Transplantation proceedings最新文献

{"title":"Disseminated Cunninghamella bertholletiae Infection From Latent Lower Limb Mass After Kidney Transplant: A Case Report","authors":"Yadi Wang,&nbsp;Keqin Zhang,&nbsp;Ling Liu,&nbsp;Runtian Qu","doi":"10.1016/j.transproceed.2025.03.032","DOIUrl":"10.1016/j.transproceed.2025.03.032","url":null,"abstract":"<div><h3>Background</h3><div>Cunninghamella <em>bertholletiae</em> (C. <em>bertholletiae</em><span><span>), a rare yet highly virulent species within the Mucorales order, predominantly affects individuals with compromised immune systems. Disseminated infections caused by this </span>pathogen<span><span> frequently lead to severe complications, underscoring the necessity for prompt diagnosis and aggressive therapeutic interventions. Invasive fungal diseases (IFDs) continue to be a major cause of morbidity and mortality among </span>kidney transplant<span> recipients, characterized by elevated incidence and mortality rates. The early and precise identification of fungal pathogens is crucial for optimizing patient outcomes.</span></span></span></div></div><div><h3>Case presentation</h3><div>This report presents a case study of a 37-year-old male kidney transplant recipient who developed a disseminated C. <em>bertholletiae</em><span><span><span> infection from a latent lower limb lesion. Initially, he showed symptoms of high fever and dyspnea, leading to diagnoses of sepsis<span><span>, severe pneumonia, acute respiratory distress syndrome, and </span>allograft dysfunction. After surgery, he had recurrent </span></span>pleural effusion and worsening </span>pulmonary nodules. Metagenomic next-generation sequencing (mNGS) confirmed C. </span><em>bertholletiae</em><span> infection, and histopathology<span> revealed mucormycosis with vascular invasion, thrombosis, and tissue necrosis<span><span>. The patient underwent a 13-month antifungal treatment with </span>amphotericin B lipid complex<span><span>, posaconazole, and </span>isavuconazole.</span></span></span></span></div></div><div><h3>Conclusion</h3><div><span>This case highlights the essential role of histopathology and mNGS in early detection of rare IFDs and stresses the need for a multidisciplinary approach combining surgery with antifungal therapy. The effective management of disseminated C. </span><em>bertholletiae</em><span><span> infection using a triple antifungal regimen offers important insights for future cases, underscoring the importance of early diagnosis and personalized treatment in </span>immunocompromised patients.</span></div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1319-1324"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121917","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":"Role of Nuclear Scan in a Patient With Recurrent Focal Segmental Glomerulosclerosis Post-Transplantation: A Case Report","authors":"Sylvain Trincal ,&nbsp;Diane Giovannini ,&nbsp;Julie Roux ,&nbsp;Hamza Naciri Bennani ,&nbsp;Rémi Richaud ,&nbsp;Thomas Jouve ,&nbsp;Paolo Malvezzi ,&nbsp;Lionel Rostaing","doi":"10.1016/j.transproceed.2025.07.004","DOIUrl":"10.1016/j.transproceed.2025.07.004","url":null,"abstract":"<div><div>A 35-year-old patient was diagnosed with biopsy-confirmed, steroid-and rituximab-resistant primary focal-segmental-glomerulosclerosis. While on hemodialysis, diuresis was maintained; proteinuria persisted at 9 g/g creatinine. He underwent kidney transplantation; 2-months post-transplantation, persistent proteinuria (3 g/g creatinine; albuminuria exceeding 50%) was observed. The serum creatinine level was 2.2 mg/dL. The kidney-transplant biopsy was normal. Technetium-99m-dimercaptosuccinic-acid (DMSA) renal scan revealed that native kidneys contributed to 30% of renal function. Irbesartan 150 mg/d/dapagliflozin 10 mg/d was started. Six months post-transplantation, proteinuria progressively increased to 7 to 8 g/g. We therefore decided to implement daily immunoadsorption sessions (11 sessions) followed by rituximab (1 infusion of 350 mg/m²). This allowed partial remission.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1315-1318"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850249","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":"First Successful HeartMate 3 Implantation in the Pediatric Population in Brazil","authors":"Estela Azeka,&nbsp;Luis Fernando Bernal da Costa Seguro,&nbsp;Adailson Wagner Siqueira,&nbsp;Luiz Fernando Caneo,&nbsp;Nana Miura,&nbsp;Marcelo Biscegli Jatene","doi":"10.1016/j.transproceed.2025.08.009","DOIUrl":"10.1016/j.transproceed.2025.08.009","url":null,"abstract":"<div><div>The purpose of this study was to describe the first successful Heartmate 3 implantation in the pediatric population in Brazil.