Transplantation proceedings最新文献

{"title":"Retrospective Analysis of the Effect of Sarcopenia on Mortality and Morbidity in Liver Transplant Patients","authors":"Ahmet Onur Demirel ,&nbsp;Uğur Topal ,&nbsp;Burak Yavuz ,&nbsp;Yunus Kaycı ,&nbsp;Cihan Atar ,&nbsp;Ahmet Gökhan Sarıtaş ,&nbsp;Abdullah Ülkü ,&nbsp;Ferhat Can Pişkin ,&nbsp;Atılgan Tolga Akçam","doi":"10.1016/j.transproceed.2025.03.016","DOIUrl":"10.1016/j.transproceed.2025.03.016","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia significantly influences morbidity and mortality in liver transplant recipients. The psoas muscle area index and prognostic nutritional index (PNI) are potential indicators of sarcopenia’s impact on postoperative outcomes. However, their association with postoperative morbidity and mortality in cadaveric liver transplant recipients remains underexplored.</div></div><div><h3>Methods</h3><div>Data from 52 patients who underwent cadaveric liver transplantation at Çukurova University over 10 years were analyzed. Sarcopenia was assessed using psoas muscle area index (cutoffs, 4.62 mm²/cm² for males and 2.66 mm²/cm² for females, based on Bahat et al) and PNI (cutoffs, ≤45 for low and &gt;45 for high, based on Li et al). Postoperative morbidity was evaluated using the Clavien–Dindo classification. The main outcomes were overall survival and morbidity rates.</div></div><div><h3>Results</h3><div>Sarcopenic patients had shorter survival (62.2 ± 16.4 months) compared with nonsarcopenic patients (83.6 ± 11.4 months), although this difference was not statistically significant (<em>P</em> = .370). Sarcopenia was more common in males, Child–Pugh C patients, those with ascites, American Society of Anesthesiologists score of ≥3, and a Clavien–Dindo grade of ≥3 patients. It was significantly associated with low body mass index and albumin levels (<em>P</em> &lt; .05) and was more prevalent in the low PNI group. A significant correlation was observed between PNI and Child–Pugh score (<em>P</em> = .012), alpha fetoprotein, and albumin levels (<em>P</em> = .007 and <em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>Sarcopenia negatively impacts survival, whereas a higher PNI correlates with a lower mortality risk. Further multicenter prospective studies with a larger population are needed to validate these findings.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 833-840"},"PeriodicalIF":0.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047100","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":"Longitudinal Assessment of Solid Organ Transplant Recipients With SARS-CoV-2 Infection","authors":"Will Vuyk ,&nbsp;Max Bobholz ,&nbsp;Isla Emmen ,&nbsp;Andrew Lail ,&nbsp;Nicholas Minor ,&nbsp;Pavan Bhimalli ,&nbsp;Jens C. Eickhoff ,&nbsp;Hunter J. Ries ,&nbsp;Heather Machkovech ,&nbsp;Wanting Wei ,&nbsp;Andrea Weiler ,&nbsp;Alex Richardson ,&nbsp;Carson DePagter ,&nbsp;Grace VanSleet ,&nbsp;Maansi Bhasin ,&nbsp;Sarah Kamal ,&nbsp;Sydney Wolf ,&nbsp;Aanya Virdi ,&nbsp;Taylor Bradley ,&nbsp;Angela Gifford ,&nbsp;Jacqueline Garonzik-Wang","doi":"10.1016/j.transproceed.2025.04.004","DOIUrl":"10.1016/j.transproceed.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Compared with immunocompetent individuals, those who are immunocompromised, including solid organ transplant (SOT) recipients, have higher SARS-CoV-2-related morbidity and mortality. We determined the duration of SARS-CoV-2 RNA positivity to evaluate viral persistence in SOT recipients.</div></div><div><h3>Methods</h3><div>This study prospectively followed SOT recipients who recently tested positive for SARS-CoV-2. The duration of viral RNA shedding in nasal swabs and stool samples was tracked, and viral genome sequencing was performed where possible. Persistent infection was defined as a positive nucleic acid amplification test (NAAT) for SARS-CoV-2 at 28 days or later after initial infection. This duration was chosen based on the U.S. Centers for Disease Control and Prevention (CDC) recommendation that immunocompromised individuals isolate for at least 20 days [<span><span>1</span></span>], compared with 10 days for non-immunocompromised individuals.</div></div><div><h3>Results</h3><div>Of 30 SOT recipients, 12 (40%) had positive SARS-CoV-2 RNA in nasal swabs or stool (cycle threshold [Ct] &lt; 40) at 28 or more days after the first positive SARS-CoV-2 test. Immunocompromised (IC) subject 015 had high viral loads (Ct &lt; 30) at 28 days, with continued detection for 54 days.</div></div><div><h3>Conclusions</h3><div>In 12 of 30 SOT subjects, SARS-CoV-2 RNA was detected at or beyond 28 days post-detection (dpd), despite vaccination and antibody and/or antiviral treatment in most participants. Three subjects tested positive for SARS-CoV-2 RNA past 50 dpd. Viral persistence in the setting of host immune suppression, coupled with exposure to antiviral treatments, raises concern about the selection of unusual viral variants.