Transplantation proceedings最新文献

{"title":"Efficacy and Safety of a Desensitization Treatment With Rituximab and Immunoglobulin in Hyperimmunized Patients Awaiting a Cadaveric Kidney Transplantation","authors":"Elena González García ,&nbsp;María López Oliva ,&nbsp;Esther Mancebo ,&nbsp;María José Santana ,&nbsp;Lina María León Machado ,&nbsp;Cristina Fuentes Fernández ,&nbsp;Carlos Jiménez","doi":"10.1016/j.transproceed.2024.12.001","DOIUrl":"10.1016/j.transproceed.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Patients on a kidney transplant waiting list with antibodies against more than 80% of a panel reactive antibody (PRA) are difficult to transplant, even with national or regional programs. Desensitization treatment with high-dose intravenous immunoglobulin and rituximab could be offered to patients with a long waiting time for a cadaveric donor to improve their odds of finding a kidney.</div></div><div><h3>Methods</h3><div>This was a retrospective, single-center study including all hyperimmunized patients on the waiting list for a cadaveric kidney donor who received a desensitization treatment between 2010 and 2020. Eight patients (50% male patients, mean age = 41.5±16.4 years) were desensitized with intravenous immunoglobulin and rituximab. Seventy-five percent of the patients had received a previous transplant. The median PRA calculated was 98%. The mean follow-up time after transplantation was 67 months.</div></div><div><h3>Results</h3><div>No patient presented significant side effects to desensitization treatment. Seven of the 8 patients (87.5%) received a transplant from a cadaveric donor, in a median 8 months after desensitization. In the immediate post-transplant period, there were two graft losses (28.6%) due to non-immunological causes (1 venous thrombosis in a patient with a coagulation disorder and 1 primary graft failure). Creatinine levels at 1 and 5 years were 1.4 ± 0.2 mg/dL and 1.7 ± 0.6 mg/dL, respectively. There were no episodes of acute rejection. No patient developed cancer during the follow-up.</div></div><div><h3>Conclusions</h3><div>Desensitization treatment with immunoglobulin and rituximab on hyperimmunized patients on the cadaveric transplant waiting list is a safe and effective treatment that increases the chances of achieving a kidney transplant in highly sensitized patients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 3-6"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928959","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":"Sensitization on Hemodialysis After Renal Graft Failure: HLA Incompatibility Still Matters","authors":"Mar Huelva-López,&nbsp;Marta Ciudad-Montejo,&nbsp;Carlos Fernando Novillo-Sarmiento,&nbsp;Cayetana Moyano-Peregrín,&nbsp;Victoria Eugenia García-Montemayor,&nbsp;Raquel Ojeda-López,&nbsp;María Luisa Agüera-Morales,&nbsp;Alberto Rodríguez-Benot","doi":"10.1016/j.transproceed.2024.11.032","DOIUrl":"10.1016/j.transproceed.2024.11.032","url":null,"abstract":"<div><div>Patients with renal graft failure can develop human leukocyte antigen (HLA) sensitization when returning to dialysis. There is no consensus on which factors could be associated with an increased risk of this kind of sensitization after graft loss. To try to identify some of these factors, a retrospective observational study was performed in our center. Demographic and transplant-related data were collected: HLA mismatches, changes in calculated panel reactive antibody percentage over time, the immunosuppression withdrawal schedule during the first year on hemodialysis (HD), among others. Patients who developed anti-HLA antibodies after 1 year on HD had a greater number of total HLA mismatches (4.15 ± 1.3 vs 3.3 ± 1.1; <em>P</em> = .001), HLA-DR (1.35 ± 0.7 vs 0.7 ± 0.6; <em>P</em> = .001) and HLA-A mismatches (1.70 ± 0.5 vs 1.27 ± 0.7; <em>P</em> = .004) than patients who never developed anti-HLA antibodies. When we only analyzed patients who develop ≥98% calculated panel reactive antibody versus those who persist without anti-HLA antibodies, these differences were more evident (5.2 ± 1.1 MM vs 3.3 ± 1.1 MM; <em>P</em> &lt; .001). The timing of discontinuation of immunosuppression did not influence sensitization. Thus, we have observed that HLA mismatches influence HLA sensitization after graft failure at least during the first year on HD. This study supports the importance of prioritizing HLA matching in patients who may require &gt;1 graft over the years and being aware of the potential importance of HLA mismatches on sensitization on HD.