Transplantation proceedings最新文献

{"title":"Long-Term Outcomes of Kidney Transplantation With Inferior Vena Cava Outflow: A Single Center Experience","authors":"Andreia Ministro,&nbsp;Mickael Henriques,&nbsp;Bernardo Marques da Silva,&nbsp;Alice Santana,&nbsp;Teresa Pereira,&nbsp;Carlos Miranda,&nbsp;José Lopes,&nbsp;Luís Mendes Pedro,&nbsp;Augusto Ministro","doi":"10.1016/j.transproceed.2026.02.026","DOIUrl":"10.1016/j.transproceed.2026.02.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Standard renal transplantation uses external iliac vessels. Iliac or IVC occlusion often excludes candidates, but a patent proximal IVC offers an alternative outflow.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed kidney transplants with IVC anastomosis at a tertiary hospital (Jan 2000–Aug 2024). Outcomes were 30-day mortality and long-term graft survival.</div></div><div><h3>Results</h3><div>Among 1235 transplants, 14 required IVC anastomosis. Median follow-up was 110 months; median age 34 years; 8/14 were men. Indications included ilio-cava thrombosis, multiple transplants, or adult grafts in low-weight children. Thirteen grafts were placed in the right iliac fossa, one intraperitoneally; 10 were right kidneys, 12 from deceased donors. Seven cases used donor vena cava for vein extension. Two grafts failed (humoral rejection at 5 years; acute ischemia at 3 months). Remaining grafts functioned with mean creatinine 1.55 mg/dL at 5 years. No patient died within 30 days.</div></div><div><h3>Conclusion</h3><div>With longer End Stage Renal Disease survival, cases with limited vascular access or multiple transplants will rise. Proximal IVC anastomosis, though complex, is feasible and provides durable venous drainage.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1238-1240"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438763","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":"Liver Transplant Outcomes in Patients with Nontumoral Portal Vein Thrombosis: A Decade of Single-Center Experience in Latin America","authors":"Grecia Lizzetti-Mendonza,&nbsp;Daniel Reis Waisberg,&nbsp;Rodrigo Bronze Martino,&nbsp;Jhosimar Alvarez,&nbsp;Ricardo Ozelame,&nbsp;Rafael Soares Pinheiro,&nbsp;Vinícius Rocha-Santos,&nbsp;Liliana Ducatti,&nbsp;Rubens Macedo Arantes,&nbsp;João Paulo Costa Santos,&nbsp;Paola Espinoza Alvarez,&nbsp;Pedro Marin-Castro,&nbsp;Luciana Bertocco Haddad,&nbsp;Flavio Henrique Galvão,&nbsp;Wellington Andraus","doi":"10.1016/j.transproceed.2026.06.018","DOIUrl":"10.1016/j.transproceed.2026.06.018","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Portal vein thrombosis (PVT) remains a challenging condition in liver transplantation (LT). The impact of reconstruction techniques remains controversial, especially in Latin America. This study aimed to evaluate early and late outcomes of LT in patients with PVT at a high-volume Brazilian center.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Portal vein thrombosis (PVT) remains a challenging condition in liver transplantation (LT). The impact of reconstruction techniques remains controversial, especially in Latin America. This study aimed to evaluate early and late outcomes of LT in patients with PVT at a high-volume Brazilian center.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Retrospective single-center study including adult patients with intraoperatively confirmed PVT undergoing LT between January 2015 and December 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Retrospective single-center study including adult patients with intraoperatively confirmed PVT undergoing LT between January 2015 and December 2024.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 1088 eligible LTs, 207 (19.02%) had PVT. Median recipient age was 59 years, and 68.59% were male. The median MELD-Na score was 17, and MELD exception points were granted to 141 patients. PVT was graded as Yerdel I in 46.85%, II in 27.05%, III in 13.52%, and IV in 12.56% of patients. Anatomical reconstruction was performed in 78.74%. Nonanatomical reconstructions were performed in 44 cases (21.25%), including 16 superior mesenteric vein jump grafts, 12 portal vein anastomoses to enlarged varices, 9 renoportal anastomoses, 5 dual-inflow reconstructions, and 2 portal vein arterialization. Perioperative survival was 86.0%. Independent predictors of decreased 30-day survival were nonanatomical portal reconstruction (&lt;em&gt;P&lt;/em&gt; = .04), primary graft nonfunction (&lt;em&gt;P&lt;/em&gt; &lt; .01), and higher intraoperative packed red blood cell transfusion (&lt;em&gt;P&lt;/em&gt; = .013). Long-term survival was significantly lower in patients requiring nonanatomical reconstruction or postoperative hemodialysis (&lt;em&gt;P&lt;/em&gt; &lt; .01). Yerdel grade, MELD score, donor risk index, and graft steatosis were not associated with mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Among 1088 eligible LTs, 207 (19.02%) had PVT. Median recipient age was 59 years, and 68.59% were male. The median MELD-Na score was 17, and MELD exception points were granted to 141 patients. PVT was graded as Yerdel I in 46.85%, II in 27.05%, III in 13.52%, and IV in 12.56% of patients. Anatomical reconstruction was performed in 78.74%. Nonanatomical reconstructions were performed in 44 cases (21.25%), including 16 superior mesenteric vein jump grafts, 12 portal vein anastomoses to enlarged varices, 9 renoportal anastomoses, 5 dual-inflow reconstructions, and 2 portal vein arterialization. Perioperative survival was 86.0%. Independent predictors of decreased 30-day survival were nonanatomical portal reconstruction (&lt;em&gt;P&lt;/em&gt; = .04), primary graft nonfunction (&lt;em&gt;P&lt;/em&gt; &lt; .01), and higher intraoperative packed red blood ce","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1336-1342"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451166","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":"Conventional Liver Retransplantation with Caval Replacement for Suprahepatic Inferior Vena Cava Stenosis Secondary to a Malpositioned TIPS: A Case Report","authors":"Maciana Santos Silva,&nbsp;Daniel Reis Waisberg,&nbsp;Vinicius Rocha-Santos,&nbsp;Rodrigo Bronze Martino,&nbsp;Rubens Macedo Arantes,&nbsp;Rafael Soares Pinheiro,&nbsp;Liliana Ducatti,&nbsp;Isabela Couto Mendonça,&nbsp;Luciana Bertocco Haddad,&nbsp;Airton Mota Moreira,&nbsp;Francisco Cesar Carnevale,&nbsp;Wellington Andraus","doi":"10.1016/j.transproceed.2026.07.004","DOIUrl":"10.1016/j.transproceed.2026.07.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established bridging therapy for the management of severe complications of portal hypertension. However, the impact of long-standing malpositioned TIPS on liver transplantation remains scarcely reported</div></div><div><h3>Case Report</h3><div>A 64-year-old male with alcoholic cirrhosis and refractory hepatic hydrothorax underwent TIPS placement with sustained clinical benefit for nearly 8 years. He later developed refractory ascites and recurrent hepatic encephalopathy and was listed for liver transplantation. He subsequently underwent the procedure using the piggyback technique, requiring venoplasty of the lateral wall of the inferior vena cava due to extensive pericaval fibrosis associated with a long-standing malpositioned TIPS, which was markedly protruded into the right atrium. Within 48 hours, the patient developed primary non-function and required emergent retransplantation. Intraoperatively, pressure measurements demonstrated a gradient between the infrahepatic and suprahepatic vena cava (16 and 9 mmHg, respectively), consistent with significant hepatic venous outflow obstruction. Extensive residual fibrosis near the suprahepatic inferior vena cava was also observed. The conventional technique with caval replacement was used, allowing resection of the stenotic suprahepatic inferior vena cava segment affected by fibrosis secondary to the malpositioned TIPS. At the end of the procedure, venous pressures were equalized between the suprahepatic and infra-renal inferior vena cava (10 mm Hg). The patient recovered uneventfully and is currently under outpatient follow-up.</div></div><div><h3>Conclusion</h3><div>Long-term TIPS-related anatomical alterations, particularly in the setting of malposition, may increase surgical complexity during liver transplantation and require tailored operative strategies. Awareness of these challenges by the transplant team is essential to optimize outcomes in this unique patient population.