Transplantation proceedings最新文献

{"title":"Tolerability and Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists in Lung Transplant Recipients: A Single Center Report","authors":"Claire E. Fishman ,&nbsp;Ciara Walshe ,&nbsp;Tamara Claridge ,&nbsp;Stephanie Witek ,&nbsp;Krishna Pandya ,&nbsp;Jason D. Christie ,&nbsp;Joshua M. Diamond ,&nbsp;Michaela R. Anderson","doi":"10.1016/j.transproceed.2024.11.016","DOIUrl":"10.1016/j.transproceed.2024.11.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetes and obesity increase risk of death after lung transplantation. Optimal treatment of diabetes and obesity may improve post-transplant outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are FDA-approved to treat diabetes and obesity and demonstrate improvement in renal and cardiovascular outcomes in the general population. However, side effects may limit tolerability in lung transplant recipients. We hypothesized that GLP-1RA would be stopped due to side effects in a higher proportion of lung transplant recipients compared to the general population but result in weight loss for those who were able to tolerate them.</div></div><div><h3>Methods</h3><div>We performed a single-center case series of lung transplant recipients initiated on a GLP-1RA post-transplant between April 1, 2005 and December 31, 2023. We assessed side effects and complications during GLP-1RA use. Weight was assessed at time of GLP-1RA initiation and 3-, 6-, and 12-months postinitiation.</div></div><div><h3>Results</h3><div>Fifty-nine lung transplant recipients initiated a GLP-1RA during the study period with a median (IQR) total time of use of 590 (280-891) days. Thirty-seven percent (22/59) stopped the medication due to side effects, with nausea and vomiting being most common. The median (IQR) percent change in weight at 12-months post-GLP-1RA initiation was -2.5% (-8.7% to 1.5%).</div></div><div><h3>Discussion</h3><div>We report the largest study evaluating GLP-1RA use in lung transplant recipients. Discontinuation rates are higher and weight loss is lower than in the general population. However, most lung transplant recipients tolerated long-term use of GLP-1RA. Further work is required to identify which recipients are most likely to benefit and how to optimize tolerability.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 342-347"},"PeriodicalIF":0.8,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796747","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":"Paired Exchange Living Donor Liver Transplantation: A Single Center Experience From Turkiye","authors":"Ayhan Dinckan ,&nbsp;Eryigit Eren ,&nbsp;Fatih Ensaroglu ,&nbsp;Taylan Sahin ,&nbsp;Hakan Parlak ,&nbsp;Ali Kocyigit ,&nbsp;Utku Alkara ,&nbsp;Murat Akyildiz ,&nbsp;Mehmet Tokac","doi":"10.1016/j.transproceed.2024.11.002","DOIUrl":"10.1016/j.transproceed.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>In countries with low rates of deceased donor solid organ transplantations, live-donor liver transplantation is the preferred definitive treatment for children and adults with end-stage liver disease. However, it is known that a remarkable number of potential living liver donors are rejected due to ABO incompatibility, suboptimal liver mass, or anatomical features. Paired exchange liver transplantation (PELT) practice emerged to overcome these obstacles. Herein, we present the results of our single-center experience with PELT and compare them with previously reported data.</div></div><div><h3>Methods</h3><div>Patients who underwent PELT between January 2015 and December 2022 constituted the target population. The collected recipient data included demographic parameters, the model for end-stage liver disease score, graft-recipient weight ratio, indication for LT and paired exchange, body-mass index, duration of hospital stay, duration of intensive care unit stay, postoperative complications and inpatient mortality. Donor data, including demographic characteristics, body mass index, type of liver graft (right lobe or left lateral segment), graft weight (g), type of portal vein anatomy (Type 1, 2, or 3), type of biliary anatomy (Type 1, 2, 3a, 3b), duration of hospital stay, complications and mortality were retrieved.