Transplantation Direct最新文献

{"title":"The Highest Anti-B Antibody Titer of 8192 in a Patient Undergoing ABO-incompatible Living-donor Liver Transplantation: How to Achieve Donor-specific B-cell Tolerance?","authors":"Tetsuya Tajima, Koichiro Hata, Shoichi Kageyama, Jiro Kusakabe, Kimiko Yurugi, Rie Hishida, Hidenori Ohe, Akira Mori, Hideaki Okajima, Miki Nagao, Shinji Uemoto, Etsuro Hatano","doi":"10.1097/TXD.0000000000001859","DOIUrl":"10.1097/TXD.0000000000001859","url":null,"abstract":"","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 9","pages":"e1859"},"PeriodicalIF":1.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Excess Mortality Among Waitlisted Kidney, Heart, and Liver Transplant Candidates.","authors":"Amanda Jean Vinson, Xun Zhang, Lauren T Grinspan, Bethany J Foster","doi":"10.1097/TXD.0000000000001856","DOIUrl":"10.1097/TXD.0000000000001856","url":null,"abstract":"<p><strong>Background: </strong>Sex differences in excess mortality risk (ie, above expected in the age-, sex-, and race-matched general population) among candidates waitlisted for transplant may reflect sex bias in access to the waitlist, disparities in allocation policies, and/or sex differences in care for patients with organ failure.</p><p><strong>Methods: </strong>We used time-dependent relative survival models to determine the relative excess risk of mortality in females compared with males recorded in the Scientific Registry of Transplant Recipients who were waitlisted for kidney, heart, or liver transplant from 1988 to 2019, accounting for the modifying effects of candidate age and listing era.</p><p><strong>Results: </strong>Among 644 262 kidney and 106 353 heart candidates, excess mortality was higher in female than male kidney candidates <60 y, but lower in female kidney candidates ≥60 y and heart candidates ≥12 y; patterns did not differ by era. Among 259 230 liver candidates, patterns differed by era of waitlisting. Excess mortality was lower for female than male liver candidates 0-12 and 25-44 y, and higher for females than males 13-24 y, without differences by era. Excess mortality was lower for female than male liver candidates 45-59 y waitlisted 1988-2011, but not different by sex for those waitlisted 2012-2019. Among liver candidates ≥60 y, excess mortality did not differ by sex for those waitlisted 1988-2011 but was higher for females than males waitlisted 2012-2019.</p><p><strong>Conclusions: </strong>The patterns of sex differences in excess mortality observed among waitlisted transplant candidates likely reflect the selection of healthier, lower-risk females than males for waitlisting and higher mortality risks for females with organ failure.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 9","pages":"e1856"},"PeriodicalIF":1.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modernizing the Design Process for US Organ Allocation Policy: Toward a Continuous Distribution Policy for Kidneys.","authors":"Elijah Pivo, James Alcorn, Dimitris Bertsimas, Sarah E Booker, Keighly Bradbrook, Thomas G Dolan, Lindsay V Larkin, Kayla R Temple, Nikolaos Trichakis","doi":"10.1097/TXD.0000000000001780","DOIUrl":"10.1097/TXD.0000000000001780","url":null,"abstract":"<p><strong>Background: </strong>The allocation of a limited supply of donor organs remains a critical challenge for organ transplantation. The analytical tools that policymakers rely upon for improving allocation policy have seen little advancement since the introduction of computer simulation in 1995. In recent years, simulation has increasingly become a bottleneck in the policy design process. Partnering with the Organ Procurement and Transplantation Network Kidney Transplantation Committee, our team introduced new analytical techniques into the policy design process.</p><p><strong>Methods: </strong>A new simulation algorithm was developed that reduces the time required to simulate 1 y of allocation from >6 h down to about 15 s while using the same simulation model as the preexisting simulator used by the Organ Procurement and Transplantation Network. This improvement enabled the simulation of thousands of allocation policies, allowing the introduction of multiobjective optimization as a primary method for policy design. An interactive website was created for committee members to analyze results and perform policy optimization.