Transplantation proceedings最新文献

{"title":"The Therapeutic Effect of Polydeoxyribonucleotide on Lung Ischemia-Reperfusion Injury","authors":"Fenghua Sun,&nbsp;Cong Xu","doi":"10.1016/j.transproceed.2026.05.026","DOIUrl":"10.1016/j.transproceed.2026.05.026","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to explore the therapeutic role of polydeoxyribonucleotide (PDRN) in lung ischemia-reperfusion injury (LIRI).</div></div><div><h3>Methods</h3><div>A mouse model of LIRI was established. Experimental groups included the control group, model group, model + low-dose PDRN group, model + high-dose PDRN group, and model + high-dose PDRN combined with AKT inhibitor group. Pathological changes in mouse lung tissues were observed using H&amp;E staining, and cell apoptosis was detected via TUNEL assay. Serum levels of malondialdehyde (MDA) and interleukin-1β (IL-1β) were measured, while protein expression levels of BCL-2, BAX, cleaved-Caspase-3, and p-AKT/AKT were determined using Western blot.</div></div><div><h3>Results</h3><div>Compared with the control group, the model group showed bronchial wall thickening in lung tissues, with extensive red blood cell infiltration and inflammatory cell accumulation in the lung interstitium, indicating significant tissue damage. Additionally, levels of IL-1β, MDA, BAX, and cleaved-Caspase-3 were elevated, while BCL-2 expression and p-AKT/AKT ratio were reduced. In contrast, the model + low-dose PDRN group and model + high-dose PDRN group exhibited alleviated lung tissue damage, reduced inflammatory cell infiltration, decreased levels of IL-1β, MDA, BAX, and cleaved-Caspase-3, and increased BCL-2 expression and p-AKT/AKT ratio, suggesting therapeutic effects. However, in the model + high-dose PDRN + AKT inhibitor group, lung tissue damage, inflammatory responses, and cell apoptosis were aggravated, with increased IL-1β, MDA, BAX, and cleaved-Caspase-3 levels, and decreased BCL-2 expression and p-AKT/AKT ratio.</div></div><div><h3>Conclusions</h3><div>PDRN exerts a therapeutic effect on LIRI by reducing cell apoptosis and inflammatory responses through the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1172-1179"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221370","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 Nomogram Predicts the Need for Internal Iliac Vein Dissection During Renal Transplantation: A Multicenter Collaborative Study","authors":"Daisuke Yamada,&nbsp;Yuki Nakamura,&nbsp;Yasuo Ishii,&nbsp;Jun-Ichi Teranishi,&nbsp;Koji Oba,&nbsp;Satoru Taguchi,&nbsp;Yoshifumi Hamasaki,&nbsp;Yuta Yamada,&nbsp;Jun Kamei,&nbsp;Motonobu Nakamura,&nbsp;Ryo Matsuura,&nbsp;Yoshitaka Kinoshita,&nbsp;Hotaka Matsui,&nbsp;Shigenori Kakutani,&nbsp;Aya Niimi,&nbsp;Sayuri Takahashi,&nbsp;Masaomi Nangaku,&nbsp;Haruki Kume","doi":"10.1016/j.transproceed.2026.06.003","DOIUrl":"10.1016/j.transproceed.2026.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Internal iliac vein dissection (IIVD) can be used for optimal venous anastomosis during renal transplantation; however, it poses a massive bleeding risk. No method has been established yet to identify the need for IIVD during renal transplantation.</div></div><div><h3>Aim</h3><div>To develop a preoperative predictive nomogram that assesses IIVD necessity for safe living-donor renal transplantation.</div></div><div><h3>Methods</h3><div>Data were retrieved from electronic medical records for 523 consecutive living-donor renal transplant cases at 4 institutions between 2009 and 2024. The key preoperative variables included recipient anatomical factors and donor kidney characteristics. Correlations among variables were examined to avoid multicollinearity. Variables were selected using the step-down method of multiple logistic regression.</div></div><div><h3>Results</h3><div>Eight pediatric transplant patients and 15 patients with renal vein venoplasty were excluded; hence, 500 patients were included in the final analysis. Caudal branch of the internal iliac vein, shallowness of the iliopsoas muscle, laterality of the transplanted pelvis, kidney thickness, and laterality of the transplanted kidney were incorporated into a nomogram. The model demonstrated good accuracy (C-index: 0.79). Internal validation via bootstrap resampling yielded an optimism-corrected C-index of 0.79 and a calibration plot with an intercept of 0.03 and a slope of 0.95, indicating no major overfitting.</div></div><div><h3>Conclusions</h3><div>Our nomogram can assess IIVD necessity and facilitate surgical planning and intraoperative decision-making to ensure safe living-donor kidney transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1049-1058"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280644","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":"Appropriate Risk Classification and Low-Dose Rituximab May Help Prevent Acute Rejection in ABO-Compatible Living Kidney Transplantation","authors":"Miruzato Fukuda,&nbsp;Takayoshi Yokoyama,&nbsp;Katsuyuki Miki,&nbsp;Kiho Tanaka,&nbsp;Manabu Kamiyama,&nbsp;Yuki Nakamura,&nbsp;Yasuo Ishii","doi":"10.1016/j.transproceed.2026.06.010","DOIUrl":"10.1016/j.transproceed.2026.