Transplantation proceedings最新文献

{"title":"Orthotopic Liver Transplantation for Giant Hepatic Hemangioma Involving the Entire Liver With Intra-Abdominal Hypertension: A Case Report","authors":"Daniel Reis Waisberg,&nbsp;Jhosimar Alvarez De La Hoz,&nbsp;Maciana Santos Silva,&nbsp;Rafael Soares Pinheiro,&nbsp;Rodrigo Bronze Martino,&nbsp;Liliana Ducatti,&nbsp;Rubens Macedo Arantes,&nbsp;Luciana Bertocco Haddad,&nbsp;João Paulo Costa Santos,&nbsp;Flávio Henrique Galvão,&nbsp;André Dong Lee,&nbsp;Alice Tung Song,&nbsp;Vinícius Rocha-Santos,&nbsp;Wellington Andraus","doi":"10.1016/j.transproceed.2026.06.025","DOIUrl":"10.1016/j.transproceed.2026.06.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatic hemangioma (HH) is the most common benign liver tumor, usually &lt;4 cm and asymptomatic. Rarely, lesions become massive or diffuse, causing severe abdominal mass effect or complications such as Kasabach-Merritt syndrome with consumptive coagulopathy. When surgical resection is unfeasible, liver transplantation (LT) may be considered. Adult LT for unresectable HH is extremely rare, with only 27 cases reported worldwide. The aim of this study is to describe a case of giant HH that encompassed the whole liver and caused abdominal hypertension, eventually requiring LT.</div></div><div><h3>Case report</h3><div>A male patient with HH presented with progressive hepatomegaly, abdominal pain, weight loss, reduced intake, edema, dental bleeding, and pancytopenia. Deceased-donor LT was performed using a modified left-to-right piggyback technique and a Mercedes incision. The explanted liver weighed 8.675 kg with near-total parenchymal replacement by diffuse hemangiomatosis. Postoperative recovery was uneventful, and he was discharged home 11 days after the procedure. The patient remains clinically well almost 10 years after LT.</div></div><div><h3>Conclusion</h3><div>LT for diffuse massive HH, although exceptionally rare, is feasible in selected adults. The modified left-to-right piggyback technique is useful to overcome intraoperative difficulties that may arise due to massive hepatomegaly.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1410-1413"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564465","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":"Salvage Ex Situ Hepatectomy With Liver Autotransplantation for Recurrent Intraductal Papillary Neoplasm of the Bile Ducts (IPNB): A Case Report","authors":"Gabriel Bayona-Alvarado,&nbsp;Daniel Reis Waisberg,&nbsp;Rafael Soares Pinheiro,&nbsp;Maciana Santos Silva,&nbsp;Rubens Macedo Arantes,&nbsp;Liliana Ducatti,&nbsp;Carolline Moura,&nbsp;Luciana Bertocco Haddad,&nbsp;Alice Tung Song,&nbsp;Vinicius Rocha-Santos,&nbsp;Rodrigo Bronze Martino,&nbsp;Wellington Andraus","doi":"10.1016/j.transproceed.2026.06.028","DOIUrl":"10.1016/j.transproceed.2026.06.028","url":null,"abstract":"<div><h3>Introduction</h3><div>Locally advanced hepatic tumors involving the hepatic veins and inferior vena cava (IVC) represent a major surgical challenge and are often considered unresectable using conventional <em>in situ</em> techniques. In such settings, <em>ex situ</em> hepatectomy with liver autotransplantation emerges as an extreme yet potentially curative strategy that combines oncologic liver surgery and transplant principles. By enabling total vascular exclusion, hypothermic perfusion, and <em>ex situ</em> vascular reconstruction on the bench, this technique allows radical resections with controlled management of complex vascular invasion. Although rarely indicated, it may offer a salvage option for carefully selected patients with recurrent disease and otherwise limited therapeutic alternatives.