Transplantation proceedings最新文献

{"title":"Belatacept Conversion in Kidney Transplant Recipients with Congestive Heart Failure: Survival and 30-Day Readmission Outcomes","authors":"Harshitha Mogallapalli ,&nbsp;Fauzia Osman ,&nbsp;Sandesh Parajuli ,&nbsp;Neetika Garg ,&nbsp;Fahad Aziz ,&nbsp;Arjang Djamali ,&nbsp;Brad C. Astor ,&nbsp;Maha A. Mohamed","doi":"10.1016/j.transproceed.2025.03.023","DOIUrl":"10.1016/j.transproceed.2025.03.023","url":null,"abstract":"<div><div>Calcineurin inhibitors (CNIs) are deleterious to cardiovascular risk in kidney transplant recipients (KTRs). Data on the impact of belatacept on KTRs with congestive heart failure (CHF) are scarce. We hypothesized that conversion to belatacept will have better patient and graft survival and a lower rate of readmissions within 30 days after discharge compared with long-term CNI use. We analyzed data from KTRs admitted to CHF between 2014 and 2019. A total of 28 recipients converted to belatacept and were matched with 339 who continued on CNIs. There was no significant difference in patient demographics, or primary disease between the two groups. The adjusted hazard ratio associated with conversion was (0.87 [95% CI, 0.35-2.11] for death, (0.91, [95% CI, 0.39-2.13] for graft failure and (adjusted hazard ratio, 1.91, [95% confidence interval (CI), 0.90–4.06]) for 30-day postdischarge readmission between the two groups. Patients converted to belatacept were at a higher risk of rejection (adjusted hazard ratio, 13.8; 95% CI, 7.48–25.3). Patient and graft survival and 30-day readmission after CHF hospital discharge did not differ significantly between belatacept conversion and CNI continuation. The incidence of rejection was higher in the belatacept conversion group, suggesting a need for closer follow-up of patients on belatacept therapy.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 771-776"},"PeriodicalIF":0.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083115","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":"Diagnostic Value of Color Doppler Ultrasound in Transplanted Renal Artery Stenosis","authors":"Yu Huimin,&nbsp;Kong Weina,&nbsp;Niu Ningning,&nbsp;Wu Hongtao,&nbsp;Zhang Guoying,&nbsp;Hao Xiaoye,&nbsp;Wang Jing,&nbsp;Tang Ying","doi":"10.1016/j.transproceed.2025.03.009","DOIUrl":"10.1016/j.transproceed.2025.03.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study is to investigate the diagnostic features and efficacy of ultrasonography in transplanted renal artery stenosis (TRAS).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We collected data from 20 patients diagnosed with TRAS via digital subtraction angiography (DSA) between July 2016 and January 2024 at the First Central Hospital of Tianjin. Additionally, we randomly selected 30 patients with normal blood flow and stable renal function following renal transplantation to serve as the control group. We utilized color Doppler ultrasound to assess various blood flow parameters, including the peak systolic velocity (PSV1) and diastolic velocity (EDV1) of the interlobar artery, the resistance index (RI) of the interlobar artery, and the systolic acceleration time (SAT) of the interlobar artery. We also measured the velocity of the interlobar vein (V), the peak systolic velocity (PSV2) and diastolic velocity (EDV2) at the stenosis site of the transplanted renal artery, the resistance index at the stenosis site, and the diameter of the stenosis of the transplanted renal artery (D). Concurrently, we recorded creatinine (Cr) levels within 24 hours. We compared the color Doppler ultrasound blood flow parameters of the TRAS group before interventional therapy with those of the control group and constructed ROC curves to determine the area and critical values under each parameter curve. We also selected cases post-stent implantation to compare the differences in color Doppler blood flow parameters before and after treatment, thereby analyzing the characteristics of hemodynamic changes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;PSV1, EDV1, interlobar RI, stenosis RI in the TRAS group were significantly lower than those in the control group (t = 6.976, &lt;em&gt;P = .&lt;/em&gt;000; T = 3.748, &lt;em&gt;P = .