Transplantation proceedings最新文献_第2页

Impact of Adding Bedside Cycling to Intensive Care Unit Rehabilitation on Physical Function and Length of Stay After Liver Transplantation: A Randomized Controlled Trial 在重症监护室康复治疗中增加床边骑自行车对肝移植术后身体功能和住院时间的影响：随机对照试验

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-05 DOI: 10.1016/j.transproceed.2024.08.030

{"title":"Impact of Adding Bedside Cycling to Intensive Care Unit Rehabilitation on Physical Function and Length of Stay After Liver Transplantation: A Randomized Controlled Trial","authors":"","doi":"10.1016/j.transproceed.2024.08.030","DOIUrl":"10.1016/j.transproceed.2024.08.030","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the effectiveness of early bedside cycling training in enhancing recovery among patients following liver transplantation.</p></div><div><h3>Methods</h3><p>A total of 64 patients who underwent liver transplantation were randomly assigned to either an experimental group or a control group, with 32 patients in each group. Patients in the control group received routine rehabilitation training after postoperative consciousness recovery and tracheal extubation. The experimental group received supplemental lower limb bedside cycling training in addition to the routine rehabilitation. Differences in physical function, length of intensive care unit, and hospital stays were compared between the two groups.</p></div><div><h3>Results</h3><p>The experimental group showed significantly greater improvements in physical function, such as activities of daily living scores and Berg Balance Scale scores, compared to the control group (<em>P</em> < .05). While the experimental group also exhibited decreased length of intensive care unit and hospital stays compared to the control group, these differences lacked statistical significance.</p></div><div><h3>Conclusion</h3><p>Early bedside cycling training contributes to enhanced physical function, such as balance function and activities of daily living, among patients undergoing liver transplantation.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147275","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}

引用次数: 0

Immune Rejection of Cartilage in a Swine Vascularized Composite Allotransplantation Model 猪血管化复合体同种异体移植模型中软骨的免疫排斥反应

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-05 DOI: 10.1016/j.transproceed.2024.08.042

{"title":"Immune Rejection of Cartilage in a Swine Vascularized Composite Allotransplantation Model","authors":"","doi":"10.1016/j.transproceed.2024.08.042","DOIUrl":"10.1016/j.transproceed.2024.08.042","url":null,"abstract":"<div><h3>Background</h3><p>Cartilage is a crucial tissue in vascularized composite allotransplantation (VCA) and plays a pivotal role in restoring motor function, especially in joint allotransplantation. Nevertheless, our understanding of immune rejection in cartilage remains limited and contentious. This study seeks to investigate the immune rejection of cartilage in a large animal model of VCA.</p></div><div><h3>Methods</h3><p>Cartilage, including articular cartilage and meniscus, as well as skin, muscle and lymph node, was retrieved from a swine heterotopic VCA graft when the skin of the graft suffered from grade III-IV rejection. Histologic examination, transmission electron microscopy and immunofluorescent staining were used to investigate immune rejection.</p></div><div><h3>Results</h3><p>Histologic examination revealed the infiltration of inflammatory cells and tissue destruction in cartilage. Transmission electron microscopy confirmed tissue damage and necrosis in cartilage. However, cartilage exhibited milder tissue damage when compared to rejected skin and muscle. Immunofluorescent staining revealed the activation of both the innate and adaptive immune systems, accompanied by an up-regulation of cell death biomarkers, including apoptosis and pyroptosis, in the rejected cartilage.</p></div><div><h3>Conclusion</h3><p>Our study demonstrates that cartilage is not immunologically privileged and undergoes immune rejection concurrently with skin and muscle in the VCA graft, though with less severe inflammation and rejection.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147274","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}

引用次数: 0

Depression and Quality of Life in Transplant Recipients During the COVID-19 Pandemic COVID-19 大流行期间移植受者的抑郁和生活质量。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-05 DOI: 10.1016/j.transproceed.2024.08.034

