Transplantation proceedings最新文献

{"title":"Alirocumab in Adult Patients With Hyperlipidemia After Liver Transplantation: A Short-term Observation","authors":"Tieyan Fan ,&nbsp;Yan Yan ,&nbsp;Jingyue Wang ,&nbsp;Jun Li ,&nbsp;Guangxun Xu ,&nbsp;Qian Lu ,&nbsp;Hong Chen","doi":"10.1016/j.transproceed.2025.04.005","DOIUrl":"10.1016/j.transproceed.2025.04.005","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical efficacy of alirocumab in postoperative hyperlipidemia among liver transplant recipients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of clinical data from liver transplant recipients with postoperative hyperlipidemia who received alirocumab treatment at our institution.</div></div><div><h3>Results</h3><div>Seventeen cases were observed, with a male-to-female ratio of 12:5. Patient ages ranged from 44 to 65 years, with an average age of 55.47 years. The initiation of alirocumab treatment occurred between 1 and 196 months postliver transplantation, averaging 44.88 months. Treatment duration was a minimum of 3 months. The levels of blood lipids were assessed at 4, 8, and 12 weeks during the treatment regimen. At 8 weeks, a statistically significant reduction in total cholesterol was recorded (<em>P = .012</em>), and this decrease was further pronounced at 12 weeks (<em>P = .004</em>). For LDL cholesterol, significant decreases were evident at 4 weeks (<em>P = .011</em>), 8 weeks (<em>P = .005</em>), and 12 weeks (<em>P = .004</em>). No significant changes were observed in high-density lipoprotein (HDL) cholesterol and triglyceride levels throughout the study period. In addition, all patients maintained stable liver function and immunosuppressant concentrations.</div></div><div><h3>Conclusions</h3><div>Alirocumab demonstrated a significant reduction in total cholesterol and low-density lipoprotein cholesterol levels among liver transplant recipients, with no observed increase in the risk of rejection. This suggests the potential effectiveness of alirocumab as a lipid-lowering therapy in liver transplant recipients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 810-815"},"PeriodicalIF":0.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Thyroid Hormones on Brain-Dead Organ Donors: A Systematic Review and Meta-Analysis","authors":"Luís Fernando Ferreira Cavalcante ,&nbsp;Alonzo Armani Prata ,&nbsp;Caio Rezende Lima ,&nbsp;Gabriela Blanco Stutz ,&nbsp;Thalia Melamed ,&nbsp;Paulo Ricardo Gessolo Lins ,&nbsp;Alexandra Régia Dantas Brígido","doi":"10.1016/j.transproceed.2025.03.028","DOIUrl":"10.1016/j.transproceed.2025.03.028","url":null,"abstract":"<div><h3>Introduction</h3><div>The administration of thyroid hormones (TH) in brain-dead donors has been proposed as a strategy to improve organ viability for transplantation, addressing the neuroendocrine insufficiency caused by brain death. While evidence suggests potential benefits, such as hemodynamic stabilization and enhanced organ function, the impact of TH replacement on donor utilization rates and transplant outcomes remains unclear.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis of randomized controlled trials (RCT) comparing TH administration with placebo or standard-of-care. Mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model, and Heterogeneity was assessed using I².</div></div><div><h3>Results</h3><div>Six studies involving a total of 1,197 brain-dead organ donors were included. Of these, 601 received TH, while 597 were given either a placebo or standard-of-care treatment. Overall, the number of transplanted hearts (RR 0.99; 95% CI 0.84-1.17; <em>P =</em> .92), lungs (RR 1.07; 95% CI 0.65-1.75; p 0.80), and livers (RR 1.00; 95% CI 0.78-1.28; <em>P =</em> .99) was similar between groups. Cardiac index showed no significant difference between groups (MD –0.05; 95% CI –0.28 to 0.19; <em>P =</em> .71), and similar trends were observed for other hemodynamic parameters, including heart rate (MD 5.11; 95% CI –1.47 to 11.69; <em>P =</em> .13), pulmonary capillary wedge pressure (MD -0.02; 95% CI –1.54 to 1.50; <em>P =</em> .98), and central venous pressure (MD 0.76; 95% CI –0.63 to 2.14; <em>P =</em> .28), indicating that TH administration did not significantly alter these measures compared to placebo or standard-of-care treatment.</div></div><div><h3>Conclusion</h3><div>Our data suggest that administering TH to brain-dead potential organ donors does not effectively increase the number of organ transplants and has no impact on hemodynamic parameters.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 698-705"},"PeriodicalIF":0.