</div></div><div><h3>Case Report</h3><div>A 64-year-old woman with a history of left hepatectomy for intraductal papillary neoplasm of the bile duct (IPNB) with cystic degeneration developed recurrent disease in the caudate lobe, with intimate proximity to the major vascular structures of the right hemiliver. Curative-intent salvage <em>ex situ</em> hepatectomy with liver autotransplantation was performed without venovenous bypass, using a temporary portocaval shunt for hemodynamic stability. The liver was perfused with Custodiol solution under hypothermic conditions, followed by <em>ex situ</em> caudate lobe resection with meticulous dissection of the lesion from the right hepatic vein, right portal vein, and right hepatic duct. A large V5 hepatic vein branch was reconstructed using iliac vein allograft. Total ischemia time was 229 minutes and operative time was 625 minutes. After revascularization, the graft showed good aspect without reperfusion syndrome. Histopathology revealed recurrent IPNB with high-grade dysplasia and negative margins. The patient recovered well and was discharged home on postoperative day 15.</div></div><div><h3>Conclusion</h3><div><em>Ex situ</em> hepatectomy with liver autotransplantation is a feasible salvage therapy for recurrent hepatic tumors in anatomically complex locations,enabling radical resections and favorable functional outcomes in specialized centers.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1406-1409"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581910","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":"Left Renal Vein Ligation in Patients With Liver Cirrhosis and Spontaneous Splenorenal Shunt in Liver Transplantation","authors":"Alexandre Corrente de Oliveira,&nbsp;Catarina Marcos Moldão,&nbsp;João Pedro Soares Costa,&nbsp;Mateus Silva Feijó,&nbsp;Wilson Júnior Pereira da Silva,&nbsp;Elizandra Letícia Vieira Terra,&nbsp;Fernanda de Sousa Rodrigues,&nbsp;Ana Virginia Figueira,&nbsp;Tiago Morato,&nbsp;Silas Romeres,&nbsp;Danielle Sacchi Bitencourt,&nbsp;Henrique Rocha,&nbsp;Natalia Trevizoli,&nbsp;Luiz Gustavo dias,&nbsp;Priscilla Brizolla de Campos,&nbsp;Gabriel Cajá,&nbsp;Raquel Ullmann,&nbsp;Fernando Jorge,&nbsp;Andre Luis Conde Watanabe","doi":"10.1016/j.transproceed.2026.07.001","DOIUrl":"10.1016/j.transproceed.2026.07.001","url":null,"abstract":"<div><div>Adequate hepatopetal portal venous inflow is a prerequisite for graft viability and functional recovery after liver transplantation. In some recipients, large portosystemic collaterals persist despite transplantation, diverting portal flow and predisposing to portal steal and subsequent graft dysfunction. Spontaneous splenorenal shunts (SSS) represent a particularly challenging manifestation of this phenomenon. Several surgical strategies have been proposed to restore effective portal inflow, including splenectomy, shunt ligation, and left renal vein ligation (LRVL). Compared with alternative approaches, LRVL is technically easier and less invasive, making it an attractive adjunctive maneuver. However, its optimal indications and long-term clinical consequences—particularly with respect to graft performance and renal function—remain incompletely defined. Although prior reports suggest that LRVL can attenuate portosystemic shunting and enhance hepatopetal portal flow, the existing evidence is heterogeneous and largely derived from small, single-center series. In this study, we compared outcomes among liver transplant recipients with SSS managed with or without LRVL, with a focus on perioperative outcomes, graft-related complications, renal and liver function, and survival, in order to better delineate the clinical role of LRVL. Donors were not prisoners, coerced, or paid.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1288-1292"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586489","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":"Impact of Bacterial Infections in Adult Heart Transplant Recipients: A Single-Center Experience (2017–2024)","authors":"Tania Mara Varejão Strabelli,&nbsp;Gabriel Fialkovitz,&nbsp;Luis Fernando Bernal da Costa Seguro,&nbsp;Fernanda Barone,&nbsp;Fernando Bacal","doi":"10.1016/j.transproceed.2026.07.008","DOIUrl":"10.1016/j.transproceed.2026.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Adult heart transplant candidates are increasingly hospitalized while awaiting transplantation, frequently requiring intravenous vasoactive drugs and mechanical circulatory support. These conditions are well-established risk factors for healthcare-associated infections, which may adversely affect early post-transplant outcomes.