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 27-29"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934196","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":"Extension of the Right Renal Vein in Deceased Donor Kidney Transplantation: A Literature Review and Analysis at Our Center","authors":"Sergio Martín Prieto Millán,&nbsp;Oskar Jon Estradé Suárez,&nbsp;Ana Isabel Llorente García,&nbsp;Joel Sanz Casero,&nbsp;Andrea Carlevaris Fernández,&nbsp;Iván Olano Grasa,&nbsp;Jorge García- Olavarri Rodríguez,&nbsp;Beatriz Martínez González,&nbsp;Jesús Padilla Nieva,&nbsp;David Lecumberri Castaños","doi":"10.1016/j.transproceed.2024.11.033","DOIUrl":"10.1016/j.transproceed.2024.11.033","url":null,"abstract":"<div><h3>Introduction</h3><div>The length of the right renal vein is a crucial vascular factor in kidney transplantation. Its shorter length compared to the left renal vein complicates venous anastomosis. The aim of this article is to review the literature on this topic and provide data from our experience.</div></div><div><h3>Materials and Methods</h3><div>A bibliographic review was conducted in PubMed using the keywords “kidney transplant,” “deceased donor,” “right kidney,” and “renal vein extension.” Three studies evaluating the feasibility and clinical outcomes of right renal vein extension in transplants were selected and analyzed. Additionally, a retrospective analysis of kidney transplants performed at Hospital Universitario Cruces in 2023 was carried out, focusing on cases where the technique of extending with a vena cava patch was used. Parameters such as surgical time, vascular complications, graft viability, and postoperative renal function were evaluated.</div></div><div><h3>Results</h3><div>The reviewed studies indicate that the extension of the right renal vein is safe and effective, facilitating surgery and reducing warm ischemia time as well as the incidence of complications such as renal artery kinking. The analysis of transplants at our center in 2023 showed similar results, with a simplified procedure and no increase in the risk of complications.</div></div><div><h3>Conclusion</h3><div>The extension of the right renal vein with a vena cava patch is an effective technique that does not increase morbidity or compromise graft viability, improving long-term clinical outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 10-12"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019357","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 Case of Autoimmune Hemolytic Anemia Following COVID-19 Infection Accompanied by Acute Tubulointerstitial Nephritis in a Kidney Transplant Recipient","authors":"Dong Wook Kim ,&nbsp;In Hwa Jeong ,&nbsp;Young Ki Son ,&nbsp;Seo Hee Rha ,&nbsp;Young Soo Chung","doi":"10.1016/j.transproceed.2024.10.042","DOIUrl":"10.1016/j.transproceed.2024.10.042","url":null,"abstract":"<div><h3>Background</h3><div>Acute tubular injury is one of the main causes of acute tubular injury (acute kidney injury ) in patients with COVID-19 infection. Autoimmune hemolytic anemia (AIHA) is also one of the autoimmune complications of COVID-19. However, AIHA accompanied by acute tubulointerstitial nephritis (ATIN) caused by SARS-CoV-2 is rarely reported. Here, we report a kidney transplant recipient who underwent graftectomy owing to ATIN accompanied by AIHA, possibly exacerbated by COVID-19 infection.</div></div><div><h3>Case Presentation</h3><div>A 32-year-old male renal allograft recipient owing to immunoglobulin A nephropathy visited the emergency department owing to dyspnea and general weakness. Three weeks earlier, the patient had been transplanted with deceased-donor kidney with full HLA-A, -B, -DR match, and had been on tacrolimus, prednisolone, and mycophenolate since then. At the time of the visit, laboratory findings revealed hemoglobin of 2.4 g/dL, reticulocyte of 21.7%, total bilirubin of 1.9 mg/dL, direct bilirubin of 0.3 mg/dL, lactate dehydrogenase of 946 U/L, haptoglobin of &lt;10 mg/dL, and severe red cell agglutination on peripheral blood smear, which suggested AIHA. In addition, his SARS-CoV-2 real-time polymerase chain reaction test was positive. During steroid treatment for AIHA, a sudden decrease in urine volume, estimated glomerular filtration rate (from 64.9 to 35.1 mL/min/1.73 m²) and increase of creatinine (from 1.42 to 2.36 mg/dL) indicated renal function deterioration, so steroid was increased to 500 mg. On the third day of renal function deterioration, dialysis was started owing to anuria and fluid retention. On renal biopsy, C4d was absent; however, ATIN with eosinophilic infiltration was observed. On renal ultrasound examination, a severely enlarged kidney with edema was observed. At the same time, the patient had a high fever with increased C-reactive protein and procalcitonin. Graftectomy was performed to prevent secondary infection. The postgraftectomy renal biopsy showed renal parenchymal and hilar inflammatory change, endotheliitis, and lymphocytic infiltration of peripheral nerve fibers. After graftectomy, dialysis was maintained and AIHA had ameliorated.