Transplantation proceedings最新文献

{"title":"Promising Long-Term Outcomes of Lung Transplantation With Hepatitis C Positive Donors: Insights From the UNOS Registry","authors":"Elizabeth J. Bashian ,&nbsp;Eleanor E. Bashian ,&nbsp;Ye In Christopher Kwon ,&nbsp;Matthew Ambrosio ,&nbsp;Zachary Fitch ,&nbsp;Lauren J. Taylor ,&nbsp;Vipul Patel ,&nbsp;Walker Julliard ,&nbsp;Vigneshwar Kasirajan ,&nbsp;Zubair A. Hashmi","doi":"10.1016/j.transproceed.2025.02.044","DOIUrl":"10.1016/j.transproceed.2025.02.044","url":null,"abstract":"<div><h3>Background</h3><div>The development of effective direct-acting antiviral treatment (DAAT) for hepatitis C virus (HCV) has opened the possibility of using HCV+ donors. We aimed to assess the long-term feasibility of lung transplantation using organs from HCV+ donors.</div></div><div><h3>Methods</h3><div>We used the UNOS database to evaluate adult lung transplant recipients between 2000 and 2023. HCV+ organs were further divided into those positive for both antibody and nucleic acid testing (NAT) or antibody testing alone. Baseline recipient and donor characteristics were compared. The Kaplan–Meier method was used to assess 30-day, 1-year, and 5-year survival. We performed risk analyses using multivariate Cox regression analyses.</div></div><div><h3>Results</h3><div>41,797 lung transplants were performed, among which 945 used HCV+ donors. Recipients of HCV+ lungs had higher FEV1 (<em>P</em> &lt; .001), older (<em>P</em> &lt; .001), and had higher BMI (<em>P</em> &lt; .001). While 5-year survival did not differ between recipients of HCV+ and HCV- donor lungs (<em>P</em> = .093), graft survival was superior among recipients of HCV+ lungs (<em>P</em> = .038). Acute rejection rates were also lower for recipients of HCV+ lungs (<em>P</em> = .018). However, recipients of HCV+ lungs required significantly higher time on the ventilator post-transplant (<em>P</em> = .033). Donor HCV+ status, regardless of whether they were NAT- (HR 1.03, <em>P</em> = .766) or NAT+ (HR 0.89, <em>P</em> = .24), was not associated with adverse outcomes.</div></div><div><h3>Conclusions</h3><div>Lung transplantation with HCV+ donor lungs demonstrates promising outcomes up to 5 years post-transplant. With careful preoperative screening, DAAT treatments, and postoperative management, recipients of HCV+ lungs may expect minimal additional complications.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 612-618"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631163","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":"Development and Validation of a Nomogram for Predicting Subtherapeutic Tacrolimus Blood Levels in Renal Transplant Recipients: A Multivariate Logistic Regression Analysis","authors":"Bowen Duan,&nbsp;Jinxian Gao,&nbsp;Bin Ge,&nbsp;Shujin Wu,&nbsp;Jing Yu","doi":"10.1016/j.transproceed.2025.02.025","DOIUrl":"10.1016/j.transproceed.2025.02.025","url":null,"abstract":"<div><div>This study constructs a nomogram risk prediction model to identify factors affecting subtherapeutic tacrolimus (FK506) blood concentrations in postrenal transplant patients, enhancing clinical management. Data from renal transplant patients treated with tacrolimus from January to December 2023 were analyzed using multivariate logistic regression to identify risk factors. A nomogram model was constructed and validated through cross-validation and bootstrapping. Predictive performance was assessed via receiver operating characteristic curve and Hosmer– Lemeshow test. Among 340 patients, 224 achieved target FK506 concentrations (5-15 ng/mL). Independent risk factors for subtherapeutic levels included white blood cell count ≤4 × 10^9/L, total bilirubin &gt;20 μmol/L, creatinine &gt;73 μmol/L, and blood urea nitrogen ≤7.1 mmol/L. The model's receiver operating characteristic area under the curve was 0.84, with a Hosmer– Lemeshow test <em>P</em>-value of .386, indicating high predictive accuracy and good calibration. The nomogram effectively predicts subtherapeutic FK506 levels, providing a valuable tool for personalized patient management. Future research should refine and externally validate the model.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 529-537"},"PeriodicalIF":0.