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Rituximab desensitization improves outcomes in ABO-incompatible (ABOi) kidney transplantation, and a fixed dose of 200 mg has been shown to prevent antibody-mediated rejection with fewer infections. Although the risk of ABO-compatible (ABOc) transplants is generally low, acute rejection still occurs, suggesting undetected antibodies. Previous studies on ABOc have emphasized conventional dosing or universal administration in non-sensitized recipients, without individualized stratification. We assessed low-dose rituximab in ABOc recipients and propose a preoperative risk-classification framework.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 264 living-donor kidney transplants between January 2015 and July 2024. After excluding ABOi transplants and cases involving double-filtration plasmapheresis/intravenous immunoglobulin, 158 ABOc recipients were included. Recipients were stratified into rituximab (n = 28; single 200 mg dose 14 days before transplant) and rituximab-free (n = 130) groups. The primary endpoints were 1-year acute rejection and infections.</div></div><div><h3>Results</h3><div>The rituximab group had a higher immunologic risk, with fewer related donors (32.1% vs 66.2%; <em>p</em> = .002), and more sensitized (67.9% vs 39.2%; <em>p</em> = .011) or donor-specific antibody (DSA)-positive (17.9% vs 1.5%; <em>p</em> = .001) recipients. Despite this, 1-year acute rejection was lower (0% (0/28) vs 10.8% (14/130); <em>p</em> = .133), with a trend toward improved rejection-free survival (log-rank <em>p</em> = .075), and 1-year infection rates were similar (21.4% vs 23.1%; <em>p</em> = 1.0; log-rank <em>p</em> = .83). In the DSA-positive subgroup (rituximab n = 5; control n = 2), all treated patients remained rejection-free, whereas both untreated patients developed rejection.</div></div><div><h3>Conclusions</h3><div>In ABOc recipients, risk-stratified preoperative low-dose rituximab may help prevent rejection without increasing infections. Our proposed risk-stratification framework may guide patient selection, but these preliminary findings require validation in larger prospective studies.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1014-1021"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280665","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":"Mitochondrial Transplantation-Mediated Restoration of Mitochondrial Function Alleviates Hepatic Ischemia-Reperfusion Injury in Mice","authors":"Yanling Hua,&nbsp;Zhiyu Wang,&nbsp;Minhao Wang,&nbsp;Yiqun Li,&nbsp;Li Li","doi":"10.1016/j.transproceed.2026.04.031","DOIUrl":"10.1016/j.transproceed.2026.04.031","url":null,"abstract":"<div><h3>Background</h3><div>Hepatic ischemia-reperfusion injury (HIRI) is a major complication in liver surgery and transplantation, with mitochondrial dysfunction playing a central role. Mitochondrial transplantation has shown promise in other organ systems, but its effects and mechanisms in HIRI remain incompletely understood.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the protective effects of mitochondrial transplantation on HIRI and explore the underlying molecular mechanisms.</div></div><div><h3>Methods</h3><div>HIRI was induced in male C57BL/6 mice by 60 minutes of partial hepatic ischemia followed by 3 hours of reperfusion. Autologous liver mitochondria (0.5 mg/kg) or vehicle were administered intravenously at the onset of reperfusion. In parallel, human THLE-2 hepatocytes were subjected to oxygen-glucose deprivation/reoxygenation (OGD/R) with or without mitochondrial supplementation (50 μg/mL). Liver injury (serum ALT/AST, measured as mass concentrations by ELISA), histopathology, cytokine profiles (TNF-α, IL-6, IL-10), apoptosis (Bax, Bcl-2, Cleaved Caspase-3, Annexin V), mitochondrial function (membrane potential, ROS production), and cell viability were assessed.</div></div><div><h3>Results</h3><div>Mitochondrial transplantation was associated with significantly reduced serum ALT and AST levels and attenuated histopathological liver damage in vivo (<em>**p &lt;</em> .01). These changes correlated with a shift in cytokine balance, characterized by lower TNF-α and IL-6 and higher IL-10 levels, and with reduced expression of pro-apoptotic markers. In vitro, mitochondrial supplementation was associated with improved hepatocyte viability, reduced enzyme leakage, modulated cytokine secretion, and decreased apoptosis following OGD/R. These protective effects correlated with preserved mitochondrial membrane potential and reduced mitochondrial superoxide production.