Transplantation proceedings最新文献

{"title":"Predicting Residual Renal Function and Long-Term Renal Function Recovery in Living Kidney Donors Using Pre-Donation Computed Tomography Volumetry","authors":"Kazuro Kikkawa ,&nbsp;Masahiro Tamaki ,&nbsp;Seita Sugitani ,&nbsp;Shota Komidori ,&nbsp;Mitsuho Kato ,&nbsp;Shohei Omori ,&nbsp;Kenji Kodama ,&nbsp;Kouhei Maruno ,&nbsp;Tatsuya Hazama ,&nbsp;Toshifumi Takahashi ,&nbsp;Yuya Yamada ,&nbsp;Masakazu Nakashima ,&nbsp;Noriyuki Ito","doi":"10.1016/j.transproceed.2025.05.014","DOIUrl":"10.1016/j.transproceed.2025.05.014","url":null,"abstract":"<div><h3>Background</h3><div>Living kidney donors recover their renal function after a decreased glomerular filtration rate initially. We evaluated the relationship between residual renal function predicted from split renal function measured using computed tomography (CT) volumetry and the actual compensation of renal function after donation.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed living kidney donors between June 2011 and October 2021. The kidney function at predonation and at 3 months, 1 year, and 3 years postdonation was also reviewed. Predicted residual renal function was calculated using the predonation estimated glomerular filtration rate and CT volumetry. The renal functional recovery rate was calculated using predicted residual renal function and postdonation estimated glomerular filtration rate.</div></div><div><h3>Results</h3><div>We retrospectively assessed 57 living kidney donors, including 29 and 28 donors aged &lt; 65 and ≥ 65 years, respectively. Although the ≥ 65-year-old donors had significantly lower postdonation estimated glomerular filtration rate and renal functional recovery rate than those aged &lt; 65 years at 3 months and 1 year, the difference was not significantly different at 3 years. Furthermore, longitudinal postdonation changes in the estimated glomerular filtration rate and renal functional recovery rate were significantly different between the two groups.</div></div><div><h3>Conclusions</h3><div>Predonation renal volume decreases with age in living kidney donors. Although age is strongly correlated with postdonation estimated glomerular filtration rate, long-term renal functional recovery was identified in older donors. Therefore, the predicted renal functional reserve should be assessed in older donors.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 982-988"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532166","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":"Use of Preoperative Renal Volumetry to Predict Postdonation Renal Function With Inulin Clearance as Indicator in Japan","authors":"Asuka Sano ,&nbsp;Takayuki Sugiyama ,&nbsp;Shinsuke Isobe ,&nbsp;Yoshihiro Tsuchiya ,&nbsp;Gaku Ishikawa ,&nbsp;Ayana Takemura ,&nbsp;Syunsuke Watanabe ,&nbsp;Kyohei Watanabe ,&nbsp;Yuto Matsushita ,&nbsp;Hiromitsu Watanabe ,&nbsp;Keita Tamura ,&nbsp;Daisuke Motoyama ,&nbsp;Atsushi Otsuka ,&nbsp;Teruo Inamoto","doi":"10.1016/j.transproceed.2025.05.017","DOIUrl":"10.1016/j.transproceed.2025.05.017","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to investigate the utility of preoperative CT-based renal volume assessment to predict postoperative renal function in living kidney donors. Specifically, favorable renal function was defined as chronic kidney disease (CKD) stage 1 or 2 at 1 year after donation, determined by the glomerular filtration rate (GFR) measured based on inulin clearance (Cin).</div></div><div><h3>Methods</h3><div>This study included 40 donors who underwent kidney donation at our institution between June 2012 and May 2021. GFR was measured using Cin, and CKD stages were assigned accordingly. Predictive factors for favorable renal function (CKD stage 1 or 2) at 1 year postdonation were analyzed using logistic regression.</div></div><div><h3>Results</h3><div>The median donor age was 63 years (range: 37-75), and 35.0% were male. Median pre- and postoperative Cin values were 84.9 (range: 59.0-133.4) and 56.7 (range: 34.7-95.0) mL/min, respectively. Multivariate logistic regression revealed age ≤ 55 and residual kidney volume-to-weight ratio (RKV/W) ≥ 2.78 as independent factors predicting favorable renal function. A scoring system based on these factors (0 points for none, 1 point for 1 factor, 2 points for both) demonstrated significantly better postoperative renal function in donors with 1 or more points compared with those with 0 points (median Cin: 63.3 vs 53.7 mL/min, respectively, <em>P</em> = .00074).</div></div><div><h3>Conclusions</h3><div>Age and RKV/W are factors predicting favorable renal function after kidney donation. A predictive scoring system based on these factors could assist in assessing donor eligibility and guiding clinical decision-making.