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627296","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 Eradication of Hepatitis C Virus after Liver Transplantation Improved Liver Function and Maintained the Health-related Quality of Life","authors":"Atsushi Takai ,&nbsp;Yoshihide Ueda ,&nbsp;Etsuro Hatano ,&nbsp;Hiroshi Seno","doi":"10.1016/j.transproceed.2025.02.040","DOIUrl":"10.1016/j.transproceed.2025.02.040","url":null,"abstract":"<div><h3>Background</h3><div>The outcomes of hepatitis C virus eradication and health-related quality of life in the patients treated with direct-acting antivirals (DAAs) after liver transplantation were examined.</div></div><div><h3>Methods</h3><div>Thirty-five patients with HCV infection treated with sofosbuvir/ledipasvir after liver transplantation were enrolled in the study. The achievement rate of sustained viral response (SVR), liver function and health-related quality of life based on Short-Form-36 version 2 were evaluated.</div></div><div><h3>Results</h3><div>All 35 patients achieved SVR and liver function was improved to a level comparable to that of non-transplanted cases by the DAA treatment. As to health-related quality of life, the scores of general health, vitality and mental health were comparable to Japanese national standard scores among 8 subscales of Short-Form-36 version 2.</div></div><div><h3>Conclusion</h3><div>HCV eradication after liver transplantation is useful for not only improving liver function but maintaining health-related quality of life.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 593-597"},"PeriodicalIF":0.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627299","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":"Pretransplant Midodrine Use—A Risk Factor for Graft Loss at 1 Year in Kidney Transplant Recipients?","authors":"Jayanthan Subramanian ,&nbsp;April Logan ,&nbsp;Farjad Siddiqui ,&nbsp;Sai Rithin Punjala ,&nbsp;Lauren Von Stein ,&nbsp;Priyamvada Singh ,&nbsp;Pranit Chotai ,&nbsp;Ashley Limkemann ,&nbsp;Musab Al-Ebrahim ,&nbsp;Austin D. Schenk ,&nbsp;William K. Washburn ,&nbsp;Amer Rajab ,&nbsp;Navdeep Singh","doi":"10.1016/j.transproceed.2025.02.024","DOIUrl":"10.1016/j.transproceed.2025.02.024","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypotension is a frequent complication of patients who are on chronic maintenance hemodialysis. Midodrine is an alpha-1 adrenergic agonist used to treat patients on hemodialysis who have chronic hypotensiom. The aim of our study was to evaluate if patients who required midodrine for hypotension had inferior outcomes compared to those who did not require midodrine.</div></div><div><h3>Methods</h3><div>All kidney transplants performed at The Ohio State University Wexner Medical Center between January 2015 and January 2021 were analyzed. Patients that had a dual solid organ transplant that included a kidney transplant were excluded from our study. Patients were divided into two groups based on midodrine use. The main outcomes of interest were graft and patient survival at 1-year.</div></div><div><h3>Results</h3><div>A total of 1538 kidneys were transplanted during the study period. A total of 1070 were recipients of deceased donor kidney transplants, 468 were recipients of living donor kidney transplants. In the deceased donor group the estimated glomerular filtration rate was higher in the non-midodrine patients compared to the midodrine group and this difference was statistically significant. Graft survival at 1 year was higher in the non-midodrine group (96% vs 79% <em>P</em>, .0001 OR 6.6). Patient survival at 1-year was also higher in the non-midodrine group (97% vs 86%, <em>P</em> = .0002, OR 6.3). Time to graft failure and patient death was faster in the midodrine group (<em>P</em> &lt; .0001 for both).</div></div><div><h3>Conclusion</h3><div>The need for Midodrine to maintain blood pressure before kidney transplantation can serve as a marker for inferior graft and patient outcomes at 1-year. Additional studies with more data are needed to further support this theory and adjust for confounding effects.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 522-528"},"PeriodicalIF":0.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631162","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 Oral Isavuconazole Monotherapy for Invasive Pulmonary Mucormycosis in Kidney Transplant Recipients: Case Reports and Literature Review","authors":"Zeng-Jie Wang ,&nbsp;Jue Zhang ,&nbsp;Yun-Ying Shi","doi":"10.1016/j.transproceed.2025.02.047","DOIUrl":"10.1016/j.transproceed.2025.02.047","url":null,"abstract":"<div><div>This study represents 2 cases of kidney transplant recipients (KTRs) with invasive pulmonary Rhizopus infection, successfully treated with oral isavuconazole monotherapy without lobectomy. The rapid detection via mNGS of bronchoalveolar lavage fluid enabled early diagnosis and timely intervention, resulting in complete recovery and stable graft function. The literature review revealed a 16.7% mortality rate among 13 cases, with a higher mortality rate of 66.7% among patients receiving antifungal treatment without surgical intervention. Our findings underscore the efficacy of isavuconazole as a first-line monotherapy, characterized by lower nephrotoxicity and fewer interactions with immunosuppressants, and emphasize the crucial role of metagenome next-generation sequencing (mNGS) in early diagnosis of invasive mucormycosis in high-risk population.