Transplantation proceedings最新文献

{"title":"Islet Transplantation Provides Superior Glycemic Control and Maintenance of Better Islet Architecture Compared to Early Insulin Treatment in 50% Pancreatectomized Mice","authors":"Byung-Joon Kim ,&nbsp;Heekyoung Park ,&nbsp;Jun-Seop Shin ,&nbsp;Jin Kuk Kim ,&nbsp;Kwang-Won Kim","doi":"10.1016/j.transproceed.2025.05.029","DOIUrl":"10.1016/j.transproceed.2025.05.029","url":null,"abstract":"<div><div>Early insulin intervention is speculated to promote β-cell rest, potentially preserving and regenerating residual β-cells in β-cell-deficient environments, such as recent-onset type 1 diabetes. However, exogenous insulin supplementation is supposed not to be enough to fulfill these beneficial outcomes. To investigate this, we employed a 50% partial pancreatectomy (Px) in mice as a model for β-cell deficiency. Four experimental groups are included: 1. a sham group that underwent 50% Px (sham group), 2. control group that underwent 50% Px with saline injection for 7 days (Px group), 3. insulin group that administered insulin injection for 7 days post-Px (PX+INS group) and 4. islet transplantation group that islet transplantation after 50% Px. (PX+IT group). Intraperitoneal glucose tolerance tests (IPGTTs) were performed at 3- and 7-days postinsulin treatment or IT, and glycemic control was assessed by calculating the area under the curve (AUC) of blood glucose concentrations. Histomorphometric analysis was used to evaluate islet distribution, islet morphology and the composition of β- and α-cells. The results showed significantly improved glucose tolerance at 3- and 7- days in the islet-transplantation group compared to the insulin-treated group. Islet proportions in the pancreas were similar across groups; however, the insulin-treated group exhibited a significant increase in α-cell numbers, with their distribution extending both to the periphery and inner core of the islets. Our findings demonstrate that islet transplantation is superior to insulin treatment for glycemic control following 50% pancreatectomy in mice. Short-term insulin treatment was associated with α-cell expansion and worsened glycemic outcomes. These results suggest that islet transplantation is more effective in β-cell-deficient conditions, and caution is warranted when implementing early preventive insulin interventions.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1196-1200"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512995","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":"Graft-Versus-Host Disease as a Risk Factor for Heart Failure After Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study","authors":"Tong Wang ,&nbsp;Qian Zhu ,&nbsp;Hongfei Zhao ,&nbsp;Huan Liu","doi":"10.1016/j.transproceed.2025.05.030","DOIUrl":"10.1016/j.transproceed.2025.05.030","url":null,"abstract":"<div><h3>Background</h3><div>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a critical therapeutic option for hematologic malignancies. However, it is associated with severe complications, including graft-versus-host disease (GVHD). While GVHD is widely recognized for its impact on various organs, its role in the development of heart failure (HF) remains insufficiently understood. This study investigates the association between GVHD and HF following allo-HSCT, focusing on identifying key risk factors contributing to HF development.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 220 patients who underwent allo-HSCT between 2005 and 2024. HF was defined by clinical criteria and left ventricular ejection fraction. The association of GVHD severity (acute and chronic), inflammatory markers (tumor necrosis factor-alpha, interleukin-6), and cardiac biomarkers (B-type natriuretic peptide) with HF was analyzed. Multivariate logistic regression was performed to identify independent predictors of HF.</div></div><div><h3>Results</h3><div>Patients with HF demonstrated significantly lower left ventricular ejection fraction (33.92% ± 6.73% vs 61.51% ± 6.18%, <em>P</em> = .021) and higher levels of B-type natriuretic peptide (393.29 ± 71.29 ng/L vs 307.92 ± 76.28 ng/L, <em>P</em> = .042), tumor necrosis factor-alpha (80.3 ± 20.4 pg/mL vs 40.2 ± 10.1 pg/mL, <em>P</em> &lt; .001), and interleukin-6 (65.1 ± 15.7 pg/mL vs 25.4 ± 8.6 pg/mL, <em>P</em> &lt; .001) compared to controls. Severe acute GVHD (Grade ≥III) significantly increased the risk of HF (odds ratio = 3.5, <em>P</em> &lt; .001). Patients with multiple GVHD-related complications had a 3.6-fold higher likelihood of HF development (<em>P</em> &lt; .01). Echocardiographic findings revealed significant cardiac remodeling in HF patients, with increased left ventricular end-diastolic diameter (68.76 ± 7.23 mm vs 44.18 ± 7.16 mm, <em>P</em> = .004) and left ventricular posterior wall thickness (12.18 ± 4.32 mm vs 4.46 ± 2.19 mm, <em>P</em> = .002). Additionally, HF patients experienced more severe transplant-related complications, including infections (29.0% vs 10.6%, <em>P</em> = .041) and hemorrhagic cystitis (23.4% vs 7.1%, <em>P</em> = .027). Mortality was significantly higher in the HF group (86.0% vs 41.6%, <em>P</em> &lt; .001), with infection (71.0%) and HF (21.5%) being the leading causes of death. GVHD significantly heightens the risk of HF after allo-HSCT.