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996421","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":"When to Remove Tracheal Intubation During ECMO Support in Lung Transplant Patients With Idiopathic Pulmonary Fibrosis","authors":"Jing Tian,&nbsp;Ke Jin,&nbsp;Yan Dong,&nbsp;Hongyang Xu","doi":"10.1016/j.transproceed.2025.03.026","DOIUrl":"10.1016/j.transproceed.2025.03.026","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplantation is the optimal treatment choice, while extracorporeal membrane oxygenation (ECMO) provides cardiopulmonary support during the perioperative period of lung transplantation. Currently, there is no reported research on the ECMO withdrawal and duration of mechanical ventilation (MV) in idiopathic pulmonary fibrosis (IPF) patients undergoing lung transplantation. Therefore, this study aims to evaluate the impact of ECMO duration on prolonged mechanical ventilation (PMV) time in patients, attempting to explore the relationship between the two.</div></div><div><h3>Methods</h3><div>This study included 170 patients with IPF who underwent lung transplantation under ECMO technology. The patients were divided into normal and delayed groups based on the ECMO application time of 72 hours. A multifactor logistic regression analysis was conducted to explore the independent risk factors for PMV time, and restricted cubic spline (RCS) was used to investigate the relationship between ECMO application time and MV time. Receptor operating characteristics (ROC) were further used to find the cut-off value of ECMO application time to predict PMV time.</div></div><div><h3>Results</h3><div>In the normal group, there were 135 cases, of which 79.25% (107 cases) were males and 20.74% (28 cases) were females, whereas in the delayed group, there were 35 cases, of which 57.14% (20 cases) were males and 42.86% (15 cases) were females. In the RCS curves, there was a nonlinear correlation between the duration of ECMO application and the duration of MV, which tended to increase as the duration of ECMO application increased. According to univariate and multivariate logistic analyses, ECMO application time was an influential factor in the occurrence of PMV time, in which the OR of PMV time was 2.02 (95% CI 1.11,1.63, <em>P</em> = .001) when ECMO application time was ≥ 52.01 hours.</div></div><div><h3>Conclusion</h3><div>After lung transplantation, there is a nonlinear relationship between the application time of ECMO and MV time in patients with IPF. The application time of ECMO can predict well the extension of MV in patients during ICU stay. Therefore, clinicians can assess the duration of MV in patients with IPF based on the application time of ECMO, further avoiding complications related to MV.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 876-884"},"PeriodicalIF":0.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061749","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":"Echinococcal Liver Infections: Comparing Transplant Strategies for Granulosus and Alveolaris","authors":"Yazici Sinan Efe ,&nbsp;Atasever Ahmet ,&nbsp;Turan Ebru ,&nbsp;Sahin Tolga ,&nbsp;Yuzer Yildiray","doi":"10.1016/j.transproceed.2025.04.006","DOIUrl":"10.1016/j.transproceed.2025.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate liver transplantation strategies for patients with <em>Echinococcus granulosus</em> (EG) and <em>Echinococcus alveolaris</em> (EA), comparing surgical approaches, complications, and outcomes in both groups.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 11 patients who underwent liver transplantation for EG or EA at our center between 2006 and 2024. Patient data included demographics, surgical details, preoperative and postoperative management, and follow-up outcomes.</div></div><div><h3>Results</h3><div>All EG patients presented with cirrhosis, primarily due to treatment-related complications, while EA patients exhibited diffuse parenchymal and hilar involvement. Transplantation in EG cases was performed to address complications, whereas EA cases required transplantation due to the disease’s malignant behavior and advanced liver involvement. All patients underwent living donor liver transplantation, with inferior vena cava (IVC) plasty performed in 2 EA patients. No recurrence was observed in either group during follow-up. Mortality was reported in 2 EG patients: 1 due to early postoperative complications and another from leukemia 2 years post-transplant. EA patients achieved excellent outcomes, with no mortality or recurrence observed during a mean follow-up period of 10 years.</div></div><div><h3>Conclusions</h3><div>Liver transplantation is a safe and effective treatment for EG and EA, requiring distinct strategies tailored to each disease. EG transplants are typically performed to manage complications, whereas EA transplants necessitate advanced surgical techniques, including minimal liver manipulation and IVC plasty. These findings emphasize the critical role of specialized centers and tailored strategies in managing complex echinococcal liver infections.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 916-921"},"PeriodicalIF":0.