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1414-1418"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633480","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":"Barth Syndrome and Referral to Heart Transplantation: Single-Center Experience and Literature Review","authors":"Juliana Roberta Motta Ragozzino,&nbsp;Adailson Wagner Siqueira,&nbsp;Nana Miura,&nbsp;Estela Azeka","doi":"10.1016/j.transproceed.2026.07.013","DOIUrl":"10.1016/j.transproceed.2026.07.013","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Barth syndrome is an X-linked mitochondrial disorder caused by pathogenic variants in the &lt;em&gt;TAZ&lt;/em&gt; gene, resulting in impaired cardiolipin remodeling and mitochondrial dysfunction. Cardiomyopathy is the most prominent manifestation, often presenting in early infancy and potentially progressing to advanced heart failure requiring heart transplantation. Due to phenotypic overlapping with other cardiac diseases, diagnosis is frequently delayed. The aim of this study was to describe our experience with pediatric patients with Barth syndrome referred to heart transplantation and their clinical outcomes at the largest heart transplantation center in Latin America.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Barth syndrome is an X-linked mitochondrial disorder caused by pathogenic variants in the &lt;em&gt;TAZ&lt;/em&gt; gene, resulting in impaired cardiolipin remodeling and mitochondrial dysfunction. Cardiomyopathy is the most prominent manifestation, often presenting in early infancy and potentially progressing to advanced heart failure requiring heart transplantation. Due to phenotypic overlapping with other cardiac diseases, diagnosis is frequently delayed. The aim of this study was to describe our experience with pediatric patients with Barth syndrome referred to heart transplantation and their clinical outcomes at the largest heart transplantation center in Latin America.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We retrospectively reviewed pediatric patients with Barth syndrome referred for heart transplantation evaluation at the Heart Institute (InCor), University of São Paulo Medical School, between 1992 and 2025. Clinical characteristics, heart failure severity, transplant evaluation, treatment response, listing status, and outcomes were described.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We retrospectively reviewed pediatric patients with Barth syndrome referred for heart transplantation evaluation at the Heart Institute (InCor), University of São Paulo Medical School, between 1992 and 2025. Clinical characteristics, heart failure severity, transplant evaluation, treatment response, listing status, and outcomes were described.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We retrospectively reviewed three pediatric patients with genetically confirmed Barth syndrome referred to our center for heart transplantation evaluation. Despite severe early cardiac involvement, they exhibited markedly different heart failure trajectories. Barth syndrome cardiomyopathy follows a highly heterogeneous clinical course. Although some patients demonstrate significant recovery with optimized heart failure therapy, others progress to end-stage heart failure requiring transplantation. Our experience reinforces that early referral to pediatric heart transplant centers and individualized transplant listing based on longitudinal clinical evolution, rather than left ventricular ejection fraction alone, may optimize patient outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We retrospectively reviewed three pediatric patients with genetically confir","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1353-1355"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703304","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":"Evaluation of Accuracy of Estimated Ideal Body Weight in Hemodialysis Patients: Comparison of Measured Weight and Blood Pressure Control After Renal Transplantation","authors":"Lucas de Queiroz,&nbsp;Claudia de Oliveira,&nbsp;Tainá Veras de Sandes-Freitas","doi":"10.1016/j.transproceed.2026.07.006","DOIUrl":"10.1016/j.transproceed.2026.07.006","url":null,"abstract":"<div><h3>Introduction</h3><div>End-stage chronic kidney disease is a growing problem, and the management of dry weight in hemodialysis patients remains a challenge. Clinical assessment for estimating dry weight is the main method used in medical practice. This study aimed to evaluate the accuracy of clinical estimation of dry weight and to investigate associated factors that impact this measurement</div></div><div><h3>Method</h3><div>This retrospective study included 74 renal graft recipients from a university hospital between 2020 and 2023, with an estimated glomerular filtration rate ≥ 45 mL/min/1.73 m² at the evaluation time points of 15 or 30 