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1007-1012"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532221","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":"Post-Liver Transplantation Hepatitis B Prophylaxis in Canada: Results of a National Survey","authors":"Kai Zhu ,&nbsp;Eric M. Yoshida ,&nbsp;Daljeet Chahal ,&nbsp;Ben Cox ,&nbsp;Andrew W. Shih ,&nbsp;Vladimir Marquez ,&nbsp;Trana Hussaini","doi":"10.1016/j.transproceed.2025.05.016","DOIUrl":"10.1016/j.transproceed.2025.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Chronic hepatitis B remains a significant concern in liver transplantation (LT) due to the risk of graft reinfection. Hepatitis B immunoglobulin (HBIG), combined with nucleos(t)ide analogues (NAs), has been the standard prophylactic approach. However, HBIG-free regimens are emerging, and practices vary across transplant centers. This study aims to describe the current Hepatitis B virus (HBV) prophylaxis policies in Canadian LT programs.</div></div><div><h3>Methods</h3><div>A virtual survey was distributed to all LT centers in Canada through the Canadian Liver Transplant Network. Data on HBIG use, NA selection, monitoring protocols, and recurrence management were collected and analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>Nine respondents from 6 Canadian LT centers participated. All centers use HBIG post-transplant, with intramuscular HepaGam B being the most common formulation. HBIG duration varied, with most centers administering it for 6 months to 1 year. Tenofovir was the predominant NA used. HBV recurrence monitoring occurred every 3 months in most centers. Management of recurrence varied, with some centers reinitiating HBIG, while others adjusting NA therapy.</div></div><div><h3>Conclusions</h3><div>While HBIG and NA combination therapy remains the standard in Canada, significant variations exist in HBIG duration and recurrence management. A growing shift toward HBIG-free regimens in select populations highlights the need for standardized guidelines to optimize post-transplant HBV prophylaxis.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1104-1106"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340734","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":"Anxiety and Depression Outcomes in Liver Transplant Candidates and Recipients Using the Hospital Anxiety and Depression Scale","authors":"Ali Emre Bardak ,&nbsp;Asli Cifcibasi Ormeci ,&nbsp;Zuhal Yildiz ,&nbsp;Volkan Senkal ,&nbsp;Ziya Imanov ,&nbsp;Zulal Istemihan ,&nbsp;Kanan Nuriyev ,&nbsp;Aynura Rustamzada ,&nbsp;Sezen Genc ,&nbsp;Filiz Akyuz ,&nbsp;Kadir Demir ,&nbsp;Fatih Besisik ,&nbsp;Sabahtattin Kaymakoglu ,&nbsp;Bilger Cavus","doi":"10.1016/j.transproceed.2025.05.032","DOIUrl":"10.1016/j.transproceed.2025.05.032","url":null,"abstract":"<div><h3>Objectives</h3><div>Liver transplantation is a life-saving treatment for patients with end-stage liver disease, but it is associated with significant psychological burdens, including anxiety and depression. This study aimed to evaluate the anxiety and depression of this population using the Hospital Anxiety and Depression Scale (HADS) and to identify associated demographic and clinical factors.</div></div><div><h3>Methods</h3><div>This study included 113 liver transplant candidates and recipients. Anxiety and depression were assessed using the HADS with an anonymous questionairre. Subgroup analyses were conducted based on transplant status, donor type, gender, age, body mass index, education level, and antidepressant use.</div></div><div><h3>Results</h3><div>The mean overall HADS score was 11.16. Although female participants showed slightly higher mean anxiety, depression, and overall HADS scores, the differences were not statistically significant. Generation Z had the highest anxiety scores (significantly greater than Generation X, <em>P = .</em>048, and Baby Boomers, <em>P = .</em>034), while Baby Boomers had the highest, albeit non-significant, depression scores. Education level and BMI categories showed no significant group differences. Individuals taking antidepressants had significantly elevated anxiety (<em>P = .</em>044) and overall HADS (<em>P = .</em>026) scores. Among candidates, having a confirmed living donor was associated with significantly lower depression (<em>P = .</em>034) and overall HADS (<em>P = .</em>043). Time since transplantation showed no significant correlation with psychological outcomes.</div></div><div><h3>Conclusions</h3><div>Psychological distress is prevalent among liver transplant candidates and recipients, and it has a substantial impact on morbidity and mortality. Raising awareness for the recognition of the psychological aspect of transplantation is critical to improve mental health and clinical outcomes in this population.