&lt;/em&gt;000; Z = -4.115, &lt;em&gt;P = .&lt;/em&gt;000; T = 6.537, &lt;em&gt;P = .&lt;/em&gt;000; Z = -4.979, &lt;em&gt;P = .&lt;/em&gt;000). Conversely, the PSV2, EDV2, SAT, and Cr levels in the TRAS group were higher than those in the control group (Z = -5.942, &lt;em&gt;P = .&lt;/em&gt;000; Z = -5.735, &lt;em&gt;P = .&lt;/em&gt;000; Z = -5.897, &lt;em&gt;P = .&lt;/em&gt;000; Z = -5.941, &lt;em&gt;P = .&lt;/em&gt;000). ROC curve analysis revealed that PSV2 exhibited the highest sensitivity and specificity for diagnosing TRAS, both at 100%, with a critical value of 205 cm/s. This was followed by the interlobar artery SAT, which showed a sensitivity of 95% and a specificity of 100%, with a critical value of 0.08 s. Additionally, after stent placement, the PSV1, EDV1, interlobar RI, and stenosis RI were significantly higher than before stent placement (Z = -5.17, &lt;em&gt;P = .&lt;/em&gt;000; Z = -2.695, &lt;em&gt;P = .&lt;/em&gt;019; T = 3.841, &lt;em&gt;P = .&lt;/em&gt;002; Z = -4.974, &lt;em&gt;P = .&lt;/em&gt;000). In contrast, the PSV2, EDV2, and Cr levels after stent placement were lower than those prior to the procedure (t = 7.518, &lt;em&gt;P = .&lt;/em&gt;000; T = 5.837, &lt;em&gt;P = .&lt;/em&gt;000; Z = 11.567, &lt;em&gt;P = .&lt;/em&gt;000).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Color doppler ultrasound is a","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 777-783"},"PeriodicalIF":0.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059299","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":"Improved Survival of Lung Transplant Patients With Subsequent Renal Transplant","authors":"Renita Wilson ,&nbsp;J. Asher Jenkins ,&nbsp;Juan Maria Farina ,&nbsp;Blake Langlais ,&nbsp;Jonathan D’Cunha ,&nbsp;Ashraf Omar ,&nbsp;Hasan Khamash ,&nbsp;Pedro Reck dos Santos","doi":"10.1016/j.transproceed.2025.04.007","DOIUrl":"10.1016/j.transproceed.2025.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplantation (LTx) is the definitive treatment for patients with end-stage pulmonary disease; however, the transplant process often results in variable degrees of renal dysfunction. Ultimately, some patients may require a subsequent renal transplant (RTx). A RTx as an intervention for LTx recipients with underlying kidney failure has been studied, but data about RTx to treat renal failure following LTx are limited. This study aims to explore factors that may predict the need for RTx after LTx and to analyze survival outcomes of this intervention.</div></div><div><h3>Methods</h3><div>The International Society for Heart and Lung Transplantation (ISHLT) Registry was utilized to compare 334 cases of RTx after LTx with 2 control groups who had (1) similarly impaired renal function (n = 1336), and (2) preserved renal function at the time of the LTx (n = 1336).</div></div><div><h3>Results</h3><div>We identified variables such as recipient age, body mass index (BMI), 6-minute walking distance (6-MWD), and history of diabetes as factors to be evaluated in the context of renal function at LTx. RTx post-LTx recipients demonstrated improved survival compared with LTx-only recipients with impaired renal function but worsened survival compared with LTx-only recipients with preserved renal function at LTx.</div></div><div><h3>Conclusions</h3><div>Thus, we identify a possible role for early RTx referral as a strategy to increase survival following LTx in patients with pre-existing renal dysfunction.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 849-858"},"PeriodicalIF":0.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061676","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 Novel Visible Method for Monitoring Kidney Rejection: Homologous Donor-Derived Sentinel Skin","authors":"Xiangke Rong ,&nbsp;Kai Wang ,&nbsp;Jiezhang Tang ,&nbsp;Jizhong Yang ,&nbsp;Huilong Wang ,&nbsp;Kepu Liu ,&nbsp;Zhibin Li ,&nbsp;Jing Li ,&nbsp;Geng Zhang ,&nbsp;Chenggang Yi","doi":"10.1016/j.transproceed.2025.03.027","DOIUrl":"10.1016/j.transproceed.2025.03.027","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Rejection in facial transplant patients is always accompanied by changes in skin appearance and can be monitored by observation of the skin. Acute rejection (AR) after kidney transplantation has a significant impact on the function of the transplanted kidney, which is relatively difficult to monitor. In this study, the skin of the same donor was used as a sentinel for monitoring the rejection of kidney transplantation.