Transplantation Direct最新文献

{"title":"Case Report: The Use of Cryopreserved Saphenous Vein in Reconstruction of Transplant Renal Artery Dissection","authors":"Jasmine C. Hwang, Michael J. Moritz","doi":"10.1097/TXD.0000000000001546","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001546","url":null,"abstract":"","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"40 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Czech-Slovak Intercountry Islet Autotransplantation—Brief Case Report","authors":"P. Girman, Jan Kriz, Lenka Németová, I. Leontovyc, K. Bittenglová, L. Nosáková, Miroslav Pindura, Patrik Horan, Peter Bánovčin, B. Palkóci, D. Osinová, Daniel Bolek, J. Miklušica","doi":"10.1097/TXD.0000000000001562","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001562","url":null,"abstract":"I slet autotransplantation is an effective procedure that prevents or lessens diabetes after a total pancreatectomy. Posttransplant insulin-independence rate may be as high as 30%, according to the recent data reported by experienced centers. 1 The procedure availability in various countries depends on the presence of an islet isolation laboratory. Transplantation success depends on the professional laboratory team and the number of islet isolations. Training the special isolation team is a long-term process, taking several years and requiring institutional support, funding, and overcoming the first period of unsuccessful isolations. Recent review of islet isolation facilities shows plenty of inactive or partially active laboratories. This is a significant obstacle to the further increase of islet transplantation numbers. 2","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"24 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical and Surgical Management of the Failed Pancreas Transplant","authors":"Michael J. Casey, N. Murakami, S. Ong, Joel T Adler, Neeraj Singh, Haris Murad, Sandesh Parajuli, Beatrice P. Concepcion, Michelle L. Lubetzky, M. Pavlakis, K. Woodside, Arman Faravardeh, A. Basu, E. Tantisattamo, A. Aala, Angelika G. Gruessner, D. Dadhania, K. Lentine, Matthew Cooper, Ronald F. Parsons, T. Alhamad","doi":"10.1097/TXD.0000000000001543","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001543","url":null,"abstract":"Despite the continued improvements in pancreas transplant outcomes in recent decades, a subset of recipients experience graft failure and can experience substantial morbidity and mortality. Here, we summarize what is known about the failed pancreas allograft and what factors are important for consideration of retransplantation. The current definition of pancreas allograft failure and its challenges for the transplant community are explored. The impacts of a failed pancreas allograft are presented, including patient survival and resultant morbidities. The signs, symptoms, and medical and surgical management of a failed pancreas allograft are described, whereas the options and consequences of immunosuppression withdrawal are reviewed. Medical and surgical factors necessary for successful retransplant candidacy are detailed with emphasis on how well-selected patients may achieve excellent retransplant outcomes. To achieve substantial medical mitigation and even pancreas retransplantation, patients with a failed pancreas allograft warrant special attention to their residual renal, cardiovascular, and pulmonary function. Future studies of the failed pancreas allograft will require improved reporting of graft failure from transplant centers and continued investigation from experienced centers.","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"28 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138633193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Postoperative Graft Inflammation in Pancreas Transplant Patients With Early Graft Thrombosis","authors":"Kristina Rydenfelt, G. Kjøsen, R. Horneland, J. Krey Ludviksen, Trond Geir Jenssen, P. Line, T. Tønnessen, T. E. Mollnes, H. Haugaa, Søren Erik Pischke","doi":"10.1097/TXD.0000000000001567","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001567","url":null,"abstract":"Background. Graft thrombosis is the main cause of early graft loss following pancreas transplantation, and is more frequent in pancreas transplant alone (PTA) compared with simultaneous pancreas-kidney (SPK) recipients. Ischemia-reperfusion injury during transplantation triggers a local thromboinflammatory response. We aimed to evaluate local graft inflammation and its potential association with early graft thrombosis. Methods. In this observational study, we monitored 67 pancreas-transplanted patients using microdialysis catheters placed on the pancreatic surface during the first postoperative week. We analyzed 6 cytokines, interleukin-1 receptor antagonist (IL-1ra), IL-6, IL-8, interferon gamma-induced protein 10 (IP-10), macrophage inflammatory protein 1β (MIP-1β), IL-10, and the complement activation product complement activation product 5a (C5a) in microdialysis fluid. We compared the dynamic courses between patients with pancreas graft thrombosis and patients without early