</p><p><strong>Results: </strong>These techniques were applied to the development of new continuous distribution allocation policies for kidneys. We detail the policy design process, present graphical results from 50 000 policy simulations, and highlight 4 policies optimized to balance between multiple objectives differently.</p><p><strong>Conclusions: </strong>Advances in analytical tools offer a path to improving organ transplantation through more effective and equitable organ allocation policies.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 9","pages":"e1780"},"PeriodicalIF":1.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex- and Age-based Comparison of Key Clinical Markers of Immunity After Heart and Kidney Transplantation.","authors":"Whitney A Perry, Jennifer K Chow, Audrey E Martino, Nicholas E Heger, Aleah Holmes, Alexandra Werner, Marta Rodriguez Garcia, Amanda R Vest, Ashtar Chami, Pritha Sen, David R Snydman","doi":"10.1097/TXD.0000000000001846","DOIUrl":"10.1097/TXD.0000000000001846","url":null,"abstract":"<p><strong>Background: </strong>The combined effects of age and sex impact important posttransplant outcomes. Despite key physiologic differences in metabolic and immune function, older women are often indiscriminately grouped with either young women or older men. We examined sex- and age-based differences in clinical markers of immunity in heart and kidney recipients, with specific attention to those of postmenopausal women.</p><p><strong>Methods: </strong>Blood was prospectively collected before transplantation, and at 1 and 6 mo posttransplantation, alongside 12 mo of clinical data. Patients were stratified by age, biological sex, and menopause status. Absolute lymphocyte count (ALC), CD4⁺ and CD8⁺ lymphocyte subsets, total IgG, 4 selected cytokines, estradiol and progesterone, and cumulative incidence of infection were quantified within groups. The relationship between menopause category (premenopausal women, postmenopausal women, men) and 6-mo ALC was tested by linear regression, controlling for multiple confounding variables.</p><p><strong>Results: </strong>The cohort included 40 heart, 23 kidney, and 3 heart-kidney recipients categorized as 10 women older than 50 y, 12 women 50 y and younger, 26 men older than 50 y, and 18 men 50 y and younger. At 6 mo posttransplant, mean ALC among older women (0.59 K/µL) fell to a far lower range of lymphopenia than in young women (0.9 K/µL), older men (0.85 K/µL), and younger men (0.82 K/µL). Postmenopausal women had significantly lower ALC compared with premenopausal women (<i>P</i> = 0.03) and men (<i>P</i> = 0.05). Women older than 50 y also had the greatest cumulative incidence of infection by 1 y compared with other groups.</p><p><strong>Conclusions: </strong>These findings support the concern for increased risk of infection in postmenopausal organ transplant recipients.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 9","pages":"e1846"},"PeriodicalIF":1.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Lactate Clearance Patterns During Normothermic Machine Perfusion Predict Posttransplant Biliary Complications in Donation After Circulatory Death Liver Transplantation.","authors":"Ayato Obana, Miho Akabane, Hannah Chi, Nolan Ladd, Andrew Nguyen, Lin Abigail Tan, Rithin Punjala, Kejal Shah, Matthew Hamilton, Ashley Limkemann, Navdeep Singh, Musab Alebrahim, Khalid Mumtaz, Austin Schenk, Sylvester Black, Kenneth Washburn","doi":"10.1097/TXD.0000000000001823","DOIUrl":"10.1097/TXD.0000000000001823","url":null,"abstract":"<p><strong>Background: </strong>Normothermic machine perfusion (NMP) enables real-time assessment of liver graft viability through various biomarkers. Although lactate clearance during NMP has been associated with graft outcomes, its dynamic patterns and relationship with posttransplant biliary complications (PTBCs) remain poorly understood. We sought to evaluate whether dynamic lactate clearance patterns during NMP could predict PTBCs in both donations after circulatory death (DCD) and brain death (DBD) liver transplantation (LT).