</div></div><div><h3>Methods</h3><div>A 3 cm × 5 cm skin was procured from the kidney donor and was grafted to the recipient at the same time as the kidney transplantation, to serve as a sentinel for monitoring AR. Postoperatively, kidney rejection was monitored by observing changes in the appearance of the sentinel skin (SS). The safety of this procedure was also evaluated by comparing the renal function in 12 patients in the sentinel skin graft group and 20 patients with kidney transplantation alone.</div></div><div><h3>Results</h3><div>The same immunosuppressive regimen was used postoperatively in patients with SS transplantation and those with kidney transplantation merely. There was also no statistical difference in creatinine and urea nitrogen between the 2 groups (<em>P</em> &gt; .05), but a difference in urine protein (UP) (<em>P</em> &lt; .05) in 2 weeks, 1and 2 months, which was lower in the test group, and no difference in 3 months. In addition, 1 patient had changes in the SS indicating rejection, while creatinine was normal at that time, which was followed by SS and kidney biopsy, suggesting both were of different grades of rejection.</div></div><div><h3>Conclusions</h3><div>SS combined with simultaneous kidney transplantation is a safe and feasible surgical approach. In particular, The SS holds promise for monitoring rejection and also sub-clinical rejection.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 793-798"},"PeriodicalIF":0.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065525","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":"Preemptive Conversion to mTOR Inhibition to Prevent Primary Cytomegalovirus Infection in Kidney Transplantation with High-Risk Serostatus","authors":"Jan Paulwitz ,&nbsp;Laura Vonbrunn ,&nbsp;Katharina Heller ,&nbsp;Anne Dieterle ,&nbsp;Hendrik Apel ,&nbsp;Mario Schiffer ,&nbsp;Michael S. Wiesener ,&nbsp;Thomas Dienemann","doi":"10.1016/j.transproceed.2025.03.029","DOIUrl":"10.1016/j.transproceed.2025.03.029","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplantation (KTx) is the treatment of choice for patients with end-stage renal disease. Cytomegalovirus (CMV) infection remains a serious complication of KTx. The most vulnerable patients are naïve recipients (R-) transplanted from a CMV-seropositive donor (D+). Mammalian target of rapamycin inhibitors (mTOR-I) have been shown to have advantages over mycophenolate in terms of CMV infections. In this study, we addressed the effect of preemptive conversion to mTOR-I before ending prophylaxis with valganciclovir in high-risk patients with a D+/R- CMV serostatus.</div></div><div><h3>Methods</h3><div>The study involved inclusion and analysis of all patients with D+/R- CMV serostatus before and after the protocol change with a conversion to mTOR-I at 6 months after KTx. The main study endpoints were primary CMV infection, maximal viral load, and hospitalization for CMV infection. Because prevention of primary CMV infections was the primary endpoint, we excluded breakthrough infections under prophylaxis.</div></div><div><h3>Results</h3><div>The primary analysis included 44 patients in the control group and 39 patients in the mTOR group. The 2 groups did not have any significant differences in clinical characteristics, immunosuppressive treatment, transplant function, and rates of rejection. Between 6 and 12 months (when mTOR-I were established), the mTOR group showed a numerically lower incidence of CMV infections, as well as numerically fewer hospitalizations. No serious complications were observed with mTOR-I.</div></div><div><h3>Conclusion</h3><div>Preemptive conversion from mycophenolate to mTOR-I may be helpful to prevent or attenuate primary infection in CMV high-risk kidney transplant recipients. Differences were not statistically significant. A larger study, ideally a prospective randomized trial, is needed to validate these findings.