Transplantation proceedings最新文献

{"title":"Performance of Glomerular Filtration Rate Estimating Equations in Kidney Transplant Recipients of Various Races: A Retrospective Cohort Study","authors":"Pooja Budhiraja ,&nbsp;Richard Butterfield ,&nbsp;Musab Hommos ,&nbsp;Raymond L. Heilman ,&nbsp;Wisit Cheungpasitporn ,&nbsp;Salah Alajous ,&nbsp;Hay Me Me ,&nbsp;Harini A. Chakkera ,&nbsp;Rebecca L. Corey ,&nbsp;Bassam G. Abu Jawdeh ,&nbsp;Hassan A. Khamash","doi":"10.1016/j.transproceed.2024.12.026","DOIUrl":"10.1016/j.transproceed.2024.12.026","url":null,"abstract":"<div><h3>Background</h3><div>We assessed the accuracy of different GFR estimating equations in kidney transplant recipients across diverse racial backgrounds, addressing the previously identified validation gap in multiethnic populations predominantly studied in White cohorts.</div></div><div><h3>Methods</h3><div>In this single-center study, eGFR was compared to the measured GFR (mGFR) one year following kidney transplantation.</div></div><div><h3>Results</h3><div>The 1-year eGFR and mGFR data from 1145 participants (54% Whites, 23% Hispanics, 9% Blacks, 7% Native Americans, and 6% Asians) revealed varied correlations across racial groups. For Whites, the combined 2021 CKD-EPI creatinine-cystatin C formulas demonstrated a stronger correlation <em>(r = 0.72, [0.65, 0.78])</em> compared to the 2021 CKD-EPI creatinine and EKFC cystatin C equation. This equation also achieved the highest accuracy <em>(P30: 77.1%).</em> In Black recipients, both the 2009 CKD-EPI (<em>r</em> = 0.56 <em>[0.42, 0.68]</em>) and the 2021 CKD-EPI creatinine (<em>r</em> = 0.56 <em><u>[</u>0.41, 0.68]</em>) exhibited modest correlations. The 2021 CKD-EPI creatinine-cystatin C equation showed improved correlation <u>(</u><em>r = 0.63 (0.43, 0.77)</em>] and an accuracy of <em>62.7% (P30)</em><u>,</u> which was slightly lower than the EKFC cystatin C equation <em>(P30: 64.7%)</em>. However, neither the EKFC (rescaled) cystatin C nor the race-free kidney-specific equations outperformed existing eGFR equations for Black participants In Hispanic patients, combined creatinine-cystatin C equations outperformed creatinine-only equations. Among Native Americans, the combined creatinine-cystatin, EKFC (rescaled) cystatin C, and race-free kidney-specific equations achieved an accuracy rate exceeding 85%. In Asians, the CKD-EPI creatinine-cystatin C equation showed the highest correlation, while the race-free kidney-specific equation had the most accuracy.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that creatinine-cystatin C combined equations outperformed single-marker formulas across all racial groups, with negligible differences between the 2009 CKD EPI and the race-neutral 2021 CKD-EPI version.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 230-240"},"PeriodicalIF":0.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019377","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":"Evaluation of Liver Volume Estimation Methods in Living Donor Liver Transplant: CT Volumetry vs MeVis, With Comparison of Open and Laparoscopic Surgery","authors":"Ek Khoon Tan ,&nbsp;Victoria Zheng ,&nbsp;Seok Yin Tuieng ,&nbsp;Albert Su Chong Low ,&nbsp;Steve Tian Sung Chai ,&nbsp;Yi Xuan Phang ,&nbsp;Ye Xin Koh ,&nbsp;Alexander Yaw Fui Chung ,&nbsp;Peng Chung Cheow ,&nbsp;Prema Raj Jeyaraj ,&nbsp;Brian Kim Poh Goh","doi":"10.1016/j.transproceed.2024.12.017","DOIUrl":"10.1016/j.transproceed.2024.12.017","url":null,"abstract":"<div><h3>Background</h3><div>Accurately assessing graft volume is crucial for donor and recipient safety in living donor liver transplantation. This can be performed using manual computed tomography volumetry (CTvol) or semiautomated methods (MeVis). We aimed to compare CTvol and MeVis in estimating the actual graft weight during LDLT, and analyse any differences in weight between laparoscopic and open donor hepatectomy.</div></div><div><h3>Methods</h3><div>A retrospective study of living donors between 2015 and 2022 with complete imaging data was performed. Graft weights were estimated using (1) CT volumetry and (2) semiautomated MeVis software. The primary outcome was graft weight variance ([Predicted weight–Actual weight]/Predicted weight) × 100. The secondary outcome of interest was whether open or laparoscopic surgery affected graft weight variance.