</div></div><div><h3>Results</h3><div>Among 18 recipients, 14 (78%) were male, and 4 (22%) were female. The mean recipient age was 50.7 [2-66], while the mean donor age was 29.3 [18-40]. The mean follow-up period was 31.9 [12-71] months. The 1-year patient and graft survivals were calculated as 83.3% and 88.9%.</div></div><div><h3>Conclusion</h3><div>The PELT can be utterly feasible at transplant centers with remarkable LDLT experience.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 272-276"},"PeriodicalIF":0.8,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796746","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":"Effect of CYP 3A4*1B and CYP3A5*3 Gene Polymorphisms in Antirejection of Tacrolimus in Liver Transplant Patients","authors":"Xia Zhou ,&nbsp;Rujia Tang ,&nbsp;Dali Zhang,&nbsp;Xi He,&nbsp;Zhenwen Liu,&nbsp;Yinjie Gao,&nbsp;Hongling Liu","doi":"10.1016/j.transproceed.2024.10.030","DOIUrl":"10.1016/j.transproceed.2024.10.030","url":null,"abstract":"<div><h3>Background</h3><div>Tacrolimus is a substrate of CYP 3A5; to reduce the rate of liver injury and rejection in liver transplant (LT) recipients, it is feasible to optimize the administration of tacrolimus by adding CYP gene polymorphism.</div></div><div><h3>Methods</h3><div>We divided 151 LT recipients randomly into an optimization group and a control group. All were tested routinely for clinical indicators such as FK506 trough concentration and biochemistry, and their complications and survival were observed. The optimization group additionally detected single nucleotide polymorphisms in the CYP 3A4*1B and CYP 3A5*3 genes.</div></div><div><h3>Results</h3><div>There were no significant differences in tacrolimus dosage, FK506 trough concentrations, and concentration/dose value between the 2 groups. In the optimization group, all patients tested CYP 3A4*1B as wild type. CYP 3A5*3 detection classification included 35 with the G/G mutation (45.5%) and 36 A/G wild-type individuals (46.8%). The concentration/dose values of G/G mutant patients were significantly higher than those of A/G wild-type and A/A mutant patients (G/G vs. A/G; <em>P</em> &lt; .05), and no significant difference in FK506.</div></div><div><h3>Conclusion</h3><div>The CYP 3A4*1B genotype has less influence on tacrolimus metabolism. The genetic polymorphism of CYP 3A5*3 is obvious and largely affects tacrolimus metabolism, and the variant patients need lower doses of tacrolimus to reach the target concentration.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 298-304"},"PeriodicalIF":0.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Fibrinogen and Platelets in Mouse Liver Ischemia-Reperfusion Injury: Distribution and Pathophysiological Insights","authors":"Meng-Qi Dong ,&nbsp;Zhi-Hao Huang ,&nbsp;Zhi-min Liu ,&nbsp;Yuan Lin ,&nbsp;Feng-Yong Liu ,&nbsp;Wei-Jie Zhou","doi":"10.1016/j.transproceed.2024.10.045","DOIUrl":"10.1016/j.transproceed.2024.10.045","url":null,"abstract":"<div><div>Liver ischemia-reperfusion (I/R) injury is a critical issue in clinical settings, particularly in liver transplantation and resection, leading to severe hepatocellular dysfunction and organ failure. This study investigates the role of fibrinogen and platelets in liver I/R injury, focusing on their distribution and pathophysiological impact within liver lobules. Using a mouse model, we examined the expression and localization of fibrinogen and platelets at various time points postreperfusion. In normal liver, fibrinogen is predominantly expressed in hepatic sinusoids near the portal vein, with sparse platelet distribution. Following I/R injury, fibrinogen expression significantly increases in hepatic sinusoids and hepatocytes, accompanied by substantial platelet aggregation and embolization, particularly in Zone 1 of the liver lobules. These findings highlight the zonal heterogeneity of fibrinogen distribution and its regulatory function in platelet adhesion and microthrombi formation. This study provides crucial insights for developing therapeutic strategies targeting fibrinogen and platelet interactions to mitigate liver I/R injury.