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that mitochondrial transplantation is associated with mitigation of HIRI in a murine model and with improved mitochondrial parameters in stressed hepatocytes. These correlative data support the potential of this approach as a therapeutic strategy for HIRI.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1207-1216"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221348","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 CMV Risk Stratification, Donor Characteristics, and Post-Transplant Outcomes in Kidney Transplant Recipients: A Retrospective Eurotransplant Center Analysis","authors":"Fabian Haak,&nbsp;Christina Süß,&nbsp;Uwe Scheuermann,&nbsp;Julia Unruh,&nbsp;Alena Spagnolo,&nbsp;Sandra Nickel,&nbsp;Anna Stilkerich,&nbsp;Sophie Seiffer,&nbsp;Hans-Jonas Meyer,&nbsp;Svitlana Ziganshyna,&nbsp;Jan Kowald,&nbsp;Daniel Seehofer,&nbsp;Sebastian Rademacher,&nbsp;Hans-Michael Tautenhahn","doi":"10.1016/j.transproceed.2026.06.012","DOIUrl":"10.1016/j.transproceed.2026.06.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Cytomegalovirus (CMV) infection remains a major complication after kidney transplantation. Prophylactic and preemptive antiviral strategies are central to infection prevention, particularly in high-risk donor-positive/recipient-negative (D+/R−) constellations. While the IMPACT trial suggested that extending valganciclovir prophylaxis to 200 days reduces CMV disease, real-world data remain inconsistent, and the impact of donor characteristics on CMV-related outcomes is incompletely understood. This study evaluated CMV prophylaxis practices, donor characteristics, and post-transplant outcomes in a large single-center kidney transplant cohort.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We retrospectively analyzed 635 kidney transplant recipients treated at the University Hospital of Leipzig between 1993 and 2014. Collected data included CMV serostatus, prophylaxis regimen and duration, donor characteristics, viral load, infection timing, and dialysis-free survival. Only patients transplanted between 2001 and 2014 were included in analyses of prophylaxis duration to ensure uniform valganciclovir use. CMV infection was defined as a positive IgM or PCR result post-transplantation. Multivariable regression analyses were used to assess factors associated with CMV replication and dialysis-free survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;CMV prophylaxis was administered to 37.1% of patients (77% D+/R−, 32.1% D+/R+, 19.6% D−/R+, and 18.3% D−/R−). CMV infection occurred in 20% of the cohort, with the highest incidence observed in D+/R− recipients (28%). In this high-risk group, extended prophylaxis (&gt;200 days) was associated with delayed but not prevented CMV infection, resulting in reduced CMV-free survival (&lt;em&gt;p&lt;/em&gt; &lt; .0001), delayed infection onset (&lt;em&gt;p&lt;/em&gt; = .023), and higher viral loads (&lt;em&gt;p&lt;/em&gt; = .003). Infections occurred predominantly within 1–3 months post-transplant in D+/R− and D+/R+ recipients, whereas D−/R+ patients more frequently exhibited late-onset infection (&gt;12 months). In multivariable analyses, receipt of an expanded criteria donor kidney was independently associated with both reduced dialysis-free survival and increased risk of post-transplant hCMV replication, independent of CMV serostatus and recipient sex.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Extended valganciclovir prophylaxis in high-risk D+/R− kidney transplant recipients was associated with delayed but not prevented CMV infection, resulting in reduced CMV-free survival and higher viral loads. In addition, donor characteristics—particularly expanded criteria donor (ECD) status—were independently associated with increased risk of post-transplant CMV replication and reduced dialysis-free survival. These findings suggest that CMV outcomes after kidney transplantation are associated with not only prophylaxis duration but also donor quality, underscoring the need for individualized prophylaxis strategies tailored to both virological risk ","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1059-1068"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311252","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":"The Real-World Safety and Effectiveness of Rituximab in Preventing Antibody-Mediated Rejection in ABO-Incompatible Liver Transplantation: All-Case Postmarketing Surveillance in Japan","authors":"Mana Kobayashi,&nbsp;Junko Sakamoto,&nbsp;Takashi Ando","doi":"10.1016/j.transproceed.2026.05.014","DOIUrl":"10.1016/j.transproceed.2026.05.014","url":null,"abstract":"<div><h3>Background</h3><div>In ABO-incompatible (ABOi) liver transplantation, antibody-mediated rejection (AMR) is a challenging post-transplant complication. In Japan, rituximab was approved in 2016 to prevent AMR in ABOi kidney and liver transplantation and in 2023 to prevent and treat AMR in kidney, liver, heart, lung, pancreas, and intestine transplantation.