</div></div><div><h3>Results</h3><div>Of the 33 donors, 52.6% were right liver without middle hepatic vein grafts. Nineteen donors (57.6%) underwent open hepatectomy. Both CTvol (r = 0.70; <em>P</em> &lt; .001) and MeVis (r = 0.85; <em>P</em> &lt; .001) showed strong correlation with actual graft weight. Weight variance using CTvol was −2.9% vs −15.3% (<em>P</em> = .04) for open vs laparoscopic, while the corresponding using MeVis was −0.9% vs −8.5% (<em>P</em> = .11). Actual graft-to-recipient weight ratio predicted by MeVis was similar between open and laparoscopic approaches (−0.01 vs 0.07; <em>P</em> = .12).</div></div><div><h3>Conclusions</h3><div>Both CT volumetry and MeVis showed strong correlation between predicted and actual graft weights. Laparoscopic hepatectomy showed greater variability in graft weight estimation using CT volumetry, but MeVis was similar across both open and laparoscopic surgery.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 292-297"},"PeriodicalIF":0.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019355","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 Multiple Kidney Retransplants on Post-Transplant Outcomes in the United States","authors":"Charat Thongprayoon ,&nbsp;Oscar A. Garcia Valencia ,&nbsp;Jing Miao ,&nbsp;Iasmina M. Craici ,&nbsp;Shennen A. Mao ,&nbsp;Michael A. Mao ,&nbsp;Supawit Tangpanithandee ,&nbsp;Justin H. Pham ,&nbsp;Napat Leeaphorn ,&nbsp;Wisit Cheungpasitporn","doi":"10.1016/j.transproceed.2024.12.016","DOIUrl":"10.1016/j.transproceed.2024.12.016","url":null,"abstract":"<div><h3>Background</h3><div>Kidney retransplantation offers a valuable treatment option for patients who experience graft failure after their initial transplant. There is an increasing number of patients undergoing multiple retransplants. However, the impact of multiple kidney retransplants on post-transplant outcomes remains unclear. This study aimed to assess the association between the number of kidney retransplants and post-transplant outcomes in kidney retransplant recipients.</div></div><div><h3>Methods</h3><div>We used the Organ Procurement and Transplantation Network and United Network for Organ Sharing (OPTN/UNOS) database to identify kidney-only retransplant recipients in United States from 2010 through 2019. We categorized kidney retransplant recipients based on their number of kidney retransplant into one and two plus kidney retransplant groups. The association of one vs two plus kidney retransplants with death-censored graft failure and patient death was assessed using Cox proportional hazard analysis, and acute rejection using logistic regression analysis.</div></div><div><h3>Results</h3><div>Of 17,433 kidney retransplant recipients included in this study, 15,821 (91%) and 1612 (9%) had one and two plus kidney retransplants, respectively. Patients with two plus kidney retransplants were younger, predominantly White, had higher panel reactive antibody (PRA), public insurance, and education, but had less history of diabetes mellitus and total HLA mismatch compared with patients with one kidney retransplant. After adjusting for potential confounders, having two plus kidney retransplants was significantly associated with increased risk of death-censored graft failure (hazard ratio [HR] = 1.20, 95% confidence interval [CI] = 1.02-1.42) and allograft rejection (odds ratio [OR] = 1.30, 95% CI = 1.09-1.54), but it was not significantly associated with patient death.</div></div><div><h3>Conclusions</h3><div>Patients undergoing multiple kidney retransplants face a higher risk of graft failure and rejection compared with those with a single retransplant. These findings underscore the need for tailored management and monitoring strategies to improve outcomes for patients receiving multiple kidney retransplants.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 214-222"},"PeriodicalIF":0.