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 922-930"},"PeriodicalIF":0.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060211","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":"Post-Transplant Self-Management, Self-Efficacy, and Subjective Well-Being in Heart Transplant Recipients: A Cross-Sectional Study","authors":"Jing Lai ,&nbsp;Danying Ma ,&nbsp;Wei Wang ,&nbsp;Lingzi Wu ,&nbsp;Yuan Liu","doi":"10.1016/j.transproceed.2025.04.002","DOIUrl":"10.1016/j.transproceed.2025.04.002","url":null,"abstract":"<div><h3>Aim</h3><div>To explore the current status and influencing factors of transplant recipients’ subjective well-being, self-management, and self-efficacy at home after heart transplantation (HTx).</div></div><div><h3>Method</h3><div>In this cross-sectional study, we used an online questionnaire to survey 83 HTx recipients who had been discharged from the largest HTx center in South China for more than 6 months. The time since transplantation ranged from 6 months to 14 years. Three self-assessment tools were used: the Chinese version of the Index of Wellbeing and Index of General Affect, the HTx self-management questionnaire, and the Self-Efficacy for Managing Chronic Disease 6-Item Scale.</div></div><div><h3>Results</h3><div>In this study, the well-being index ranged from 5.73 to 14.70 points, with a median of 12.60 (P25 = 10.79, P75 = 13.70). The overall subjective well-being of the HTx recipients was at a good level. Transplant recipients with a history of readmission (<em>Z</em> = 2.271, <em>P</em> = .023), unrecovered activity tolerance (<em>Z</em> = 3.532, <em>P</em> &lt; .001), ignorance of the content of cardiac rehabilitation (<em>Z</em> = 2.703, <em>P</em> = .007), and a negative attitude toward the transplant (<em>Z</em> = 2.438, <em>P</em> = .015) and preoperative use of inotropic agents (Z = 1.999, <em>P</em> = .046) had lower levels of well-being. Subjective well-being is positively related to self-management and self-efficacy, where the stronger the self-management, the higher the level of well-being and self-efficacy.</div></div><div><h3>Conclusions</h3><div>The HTx recipients in this study had higher overall levels of self-management, self-efficacy, and well-being. However, there remain problems associated with poor treatment compliance and poor home cardiac rehabilitation effectiveness. Transplant recipients whose activity tolerance has returned to pre-transplant levels have higher levels of self-management, suggesting that the transplant team should take measures to improve the treatment compliance of HTx recipients, as well as to provide home cardiac rehabilitation guidance to maximize the recovery of activity tolerance and improve the well-being of transplant recipients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 841-848"},"PeriodicalIF":0.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033699","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":"Sleep Quality and Its Influencing Factors in Hemodialysis and Renal Transplant Patients Across Various Stages","authors":"Xu Zhang ,&nbsp;Xu-Liang Yang ,&nbsp;Yao-Hong Liu ,&nbsp;Xin-Ping Lei ,&nbsp;Xu-Feng Zhang ,&nbsp;Qiu-Xiang Kang","doi":"10.1016/j.transproceed.2025.03.002","DOIUrl":"10.1016/j.transproceed.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>Sleep disorder is a prominent clinical symptom in CKD patients. It is highly prevalent and harmful and is related to numerous influencing factors. The aim of this study was to analyze the possible influencing factors of hemodialysis and renal transplant patients at different periods.</div></div><div><h3>Methods</h3><div>Twenty-six patients were selected in each of the following groups: hemodialysis (group A), 3 months after renal transplantation (group B), 3 to 12 months after renal transplantation (group C), and more than 1 year after renal transplantation (group D).The patients' sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI). This study collected clinical and laboratory data related to sleep problems, such as creatinine, calcium, phosphorus, potassium, hemoglobin, albumin and alkaline phosphatase, while also investigating psychological conditions such as depression and anxiety. Multiple linear regression was used to predict sleep status based on anxiety, depression, creatinine, blood calcium, blood phosphorus, blood potassium, hemoglobin and albumin.</div></div><div><h3>Results</h3><div>Compared with group A, the scores of PSQI in groups B and C were significantly lower, and the differences were statistically significant (<em>P</em> ≤ .05); however the differences were not significant in group D (<em>P</em> ≥ .05).Among the eight independent variables, anxiety, creatinine, and blood phosphorus significantly influenced sleep status (<em>P</em> ≤ .05). Conversely, depression, blood calcium, blood potassium, hemoglobin, and albumin did not show a statistically significant effect on sleep status (<em>P</em> ≥ .05).