Transplantation proceedings最新文献

{"title":"N-Acetylcysteine and Liver Transplant. Advantages of its Administration in Multi-Organ Donors Especially During World-Economical-Crisis. Long-Term Sub-Group Analysis in a Randomized Study","authors":"Michele Finotti ,&nbsp;Alberto Zanetto ,&nbsp;Alessandro Vitale ,&nbsp;Manuel Rodriguez-Davalos ,&nbsp;Patrizia Burra ,&nbsp;Umberto Cillo ,&nbsp;Francesco D'Amico","doi":"10.1016/j.transproceed.2024.11.038","DOIUrl":"10.1016/j.transproceed.2024.11.038","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation (LT) is the main indication for the treatment of end-stage liver disease but have to face organ shortages. Using marginal donors is an option to increase the donor pool. Previous studies showed that the graft procured using N-acetylcysteine (NAC) provides a longer survival compared to perfusion with standard solutions, especially in marginal liver donors. We now evaluate the effect of NAC perfusion compared to control (no NAC protocol) at a 5-year follow-up, with a special focus on the overall survival (OS) and graft survival.</div></div><div><h3>Methods</h3><div>Single-center, retrospective review of the OS and graft survival among NAC and control group, with a sub-stratification based on the LT indication.</div></div><div><h3>Results</h3><div>140 donors were enrolled: 69 in the NAC protocol and 71 in the control group. The 5-year OS was 84% in the NAC protocol compared to 63% in the control (<em>P = .</em>0045). In LT for HCC, the OS at 5 years was 80% and 55% in the study group and control group, respectively (<em>P = .</em>04), with no statistical difference in the RFS (<em>P = .</em>46). Furthermore, in cost analysis, the resources needed for the NAC protocol is negligible compared to the control group. Beneficial tendency of NAC protocol application has been seen in the other organs (lungs, hearts, pancreas, kidney and intestine)</div></div><div><h3>Conclusion</h3><div>The application of NAC infusion in liver donors improves the overall survival of the recipient, especially in the HCC and HCV LT indications.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 264-271"},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985942","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":"Evaluating AI Chatbot Responses to Postkidney Transplant Inquiries","authors":"Yihua Zhan ,&nbsp;Xutao Chen ,&nbsp;Feihong Ye ,&nbsp;Zhikai Wu ,&nbsp;Muhammad Usman ,&nbsp;Zhihan Yuan ,&nbsp;Han Wu ,&nbsp;Jian Huang ,&nbsp;Hao Yu","doi":"10.1016/j.transproceed.2024.12.028","DOIUrl":"10.1016/j.transproceed.2024.12.028","url":null,"abstract":"<div><div>This study evaluated the capability of three AI chatbots—ChatGPT 4.0, Claude 3.0, and Gemini Pro, as well as Google—in responding to common postkidney transplantation inquiries. We compiled a list of frequently asked postkidney transplant questions using Google and Bing. Response quality was rated on a 5-point Likert scale, while understandability and actionability were measured with the Patient Education Materials Assessment Tool (PEMAT). Readability was assessed using the Flesch Reading Ease and Flesch-Kincaid Grade Level metrics, with statistical analysis conducted via non-parametric tests, specifically the Kruskal-Wallis test, using SPSS. We gathered 127 questions, which were addressed by the chatbots and Google. The responses were of high quality (median Likert score: 4 [4,5]), good understandability (median PEMAT understandability score: 72.7% [62.5,77.8]), but poor actionability (median PEMAT operability score: 20% [0%-20%]). The readability was challenging (median Flesch Reading Ease score: 22.1 [8.7,34.8]), with a Flesch-Kincaid Grade Level akin to undergraduate-level text (median score: 14.7 [12.3,16.7]). Among the chatbots, Claude 3.0 provided the most reliable responses, though they required a higher reading level. ChatGPT 4.0 offered the most comprehensible responses. Moreover, Google did not outperform the chatbots in any of the scoring metrics.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 394-405"},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019340","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":"Multimodal Inpatient Prehabilitation Prior to Heart or Lung Transplantation in a Latin American Transplant Reference Center","authors":"Franco Appiani ,&nbsp;Belen Abara ,&nbsp;Ivan Ramirez ,&nbsp;Christian Andrade ,&nbsp;Joel Melo ,&nbsp;Fernando Barra ,&nbsp;Fernando Javier Verdugo ,&nbsp;Victor Rossel ,&nbsp;Jongsung Lim ,&nbsp;Erika Donoso ,&nbsp;Urania Arrué ,&nbsp;Maria Paz Riquelme","doi":"10.1016/j.transproceed.2024.11.034","DOIUrl":"10.1016/j.transproceed.2024.11.034","url":null,"abstract":"<div><h3>Introduction</h3><div>Whether the implementation of a multimodal prehabilitation program is effective and safe for high-risk heart or lung transplantation candidates, whose condition prevents hospital discharge, is unclear.