Transplantation proceedings最新文献

{"title":"Comparative Analysis of Plasmapheresis Versus Plasmapheresis Combined With Continuous Renal Replacement Therapy in Adult Liver Failure: A Retrospective Observational Study","authors":"Ilhan Ocak, Mustafa Colak, Bilge Nur Bilici","doi":"10.1016/j.transproceed.2025.02.051","DOIUrl":"10.1016/j.transproceed.2025.02.051","url":null,"abstract":"<div><h3>Background</h3><div>Liver failure constitutes a critical medical condition marked by the rapid decline in hepatic functions. Novel therapeutic approaches, including therapeutic plasma exchange (TPE) and continuous venovenous hemodiafiltration (CVVHDF), have emerged as promising modalities for mitigating the effects of this condition by facilitating detoxification and enhancing liver function. The efficacy of these interventions, whether administered individually or in combination, is a prominent area of investigation in the management of liver failure among adult populations. This study aims to evaluate the role and effectiveness of TPE, both as a standalone treatment and in conjunction with CVVHDF, in the management of liver failure in adult patients.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted in a Liver Transplant Intensive Care Unit (LTICU), focusing on the medical records of adult patients aged 35 to 62 years. The patient cohort consisted of individuals admitted between January 1, 2021, and June 1, 2024, due to acute liver failure or acute-on-chronic liver failure. The analysis specifically included patients who underwent therapeutic plasma exchange (TPE) or those who received continuous renal replacement therapy in conjunction with TPE. For the statistical analysis, a <em>P</em>-value of less than .05 was deemed indicative of statistical significance. The study encompassed a total of 47 patients with liver failure, comprising 23 males and 24 females. Among these patients, 25 (53.2%) received only TPE, while 22 (46.8%) were treated with a combination of TPE and continuous venovenous hemodiafiltration (CVVHDF).</div></div><div><h3>Results</h3><div>In the cohort of patients who received only therapeutic plasma exchange (TPE), the median International Normalized Ratio (INR) improved significantly, decreasing from 2 (1.6-2.6) to 1.3 (1.1-1.7). Similarly, alanine aminotransferase levels reduced from 351 (66-1482) to 166 (71-367), while aspartate aminotransferase levels decreased from 259 (132-1392) to 86 (35-160). In the group receiving a combination of TPE and continuous venovenous hemodiafiltration (CVVHDF), notable reductions were also observed: INR decreased from 3 (2.4-4.7) to 1.5 (1.3-2.4), alanine aminotransferase levels dropped from 691 (59-2397) to 162 (70-1060), and aspartate aminotransferase levels fell from 916 (134-1828) to 69 (45-503). These changes were statistically significant, with <em>P</em>-values of less than .05 for each parameter in both treatment groups. Overall, 21 patients achieved survival without requiring a liver transplant, while 7 patients underwent liver transplantation, resulting in a transplant-free survival rate of 44.7%.</div></div><div><h3>Conclusion</h3><div>The findings from our study on the management of liver failure in adults demonstrate that both therapeutic plasma exchange (TPE) administered alone and in conjunction with continuous venovenous hemodiafiltration (C","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 598-605"},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660232","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":"Comparative Analysis of Treatment Outcomes and Prognostic Factors in Early T-Precursor Versus Non-ETP Acute Lymphoblastic Leukemia Following Allogeneic Hematopoietic Stem Cell Transplantation in Adolescents and Young Adults","authors":"Chengsen Cai ,&nbsp;Huizhu Kang ,&nbsp;Peng Ke ,&nbsp;Mengjie Cai ,&nbsp;Ming Gao ,&nbsp;Chengyuan Gu ,&nbsp;Ruju Wang ,&nbsp;Jiaqian Qi ,&nbsp;Depei Wu ,&nbsp;Yue Han","doi":"10.1016/j.transproceed.2025.02.029","DOIUrl":"10.1016/j.transproceed.2025.02.029","url":null,"abstract":"<div><div>This study evaluates the outcomes and risk factors associated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in adolescents and young adults (AYA) diagnosed with early T-precursor (ETP) acute lymphoblastic leukemia (ALL) compared to non-ETP ALL.We retrospectively analyzed 178 AYA patients with T-ALL who were treated between September 2014 and December 2022. Out of 178 patients, 128 underwent allo-HSCT, with a median age of 25 years (range: 18-35). Among them, 49 were in the ETP group and 79 in the non-ETP group. Neutrophil and platelet engraftment times were comparable between groups. 