</div></div><div><h3>Methods</h3><div>We conducted an all-case postmarketing surveillance to assess the safety and effectiveness of rituximab in ABOi liver transplant recipients, with a registration period between February 29, 2016 and May 9, 2021. The safety endpoint was the occurrence of adverse drug reactions (ADRs). The effectiveness endpoints were the AMR-free rates at weeks 4 and 24 post-transplant. Graft survival rates, rejection-free rates (excluding AMR), and survival rates at weeks 24 and 48 were also assessed.</div></div><div><h3>Results</h3><div>In the safety analysis set, 50.3% (91/181) were male, 8.8% (16/181) were aged ≥ 65 years, 12.8% (23/180) were considered at high risk for cytomegalovirus (CMV) infection, and 95.0% (171/180) received a single infusion preoperatively. ADRs and serious ADRs occurred in 65.7% (119/181) and 27.6% (50/181), respectively. ADRs associated with infection occurred in 57.5% (104/181), with CMV infection being the most frequent event. Twenty-four adverse events leading to death occurred in 16 patients, 7 of whom died from 11 ADRs. In the effectiveness analysis set of 183 patients, the AMR-free rate was 93.4% at weeks 4 and 24. At week 48, the graft survival rate was 94.8%, and the survival rate was 90.6%.</div></div><div><h3>Conclusion</h3><div>Rituximab had an acceptable safety profile in real-world settings in ABOi liver transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1104-1113"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221407","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":"Malakoplakia In Lung Transplant Recipients: Case Series","authors":"Oguz T. Ayaz,&nbsp;Kemarut Laothamatas,&nbsp;Anjali Saqi,&nbsp;Luke Benvenuto,&nbsp;Philippe H. Lemaitre,&nbsp;Selim M. Arcasoy","doi":"10.1016/j.transproceed.2026.05.016","DOIUrl":"10.1016/j.transproceed.2026.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Malakoplakia is a rare granulomatous inflammatory disorder caused by impaired macrophage bactericidal activity, most often occurring in immunocompromised patients and commonly associated with chronic bacterial infection. Reports in lung transplant recipients remain limited.</div></div><div><h3>Methods</h3><div>We performed a retrospective review of lung transplant recipients diagnosed with malakoplakia at our center. Clinical presentation, microbiology, management strategies, and outcomes were analyzed descriptively.</div></div><div><h3>Results</h3><div>Five lung transplant recipients developed 6 episodes of malakoplakia between 5 and 19 months post-transplant. Organ involvement was heterogeneous and included bladder, lung, sigmoid colon, mesenteric lymph nodes, vulvar and labial soft tissues, and prostate. One patient experienced recurrent pulmonary malakoplakia 77 months after the initial episode, representing the first reported recurrence in a solid organ transplant recipient. Chronic bacterial infection was present in all cases.</div></div><div><h3>Conclusions</h3><div>Malakoplakia is an uncommon but important complication after lung transplantation with diverse clinical presentations and potential for recurrence. Early tissue diagnosis, targeted antimicrobial therapy, and individualized immunosuppression adjustment are critical for optimal management.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1180-1184"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148195350","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":"En-Bloc Kidney Procurement Significantly Reduces Organ Extraction Time","authors":"Felix Boll,&nbsp;Elke Stoschek,&nbsp;Anna L. Herzog,&nbsp;Kai Lopau,&nbsp;Johan F. Lock,&nbsp;Johanna C. Wagner","doi":"10.1016/j.transproceed.2026.05.021","DOIUrl":"10.1016/j.transproceed.2026.05.021","url":null,"abstract":"<div><div>Different surgical techniques of kidney procurement exist, for example, simultaneous en-bloc and sequential nephrectomy. After warm dissection, cross-clamping of the large vessels and perfusion of the organs, the cold dissection and extraction of organs is done. During the extraction time, organs are cut off from blood supply and, despite the cold flush, are not adequately cooled, which can result in ischemic damage. We propose that en-bloc kidney procurement shortens extraction time. We analyzed 242 cases of kidney procurement in Germany between January 2017 and December 2023 from donations after brain death (DBD) and compared the influence of the surgical techniques (en-bloc and sequential nephrectomy) on the extraction time of the first retrieved kidney. Kidneys procured with the en-bloc technique had significantly lower extraction times (median 44 vs. 60 minutes; <em>p</em> &lt; .001), which was further confirmed in the multivariate linear regression analysis with a shortening of extraction time by approximately 14 minutes. In conclusion, en-bloc kidney procurement significantly shortens the organ extraction time in DBD organ procurement.