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019362","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":"Placental Membrane Transplantation: Can It Be A Solution For Tissue Defect Repair In Giant Omphaloceles","authors":"Olga Devrim Ayvaz ,&nbsp;Ayşenur Celayir ,&nbsp;Oya Demirci","doi":"10.1016/j.transproceed.2024.12.015","DOIUrl":"10.1016/j.transproceed.2024.12.015","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the effect of placental membrane covering of the omphalocele sac on the healing of giant omphaloceles requiring silo repair that could not be treated primarily.</div></div><div><h3>Methods</h3><div><u>This prospective study was performed between October 2021 and October 2023 with the approval of our hospital's ethics committee.</u> All pregnant women diagnosed with prenatal giant omphalocele were informed that their own placenta could be used for omphalocele repair if necessary, and their consent was obtained.</div></div><div><h3>Results</h3><div>Over 24 months, 7 omphaloceles could not be closed primarily, and the placental amniotic membranes were wrapped around the omphalocele sacs and left for secondary healing. All patients underwent cesarean section. The mean gestational age at delivery was 37.6 ± 1.1 weeks (range, 36-39 weeks) according to the last menstruation and 35.3 ± 3.3 weeks (range, 29-39 weeks) according to ultrasound. The mean birth weight was 2814.3 ± 704.9 g (range, 1340-3400 g). Two infants were male (28.5%), and 5 were female (71.5%). The liver and intestines were in the omphalocele sacs. The mean transverse diameter, vertical diameter, and height of omphalocele sac were 15 ± 3.36 cm (range, 11-20 cm), 15.43 ± 3.1 cm (range, 12-19 cm), and 12.33 ± 3.13 cm (range, 8-16 cm), respectively. All the patients had unresectable livers that adhered to the sac. One of the patients had an omphalocele that ruptured during birth, and placental transplantation was performed after rupture repair. After wrapping with the placental membrane, all healed with tight granulation tissue. The mean hospitalization duration was 48.86 ± 26.99 days (range, 21-101 days). The median ventral hernia diameter was 7.07 ± 2.09 cm (range, 5-10 cm). The mean follow-up duration was 10.7 ± 6.8 months (range, 3-23 months). <u>The discharge weight of the infants increased by an average of 789.28</u> ± <u>532.5 g compared with their birth weight, which was statistically significant (</u><em><u>P =</u></em> <u>.028). The average transverse diameter of the omphalocele sac decreased by an average of 7.92</u> ± <u>3.67 cm compared with that at birth, which was statistically significant (</u><em><u>P =</u></em> <u>.018). The vertical diameter measurement of the omphalocele sac decreased by an average of 5.75</u> ± <u>2.18 cm at discharge compared with that at birth, which was statistically significant (</u><em><u>P =</u></em> <u>.046).</u></div></div><div><h3>Conclusions</h3><div>Wrapping the maternal placental membrane around the omphalocele sac is an inexpensive, effective, safe, and successful treatment method for preventing sac rupture during the secondary healing of giant omphaloceles.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 364-370"},"PeriodicalIF":0.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019380","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 Altered Graft Position During Living Donor Liver Retransplantation and its Outcomes","authors":"Hidekazu Yamamoto ,&nbsp;Kaori Isono ,&nbsp;Masaki Honda ,&nbsp;Yasuhiko Sugawara ,&nbsp;Yukihiro Inomata ,&nbsp;Taizo Hibi","doi":"10.1016/j.transproceed.2024.12.029","DOIUrl":"10.1016/j.transproceed.2024.12.029","url":null,"abstract":"<div><h3>Introduction</h3><div>Liver retransplantation (reLT), which is the only treatment for liver graft failure, remains challenging not only because of its technical nature but also because it is performed in high-risk patients.</div></div><div><h3>Methods</h3><div>Nineteen patients who underwent reLT (second LT, <em>n</em> = 18; third LT, <em>n</em> = 1) between 1999 and 2021 were divided into two groups according to the graft laterality between prior transplantation and reLT (ipsilateral group, <em>n</em> = 9; contralateral group, <em>n</em> = 10). The aim of this study was to evaluate the short- and the long-term outcomes of patients who underwent living donor reLT and compared graft survival between ipsilateral and contralateral grafts.