</p><p><strong>Methods: </strong>We conducted a single-center retrospective study of 140 LT recipients (88 DCDs, 52 DBDs) undergoing NMP (2022-2024). K-means clustering analysis was applied to lactate clearance patterns during the first 3 h of NMP. The primary outcome was PTBCs. Multivariate logistic regression analysis was used to identify independent predictors for PTBC.</p><p><strong>Results: </strong>K-means clustering revealed 3 distinct patterns: consistently low (cluster A), rapid clearance (cluster B), and prolonged elevation (cluster C). DCD grafts demonstrated more pronounced differences in lactate clearance and higher rates of persistent elevation than DBD grafts. For DCD grafts, the distribution was cluster A (26.1%, n = 23), cluster B (37.5%, n = 33), and cluster C (36.4%, n = 32), whereas DBD grafts showed cluster A (55.8%, n = 29), cluster B (17.3%, n = 9), and cluster C (26.9%, n = 14). In DCD grafts, PTBC rates were significantly higher in cluster C (37.5%) than in clusters A (13.0%, <i>P</i> = 0.045) and B (15.2%, <i>P</i> = 0.04). This association remained significant in multivariate analysis (adjusted odds ratio, 4.76; 95% confidence interval, 1.03-21.9; <i>P</i> = 0.045). No differences in recipient or donor variables were observed across clusters. Among DBD grafts, no intercluster differences in PTBC rates were found.</p><p><strong>Conclusions: </strong>Dynamic lactate clearance patterns during NMP predict PTBCs in DCD LT. This novel approach may enable more precise risk stratification and guide posttransplant surveillance strategies for DCD grafts.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 8","pages":"e1823"},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is 2 h of Hypothermic Machine Perfusion for Pancreas Preservation Effective in Improving Graft Reperfusion?","authors":"Benoit Mesnard, Christophe Masset, Etohan Ogbemudia, Sarah Bruneau, Mohamed Elzawahry, Stéphanie Le Bas-Bernardet, David Minault, Jeremy Hervouet, Diego Cantarovich, Jérôme Rigaud, Lionel Badet, Peter Friend, Rutger Ploeg, Gilles Blancho, James Hunter, Thomas Prudhomme, Julien Branchereau","doi":"10.1097/TXD.0000000000001834","DOIUrl":"10.1097/TXD.0000000000001834","url":null,"abstract":"<p><strong>Background: </strong>Static cold storage (SCS) remains the standard method for organ preservation. The development of parenchymal edema during prolonged hypothermic machine perfusion (HMP) was a major barrier to the introduction of this technique for the preservation of pancreases. A short period of HMP could optimize the pancreas for reperfusion while minimizing the side effects related to perfusion. Our objective is to evaluate the impact of short-term HMP on the pancreatic reperfusion.</p><p><strong>Methods: </strong>A preclinical study using a controlled donation after circulatory death porcine model was conducted. After procurement, the pancreases were preserved under hypothermic conditions for 2 h either by SCS (n = 4) or HMP (n = 4). After these 2 h of preservation, the pancreases were reperfused using a normothermic machine perfusion (NMP) for 2 h. During NMP, oxygenation, perfusion parameters, biochemical analyses, a glucose stimulation insulin secretion test, and an evaluation of ischemia/reperfusion injury by photoacoustic tomography were assessed.</p><p><strong>Results: </strong>During NMP, resistance indices were significantly lower in the HMP group compared with the SCS group, even after 2 h of reperfusion. The tissue oxygen partial pressure was higher throughout NMP after HMP preservation. Lactate and amylase levels were equal between the 2 groups. Lipase levels were higher in the HMP group. The glucose stimulation test showed no difference between the 2 groups. Photoacoustic tomography assessment showed no endothelial damage in either group.