Transplantation proceedings最新文献

{"title":"Comparison of Multimodal Pain Control Following Bilateral Lung Transplantation","authors":"John A. Treffalls ,&nbsp;Victoria K. Hart ,&nbsp;Connor McDonald ,&nbsp;Lara Jones ,&nbsp;Holly Keyt ,&nbsp;Nitin A. Das ,&nbsp;Edward Y. Sako","doi":"10.1016/j.transproceed.2025.05.023","DOIUrl":"10.1016/j.transproceed.2025.05.023","url":null,"abstract":"<div><h3>Purpose</h3><div>Opioid administration is common following bilateral lung transplantation (BLTx) but is associated with adverse side effects and potential for opioid use disorder. This study aimed to compare the use of intercostal cryoablation, liposomal bupivacaine (LipoB), and standard therapy on patient-reported pain, opioid administration, and clinical outcomes following BLTx.</div></div><div><h3>Methods</h3><div>A retrospective review of all BLTx performed at a single center from January 2016 to December 2023 was performed. Due to varying surgeon preferences, patients received intraoperative cryoablation or LipoB in addition to systemic pain control measures or systemic measures only in the intra- or peri-operative period. Primary outcomes included patient-reported pain and the amount of opioid administration. Secondary outcomes included opioid-related complications and perioperative outcomes. Opioid administration was standardized using morphine milligram equivalents. Opioid levels and pain scores were predicted using a mixed-effects model.</div></div><div><h3>Results</h3><div>Of the 153 patients included, 42.5% (<em>n</em> = 65) received systemic-only, 31.4% (<em>n</em> = 48) received LipoB, and 26.1% (<em>n</em> = 40) received cryoablation. Patients receiving cryoablation reported significantly lower pain through postoperative day 14 (<em>P</em> &lt; .0001). Opioid administration was not different between groups (<em>P</em> = .107). Patients receiving cryoablation had lower rates of postoperative ileus (<em>P</em> = .004) but longer intensive care unit and postoperative length of stay (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Cryoablation was associated with a clinically significant reduction in patient-reported pain following BLTx. Significantly longer length of stay in the cryoablation group warrants future prospective, randomized investigation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1114-1119"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532201","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":"Successful Pregnancy After Renal Transplantation: A Report of 4 Cases","authors":"Zhou Yujie,&nbsp;Qiu Tao,&nbsp;Zhou Jiangqiao","doi":"10.1016/j.transproceed.2025.06.001","DOIUrl":"10.1016/j.transproceed.2025.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the maternal and neonatal outcomes of pregnant patients after kidney transplantation, analyze the influencing factors, and provide a reference for clinical management.</div></div><div><h3>Methods</h3><div>The clinical data of 4 pregnant patients after renal transplantation in our hospital were retrospectively analyzed, including basic information, pregnancy and delivery, use of immunosuppressive agents, and maternal and infant prognosis. The related issues of pregnancy after renal transplantation are discussed in combination with a literature review.</div></div><div><h3>Results</h3><div>All the four patients delivered successfully. The main complications during pregnancy are gestational hypertension, gestational diabetes mellitus, and proteinuria. All the newborns were born preterm with birth weights between 1860 and 2990 g at 34 to 36 weeks of gestation and were in good health after birth. The renal function of 3 patients was stable after delivery, and 1 patient had proteinuria increased to “4+” after delivery and was in the recovery period.</div></div><div><h3>Conclusions</h3><div>Under strict monitoring and reasonable management, pregnancy after renal transplantation can achieve good maternal and neonatal outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1176-1179"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370029","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":"Cytomegalovirus Infection Risk Factors in Allogeneic Hematopoietic Stem Cell Transplantation Can Defibrotide Be a Risk Factor?","authors":"Lecturer Zeynep Burçin Yılmaz ,&nbsp;Funda Memişoğlu ,&nbsp;Emine Hidayet ,&nbsp;İrfan Kuku ,&nbsp;Mehmet Ali Erkurt ,&nbsp;Emin Kaya ,&nbsp;İlhami Berber","doi":"10.1016/j.transproceed.2025.05.018","DOIUrl":"10.1016/j.transproceed.2025.05.018","url":null,"abstract":"<div><h3>Introduction and Purpose</h3><div>Cytomegalovirus (CMV) infection is a prevalent complication, affecting 30% to 50% of patients following Allogeneic Hematopoietic Stem Cell Transplantation (allo-AHCT). This study aims to investigate the risk factors contributing to CMV infection development.