days post-transplantation. Pre-transplant estimated dry weight, post-transplant measured weight, number of antihypertensive medications, and other variables were analyzed</div></div><div><h3>Results</h3><div>The sensitivity of clinical assessment in estimating pre-transplant dry weight was 62.5% and 75%, and the specificity was 61.9% and 76.2% at 15 and 30 days post-transplantation, respectively. In the sample, 41.9% of the evaluated recipients presented a measured weight one month after transplantation that was lower than the dry weight estimated during dialysis (variation greater than 3%), along with a reduction in the number of antihypertensive medications from 1.58 ± 1.31 to 1.04 ± 1.08</div></div><div><h3>Conclusion</h3><div>Clinical estimation of dry weight demonstrates limited accuracy, highlighting the need for new cost-effective methods to improve volume management in hemodialysis patients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1241-1246"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703355","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":"Inflammatory Pseudotumor Due to Actinomycosis Simulating Post-Transplant Lymphoproliferative Disorder","authors":"Grecia Lizzetti-Mendoza,&nbsp;Daniel Reis Waisberg,&nbsp;Gabriel Bayona-Alvarado,&nbsp;Ricardo Ozelame,&nbsp;Liliana Ducatti,&nbsp;Rubens Macedo Arantes,&nbsp;Rodrigo Bronze Martino,&nbsp;Vinicius Rocha-Santos,&nbsp;Rafael Soares Pinheiro,&nbsp;Luciana Bertocco Haddad,&nbsp;Maciana Santos Silva,&nbsp;Ryan Yukimatsu Tanigawa,&nbsp;Manoel Souza Rocha,&nbsp;Alice Tung Wan Song,&nbsp;Wellington Andraus","doi":"10.1016/j.transproceed.2026.04.014","DOIUrl":"10.1016/j.transproceed.2026.04.014","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Rare pathology with low clinical suspicion and high risk of underdiagnosis.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Nonspecific clinical and imaging presentation that may mimic neoplastic processes.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Diagnostic difficulty due to the low sensitivity of imaging studies and cultures.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Histopathology as the key element for etiological confirmation.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Potentially curable disease with prolonged antibiotic therapy and favorable prognosis.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Hepatic actinomycosis is a rare infection caused by anaerobic, gram-positive &lt;em&gt;Actinomyces&lt;/em&gt; bacteria. Liver involvement represents 5% of all actinomycosis cases and usually occurs secondary to intra-abdominal infections, spreading via the porto-mesenteric venous system. Clinical symptoms and imaging findings are typically heterogeneous and nonspecific, often mimicking malignant tumors, which makes diagnosis difficult and frequently one of exclusion. Immunosuppressed patients, including liver transplant recipients, have increased risk and the disease should be considered when a solitary or atypical hepatic mass is detected.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Hepatic actinomycosis is a rare infection caused by anaerobic, gram-positive &lt;em&gt;Actinomyces&lt;/em&gt; bacteria. Liver involvement represents 5% of all actinomycosis cases and usually occurs secondary to intra-abdominal infections, spreading via the porto-mesenteric venous system. Clinical symptoms and imaging findings are typically heterogeneous and nonspecific, often mimicking malignant tumors, which makes diagnosis difficult and frequently one of exclusion. Immunosuppressed patients, including liver transplant recipients, have increased risk and the disease should be considered when a solitary or atypical hepatic mass is detected.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Case Report&lt;/h3&gt;&lt;div&gt;The case discussed involves a female patient who underwent living-donor liver transplantation and biliodigestive anastomosis in 2018 for cirrhosis secondary to hepatitis B virus infection. She developed chronic biliary stenosis managed with periodic exchanges of percutaneous transhepatic biliary drain. In 2024, she presented with catheter displacement and peri-drain bile leakage. An abdominal computed tomography scan revealed a 150 mL hepatic collection compatible with abscess. Percutaneous drainage and antibiotics were started, but poor clinical and radiologic response raised suspicion for post-transplant lymphoproliferative disorder. A guided liver biopsy ultimately identified &lt;em&gt;Actinomyces sp&lt;/em&gt;., confirming hepatic actinomycosis. Treatment with intravenous ampicillin for 1 month led to major improvement and 90% lesion resolution. She was discharged on oral amoxicillin-clavulanate for additional 3 months, with outpatient follow-up demonstrating favorable clinical response.