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1170-1175"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512994","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":"Construction and Evaluation of a Nomogram for Unplanned Readmission Within 1 Year After Kidney Transplantation: Based on Lasso-Logistic Regression Model","authors":"Weiwei Cao ,&nbsp;Bei Ding ,&nbsp;Kejing Zhu ,&nbsp;Li Ma ,&nbsp;Minghuan Zhong ,&nbsp;Yulin Niu","doi":"10.1016/j.transproceed.2025.05.012","DOIUrl":"10.1016/j.transproceed.2025.05.012","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and evaluate a risk prediction model for unplanned readmission within 1 year following kidney transplantation using Lasso-logistic regression.</div></div><div><h3>Methods</h3><div>Clinical data of kidney transplant recipients from the Department of Organ Transplantation at the Affiliated Hospital of Guizhou Medical University, spanning April 2017 to June 2023, were retrospectively analyzed. Initially, Lasso regression analysis was used to select predictive variables. Subsequently, logistic regression analysis was employed to construct a risk prediction model, which was presented as a nomogram. Bootstrap repeated sampling was conducted 1000 times for internal model validation. The comprehensive efficacy of the prediction model was assessed from four dimensions: discrimination, fit, calibration, and clinical benefit.</div></div><div><h3>Results</h3><div>The incidence of unplanned readmission within 1-year post-transplant was 36.48%. Serum creatinine, cystatin C, albumin, serum potassium, serum magnesium, drinking history, rejection, and length of stay were the predictors of unplanned readmission within 1 year after renal transplantation. The comprehensive ability of the risk prediction model for unplanned readmission within 1 year after renal transplantation was as follows: The area under the receiver operating characteristic curve of the nomogram model was 0.715 (95% CI: 0.673-0.757). The internal validation results showed that the corrected C-index was 0.700. The positive predictive value of the model was 0.533 and the negative predictive value was 0.785. The Hosmer–Lemeshow goodness of fit test result was <em>χ</em>² = 4.941, <em>P</em> = 0.764, indicating a satisfactory fit of the model. In the calibration curve, the actual fitting curve was well-fitted to the standard curve, and the model calibration ability was acceptable. The clinical decision curve confirmed the clinical value of the model and its positive impact on actual decision-making.</div></div><div><h3>Conclusions</h3><div>The constructed model demonstrates considerable predictive value for unplanned readmission within 1 year after kidney transplantation. It serves as a valuable tool for early clinical warning, enabling healthcare professionals to formulate personalized preventive strategies based on identified risk factors.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 989-1000"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500003","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":"Renal Transplantation in Relation to Positive T-cell Flow Cytometric Crossmatch: A Retrospective Study","authors":"Hisashi Murakami,&nbsp;Yuki Nakamura,&nbsp;Katsuyuki Miki,&nbsp;Takayoshi Yokoyama,&nbsp;Yasuo Ishii","doi":"10.1016/j.transproceed.2025.05.011","DOIUrl":"10.1016/j.transproceed.2025.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Human leukocyte antigen antibodies play a significant role in kidney transplant rejection at all stages. Cross-matching and human leukocyte antigen antibody testing, especially in donor-specific antibody (DSA)-positive cases, are essential for reducing the risk of antibody-mediated rejection. Despite increasing numbers of DSA-positive transplants with desensitization therapy, guidelines for assessing transplant suitability and therapy selection remain undefined. This study retrospectively evaluated 12-month outcomes in patients with kidney transplants and positive flow cytometric crossmatch-T (FCXM-T) results.</div></div><div><h3>Methods</h3><div>This study analyzed 200 patients who received kidney transplants at Toranomon Hospital Renal Center between January 2015 and January 2022. Of these, 161 living-donor transplants were selected. The patients were divided into FCXM-T-positive and FCXM-T-negative groups. Regardless of ABO incompatibility, antithymocyte globulin, and rituximab or intravenous immunoglobulin were administered in FCXM-T-positive and DSA-positive cases, whereas rituximab or intravenous immunoglobulin was administered in FCXM-T-positive and DSA-negative cases. Serum creatinine and proteinuria levels were compared 12 months postoperatively using overlap weighting to balance the background factors. FCXM-T-positive cases were further assessed for new DSA development and desensitization effects.</div></div><div><h3>Results</h3><div>After overlap weighting, creatinine levels (1.33 mg/dL vs 1.38 mg/dL, <em>P</em> = .17) and proteinuria positivity (24% vs 30%, <em>P</em> = .93) did not differ between the FCXM-T-positive and FCXM-T-negative groups at 12 months. The appearance of new DSA was also similar between the groups, suggesting comparable short-term outcomes with appropriate desensitization therapy.