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1281-1283"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983502","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":"Mycotic Aneurysm Following Renal Transplantation: A Rare Complication Linked To Contaminated Preservation Fluid- A Case Report","authors":"Beatriz Gil Braga ,&nbsp;Ana Cunha ,&nbsp;Henrique Almeida ,&nbsp;Carlos Pereira ,&nbsp;João Diogo Castro ,&nbsp;Rui Machado ,&nbsp;Ana Cipriano ,&nbsp;José Silvano ,&nbsp;La Salete Martins ,&nbsp;Ana Castro ,&nbsp;Cristina Freitas","doi":"10.1016/j.transproceed.2025.08.002","DOIUrl":"10.1016/j.transproceed.2025.08.002","url":null,"abstract":"<div><div>Mycotic pseudoaneurysms are rare yet potentially fatal complications following kidney transplantation, typically associated with infection and high morbidity. This report describes the case of a 66-year-old man who developed a mycotic pseudoaneurysm 4 months after a second renal transplant. The clinical course was notable for initial contamination of the preservation fluid with carbapenemase-producing <em>Klebsiella pneumoniae</em>, followed by delayed onset of symptoms and vascular complications. Despite early antimicrobial treatment and apparent graft stability, the patient later presented with graft dysfunction, low back pain, and systemic signs of infection. Imaging revealed a saccular pseudoaneurysm of the left iliac artery causing compression of the renal vein and ureter. Given the suspicion of a mycotic origin, endovascular exclusion of the pseudoaneurysm was performed using a covered stent, in conjunction with a femoro-femoral bypass. Targeted antibiotic therapy was administered for 6 weeks. Remarkably, graft function improved post-intervention and remained stable at 1-year follow-up. This case underscores the importance of rigorous post-transplant surveillance, especially in patients exposed to infected preservation fluids. It also highlights that, in selected cases, graft-preserving endovascular approaches may be successful alternatives to nephrectomy, even in the presence of infection. A multidisciplinary strategy combining individualized clinical judgment, targeted antimicrobial therapy, and minimally invasive intervention was crucial to the favorable outcome. This case contributes to the limited evidence supporting conservative management of infected pseudoaneurysms and emphasizes the need for ongoing clinical vigilance and tailored therapeutic approaches in immunocompromised transplant recipients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1296-1299"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984568","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":"Intrapulmonary Epstein-Barr Virus-Associated Smooth Muscle Tumor after Bilateral Lung Transplantation: A Case Report","authors":"Ting Ma ,&nbsp;Jilong Qin ,&nbsp;Yu Deng","doi":"10.1016/j.transproceed.2025.07.017","DOIUrl":"10.1016/j.transproceed.2025.07.017","url":null,"abstract":"<div><div>Epstein-Barr virus-associated smooth-muscle tumor is an uncommon oncovirus-related neoplasm in the setting of solid organ transplantation. We report a case of a 69-year-old man who had no symptoms and a lung nodule was found incidentally on chest CT 2 years after bilateral lung transplantation. Surgical resection of the nodule was performed and pathology proved an EBV-SMT. No evidence of recurrence or metastasis was found till now. An incidental solid lung nodule with interval growth in the late stage of lung transplant should raise the suspicion of EBV-SMT. The surgery resection is the treatment of choice with a favorable prognosis.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1376-1378"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839580","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 Retrograde Management of Encrusted Double J Stent in Kidney Transplantation Patient","authors":"Yazeed Alghabban ,&nbsp;Mostafa Ayyad ,&nbsp;Ahmed Ali ,&nbsp;Magdy S. Elbahnasawy ,&nbsp;Mohamed H. Zahran","doi":"10.1016/j.transproceed.2025.05.037","DOIUrl":"10.1016/j.transproceed.2025.05.037","url":null,"abstract":"<div><div>Managing ureteral and renal pelvis pathology through retrograde endoscopy is not a straightforward task in kidney transplant patients. We present a case involving an encrusted double J stent in a kidney transplant patient. Using a holmium LASER through a retrograde ureteroscopy, we disintegrated the encrustation on both the upper and lower coils and successfully removed the DJ stent. This effectively demonstrates that retrograde management of encrusted DJ in transplant patients is feasible and safe, provided it is undertaken in the appropriate circumstances and with advanced endourological tools available.