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 544-551"},"PeriodicalIF":0.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627297","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":"Saliva Samples as a Potential Tool for the Diagnosis and Monitoring of Cytomegalovirus Reactivation in Children Undergoing Transplantation","authors":"Alejandra Pando-Caciano ,&nbsp;Pauline E. Mamaní-Cajachagua ,&nbsp;Alejandra A. Ingunza-Tapia ,&nbsp;Gerardo J. Sánchez-García ,&nbsp;Xiomara L. Caffo-Valentín ,&nbsp;Emiliana Rizo-Patrón ,&nbsp;Sergio A. Murillo-Vizcarra ,&nbsp;Holger Maita-Malpartida","doi":"10.1016/j.transproceed.2025.02.023","DOIUrl":"10.1016/j.transproceed.2025.02.023","url":null,"abstract":"<div><h3>Background</h3><div>Regular monitoring of cytomegalovirus (CMV) reactivation in children who undergo transplantation is performed by molecular testing on blood samples. This highlights the need to explore noninvasive alternatives, such as saliva. The present study evaluated the usefulness of saliva samples for detecting and monitoring CMV reactivation in children undergoing transplantation at a referral center in Lima, Peru.</div></div><div><h3>Methods</h3><div>A total of 85 paired samples of liquid saliva and whole blood and 91 paired samples of swab-collected saliva and whole blood from 16 children who underwent transplantation were analyzed by quantitative polymerase chain reaction (qPCR).</div></div><div><h3>Results</h3><div>The positivity rates for whole blood, liquid, and swab-collected saliva were 12.59%, 15.29%, and 12.09%, respectively. No significant differences were observed in viral load among the samples, and there was no remarkable correlation or agreement between saliva and whole blood. However, 19 samples from 4 patients were positive in their saliva but negative in their respective whole blood pairs. One patient who was positive in both the saliva samples and negative in blood developed gastrointestinal CMV disease.</div></div><div><h3>Conclusions</h3><div>Saliva may serve as a promising diagnostic tool for detecting and monitoring CMV reactivation in pediatric transplant recipients. Further studies should explore the significance of the saliva viral load to guide pre-emptive therapy and predict disease development.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 663-669"},"PeriodicalIF":0.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607644","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":"Uncommon Etiology for a Rare Post-Transplant Esophago-Lymphatic Fistula","authors":"Ahmed A. Amin,&nbsp;Ehab Abufarhaneh,&nbsp;Tariq Ali,&nbsp;Ali M. Shendi,&nbsp;Dieter Broering","doi":"10.1016/j.transproceed.2025.02.014","DOIUrl":"10.1016/j.transproceed.2025.02.014","url":null,"abstract":"<div><div>Esophageal tuberculosis (TB) is a rare finding, and esophageal TB fistulas are even rarer. In general, esophageal fistulas are an uncommon finding in everyday practice, but it is frequently seen in advanced endoscopy centers. It can be either congenital or acquired. The acquired type is most commonly a complication of advanced mediastinal malignancy. Other etiologies include trauma, radiation, infections, surgery, aortic aneurysms, or esophageal stents. The most common type of esophageal fistulas is trachea-esophageal. Other types include esophago-aortic, esophago-lymphatic, and esophago-respiratory (other than trachea). The diagnosis is usually made by imaging (barium studies, computed tomography [CT], and magnetic resonance imaging) and endoscopy. Endoscopy is vital in confirming the site of the fistula, assessing the extent, obtaining tissue for histopathologic diagnosis, and, in selected cases, providing therapeutic options. TB esophageal fistulas are diagnosed by endoscopy and biopsy, and the treatment is usually pharmacological.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 3","pages":"Pages 442-444"},"PeriodicalIF":0.