{"title":"Depression and Quality of Life in Transplant Recipients During the COVID-19 Pandemic","authors":"","doi":"10.1016/j.transproceed.2024.08.034","DOIUrl":"10.1016/j.transproceed.2024.08.034","url":null,"abstract":"<div><h3>Introduction</h3><p>Depression prevention is crucial for maintaining both physical and mental health and enhancing individuals’ quality of life (QOL) post-transplantation. Despite the heightened susceptibility of post-transplant patients to COVID-19 infection, the relationship between depression and QOL during the pandemic remains unclear. This study aimed to (1) identify depression and QOL during the pandemic in kidney and liver transplant patients, and (2) explore the relationship between QOL and depression.</p></div><div><h3>Design</h3><p>This cross-sectional study involved patients aged 20 years or older who were at least 6 months post-transplantation. Depression and QOL were assessed using the Patient Health Questionnaire-9 and the 8-item Short-Form Health Survey, respectively. Logistic regression analysis was conducted to examine the relationship between QOL and depression. The study included 204 participants comprising 68 postkidney transplant and 136 postliver transplant patients.</p></div><div><h3>Results</h3><p>Among all participants, depressive symptoms were present 30% of the time, with 8.3% experiencing moderate or severe depression. Logistic regression analysis revealed that depression (mental component summary; OR = 2.419, <em>P</em> < .001, 95% CI: 1.862–2.915) and postoperative period (physical component summary; OR = 1.397, <em>P</em> = .008, 95% CI: 1.094–1.733) significantly influenced QOL.</p></div><div><h3>Conclusion</h3><p>This study suggests that the prevention of depression in emerging infectious disease pandemics may contribute to maintaining the mental QOL of transplant recipients.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147273","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}

引用次数: 0

Moderate-Flow Perfusion is Superior to Low-Flow Perfusion in Ex Situ Lung Perfusion 原位肺灌注中，中流量灌注优于低流量灌注

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-05 DOI: 10.1016/j.transproceed.2024.08.032

{"title":"Moderate-Flow Perfusion is Superior to Low-Flow Perfusion in Ex Situ Lung Perfusion","authors":"","doi":"10.1016/j.transproceed.2024.08.032","DOIUrl":"10.1016/j.transproceed.2024.08.032","url":null,"abstract":"<div><h3>Background</h3><p>Full-flow perfusion during prolonged ex situ lung perfusion (ESLP) results in unacceptable pulmonary edema formation. Clinical ESLP at 30% to 50% predicted cardiac output (CO) supports acceptable physiologic outcomes; however, progressive pulmonary edema still develops. Lower flow rates may provide equivalent physiologic preservation with less edema formation due to reduced hydrostatic pressures. We report our results of moderate-flow (MF; 30% CO) vs low-flow (LF; 10% CO) negative pressure ventilation (NPV)-ESLP with transplantation.</p></div><div><h3>Methods</h3><p>Twelve pig lungs underwent 12-hours of NPV-ESLP with 30% or 10% CO (n = 6/group). Three left lungs per group were transplanted post-ESLP and assessed in vivo over 4 hours. Lung function was assessed by physiologic parameters, weight-gain, and pro-inflammatory cytokine profiles.</p></div><div><h3>Results</h3><p>Results are MF vs LF (mean ± SEM). All lungs demonstrated acceptable oxygenation post-ESLP (454.2 ± 40.85 vs 422.7 ± 31.68, <em>P</em> = .28); however, after transplantation, the MF lungs demonstrated significantly better oxygenation (300.7 ± 52.26 vs 141.9 ± 36.75, <em>P</em> = .03). There was no significant difference in compliance after ESLP (21.38 ± 2.28 vs 16.48 ± 2.34, <em>P</em> = .08); however, pulmonary artery pressure (PAP; 10.89 ± 2.28 vs 21.11 ± 0.93, <em>P</em> = .06) and pulmonary vascular resistance (PVR; 438.60 ± 97.97 vs 782.20 ± 162.20, <em>P</em> = .05) were significantly higher in the LF group. Weight gain (%) post-ESLP and post-transplant was similar between groups (29.42 ± 5.72 vs 24.17 ± 4.42, <em>P</em> = .24; and 29.63 ± 7.23 vs 57.04 ± 15.78, <em>P</em> = .09). TNF-<span><math><mi>α</mi></math></span> and IL-6 were significantly greater throughout LF ESLP.</p></div><div><h3>Conclusions</h3><p>The MF NPV-ESLP results in superior lung function with less inflammation compared to LF NPV-ESLP.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147277","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}

引用次数: 0

Haploidentical Stem Cell Transplantation With TCR αβ+/CD19+ Depletion in Children With Nonmalignant Hematologic Disorders: Outcomes From a Referral Center in Peru 在非恶性血液病患儿中进行 TCR αβ+/CD19+ 去势的单倍体干细胞移植：秘鲁一家转诊中心的治疗结果。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-04 DOI: 10.1016/j.transproceed.2024.08.038