</p><p><strong>Conclusions: </strong>Our study suggests that a short-term HMP applied to pancreases for 2 h is effective in reducing resistance indexes and improving oxygenation.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 8","pages":"e1834"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: The Impact of Hypothermic Oxygenated Perfusion (HOPE) on Immune Responses and Sterile Inflammation in a Preclinical Model of Pancreatic Transplantation by Mesnard B et al. <i>Transplantation Direct</i> 2025; 11:e1743; doi: 10.1097/TXD.0000000000001743.","authors":"Arnau Panisello-Rosello, Carlos Palmeira, Teresa Carbonell, Joan Rosello-Catafau","doi":"10.1097/TXD.0000000000001842","DOIUrl":"10.1097/TXD.0000000000001842","url":null,"abstract":"","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 8","pages":"e1842"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcome After Nonvascularized Rectus Fascia Transplantation in Solid Organ Transplantation: A Global Multicenter IIRTA Survey.","authors":"Nele Van De Winkel, Ewout Muylle, Emilio Canovai, Irum Amin, Andrew Butler, Rodrigo Vianna, Gennaro Selvaggi, Pablo Farinelli, Gabriel Gondolesi, Carmelo Loinaz, Iago Justo, Hector Vilca-Melendez, Ulrika Skogsberg Dahlgren, Gustaf Herlenius, Alireza Shamsaeefar, Hamed Nikoupour, Antoine Dubois, Marc Miserez, André D'Hoore, Robert Venick, Jacques Pirenne, Laurens J Ceulemans","doi":"10.1097/TXD.0000000000001839","DOIUrl":"10.1097/TXD.0000000000001839","url":null,"abstract":"<p><strong>Background: </strong>Abdominal wall (AW) closure after solid organ transplantation (SOT) is challenging in case of loss of abdominal domain and/or large-for-size grafts. Primary closure is crucial to avoid open abdomen-associated morbidity and mortality. Several techniques have been developed to address this challenge, including nonvascularized rectus fascia transplantation (NVRF Tx). Long-term outcome is missing.</p><p><strong>Methods: </strong>We designed a multicenter survey to analyze the worldwide experience after NVRF Tx. International Intestinal Rehabilitation And Transplantation Association members were invited to participate to a questionnaire. The survey included all NVRF Tx performed after SOT. Questions were classified into pre-, intra-, and postoperative data.</p><p><strong>Results: </strong>Of the 29 responding centers, 8 performed NVRF Tx, comprising 98 patients in total. Thirty-two patients underwent multivisceral Tx (33.3%), 27 isolated intestinal Tx (28.1%), 21 combined liver-intestinal Tx (21.9%), 8 liver Tx (8.3%), 8 other SOT (8.3%), and 2 (2.0%) not reported. Thirty NVRF (30.9%) were from third-party donors. Thirty patients (31.3%) had surgical site infections. Seventy-one (74.0%) patients had reoperations, of them 18 (26.1%) patients had NVRF removal. Median follow-up time was 31 mo (10.0-63.5). Seventeen patients presented with bulging of the AW (18.7%), 5 with herniation (5.9%). No NVRF graft rejection was reported.</p><p><strong>Conclusions: </strong>This survey reports long-term outcome after NVRF Tx, with herniation in a limited number of patients, no suspicion of clinical rejection and no additional infection and mortality. NVRF Tx has proven to be a useful option, belonging to the standard armamentarium for AW closure after SOT.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 8","pages":"e1839"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing and Validating a Biomolecular Signature of Ischemia/Reperfusion Injury in a Porcine Pancreas Allotransplantation Model.","authors":"Samrat Ray, Sujani Ganesh, Laura Martinez-Arenas, Catherine Parmentier, Masataka Kawamura, Bhranavi Arulratnam, Christian Hobeika, Emmanuel Nogueira, Francisco Calderon Novoa, Markus Selzner, Trevor W Reichman","doi":"10.1097/TXD.0000000000001793","DOIUrl":"10.1097/TXD.0000000000001793","url":null,"abstract":"<p><strong>Background: </strong>Despite considerable advancement in surgical and immunological management in pancreas transplantation, graft pancreatitis remains a feared complication after pancreas transplantation. Identification of molecular mechanisms of underlying ischemia/reperfusion injury (IRI) in pancreas transplantation could, therefore, pave the path for targeted therapy to improve surgical outcomes. The aim of the study was to identify and validate the genes differentially expressed in the early period (24 h) of graft reperfusion in pancreas transplantation.