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2263-2267"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752307","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":"Physician-Directed Mycophenolate Mofetil Dose Reduction After Kidney Transplantation: A Multicenter Real Word Experience","authors":"Hani M. Wadei ,&nbsp;Namrata Parikh ,&nbsp;Sarah Suliman ,&nbsp;Ahmed Abdelrheem ,&nbsp;Walter D. Park ,&nbsp;Byron H. Smith ,&nbsp;Carrie A. Schinstock ,&nbsp;Hatem Amer ,&nbsp;Hasan Khamash ,&nbsp;Mark D. Stegall","doi":"10.1016/j.transproceed.2024.10.034","DOIUrl":"10.1016/j.transproceed.2024.10.034","url":null,"abstract":"<div><h3>Background</h3><div>Mycophenolate mofetil (MMF) dose is commonly reduced after kidney transplantation (KT). This study examined MMF dosing in the first 5 years after KT to determine if a lower MMF dose impacted outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively studied 432 recipients who underwent KT between February 2012 and February 2015 in 3 centers. Induction was with IL-2 receptor blocker (23%) or depleting antibody (67%) and maintenance was with calcineurin inhibitor, MMF 1.5 to 2g/day and in 70% prednisone. MMF dose was reduced within the first post-KT year as clinically indicated or for elevated mycophenolic acid (MPA) levels. All 432 patients underwent 1-year protocol biopsy. Donor-specific antibodies (DSAs) were assessed at 1 year.</div></div><div><h3>Results</h3><div>At 1 year, 219 KT recipients (51%) received standard MMF (&gt; 1 g/day) and 213 (49%) received low MMF (≤ 1 gr/d). Low MMF was for clinical indication (49%) or elevated MPA level (51%). At 1 year, there was no difference in rejection rate, type and degree of rejection, degree of inflammation, or DSA formation between the low and standard MMF groups (<em>P</em> = not significant [NS]). The reason for MMF dose reduction did not impact outcome. By 5 years, 69% of the KT recipients were on ≤ 1 g/d MMF. The 5-year patient and death-censored graft survival were comparable between the low and standard MMF groups.</div></div><div><h3>Conclusions</h3><div>Almost 50% of KT recipients were on low dose MMF at 1 year and this percentage increased by 5 years. We did not observe a difference in outcomes between those on standard or low MMF dose regardless of the reason for dose reduction. Physician-directed MMF dose-reduction may be safe but randomized studies are needed to validate this finding.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2124-2133"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788293","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":"Mild Permissive Alkalosis Improves Outcomes in Porcine Negative Pressure Ventilation Ex-Situ Lung Perfusion","authors":"Keir Forgie ,&nbsp;Abeline Watkins ,&nbsp;Katie Du ,&nbsp;Alynne Ribano ,&nbsp;Nicholas Fialka ,&nbsp;Sayed Himmat ,&nbsp;Sanaz Hatami ,&nbsp;Mubashir Khan ,&nbsp;Xiuhua Wang ,&nbsp;Ryan Edgar ,&nbsp;Katie-Marie Buswell-Zuk ,&nbsp;Darren H. Freed ,&nbsp;Jayan Nagendran","doi":"10.1016/j.transproceed.2024.10.031","DOIUrl":"10.1016/j.transproceed.2024.10.031","url":null,"abstract":"<div><h3>Background</h3><div>Ex-Situ Lung Perfusion (ESLP) employs a membrane deoxygenator and mixed (N₂/O₂/CO₂) or pure sweep gas (CO₂) to target venous blood gas composition with physiologic pCO₂ and pH. Clinically, mild permissive alkalosis counteracts elevated pulmonary vascular resistance (PVR) to improve perfusion. Increased PVR and pulmonary artery pressure (PAP) during ESLP mirrors rising pro-inflammatory cytokines. Increased hydrostatic pressure worsens edema and lung function. We report improved ESLP outcomes using mild permissive alkalosis.