{"title":"Haploidentical Stem Cell Transplantation With TCR αβ+/CD19+ Depletion in Children With Nonmalignant Hematologic Disorders: Outcomes From a Referral Center in Peru","authors":"","doi":"10.1016/j.transproceed.2024.08.038","DOIUrl":"10.1016/j.transproceed.2024.08.038","url":null,"abstract":"<div><h3>Background</h3><p>Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with TCR αβ<sup>+</sup>/CD19<sup>+</sup> cell depletion is a promising therapeutic alternative for children with nonmalignant hematologic disorders, especially in low-income countries where finding a compatible donor is challenging. The use of this transplantation approach for nonmalignant hematologic disorders has not been previously described in the Peruvian pediatric population.</p></div><div><h3>Methods</h3><p>We present the outcomes of children under 19 with nonmalignant hematologic disorders who underwent haplo-HSCT with TCR αβ<sup>+</sup>/CD19<sup>+</sup> cell depletion between 2018-2022 at a referral center in Lima, Peru. Survival probabilities and cumulative incidence functions were calculated using the Kaplan-Meier method.</p></div><div><h3>Results</h3><p>A total of 17 children aged between 1 to 18.6 years (median = 9.7 years) were included. The follow-up period ranged from 10 days to 66.20 months, with a median of 4.34 months. The probability of overall survival, event-free survival, and failure-free survival was 33.70%, 31.40%, and 68.8%, respectively. The incidence rate of graft failure was 49.80%, while the mortality rate not associated with graft failure was 18.8%. The incidence rate of acute graft-versus-host disease (GvHD) was 25.60%, and the incidence rate of viral infections was 59.40%.</p></div><div><h3>Conclusions</h3><p>The high incidence rates of graft failure and viral infections suggest that these factors may negatively impact the survival of children with nonmalignant hematologic disorders who undergo haplo-HSCT with TCR αβ+/CD19+ cell depletion. Therefore, optimizing the current conditioning regimens and ensuring timely access to first, second, and third-line antivirals is crucial to improve the survival of these patients.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0041134524004585/pdfft?md5=bec86b02897b35ab7bdc443b20967551&pid=1-s2.0-S0041134524004585-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134886","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}

引用次数: 0

Recurrent and De Novo Focal Segmental Glomerulosclerosis After Kidney Transplantation: Comparison of Clinical Features and Transplant Outcomes 肾移植后复发性和新发局灶性肾小球硬化症：临床特征与移植结果的比较。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-04 DOI: 10.1016/j.transproceed.2024.08.026

{"title":"Recurrent and De Novo Focal Segmental Glomerulosclerosis After Kidney Transplantation: Comparison of Clinical Features and Transplant Outcomes","authors":"","doi":"10.1016/j.transproceed.2024.08.026","DOIUrl":"10.1016/j.transproceed.2024.08.026","url":null,"abstract":"<div><h3>Background</h3><p>Focal segmental glomerulosclerosis (FSGS) is a notable subtype of glomerulonephritis in kidney transplantation, often resulting in graft failure. Yet, research comparing transplant outcomes between de novo and recurrent FSGS is scarce. This study aims to compare clinical features and transplant outcomes between these two categories.</p></div><div><h3>Methods</h3><p>This retrospective study enrolled 773 kidney transplant recipients from two centers between January 2008 and October 2021. Patients diagnosed with FSGS through graft kidney biopsy were included. They were categorized into two groups based on the time of FSGS occurrence and results of native kidney biopsy: the recurrent FSGS group and the de novo FSGS group.</p></div><div><h3>Results</h3><p>Of 773 kidney transplant patients, 24 had primary FSGS-causing end-stage renal disease. During a median 65-month follow-up, 5 of these patients developed recurrent FSGS (incidence: 26.3%). Among 749 patients with other kidney diseases causing end-stage renal disease, 9 had de novo FSGS (incidence: 1.2%). In the recurrent FSGS group, 2 out of 5 patients experienced graft failure, with no deaths or acute rejections. Similarly, in the de novo FSGS group, 3 out of 9 patients experienced graft failure, with no deaths or acute rejections. Kaplan–Meier analysis showed slower graft loss in de novo FSGS, resulting in a higher graft survival rate compared to recurrent FSGS (probability of graft survival, 60% vs 33.3%, <em>P</em> = .036).</p></div><div><h3>Conclusions</h3><p>Graft loss progresses more slowly in de novo FSGS compared to recurrent FSGS, resulting in a higher long-term graft survival rate in de novo FSGS than in recurrent FSGS.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134899","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}