</div></div><div><h3>Objective</h3><div>To describe the epidemiology, clinical presentation, and microbiological profile of infectious complications diagnosed within 90 days after adult heart transplantation at a tertiary referral center.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted including adult patients (&gt;18 years) who underwent heart transplantation between January 2017 and December 2024. Demographic characteristics, use of mechanical circulatory support, early mortality, type of infections, and microbiological findings were evaluated.</div></div><div><h3>Results</h3><div>A total of 391 adult heart transplant recipients were included; 62% were male, with a mean age of 49 years. Intra-aortic balloon pump support was used in 70% of patients and extracorporeal membrane oxygenation in 10%. Early mortality within 30 days occurred in 12.5% of recipients. Infectious complications were highly prevalent, predominantly occurring within the first four weeks after transplantation. Primary bloodstream infections were the most frequent diagnosis (153 episodes), followed by pneumonia and symptomatic urinary tract infections (71 episodes each). The most commonly isolated pathogens were <em>Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis</em>, and <em>Pseudomonas aeruginosa</em>. Notably, <em>Candida parapsilosis</em> accounted for a substantial proportion of bloodstream infection isolates. The infection-per-patient index increased from 0.6 to 0.8 between 2017 and 2020 and to 1.4-1.7 between 2021 and 2024.</div></div><div><h3>Conclusions</h3><div>Infectious complications are highly prevalent among adult heart transplant recipients, particularly during the early postoperative period. Bloodstream infections predominate, with a microbiological profile strongly influenced by hospital-associated flora, including bacterial and fungal pathogens. These findings reinforce the importance of active surveillance, strict infection prevention strategies, and optimized recipient selection to improve early transplant outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 7","pages":"Pages 1356-1358"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671651","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 of Glucagon-Like Peptide-1 Agonist Use on Weight Trajectory and Clinical Outcomes Following Liver Transplantation","authors":"Anju Pradeep,&nbsp;Muhammad Saad Faisal,&nbsp;Kelly Chen,&nbsp;Tepe Gokturk,&nbsp;Bradley Karmo,&nbsp;Agustin Gavidia Rosario,&nbsp;Ingrid Rocha,&nbsp;Muhammad Shahzil,&nbsp;Minahil Fatima,&nbsp;Maria Rehmani,&nbsp;Mark Obri,&nbsp;Muhammad Salman Faisal,&nbsp;Syed-Mohammed Jafri","doi":"10.1016/j.transproceed.2026.05.018","DOIUrl":"10.1016/j.transproceed.2026.05.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Glucagon-Like Peptide-1 (GLP-1) analogues are increasingly being used to manage diabetes and obesity. However, their use in liver transplant (LT) recipients remains understudied. This study aimed to evaluate the clinical outcomes associated with GLP-1 use following LT.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult LT recipients between 2019-2023 at a single tertiary care center. Patients were divided into 2 groups based on GLP-1 use after transplant. Baseline demographics, comorbidities, transplant characteristics, and post-transplant outcomes were compared. Categorical variables were analyzed using Chi-square tests, and continuous variables using t-tests.</div></div><div><h3>Results</h3><div>Among 368 LT recipients, 73 (19.8%) were prescribed GLP-1 analogues post-transplant and 295 (80.2%) were not. There was no difference in demographics. GLP-1 users had higher rates of diabetes (79.5% vs. 31.2%, <em>p</em> &lt; .0001), hyperlipidemia (50.7% vs. 29.8%, <em>p</em> = .0012), and BMI at transplant (31.9 ± 6.3 vs. 28.5 ± 12.6, <em>p</em> = .0015). MASH was the leading indication for transplant in the GLP-1 group (61.9% vs. 38.1%, <em>p</em> &lt; .0001). At year 1, GLP-1 users had lower rejection rates (12.3% vs. 23.1%, <em>p</em> = .0635), with a similar trend at 3 years (6.8% vs. 9.5%, <em>p</em> = .6322). At 3 years, mortality was lower in GLP-1 users (1.4% vs. 4.7%, <em>p</em> = .3293).