</div></div><div><h3>Methods</h3><div>Twelve juvenile pig lungs underwent 12-hour Negative Pressure Ventilation (NPV)-ESLP with a physiologic pH (Control: pH 7.35-7.45, n=6) or mild permissive alkalosis (pH+: pH 7.45-7.55, n=6) by varying sweep CO₂ delivery. Three left lungs per group were transplanted and assessed over 4-hours.</div></div><div><h3>Results</h3><div>Five Control lungs failed on ESLP due to high PAPs, low compliance, and poor oxygenation. Repeat Controls (n=6) were performed to attain 12-hours of ESLP. There were no failures in the pH+ group. Results are pH+ vs Control. Oxygenation (PaO₂/FiO₂ 454.2 vs 438.2; <em>P =</em> .37) and dynamic compliance (21.38 vs 22.22 mL/cmH₂O; <em>P =</em> .41) were stable over 12-hour NPV-ESLP. Mean evaluation pH/pCO₂/HCO₃^- was 7.50/15.6/14.5 vs 7.41/38.7/24.7. Control lungs required repeat THAM and milrinone boluses on ESLP to prevent acidosis and treat elevated PVR; this was not necessary in the pH+ group. Weight-gain/hour was similar (1.23% vs 1.38%; <em>P =</em> .37). Mean left lung PF ratios 4-hours post-transplantation were 301 mmHg vs 196 mmHg (<em>P =</em> .11). Control TNF-⍺ and IL-6 perfusate concentrations were significantly greater.</div></div><div><h3>Conclusions</h3><div>Mild permissive alkalosis porcine NPV-ESLP demonstrated more reliable preservation with reduced inflammation compared to a physiologic pH strategy.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2284-2291"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776037","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":"Targeting the PANoptosome Using Necrostatin-1 Reduces PANoptosis and Protects the Kidney Against Ischemia-Reperfusion Injury in a Rat Model of Controlled Experimental Nonheart-Beating Donor","authors":"Mehmet Dokur ,&nbsp;Erdal Uysal ,&nbsp;Faruk Kucukdurmaz ,&nbsp;Serdar Altinay ,&nbsp;Sait Polat ,&nbsp;Kadir Batcioglu ,&nbsp;Yakup Yilmaztekin ,&nbsp;Turkan Guney ,&nbsp;Tugce Sapmaz Ercakalli ,&nbsp;Asli Yaylali ,&nbsp;Efe Sezgin ,&nbsp;Zafer Cetin ,&nbsp;Eyup Ilker Saygili ,&nbsp;Osman Barut ,&nbsp;Hatem Kazimoglu ,&nbsp;Gokturk Maralcan ,&nbsp;Suna Koc ,&nbsp;Mehmet Sokucu ,&nbsp;Sema Nur Dokur Yeni","doi":"10.1016/j.transproceed.2024.10.047","DOIUrl":"10.1016/j.transproceed.2024.10.047","url":null,"abstract":"<div><h3>Purpose</h3><div>Reducing renal ischemia is crucial for the function and survival of grafts from nonheartbeat donors, as it leads to inflammatory responses and tubulointerstitial damage. The primary concern with organs from nonheartbeat donors is the long warm ischemia period and reperfusion injury following renal transplantation. This study had two main goals; one goal is to determine how Necrostatin-1 targeting the PANoptosome affects PANoptosis in the nonheart-beating donor rat model. The other goal is to find out if Necrostatin-1 can protect the kidney from ischemic injury for renal transplantation surgery.</div></div><div><h3>Methods</h3><div>Twenty-four rats were grouped randomly as control and Necrostatin-1 in this experimental animal study, and we administered 1.65 mg/kg of Necrostatin-1 intraperitoneally to the experimental group for 30 minutes before cardiac arrest. We removed the rats’ left kidneys and measured various oxidative stress marker measures such as malondialdehyde, superoxide dismutase, catalase, GPx, and 8-hydroxy-2-deoxyguanosine levels. We then subjected the tissues to immunohistochemical analysis, electron microscopy, and histopathological analysis.