</div></div><div><h3>Materials and Methods</h3><div>A retrospective analysis was performed on 196 patients with hematological malignancies who underwent allo-HSCT in the Stem Cell Transplantation Unit of Inonu University Faculty of Medicine over a 5-year period. Propensity scores were calculated by matching 1:1 for gender and age variables in individuals with CMV infection and in the control group.</div></div><div><h3>Results</h3><div>Of the 196 patients included in the study, 75 (38.3 %) were female and 121 (61.7 %) were male. According to univariate analysis, CMV infection was seen more frequently in ALL patients than in AML patients (<em>p</em> = .012), while the conditioning regimen (<em>p</em> = 1) did not affect the outcome in terms of risk. Blood cyclosporine levels measured simultaneously with CMV positivity were significant in terms of risk (<em>p</em> = .006). A significant correlation was found between GvHD and CMV infection (<em>p</em> &lt; .001). According to multivariate analysis, receiving defibrotide for VOD prophylaxis posed a risk for CMV positivity.</div></div><div><h3>Conclusion</h3><div>In our study, only defibrotide prophylaxis was noted as a risk factor in multivariate analysis. While there are ongoing studies for the use of defibrotide in GVHD prophylaxis, more studies are needed to say that it is a definite risk factor for CMV. We believe that focusing on prophylactic treatments used during the transplantation process will be guiding in determining risk factors.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1133-1142"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532202","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 Study of Liver Transplant Recipients Over 69: Clinical Features and Outcomes of a Growing Group","authors":"Avi Toiv ,&nbsp;Abdulmalik Saleem ,&nbsp;Mark Obri ,&nbsp;Gorden Jacobsen ,&nbsp;Adarsh Varma ,&nbsp;Reena Salgia ,&nbsp;Syed-Mohammed R. Jafri","doi":"10.1016/j.transproceed.2025.05.033","DOIUrl":"10.1016/j.transproceed.2025.05.033","url":null,"abstract":"<div><h3>Background</h3><div>The introduction of direct-acting antivirals for hepatitis C virus has shifted liver transplantation (LT) demographics, with patients receiving increasingly more LT for other chronic liver diseases and at older ages. Historically, younger patients have been prioritized for LT due to concerns about post-transplant outcomes in older patients; however, emerging evidence suggests a need to reassess age-based eligibility criteria. This study describes the clinical characteristics and postoperative LT outcomes of patients ≥70 years compared to patients &lt; 70 years old.</div></div><div><h3>Methods</h3><div>Single center retrospective chart review of all patients who underwent LT at an academic transplant center between January 1, 2014, and September 26, 2023.</div></div><div><h3>Results</h3><div>Of 999 LT recipients, 43 were ≥70 years old (median 71 y; range 70-75) and 956 were &lt;70 years old (median 58 y; range 16-69). Postoperative liver function laboratory values, biliary complication rates, need for further procedures, and hospital readmission were similar between groups. The older cohort had a significantly longer mean length of stay (25.5 vs 14.0 days; <em>P</em> = .002), an association that was confirmed on regression analysis (<em>P</em> &lt; .001). Notably, no differences in mortality or graft failure at 1, 3, and 5 years were observed between older and younger LT recipients.</div></div><div><h3>Conclusions</h3><div>LT recipients ≥70 years-old had positive post-transplant outcomes and similar patient and graft survival as patients &lt;70 years old, although older age was associated with a longer hospital stay. Overall, LT evaluation and eligibility age criteria may need to be reevaluated to be more age inclusive.