% CI, 3.9-12.4) for lymphopenia, and 4.6 (95% CI, 2.2-9.3) for premature discontinuation or dose reduction of VGCV, respectively. Results demonstrate that BW dosing is associated with significantly less toxicity without any increase in CMV DNAemia.</span></p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 1961-1971"},"PeriodicalIF":8.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10343247","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":"Abdominal computed tomography measurements of body composition and waitlist mortality in kidney transplant candidates","authors":"Evelien E. Quint ,&nbsp;Yi Liu ,&nbsp;Omid Shafaat ,&nbsp;Nidhi Ghildayal ,&nbsp;Helen Crosby ,&nbsp;Arun Kamireddy ,&nbsp;Robert A. Pol ,&nbsp;Babak J. Orandi ,&nbsp;Dorry L. Segev ,&nbsp;Clifford R. Weiss ,&nbsp;Mara A. McAdams-DeMarco","doi":"10.1016/j.ajt.2023.11.002","DOIUrl":"10.1016/j.ajt.2023.11.002","url":null,"abstract":"<div><p><span><span>Body mass index<span> is often used to determine kidney transplant<span> (KT) candidacy. However, this measure of body composition (BC) has several limitations, including the inability to accurately capture dry weight. Objective computed tomography (CT)-based measures may improve pre-KT </span></span></span>risk stratification<span><span> and capture physiological aging more accurately. We quantified the association between CT-based BC measurements and waitlist mortality in a retrospective study of 828 KT candidates (2010-2022) with clinically obtained CT scans using adjusted competing risk regression. In total, 42.5% of candidates had myopenia, 11.4% had myopenic obesity (MO), 68.8% had myosteatosis, 24.8% had sarcopenia (probable = 11.2%, confirmed = 10.5%, and severe = 3.1%), and 8.6% had </span>sarcopenic obesity. Myopenia, MO, and sarcopenic obesity were not associated with mortality. Patients with myosteatosis (adjusted subhazard ratio [aSHR] = 1.62, 95% confidence interval [CI]: 1.07-2.45; after confounder adjustment) or sarcopenia (probable: aSHR = 1.78, 95% CI: 1.10-2.88; confirmed: aSHR = 1.68, 95% CI: 1.01-2.82; and severe: aSHR = 2.51, 95% CI: 1.12-5.66; after full adjustment) were at increased risk of mortality. When stratified by age, MO (aSHR = 2.21, 95% CI: 1.28-3.83; </span></span><em>P</em> interaction = .005) and myosteatosis (aSHR = 1.95, 95% CI: 1.18-3.21; <em>P</em> interaction = .038) were associated with elevated risk only among candidates &lt;65 years. MO was only associated with waitlist mortality among frail candidates (adjusted hazard ratio = 2.54, 95% CI: 1.28-5.05; <em>P</em> interaction = .021). Transplant centers should consider using BC metrics in addition to body mass index when a CT scan is available to improve pre-KT risk stratification at KT evaluation.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 4","pages":"Pages 591-605"},"PeriodicalIF":8.8,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72207646","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":"A propensity score matched analysis of liver transplantation outcomes in the setting of preservation solution shortage","authors":"William A. Preston ,&nbsp;Devon J. Pace ,&nbsp;Peter J. Altshuler ,&nbsp;Misung Yi ,&nbsp;Haley D. Kittle ,&nbsp;Sage A. Vincent ,&nbsp;Kenneth A. Andreoni ,&nbsp;Adam M. Frank ,&nbsp;Jaime M. Glorioso ,&nbsp;Carlo G. Ramirez ,&nbsp;Warren R. Maley ,&nbsp;Ashesh P. Shah ,&nbsp;Adam S. Bodzin","doi":"10.1016/j.ajt.2023.10.028","DOIUrl":"10.1016/j.ajt.2023.10.028","url":null,"abstract":"<div><p>The recent shortage of the University of Wisconsin (UW) solution prompted increased utilization of histidine-tryptophan-ketoglutarate (HTK) solution for liver graft preservation. This contemporary study analyzed deceased donor liver transplant outcomes following preservation with HTK vs UW. Patients receiving deceased donor liver transplantations between January 1, 2019, and June 30, 2022, were retrospectively identified utilizing the Organ Procurement and Transplant Network database, stratified by preservation with HTK vs UW, and a propensity score matching analysis was performed. Outcomes assessed included rates of primary nonfunction, graft survival, and patient survival. There were 4447 patients in each cohort. Primary nonfunction occurred in 60 (1.35%) patients in the HTK group vs 25 (0.54%) in the UW group (<em>P</em> &lt; .001). HTK was associated with lower 90-day graft survival (94.39% vs 96.09%; <em>P</em> &lt; .001) and 90-day patient survival (95.97% vs 97.38%; <em>P</em> = .001). Unmatched donation after cardiac death-specific analysis of HTK vs UW demonstrated respective rates of primary nonfunction of 1.63% vs 0.82% (<em>P</em> = .20), 90-day graft survival of 92.50% vs 95.29% (<em>P</em> = .069), and 90-day patient survival of 93.90% vs 96.35% (<em>P</em> = .077). These results suggest that HTK may not be an equivalent preservation solution for deceased donor liver transplantation.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 4","pages":"Pages 619-630"},"PeriodicalIF":8.8,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523008304/pdfft?md5=a4357f975f9a7bc9fb6f2f4b39e9d623&pid=1-s2.0-S1600613523008304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71519681","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}

{"title":"The 2022 Banff Meeting Lung Report","authors":"Elizabeth N. Pavlisko ,&nbsp;Benjamin A. Adam ,&nbsp;Gerald J. Berry ,&nbsp;Fiorella Calabrese ,&nbsp;Nahir Cortes-Santiago ,&nbsp;Carolyn H. Glass ,&nbsp;Martin Goddard ,&nbsp;John R. Greenland ,&nbsp;Daniel Kreisel ,&nbsp;Deborah J. Levine ,&nbsp;Tereza Martinu ,&nbsp;Stijn E. Verleden ,&nbsp;S. Sam Weigt ,&nbsp;Antoine Roux","doi":"10.1016/j.ajt.2023.10.022","DOIUrl":"10.1016/j.ajt.2023.10.022","url":null,"abstract":"<div><p>The Lung Session of the 2022 16th Banff Foundation for Allograft Pathology Conference—held in Banff, Alberta—focused on non-rejection lung allograft pathology and novel technologies for the detection of allograft injury. A multidisciplinary panel reviewed the state-of-the-art of current histopathologic entities, serologic studies, and molecular practices, as well as novel applications of digital pathology with artificial intelligence, gene expression analysis, and quantitative image analysis of chest computerized tomography. Current states of need as well as prospective integration of the aforementioned tools and technologies for complete assessment of allograft injury and its impact on lung transplant outcomes were discussed. Key conclusions from the discussion were: (1) recognition of limitations in current standard of care assessment of lung allograft dysfunction; (2) agreement on the need for a consensus regarding the standardized approach to the collection and assessment of pathologic data, inclusive of all lesions associated with graft outcome (eg, non-rejection pathology); and (3) optimism regarding promising novel diagnostic modalities, especially minimally invasive, which should be integrated into large, prospective multicenter studies to further evaluate their utility in clinical practice for directing personalized therapies to improve graft outcomes.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"24 4","pages":"Pages 542-548"},"PeriodicalIF":8.8,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523008249/pdfft?md5=6390aa7a276d544a3c464f77131b25b9&pid=1-s2.0-S1600613523008249-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71475834","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}