</div></div><div><h3>Findings</h3><div>The Necrostatin-1 group had a lower total tubular injury score (<em>P</em> &lt; .001) and less Caspase-3, gasdermin D, and mixed lineage kinase domain-like protein expression. Additionally, the apoptotic index of the study group was lower (<em>P</em> &lt; .001). Furthermore, the study group had higher levels of superoxide dismutase and GPx (<em>P</em> &lt; .05), whereas malondialdehyde levels were reduced (<em>P</em> = .009). Electron microscopy also revealed a significant improvement in tissue structure in the Necrostatin-1 group.</div></div><div><h3>Conclusion</h3><div>Necrostatin-1 protects against ischemic acute kidney injury in nonheart-beating donor rats by inhibiting PANoptosis via the blockade of RIPK1. As a result of this, Necrostatin-1 may offer novel opportunities for protecting donor kidneys from renal ischemia-reperfusion injury during transplantation in patients with end-stage kidney disease requiring a renal transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2268-2279"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782146","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":"Knowledge Gaps and Educational Needs in Organ Transplantation: A Study of Portuguese Medical Students","authors":"Alberto Costa Silva ,&nbsp;Teresa Pina-Vaz ,&nbsp;Margarida Henriques ,&nbsp;João Nóbrega ,&nbsp;José La Fuente de Carvalho ,&nbsp;Carlos Martins-Silva ,&nbsp;Tiago Antunes-Lopes ,&nbsp;João Alturas Silva","doi":"10.1016/j.transproceed.2024.11.014","DOIUrl":"10.1016/j.transproceed.2024.11.014","url":null,"abstract":"<div><h3>Objective</h3><div>Kidney transplantation has been a life-changing procedure for patients with end-stage renal disease (ESRD). Portugal ranks high globally in transplantation, benefiting from an “opt-out” system that presumes consent for organ donation. The effectiveness of transplantation programs depends significantly on public knowledge and the willingness to donate, where medical students play a crucial role. This study assesses the knowledge and educational needs of medical students regarding organ transplantation and donation.</div></div><div><h3>Design</h3><div>A cross-sectional survey was conducted using a structured questionnaire distributed to fifth-year medical students from 2 universities in Porto, Portugal, affiliated with different hospital centers during the 2022-2023 academic year.</div></div><div><h3>Results</h3><div>A total of 427 students responded, with a response rate of 85.0%, higher at Center 1 (93.0%) compared to Center 2 (70.0%) (<em>P</em>-value &lt; .001). The majority were aware of the opt-out legislation (92.3%) and recognized ESRD as the primary cause of kidney transplantation (96.1%). Knowledge of donation types was high, particularly for brain death (92.6%) and living donation (91.5%), but lower for donation after circulatory death (73.1%). Awareness of donation after circulatory death was significantly higher among respondents from Center 1 (79.4%) than Center 2 (59.1%; <em>P</em> &lt; .001). Only a minority were familiar with immunosuppressive drugs (36.0%) and had practical exposure to transplant-related activities. Satisfaction with transplantation education was low (8.2%), with significant differences between the centers.</div></div><div><h3>Conclusion</h3><div>The findings suggest that medical schools should enhance educational content and provide more experiences to prepare future healthcare providers adequately.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2298-2301"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775904","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":"Imbalances of Th1/Th2 and Tc1/Tc2 are Associated With Active Cytomegalovirus Infection in Infant Liver Transplant Recipients","authors":"Dan Li ,&nbsp;Chun Liu ,&nbsp;Zhongyu Kang ,&nbsp;Yan Zheng ,&nbsp;Yuliang Wang","doi":"10.1016/j.transproceed.2024.10.036","DOIUrl":"10.1016/j.transproceed.2024.10.036","url":null,"abstract":"<div><h3>Background</h3><div>Because cytomegalovirus (CMV) infection is one of the most common complications following liver transplantation (LT), it is important to analyze the impact of CMV infection on the LT-associated changes in T cells polarization. This study aimed to investigate T helper (Th) and T cytotoxic (Tc) cells polarization and their correlation in infant LT recipients with active CMV infection.