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1086-1094"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546750","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":"Precision Immunosuppression in a Carefully Selected Liver Transplant Population: Can MMF Alone “Hold the Fort “?","authors":"Bashar Fteiha ,&nbsp;Ambreen Anil Merchant ,&nbsp;Soongjin Ahn ,&nbsp;James Trotter","doi":"10.1016/j.transproceed.2025.05.034","DOIUrl":"10.1016/j.transproceed.2025.05.034","url":null,"abstract":"<div><h3>Background</h3><div>Data on mycophenolate mofetil (MMF) as a standalone immunosuppressant in liver transplants are scarce, with it typically being used alongside calcineurin inhibitors (CNIs) or, less frequently, mammalian target of rapamycin inhibitors.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of medical records with the following inclusion criteria: on CNI with or without MMF, at least 6 months from orthotopic liver transplantation, absence of rejection episodes within 12 months, stable post-transplant course, no history of previous transplantation, and no history of autoimmune diseases (primary biliary cholangitis, primary sclerosing cholangitis, or autoimmune hepatitis). Patients were weaned from CNI or mammalian target of rapamycin inhibitors progressively over 4 weeks and, if not on MMF, it was introduced progressively over 4 weeks. Liver function tests were monitored every 1 to 2 weeks for 2 to 3 months. The primary outcome of the study was the incidence of rejection after the transition to MMF monotherapy. Secondary outcomes include graft loss or patient death during follow-up.</div></div><div><h3>Results</h3><div>Thirty-three patients after liver transplantation were transitioned successfully to MMF monotherapy. Of these, 27 patients (81.8%) were successfully weaned off CNIs. The average interval between transplantation and initiation of MMF monotherapy was 84 ± 76 months, with an average follow-up duration of 8 ± 4 months. The average mean reduction in creatinine levels was 0.6648 ± 0.62 mg/dL. Acute rejection was documented in 6 patients (18.2%), with only 1 patient experiencing severe rejection requiring hospitalization; the others were managed as outpatients, with some requiring CNI reintroduction.</div></div><div><h3>Conclusion</h3><div>MMF monotherapy is a viable option for select patients after liver transplantation, with a substantial success rate and potential renal benefits. However, careful monitoring is essential to identify and manage cases of acute rejection promptly.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1071-1075"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532165","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":"Is There a Difference in Body Composition of Autologous Hematopoietic Stem Cell Transplantation Recipients on Enteral versus Parenteral Nutritional Support? A Pilot Study","authors":"Mehraneh Mohebbi ,&nbsp;Brenda Hartman ,&nbsp;Alison Andrade ,&nbsp;Uday Deotare ,&nbsp;Heather Resvick ,&nbsp;Janet Madill","doi":"10.1016/j.transproceed.2025.05.027","DOIUrl":"10.1016/j.transproceed.2025.05.027","url":null,"abstract":"<div><h3>Background</h3><div>Parenteral nutrition (PN) is the current standard of nutritional care for autologous hematopoietic stem cell transplantation (AHSCT) recipients. However, the American Society for Parenteral and Enteral Nutrition recommends using enteral nutrition (EN), because PN is more expensive and associated with higher rates of infection. Currently, there is minimal evidence examining body composition (BC) in AHSCT recipients on EN versus those on PN. Our study aimed to determine differences in BC, including muscle mass, phase angle, percent body fat, and muscle strength, in these 2 groups of patients.</div></div><div><h3>Methods</h3><div>Thirty-five AHSCT recipients were randomized to receive EN or PN. Participants were followed at baseline and 15 days and 30 days post-transplantation. Bioelectrical impedance analysis was used to measure fat mass (FM), lean body mass (LBM), and phase angle (PhA). The Z-fat-free mass index (FFMI) was calculated. Ultrasound was used to assess quadriceps muscle layer thickness (QMLT), and a dynamometer evaluated hand grip strength (HGS). Population means were used to calculate standardized PhA (SPhA). The <em>t</em> tests and χ² test were performed with SPSS software. A <em>P</em> value &lt;.05 was considered to indicate statistical significance.</div></div><div><h3>Results</h3><div>The study cohort comprised 16 EN patients and 19 PN patients, with a mean age of 61.2 ± 9.66 years. There were no significant differences between the groups in QMLT, FM, z-FFMI, HGS, SPhA, and LBM at baseline, day 15, or day 30.