</div></div><div><h3>Conclusion</h3><div>The patient had to have his allografted kidney removed owing to ATIN possibly caused by COVID-19 infection. Acute kidney injury caused by SARS-CoV-2 can be either by direct viral infection or as consequence of immunological response. The exact immunological mechanism of AIHA secondary to COVID-19 infection remains to be elucidated.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 109-115"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788317","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":"Successful Kidney Transplant From a Donor With Marfan Syndrome: A Case Report","authors":"Omar Sallout ,&nbsp;Francisco Rodriguez Silva ,&nbsp;Puneet Sindhwani ,&nbsp;Michael Rees ,&nbsp;John Rabets ,&nbsp;Obi Ekwenna ,&nbsp;Deepak Malhotra ,&nbsp;Dinkar Kaw ,&nbsp;Shobha Ratnam ,&nbsp;Kunal Yadav","doi":"10.1016/j.transproceed.2024.11.017","DOIUrl":"10.1016/j.transproceed.2024.11.017","url":null,"abstract":"<div><div>Marfan syndrome, a rare autosomal dominant connective tissue disorder caused by mutations in fibrillin-1, is primarily associated with cardiovascular complications such as aortic aneurysms and dissection. Despite the organ shortage crisis, kidneys from donors with Marfan syndrome are often rejected due to concerns about potential vascular complications. This case report presents the successful transplantation of a kidney from a 47-year-old male donor with Marfan syndrome into a 66-year-old female recipient with end-stage renal disease secondary to diabetic nephropathy. The donor had no prior history of aortic aneurysms, and peri-mortem imaging confirmed the absence of vascular complications. The transplantation was performed without complications. The recipient demonstrated excellent graft function postoperatively and at 17 months posttransplant with no evidence of vascular abnormalities. This case supports the consideration of kidneys from donors with Marfan syndrome to help reduce the organ shortage.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 97-99"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793092","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":"Maintenance Immunosuppression With Tacrolimus and Everolimus in Heart Transplantation Compared With the Usual Tacrolimus and Micophenolate Protocol: Results From a Retrospective Registry","authors":"María Vigil-Escalera ,&nbsp;Pablo Catalá ,&nbsp;Vanesa Alonso ,&nbsp;Lorena Herrador ,&nbsp;Elena García-Romero ,&nbsp;José Luis Lambert ,&nbsp;José González-Costello ,&nbsp;Beatriz Díaz-Molina","doi":"10.1016/j.transproceed.2024.11.026","DOIUrl":"10.1016/j.transproceed.2024.11.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-life data on the long-term use of a maintenance immunosuppressive protocol in heart transplant patients using delayed Everolimus + Tacrolimus are scarce.</div></div><div><h3>Methods</h3><div>This is a retrospective study that included all heart transplant patients from 2011 to 2021 in two Spanish hospitals. In Hospital A, the preferred immunosuppressive strategy included Everolimus initiation at 2 months post-transplant combined with Tacrolimus and was compared with the results of Hospital B, where a standard Tacrolimus and Mycophenolate mofetil protocol was used. Incidence of cytomegalovirus infection, cardiac allograft vasculopathy, acute rejection, renal outcomes, infections, and survival were compared.</div></div><div><h3>Results</h3><div>We studied 101 patients from Hospital A and 136 from Hospital B. Median follow-up was 4 years. We found no differences in the incidence of cytomegalovirus infection (<em>P</em> = .099), but the only two symptomatic cases occurred in Hospital B. No significant differences were found in the incidence of cardiac allograft vasculopathy (<em>P</em> = .322), although there was a trend toward earlier presentation in Hospital B. There was a tendency toward more rejection in patients from Hospital B (<em>P</em> = .051), but patients on Everolimus (Hospital A) had more bacterial infections (<em>P</em> = .013) and higher need for dyalisis or renal transplant (<em>P</em> = .004). 27% of patients on Everolimus required definite discontinuation due to side effects. There was no difference in survival after a median follow-up of 48 months.</div></div><div><h3>Conclusions</h3><div>Maintenance immunosuppression with delayed initiation of Everolimus in combination with Tacrolimus is considered a valid strategy in heart transplant patients, although discontinuation of Everolimus due to side effects is significant.