</div></div><div><h3>Discussion</h3><div>GLP-1 analogues were commonly used post-LT in patients with MASH and obesity. Despite higher metabolic burden at baseline, GLP-1 use was associated with similar or improved trends in BMI, rejection, and mortality. Larger prospective studies are needed to strengthen the evidence supporting the use of GLP-1 analogues in this high-risk population.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1092-1096"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207445","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 Economic Imperative of Living Donor Kidney Transplantation: A Single-Center Micro-Cost Analysis for Sustainable ESRD Care in Saudi Arabia","authors":"Hany M. El Hennawy,&nbsp;Nashat Al Otaibi,&nbsp;Eman Kotbi,&nbsp;Rawan Al Zahrani,&nbsp;Ghiada Al Maghrabi,&nbsp;Omar Safar,&nbsp;Tariq Jaber,&nbsp;Menna El Hennawy,&nbsp;Abdullah Khedr,&nbsp;Mona Ibrahim,&nbsp;Zahra Alshehri,&nbsp;Asim Al Saedi","doi":"10.1016/j.transproceed.2026.04.033","DOIUrl":"10.1016/j.transproceed.2026.04.033","url":null,"abstract":"<div><h3>Background</h3><div>Living donor kidney transplantation (LDKT) is the definitive treatment for end-stage renal disease (ESRD), yet locally generated economic data remain limited. This single-center study provides a primary micro-costing comparison of LDKT, hemodialysis (HD), and peritoneal dialysis (PD) from a hospital finance perspective in a central Saudi tertiary-care facility.</div></div><div><h3>Methods</h3><div>A retrospective micro-costing analysis was conducted from the healthcare provider perspective, capturing all direct medical costs from 2020 to 2023 over a 1-year horizon. Detailed cost components for HD (156 sessions/year), PD, and LDKT (donor and recipient pathways) were extracted from institutional financial records. A deterministic one-way sensitivity analysis was conducted to assess robustness.</div></div><div><h3>Results</h3><div>HD incurred the highest annual cost ($67,311.96), primarily due to personnel, consumables, and vascular access interventions. PD costs $58,946.50 annually, attributable principally to dialysate procurement. LDKT required an initial combined donor-recipient first-year investment of $60,693 (donor: $7942; recipient: $52,751), followed by a substantially lower annual maintenance cost of $12,150. Cumulative analysis demonstrated that LDKT achieves financial break-even with HD within the first 12 months and becomes the dominant long-term strategy, a result consistent across all sensitivity scenarios.</div></div><div><h3>Conclusions</h3><div>LDKT provides rapid and sustained economic advantages over dialysis modalities within the Saudi hospital context. HD entails the highest ongoing cost, whereas PD offers a more cost-effective dialysis option. The immediate break-even point and long-term cost savings of LDKT provide strong evidence to support the expansion of LDKT and PD programs as essential components of sustainable ESRD care in Saudi Arabia.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1027-1034"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213832","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":"Cultural Virtues and Health Workers’ Attitudes Toward Organ Donation: A Correlational Study","authors":"Cansu Karaoglan,&nbsp;Senay Karadag Arli","doi":"10.1016/j.transproceed.2026.04.030","DOIUrl":"10.1016/j.transproceed.2026.04.030","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare professionals occupy a central position in influencing societal attitudes and ethical decision-making concerning organ donation. Understanding how cultural virtues, such as helpfulness, spirituality, and conviction, shape these attitudes provides valuable insights for ethics education and policy development. This study aimed to examine the relationship between healthcare professionals’ attitudes toward organ donation and their cultural virtues.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional, and correlational design was adopted. The sample consisted of 201 healthcare professionals (72.1% nurses, 27.9% physicians) employed in a state hospital in Türkiye between April and July 2024. Data were gathered using the Identifying Features Form, the Post-Mortem Organ Donation Attitude Scale, and the Cultural Virtues Scale. Statistical analyses included descriptive statistics, Pearson’s correlation, and multiple regression.