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Web-Based Education on Symptoms and Adherence To Immunosuppressive Medications In Liver Transplant Patients","authors":"Nihal Dolanbay ,&nbsp;Meral Ozkan","doi":"10.1016/j.transproceed.2025.03.005","DOIUrl":"10.1016/j.transproceed.2025.03.005","url":null,"abstract":"<div><h3>Aim</h3><div>Liver transplant patients experience several symptoms associated with immunosuppressive medications and have problems in medication adherence. This study aims to examine the effect of web-based education on symptoms and adherence to immunosuppressive medications in liver transplant patients.</div></div><div><h3>Materials and Methods</h3><div>This is a randomized controlled trial study. The population of the study consisted of patients who had liver transplantation in a university hospital at least 2 months and at most 2 years before the interview (N = 116). The sample of the study consisted of a total of 90 liver transplant patients who were determined by a power analysis. The data were collected between January and July 2021 using a patient information form, the Modified Transplant Symptom Occurrence and Symptom Distress Scale-59 Items (MTSOSD-59), and the Immunosuppressive Medication Adherence Scale (IMAS).</div></div><div><h3>Results</h3><div>Liver transplant patients in the experimental group were given a web-based education for 1 month. After the education, a significant decrease was observed in their symptom’s occurrence and discomfort with symptoms scores and a significant increase in their immunosuppressive medication adherence scores, compared to that of those in the control group (<em>P &lt;</em> .05).</div></div><div><h3>Conclusion</h3><div>As a result, the web-based education reduced the symptoms and discomfort associated with immunosuppressive medications in liver transplant patients and increased their immunosuppressive medication adherence.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 803-809"},"PeriodicalIF":0.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Significance of Preoperative Computed Tomography Diagnosed Sarcopenia on Allograft and Postoperative Outcomes Following Kidney Transplantation: A Systematic Review and Meta-Analysis","authors":"Khang Duy Ricky Le ,&nbsp;Steven Nguyen ,&nbsp;Samyuktha Gomez ,&nbsp;Adnan Hassanali ,&nbsp;Hussein Hassanali ,&nbsp;Amy Barnett ,&nbsp;Rosemary Masterson ,&nbsp;Peter Hughes ,&nbsp;Karen M. Dwyer","doi":"10.1016/j.transproceed.2025.03.013","DOIUrl":"10.1016/j.transproceed.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div>The identification of individuals who will benefit most from kidney transplantation is challenging, with no clear consensus as to which clinical features provide the most prognostic information. Recently, computed tomography (CT)-diagnosed sarcopenia has proven to be accurate in predicting poorer outcomes solid organ transplant recipients. This systematic review and meta-analysis evaluates the role of sarcopenia, as defined by preoperative CT, in the prediction of postoperative recipient and allograft outcomes in patients undergoing kidney transplantation.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed on Medline, Embase, Google Scholar and CINAHL databases. Seven articles involving 1153 patients were included in this review.</div></div><div><h3>Results</h3><div>There was strong evidence to suggest that CT-defined sarcopenia was associated with increased mortality (OR: 2.72, 95% CI, 1.66-4.47, <em>P</em> &lt; .0001) and greater likelihood of readmission (OR: 1.98, 95% CI, 1.34-2.92, <em>P</em> = .00006). There was a lack of evidence to support the use of preoperative CT to define sarcopenia as a prognostic factor for allograft and other postoperative outcomes following kidney transplantation.</div></div><div><h3>Conclusions</h3><div>This systematic review and meta-analysis demonstrates evidence to suggest pretransplant sarcopenia identified on CT imaging is predictive of increased mortality and readmission. Given the limitations of evidence related to risk of bias and heterogeneity, there is a need for more robust prospective research to elucidate the true effect of CT diagnosed sarcopenia as a prognostic factor in the kidney transplant setting.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 732-745"},"PeriodicalIF":0.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061350","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":"Meta-analysis of Anxiety and Depression in Liver Transplant Patients Before and After Transplantation","authors":"Yan Dai ,&nbsp;Liping Li ,&nbsp;Shan Guan","doi":"10.1016/j.transproceed.2025.03.030","DOIUrl":"10.1016/j.transproceed.2025.03.030","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;&lt;em&gt;Liver transplantation is a life-saving intervention for patients with end-stage liver disease, but it also presents significant psychological challenges that can affect patient outcomes.