引用次数: 0

Increased Risk of Short-Term Infection After Liver Transplantation Combined With Splenectomy: Clinical Retrospective Study 肝移植合并脾切除术后短期感染风险增加：临床回顾性研究

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-04 DOI: 10.1016/j.transproceed.2024.08.043

{"title":"Increased Risk of Short-Term Infection After Liver Transplantation Combined With Splenectomy: Clinical Retrospective Study","authors":"","doi":"10.1016/j.transproceed.2024.08.043","DOIUrl":"10.1016/j.transproceed.2024.08.043","url":null,"abstract":"<div><h3>Aim</h3><p>The safety of liver transplantation and simultaneous splenectomy (LTSP) is still controversial. This study aimed to compare postoperative outcomes and infection in liver transplant recipients with and without simultaneous splenectomy.</p></div><div><h3>Methods</h3><p>Clinical data of patients who underwent liver transplantation (LT) from May 2015 to March 2023 in the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed. The main parameters measured were culture results, infection incidence, pathogens, postoperative complications, and overall survival rates.</p></div><div><h3>Results</h3><p>Of 149 patients, 35 who underwent LTSP were assigned to the LTSP group, and the remaining 114 were assigned to the LT group. The postoperative infection incidence in the LTSP group was significantly higher than in the LT group within 1 month after transplantation. The two groups had no significant differences in pathogens details and overall survival rate. SP, postoperative days (POD) 3 Neutrophil to lymphocyte ratio (NLR), POD 7 NLR, and POD 7 Hemoglobin (HGB) were independent risk factors for postoperative infection in multivariate analysis.</p></div><div><h3>Conclusion</h3><p>LTSP increases the risk of short-term postoperative infections, and postoperative NLR can be used as a marker of infection.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142239","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}

引用次数: 0

Comparison of Cytomegalovirus Reactivation in Children After Allogeneic Hematopoietic Cell Transplantation in 2 Transplant Eras 比较两个移植时代异基因造血细胞移植后儿童巨细胞病毒再激活情况

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-03 DOI: 10.1016/j.transproceed.2024.08.028

{"title":"Comparison of Cytomegalovirus Reactivation in Children After Allogeneic Hematopoietic Cell Transplantation in 2 Transplant Eras","authors":"","doi":"10.1016/j.transproceed.2024.08.028","DOIUrl":"10.1016/j.transproceed.2024.08.028","url":null,"abstract":"<div><h3>Background</h3><p>Reactivation of cytomegalovirus (CMV) is typically considered harmless as long as the immune system remains unaffected by medications or other factors. CMV reactivation may occur as a result of acute graft-versus-host disease of Grades II to IV. One possible factor contributing to this risk is the rise in the number of donors who lack genetic similarities or relationships. We hypothesized that the anti-CMV IgG level before transplantation could potentially serve as an indicator of the likelihood of CMV reactivation following hematopoietic cell transplantation.</p></div><div><h3>Methods</h3><p>We examined a cohort of young individuals who underwent allogeneic HCT between 1998 and 2022 to evaluate the occurrence of CMV reactivation. The patients were divided into 2 time periods: 1998 to 2016 (comparison group) and 2017 to 2022 (intervention group).</p></div><div><h3>Results</h3><p>Between 1998 and 2016, 292 patients underwent hematopoietic HCT. Recipients from 2017 to 2022 experienced a slightly higher risk of CMV reactivation than those from 1998 to 2016. The comparison of prophylactic and preemptive medication showed no significant difference between the periods (<em>P</em> = .32). Patients treated from 1998 to 2016 experienced a 23% decrease in the risk of symptomatic CMV reactivation and related illnesses compared to those treated from 2017 to 2022 (<em>P</em> = .08 and .15, respectively).</p></div><div><h3>Conclusions</h3><p>Our study showed that the intervention group had more symptomatic CMV reactivations. Various factors may contribute to this, including CD19-directed immunotherapy and the CMV status of the recipient before transplantation.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S004113452400469X/pdfft?md5=8a10d98875b826af6cc2a791f34e818f&pid=1-s2.0-S004113452400469X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134883","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}

引用次数: 0

Trends in Patient Characteristics on the Japanese Waiting Lists for Deceased-Donor Kidney Transplantation. Are There no Eligibility or Ineligibility Criteria for Registration and Renewal? 日本遗体肾移植等待者名单中患者特征的变化趋势。登记和更新是否没有资格或无资格标准？

