Progress in Transplantation最新文献

{"title":"Avascular Necrosis in Kidney Transplant Recipients is Associated With an Increased Risk of Patient Death.","authors":"Sonam Dolma, Fauzia Osman, Emily Zona, Angelie Santos, Fahad Aziz, Neetika Garg, Maha Mohamed, Didier Mandelbrot, Sandesh Parajuli","doi":"10.1177/15269248241237814","DOIUrl":"10.1177/15269248241237814","url":null,"abstract":"<p><p><b>Introduction:</b> Avascular necrosis is a debilitating osseous complication in transplant recipients. <b>Project Aim:</b> This program evaluation sought to describe risk factors and adverse outcomes of avascular necrosis in kidney transplant recipients. <b>Design:</b> This was a retrospective evaluation of all recipients of kidneys and simultaneous pancreas and kidneys between 2001 and 2018 from a single center. Controls were selected based on the incidence density, sampling at a 1:3 ratio based on the post-transplant interval. Outcomes of interest were acute rejection, death-censored graft failure, and patient mortality. <b>Results:</b> A total of 88 kidney recipients had avascular necrosis and were compared with 257 controls. Most of the recipient's and donors' baseline characteristics were similar between the groups, except calcineurin inhibitor-based immunosuppression was more prevalent, and non-white donors were less prevalent in the control group. Looking for risk factors for avascular necrosis, calcineurin inhibitor-based immunosuppression was associated with a lower risk for avascular necrosis in the univariate analysis, but this was not found after adjustment of multiple variables. In multivariate analysis, avascular necrosis was associated with an increased risk for patient death (hazard ratio: 1.68; 95% confidence interval: 1.16-2.44; <i>P</i> = .008) but not for acute rejection or death censored graft failure. <b>Conclusion:</b> Although limited by small sample size, this evaluation found avascular necrosis to be associated with an increased risk of patient death. This finding may be useful for the provider taking care of the patients and discussing the various outcomes after the transplant.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"41-46"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Describing Patient Populations.","authors":"Mary K Roberts, Jonathan Daw","doi":"10.1177/15269248241237823","DOIUrl":"10.1177/15269248241237823","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"58-59"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Cumulative 6 mg/kg Antithymocyte Globulin on Early Posttransplant Outcomes in Kidney Transplant Recipients with Delayed Graft Function.","authors":"Van Anh Vu, Suverta Bhayana, Helen Sweiss, Nohely Castro, Reed Hall, Joelle Nelson","doi":"10.1177/15269248241237816","DOIUrl":"10.1177/15269248241237816","url":null,"abstract":"<p><p><b>Introduction:</b> Delayed graft function in kidney transplant is associated with an increased risk of rejection and graft loss. Use of rabbit antithymocyte globulin induction in delayed graft function has been correlated with less rejection compared to basiliximab, but optimal dosing remains unknown. <b>Program Evaluation Aims:</b> The purpose of this evaluation was to retrospectively assess the short-term effectiveness and tolerability of a clinical protocol that increased the net state of immunosuppression in delayed graft function kidney transplant recipients using cumulative 6 mg/kg rabbit antithymocyte globulin induction. <b>Design:</b> This retrospective cohort included 88 kidney transplant recipients with delayed graft function, transplanted between January 2017 and March 2021, who either received cumulative 4.5 mg/kg pre-protocol or 6 mg/kg post-protocol rabbit antithymocyte globulin. Outcomes evaluated were biopsy-proven acute rejection and incidence of graft loss, infection, and cytopenia at 6 months. <b>Results:</b> A significant reduction of biopsy-proven acute rejection incidence occurred post-protocol implementation (10/33, 30.3% vs 6/55, 10.9%; <i>P</i> = .04). Of those with rejection, significantly less post-protocol patients were classified as acute cellular rejection (9/10, 90.0% vs 2/6, 33.3%; <i>P</i> = .04). No death-censored graft loss was observed in either group. Rates of cytopenia and infection were similar pre- versus post-protocol implementation. <b>Conclusion:</b> Increasing the exposure to rabbit antithymocyte globulin and maintenance immunosuppression in delayed graft function kidney transplant recipients was tolerable and significantly reduced rejection occurrence at 6 months.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"47-52"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Dissemination of Clinical Findings.","authors":"Stacee Lerret, Haley Hoy","doi":"10.1177/15269248241238854","DOIUrl":"10.1177/15269248241238854","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"34 1-2","pages":"9-10"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Pulmonary Aspergillosis with Exclusive Pleural Involvement in a Lung Transplant Recipient.","authors":"Sergio García-Martín, Víctor M Mora-Cuesta, Sara Naranjo-Gozalo, Jose Javier Jiménez-Velasco, María Pía Roiz-Mesones, Victor Fernández-Lobo","doi":"10.1177/15269248241237825","DOIUrl":"10.1177/15269248241237825","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"53-54"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated Data on Risk of Living Kidney Donation.","authors":"Thomas Kelly, Elaine