</p><p><strong>Methods: </strong>A porcine pancreas allotransplant model (n = 4) was used to identify and validate the genes aberrantly expressed in 60 min postreperfusion tissue samples (phase 1). Trends of expression of selected genes from phase 1 and corresponding protein product levels in serum were validated at defined time points for >24 h in a technically replicated external cohort (n = 3; phase 2).</p><p><strong>Results: </strong>A total of 104 genes were found to be upregulated at 60 min after pancreas graft reperfusion. The most consistently overexpressed genes were IL6, THBS1, and MIR-21 (micro-RNA) mapped to protein kinase and intracellular signaling molecular pathways. Levels of expression of these genes correlated significantly with serum interleukin-6 (<i>R</i> = 0.60-0.81; <i>P </i>< 0.01) and tumor necrosis factor-alpha levels (<i>R</i> = 0.34-41; <i>P</i> > 0.05) at corresponding time points.</p><p><strong>Conclusions: </strong>The results provide new insights into biomolecular pathways (THBS1-IL6-MIR-21 crosstalk and hydroxymethylglutarate coenzyme A reductase-linked nuclear factor kappa B activation) linked to pancreatic IRI in porcine transplantation model. Identification and validation of some novel molecular pathway interactions in human pancreas transplantation could pave the path for potential targeted therapy in alleviating graft injury in the early phases of pancreatic IRI.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 8","pages":"e1793"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Course and Baseline Predictors of Trajectories of Clinician-assessed Adherence to Immunosuppressant Medication in Patients after Kidney Transplantation: A KTx360° Substudy.","authors":"Martina de Zwaan, Mariel Nöhre, Felix Klewitz, Maximilian Bauer-Hohmann, Charlotte Kuczyk, Yesim Erim, Lena Schiffer, Deborah Meier, Julia K Wolff, Uwe Tegtbur, Lars Pape, Mario Schiffer","doi":"10.1097/TXD.0000000000001813","DOIUrl":"10.1097/TXD.0000000000001813","url":null,"abstract":"<p><strong>Background: </strong>Optimal and maintained adherence to immunosuppressive medication is essential to kidney graft success.</p><p><strong>Methods: </strong>We analyzed the longitudinal course of immunosuppressant adherence as measured with the Basel Assessment of Adherence to Immunosuppressive Medication Scale interview for up to 3-y duration of the Kidney Transplantation 360° study. Additionally, we examined putative baseline predictors of adherence trajectories. During the investigation period, patients participated in a multidisciplinary aftercare program consisting of case management, psychosocial and exercise assessments and interventions, including telemedicine support.</p><p><strong>Results: </strong>The analysis sample with at least 1 valid information on the Basel Assessment of Adherence to Immunosuppressive Medication Scale consisted of 838 adult patients (41.3% women) aged 52.3 y (SD 13.5). Adherence to immunosuppressants improved significantly during the Kidney Transplantation 360° aftercare program; however, at each assessment point, 17%-25% of the patients still reported suboptimal adherence. Baseline predictors for a better improvement of adherence were younger age, male sex, and a longer duration since transplantation. Those variables were associated with a lower adherence at baseline, and we detected a \"catch-up effect\" over time, which might have been supported by the comprehensive aftercare program.</p><p><strong>Conclusions: </strong>We believe that our aftercare program has supported the \"catch-up effect\" in adherence in younger male patients with a longer time after transplantation. However, the lack of a control group limits causal interpretations.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"11 8","pages":"e1813"},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}