American Journal of Transplantation最新文献_第9页

Impact of Kidney Allocation System 250 Policy on One Year Graft Loss. 肾脏分配制度250政策对一年移植损失的影响。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2024-12-24 DOI: 10.1016/j.ajt.2024.12.011

Xingyu Zhang,Vishnu S Potluri,Michele Molinari,Osea Giuntella,Sundaram Hariharan,Chethan M Puttarajappa

{"title":"Impact of Kidney Allocation System 250 Policy on One Year Graft Loss.","authors":"Xingyu Zhang,Vishnu S Potluri,Michele Molinari,Osea Giuntella,Sundaram Hariharan,Chethan M Puttarajappa","doi":"10.1016/j.ajt.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.011","url":null,"abstract":"A new deceased donor kidney allocation system (KAS250) was implemented in March 2021 that prioritizes recipients within a 250 nautical mile radius from the donor hospital. KAS250 was implemented to reduce geographic disparities in access to kidney transplantation. Studies have shown an increase in cold ischemia time (CIT) after KAS250 implementation but the impact on graft outcomes is unknown. Utilizing data from the Scientific Registry of Transplant Recipients, we estimated cause-specific hazards of 1-year death-censored graft loss (DCGL) and all-cause graft loss (ACGL) due to KAS250 for the post-KAS250 period (April 2021 to December 2022; N=28,584) compared to the pre-KAS250 period (January 2017 to December 2018; N=23,798). We found that the post-KAS250 period had higher DCGL (Hazard ratio 1.14; 95% CI 1.02-1.26; p=0.0187) and ACGL (Hazard ratio 1.22; 95% CI 1.13-1.31, p<.0001). Mediation analysis showed that CIT indirectly mediated 45.54% and 15.73% of KAS250 policy's effect on DCGL and ACGL, respectively. In conclusion, short-term graft outcomes in the post-KAS250 era are inferior to those in the pre-KAS250 era, with the worsening CIT being a significant contributor. Therefore, further adjustments to both the policy and transplant practices should be considered to further optimize equity and outcomes.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"25 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887604","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

Impact of repeat human leukocyte antigen mismatches on kidney graft survival: A contemporary Collaborative Transplant Study analysis. 重复hla错配对肾移植存活的影响：当代合作移植研究（cts）分析。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-22 DOI: 10.1016/j.ajt.2024.12.014

Lissa Pipeleers, Christian Unterrainer, Marie-Paule Emonds, Karl Martin Wissing, Thuong Hien Tran

{"title":"Impact of repeat human leukocyte antigen mismatches on kidney graft survival: A contemporary Collaborative Transplant Study analysis.","authors":"Lissa Pipeleers, Christian Unterrainer, Marie-Paule Emonds, Karl Martin Wissing, Thuong Hien Tran","doi":"10.1016/j.ajt.2024.12.014","DOIUrl":"10.1016/j.ajt.2024.12.014","url":null,"abstract":"Repeat human leukocyte antigen (HLA) mismatches (RMM) have been historically associated with an increased risk of graft loss after repeat kidney transplantation, in particular HLA-DR RMM in sensitized recipients. As routine use of sensitive assays can at present prevent the transplantation of RMM in hosts with donor-specific antibodies, we hypothesized that RMM would no longer be associated with graft loss. We performed a registry analysis of the Collaborative Transplant Study database including 6711 patients who received a second kidney transplant (KT) between 2010 and 2021, with at least 1 HLA-A, HLA-B, or HLA-DR mismatch. No increased risk for graft loss was observed for the second KT with a class I RMM, regardless of sensitization status. For the second KT with a HLA-DR RMM, the hazard ratio for graft loss in the first year after transplantation was 1.61 (95% CI 1.16-2.23; P = .004) compared to recipients without an RMM and increased to 2.21 (95% CI 1.24-3.63: P = .002) in sensitized recipients (latest complement-dependent cytotoxicity panel reactive antibodies >0%). Our observations suggest that class I RMM do not need to be systematically avoided. In contrast, HLA-DR RMM still had a negative impact on graft survival in this contemporary cohort, despite the widespread availability of Luminex.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880827","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