</div></div><div><h3>Conclusion</h3><div>After renal transplantation, patients' sleep status deteriorated after one year after surgery. Our study revealed that anxiety, creatinine and blood phosphorus were risk factors affecting sleep, which deserves our focused attention.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 723-731"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056228","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":"Effects of Treatment With Premarin Alone and the Combination of Premarin + Beclomethasone in Vaginal Involvement of GVHD After Hematopoietic Stem Cell Transplantation","authors":"Mansooreh Yaraghi ,&nbsp;Mohammadamin Noorafrooz ,&nbsp;Maryam Motezarre ,&nbsp;Seyed Asadollah Mousavi","doi":"10.1016/j.transproceed.2025.03.021","DOIUrl":"10.1016/j.transproceed.2025.03.021","url":null,"abstract":"<div><h3>Background</h3><div>Vaginal Graft-versus-Host Disease (GVHD) is a common complication after hematopoietic stem cell transplantation, leading to inflammation and fibrosis of the vaginal tissue. This study was conducted to compare the effectiveness of Premarin alone versus Premarin + Beclomethasone in patients with vaginal GVHD.</div></div><div><h3>Methods</h3><div>40 patients with vaginal GVHD after hematopoietic stem cell transplantation at (XXX) during the years 2018 to 2020 were randomly assigned to 2 groups: the Premarin recipient group (22 individuals) or the Premarin + Beclomethasone group (18 individuals). Symptoms, including vaginal dryness, dyspareunia, discharge, vaginal tightness, etc., were assessed before and after 6 weeks of treatment.</div></div><div><h3>Results</h3><div>After treatment, most symptoms improved in both groups. The Premarin group showed improvement in 21 out of 25 symptoms (84%), while the combination group demonstrated improvement in 22 out of 25 symptoms (88%), with no significant difference between the groups (<em>P &gt;</em> .05). The only symptom with significantly greater improvement in the combination group was vaginal tightness, which occurred in 3 out of 18 patients (17%) compared to 1 out of 22 patients (4.5%) in the Premarin group (<em>P</em> = .03).</div></div><div><h3>Conclusions</h3><div>The combination of Premarin and Clobetasol is more effective than Premarin alone, particularly in cases of vaginal tightness. Other symptoms may be associated with atrophic manifestations.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 885-890"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000998","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":"Epstein Barr Virus Quantitative Polymerase Chain Reaction Monitoring in Lung and Bone Marrow Transplant Patients to Predict Post-Transplant Lymphoproliferative Disorder: A Systematic Review","authors":"Chandima Divithotawela ,&nbsp;Shawn Z. Lee ,&nbsp;Michael Schulz ,&nbsp;Daniel C. Chambers","doi":"10.1016/j.transproceed.2025.03.008","DOIUrl":"10.1016/j.transproceed.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Epstein–Barr virus (EBV)-driven post-transplant lymphoproliferative disorder (PTLD) affects up to 10% of lung transplant patients and is associated with high morbidity and mortality. Early identification of patients at risk of PTLD and reduction in immunosuppression may be an effective way to prevent future diseases.</div></div><div><h3>Methods</h3><div>A systematic review was conducted of all bone marrow (BMT/HSCT) and lung transplant studies published in English that assessed quantitative peripheral blood EBV PCR monitoring as a predictive measure of future PTLD occurrence. Studies on pre-emptive therapy before the diagnosis of PTLD were excluded.</div></div><div><h3>Results</h3><div>A thousand of hundred sixty-three studies were screened, and 12 were eligible for the final analysis. The two lung transplant studies reported 60% to 80% sensitivity (SN) and 60% to 86% negative predictive value (NPV), but poor specificity (SP) (30%-75%) and positive predictive value (PPV) (30%-67%). HSCT studies also showed good SN (71.4%-100%) and NPV (94%-100%). However, the SP (range, 50%-96%) and PPV (range, 14%-75%) were poor. The included studies used nonstandardized EBV PCR testing methods, which affected the validity of the results and the applicability of the findings to other transplant programs. Most studies were retrospective and included a small number of cases.</div></div><div><h3>Conclusions</h3><div>In conclusion, this systematic review demonstrated the lack of good-quality evidence and poor SP and PPV of EBV PCR monitoring to predict PTLD development in lung transplantation. The use of PCR-guided preemptive therapy for future PTLD prevention is questionable. Further studies with standardized EBV PCR measurements are required.