</div></div><div><h3>Conclusion</h3><div>AHSCT recipients on EN had similar body composition to those on PN, providing convincing evidence that EN may be an acceptable and less expensive nutritional modality in AHSCT recipients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1153-1160"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565601","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":"Letter to the Editor: Quader M, Kiernan Z, Labate G, Chen Q. Hypothermic myocardial preservation: the freezing debate. Transplant Proc. 2025;57(4):653–662. Fear of Freezing Fallacy: Storage in Melting Ice Cannot Damage the Donor Heart","authors":"Franklin Rosenfeldt","doi":"10.1016/j.transproceed.2025.06.005","DOIUrl":"10.1016/j.transproceed.2025.06.005","url":null,"abstract":"<div><div>The recent report by Quader et al (Quader M, Kiernan Z, Labate G, et al. Hypothermic myocardial preservation: the freezing debate. <em>Transplant Proc.</em> 2025;57(4):653–662) addresses a critical question in donor heart preservation: does storage at 0 °C cause myocardial injury? Their findings show that hearts stored in melting water ice for 4 hours retain structural and functional integrity, contradicting earlier assumptions about freezing damage. This editorial places their findings in historical context, evaluates prior conflicting evidence, and underscores important implications for clinical practice.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1205-1206"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556363","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":"Transplant Ureteral Stenosis Caused by Polyomavirus Ureteritis in Allograft Kidney Transplantation: Two Cases Report and a Literature Review","authors":"Tianlu Zhang ,&nbsp;Qinyun Wu ,&nbsp;Rongfang Shen ,&nbsp;Wenhan Peng ,&nbsp;Zhenpeng Jin ,&nbsp;Sulin Luo ,&nbsp;Luying Guo ,&nbsp;Meifang Wang ,&nbsp;Jianyong Wu ,&nbsp;Jianghua Chen ,&nbsp;Rending Wang","doi":"10.1016/j.transproceed.2025.05.026","DOIUrl":"10.1016/j.transproceed.2025.05.026","url":null,"abstract":"<div><h3>Background</h3><div>Polyomavirus ureteritis is a rare but increasingly recognized complication in kidney transplantation, with the potential to cause ureteral stenosis and graft loss. We report two pathologically confirmed cases of polyomavirus ureteritis presenting as ureteral stenosis, successfully treated with ureterovesical reimplantation surgery and adjustments in immunosuppressive therapy.</div></div><div><h3>Case presentation</h3><div>The first case describes a 41-year-old male renal transplant recipient, who presented with progressive hydronephrosis and an elevated serum creatinine (Scr) level of 308 μmol/L 5 months post-transplant. The second case involves a 25-year-old female recipient who developed hydronephrosis and dilatation of the upper ureter in the transplanted kidney 2 months post-transplant, with a subsequent rise in Scr level to 167 μmol/L. Urine tests revealed high polyomavirus loads, while blood viremia tests remained negative. Ureteral biopsy confirmed polyomavirus ureteritis through simian virus 40 immunohistochemical staining. Following successful ureterovesical reimplantation surgery and tailored reduction in immunosuppressive regimens, both patients cleared the virus in urine and their Scr levels returned to baseline.</div></div><div><h3>Conclusion</h3><div>This report highlights ureteral polyomavirus infection as a critical differential diagnosis in cases of ureteral stenosis among kidney transplant recipients. Accurate diagnosis requires thorough pathological evaluation, including simian virus 40 staining of ureteral tissue. Early recognition and individualized therapeutic strategies are essential to preserve graft function and improve patient outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1001-1006"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500006","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 Perioperative Lung Ultrasound Scores in Laparoscopic Living Donor Nephrectomy Surgeries: A Prospective Observational Trial","authors":"Emre S. Bingül ,&nbsp;Mert Canbaz ,&nbsp;Tzevat Tefik ,&nbsp;Mevlüt Tayfun Oktar ,&nbsp;Meltem Savran Karadeniz","doi":"10.1016/j.transproceed.2025.05.013","DOIUrl":"10.1016/j.transproceed.2025.05.013","url":null,"abstract":"<div><h3>Background</h3><div>Laparoscopic upper abdominal surgeries are prone to respiratory complications, possibly due to mechanical ventilation and the surgery itself. In this study, we aimed to investigate the changes in lung condition in living donor nephrectomy patients using perioperative ultrasound guidance.