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568333","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":"Recurrence of Myopathy After Liver Transplantation for Patients With End-Stage GSD Type IIIa","authors":"He Wang ,&nbsp;Wei Qu ,&nbsp;Ying Liu ,&nbsp;Liang Zhang ,&nbsp;En-Hui He ,&nbsp;Zhi-Jun Zhu ,&nbsp;Li-Ying Sun","doi":"10.1016/j.transproceed.2025.02.005","DOIUrl":"10.1016/j.transproceed.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Glycogen storage disease (GSD) is an inherited metabolic disorder affecting glycogen metabolism. The overall incidence of GSD is estimated to be 1 in every 20,000 to 43,000 newborns. GSD is classified into 12 types based on the enzyme deficiency and the tissues affected. Disorders in glycogen degradation may primarily impact the liver, muscles, or both.</div></div><div><h3>Results</h3><div>In this case report, we discuss a patient with end-stage liver disease due to GSD IIIa who was treated with liver transplantation. Following liver transplantation, the patient's cirrhosis was cured. Six years post-surgery, the patient developed elevated creatine kinase levels without any obvious cause, along with occasional lower limb weakness after exertion. Muscle biopsy revealed pathological changes consistent with vacuolar myopathy.</div></div><div><h3>Conclusions</h3><div>Liver transplantation does not fully cure glycogen storage disease type IIIa myopathy, necessitating ongoing postoperative follow-up with regular creatine kinase monitoring and other laboratory assessments.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 3","pages":"Pages 475-480"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560531","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":"Rescue Transplant Renal Artery Stenting With Off Label Advanta V12 Covered Stent for Extrarenal Pseudoaneurysm: A Case of Renal Graft Dysfunction Due to Pseudomonas Septicemia","authors":"Rasmiranjan Padhi ,&nbsp;Virag Sanjay Shethna ,&nbsp;Jagadeesan Dhanasekaran ,&nbsp;S Goutham ,&nbsp;Madhava Rao ,&nbsp;KS Vengetesh","doi":"10.1016/j.transproceed.2025.02.016","DOIUrl":"10.1016/j.transproceed.2025.02.016","url":null,"abstract":"<div><div>Among the vascular complications in post-renal transplant recipients, extrarenal pseudoaneurysms are extremely rare &lt; 1%, but can cause allograft loss and mortality. The most common cause of mycotic pseudoaneurysm is fungal followed by bacterial. Among the bacteria, pseudomonas aeruginosa is the most com`mon organism. The treatment of extrarenal pseudoaneurysms are individualized and transplant nephrectomy is the gold standard for definitive treatment but with the expense of allograft loss. In hemodynamic instability, endovascular prosthesis has become the first choice for salvaging the renal allograft. We present a case of transplant renal artery (TRA) mycotic pseudoaneurysm in the setting of pseudomonas septicemia presented with allograft dysfunction 42 days post-renal transplant, successfully salvaged with endovascular technique using the Advanta V12 covered stent.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 3","pages":"Pages 464-467"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538221","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":"Case Report: A Unique Case of Hemophagocytic Lymphohistiocytosis in Heart Transplant","authors":"Boaz Elad ,&nbsp;Wojciech Rzechorzek ,&nbsp;Kelly Axsom ,&nbsp;Justin Fried ,&nbsp;Farhana Latif ,&nbsp;Adil Yunis ,&nbsp;Carolyn Hennecken ,&nbsp;Rubin Salazar ,&nbsp;Kyung T. Oh ,&nbsp;David L. Diuguid ,&nbsp;Andrew H. Lipsky ,&nbsp;Ron S. Gejman ,&nbsp;Gabriel Sayer ,&nbsp;Nir Uriel ,&nbsp;Dor Lotan","doi":"10.1016/j.transproceed.2025.02.021","DOIUrl":"10.1016/j.transproceed.2025.02.021","url":null,"abstract":"<div><div>Hemophagocytic lymphohistiocytosis (HLH) is a rare and deadly disease that presents significant diagnostic challenges. The complexity of diagnosis and treatment is further increased among transplant recipients, yet reports on solid organ transplants, and specifically heart transplant recipients, remain scarce. Herein, we elucidate the diagnostic journey, clinical evolution, and therapeutic approach undertaken for a heart transplant recipient afflicted with hemophagocytic lymphohistiocytosis, followed by a review of the literature.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 3","pages":"Pages 481-484"},"PeriodicalIF":0.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532284","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}