</div></div><div><h3>Results</h3><div>For hepatic vein reconstruction, the previous anastomotic orifice of the recipient was used in 8 (88.9%) patients in the ipsilateral group, while a new orifice on inferior vena cava of the recipient was created in 8 (80%) patients in the contralateral group. The conduit for the portal vein and hepatic artery were employed in 2 and 2 patients in the ipsilateral group and in 5 and 0 patients in the contralateral group, respectively. The overall incidence of hepatic artery and portal vein complications was 11.1% and 11.1% in the ipsilateral group, and 30% and 11.1% in the contralateral group, respectively. The 1-, 5-year graft survival rates were 70.8%, 66.7% in the ipsilateral group, and 70%, 70% in the contralateral group, respectively.</div></div><div><h3>Conclusions</h3><div>There was no difference between ipsilateral and contralateral grafts in reLT in terms of surgical complications and graft survival.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 284-291"},"PeriodicalIF":0.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019361","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":"Early-Onset Seizures After Orthotopic Liver Transplantation: A Single-Center Retrospective Study","authors":"Federica Avorio ,&nbsp;Giovanna Russelli ,&nbsp;Rossella Alduino ,&nbsp;Antonio Arcadipane ,&nbsp;Salvatore Gruttadauria ,&nbsp;Vincenzina Lo Re","doi":"10.1016/j.transproceed.2024.12.021","DOIUrl":"10.1016/j.transproceed.2024.12.021","url":null,"abstract":"<div><h3>Background</h3><div>After encephalopathy, epileptic seizures (ES) are the second most common neurologic complication after orthotopic liver transplantation (OLT) and may announce a disabling/fatal neurologic disease.</div></div><div><h3>Methods</h3><div>In this retrospective study, we collected clinical information from patients who underwent OLT at our institution and analyzed outcomes and potential risk factors for developing ES after OLT.</div></div><div><h3>Results</h3><div>Fourteen of our 376 patients (3.72%) who underwent OLT had ES. After excluding 2 patients with already known epilepsy, among the other 12 patients, 2 were diagnosed with nonanoxic cerebral edema, 2 with anoxic damage, 1 with intracranial hemorrhage, 1 with metabolic derangement, and 4 with neurotoxicity; 2 did not receive a diagnosis of certainty. 9 of 12 patients had structural abnormalities on neuroimaging exams. Patients with ES had lower body mass index, higher rate of pretransplant portal thrombosis, and lower pre-transplant plasma concentration of albumin than patients without ES. Multiple post-transplantation systemic complications, postoperative infections, and graft rejection were correlated with a significantly higher risk of ES. Compared with patients without seizures, patients with ES had longer in-hospital and intensive care unit (ICU) length of stay, higher probability of ICU readmission, in-hospital death, and need for rehabilitation. Just 3 of the 12 patients with ES had a good prognosis, while the other 9 had at least mild neurologic sequelae, 5 of whom died because of the underlying neurologic disease.</div></div><div><h3>Conclusions</h3><div>ES after OLT may announce detrimental neurologic disease. When an underlying neurologic disease is excluded, prognosis in terms of seizure recurrence and long-term antiseizure medication need is warranted.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 324-331"},"PeriodicalIF":0.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019315","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":"N-Acetylcysteine and Liver Transplant. Advantages of its Administration in Multi-Organ Donors Especially During World-Economical-Crisis. Long-Term Sub-Group Analysis in a Randomized Study","authors":"Michele Finotti ,&nbsp;Alberto Zanetto ,&nbsp;Alessandro Vitale ,&nbsp;Manuel Rodriguez-Davalos ,&nbsp;Patrizia Burra ,&nbsp;Umberto Cillo ,&nbsp;Francesco D'Amico","doi":"10.1016/j.transproceed.2024.11.038","DOIUrl":"10.1016/j.transproceed.2024.11.038","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation (LT) is the main indication for the treatment of end-stage liver disease but have to face organ shortages. Using marginal donors is an option to increase the donor pool. Previous studies showed that the graft procured using N-acetylcysteine (NAC) provides a longer survival compared to perfusion with standard solutions, especially in marginal liver donors. We now evaluate the effect of NAC perfusion compared to control (no NAC protocol) at a 5-year follow-up, with a special focus on the overall survival (OS) and graft survival.