</div></div><div><h3>Conclusions</h3><div>These findings underscore the necessity for proactive cardiovascular monitoring and targeted therapeutic interventions in GVHD patients to prevent the development of HF.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1161-1169"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487604","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":"Takotsubo Cardiomyopathy After Orthotopic Liver Transplantation: A Case Series","authors":"Zhao Hong-Qiang ,&nbsp;Guo Zhe ,&nbsp;Tong Xuan,&nbsp;Li Shan,&nbsp;Wu Guang-Dong,&nbsp;Yu Li-Han,&nbsp;Li Ang,&nbsp;Hou Yu-Cheng,&nbsp;Tang Rui","doi":"10.1016/j.transproceed.2025.05.020","DOIUrl":"10.1016/j.transproceed.2025.05.020","url":null,"abstract":"<div><div>This study examines takotsubo cardiomyopathy (TTS) following liver transplantation (LT). Out of 739 LT patients from 2018 to 2024, 76 developed cardiac dysfunction, with 6 cases of TTS, all male. TTS incidence post-LT was 0.8%, with alcoholic cirrhosis as the main diagnosis. TTS occurred a median of 2 days post-LT, highlighting early complications. High catecholamine levels were noted in 1 case. The study stresses the need for differential diagnosis of TTS in post-LT cardiac dysfunction, especially in alcohol abuse patients, with aggressive treatment including IABP, volume management, and anticoagulation. Echocardiographic assessment post-LT is crucial for TTS detection and management.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1058-1062"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532168","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":"Thoracoabdominal Normothermic Regional Perfusion: Technical Tips for Abdominal Transplant Surgeons","authors":"Maria Baimas-George ,&nbsp;Rashikh Choudhury ,&nbsp;Marissa Di Napoli ,&nbsp;Elizabeth Bashian ,&nbsp;Anna Ha ,&nbsp;Hani Grewal ,&nbsp;Yanik Bababekov ,&nbsp;George Justison ,&nbsp;Michael T. Cain ,&nbsp;James J. Pomposelli ,&nbsp;Elizabeth A. Pomfret ,&nbsp;Jordan Hoffman ,&nbsp;Trevor L. Nydam","doi":"10.1016/j.transproceed.2025.04.011","DOIUrl":"10.1016/j.transproceed.2025.04.011","url":null,"abstract":"<div><h3>Background</h3><div>Donation after circulatory death (DCD) is characterized as organ procurement after irrevocable termination of cardiopulmonary function. Historically grafts from DCD donors were used with caution due to complication rates, but new techniques have led to significant strides in utilization. Normothermic regional perfusion (NRP) establishes in situ perfusion after circulatory death pronouncement, mitigating ischemic injury seen with classic cold perfusion. NRP has shown excellent clinical outcomes and the potential for significant donor pool expansion.</div></div><div><h3>Methods</h3><div>For every NRP case, our team consists of two perfusionists, one transplant surgeon, and one surgical assistant. Communication between team members as well as an organized setup of the mayo stand and perfusion system are crucial for success. Cases proceed in the following fashion: sternotomy incision and retractor placement, pericardial incision and innominate vein ligation, occlusion of the brachiocephalic arteries, venous cannula insertion, aortic cannula insertion, and initiation of NRP.</div></div><div><h3>Results</h3><div>Since October 2022, our center has utilized NRP for all DCD cases when possible, leading to 128 attempts, of which 108 progressed to cardiac death, resulting in 94 liver transplants.</div></div><div><h3>Conclusions</h3><div>Thoracic cannulation can be challenging, particularly in the hands of an abdominal transplant surgeon unfamiliar with the territory. The evolution of technique and strategy has permitted reliable results and desired outcomes to allow for proper and efficient cannulation. This article reviews the tips, tricks, and pitfalls of thoracic cannulation with NRP for the abdominal transplant surgeon.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 966-974"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565602","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":"Black Race Is Associated With Improved Short-Term Survival After Heart Transplantation Under the Current Organ Allocation Policy","authors":"Michael Zhu ,&nbsp;Charley Sun ,&nbsp;Patrick Warner ,&nbsp;Masashi Kawabori ,&nbsp;Yong Zhan","doi":"10.1016/j.transproceed.2025.05.035","DOIUrl":"10.1016/j.transproceed.2025.05.035","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate whether racial disparities in mortality after heart transplantation remain after introduction of the new United Network for Organ Sharing (UNOS) allocation policy in 2018.