</div></div><div><h3>Methods</h3><div>Twenty infant LT recipients with active CMV infection (the CMV group) and 20 recipients without CMV infection (the stable group) were enrolled. The percentages of Th1, Th2, Tc1, and Tc2 cells were detected by flow cytometry after intracellular staining for cytokines (IFN-γ and IL-10, respectively) in peripheral blood. The correlation between Th and Tc cells was analyzed by Pearson correlation coefficient.</div></div><div><h3>Results</h3><div>The percentages of Th1 and Tc1 cells were significantly decreased, whereas the percentages of Tc2 cells were significantly increased in CMV group compared with the stable group, along with significant reduction of Th1/Th2 and Tc1/Tc2 ratios (<em>P</em> &lt; .01). The percentages of Th1 cells were positively correlated with Tc1 cells (<em>P</em> &lt; .01). A higher Th1/Th2 and Tc1/Tc2 ratios were showed in the CMV group after antiviral therapy than those in the CMV group before therapy (<em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>Our findings show an imbalanced Th1/Th2 and Tc1/Tc2 immunity in infant LT recipients with active CMV infection, which were involved in the pathogenesis of CMV infection.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2172-2177"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788292","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":"Safety and Efficacy of Everolimus Use to Preserve Renal Function in Intestinal and Multivisceral Transplantation Patients","authors":"Colin Hartgerink ,&nbsp;Avi Toiv ,&nbsp;Arif Sarowar ,&nbsp;Ella Todd ,&nbsp;Shunji Nagai ,&nbsp;Yakir Muszkat ,&nbsp;Nemie Beltran ,&nbsp;Syed-Mohammed Jafri","doi":"10.1016/j.transproceed.2024.10.043","DOIUrl":"10.1016/j.transproceed.2024.10.043","url":null,"abstract":"<div><h3>Background</h3><div>As calcineurin inhibitors are associated with renal impairment post intestinal transplant, use of everolimus (EVR) may provide renal-sparing benefits.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis focused on EVR use and renal function after intestinal or multivisceral transplant. No prisoners were used in the study. This study is compliant with the Helsinki Congress and the Declaration of Istanbul.</div></div><div><h3>Results</h3><div>A total of 28 patients, 18 patients who underwent isolated intestinal transplant, and 10 patients who underwent multivisceral transplant, were included in this study. For 13 patients that never received EVR, the average change in estimated glomerular filtration rate (eGFR) compared to baseline at the time of transplant were as follows: 1 year post-transplant = –18.1%; 2 years = –43.7%; 3 years = –44.1; and 5 years = –43.3%. For 15 patients who received EVR after transplant, average duration of EVR therapy was (579.60 ± 784.15) days with 87% of patients ultimately removed from medication due to side effects. In the EVR group, the average change in eGFR compared to baseline were as follows: 1 year post-transplant = –37.5%; 2 years = –43.5%; 3 years = –54.2%; and 5 years = –42.9%. After the initiation of EVR, the average change in eGFR compared to eGFR at time of EVR initiation was as follows: 1 year = +5.9%; 2 years = –1.57%; 3 years = –5.01%; and 5 years = –1.79%.</div></div><div><h3>Conclusions</h3><div>This study suggests that EVR can play an important role in preserving renal function in intestinal and multivisceral transplant recipients, but tolerance of EVR is highly variable in this patient population.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2250-2254"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741824","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}