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study at a cardiothoracic transplant center in Chile. Two cohorts of hospitalized patients listed for heart or lung transplant were studied: the first underwent traditional (historical) and nonstructured prehabilitation, and the second underwent protocol-driven multimodal prehabilitation (MP). Adverse events and preoperative functional changes in the MP group were documented, as well as comparative postoperative outcomes between both cohorts.</div></div><div><h3>Results</h3><div>Between 2018 and 2023, 24 transplant recipients were analyzed. During the MP phase, significant improvement was observed in Medical Research Council scale (52.0 ± 7 to 58.7 ± 3; <em>P</em> = .042), sit-to-stand test (7.1 ± 7 to 15.9 ± 6; <em>P</em> = .018), and euthymic state (from 4 to 10 patients; <em>P</em> .036), without reported adverse events. Postoperatively, MP group demonstrated faster standing (1.9 ± 0.7 vs 1.3 ± 0.5 days; <em>P</em> = .05) and sitting times (2.0 ± 0.7 vs 1.2 ± 0.5 days; <em>P</em> = .007), with more early extubations (3 vs 11; <em>P</em> = .003) in comparison to the historical prehabilitation cohort.</div></div><div><h3>Conclusion</h3><div>In this small retrospective study, MP in hospitalized patients awaiting heart or lung transplantation appears to be safe and associated with improvements in pre- and postoperative outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 348-354"},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019375","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":"Syndecan-1 in the Serum of Deceased Kidney Donors as a Potential Biomarker of Kidney Function","authors":"Pavel Navratil ,&nbsp;Sukhdeep Sahi ,&nbsp;Petra Hruba ,&nbsp;Alena Ticha ,&nbsp;Katarina Timkova ,&nbsp;Ondrej Viklicky ,&nbsp;Vladimir Cerny ,&nbsp;David Astapenko","doi":"10.1016/j.transproceed.2024.12.031","DOIUrl":"10.1016/j.transproceed.2024.12.031","url":null,"abstract":"<div><h3>Background</h3><div>The process of kidney transplantation remains the optimal treatment for end-stage renal disease, offering improved quality of life and increased survival rates compared to long-term dialysis. However, despite advances in surgical techniques, immunosuppression regimens, and post-operative care, there are still significant challenges in predicting the organ's status and long-term outcomes of transplantation. Among the many factors that influence graft survival, the quality of the donated organ plays a fundamental role. There is an ongoing need for accurate and reliable biomarkers. Syndecan-1 is found in the endothelial glycocalyx and shed at a higher rate into the blood during systemic pathological conditions. The aim of this study is to evaluate the potential of serum syndecan-1 levels as a biomarker for assessing donor kidney quality and to investigate its correlation with donor characteristics and short-term outcomes in kidney recipients.</div></div><div><h3>Material and Methods</h3><div>We investigated serum syndecan-1 levels in 80 deceased donors and correlated them with donor characteristics and short-term outcomes (defined as delayed graft function - defined as the need for dialysis within the first week post-transplantation and renal function at 3 months post-transplantation - assessed using serum creatinine levels) in 104 corresponding kidney recipients. This single-center retrospective observational cohort study was conducted from April to December 2021.</div></div><div><h3>Results</h3><div>The donor pool consisted of 65% males with a median age of 53 years. Of these, 45 donors (56%) were classified as extended criteria donors. Higher syndecan-1 levels correlated with the last creatinine levels before organ procurement (<em>R</em> = 0.32, <em>p</em> = 0.01) and were marginally higher in donors with acute kidney injury (<em>p</em> = 0.07). However, syndecan-1 levels were not associated with short-term outcomes in kidney recipients (renal function at 3 months).