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 59-66"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928965","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":"Organ Procurement From a Brain-Dead Pregnant Woman in Third Trimester With Nonviable Fetus in Utero: A Case Report","authors":"Michael Ghio ,&nbsp;Aaron Cotton-Betteridge ,&nbsp;Brian Chen ,&nbsp;Humberto E. Bohorquez ,&nbsp;Anil Paramesh","doi":"10.1016/j.transproceed.2024.12.027","DOIUrl":"10.1016/j.transproceed.2024.12.027","url":null,"abstract":"<div><h3>Background</h3><div>Organ procurement from brain-dead pregnant women is rare and typically occurs postfetal delivery. In this case report, we describe organ procurement from a brain-dead woman in her third trimester of pregnancy with a nonviable fetus remaining in utero.</div></div><div><h3>Case Summary</h3><div>We report a 33-year-old woman at 38 weeks gestation who suffered anoxic brain injury following cardiac arrest due to suspected opioid overdose. After confirming brain death and fetal demise, organ procurement was performed with the fetus in situ. Despite significant anatomical challenges, successful procurement of the liver and kidneys was achieved through innovative surgical strategies.</div></div><div><h3>Conclusion</h3><div>This case highlights the feasibility of organ procurement in late-stage pregnancy with fetus in situ, emphasizing multidisciplinary planning and surgical adaptability.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 94-96"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967685","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":"2024 SET ACKNOWLEDGEMENT with LOGOS","authors":"","doi":"10.1016/S0041-1345(25)00035-1","DOIUrl":"10.1016/S0041-1345(25)00035-1","url":null,"abstract":"","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Page 2"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377533","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":"First Case Report of no Fibrous Capsule Kidney Transplantation","authors":"Lin Fan ,&nbsp;Zhiping Xia ,&nbsp;Hui Xie ,&nbsp;Weiyu Wang ,&nbsp;Zhen Fu ,&nbsp;Guizhu Peng ,&nbsp;Qifa Ye","doi":"10.1016/j.transproceed.2024.10.046","DOIUrl":"10.1016/j.transproceed.2024.10.046","url":null,"abstract":"<div><div>Kidney transplantation (KT) is the optimal treatment for end-stage renal disease. This paper discusses a case where a donated kidney lacking a fibrous capsule was carefully utilized for transplantation. The organ underwent rigorous evaluation and received approval from the ethics committee, with full informed consent obtained from the recipient and their family. Although surface bleeding of the kidney occurred during the operation and was challenging to control, the recipient was successfully discharged 22 days post-transplantation. In conclusion, kidneys lacking a fibrous capsule can be safely used for transplantation after careful evaluation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 105-108"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793090","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":"Danger Biomarkers in Perfusates From Fatty Liver Grafts Subjected to Cold Storage Preservation in Different Preservation Solutions","authors":"Arnau Panisello Rosello ,&nbsp;Gabriela Chullo ,&nbsp;Miguel Pera ,&nbsp;Ramon Bataller ,&nbsp;Yiliam Fundora-Suárez ,&nbsp;Rene Adam ,&nbsp;Teresa Carbonell ,&nbsp;Joan Rosello Catafau","doi":"10.1016/j.transproceed.2024.11.029","DOIUrl":"10.1016/j.transproceed.2024.11.029","url":null,"abstract":"<div><div>Static cold storage remains the traditional standard for liver graft preservation prior to transplantation in both clinical and experimental settings. The use of polyethylene glycol 35 solutions, such as Institut Georges Lopez-2 (IGL2) preservation solution, for protecting against mitochondrial damage during cold static preservation necessitates combination with hypothermic oxygenated perfusion to enhance liver graft performance. This study presents a preliminary comparative evaluation of “danger signals” indicating hepatocellular injury (transaminases, lactate content), mitochondrial damage (glutamate dehydrogenase release), and cytokine release in liver perfusates from suboptimal grafts (fatty livers) subjected to 24-hour cold storage. We refined an original IGL2 solution, referred to as IGL2-M solution, which was compared to Histidine-Tryptophan-Ketoglutarate preservation solution used as a control. The IGL2-M solution demonstrated superior efficacy in preventing hepatocellular and mitochondrial damage in vulnerable steatotic grafts against ischemia-reperfusion injury. The IGL2-M solution better preserved the quality of fatty liver grafts compared to the Histidine-Tryptophan-Ketoglutarate solution, as evidenced by fewer danger signals after 24 hours of cold static preservation. Further investigations are warranted to explore these findings in greater depth.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 1","pages":"Pages 37-42"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934210","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}