</div></div><div><h3>Conclusions</h3><div>Preoperative desensitization, including antithymocyte globulin, may enable safe kidney transplantation in FCXM-T-positive patients, yielding outcomes comparable to those of low-risk patients. Further long-term studies are required to confirm these findings.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1018-1024"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532167","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":"Comparison of Histological Analysis and Gross Assessment for Detection of Donor Liver Macrovesicular Steatosis in Liver Transplantation: A Systematic Review and Meta-Analysis","authors":"Zahra Beyzaei ,&nbsp;Zahra Bagheri ,&nbsp;Sara Karimzadeh ,&nbsp;Bita Geramizadeh","doi":"10.1016/j.transproceed.2025.05.031","DOIUrl":"10.1016/j.transproceed.2025.05.031","url":null,"abstract":"<div><h3>Background</h3><div>Conflicting information exists regarding the impact of different detection methods for macrovesicular steatosis (MaS) in liver transplantation (LT). Therefore, the two MaS estimation methods, histological analysis and gross examination, and their influence on LT were compared.</div></div><div><h3>Methods</h3><div>We included all studies describing allograft steatosis in adult deceased donor’s LT. The outcome was evaluated either by histological analysis or macroscopic assessment by the surgeon.</div></div><div><h3>Results</h3><div>Of the 3483 studies, 21 were eligible and included in our analysis (3155 participants). In the histological analysis detection method, the results showed a significantly higher graft loss at 1-year follow-up (odds ratio [OR] 1.61, <em>P</em> = .01), 3-year (OR 1.45, <em>P</em> = .05), and 5-year (OR 1.65, <em>P</em> = .01) in the moderate/severe MaS patients following transplantation. In the gross examination method, all results were statistically insignificant. The meta-regression, adjusting for the detection method, suggests a significant association between the histological method and increased graft loss compared to the gross method.</div></div><div><h3>Conclusions</h3><div>Our data demonstrate that the patients evaluated through the histological method tend to have reliable outcomes to those evaluated through gross examination. Therefore, it may be crucial to use precise donor steatosis evaluation using the histological method.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1076-1085"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562455","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":"Quantification of Peripheral White Blood Cell Subtypes and Delayed Graft Function after Kidney Transplantation: A Single Center Analysis","authors":"Jingyi Zhou ,&nbsp;Meifang Wang ,&nbsp;Hao Deng ,&nbsp;Jianghua Chen","doi":"10.1016/j.transproceed.2025.06.008","DOIUrl":"10.1016/j.transproceed.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Delayed graft function (DGF) is a critical complication following donation after circulatory death (DCD) kidney transplantation, with immunological factors contributing to its pathogenesis. This study aimed to assess whether early quantification of peripheral white blood cell (WBC) subtypes predicts DGF onset and outcomes.</div></div><div><h3>Methods</h3><div>In this single-center retrospective analysis, 217 DCD kidney transplant recipients (from January 2022 to December 2023) were included. Peripheral WBC subtypes (CD45+, CD3+, CD4+, CD8+, CD16+CD56+, and CD19+) were quantified via flow cytometry on postoperative day 1. Statistical analyses included logistic regression and receiver operating characteristic (ROC) curve evaluation.</div></div><div><h3>Results</h3><div>Among the recipients, 16.13% (35/217) developed DGF. The patients with DGF demonstrated higher serum creatinine (SCr) at discharge (235.04 ± 130.44 vs 141.90 ± 81.88 μmol/L, <em>P</em> &lt; .001) and 1-year follow-up (145.76 ± 101.57 vs 108.07 ± 36.93 μmol/L, <em>P</em> &lt; .001), with increased graft loss (7.4% vs 0.5%, <em>P</em> = .047). A lower helper T cell (CD3+CD4+) ratio predicted DGF onset (area under the curve [AUC] = 0.893, <em>P</em> = .001). Subgroup analysis of patients with DGF linked elevated cytotoxic T cell (CD3+CD8+) ratios to poor outcomes (SCr &gt; 150 μmol/L/proteinuria at 1 year; AUC = 0.846, <em>P</em> = 0.023). Induction therapy modified these associations: Basiliximab preserved subtype differences, while antithymocyte globulin (ATG) abolished them.</div></div><div><h3>Conclusions</h3><div>Early postoperative quantification of WBC subtypes, particularly helper and cytotoxic T cells, offers prognostic value for DGF and its outcomes. These findings highlight the utility of routine immunological monitoring in guiding clinical management. Further studies are needed to unravel the underlying mechanisms and therapeutic implications.