&lt;/div&gt;&lt;/","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1326-1329"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059041","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":"Hepatic Artery Thrombosis After Liver Transplantation: Treatment and Outcomes at a Brazilian Tertiary Center","authors":"Paolla Ravida Alves de Macedo,&nbsp;Lara Garcia Victório Pessotto,&nbsp;Fernanda Dias Teramoto,&nbsp;Júlia Caixeta Loureiro,&nbsp;Aline Garcia,&nbsp;Beatriz Piaulino de Araujo,&nbsp;Carla Batista Moísés,&nbsp;Alexandre Foratto,&nbsp;Cristian Jaillita Meneses,&nbsp;Guilherme Gomes de Almeida Lacerda,&nbsp;Ilka de Fatima Santana Boin,&nbsp;Simone Reges Perales,&nbsp;Elaine Cristina de Ataide","doi":"10.1016/j.transproceed.2026.04.012","DOIUrl":"10.1016/j.transproceed.2026.04.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Liver transplantation (LT) is the main treatment for liver cirrhosis and other conditions. Hepatic artery thrombosis (HAT) is a complication described in up to 15% of LTs in adults.</div></div><div><h3>Objective</h3><div>To evaluate the characteristics of patients who developed HAT, describe the different treatments performed in a tertiary center, and compare outcomes.</div></div><div><h3>Methods</h3><div>This study is a retrospective cohort study based on medical record review of patients who underwent LT between January 2013 and December 2023.</div></div><div><h3>Results</h3><div>A total of 548 LTs were evaluated, of which 88 patients (16.05%) developed HAT. The proposed treatments were: expectant management in 7 patients (7.95%); endovascular treatment in 14 patients (15.90%); and LrT in 59 patients (67.05%). All patients in the expectant management group died, with a mean survival of 672.8 days (range 93-1583); 1- and 5-year mortality 40% and 100%, respectively. In the endovascular treatment group, 9 patients (69.23%) died, with a mean survival of 132 days (range 4-571); 1- and 5-year survival rates were 38.46% and 30.76%, respectively. Among patients indicated for LrT, 23 (26.13%) died before undergoing the procedure; thus, LrT was performed in 36 patients (40.9% of diagnosed HAT and 61.01% of those listed for re-LT). Of these, 22 (61.11%) died, with a post–LrT mean survival of 1290.45 days (range 1-4184); 1- and 5-year survival rates were 55.55% and 38.88%, respectively.</div></div><div><h3>Conclusion</h3><div>HAT after LT represents a therapeutic challenge. Endovascular management was associated with positive outcomes; however, Lrt demonstrated the greatest long-term survival benefit.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1305-1307"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059081","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":"Improving Medication Adherence in Kidney Transplant Recipients Through Educational Intervention and Monitoring: A Randomized Clinical Trial","authors":"Carolina Heinrich de Oliveira,&nbsp;Anita Schweig,&nbsp;Beatriz Paganin Gonçalves,&nbsp;Carolina Andrade Bissani,&nbsp;Maria Antônia Peres Saldanha,&nbsp;Alessandra Dalla Rosa Santini,&nbsp;Evellinne Riva,&nbsp;Helena Dai Prá Maestri,&nbsp;Rafael Vianna Behr,&nbsp;Leonardo Viliano Kroth","doi":"10.1016/j.transproceed.2026.05.011","DOIUrl":"10.1016/j.transproceed.2026.05.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Kidney graft survival after transplantation is highly dependent on continuous adherence to immunosuppressive therapy. Poor adherence is a significant cause of graft loss, and educational interventions to optimize care have been proposed. We evaluated the effect of standardized educational interventions on knowledge, adherence, and clinical outcomes in kidney transplant recipients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Kidney graft survival after transplantation is highly dependent on continuous adherence to immunosuppressive therapy. Poor adherence is a significant cause of graft loss, and educational interventions to optimize care have been proposed. We evaluated the effect of standardized educational interventions on knowledge, adherence, and clinical outcomes in kidney transplant recipients.