Tenofovir-associated Fanconi Syndrome in liver transplant recipients with hepatitis B: A retrospective case series. 乙肝肝移植受者的替诺福韦相关范可尼综合征：回顾性病例系列

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-21 DOI: 10.1016/j.ajt.2024.12.015

Erica Loon, Nicholas Lim, Giovanni A Roldan, John Lake

引用次数: 0

Risk adjustment of organ donor referrals is insufficient to determine donor potential and organ procurement organization approach rates. 器官供体转诊的风险调整不足以确定供体潜力和OPO接诊率。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-21 DOI: 10.1016/j.ajt.2024.12.012

Thomas Mone, J Thomas Rosenthal

引用次数: 0

The concept of immunothrombosis in pancreas transplantation. 胰腺移植中免疫血栓的概念。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-19 DOI: 10.1016/j.ajt.2024.11.025

Christophe Masset, Nicolas Drillaud, Catherine Ternisien, Nicolas Degauque, Nathalie Gerard, Sarah Bruneau, Julien Branchereau, Gilles Blancho, Benoit Mesnard, Sophie Brouard, Magali Giral, Diego Cantarovich, Jacques Dantal

{"title":"The concept of immunothrombosis in pancreas transplantation.","authors":"Christophe Masset, Nicolas Drillaud, Catherine Ternisien, Nicolas Degauque, Nathalie Gerard, Sarah Bruneau, Julien Branchereau, Gilles Blancho, Benoit Mesnard, Sophie Brouard, Magali Giral, Diego Cantarovich, Jacques Dantal","doi":"10.1016/j.ajt.2024.11.025","DOIUrl":"10.1016/j.ajt.2024.11.025","url":null,"abstract":"Early failure of a pancreatic allograft due to complete thrombosis has an incidence of approximately 10% and is the main cause of comorbidity in pancreas transplantation. Although several risk factors have been identified, the exact mechanisms leading to this serious complication are still unclear. In this review, we define the roles of the individual components involved during sterile immunothrombosis-namely endothelial cells, platelets, and innate immune cells. Further, we review the published evidence linking the main risk factors for pancreatic thrombosis to cellular activation and vascular modifications. We also explore the unique features of the pancreas itself: the vessel endothelium, specific vascularization, and relationship to other organs-notably the spleen and adipose tissue. Finally, we summarize the therapeutic possibilities for the prevention of pancreatic thrombosis depending on the different mechanisms such as anticoagulation, anti-inflammatory molecules, endothelium protectors, antagonism of damage-associated molecular patterns, and use of machine perfusion.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870601","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

Effectiveness of hepatitis A immunization after pediatric liver transplantation: A retrospective observational analysis. 儿童肝移植后甲型肝炎免疫接种的有效性：回顾性观察分析。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-19 DOI: 10.1016/j.ajt.2024.12.009

Tobias Laue, Norman Junge, Christoph Leiskau, Frauke Mutschler, Johanna Ohlendorf, Ulrich Baumann

{"title":"Effectiveness of hepatitis A immunization after pediatric liver transplantation: A retrospective observational analysis.","authors":"Tobias Laue, Norman Junge, Christoph Leiskau, Frauke Mutschler, Johanna Ohlendorf, Ulrich Baumann","doi":"10.1016/j.ajt.2024.12.009","DOIUrl":"10.1016/j.ajt.2024.12.009","url":null,"abstract":"This retrospective study aimed to investigate the response to hepatitis A virus (HAV) immunization following liver transplantation. We analyzed 234 vaccination records of 284 children who underwent liver transplantation between January 2003 and July 2021, including annual serologic results. Of the 120 HAV-naïve patients, approximately 71% and 83% showed seroconversion after receiving 1 and 2 vaccine doses, respectively. The third dose increased the seroconversion rate to 93%. In multivariable logistic regression analysis, the number of vaccine doses and age at first vaccine dose were independently associated with seroconversion. In contrast, additional immunosuppression with mycophenolate mofetil was negatively associated with seroconversion. In Cox regression analysis, of all 96 seroconverted children, younger age at first vaccination and additional immunosuppression with either mycophenolate mofetil or prednisolone were identified as independent risk factors for the early loss of HAV immunity. In summary, HAV immunization with the 3-dose vaccination series is recommended for pediatric liver transplant recipients. Antibody testing and booster vaccinations, if necessary, are recommended, especially for those living in endemic areas or with additional immunosuppressive treatments.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870597","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