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-03 DOI: 10.1016/j.transproceed.2024.08.029

{"title":"Trends in Patient Characteristics on the Japanese Waiting Lists for Deceased-Donor Kidney Transplantation. Are There no Eligibility or Ineligibility Criteria for Registration and Renewal?","authors":"","doi":"10.1016/j.transproceed.2024.08.029","DOIUrl":"10.1016/j.transproceed.2024.08.029","url":null,"abstract":"<div><h3>Background</h3><p>Controversial issues in registering candidates for deceased-donor kidney transplantation (DDKT) comprise various factors, including age, life expectancy, and dialysis duration. We investigated patient characteristics on the waiting list and discussed suitable criteria in Japan, which has a long waiting period.</p></div><div><h3>Methods</h3><p>This study included 592 patients on the waiting list for DDKT at our institute between 1982 and 2023. We retrospectively reviewed patients’ medical charts and obtained their clinical information. Patient characteristics according to outcomes and eligibility criteria for applying for or renewing registration were investigated. No prisoners were used in the study, and the participants were neither coerced nor paid.</p></div><div><h3>Results</h3><p>Approximately 70%, 45%, and 14.5% of the registered patients were aged >60, >70, and 80 years, respectively. The number of patients aged ≥70 years gradually decreased over time. The median waiting periods of patients who underwent and interrupted DDKT were 13 and 7 years, respectively. Patients in their 70s with a >15-year dialysis period tended to have opportunities for DDKT. Living-donor kidney transplantation was performed in patients aged <60 years. Waiting patients were significantly younger and had a shorter dialysis duration. Advanced age at registration was associated with a significantly high risk of interruption.</p></div><div><h3>Conclusions</h3><p>Advanced age and longer dialysis periods were considered at registration because patients with these factors tended to experience interruptions despite the long waiting period and high cost. Although older patients can undergo DDKT, factors including surgical cost and risks are considered. Eligibility/ineligibility criteria should be established for DDKT waiting lists in Japan.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134900","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}

引用次数: 0

Fludarabine Melphalan, Reduced-dose Busulfan Versus Fludarabine, Melphalan, Full-dose Busulfan in Patients Receiving Cord Blood Transplantation 在接受脐带血移植的患者中，氟达拉滨-美法仑、减量布舒凡与氟达拉滨-美法仑、全量布舒凡的对比。

IF 0.8 4区医学

Transplantation proceedings Pub Date : 2024-09-03 DOI: 10.1016/j.transproceed.2024.08.031

{"title":"Fludarabine Melphalan, Reduced-dose Busulfan Versus Fludarabine, Melphalan, Full-dose Busulfan in Patients Receiving Cord Blood Transplantation","authors":"","doi":"10.1016/j.transproceed.2024.08.031","DOIUrl":"10.1016/j.transproceed.2024.08.031","url":null,"abstract":"<div><h3>Background</h3><p>Various reduced-intensity conditioning/reduced-toxicity conditioning regimens have been developed for patients receiving allogeneic hematopoietic cell transplantation. The balance between disease relapse and toxicity can be partly dependent on reduced-intensity conditioning/reduced-toxicity conditioning regimens. This retrospective study aimed to compare the nonrelapse mortality, relapse incidence, progression-free survival, and overall survival rates between the fludarabine/melphalan/reduced-dose busulfan (Flu/Mel/Bu2; busulfan at a dose of 6.4 mg/kg intravenously) and fludarabine/melphalan/full-dose busulfan (Flu/Mel/Bu4; busulfan at a dose of 12.8 mg/kg intravenously) regimens in patients receiving umbilical cord blood transplantation.</p></div><div><h3>Method</h3><p>Eighty-seven adult patients who received the Flu/Mel/Bu2 (<em>n</em> = 45) or Flu/Mel/Bu4 (<em>n</em> = 42) regimen as a conditioning regimen before umbilical cord blood transplantation at our institution between January 2013 and December 2022 were included in this study.</p></div><div><h3>Results</h3><p>There were no significant differences in terms of clinical outcomes including nonrelapse mortality, relapse incidence, progression-free survival, and overall survival rates between the two regimens. Further, even in higher-risk patients classified according to the Refined Disease Risk Index, the Flu/Mel/Bu2 regimen was comparable to the Flu/Mel/Bu4 regimen.</p></div><div><h3>Conclusion</h3><p>The novel Flu/Mel/Bu2 regimen could be applied in clinical settings as it can be tolerated and effective in older patients.</p></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134885","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}

引用次数: 0