&lt;/em&gt; These challenges include managing preoperative expectations, postoperative &lt;em&gt;expectations, adjusting to postoperative changes, and addressing long-term health concerns, all of which contribute to high levels of anxiety and depression in this patient group. This study aims to explore&lt;/em&gt; the prevalence and changes in anxiety and depression among liver transplant patients before and after transplantation through a comprehensive meta-analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The data extracted for the article &lt;em&gt;included the number of episodes of depression and anxiety,&lt;/em&gt; the total number of liver transplant patients, the mean and standard deviation of the Hospital Anxiety and Depression (HADS) scale before and after liver transplantation, and the mean and standard deviation of the SF-36 Quality of Life Assessment Scale, &lt;em&gt;A search was conducted in the PubMed, Web of Science, Embase, and Cochrane databases were searched up to October 3, 2023, All previous articles were reviewed&lt;/em&gt;, and the results were analyzed using Stata.14 software.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In this meta-analysis, the study found that the incidence of pre-transplant anxiety was 52% (95 CI%: 0.38, 0.66), &lt;em&gt;and the incidence of&lt;/em&gt; depression was 47% (95 CI%: 0.34, 0.60), after transplantation, the patient's anxiety and depression were improved to some extent, the incidence of anxiety before transplantation was 52% (95 CI%: 0.38, 0.66), and the incidence of anxiety after transplantation was 3% (95 CI%: -0.05, 0.12). The incidence of depression before transplantation was 65% (95 CI%: 0.56, 0.73), and the incidence of anxiety after transplantation was 42% (95 CI%: 0.38, 0.46). In addition, the study found that patients' anxiety and depression were significantly improved with the extension of time after transplantation. Furthermore, the study revealed that patients' anxiety and depression significantly improved with the passage of time after transplantation. &lt;em&gt;Anxiety levels were measured as [WMD 6.55 (95% CI: 3.68, 9.42)] within 3 months, [WMD 5.44 (95% CI: -0.84, 11.93)] after 3 months, and improved further after 3 months, with a WMD of [3.48 (95% CI: 0.88, 7.84)]. Additionally, the anxiety level at 3 months showed a WMD of [8.47 (95% CI: 2.79, 14.14)].&lt;/em&gt; Finally, the study evaluated the patients' quality of life and health and found significant improvement after transplantation. The score on the SF-36 Quality of Life Assessment Scale increased by &lt;em&gt;[WMD&lt;/em&gt; 18.44 (95% CI: 14.08, 22.80)].&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Dynamic psychological assessment of patients before and within 3 months after liver transplantation is meaningful and may improve patient outcomes from the perspective of caring for patients' psycholo","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 891-904"},"PeriodicalIF":0.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035577","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 Novel Method to Estimate Donor-Derived Cell-Free DNA in Pregnant Kidney Transplant Recipients: A Proof-of-Concept Study","authors":"Jessica Tang ,&nbsp;Lior Kashani Ligumsky ,&nbsp;Kate Woodruff ,&nbsp;Christine Jang ,&nbsp;Nicole Charland ,&nbsp;Nour Al Haj Baddar ,&nbsp;Ebad Ahmed ,&nbsp;Paul Van Hummelen ,&nbsp;Gabrielle Heilek ,&nbsp;Bernhard Zimmermann ,&nbsp;Suphamai Bunnapradist ,&nbsp;Hossein Tabriziani ,&nbsp;Yalda Afshar","doi":"10.1016/j.transproceed.2025.03.025","DOIUrl":"10.1016/j.transproceed.2025.03.025","url":null,"abstract":"<div><h3>Background</h3><div>Pregnant kidney transplant recipients (KTRs) are a vulnerable, high-risk population, susceptible to obstetrical complications, as well as graft rejection. Current methods used to monitor kidney transplant function lack specificity. Recently, donor derived cell-free DNA (dd-cfDNA) has emerged as a non-invasive biomarker for assessing risk for allograft rejection in KTRs. However, utilizing dd-cfDNA to monitor allograft status in pregnant KTRs requires the ability to distinguish between fetal/placental, donor, and KTR derived cfDNA.</div></div><div><h3>Methods</h3><div>We developed a custom bioinformatics analysis to identify and measure dd-cfDNA in 6 pregnant KTRs by sequencing maternal cfDNA (blood sample) and paternal genomic DNA (buccal swab).</div></div><div><h3>Results</h3><div>We demonstrate our ability to successfully measure dd-cfDNA in 4/6 pregnant KTRs.</div></div><div><h3>Conclusions</h3><div>This proof-of-concept study demonstrates that dd-cfDNA can be measured in pregnant KTRs. This study lays the foundation for future research on dd-cfDNA correlations with maternal fetal conditions to help improve allograft care for this specific patient population.