complications (event-free) and between PTA and SPK recipients. Levels of the local inflammatory markers, and plasma markers C-reactive protein, pancreas amylase, and lipase were evaluated on the day of thrombosis diagnosis compared with the first week in event-free patients. Results. IL-10 and C5a were not detectable. Patients with no early complications (n = 34) demonstrated high IL-1ra, IL-6, IL-8, IP-10, and MIP-1β concentrations immediately after surgery, which decreased to steady low levels during the first 2 postoperative days (PODs). Patients with early graft thrombosis (n = 17) demonstrated elevated IL-6 (P = 0.003) concentrations from POD 1 and elevated IL-8 (P = 0.027) concentrations from POD 2 and throughout the first postoperative week compared with patients without complications. IL-6 (P < 0.001) and IL-8 (P = 0.003) were higher on the day of thrombosis diagnosis compared with patients without early complications. No differences between PTA (n = 35) and SPK (n = 32) recipients were detected. Conclusions. Local pancreas graft inflammation was increased in patients experiencing graft thrombosis, with elevated postoperative IL-6 and IL-8 concentrations, but did not differ between PTA and SPK recipients. Investigating the relationship between the local cytokine response and the formation of graft thrombosis warrants further research.","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"35 10","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138633015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Living-donor Lobar Lung Transplantation With BK Virus-related Hemorrhagic Cystitis Throughout the Perioperative Period","authors":"Y. Tomioka, S. Otani, S. Tanaka, K. Miyoshi, M. Okazaki, S. Sugimoto, M. Yamane, Shinichi Toyooka","doi":"10.1097/TXD.0000000000001556","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001556","url":null,"abstract":",","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"26 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Social Deprivation Among Living Kidney Donor–Recipient Pairs","authors":"MD Anne M. Huml, MD Yara Bilen, PhD Jesse D. Schold, MA Susana Arrigain, PhD R. Blake Buchalter","doi":"10.1097/TXD.0000000000001559","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001559","url":null,"abstract":"Background. Living kidney transplant is the most effective renal replacement therapy for patients with end-stage kidney disease. Community-level factors contribute to pervasive socioeconomic and racial disparities in access to living donor kidney transplantation. Little is known about social and environmental conditions between living donors and recipients. Further understanding of these relationships may enhance opportunities for transplantation. Methods. From 2010 to 2020, 59 575 living kidney donor–recipient pairs (≥18 y old) were identified using the Scientific Registry of Transplant Recipients. Living donors and recipients were geocoded to area-level social deprivation index (SDI). The primary outcome was difference between recipient and donor SDI. We used multivariable logistic regression to examine recipient and donor characteristics association with residence in different SDI communities. Results. Living kidney donation occurs across all strata of social deprivation; including when donors, recipients or both reside in more disadvantaged communities. Donor–recipient race combination and biological relationship are associated with differences in SDI. When compared with White recipients of White donors, Black and Hispanic recipients were more likely to reside in more disadvantaged areas (odds ratio = 2.41 [2.19-2.66] and 1.97 [1.78-2.19]). Recipients in anonymous and paired donations were more likely to reside in areas of more disadvantage than their donors (odds ratio = 1.27 [1.15-1.40] and 1.32 [1.23-1.41] compared with biological); attenuating socioeconomic disparities in access to living donor transplantation. Conclusions. Findings illustrate the social and environmental relationships between living kidney donor–recipient pairs that are important to develop targeted approaches and address barriers to living kidney transplantation. Best practices from areas of high deprivation with successful living kidney transplantation can be shared.","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"42 5","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138633171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Metabolic Measures Predict Long-term Insulin Independence in Recipients of Total Pancreatectomy and Islet Autotransplantation","authors":"Y. Nanno, James S. Hodges, Martin L. Freeman, G. Trikudanathan, S. Schwarzenberg, E. Downs, Karthik Ramanathan, Timothy L. Pruett, Gregory J. Beilman, S. Chinnakotla, Bernhard J. Hering, M. Bellin","doi":"10.1097/TXD.0000000000001561","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001561","url":null,"abstract":"Background. Although diabetes after total pancreatectomy and islet autotransplantation (TP-IAT) is one of the biggest concerns for TP-IAT recipients and physicians, reliable prediction of post-TP-IAT glycemic control remains