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 784-792"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049388","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":"Retrospective Analysis of the Effect of Sarcopenia on Mortality and Morbidity in Liver Transplant Patients","authors":"Ahmet Onur Demirel ,&nbsp;Uğur Topal ,&nbsp;Burak Yavuz ,&nbsp;Yunus Kaycı ,&nbsp;Cihan Atar ,&nbsp;Ahmet Gökhan Sarıtaş ,&nbsp;Abdullah Ülkü ,&nbsp;Ferhat Can Pişkin ,&nbsp;Atılgan Tolga Akçam","doi":"10.1016/j.transproceed.2025.03.016","DOIUrl":"10.1016/j.transproceed.2025.03.016","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia significantly influences morbidity and mortality in liver transplant recipients. The psoas muscle area index and prognostic nutritional index (PNI) are potential indicators of sarcopenia’s impact on postoperative outcomes. However, their association with postoperative morbidity and mortality in cadaveric liver transplant recipients remains underexplored.</div></div><div><h3>Methods</h3><div>Data from 52 patients who underwent cadaveric liver transplantation at Çukurova University over 10 years were analyzed. Sarcopenia was assessed using psoas muscle area index (cutoffs, 4.62 mm²/cm² for males and 2.66 mm²/cm² for females, based on Bahat et al) and PNI (cutoffs, ≤45 for low and &gt;45 for high, based on Li et al). Postoperative morbidity was evaluated using the Clavien–Dindo classification. The main outcomes were overall survival and morbidity rates.</div></div><div><h3>Results</h3><div>Sarcopenic patients had shorter survival (62.2 ± 16.4 months) compared with nonsarcopenic patients (83.6 ± 11.4 months), although this difference was not statistically significant (<em>P</em> = .370). Sarcopenia was more common in males, Child–Pugh C patients, those with ascites, American Society of Anesthesiologists score of ≥3, and a Clavien–Dindo grade of ≥3 patients. It was significantly associated with low body mass index and albumin levels (<em>P</em> &lt; .05) and was more prevalent in the low PNI group. A significant correlation was observed between PNI and Child–Pugh score (<em>P</em> = .012), alpha fetoprotein, and albumin levels (<em>P</em> = .007 and <em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>Sarcopenia negatively impacts survival, whereas a higher PNI correlates with a lower mortality risk. Further multicenter prospective studies with a larger population are needed to validate these findings.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 833-840"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047100","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":"Longitudinal Assessment of Solid Organ Transplant Recipients With SARS-CoV-2 Infection","authors":"Will Vuyk ,&nbsp;Max Bobholz ,&nbsp;Isla Emmen ,&nbsp;Andrew Lail ,&nbsp;Nicholas Minor ,&nbsp;Pavan Bhimalli ,&nbsp;Jens C. Eickhoff ,&nbsp;Hunter J. Ries ,&nbsp;Heather Machkovech ,&nbsp;Wanting Wei ,&nbsp;Andrea Weiler ,&nbsp;Alex Richardson ,&nbsp;Carson DePagter ,&nbsp;Grace VanSleet ,&nbsp;Maansi Bhasin ,&nbsp;Sarah Kamal ,&nbsp;Sydney Wolf ,&nbsp;Aanya Virdi ,&nbsp;Taylor Bradley ,&nbsp;Angela Gifford ,&nbsp;Jacqueline Garonzik-Wang","doi":"10.1016/j.transproceed.2025.04.004","DOIUrl":"10.1016/j.transproceed.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Compared with immunocompetent individuals, those who are immunocompromised, including solid organ transplant (SOT) recipients, have higher SARS-CoV-2-related morbidity and mortality. We determined the duration of SARS-CoV-2 RNA positivity to evaluate viral persistence in SOT recipients.</div></div><div><h3>Methods</h3><div>This study prospectively followed SOT recipients who recently tested positive for SARS-CoV-2. The duration of viral RNA shedding in nasal swabs and stool samples was tracked, and viral genome sequencing was performed where possible. Persistent infection was defined as a positive nucleic acid amplification test (NAAT) for SARS-CoV-2 at 28 days or later after initial infection. This duration was chosen based on the U.S. Centers for Disease Control and Prevention (CDC) recommendation that immunocompromised individuals isolate for at least 20 days [<span><span>1</span></span>], compared with 10 days for non-immunocompromised individuals.