</div></div><div><h3>Methods</h3><div>All adult heart transplant (HTX) recipients between October 2018 and January 2023 were identified from the UNOS database. Donor and recipient characteristics were compared between black and white recipients. Clinical outcomes also were compared between the 2 racial groups before and after propensity score matching (PSM).</div></div><div><h3>Results</h3><div>A total of 7325 white and 2865 black recipients of isolated first-time HTX were included. PSM identified 2862 pairs of recipients. Black recipients had lower 30-day mortality (1.8% vs 3.2%; <em>P</em> = .001) and 180-day mortality (5.6% vs 7.0%; <em>P</em> = .043); however, 1-year mortality was not significantly different between black and white recipients (7.7% vs 8.7%; <em>P</em> = .164). Multivariate analysis revealed the black race was significantly associated with a lower risk of 30-day mortality (hazard ratio, 0.73; 95% confidence interval, 0.54-0.98; <em>P</em> = .037).</div></div><div><h3>Conclusion</h3><div>Under the new allocation policy, black HTX recipients have lower short-term mortality; however, the survival benefit of black HTX recipients appears to dissipate over time. This new pattern of disparities in HTX warrants further investigation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1107-1113"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562454","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":"Belatacept Conversion in Kidney Transplant Recipients with Congestive Heart Failure: Survival and 30-Day Readmission Outcomes","authors":"Harshitha Mogallapalli ,&nbsp;Fauzia Osman ,&nbsp;Sandesh Parajuli ,&nbsp;Neetika Garg ,&nbsp;Fahad Aziz ,&nbsp;Arjang Djamali ,&nbsp;Brad C. Astor ,&nbsp;Maha A. Mohamed","doi":"10.1016/j.transproceed.2025.03.023","DOIUrl":"10.1016/j.transproceed.2025.03.023","url":null,"abstract":"<div><div>Calcineurin inhibitors (CNIs) are deleterious to cardiovascular risk in kidney transplant recipients (KTRs). Data on the impact of belatacept on KTRs with congestive heart failure (CHF) are scarce. We hypothesized that conversion to belatacept will have better patient and graft survival and a lower rate of readmissions within 30 days after discharge compared with long-term CNI use. We analyzed data from KTRs admitted to CHF between 2014 and 2019. A total of 28 recipients converted to belatacept and were matched with 339 who continued on CNIs. There was no significant difference in patient demographics, or primary disease between the two groups. The adjusted hazard ratio associated with conversion was (0.87 [95% CI, 0.35-2.11] for death, (0.91, [95% CI, 0.39-2.13] for graft failure and (adjusted hazard ratio, 1.91, [95% confidence interval (CI), 0.90–4.06]) for 30-day postdischarge readmission between the two groups. Patients converted to belatacept were at a higher risk of rejection (adjusted hazard ratio, 13.8; 95% CI, 7.48–25.3). Patient and graft survival and 30-day readmission after CHF hospital discharge did not differ significantly between belatacept conversion and CNI continuation. The incidence of rejection was higher in the belatacept conversion group, suggesting a need for closer follow-up of patients on belatacept therapy.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 771-776"},"PeriodicalIF":0.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083115","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":"Diagnostic Value of Color Doppler Ultrasound in Transplanted Renal Artery Stenosis","authors":"Yu Huimin,&nbsp;Kong Weina,&nbsp;Niu Ningning,&nbsp;Wu Hongtao,&nbsp;Zhang Guoying,&nbsp;Hao Xiaoye,&nbsp;Wang Jing,&nbsp;Tang Ying","doi":"10.1016/j.transproceed.2025.03.009","DOIUrl":"10.1016/j.transproceed.2025.03.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study is to investigate the diagnostic features and efficacy of ultrasonography in transplanted renal artery stenosis (TRAS).