unestablished. This study was conducted to identify early predictors of insulin independence and goal glycemic control by hemoglobin A1c (HbA1c) ≤ 6.5% after TP-IAT. Methods. In this single-center, retrospective study, patients who underwent TP-IAT (n = 227) were reviewed for simple metabolic markers or surrogate indices of β-cell function obtained 3 mo after TP-IAT as part of standard clinical testing. Long-term metabolic success was defined as (1) insulin independence and (2) HbA1c ≤ 6.5% 1, 3, and 5 y after TP-IAT. Single- and multivariate modeling used 3-mo markers to predict successful outcomes. Results. Of the 227 recipients, median age 31 y, 30% male, 1 y after TP-IAT insulin independence, and HbA1c ≤ 6.5% were present in 39.6% and 72.5%, respectively. In single-predictor analyses, most of the metabolic markers successfully discriminated between those attaining and not attaining metabolic goals. Using the best model selected by random forests analysis, we accurately predicted 1-y insulin independence and goal HbA1c control in 77.3% and 86.4% of the patients, respectively. A simpler “clinically feasible” model using only transplanted islet dose and BETA-2 score allowed easier prediction at a small accuracy loss (74.1% and 82.9%, respectively). Conclusions. Metabolic testing measures performed 3 mo after TP-IAT were highly associated with later diabetes outcomes and provided a reliable prediction model, giving valuable prognostic insight early after TP-IAT and help to identify recipients who require early intervention.","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"18 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138633201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts for the 2023 Transplantation Society of Australia and New Zealand Annual Scientific Meeting","authors":"","doi":"10.1097/txd.0000000000001560","DOIUrl":"https://doi.org/10.1097/txd.0000000000001560","url":null,"abstract":"","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"450 ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139022122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Postmortem Identification of Vascular Ehlers-Danlos Syndrome in a Lung Transplant Recipient: Erratum.","authors":"","doi":"10.1097/TXD.0000000000001570","DOIUrl":"https://doi.org/10.1097/TXD.0000000000001570","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/TXD.0000000000001469.].</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"9 12","pages":"e1570"},"PeriodicalIF":2.3,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462849","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 a HOPE Program in a Real-life Setting: A Brazilian Case Series.","authors":"Amanda P C S Boteon, Marisa R D Lima, Bianca Della Guardia, Mauricio F Carvalho, Andrea Schlegel, Yuri L Boteon","doi":"10.1097/TXD.0000000000001555","DOIUrl":"10.1097/TXD.0000000000001555","url":null,"abstract":"<p><strong>Background: </strong>Although hypothermic oxygenated perfusion (HOPE) improves posttransplant outcomes, setting up machine perfusion programs may be subjected to specific obstacles under different conditions. This study aims to describe the establishment of HOPE in a real-life setting in Brazil.</p><p><strong>Methods: </strong>Extended criteria donors in donation after brain death organs preserved by HOPE were accepted for higher-risk candidates needing expedited transplantation, perceived as those who would benefit most from the technique because of its limited availability. Extended criteria donors was defined by the Eurotransplant criteria. High-risk transplant candidates were characterized by suboptimal surgical conditions related to the recipient or the procedure.</p><p><strong>Results: </strong>Six HOPE-preserved grafts were transplanted from February 2022 to August 2022. The mean donor risk index was 1.7 (SD 0.5). One organ was severely steatotic, and 3 had an anticipated cold ischemia time above 12 h. Recipients' mean model for end-stage liver disease was 28.67 (SD 6.79), with 1 case of retransplant, 1 of refractory ascites, and 1 of acute-on-chronic liver failure. The mean cold ischemia time was 5 h 42 min (SD 82 min), HOPE 6 h 3 min (SD 150 min), and total preservation time 11 h 46 min (SD 184 min). No case had early allograft dysfunction. The mean length of hospital stay was 10 d with 100% graft and patient survival and no ischemic cholangiopathies at a median follow-up of 15 mo (min 12, max 18). Costs and country-specific legal regulations for device utilization were the major hurdles to implementing the program.</p><p><strong>Conclusion: </strong>We presented a pathway to introduce and rationalize the use of HOPE in a scenario of challenging donor-recipient matching with good results. These findings may aid in implementing machine perfusion programs, especially in settings with limited resources or complex transplant logistics.</p>","PeriodicalId":23225,"journal":{"name":"Transplantation Direct","volume":"9 12","pages":"e1555"},"PeriodicalIF":2.3,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719638","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}