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1325-1328"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839614","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":"Time Elapsed Between the Family Interview and Decision Making for Organ and Tissue Donation","authors":"Maria Luísa de Souza ,&nbsp;Nathalia Malaman Galhadi ,&nbsp;Klênio de Oliveira Bonfim ,&nbsp;Mariana Dolce Marques ,&nbsp;Rafaela Batista dos Santos Pedrosa","doi":"10.1016/j.transproceed.2025.07.010","DOIUrl":"10.1016/j.transproceed.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Family authorization is required for organ donation, and the decision-making process is often hindered by emotional distress, lack of understanding, and limited time. The aim of this study was to quantify the time elapsed between the confirmation of brain death (BD) and the family’s decision to authorize or refuse organ and tissue donation, and to analyze its influence on the outcome of the decision.</div></div><div><h3>Method</h3><div>A quantitative, cross-sectional, retrospective study was conducted through the analysis of 240 medical records of potential organ donors between 2021 and 2023 at an Organ Procurement Organization in São Paulo, Brazil. Sociodemographic and clinical data were collected, including information about the BD process, family interviews, and decision times. Statistical analyses were performed using the SAS software, version 9.4.</div></div><div><h3>Results</h3><div>Of the 240 potential donors, 57.92% were male, with an average age of 47.7 years. The leading causes of BD were subarachnoid hemorrhage, traumatic brain injury, and stroke. Interviews were primarily conducted by nurses (68.33%), with spouses and children being the main decision-makers. Overall, 57.98% of families consented to donation. The average time between the interview and decision-making was 9.05 hours, with a median of 5 hours. Families who consented had a significantly longer decision time (median of 5.91 hours) compared to those who refused (4.25 hours).</div></div><div><h3>Conclusion</h3><div>The study demonstrates that longer decision-making time is associated with higher rates of family consent for organ donation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1258-1260"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839615","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":"Donor With Occult Breast Cancer: The Fate of Multiple Organ Recipients: A Case Report And Review of the Literature","authors":"Hanna Storoniak ,&nbsp;Alicja Dębska-Ślizień ,&nbsp;Andrzej Chamienia ,&nbsp;Anna Drobińska ,&nbsp;Piotr Remiszewski ,&nbsp;Elżbieta Senkus-Konefka ,&nbsp;Jacek Wojarski ,&nbsp;Sławomir Żegleń ,&nbsp;Ewelina Serkies-Minuth ,&nbsp;Katarzyna Michalska-Małecka ,&nbsp;Tomasz Stefaniak ,&nbsp;Rafał Pęksa ,&nbsp;Wojciech Biernat ,&nbsp;Maciej Wilczyński ,&nbsp;Paulina Rościcka ,&nbsp;Jarosław Kobiela ,&nbsp;Aleksandra Zgryzniak","doi":"10.1016/j.transproceed.2025.04.009","DOIUrl":"10.1016/j.transproceed.2025.04.009","url":null,"abstract":"<div><div><span>We present the outcomes of organ recipients from a 69-year-old female donor diagnosed with occult breast cancer. The donor had no relevant medical history<span> nor aberrant finding or sings of malignancy at the time of </span></span>organ procurement<span><span>. The organ donation encompassed the right kidney, liver, lungs, and corneas, which were thereafter transplanted. The left kidney of the donor was not accepted due to macroscopic features of chronic injury. Routine histopathological examination disclosed microscopic metastasis<span><span> of lobular breast carcinoma. Consequently, given the elevated risk of transmission, the following interventions were implemented: the kidney recipient underwent </span>nephrectomy followed by the discontinuation of </span></span>immunosuppression<span><span>; the liver recipient was administered letrozole and subsequently underwent liver </span>retransplantation<span> 3 months later; the lung recipient received a therapeutic regimen consisting of goserelin and letrozole; and the cornea recipient received nonvascular tissues. At the most recent follow-up in October 2024 (13 months post-transplantation), all recipients were reported to be in good health and free from disease. This remarkable case underscores that even an exhaustive evaluation of the donor may not unveil the presence of malignancy. Appropriate logistical and therapeutic strategies are crucial in preventing the transmission of cancer. Although the risk of malignancy transmission remains low, it is still present, necessitating that patients remain under vigilant medical supervision.