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1050-1057"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546749","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":"Grafting Islets to a Prevascularized Subcutaneous Site to Improve Transplant Survival and Function: A Mouse Model","authors":"Tsuyoshi Okada ,&nbsp;Takashi Kuise ,&nbsp;Kenjiro Kumano ,&nbsp;Hiroshi Tazawa ,&nbsp;Toshiyoshi Fujiwara","doi":"10.1016/j.transproceed.2025.05.019","DOIUrl":"10.1016/j.transproceed.2025.05.019","url":null,"abstract":"<div><h3>Background</h3><div>The subcutaneous space is regarded as a potential site for islet transplantation; however, hypoxic conditions are a major drawback. We hypothesized that islet transplantation into a prevascularized subcutaneous space created using in-body tissue architecture technology would improve islet engraftment and contribute to maintaining the function of transplanted islets.</div></div><div><h3>Methods</h3><div>Five hundred syngeneic islets were transplanted into the prevascularized subcutaneous space (PSS) constructed by the implantation of a silicone rod for 2 weeks in C57BL/6J diabetic mice. Diabetic mice transplanted with islets into the unmodified subcutaneous space (USS) were used as the controls. After transplantation, nonfasting blood glucose levels were monitored for 8 weeks, and an intraperitoneal glucose tolerance test and histological evaluation were performed.</div></div><div><h3>Results</h3><div>Five of the 10 recipients in the PSS group and two of the nine recipients in the USS group returned to normoglycemia. Engraftment of the transplanted islets was detected in nine of the 10 recipients in the PSS group, and the engraftment rate in the PSS group was significantly higher than that in the USS group (<em>P</em> = .005). Intraperitoneal glucose tolerance test results showed that the glucose tolerance of recipient mice in the PSS group was significantly better than that of the diabetic mice. Histological analysis revealed that the density of capillary vessels in the connective tissue surrounding the engrafted islets in the PSS group was significantly higher than that in the USS group (41.7/mm² vs 7.2/mm², <em>P</em> &lt; .01).</div></div><div><h3>Conclusion</h3><div>Islet transplantation into the PSS using in-body tissue architecture technology has the potential to improve graft survival.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1187-1195"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500004","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":"Survival of Highly Sensitized Patients on the Waiting List for Kidney Transplantation at Modena Transplant Center","authors":"Giacomo Mori ,&nbsp;Jessica Plessi ,&nbsp;Niccolò Morisi ,&nbsp;Laura Tonelli ,&nbsp;Laura Melara ,&nbsp;Giuseppe Oliviero ,&nbsp;Alice Parmigiani ,&nbsp;Marco Ferrarini ,&nbsp;Stefano Di Sandro ,&nbsp;Gabriele Donati","doi":"10.1016/j.transproceed.2025.04.010","DOIUrl":"10.1016/j.transproceed.2025.04.010","url":null,"abstract":"<div><h3>Background</h3><div>HLA sensitization plays a pivotal role in kidney transplantation. The presence of anti HLA antibodies strongly limits access to transplantation to subjects on the waiting list, particularly for highly sensitized patients. The aim of this study is to evaluate the waiting time of highly sensitized candidates, when compared with patients with a lower level of sensitization, and the respective survival rates on the waiting list.</div></div><div><h3>Methods</h3><div>We conducted a single center retrospective observational study stratified according to calculated panel reactive antibodies (cPRAs) in highly sensitized patients (cPRA ≥ 80%) and patients with a lower level of sensitization (NH; cPRA &lt; 80%). A total of 911 patients on the waiting list were considered. Survival analysis was performed according to Kaplan Meier, and multivariate analysis was performed with Cox regression. Mortality data were collected only for 222 patients who were residents in the Province of Modena, Italy.</div></div><div><h3>Results</h3><div>Highly sensitized subjects have a significantly longer waiting time from enrollment to kidney transplantation when compared to patients with a lower level of sensitization, but in our highly sensitized patients the mortality rate resulted slightly lower because of the protective effect of a younger age at enrollment.</div></div><div><h3>Conclusions</h3><div>Highly sensitized patients wait longer to achieve kidney transplantation, but they do not show worse survival rates, likely because of a younger age at enrollment. These results highlight the importance of innovative strategies to allow access to transplantation to highly sensitive subjects to limit the personal and social cost of a prolonged stay on dialysis.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 975-981"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500005","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}