3-year OS rates were 67.3% for ETP and 65.8% for non-ETP patients; 3-year LFS rates were 65.3% and 65.8%, respectively, showing no significant difference. Cumulative incidence of relapse (22.1% vs. 21.6%) and non-relapse mortality rates (17.8% vs. 13.7%) were similar. The incidence of acute and chronic GVHD, along with infections, showed no significant differences. Multivariable analysis revealed first complete remission before transplantation as a positive predictor for OS and LFS in non-ETP patients. In ETP patients, a white blood cell count below 30 × 10⁹/L predicted better LFS outcomes. A hemoglobin level below 120 g/L was independently associated with improved OS in non-ETP patients. Allo-HSCT offers effective improvement in prognosis for ETP-ALL, with survival outcomes comparable to non-ETP ALL patients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 619-626"},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 13-Year Nationwide Analysis of Nocardia and Actinomyces Infection Outcomes in Liver Transplant Recipients","authors":"Andrej M. Sodoma ,&nbsp;James R. Pellegrini Jr. ,&nbsp;Rezwan F. Munshi ,&nbsp;Samuel Greenberg ,&nbsp;Sonika Rathi ,&nbsp;Tulika Saggar ,&nbsp;Atul Sinha ,&nbsp;Jiten Desai ,&nbsp;Paul Mustacchia","doi":"10.1016/j.transproceed.2025.02.037","DOIUrl":"10.1016/j.transproceed.2025.02.037","url":null,"abstract":"<div><div>Liver transplant (LT) recipients have a profound susceptibility to infections. Although <em>Nocardia</em> and <em>Actinomyces</em> (NAs) are well-known bacteria that typically affect immunosuppressed patients, a scarcity of research exists on the effects of LT with NA infections. Our study aims to evaluate the outcomes associated with NA infections in patients with LT. Patients were selected from the National Inpatient Sample (NIS) from 2008 through 2020. International Classification of Disease revision 9 (ICD-9) and ICD revision 10 (ICD-10) codes. Patients admitted with a history of LT were subdivided into those who were and were not diagnosed with an NA infection. Records were weighted using the NIS algorithm. Primary outcomes were all-cause hospital mortality, acute kidney injury (AKI), acute myocardial infarction (AMI), shock, and a composite of these. Secondary outcomes were length of stay, total charges, cytomegalovirus (CMV), and transplant rejection. Demographics and comorbidities were compared between the groups with a weighted chi-square test. Outcomes were compared between the two groups, and adjusted odds ratios (ORs) and regression coefficients were calculated using weighted logistic or linear regression as appropriate. ORs were adjusted for age, gender, race, hospital characteristics, Charlson Comorbidity Index (CCI), median income based on zip code, weekend admission, and insurance. There were 469,141 patients with LT who were included in this study, 310 of them had NA infection (0.07%). Patients in each group were of similar age, race, and overall medical complexity (<em>P</em> &gt; .05). Patients with NA infection were less likely to have a history of coronary artery disease (CAD; 4.84% vs 16.20%, <em>P</em> &lt; .05), hypertension (14.53% vs 25.82%, <em>P</em> &lt; .05), and obesity (1.61% vs 9.0%, <em>P</em> &lt; .05) than the healthy controls. Patients with LT with NA infection were found to have higher odds of mortality (OR = 5.50, <em>P</em> &lt; .001), AKI (OR = 1.9, <em>P</em> &lt; .05), composite outcome (OR = 2.19, <em>P</em> &lt; 0.01), and more likely to have CMV infection (OR = 6.38, <em>P</em> &lt; .01). Patients with LT with NA infection stayed 13.11 days longer in the hospital (<em>P</em> &lt; .01) with charges of $60,399 more (<em>P</em> &lt; .01) than the healthy controls. Patients with LT who acquired an NA infection were at nearly six-fold higher odds of death and other negative outcomes. Based on previous research that has demonstrated organ transplant patients to be at high risk of infections, more vigilant care should be taken to protect patients with LT from such opportunistic infections.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 670-674"},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660229","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":"Barriers to Kidney Transplantation in Urban Hemodialysis Centers in Pakistan: A Cross-Sectional Study","authors":"Hasaan Salman Shafi ,&nbsp;Syed Abdullah Ali Shah ,&nbsp;Irfan Ahmad ,&nbsp;Nabiha Rizvi ,&nbsp;Salman Tahir Shafi ,&nbsp;Omair Farooq","doi":"10.1016/j.transproceed.2025.02.048","DOIUrl":"10.1016/j.transproceed.2025.02.048","url":null,"abstract":"<div><h3>Background and aims</h3><div>End-stage kidney disease is a global health challenge that has greatly affected low-income and middle-income countries. While a living donor kidney transplant (LDKT) is the most optimal treatment for end-stage kidney disease, many medical and nonmedical barriers persist which hinder transplant rates. This study aims to identify the various medical, psychological, and socioeconomic barriers to LDKT among patients in urban hemodialysis centers in Pakistan.