</span></span></span></div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1310-1314"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013939","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":"Sonographic Hepatosplenic Ratio: A Noninvasive Method to Diagnose Graft Steatosis in Liver Transplantation","authors":"Stefania Roselli ,&nbsp;Piercarmine Panzera ,&nbsp;Maria Filippa Valentini ,&nbsp;Gianluigi Gigante ,&nbsp;Irene Scalera ,&nbsp;Grazia Labellarte ,&nbsp;Oronzo Ligurgo ,&nbsp;Nunzio Tralli ,&nbsp;Francesco D’Amico ,&nbsp;Francesco Tandoi","doi":"10.1016/j.transproceed.2025.05.007","DOIUrl":"10.1016/j.transproceed.2025.05.007","url":null,"abstract":"<div><div><span>Liver steatosis<span> is considered one of the most common disorders. Macrovesicular steatosis in donor livers is a major cause of graft failure<span> and remains difficult to assess. The aim of this study is to evaluate the correlation between the hepato-splenic ratio (HSR) obtained by back table ultrasound (US) and the histological grade of graft steatosis, using liver biopsy<span> as a reference. Between October 2019 and December 2021, 50 cadaveric liver transplant<span> donors were studied. Back-table US was used to determine the HSR, which is obtained by dividing the mean brightness level of the liver region of interest by that of the splenic region. Biopsy was performed in all donors and fixed in 4% formalin<span>. The histological variables analyzed were steatosis, fibrosis and inflammatory infiltrate. Spearman's coefficient was used to assess the correlation between the HSR and the presence of macrovesicular hepatic steatosis (r 0.28, </span></span></span></span></span></span><em>P</em> &lt; .05<em>).</em> The cut-off of hepato-splenic ratio to predict steatosis is 0.91 (sensitivity 75% and specificity 57%). The mean ± SD of the ratio in the control and steatosis group were 0.9 ± 0.14 and 1.03 ± 0.3 (<em>P =</em> .11), respectively. The HSR can be a simple, objective and noninvasive method to assess the quality of the liver, which can be used in some contexts of liver procurement, when second-level imaging is not available or when liver biopsy is not possible.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1214-1218"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337405","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":"Horseshoe Kidney Transplantation from a Deceased Cardiac Death Donor: A Case Report","authors":"Luca Perin ,&nbsp;Maurizio Romano ,&nbsp;Enrico Dalla Bona ,&nbsp;Michele Finotti ,&nbsp;Alessandro Iacomino ,&nbsp;Margherita Mangino ,&nbsp;Filomena Sergi ,&nbsp;Rossana Maffei ,&nbsp;Maurizio Nordio ,&nbsp;Paolo Zanatta ,&nbsp;Giacomo Zanus","doi":"10.1016/j.transproceed.2025.05.010","DOIUrl":"10.1016/j.transproceed.2025.05.010","url":null,"abstract":"<div><div>The use of marginal kidney donors with congenital morphological anomalies, such as the “horseshoe” kidney, presents itself as a solution to expand the donor pool. The vascular and urinary anatomy of the horseshoe kidney is complex. These patients are more frequently affected by hydronephrosis, vesicoureteral reflux, urinary tract infections, and urolithiasis. The horseshoe kidney can be transplanted “en bloc” or as a single kidney after “splitting.” A 54-year-old patient with end-stage renal failure, on hemodialysis for 4 years, was transplanted with a “horseshoe” graft from a deceased cardiac death (DCD) III Maastricht-type donor. The “preoperative” computed tomography (CT) documented the presence of a “horseshoe” kidney, non-divisible due to the presence of a shared lower polar renal artery between both kidneys. There were no anomalies in the collecting systems except for a slight dilation of the right renal pelvis. The distal side of the inferior vena cava was anastomosed end-to-side with the external iliac vein. The left common iliac artery of the donor was sutured end-to-side with the external iliac artery. The ureters were implanted separately after the placement of the Double J (DJ) stents. There were no perioperative complications. Immunosuppressive therapy was induced with ATG and subsequently tacrolimus and mycophenolate mofetil were introduced. In 4 months of follow-up, the patient developed a lymphocele that was drained percutaneously. The DJ stents were removed after 3 months. The donor with a horseshoe kidney, in the absence of a urological pathological history, can be considered for transplantation even in a DCD setting by planning an appropriate preoperative strategy.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 7","pages":"Pages 1233-1237"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337404","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}