</div></div><div><h3>Results</h3><div>Participants’ mean score on the Organ Donation Attitude Scale (67.31 ± 14.48) reflected generally positive attitudes. Significant correlations emerged between the Organ Donation Attitude Scale and Spirituality (<em>p</em> = .019), between Family Approval and Spirituality (<em>p</em> &lt; .001), between Positive Attitude and Conviction (<em>p</em> = .029), and between Family Approval and Conviction (<em>p</em> = .026). Regression analysis identified spirituality (β = 0.159; <em>p</em> &lt; .05) as a significant predictor of organ donation attitudes.</div></div><div><h3>Conclusion</h3><div>Healthcare professionals exhibited favorable ethical attitudes toward organ donation, with spirituality exerting a particularly strong influence. These findings suggest that spiritual and cultural virtues guide moral reasoning and altruistic motivation in clinical decision-making. Integrating cultural and spiritual perspectives into professional ethics and training programs may enhance healthcare professionals’ engagement with organ donation practices.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 955-960"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213850","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 Role of Machine Perfusion in Liver Transplant Surgeon Training","authors":"Pietro Matucci-Cerinic,&nbsp;Nicola Martin,&nbsp;Giorgia Zanchi,&nbsp;Mattia Zambon,&nbsp;Lara Bonello,&nbsp;Riccardo Pravisani,&nbsp;Vittorio Cherchi,&nbsp;Dario Lorenzin,&nbsp;Vittorio Bresadola,&nbsp;Giovanni Terrosu,&nbsp;Umberto Baccarani","doi":"10.1016/j.transproceed.2026.05.020","DOIUrl":"10.1016/j.transproceed.2026.05.020","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation (LT) is a complex surgical procedure, with a well-recognized learning curve. Machine perfusion (MP) has been shown to mitigate ischemia–reperfusion injury and extend graft preservation time.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single-center study including adult patients who underwent LT between January 1, 2021, and October 16, 2025. Patients were stratified into 3 groups according to transplant surgeon experience and graft storage: group Y-MP, young surgeons (&lt;44 years) using MP; group S-SCS, senior surgeons (&gt;52 years) using static cold storage (SCS); and group S-MP, senior surgeons using MP (gold standard). Recipient and donor characteristics, perioperative variables, early graft function scores (primary nonfunction, early allograft dysfunction, model for early allograft function, early allograft failure simplified estimation), and postoperative laboratory parameters were analyzed and compared among groups.</div></div><div><h3>Results</h3><div>A total of 136 patients were included in the analysis (37 in Y-MP, 68 in S-SCS, and 29 in S-MP). Baseline recipient characteristics and MELD scores were comparable across groups. Operative time and blood loss were significantly higher in Y-MP; however, no significant differences were observed in primary graft outcomes (primary nonfunction, early allograft dysfunction, early allograft failure simplified estimation scores) except for MEAF. Early postoperative transaminase levels were significantly lower in Y-MP compared with S-SCS, particularly on postoperative days 1 and 3.</div></div><div><h3>Conclusions</h3><div>MP clearly ameliorates organ storage and LT logistics, but it could also be considered for young surgeons’ training in performing LT. MP may represent a valuable tool in the learning curve of LT, enabling progression without compromising early graft outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1125-1128"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221341","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":"Normalized Serum Calcium and Maintained Tacrolimus Levels by Cinacalcet Use in Kidney Transplant Recipients","authors":"Aschariya Wipattanakitcharoen,&nbsp;Kullaya Takkavatakarn,&nbsp;Suwasin Udomkarnjananun,&nbsp;Paweena Susantitaphong,&nbsp;Jeerath Phannajit","doi":"10.1016/j.transproceed.2026.05.017","DOIUrl":"10.1016/j.transproceed.2026.05.017","url":null,"abstract":"<div><h3>Background</h3><div>Hypercalcemia with persistent hyperparathyroidism after kidney transplantation is an important risk of cardiovascular disease and allograft dysfunction in kidney transplant recipients (KTRs). Cinacalcet, a calcium-sensing receptor agonist, is commonly used in chronic hemodialysis recipients with secondary hyperparathyroidism; however, its effect and safety in kidney transplant recipients are not established.