</div></div><div><h3>Methods</h3><div>A cross-sectional study of patients undergoing hemodialysis in urban hospitals across three urban cities in Pakistan was conducted. Participants were given a structured questionnaire addressing demographics, medical history, socioeconomic status, and transplantation awareness.</div></div><div><h3>Results</h3><div>The median age was 54 years (IQR 20), with 56.2% male participants. Barriers were identified as socioeconomic (61.4%), medical (32.6%), and psychological (6%). Significant differences in median age were observed across groups (<em>P</em> &lt; .01), with socioeconomic barriers associated with younger patients (median age 49 years) compared to medical (median 63 years) and psychological (59 years) barriers. Patients with socioeconomic barriers were younger (<em>P</em> ≤ .01), had lower income (<em>P</em> = .02), and had relatively lower rates of marriage (<em>P</em> = .02) compared to those in other categories. Lack of donors and lack of financial resources were the most common barriers, cited by 50.2% and 50% of participants, respectively.</div></div><div><h3>Conclusions</h3><div>Socioeconomic barriers are the leading obstacles to LDKT in Pakistan. Efforts must be made to address these barriers, such as a deceased donor program, financial aid, and improving patient knowledge about LDKT. Further studies should explore rural populations and psychological barriers in greater depth.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 552-557"},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660231","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":"Current Applications and Developments of Natural Language Processing in Kidney Transplantation: A Scoping Review","authors":"René Gatsinga ,&nbsp;Rachel Shu-En Lau ,&nbsp;Benjamin Jia Han Lim ,&nbsp;Khi Yung Fong ,&nbsp;Marc Zhen Guo Yeong ,&nbsp;Amber Hwa Hwa Chung ,&nbsp;Lay Guat Ng ,&nbsp;Edwin Jonathan Aslim ,&nbsp;Valerie Huei Li Gan ,&nbsp;Ee Jean Lim","doi":"10.1016/j.transproceed.2025.02.027","DOIUrl":"10.1016/j.transproceed.2025.02.027","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Natural language processing (NLP) is a subfield of artificial intelligence that enables computers to process human language. As most human interactions today involve the internet and electronic devices, NLP tools quickly become indispensable to modern life. The use of NLP tools in medical practice and research is growing fast. This scoping review evaluates the current and potential future applications of NLP in kidney transplantation medicine.</div></div><div><h3>Design</h3><div>We conducted an electronic literature search on NLP in the setting of kidney transplantation on PubMed, EMBASE, and Scopus from inception to August 26, 2024. Two independent investigators conducted the search strategy and reviewed abstracts and full texts; conflicts were resolved after discussion with a third and fourth author. A total of ten studies were included in the study.</div></div><div><h3>Results</h3><div>The most commonly studied clinical applications of NLP in kidney transplantation are its use as an adjunct tool to facilitate early diagnosis of renal disease and as an effective predictor of graft loss and complications among kidney transplant recipients. Some researchers were able to predict organs at risk of delayed implant or discard by analyzing donors’ EHR; this has the potential to improve organ utilization significantly. In clinical research, NLP tools can be tailored to perform specific tasks of interest on unstructured text. By studying n comments from social media and news websites, 1 group was able to gauge public perception of transplant policies and identify potential actions to improve access to transplant care.</div></div><div><h3>Conclusions</h3><div>NLP tools have only recently been introduced into medical research, but they are already significantly impacting kidney transplantation medicine. The literature demonstrates the potential to improve early diagnosis of renal failure, predict renal transplantation outcomes, improve organ utilization, and support advocacy and policymaking. With more widespread use of EHR globally and the continued development of NLP technology, these tools are poised to revolutionize the practice of renal transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 558-568"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639956","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":"4-Color Flow Cytometric Cytotoxicity Crossmatch Using Whole Blood Lysis","authors":"Dong Il Won ,&nbsp;Jeong-Hoon Lim ,&nbsp;Jang-Hee Cho ,&nbsp;Chan-Duck Kim ,&nbsp;Seung Huh","doi":"10.1016/j.transproceed.2025.02.034","DOIUrl":"10.1016/j.transproceed.2025.02.034","url":null,"abstract":"<div><h3>Background</h3><div>The conventional lymphocyte crossmatch (XM) assay necessitates mononuclear cell isolation. In our previous work, we introduced a novel 3-laser, 4-color flow cytometric (FC) XM protocol utilizing whole blood lysis (WBL) and CD45 fluorescence-triggered acquisition to detect human leukocyte antigen (HLA) antibody binding. Building on this, we aimed to adapt these advancements for complement-dependent cytotoxicity (CDC) XM using FC (FCCDC).