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 931-939"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056815","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":"Efficacy and Safety of Induction Therapy in Kidney Transplant Recipients: A Propensity Score Matching Analysis in a Multicenter Retrospective Observational Study","authors":"Vural Taner Yılmaz ,&nbsp;Erol Demir ,&nbsp;Hüseyin Koçak ,&nbsp;Ayşe Sinangil ,&nbsp;Rahmi Yılmaz ,&nbsp;Şebnem Karakan ,&nbsp;Rezzan Eren Sadioğlu ,&nbsp;Berna Yelken ,&nbsp;Ebru Ok ,&nbsp;Murathan Uyar ,&nbsp;Arzu Velioğlu ,&nbsp;Ergün Parmaksız ,&nbsp;Elif Arı Bakır ,&nbsp;Ülkem Çakır ,&nbsp;Nurhan Seyahi ,&nbsp;Hamad Dheir ,&nbsp;Aydın Türkmen","doi":"10.1016/j.transproceed.2025.04.003","DOIUrl":"10.1016/j.transproceed.2025.04.003","url":null,"abstract":"<div><h3>Bacground</h3><div>This study aimed to compare the efficacy and safety of induction treatments in kidney transplant recipients.</div></div><div><h3>Methods</h3><div>A total of 2564 kidney transplant recipients from 15 transplant centers were included in the study and were categorized into 3 groups for comparison. Group 1: No induction (n = 222, 8.7%), Group 2: Anti-T lymphocyte globulin (ATLG, n = 1794, 70%) and Group 3: Basiliximab (n = 548, 21.4%). The results were compared across 3 post-transplant periods: the first month, the 1st to 6th month, and the 6th to 12th month.</div></div><div><h3>Results</h3><div>Prior to propensity score matching (PSM), there were no significant differences in graft/patient survival, BKV (polyomavirus) incidence, or rejection rates during the first month among the groups. However, the Anti-T lymphocyte globulin (ATLG) group exhibited higher rates of developing donor-specific antibodies (DSA), cytomegalovirus (CMV) infection, general infections, and delayed graft function (DGF), along with higher rejection rates at 1 month post-transplant. After the PSM analysis, rejection rates (which were higher in the ATLG group compared to the Basiliximab group only in the first month), graft/patient loss, and BKV rates were comparable. Infection, CMV, and DSA rates remained elevated in the ATLG group. Clinical results of groups 1 and 3 were similar.</div></div><div><h3>Conclusions</h3><div>This study shown that ATLG provides positive clinical results despite increased infection and DSA formation in patients with high immunological risk, whereas the efficacy and necessity of induction in patients with low-moderate immunological risk is debatable.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 713-722"},"PeriodicalIF":0.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047187","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":"Enhancing Lung Transplant Outcomes: The Critical Role of Pretransplant Gastroenterological Evaluations","authors":"Mahmut Yüksel ,&nbsp;Erdal Yekeler ,&nbsp;Kerem Kenarlı ,&nbsp;Diler Taş Kılıç ,&nbsp;Fatmanur Çelik Başaran ,&nbsp;Yavuz Çağır ,&nbsp;Ahmet Akbay ,&nbsp;Fatma Ebru Akın ,&nbsp;Mevlüt Hamamcı ,&nbsp;Çağdaş Kalkan ,&nbsp;Hasan Tankut Köseoğlu ,&nbsp;Çağdaş Erdoğan","doi":"10.1016/j.transproceed.2025.03.014","DOIUrl":"10.1016/j.transproceed.2025.03.014","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the influence of gastroenterological health on lung transplant candidacy and outcomes, advocating for a standardized pretransplant gastrointestinal assessment protocol.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at a high-volume tertiary care center from January 2019 to December 2022. Adult patients undergoing comprehensive pre-transplant evaluations, including detailed gastroenterological assessments, were categorized based on their approval status for lung transplantation.</div></div><div><h3>Results</h3><div>Among the candidates evaluated, 19.2% were approved for transplantation. Gastroenterological issues led to the rejection of numerous candidates. Significant rejection factors included advanced liver fibrosis (22.6%), Hepatitis B and C, high-grade dysplasia, intra-mucosal carcinoma, and severe cases of gastroesophageal reflux disease (GERD). These conditions, often associated with severe complications such as portal hypertension and cirrhosis, were pivotal in influencing transplant eligibility and patient outcomes.</div></div><div><h3>Conclusion</h3><div>The findings underscore the critical role of gastroenterological health in the lung transplant evaluation process. Implementing a standardized gastrointestinal assessment protocol could enhance the identification of at-risk patients, reduce post-transplant complications, and improve overall outcomes. This study highlights the need for rigorous pre-transplant evaluations to optimize patient management and transplantation success, promoting the integration of comprehensive gastroenterological assessments into standard care practices for lung transplant candidates.