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this randomized clinical trial including 59 patients, the intervention group (n = 31) received 2 health education sessions (video, booklet, and oral explanations), while the control group (n = 28) received only routine discharge guidance. Patients’ knowledge was assessed using a questionnaire before and after the intervention, and adherence was measured with the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). Clinical outcomes were monitored for 12 months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;In this randomized clinical trial including 59 patients, the intervention group (n = 31) received 2 health education sessions (video, booklet, and oral explanations), while the control group (n = 28) received only routine discharge guidance. Patients’ knowledge was assessed using a questionnaire before and after the intervention, and adherence was measured with the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS). Clinical outcomes were monitored for 12 months.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Educational interventions had a highly significant impact on patients’ knowledge. At 1 week after discharge, the intervention group scored significantly higher than the control group (7.5 vs 5.1; &lt;em&gt;P&lt;/em&gt; &lt; .001). Adherence assessed by BAASIS at 6 months was statistically similar in the 2 groups (45.2% vs 39.3%; &lt;em&gt;P&lt;/em&gt; = .697). No statistically significant between-group differences were observed in rejection rates, infections, or survival during the first year.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Educational interventions had a highly significant impact on patients’ knowledge. At 1 week after discharge, the intervention group scored significantly higher than the control group (7.5 vs 5.1; &lt;em&gt;P&lt;/em&gt; &lt; .001). Adherence assessed by BAASIS at 6 months was statistically similar in the 2 groups (45.2% vs 39.3%; &lt;em&gt;P&lt;/em&gt; = .697). No statistically significant between-group differences were observed in rejection rates, infections, or survival during the first year.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Educational interventions proved to be an effective strategy to increase patients’ knowledge about post-transplantation t","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1247-1250"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280771","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":"Living Donor Kidney Transplantation: Comparison of Graft Survival Between First and Second Transplants—A Single-Center Experience","authors":"Beatriz Cortez Ferreira,&nbsp;Sofia Ventura,&nbsp;Clara Pardinhas,&nbsp;Rita Leal,&nbsp;Luís Rodrigues,&nbsp;Maria Guedes Marques,&nbsp;Lídia Santos,&nbsp;Catarina Romãozinho,&nbsp;Helena Sá,&nbsp;Arnaldo Figueiredo","doi":"10.1016/j.transproceed.2026.06.008","DOIUrl":"10.1016/j.transproceed.2026.06.008","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Second living donor kidney transplantation achieved graft survival comparable to first transplantation.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Favorable outcomes were observed despite higher immunological risk in retransplanted recipients.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Risk-adapted induction therapy and living donor advantages may mitigate retransplantation risk.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Kidney transplantation is the optimal renal replacement therapy, offering superior survival and quality of life compared with dialysis. Although outcomes after repeat transplantation may be inferior to those of first transplantation, retransplantation provides a survival benefit compared with remaining on dialysis. Living donor kidney transplantation (LDKT) offers advantages such as improved HLA matching and reduced cold ischemia time, potentially mitigating retransplantation-related risks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Kidney transplantation is the optimal renal replacement therapy, offering superior survival and quality of life compared with dialysis. Although outcomes after repeat transplantation may be inferior to those of first transplantation, retransplantation provides a survival benefit compared with remaining on dialysis. Living donor kidney transplantation (LDKT) offers advantages such as improved HLA matching and reduced cold ischemia time, potentially mitigating retransplantation-related risks.