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We collected data from 20 patients diagnosed with TRAS via digital subtraction angiography (DSA) between July 2016 and January 2024 at the First Central Hospital of Tianjin. Additionally, we randomly selected 30 patients with normal blood flow and stable renal function following renal transplantation to serve as the control group. We utilized color Doppler ultrasound to assess various blood flow parameters, including the peak systolic velocity (PSV1) and diastolic velocity (EDV1) of the interlobar artery, the resistance index (RI) of the interlobar artery, and the systolic acceleration time (SAT) of the interlobar artery. We also measured the velocity of the interlobar vein (V), the peak systolic velocity (PSV2) and diastolic velocity (EDV2) at the stenosis site of the transplanted renal artery, the resistance index at the stenosis site, and the diameter of the stenosis of the transplanted renal artery (D). Concurrently, we recorded creatinine (Cr) levels within 24 hours. We compared the color Doppler ultrasound blood flow parameters of the TRAS group before interventional therapy with those of the control group and constructed ROC curves to determine the area and critical values under each parameter curve. We also selected cases post-stent implantation to compare the differences in color Doppler blood flow parameters before and after treatment, thereby analyzing the characteristics of hemodynamic changes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;PSV1, EDV1, interlobar RI, stenosis RI in the TRAS group were significantly lower than those in the control group (t = 6.976, &lt;em&gt;P = .&lt;/em&gt;000; T = 3.748, &lt;em&gt;P = .&lt;/em&gt;000; Z = -4.115, &lt;em&gt;P = .&lt;/em&gt;000; T = 6.537, &lt;em&gt;P = .&lt;/em&gt;000; Z = -4.979, &lt;em&gt;P = .&lt;/em&gt;000). Conversely, the PSV2, EDV2, SAT, and Cr levels in the TRAS group were higher than those in the control group (Z = -5.942, &lt;em&gt;P = .&lt;/em&gt;000; Z = -5.735, &lt;em&gt;P = .&lt;/em&gt;000; Z = -5.897, &lt;em&gt;P = .&lt;/em&gt;000; Z = -5.941, &lt;em&gt;P = .&lt;/em&gt;000). ROC curve analysis revealed that PSV2 exhibited the highest sensitivity and specificity for diagnosing TRAS, both at 100%, with a critical value of 205 cm/s. This was followed by the interlobar artery SAT, which showed a sensitivity of 95% and a specificity of 100%, with a critical value of 0.08 s. Additionally, after stent placement, the PSV1, EDV1, interlobar RI, and stenosis RI were significantly higher than before stent placement (Z = -5.17, &lt;em&gt;P = .&lt;/em&gt;000; Z = -2.695, &lt;em&gt;P = .&lt;/em&gt;019; T = 3.841, &lt;em&gt;P = .&lt;/em&gt;002; Z = -4.974, &lt;em&gt;P = .&lt;/em&gt;000). In contrast, the PSV2, EDV2, and Cr levels after stent placement were lower than those prior to the procedure (t = 7.518, &lt;em&gt;P = .&lt;/em&gt;000; T = 5.837, &lt;em&gt;P = .&lt;/em&gt;000; Z = 11.567, &lt;em&gt;P = .&lt;/em&gt;000).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Color doppler ultrasound is a","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 777-783"},"PeriodicalIF":0.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059299","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":"Improved Survival of Lung Transplant Patients With Subsequent Renal Transplant","authors":"Renita Wilson ,&nbsp;J. Asher Jenkins ,&nbsp;Juan Maria Farina ,&nbsp;Blake Langlais ,&nbsp;Jonathan D’Cunha ,&nbsp;Ashraf Omar ,&nbsp;Hasan Khamash ,&nbsp;Pedro Reck dos Santos","doi":"10.1016/j.transproceed.2025.04.007","DOIUrl":"10.1016/j.transproceed.2025.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplantation (LTx) is the definitive treatment for patients with end-stage pulmonary disease; however, the transplant process often results in variable degrees of renal dysfunction. Ultimately, some patients may require a subsequent renal transplant (RTx). A RTx as an intervention for LTx recipients with underlying kidney failure has been studied, but data about RTx to treat renal failure following LTx are limited. This study aims to explore factors that may predict the need for RTx after LTx and to analyze survival outcomes of this intervention.</div></div><div><h3>Methods</h3><div>The International Society for Heart and Lung Transplantation (ISHLT) Registry was utilized to compare 334 cases of RTx after LTx with 2 control groups who had (1) similarly impaired renal function (n = 1336), and (2) preserved renal function at the time of the LTx (n = 1336).</div></div><div><h3>Results</h3><div>We identified variables such as recipient age, body mass index (BMI), 6-minute walking distance (6-MWD), and history of diabetes as factors to be evaluated in the context of renal function at LTx. RTx post-LTx recipients demonstrated improved survival compared with LTx-only recipients with impaired renal function but worsened survival compared with LTx-only recipients with preserved renal function at LTx.</div></div><div><h3>Conclusions</h3><div>Thus, we identify a possible role for early RTx referral as a strategy to increase survival following LTx in patients with pre-existing renal dysfunction.