Randomized trial investigating the utility of a liver tissue transcriptional biomarker in identifying adult liver transplant recipients not requiring maintenance immunosuppression. 随机试验研究肝组织转录生物标志物在识别不需要维持免疫抑制的成人肝移植受者中的效用。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-18 DOI: 10.1016/j.ajt.2024.12.002

Julien Vionnet, Jorge Torres-Yaguana, Rosa Miquel, Juan G Abraldes, Jurate Wall, Elisavet Kodela, Juan-Jose Lozano, Pablo Ruiz, Miguel Navasa, Aileen Marshall, Frederik Nevens, Will Gelson, Joanna Leithead, Steven Masson, Elmar Jaeckel, Richard Taubert, Phaedra Tachtatzis, Dennis Eurich, Kenneth J Simpson, Eliano Bonaccorsi-Riani, James Ferguson, Alberto Quaglia, Anthony J Demetris, Andrew J Lesniak, Maria Elstad, Marc Delord, Abdel Douiri, Irene Rebollo-Mesa, Marc Martinez-Llordella, Juliete A F Silva, James F Markmann, Alberto Sánchez-Fueyo

{"title":"Randomized trial investigating the utility of a liver tissue transcriptional biomarker in identifying adult liver transplant recipients not requiring maintenance immunosuppression.","authors":"Julien Vionnet, Jorge Torres-Yaguana, Rosa Miquel, Juan G Abraldes, Jurate Wall, Elisavet Kodela, Juan-Jose Lozano, Pablo Ruiz, Miguel Navasa, Aileen Marshall, Frederik Nevens, Will Gelson, Joanna Leithead, Steven Masson, Elmar Jaeckel, Richard Taubert, Phaedra Tachtatzis, Dennis Eurich, Kenneth J Simpson, Eliano Bonaccorsi-Riani, James Ferguson, Alberto Quaglia, Anthony J Demetris, Andrew J Lesniak, Maria Elstad, Marc Delord, Abdel Douiri, Irene Rebollo-Mesa, Marc Martinez-Llordella, Juliete A F Silva, James F Markmann, Alberto Sánchez-Fueyo","doi":"10.1016/j.ajt.2024.12.002","DOIUrl":"10.1016/j.ajt.2024.12.002","url":null,"abstract":"The maintenance of stable allograft status in the absence of immunosuppression (IS), known as operational tolerance, can be achieved in a small proportion of liver transplant recipients, but we lack reliable tools to predict its spontaneous development. We conducted a prospective, multicenter, biomarker-strategy design, IS withdrawal clinical trial to determine the utility of a predictive biomarker of operational tolerance. The biomarker test, originally identified in a patient cohort with high operational tolerance prevalence, consisted of a 5-gene transcriptional signature measured in liver tissue collected before initiating IS weaning. One hundred sixteen adult stable liver transplant recipients were randomized 1:1 to either arm A (IS withdrawal regardless of biomarker status) or arm B (IS withdrawal in biomarker-positive recipients). Immunosuppression withdrawal was initiated in 82 participants, rejection occurred in 54 (67.5%), and successful discontinuation of IS was achieved in 22 (27.5%), but only 13 (16.3%) met operational tolerance histologic criteria (10 in arm A; 3 in arm B). The biomarker test did not yield useful information in selecting patients able to successfully discontinue IS. Operational tolerance was associated with time posttransplant, recipient age, presence of circulating exhausted CD8+ T cells, and a reduced number of immune synapses within the graft.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870599","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

ATP-mediated signaling of P2X7 receptors controls donor extracellular vesicle release and MHC cross-decoration after allotransplantation. atp介导的P2X7受体信号传导控制异体移植后供体细胞外囊泡释放和MHC交叉修饰。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-16 DOI: 10.1016/j.ajt.2024.12.008