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1069-1072"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213779","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":"Twenty-One Years of Insights From A Single-Center Living Kidney Donation Program","authors":"Joana Andrade Lopes,&nbsp;Vítor Fernandes,&nbsp;Adriana Santos,&nbsp;Ana Nunes,&nbsp;Ana Pinho,&nbsp;Ana Rocha,&nbsp;Inês Ferreira,&nbsp;Isabel Tavares,&nbsp;Joana Santos,&nbsp;Manuela Bustorff,&nbsp;Manuel Pestana,&nbsp;Ana Cerqueira,&nbsp;Susana Sampaio","doi":"10.1016/j.transproceed.2026.06.015","DOIUrl":"10.1016/j.transproceed.2026.06.015","url":null,"abstract":"<div><div>Kidney transplantation provides superior survival, quality of life, and cost-effectiveness compared with dialysis. Living donor kidney transplantation further improves outcomes by reducing waiting times and increasing access. We report a 21-year single-center retrospective analysis of the LDKT program at ULS São João, including 120 transplants performed between 2004 and 2024. Donor and recipient demographic, clinical, and immunological characteristics and post-transplant outcomes were reviewed. Primary endpoints were patient and graft survival at 1, 3, 5, 10, 15, and 20 years; secondary outcomes included renal function, rejection episodes, and major complications. Recipients had a mean age of 43.2 ± 9.9 years, 70% male, and 18.3% underwent preemptive transplantation. Donors had a mean age of 47.1 ± 9.1 years and 76.7% were female. Seven primary graft failures occurred. The 1-year acute rejection rate was 11.5%. Median recipient eGFR at last follow-up was 60.1 mL/min/1.73 m². Graft survival was 99.1% at 1, 3, and 5 years, 92.3% at 10 years, and 83.9% at 15 and 20 years; patient survival was 100% at 1 and 3 years and 98.6% thereafter. Donors maintained stable long-term renal function. This experience confirms LDKT as a safe, effective, and durable therapy for end-stage kidney disease and supports expanding living donation in Portugal.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 1035-1041"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297926","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":"Preoperative Predictive Modeling of Recurrent Graft Failure: Development and Validation of a 12-Month Prognostic Tool in Kidney Transplant Recipients","authors":"Tongtong Shen,&nbsp;Xinyao Wang,&nbsp;Xueyu Liu,&nbsp;Wen Zheng","doi":"10.1016/j.transproceed.2026.05.027","DOIUrl":"10.1016/j.transproceed.2026.05.027","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplantation is among the most effective treatments for end-stage renal disease. However, kidney transplant (KT) recipients remain at a relatively high risk of mortality, with underlying causes yet to be fully elucidated. This study aim to develop a machine learning model to predict 12-month graft survival in KT recipients and to analyze the relationship between key postoperative indicators and graft survival.</div></div><div><h3>Methods</h3><div>We retrospectively collected clinical data from 368 KT recipients who underwent allogeneic transplantation between April 2016 and September 2022. A novel feature selection method was employed to exclude variables with weak correlations to outcomes. Eight machine learning algorithms were compared to develop an optimal predictive model, with a primary focus on efficiency.</div></div><div><h3>Results</h3><div>Among the evaluated models, the light gradient boosting machine model demonstrated superior predictive performance, achieving an area under the receiver operating characteristic curve of 0.80 and 0.71 for internal and external validations, respectively. Notably, we redefined the threshold for assessing renal dysfunction in KT recipients, proposing an estimated glomerular filtration rate of 45 mL/min/1.73 m² as a more precise standard.</div></div><div><h3>Conclusion</h3><div>The proposed machine learning model and the newly established estimated glomerular filtration rate threshold provide accurate assessments of graft dysfunction severity, offering robust support for clinical decision-making in kidney transplantation management.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 6","pages":"Pages 986-993"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221391","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}