Perlman","doi":"10.1177/15269248241237826","DOIUrl":"10.1177/15269248241237826","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"57"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xenotransplantation and Future Equitable Access.","authors":"Daniel J Hurst","doi":"10.1177/15269248241237817","DOIUrl":"10.1177/15269248241237817","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"60-61"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Analysis of Litigation in Organ Transplantation for Allegations of Insufficient Policy Coverage, Discrimination and Malpractice.","authors":"Jacob Mago, Mihir Tandon, Naoru Koizumi, Marissa Firlie, Lauren Fang, Scott Serpico, Alejandro Chiodo Ortiz, Megumi Inoue, Patrick Raymond Baxter, Yang Yu, Monique John, Kassem-Ali Jihad Abbas, Liban Dinka, Obi Ekwenna, Meng-Hao Li, Jorge Ortiz","doi":"10.1177/15269248241237822","DOIUrl":"10.1177/15269248241237822","url":null,"abstract":"<p><p><b>Introduction:</b> Transplantation is a field with unique medical and administrative challenges that involve an equally diverse array of stakeholders. Expectantly, the litigation stemming from this field should be similarly nuanced. There is a paucity of comprehensive reviews characterizing this medicolegal landscape. <b>Design:</b> The Caselaw Access Project Database was used to collect official court briefs of 2053 lawsuits related to kidney, liver, heart, lung, and pancreas transplantation. A thematic analysis was undertaken to characterize grounds for litigation, defendant type, and outcomes. Cases were grouped into policy, discrimination, poor or unsuccessful outcome, or other categories. <b>Results:</b> One hundred sixty-four court cases were included for analysis. Cases involving disputes over policy coverage were the most common across all organ types (N = 55, 33.5%). This was followed by poor outcomes (N = 51, 31.1%), allegations of discrimination against prison systems and employers (N = 37, 22.6%) and other (N = 21, 12.8%). Defendants involved in discrimination trials won with the greatest frequency (N = 29, 90.62%). Defendants implicated in policy suits won 65.3% (N = 32), poor outcomes 62.2% (N = 28), and other 70% (N = 14). Of the 51 cases involving poor outcomes, plaintiffs indicated lack of informed consent in 23 (45.1%). <b>Conclusion:</b> Reconsidering the informed consent process may be a viable means of mitigating future legal action. Most discrimination suits favoring defendants suggested previous concerns of structural injustices in transplantation may not be founded. The prevalence of policy-related cases could be an indication of financial burden on patients. Future work and advocacy will need to substantiate these concerns and address change where legal recourse falls short.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"11-19"},"PeriodicalIF":0.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Digital Health Interventions to Promote Prehabilitation Prior to Kidney Transplantation.","authors":"Henry H L Wu, Wing-Yin Leung, Arvind Ponnusamy, Alexander Woywodt","doi":"10.1177/15269248241237824","DOIUrl":"10.1177/15269248241237824","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"62-63"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Strategies Used to Balance Health and Work Across the Solid Organ Transplantation Trajectory","authors":"Keira Gaudet, Marc Corbiere, Tianyan Chen, Heloise Cardinal, Marie Achille","doi":"10.1177/15269248241239245","DOIUrl":"https://doi.org/10.1177/15269248241239245","url":null,"abstract":"Introduction: Workers who undergo solid organ transplantation report frequent conflicts between the unpredictable demands of their health condition and the rigid requirements of their employer and of health services. The present study aimed to describe the self-management strategies adopted by workers while staying at work before transplantation and during sustainable return-to-work posttransplantation. Methods: Fifteen employed kidney, liver, and lung transplant recipients were recruited from 2 large urban university health centers in Montreal, Canada. Three focus groups were held, and thematic analysis was performed. Findings: Seven strategies were identified: responding promptly and consistently to fatigue-related needs, planning ahead with immediate supervisors while remaining strategic about when to disclose transplantation, requesting work accommodations, requesting flexibility in healthcare provision, consulting physicians about work-related issues, informing co-workers about work limitations and immunosuppression and asking not to be treated differently in the workplace. Conclusion: Access to work accommodations, support from physicians and flexibility in treatment and appointment schedules supported workers’ ability to manage their health while staying at work before and after undergoing solid organ transplantation. In light of findings, it may be useful for healthcare professionals to address workers’ concerns about work limitations and work accommodation implementation, especially when the illness-management burden increases before transplantation and during posttransplantation sick leave. Future studies could describe the strategies used by other important stakeholders when attempting to provide support to workers.","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"124 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140564181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}