</div></div><div><h3>Methods</h3><div>Single-center, retrospective review of the OS and graft survival among NAC and control group, with a sub-stratification based on the LT indication.</div></div><div><h3>Results</h3><div>140 donors were enrolled: 69 in the NAC protocol and 71 in the control group. The 5-year OS was 84% in the NAC protocol compared to 63% in the control (<em>P = .</em>0045). In LT for HCC, the OS at 5 years was 80% and 55% in the study group and control group, respectively (<em>P = .</em>04), with no statistical difference in the RFS (<em>P = .</em>46). Furthermore, in cost analysis, the resources needed for the NAC protocol is negligible compared to the control group. Beneficial tendency of NAC protocol application has been seen in the other organs (lungs, hearts, pancreas, kidney and intestine)</div></div><div><h3>Conclusion</h3><div>The application of NAC infusion in liver donors improves the overall survival of the recipient, especially in the HCC and HCV LT indications.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 264-271"},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating AI Chatbot Responses to Postkidney Transplant Inquiries","authors":"Yihua Zhan ,&nbsp;Xutao Chen ,&nbsp;Feihong Ye ,&nbsp;Zhikai Wu ,&nbsp;Muhammad Usman ,&nbsp;Zhihan Yuan ,&nbsp;Han Wu ,&nbsp;Jian Huang ,&nbsp;Hao Yu","doi":"10.1016/j.transproceed.2024.12.028","DOIUrl":"10.1016/j.transproceed.2024.12.028","url":null,"abstract":"<div><div>This study evaluated the capability of three AI chatbots—ChatGPT 4.0, Claude 3.0, and Gemini Pro, as well as Google—in responding to common postkidney transplantation inquiries. We compiled a list of frequently asked postkidney transplant questions using Google and Bing. Response quality was rated on a 5-point Likert scale, while understandability and actionability were measured with the Patient Education Materials Assessment Tool (PEMAT). Readability was assessed using the Flesch Reading Ease and Flesch-Kincaid Grade Level metrics, with statistical analysis conducted via non-parametric tests, specifically the Kruskal-Wallis test, using SPSS. We gathered 127 questions, which were addressed by the chatbots and Google. The responses were of high quality (median Likert score: 4 [4,5]), good understandability (median PEMAT understandability score: 72.7% [62.5,77.8]), but poor actionability (median PEMAT operability score: 20% [0%-20%]). The readability was challenging (median Flesch Reading Ease score: 22.1 [8.7,34.8]), with a Flesch-Kincaid Grade Level akin to undergraduate-level text (median score: 14.7 [12.3,16.7]). Among the chatbots, Claude 3.0 provided the most reliable responses, though they required a higher reading level. ChatGPT 4.0 offered the most comprehensible responses. Moreover, Google did not outperform the chatbots in any of the scoring metrics.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 394-405"},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Inpatient Prehabilitation Prior to Heart or Lung Transplantation in a Latin American Transplant Reference Center","authors":"Franco Appiani ,&nbsp;Belen Abara ,&nbsp;Ivan Ramirez ,&nbsp;Christian Andrade ,&nbsp;Joel Melo ,&nbsp;Fernando Barra ,&nbsp;Fernando Javier Verdugo ,&nbsp;Victor Rossel ,&nbsp;Jongsung Lim ,&nbsp;Erika Donoso ,&nbsp;Urania Arrué ,&nbsp;Maria Paz Riquelme","doi":"10.1016/j.transproceed.2024.11.034","DOIUrl":"10.1016/j.transproceed.2024.11.034","url":null,"abstract":"<div><h3>Introduction</h3><div>Whether the implementation of a multimodal prehabilitation program is effective and safe for high-risk heart or lung transplantation candidates, whose condition prevents hospital discharge, is unclear.