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 859-867"},"PeriodicalIF":0.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051317","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":"COVID-19 Infection May Lead to Increased CMV Infection in Renal Transplant Recipients","authors":"Banu Yılmaz ,&nbsp;Sibel Ersan ,&nbsp;Gül Mingsar ,&nbsp;Mehmet Tanrısev ,&nbsp;Hülya Çolak ,&nbsp;Orçun Ural","doi":"10.1016/j.transproceed.2025.03.004","DOIUrl":"10.1016/j.transproceed.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has caused significant mortality and morbidity, especially in renal transplant recipients. The mortality and hospitalization rate of COVID-19 infected transplant recipients is much higher than in the healthy population. Although progress has been made in the management of COVID-19 in renal transplant recipients, there are still unexplained clinical differences among patients. We think that cytomegalovirus (CMV) infection may also play a role in this clinical difference in COVID-19 infected transplant recipients. For this purpose, we aimed to screen for the presence of CMV viremia or infection in kidney transplant patient groups who were and were not diagnosed with COVID-19 in the last year.</div></div><div><h3>Method</h3><div>We included 191 consecutive kidney transplant recipients followed in our transplant clinic. The patients were divided into two groups according to whether they had COVID-19 infection or not in the last 1 year. CMV DNA levels were tested in the whole patients’ groups. We compared CMV positivity rates in patients with and without COVID-19.</div></div><div><h3>Results</h3><div>There were 83 patients who had COVID-19 and 108 patients who did not. Whereas CMV viremia was detected in 15 transplant recipients with COVID-19 infection, CMV viremia was detected in 4 patients who did not have COVID-19 (<em>P</em> = .001, logistic regression = 4.8, 95% confidence interval [CI] = 1328–17,103; Figure 1).There was no difference in terms of immunosuppressive therapy, steroid use, duration, and type of transplantation. The COVID-19 negative and positive groups were similar in lymphocyte and leukocyte counts (Table 1). In the multivariate analysis, CMV positivity was found to be positively associated with COVID-19 infection but lymphocyte count and estimated glomerular filtration rate (eGFR) were found to be independently and negatively correlated.</div></div><div><h3>Conclusions</h3><div>CMV infection may accompany COVID-19 or may occur in the post-COVID-19 period. It can cause increased morbidity and mortality. Routine screening and early treatment for CMV may reduce mortality in high-risk group.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 910-915"},"PeriodicalIF":0.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061747","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":"MELD Score Before and After Plasmapheresis in Recipients of ABO-Incompatible Living Donor Liver Transplantation","authors":"Ja Eun Lee,&nbsp;Sooyeon Lee,&nbsp;Justin Sangwook Ko,&nbsp;Mi Sook Gwak,&nbsp;Gaab Soo Kim","doi":"10.1016/j.transproceed.2025.03.017","DOIUrl":"10.1016/j.transproceed.2025.03.017","url":null,"abstract":"<div><h3>Background</h3><div>In ABO-incompatible living donor liver transplantation (LDLT), many strategies including plasmapheresis have been introduced to overcome the ABO blood group barrier. After plasmapheresis, the MELD score can change because the levels of its three components [international normalized ratio (INR), total bilirubin (Tb), and creatinine (Cr)] may be affected.</div></div><div><h3>Method</h3><div>Present study included 142 recipients of ABO-incompatible LDLT. MELD score was calculated according to the original formula [11.2 ln (INR) + 3.78 ln (Tb) + 9.56 ln (Cr) + 6.43]. We compared the MELD score and the three components of the MELD score before and after plasmapheresis.</div></div><div><h3>Results</h3><div>In the entire cohort, MELD score decreased from 13 to 11 after plasmapheresis. MELD score increased in 41 (28.9%), maintained in 25 (17.6%), and decreased in 76 (53.5%) recipients. The change of INR, Tb, and Cr was mostly in the same direction as the change of MELD score.</div></div><div><h3>Conclusion</h3><div>MELD scores of ABO-incompatible LDLT recipients mostly change after plasmapheresis. Decline in MELD score was most common, followed by rise and maintenance.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 5","pages":"Pages 799-802"},"PeriodicalIF":0.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040395","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}