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 706-712"},"PeriodicalIF":0.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035357","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":"In-Situ Hemodynamics and Oxygen Utilization in Right Lobe Grafts During Living Donor Hepatectomy","authors":"Yong K. Kwon ,&nbsp;Navpreet Kaur ,&nbsp;Yuri Genyk","doi":"10.1016/j.transproceed.2025.03.018","DOIUrl":"10.1016/j.transproceed.2025.03.018","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have examined liver graft hemodynamics during living donor liver transplants; however, to the best of our knowledge, the hemodynamics of the partial graft during donor hepatectomy have not been thoroughly explored. We analyzed intraoperative graft hemodynamics and oxygen utilization data following parenchymal dissection during living donor hepatectomy.</div></div><div><h3>Methods</h3><div>The following parameters were measured intraoperatively in 63 right hepatic lobe living donor hepatectomy cases: right portal vein (RPV) and right hepatic artery (RHA) blood flow after parenchymal transection, along with blood gas analysis from the RPV, RHA, and right hepatic vein. Using these flow and blood gas analysis data, oxygen delivery and oxygen consumption of the right lobe graft were calculated and analyzed.</div></div><div><h3>Results</h3><div>A significant decrease in graft weight-normalized RHA flow was observed as the portal vein gradient increased, while graft weight-normalized RPV flow remained relatively constant. No differences in weight-normalized flow or blood gas data were observed between male and female donors. However, donors aged 40 years and older exhibited a statistically significant reduction in graft weight-normalized RHA oxygen delivery compared to younger donors (<em>P =</em> .042).</div></div><div><h3>Conclusions</h3><div>High portal pressure and donor age are known risk factors for small-for-size syndrome in living donor liver transplantation. Our data showed that even a relatively small increase in portal vein gradient significantly reduces RHA flow, negatively affecting oxygen delivery. This suggests that right lobe grafts may be prone to ischemic injury, especially in recipients with a low graft-to-recipient weight ratio from older donors.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 816-822"},"PeriodicalIF":0.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034405","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-Derived Bacterial Infections in Deceased Donor Liver Transplantation: Reassessment of Risk in the Era of Marginal Grafts","authors":"Caterina Accardo ,&nbsp;Ivan Vella ,&nbsp;Sergio Li Petri ,&nbsp;Duilio Pagano ,&nbsp;Fabrizio di Francesco ,&nbsp;Alessandra Mularoni ,&nbsp;Marco Barbàra ,&nbsp;Marco Canzonieri ,&nbsp;Paolo Grossi ,&nbsp;Salvatore Gruttadauria","doi":"10.1016/j.transproceed.2025.03.015","DOIUrl":"10.1016/j.transproceed.2025.03.015","url":null,"abstract":"<div><h3>Background</h3><div>The shortage of available organs for liver transplant has, over time, led to the inclusion of donors at risk of transmitting bacterial infections. In Italy, depending on the severity of this risk, these organs are only allocated to patients in serious clinical conditions, consequently, their use in a shortage context is further restricted.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed a consecutive series of 194 liver transplants from deceased adult donors performed at our institute between 2019 and 2021 and performed a statistical comparison between 2 groups: recipients of livers with a risk of transmission of bacterial infection (BR group) vs recipients of livers with no risk (noBR group). Primary endpoints include 90-day and 1-year survival rates of recipients, and secondary endpoints focus on the incidence of complications of grade ≥3 according to Clavien–Dindo and donor-related infections.</div></div><div><h3>Results</h3><div>Ninety-day and 1-year mortality in the BR vs noBR group was 5% vs 7% and 5% vs 14%, respectively. Major complications at 90 days occurred in 37% of the BR group vs 47% in the noBR group. No statistical differences were observed in the 2 recipient groups with respect to clinical outcomes. Cases of donor-derived infections also occurred in the noBR group.</div></div><div><h3>Conclusions</h3><div>Organs at risk of transmitting bacterial infections have comparable outcomes to other organs when appropriate risk reduction strategies are implemented. It is necessary to remove restrictions on these organs, which are becoming increasingly common in our shortage context.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 823-832"},"PeriodicalIF":0.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046606","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}