</div></div><div><h3>Conclusions</h3><div>The data suggests syndecan-1 could be a potential biomarker for assessing donor kidney quality, although its implications on recipient outcomes require further study. This pilot investigation underscores the importance of syndecan-1 in evaluating organ quality but highlights the necessity for more extensive research to validate these findings and explore their implications in transplant success.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 187-193"},"PeriodicalIF":0.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985943","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":"Central Nervous System Infections in Recipients of Solid Organ Transplant","authors":"Oscar Morado-Aramburo,&nbsp;Leeja Joseph,&nbsp;Harmanpreet Kaur,&nbsp;Rodrigo Hasbun","doi":"10.1016/j.transproceed.2024.12.032","DOIUrl":"10.1016/j.transproceed.2024.12.032","url":null,"abstract":"<div><h3>Background</h3><div>Central nervous system (CNS) infections are severe and life-threatening complications that can occur in solid organ transplant (SOT) recipients. We describe the epidemiology, clinical presentation, diagnosis, disease course, and outcome of CNS infections in SOT.</div></div><div><h3>Methods</h3><div>We analyzed data of patients who underwent transplantation from September 2012 to February 2023, diagnosed and treated for CNS infections at our institution in Houston, TX. Data were retrospectively collected from medical charts.</div></div><div><h3>Results</h3><div>Of 1,345 patients who received a SOT, 30 (2.23%) were diagnosed with CNS infection, with a median age of 63 years, 60% were male. Time to CNS infection onset after transplant in 53.3% of the cases was after the first year. There were 15/30 (50%) cases of fungal infection, 8/30(26.7%) of viral infection, 7/30 (23.3%) of bacterial infection. There were no unknown causes. The most common etiologies were <em>Cryptococcus neoformans</em> 14/30(46.6%), and <em>nocardiosis</em> 3/30 (10%). On presentation, 22 (73.4%) patients had normal mental status, but 21 (70%) reported headaches, and 18 (60%) were febrile. Abnormal neuroimaging was found in 5 cases (16.6%) on computed tomography (CT)-scans and 10 cases (33.3%) on magnetic resonance imaging (MRI) scans. An adverse clinical outcome on discharge was noticed in 33%, and 6.7% died. Fever was associated with an increased risk of adverse clinical outcomes (OR 11; <em>P</em> = .018).</div></div><div><h3>Conclusion</h3><div>The incidence of CNS infections in SOT recipients is low but associated with substantial adverse clinical outcomes. The most common causes are fungal, with no unknown etiologies seen in this study.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 410-415"},"PeriodicalIF":0.8,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974249","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":"Serosurvey of Visceral Leishmaniasis in Organ Transplant Recipients in the South of Iran","authors":"Amirhossein Haydarian ,&nbsp;Leila Morrabi ,&nbsp;Mojtaba Shafiekhani ,&nbsp;Mostafa Omidian ,&nbsp;Bahador Sarkari","doi":"10.1016/j.transproceed.2024.12.030","DOIUrl":"10.1016/j.transproceed.2024.12.030","url":null,"abstract":"<div><h3>Background</h3><div>Visceral leishmaniasis (VL) can become active and cause specific problems in transplant recipients. The current study was conducted with the aim of serological evaluation of VL in transplant patients in a comprehensive transplantation center in Fars province southern Iran.</div></div><div><h3>Methods</h3><div>The study population included 150 organ transplant recipients. Blood sample was taken from each patient and the sera were evaluated for anti-<em>Leishmania</em> antibodies by an ELISA method. While sampling from patients, the required information was recorded in a questionnaire and finally analyzed by SPSS software.</div></div><div><h3>Results</h3><div>Out of the 150 recruited patients, 96 (64%) were men and 54 (36%) were women. The youngest participant was 18 years old and the oldest was 85, with an average age of 46.24 (±15.13). Among the participants, 79 (52.66%) had undergone kidney transplantation, 69 (46%) liver transplantation, 1 (0.66%) intestinal transplantation, and 1 (0.66%) had undergone SPK (kidney and pancreas) transplantation. The participants were from various provinces of Iran, with the majority (61.33%) residing in Fars province. Anti-<em>Leishmania</em> antibodies were detected in the sera of 4 individuals (2.7%) among the study population. The overall seroprevalence of VL did not have a statistically significant association with variables such as gender, age, type of transplant, transplant rejection, or place of residence (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>The results of the current study indicate a noticeable seroprevalence of VL in transplant patients in southern Iran. Given the potential risk of reactivation of VL in transplant patients, the need for greater attention to its prevention, timely diagnosis, and treatment becomes more obvious.