</div></div><div><h3>Methods</h3><div>A total of 164 donor/recipient pairs undergoing transplantation were stratified into 2 groups based on donor-specific HLA alloantibody presence: DSA-positive (DSA+, n = 73) and DSA-negative (DSA−, n = 91). The DSA− group was further subdivided by ABO compatibility into ABO-incompatible (ABOi, n = 52) and ABO-compatible (n = 39) subgroups. Protocol optimization for the WBL FCCDC with CD45 V500-C was conducted using a FACSLyric cytometer (BD Biosciences). T and B cell indices were calculated as delta (test minus control) percentages of dead cells (Δ%DC). WBL FCCDC results were compared with those of conventional FCCDC in each group.</div></div><div><h3>Results</h3><div>WBL FCCDC showed no significant quantitative difference from conventional FCCDC. In the DSA+ group, B cell Δ%DC values were 28.00 ± 27.14 and 19.16 ± 27.74 for WBL FCCDC and conventional FCCDC, respectively (<em>P</em> = .0777). No ABO antibody interference was observed in the ABOi subgroup. Qualitatively, B cell WBL FCCDC sensitivity in the DSA+ group was 69.9%, comparable to conventional FCCDC sensitivity (65.8%, <em>P =</em> .5078). Additionally, WBL FCCDC reduced the turnaround time by 50 minutes relative to conventional FCCDC.</div></div><div><h3>Conclusions</h3><div>WBL FCCDC achieved performance equivalent to conventional FCCDC, similar to WBL FCXM. The absence of adverse effects from the lysis step supports its integration into XM assays. Given its simplicity and maintained sensitivity, the WBL FCCDC protocol presents a viable alternative to conventional methods in histocompatibility laboratories.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 675-682"},"PeriodicalIF":0.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639955","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 Liver Transplantation After Achieving Complete Clinical Remission of Hepatocellular Carcinoma With Combination Therapy of Immune Checkpoint Inhibitors and Targeted Agents: A Case Report","authors":"Shaobo Zhang ,&nbsp;Shugeng Zhang","doi":"10.1016/j.transproceed.2025.02.041","DOIUrl":"10.1016/j.transproceed.2025.02.041","url":null,"abstract":"<div><div>Immunotherapy, primarily with immune checkpoint inhibitors, has become pivotal in the treatment of advanced hepatocellular carcinoma (HCC), leading to significant tumor burden reduction. However, its applicability in liver transplantation remains controversial. Due to the potential risks of rejection limiting large-scale clinical trials and the incomplete understanding of underlying mechanisms, whether transplant recipients can benefit from immunotherapy remains uncertain. This report describes the application of immunotherapy in liver transplantation, wherein two patients achieved complete tumor remission after receiving immunotherapy combined with other treatments before transplantation, enabling successful liver transplantation surgeries. Additionally, one patient received combination therapy with tislelizumab and lenvatinib before transplantation (Case 2), representing the first reported case utilizing this combination therapy as a bridging treatment before LT.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 580-584"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631164","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":"Hypothermic Myocardial Preservation: The Freezing Debate","authors":"Mohammed Quader ,&nbsp;Zachary Kiernan ,&nbsp;Gina Labate ,&nbsp;Qun Chen","doi":"10.1016/j.transproceed.2025.02.035","DOIUrl":"10.1016/j.transproceed.2025.02.035","url":null,"abstract":"<div><h3>Background</h3><div>Storage of hearts in ice for transportation is thought to cause post-transplantation graft dysfunction secondary to freeze injury. We studied the myocardial damage and resulting function in hearts stored at 0 °C, 4 °C and 8 °C for 4 hours.</div></div><div><h3>Methods</h3><div>Rat hearts were procured under general anesthesia and immediately stored in University of Wisconsin solution at 0 °C, 4 °C and 8 °C for 4 hours (n = 6-8/group). Hearts were then re-perfused on a Langendorff apparatus for 90 minutes using oxygenated Kreb-Henseleit buffer (37 °C). Functional parameters were recorded via a balloon tip catheter in the left ventricle. Following reperfusion hearts were collected for infarct size quantification using triphenyltetrazolium chloride staining. A separate group of hearts (n = 2-3) were similarly stored then studied for ultrastructural and biochemical changes.