Bruno Gonzalez-Nolasco, Hyshem H Lancia, Natacha Carnel-Amar, Xianding Wang, Aurore Prunevieille, Loïc Van Dieren, Alexandre G Lellouch, Curtis L Cetrulo, Gilles Benichou

{"title":"ATP-mediated signaling of P2X7 receptors controls donor extracellular vesicle release and MHC cross-decoration after allotransplantation.","authors":"Bruno Gonzalez-Nolasco, Hyshem H Lancia, Natacha Carnel-Amar, Xianding Wang, Aurore Prunevieille, Loïc Van Dieren, Alexandre G Lellouch, Curtis L Cetrulo, Gilles Benichou","doi":"10.1016/j.ajt.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.008","url":null,"abstract":"After skin allotransplantation, intercellular transfer of donor MHC molecules mediated primarily by extracellular vesicles (EVs) released by the allograft is known to contribute to semi-direct and indirect activation of alloreactive T cells involved in graft rejection. At the same time, there is ample evidence showing that initiation of adaptive alloimmunity depends on early innate inflammation caused by tissue injury and subsequent activation of myeloid cells (macrophages and dendritic cells) recognizing danger associated molecular patterns (DAMPs). Among these DAMPs, extracellular ATP plays a key role in innate inflammation through binding to P2X7 receptors. Indeed, this process leads to the activation of the NLRP3 inflammasome and subsequent production and release of inflammatory cytokines and EVs. This prompted us to evaluate the influence of innate inflammation triggered by ATP-mediated signaling of P2X7 receptors on EV release by donor cells after skin transplantation in mice. In this article, we show that inhibition of P2X7R signaling suppresses both EV release and MHC cross-decoration of leukocytes and prolongs skin allograft survival in mice. This study reveals a novel aspect of the role of innate immunity in allotransplantation.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851591","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

Transfusion specific alloimmune responses following blood transfusion pre-kidney transplantation. 肾移植前输血后输血特异性同种免疫反应。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-15 DOI: 10.1016/j.ajt.2024.12.006

Katrina J Spensley, Sevda Hassan, David J Roberts, Malgorzata Przybysiak, Fiona Regan, Colin Brown, Michelle Willicombe

{"title":"Transfusion specific alloimmune responses following blood transfusion pre-kidney transplantation.","authors":"Katrina J Spensley, Sevda Hassan, David J Roberts, Malgorzata Przybysiak, Fiona Regan, Colin Brown, Michelle Willicombe","doi":"10.1016/j.ajt.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.006","url":null,"abstract":"It is widely accepted that blood transfusions can cause allosensitisation, but it is often reported that new HLA antibodies are non-specific and transient. This study explores the effect of blood transfusion on allosensitisation in waitlisted transplant patients including the development of transfusion specific antibodies (TSAs), whilst they remain on the waiting list and longitudinally following subsequent transplantation. A total of 105 blood donors of transfusions received by 50 patients on the transplant waiting list were HLA typed. De novo HLA antibodies developed in 62% of patients following transfusion, with 34% of patients having at least one TSA. TSAs developed in 23% of patients with no circulating HLA antibodies at the time of transfusion and in 50% of patients with circulating HLA antibodies. This was associated with an average increase in calculated reaction frequency of 16.4%. Of the 34 patients who were transplanted the majority received a kidney with at least 1 shared HLA specificity with a transfusion donor. After transplantation 14.7% had a newly detected TSA within 3 months. These patients had higher rates of rejection, specifically antibody mediated rejection, at 3 years. The use of HLA-selected blood for waitlisted patients, where transfusion is unavoidable, could therefore improve transplant outcomes.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845556","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

Estimating the efficacy of felzartamab to treat antibody-mediated rejection using the iBox prognostication system. 使用 iBox 预后系统估算非扎他单抗治疗抗体介导的排斥反应的疗效。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2024-12-12 DOI: 10.1016/j.ajt.2024.12.004

Yannis Lombardi, Marc Raynaud, Martina Schatzl, Katharina A Mayer, Matthias Diebold, Uptal D Patel, Eva Schrezenmeier, Aylin Akifova, Klemens Budde, Alexandre Loupy, Georg A Böhmig

引用次数: 0