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 406-409"},"PeriodicalIF":0.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974251","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":"Dealing With Antibiotic Prophylaxis in Lung Transplantation in the Era of Multidrug Resistance: The Milano Algorithm","authors":"Andrea Lombardi ,&nbsp;Davide Mangioni ,&nbsp;Giulia Renisi ,&nbsp;Jacopo Fumagalli ,&nbsp;Letizia Morlacchi ,&nbsp;Lorenzo Rosso ,&nbsp;Alessandro Palleschi ,&nbsp;Valeria Rossetti ,&nbsp;Mauro Panigada ,&nbsp;Chiara Abbruzzese ,&nbsp;Lisa Cariani ,&nbsp;Annapaola Callegaro ,&nbsp;Mario Nosotti ,&nbsp;Francesco Blasi ,&nbsp;Giacomo Grasselli ,&nbsp;Alessandra Bandera","doi":"10.1016/j.transproceed.2024.12.024","DOIUrl":"10.1016/j.transproceed.2024.12.024","url":null,"abstract":"<div><div>Infectious complications significantly impact morbidity and mortality following lung transplantation (LuTx), with over 25% of post-transplant deaths attributed to infections. Antibiotic prophylaxis during the surgical procedure is crucial for reducing early infections, though the current use of wide-spectrum antibiotics, especially in cases of multidrug-resistant organisms (MDROs), is contentious and varies widely across centre. This practice raises concerns about antimicrobial resistance (AMR), particularly in immunosuppressed patients requiring lifelong healthcare access. Syndromic multiplex polymerase chain reaction (mPCR) tests, which detect multiple pathogens simultaneously, have shown promise in quickly identifying pathogens and resistance mechanisms, thus enabling targeted treatments. However, their application in LuTx has been limited.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 339-341"},"PeriodicalIF":0.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why Do They Persist? Understanding Living Kidney Donors and Persistence","authors":"Kelly L. Nottingham ,&nbsp;Hallie Klosterman ,&nbsp;Olivia Prevost ,&nbsp;Rebekah Perkins Crawford","doi":"10.1016/j.transproceed.2024.12.025","DOIUrl":"10.1016/j.transproceed.2024.12.025","url":null,"abstract":"<div><div>Many participants persist through the living kidney donation process, although it is challenging, multifaceted, and burdensome, particularly during the predonation evaluation (PDE) phase. This study uses a constructivist grounded theory approach to analyze the experiences of living kidney donors (LKDs) undergoing evaluation who shared their perspectives in blog reflections. One hundred five (105) blog posts met the inclusion criteria. They generated three overarching themes: (1) Facilitators to completing the PDE qualification process, (2) Burdens experienced during the PDE qualification process, and (3) Tools to mitigate burdens or enhance facilitators. Internal facilitators, such as the desire to help and other motivating emotions, emerged as key drivers for LKDs to persist through the donation process. Religious belief or faith, an external facilitator, is also crucial in motivating donors. Conversely, internal burdens, such as doubts, fears, financial concerns, and health risks, posed challenges to the donation process. External burdens also included recipient relationship management, delays and setbacks, poor communication, qualification testing, lack of support, and being denied as a donor. This study's findings shed light on the complex interplay between burdens, facilitators, and tools in shaping the experiences of LKDs during the PDE, which enabled their persistence through the process and highlights a potential persistence spectrum. The insights gained from this research can inform interventions to better support living kidney donors throughout their donation journey, enhancing the overall donor experience and potentially increasing the number of living kidney donations.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 223-229"},"PeriodicalIF":0.