</div></div><div><h3>Results</h3><div>Of 30 SOT recipients, 12 (40%) had positive SARS-CoV-2 RNA in nasal swabs or stool (cycle threshold [Ct] &lt; 40) at 28 or more days after the first positive SARS-CoV-2 test. Immunocompromised (IC) subject 015 had high viral loads (Ct &lt; 30) at 28 days, with continued detection for 54 days.</div></div><div><h3>Conclusions</h3><div>In 12 of 30 SOT subjects, SARS-CoV-2 RNA was detected at or beyond 28 days post-detection (dpd), despite vaccination and antibody and/or antiviral treatment in most participants. Three subjects tested positive for SARS-CoV-2 RNA past 50 dpd. Viral persistence in the setting of host immune suppression, coupled with exposure to antiviral treatments, raises concern about the selection of unusual viral variants.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 922-930"},"PeriodicalIF":0.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060211","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":"Post-Transplant Self-Management, Self-Efficacy, and Subjective Well-Being in Heart Transplant Recipients: A Cross-Sectional Study","authors":"Jing Lai ,&nbsp;Danying Ma ,&nbsp;Wei Wang ,&nbsp;Lingzi Wu ,&nbsp;Yuan Liu","doi":"10.1016/j.transproceed.2025.04.002","DOIUrl":"10.1016/j.transproceed.2025.04.002","url":null,"abstract":"<div><h3>Aim</h3><div>To explore the current status and influencing factors of transplant recipients’ subjective well-being, self-management, and self-efficacy at home after heart transplantation (HTx).</div></div><div><h3>Method</h3><div>In this cross-sectional study, we used an online questionnaire to survey 83 HTx recipients who had been discharged from the largest HTx center in South China for more than 6 months. The time since transplantation ranged from 6 months to 14 years. Three self-assessment tools were used: the Chinese version of the Index of Wellbeing and Index of General Affect, the HTx self-management questionnaire, and the Self-Efficacy for Managing Chronic Disease 6-Item Scale.</div></div><div><h3>Results</h3><div>In this study, the well-being index ranged from 5.73 to 14.70 points, with a median of 12.60 (P25 = 10.79, P75 = 13.70). The overall subjective well-being of the HTx recipients was at a good level. Transplant recipients with a history of readmission (<em>Z</em> = 2.271, <em>P</em> = .023), unrecovered activity tolerance (<em>Z</em> = 3.532, <em>P</em> &lt; .001), ignorance of the content of cardiac rehabilitation (<em>Z</em> = 2.703, <em>P</em> = .007), and a negative attitude toward the transplant (<em>Z</em> = 2.438, <em>P</em> = .015) and preoperative use of inotropic agents (Z = 1.999, <em>P</em> = .046) had lower levels of well-being. Subjective well-being is positively related to self-management and self-efficacy, where the stronger the self-management, the higher the level of well-being and self-efficacy.</div></div><div><h3>Conclusions</h3><div>The HTx recipients in this study had higher overall levels of self-management, self-efficacy, and well-being. However, there remain problems associated with poor treatment compliance and poor home cardiac rehabilitation effectiveness. Transplant recipients whose activity tolerance has returned to pre-transplant levels have higher levels of self-management, suggesting that the transplant team should take measures to improve the treatment compliance of HTx recipients, as well as to provide home cardiac rehabilitation guidance to maximize the recovery of activity tolerance and improve the well-being of transplant recipients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 841-848"},"PeriodicalIF":0.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033699","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":"Sleep Quality and Its Influencing Factors in Hemodialysis and Renal Transplant Patients Across Various Stages","authors":"Xu Zhang ,&nbsp;Xu-Liang Yang ,&nbsp;Yao-Hong Liu ,&nbsp;Xin-Ping Lei ,&nbsp;Xu-Feng Zhang ,&nbsp;Qiu-Xiang Kang","doi":"10.1016/j.transproceed.2025.03.002","DOIUrl":"10.1016/j.transproceed.