</div></div><div><h3>Results</h3><div>There were no signs of freeze injury in hearts stored at 0 °C by histologic or biochemical analysis. There was no significant difference in infarct size between hearts stored at 0 °C and 4 °C. Cardiac troponin I level, and left ventricle developed pressure in hearts stored at 0 °C, 4 °C, and 8 °C were comparable (all <em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>Hearts stored at 0 °C for 4 hours showed no signs of freeze injury and had similar functional parameters compared to hearts stored at 4 °C or 8 °C.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 653-662"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631161","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":"Promising Long-Term Outcomes of Lung Transplantation With Hepatitis C Positive Donors: Insights From the UNOS Registry","authors":"Elizabeth J. Bashian ,&nbsp;Eleanor E. Bashian ,&nbsp;Ye In Christopher Kwon ,&nbsp;Matthew Ambrosio ,&nbsp;Zachary Fitch ,&nbsp;Lauren J. Taylor ,&nbsp;Vipul Patel ,&nbsp;Walker Julliard ,&nbsp;Vigneshwar Kasirajan ,&nbsp;Zubair A. Hashmi","doi":"10.1016/j.transproceed.2025.02.044","DOIUrl":"10.1016/j.transproceed.2025.02.044","url":null,"abstract":"<div><h3>Background</h3><div>The development of effective direct-acting antiviral treatment (DAAT) for hepatitis C virus (HCV) has opened the possibility of using HCV+ donors. We aimed to assess the long-term feasibility of lung transplantation using organs from HCV+ donors.</div></div><div><h3>Methods</h3><div>We used the UNOS database to evaluate adult lung transplant recipients between 2000 and 2023. HCV+ organs were further divided into those positive for both antibody and nucleic acid testing (NAT) or antibody testing alone. Baseline recipient and donor characteristics were compared. The Kaplan–Meier method was used to assess 30-day, 1-year, and 5-year survival. We performed risk analyses using multivariate Cox regression analyses.</div></div><div><h3>Results</h3><div>41,797 lung transplants were performed, among which 945 used HCV+ donors. Recipients of HCV+ lungs had higher FEV1 (<em>P</em> &lt; .001), older (<em>P</em> &lt; .001), and had higher BMI (<em>P</em> &lt; .001). While 5-year survival did not differ between recipients of HCV+ and HCV- donor lungs (<em>P</em> = .093), graft survival was superior among recipients of HCV+ lungs (<em>P</em> = .038). Acute rejection rates were also lower for recipients of HCV+ lungs (<em>P</em> = .018). However, recipients of HCV+ lungs required significantly higher time on the ventilator post-transplant (<em>P</em> = .033). Donor HCV+ status, regardless of whether they were NAT- (HR 1.03, <em>P</em> = .766) or NAT+ (HR 0.89, <em>P</em> = .24), was not associated with adverse outcomes.</div></div><div><h3>Conclusions</h3><div>Lung transplantation with HCV+ donor lungs demonstrates promising outcomes up to 5 years post-transplant. With careful preoperative screening, DAAT treatments, and postoperative management, recipients of HCV+ lungs may expect minimal additional complications.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 612-618"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631163","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":"Development and Validation of a Nomogram for Predicting Subtherapeutic Tacrolimus Blood Levels in Renal Transplant Recipients: A Multivariate Logistic Regression Analysis","authors":"Bowen Duan,&nbsp;Jinxian Gao,&nbsp;Bin Ge,&nbsp;Shujin Wu,&nbsp;Jing Yu","doi":"10.1016/j.transproceed.2025.02.025","DOIUrl":"10.1016/j.transproceed.2025.02.025","url":null,"abstract":"<div><div>This study constructs a nomogram risk prediction model to identify factors affecting subtherapeutic tacrolimus (FK506) blood concentrations in postrenal transplant patients, enhancing clinical management. Data from renal transplant patients treated with tacrolimus from January to December 2023 were analyzed using multivariate logistic regression to identify risk factors. A nomogram model was constructed and validated through cross-validation and bootstrapping. Predictive performance was assessed via receiver operating characteristic curve and Hosmer– Lemeshow test. Among 340 patients, 224 achieved target FK506 concentrations (5-15 ng/mL). Independent risk factors for subtherapeutic levels included white blood cell count ≤4 × 10^9/L, total bilirubin &gt;20 μmol/L, creatinine &gt;73 μmol/L, and blood urea nitrogen ≤7.1 mmol/L. The model's receiver operating characteristic area under the curve was 0.84, with a Hosmer– Lemeshow test <em>P</em>-value of .386, indicating high predictive accuracy and good calibration. The nomogram effectively predicts subtherapeutic FK506 levels, providing a valuable tool for personalized patient management. Future research should refine and externally validate the model.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 529-537"},"PeriodicalIF":0.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627296","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}