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 849-858"},"PeriodicalIF":0.8,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061676","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 Visible Method for Monitoring Kidney Rejection: Homologous Donor-Derived Sentinel Skin","authors":"Xiangke Rong ,&nbsp;Kai Wang ,&nbsp;Jiezhang Tang ,&nbsp;Jizhong Yang ,&nbsp;Huilong Wang ,&nbsp;Kepu Liu ,&nbsp;Zhibin Li ,&nbsp;Jing Li ,&nbsp;Geng Zhang ,&nbsp;Chenggang Yi","doi":"10.1016/j.transproceed.2025.03.027","DOIUrl":"10.1016/j.transproceed.2025.03.027","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Rejection in facial transplant patients is always accompanied by changes in skin appearance and can be monitored by observation of the skin. Acute rejection (AR) after kidney transplantation has a significant impact on the function of the transplanted kidney, which is relatively difficult to monitor. In this study, the skin of the same donor was used as a sentinel for monitoring the rejection of kidney transplantation.</div></div><div><h3>Methods</h3><div>A 3 cm × 5 cm skin was procured from the kidney donor and was grafted to the recipient at the same time as the kidney transplantation, to serve as a sentinel for monitoring AR. Postoperatively, kidney rejection was monitored by observing changes in the appearance of the sentinel skin (SS). The safety of this procedure was also evaluated by comparing the renal function in 12 patients in the sentinel skin graft group and 20 patients with kidney transplantation alone.</div></div><div><h3>Results</h3><div>The same immunosuppressive regimen was used postoperatively in patients with SS transplantation and those with kidney transplantation merely. There was also no statistical difference in creatinine and urea nitrogen between the 2 groups (<em>P</em> &gt; .05), but a difference in urine protein (UP) (<em>P</em> &lt; .05) in 2 weeks, 1and 2 months, which was lower in the test group, and no difference in 3 months. In addition, 1 patient had changes in the SS indicating rejection, while creatinine was normal at that time, which was followed by SS and kidney biopsy, suggesting both were of different grades of rejection.</div></div><div><h3>Conclusions</h3><div>SS combined with simultaneous kidney transplantation is a safe and feasible surgical approach. In particular, The SS holds promise for monitoring rejection and also sub-clinical rejection.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 793-798"},"PeriodicalIF":0.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065525","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":"Preemptive Conversion to mTOR Inhibition to Prevent Primary Cytomegalovirus Infection in Kidney Transplantation with High-Risk Serostatus","authors":"Jan Paulwitz ,&nbsp;Laura Vonbrunn ,&nbsp;Katharina Heller ,&nbsp;Anne Dieterle ,&nbsp;Hendrik Apel ,&nbsp;Mario Schiffer ,&nbsp;Michael S. Wiesener ,&nbsp;Thomas Dienemann","doi":"10.1016/j.transproceed.2025.03.029","DOIUrl":"10.1016/j.transproceed.2025.03.029","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplantation (KTx) is the treatment of choice for patients with end-stage renal disease. Cytomegalovirus (CMV) infection remains a serious complication of KTx. The most vulnerable patients are naïve recipients (R-) transplanted from a CMV-seropositive donor (D+). Mammalian target of rapamycin inhibitors (mTOR-I) have been shown to have advantages over mycophenolate in terms of CMV infections. In this study, we addressed the effect of preemptive conversion to mTOR-I before ending prophylaxis with valganciclovir in high-risk patients with a D+/R- CMV serostatus.</div></div><div><h3>Methods</h3><div>The study involved inclusion and analysis of all patients with D+/R- CMV serostatus before and after the protocol change with a conversion to mTOR-I at 6 months after KTx. The main study endpoints were primary CMV infection, maximal viral load, and hospitalization for CMV infection. Because prevention of primary CMV infections was the primary endpoint, we excluded breakthrough infections under prophylaxis.</div></div><div><h3>Results</h3><div>The primary analysis included 44 patients in the control group and 39 patients in the mTOR group. The 2 groups did not have any significant differences in clinical characteristics, immunosuppressive treatment, transplant function, and rates of rejection. Between 6 and 12 months (when mTOR-I were established), the mTOR group showed a numerically lower incidence of CMV infections, as well as numerically fewer hospitalizations. No serious complications were observed with mTOR-I.</div></div><div><h3>Conclusion</h3><div>Preemptive conversion from mycophenolate to mTOR-I may be helpful to prevent or attenuate primary infection in CMV high-risk kidney transplant recipients. Differences were not statistically significant. A larger study, ideally a prospective randomized trial, is needed to validate these findings.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 784-792"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049388","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}