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>Sleep disorder is a prominent clinical symptom in CKD patients. It is highly prevalent and harmful and is related to numerous influencing factors. The aim of this study was to analyze the possible influencing factors of hemodialysis and renal transplant patients at different periods.</div></div><div><h3>Methods</h3><div>Twenty-six patients were selected in each of the following groups: hemodialysis (group A), 3 months after renal transplantation (group B), 3 to 12 months after renal transplantation (group C), and more than 1 year after renal transplantation (group D).The patients' sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI). This study collected clinical and laboratory data related to sleep problems, such as creatinine, calcium, phosphorus, potassium, hemoglobin, albumin and alkaline phosphatase, while also investigating psychological conditions such as depression and anxiety. Multiple linear regression was used to predict sleep status based on anxiety, depression, creatinine, blood calcium, blood phosphorus, blood potassium, hemoglobin and albumin.</div></div><div><h3>Results</h3><div>Compared with group A, the scores of PSQI in groups B and C were significantly lower, and the differences were statistically significant (<em>P</em> ≤ .05); however the differences were not significant in group D (<em>P</em> ≥ .05).Among the eight independent variables, anxiety, creatinine, and blood phosphorus significantly influenced sleep status (<em>P</em> ≤ .05). Conversely, depression, blood calcium, blood potassium, hemoglobin, and albumin did not show a statistically significant effect on sleep status (<em>P</em> ≥ .05).</div></div><div><h3>Conclusion</h3><div>After renal transplantation, patients' sleep status deteriorated after one year after surgery. Our study revealed that anxiety, creatinine and blood phosphorus were risk factors affecting sleep, which deserves our focused attention.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 723-731"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056228","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":"Effects of Treatment With Premarin Alone and the Combination of Premarin + Beclomethasone in Vaginal Involvement of GVHD After Hematopoietic Stem Cell Transplantation","authors":"Mansooreh Yaraghi ,&nbsp;Mohammadamin Noorafrooz ,&nbsp;Maryam Motezarre ,&nbsp;Seyed Asadollah Mousavi","doi":"10.1016/j.transproceed.2025.03.021","DOIUrl":"10.1016/j.transproceed.2025.03.021","url":null,"abstract":"<div><h3>Background</h3><div>Vaginal Graft-versus-Host Disease (GVHD) is a common complication after hematopoietic stem cell transplantation, leading to inflammation and fibrosis of the vaginal tissue. This study was conducted to compare the effectiveness of Premarin alone versus Premarin + Beclomethasone in patients with vaginal GVHD.</div></div><div><h3>Methods</h3><div>40 patients with vaginal GVHD after hematopoietic stem cell transplantation at (XXX) during the years 2018 to 2020 were randomly assigned to 2 groups: the Premarin recipient group (22 individuals) or the Premarin + Beclomethasone group (18 individuals). Symptoms, including vaginal dryness, dyspareunia, discharge, vaginal tightness, etc., were assessed before and after 6 weeks of treatment.</div></div><div><h3>Results</h3><div>After treatment, most symptoms improved in both groups. The Premarin group showed improvement in 21 out of 25 symptoms (84%), while the combination group demonstrated improvement in 22 out of 25 symptoms (88%), with no significant difference between the groups (<em>P &gt;</em> .05). The only symptom with significantly greater improvement in the combination group was vaginal tightness, which occurred in 3 out of 18 patients (17%) compared to 1 out of 22 patients (4.5%) in the Premarin group (<em>P</em> = .03).</div></div><div><h3>Conclusions</h3><div>The combination of Premarin and Clobetasol is more effective than Premarin alone, particularly in cases of vaginal tightness. Other symptoms may be associated with atrophic manifestations.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 885-890"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000998","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}