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a retrospective single-center study including all LDKT performed at ULS Coimbra between 2009-2020, with a mean follow-up of 9 years. Clinical and immunological donor–recipient variables were collected. Death-censored graft survival was assessed using Kaplan–Meier analysis and univariable Cox regression was used to explore predictors of graft loss. Acute rejection was defined according to Banff 2019 criteria.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We performed a retrospective single-center study including all LDKT performed at ULS Coimbra between 2009-2020, with a mean follow-up of 9 years. Clinical and immunological donor–recipient variables were collected. Death-censored graft survival was assessed using Kaplan–Meier analysis and univariable Cox regression was used to explore predictors of graft loss. Acute rejection was defined according to Banff 2019 criteria.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Seventy-six patients were included: 63 underwent a first LDKT and 13 a second LDKT. Baseline characteristics were similar regarding gender, dialysis vintage, HLA mismatches, and cold ischemia time. Second LDKT recipients were older (42 vs 33 years, p = 0.025), had higher historical panel reactive antibody levels, and more frequently received thymoglobulin induction (69.2% vs 16.7%, p &lt; 0.001). Serum creatinine at 1 year was associated with graft loss (p = 0.007). Acute rejection was rare (4% vs 0%). Five- and 10-year death-censored graft survival was comparable between f","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1267-1269"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406915","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":"Surgical Site Infection in Lung Transplantation: Clinical Impact and Predictive Factors: Analysis From the Portuguese Lung Transplantation Center","authors":"Catarina Pereira Moita,&nbsp;Zenito Cruz,&nbsp;Ana Inácio,&nbsp;Catarina Figueiredo,&nbsp;Ana Rita Costa,&nbsp;João Maciel,&nbsp;João Santos Silva,&nbsp;João Eurico Reis,&nbsp;Alexandra Borba,&nbsp;Paulo Calvinho,&nbsp;Luísa Semedo","doi":"10.1016/j.transproceed.2026.06.027","DOIUrl":"10.1016/j.transproceed.2026.06.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical site infection (SSI) after lung transplantation is an under-reported complication, despite its potential impact on postoperative morbidity and clinical outcomes. This study aims to evaluate the clinical impact and identify predictors of SSI in lung transplant recipients.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted including patients who underwent lung transplantation at the Portuguese Lung Transplantation Center between January 2016 and December 2024, with follow-up until June 2025. Univariate and multivariate analyses were performed to identify independent predictors.</div></div><div><h3>Results</h3><div>Among 316 transplanted patients, 25 (7.9%) developed SSI. Deep infections represented 80% of cases, including 5 with sternal osteomyelitis, occurring at a median of 25 days post-transplant (IQR: 17–43). Gram-negative bacteria were most frequently isolated, particularly <em>Enterobacteriaceae</em>. Negative-pressure wound therapy was used in 17 (68%) patients, and 8 (32%) required surgical debridement. Patients with SSI were older, predominantly female and had a higher body mass index (BMI). Moreover, they presented significantly longer ICU stay, drainage duration and hospital stay (all <em>p</em> &lt; .05). No significant differences were observed regarding primary graft dysfunction, acute or chronic rejection, or mortality. In multivariate analysis, female sex (OR 3.15; 95% CI: 1.33–7.48) and higher BMI (OR 1.21; 95% CI: 1.05–1.32) were risk factors for SSI.</div></div><div><h3>Conclusion</h3><div>SSI after lung transplantation is associated with significant postoperative morbidity, underscoring that this complication, although underestimated, remains clinically relevant. The incidence observed in our center (7.9%) is comparable to that reported in the literature. Early identification of high-risk patients may support the implementation of tailored strategies and optimize perioperative management.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1359-1366"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451179","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}