</div></div><div><h3>Methods</h3><div>Living donor nephrectomy patients who underwent fully laparoscopic surgery in the lateral position were included in the study. The lung ultrasound score (LUS) was evaluated after intubation (T1LUS), before extubation (T2LUS), and 30 minutes after extubation (T3LUS). The primary outcome was the comparison of T1LUS and T2LUS to observe the effect of the intraoperative period on lung condition. Secondarily, T3LUS also was evaluated for any residual change remaining during the acute postoperative period. In addition, the occurrence of postoperative pulmonary complications (PPCs) and changes in oxygenation were investigated.</div></div><div><h3>Results</h3><div>A total of 30 patients were enrolled in the study. T2LUS and T3LUS were significantly higher than T1LUS (18 [17-20.3] and 11 [10-14.3] vs 7 [5-9.3]; <em>P</em> &lt; .001). Only 4 patients (13%) experienced mild pulmonary complications in the first 24 hours postoperation. Patients with PPCs demonstrated higher T2LUS and T3LUS compared to patients without PPCs (21 [21-22.5] vs 18 [16.8-20] and 16 [14.5-18.3] vs 10.5 [9.8-14], respectively; <em>P</em> &lt; .05), yet arterial oxygen partial pressure (PaO₂)/fraction of inspired oxygen (FiO₂) ratios did not differ between patients with PPCs and patients without PPCs, indicating adequate oxygenation for all participants.</div></div><div><h3>Conclusion</h3><div>According to the ultrasonographic examination, the intraoperative period causes some degree of deterioration in lung condition in laparoscopic living donor nephrectomy patients. Despite the finding that patients developing PPCs tended to exhibit higher LUS, their oxygenation levels remained sufficient throughout the operative period.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1025-1033"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532161","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":"Graft Rejection After Ex Vivo T-Cell-Depleted Haploidentical Hematopoietic Cell Transplantation: Analysis of Incidence, Survival, Risk Factors, and Association With Biomarkers of Inflammation","authors":"Ladislav Król ,&nbsp;Stina Wichert ,&nbsp;Beata Tomaszewska-Toporska ,&nbsp;Stig Lenhoff ,&nbsp;Cornelis Jan Pronk ,&nbsp;Jacek Toporski ,&nbsp;Ingrid Øra ,&nbsp;Josefina Dykes ,&nbsp;Dominik Turkiewicz","doi":"10.1016/j.transproceed.2025.05.025","DOIUrl":"10.1016/j.transproceed.2025.05.025","url":null,"abstract":"<div><h3>Background</h3><div>Graft rejection (GR) is common complication after haploidentical hematopoietic cell transplantation (haplo-HCT). There are only a few studies describing the clinical presentation and potential risk factors of GR, and the optimal rescue strategy is not established.</div></div><div><h3>Objectives</h3><div>To evaluate the cumulative incidence and potential risk factors for GR following haplo-HCT, and to compare survival, clinical symptoms, selected inflammatory parameters, and lactate dehydrogenase levels in patients with and without GR.</div></div><div><h3>Methods</h3><div>A retrospective single-center study including 79 patients (59 children and 20 adults) who underwent ex vivo T-cell-depleted haplo-HCT at Skåne University Hospital from 2001 to 2020.</div></div><div><h3>Results</h3><div>The cumulative incidence of GR was 14.8% (95% CI: 7.1-22.6). The median time to GR was 21 days (13-31). Five-year overall survival for patients without GR was 45.3% (95% CI: 32.8-57.7), and 41.7% (95% CI: 13.8-69.9) for those with GR (<em>P</em> = n.s.). None of the analyzed patient- and transplant-related factors were significantly associated with GR. Macular rash was the only GR-associated symptom. Patients with GR had higher median ferritin (18,096 µg/L; 1412-95,980) and lactate dehydrogenase (10.5 µkat/L, 0.7-35.0), and lower fibrinogen (2.65 g/L; 0.9-3.9) levels then patients who engrafted.</div></div><div><h3>Conclusions</h3><div>In our cohort, GR was not associated with inferior survival and prompt retransplantation seems to be an effective rescue strategy. GR is characterized by increased levels of inflammation markers, while clinical symptoms are nonspecific. Further analysis in a larger cohort is necessary to assess whether regular monitoring of inflammatory parameters could guide preemptive treatment strategies for GR.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1143-1152"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532162","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}