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Gram-Ghost Bacilli and Additional Ziehl–Neelsen Stain for the Early Diagnosis of Driveline Infection: A Case Report","authors":"Megumi Kawano ,&nbsp;Shotaro Komeyama ,&nbsp;Tasuku Hada ,&nbsp;Hiroki Mochizuki ,&nbsp;Naoki Tadokoro ,&nbsp;Satoshi Kainuma ,&nbsp;Takuya Watanabe ,&nbsp;Satsuki Fukushima ,&nbsp;Yasumasa Tsukamoto","doi":"10.1016/j.transproceed.2024.10.035","DOIUrl":"10.1016/j.transproceed.2024.10.035","url":null,"abstract":"<div><h3>Background</h3><div>Driveline infections (DLI) caused by nontuberculous mycobacteria (NTM) in patients with implantable left ventricular assist devices (iLVAD) are rare but fatal, requiring early diagnosis and appropriate treatment. Herein, we present a rare case of DLI caused by <em>Mycobacterium chelonae</em>, which was promptly diagnosed using Gram stain and Ziehl–Neelsen stain and followed a favorable clinical course.</div></div><div><h3>Case presentation</h3><div>A 51-year-old man with an iLVAD complicated by DLI was admitted to our center. He had no fever but had a slight ache and rash around the driveline exit site on admission. The wound condition gradually deteriorated with increasing purulent discharge from the driveline exit site and an elevated inflammatory response, despite daily irrigation. Gallium scintigraphy led to the diagnosis of deep DLI, followed by surgical debridement and omental flap transposition with driveline translocation. The Gram stain of the purulent discharge from the surgical site showed unstained bacilli (Gram-neutral, neither positive nor negative) along with leukocyte phagocytosis. Additionally, the Ziehl–Neelsen stain was positive. NTM was suspected after confirming the negative polymerase chain reaction for <em>M. tuberculosis</em>. Antibiotic therapy was switched to a specific regimen for skin and soft tissue infections caused by NTM. After identifying <em>M. chelonae</em>, antibiotic therapy was switched to a more specific regimen (clarithromycin and doxycycline) for <em>M. chelonae</em> according to the susceptibility test results. The patient was discharged after 3 months without infection recurrence.</div></div><div><h3>Conclusions</h3><div>Detecting Gram-ghost bacilli and using an additional Ziehl–Neelsen stain can be beneficial for the early diagnosis of repeated DLI with unknown etiology.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 143-147"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796744","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":"Impact on Survival of Heart and Heart-Lung Transplantation in Patients With Cyanotic and Noncyanotic Congenital Heart Diseases","authors":"Víctor Donoso-Trenado ,&nbsp;Raquel López-Vilella ,&nbsp;Joaquín Rueda-Soriano ,&nbsp;Francisco Buendía-Fuentes ,&nbsp;Luis Martínez-Dolz ,&nbsp;Luis Almenar-Bonet","doi":"10.1016/j.transproceed.2024.12.005","DOIUrl":"10.1016/j.transproceed.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>A high percentage of patients with congenital heart diseases (CHD) reach adulthood and, over time, require heart transplantation (HTx) or combined heart-lung transplantation (HLTx). Among CHD, there are subgroups associated with a higher risk.</div></div><div><h3>Methods</h3><div>Retrospective analysis of HTx and HLTx in CHD patients. They are subdivided based on the etiology of cyanotic or noncyanotic CHD. Baseline characteristics and mortality are comparatively analyzed. No comparative analysis is performed between HTx and HLTx.</div></div><div><h3>Results</h3><div>A total of 1015 HTx were performed, 933 (91,9%) were first-time HTx, and 42 (4.1%) were HLTx. Of the HTx, 18 (1.8%) were in CHD patients. In the HLTx group, 18 (42.8%) had CHD. In the HTx group, cyanotic patients had fewer surgical interventions (57% vs. 18%), compared to noncyanotic patients, where corrective surgeries were more common. Cyanotic patients had a higher mortality rate (57.1% vs. 18.2%), and their median survival was slightly lower (15.9 vs. 16.7 years). In the HLTx group, ninety percent of cyanotic patients had no previous surgeries, compared to 25% in the other group. The mortality rate was higher in cyanotic patients (60% vs. 37.5%), and their median survival was lower (1.7 vs. 9.5 years). Mortality occurred mainly in the first 30 days and was higher in cyanotic patients.</div></div><div><h3>Conclusions</h3><div>In CHD patients following HTx or HLTx, cyanotic conditions are associated with lower survival, with higher mortality occurring during the first 30 days.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 86-89"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911348","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}