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted in KTRs with persistent hyperparathyroidism (intact parathyroid hormone [iPTH] &gt;65 pg/mL) for at least 1 year post-transplantation. Participants received cinacalcet 25 mg/day for 3 months. Primary outcomes were changes in serum calcium, serum phosphate, and iPTH concentrations; the secondary outcome was the effect on tacrolimus trough level.</div></div><div><h3>Results</h3><div>Thirty KTRs (mean age, 46.5 years; median time since transplantation, 3 years; mean serum creatinine, 1.5 ± 0.4 mg/dL, mean estimated glomerular filtration rate, 55.4 ± 14.6 mL/min/1.73 m²) completed the study. Administration of cinacalcet significantly reduced serum calcium levels (mean, 9.2 ± 0.7 mg/dL vs 10.1 ± 0.6 mg/dL; <em>P</em> &lt; .001) and increased serum phosphate levels (mean, 3.0 ± 0.6 mg/dL vs 2.7 ± 0.5 mg/dL; <em>P</em> = .006). iPTH levels showed no significant change (median, 178.3 pg/mL vs 176.2 pg/mL; <em>P</em> = .35). Tacrolimus trough levels remained stable (mean, 5.7 ± 1.3 vs 5.9 ± 2.8 ng/mL; <em>P</em> = .68).</div></div><div><h3>Conclusion</h3><div>Cinacalcet use can normalize serum calcium levels and maintain tacrolimus levels in KTRs with persistent hyperparathyroidism. However, long-term data, especially for cardiovascular outcomes, merit further exploration.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 968-972"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213772","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":"Depressive Symptoms, Social Support, and Health-Related Quality of Life of Patients After Lung Transplantation","authors":"Chi-Hsuan Fan,&nbsp;Wei-Hsun Chen,&nbsp;Ya-Hsin Chou,&nbsp;Chia-Hui Cheng,&nbsp;Li-Chueh Weng","doi":"10.1016/j.transproceed.2026.05.015","DOIUrl":"10.1016/j.transproceed.2026.05.015","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplant recipients often experience depressive symptoms that can negatively impact their health-related quality of life (HRQOL). This study examined the relationship between depression and HRQOL, and whether social support mediates this effect.</div></div><div><h3>Material and Methods</h3><div>A convenient sample of 47 lung transplant recipients in Taiwan was surveyed in 2024 using a structured questionnaire. The donors were not from prisoners, or from those individuals who are coerced or paid. The mediation effect was analyzed using the PROCESS model version 4.2.</div></div><div><h3>Results</h3><div>The findings showed that participants experienced moderate to high levels of social support, mild level of depression, and moderate level of health-related quality of life. Depressive symptoms had a significant direct effect on both the physical component summary (PCS) score (B = −0.6004; 95% confidence interval [CI]: −0.9485 to −0.2523; <em>p</em> = .0012) and the mental component summary (MCS) score (B = −0.8034; 95% CI: −1.2473 to −0.3594, <em>p</em> = .0007). However, the indirect effect of depressive symptoms on PCS (B = −0.0167; 95% bootstrap CI: −0.1550 to 0.1097) and MCS (B = −0.0803; 95% bootstrap CI: −0.2543 to 0.0215), mediated by social support, was not significant. Depression emerged as a significant factor influencing HRQOL, regardless of social support.</div></div><div><h3>Conclusion</h3><div>This study highlights the significant impact of depressive symptoms on HRQOL in lung transplant recipients, regardless of social support. These findings emphasize the need for routine psychological screening and early intervention for depressive symptoms.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1164-1171"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221332","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}