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study at a cardiothoracic transplant center in Chile. Two cohorts of hospitalized patients listed for heart or lung transplant were studied: the first underwent traditional (historical) and nonstructured prehabilitation, and the second underwent protocol-driven multimodal prehabilitation (MP). Adverse events and preoperative functional changes in the MP group were documented, as well as comparative postoperative outcomes between both cohorts.</div></div><div><h3>Results</h3><div>Between 2018 and 2023, 24 transplant recipients were analyzed. During the MP phase, significant improvement was observed in Medical Research Council scale (52.0 ± 7 to 58.7 ± 3; <em>P</em> = .042), sit-to-stand test (7.1 ± 7 to 15.9 ± 6; <em>P</em> = .018), and euthymic state (from 4 to 10 patients; <em>P</em> .036), without reported adverse events. Postoperatively, MP group demonstrated faster standing (1.9 ± 0.7 vs 1.3 ± 0.5 days; <em>P</em> = .05) and sitting times (2.0 ± 0.7 vs 1.2 ± 0.5 days; <em>P</em> = .007), with more early extubations (3 vs 11; <em>P</em> = .003) in comparison to the historical prehabilitation cohort.</div></div><div><h3>Conclusion</h3><div>In this small retrospective study, MP in hospitalized patients awaiting heart or lung transplantation appears to be safe and associated with improvements in pre- and postoperative outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 348-354"},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndecan-1 in the Serum of Deceased Kidney Donors as a Potential Biomarker of Kidney Function","authors":"Pavel Navratil ,&nbsp;Sukhdeep Sahi ,&nbsp;Petra Hruba ,&nbsp;Alena Ticha ,&nbsp;Katarina Timkova ,&nbsp;Ondrej Viklicky ,&nbsp;Vladimir Cerny ,&nbsp;David Astapenko","doi":"10.1016/j.transproceed.2024.12.031","DOIUrl":"10.1016/j.transproceed.2024.12.031","url":null,"abstract":"<div><h3>Background</h3><div>The process of kidney transplantation remains the optimal treatment for end-stage renal disease, offering improved quality of life and increased survival rates compared to long-term dialysis. However, despite advances in surgical techniques, immunosuppression regimens, and post-operative care, there are still significant challenges in predicting the organ's status and long-term outcomes of transplantation. Among the many factors that influence graft survival, the quality of the donated organ plays a fundamental role. There is an ongoing need for accurate and reliable biomarkers. Syndecan-1 is found in the endothelial glycocalyx and shed at a higher rate into the blood during systemic pathological conditions. The aim of this study is to evaluate the potential of serum syndecan-1 levels as a biomarker for assessing donor kidney quality and to investigate its correlation with donor characteristics and short-term outcomes in kidney recipients.</div></div><div><h3>Material and Methods</h3><div>We investigated serum syndecan-1 levels in 80 deceased donors and correlated them with donor characteristics and short-term outcomes (defined as delayed graft function - defined as the need for dialysis within the first week post-transplantation and renal function at 3 months post-transplantation - assessed using serum creatinine levels) in 104 corresponding kidney recipients. This single-center retrospective observational cohort study was conducted from April to December 2021.</div></div><div><h3>Results</h3><div>The donor pool consisted of 65% males with a median age of 53 years. Of these, 45 donors (56%) were classified as extended criteria donors. Higher syndecan-1 levels correlated with the last creatinine levels before organ procurement (<em>R</em> = 0.32, <em>p</em> = 0.01) and were marginally higher in donors with acute kidney injury (<em>p</em> = 0.07). However, syndecan-1 levels were not associated with short-term outcomes in kidney recipients (renal function at 3 months).</div></div><div><h3>Conclusions</h3><div>The data suggests syndecan-1 could be a potential biomarker for assessing donor kidney quality, although its implications on recipient outcomes require further study. This pilot investigation underscores the importance of syndecan-1 in evaluating organ quality but highlights the necessity for more extensive research to validate these findings and explore their implications in transplant success.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 187-193"},"PeriodicalIF":0.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}