Transplantation proceedings最新文献

{"title":"Barriers to Kidney Transplantation in Urban Hemodialysis Centers in Pakistan: A Cross-Sectional Study","authors":"Hasaan Salman Shafi ,&nbsp;Syed Abdullah Ali Shah ,&nbsp;Irfan Ahmad ,&nbsp;Nabiha Rizvi ,&nbsp;Salman Tahir Shafi ,&nbsp;Omair Farooq","doi":"10.1016/j.transproceed.2025.02.048","DOIUrl":"10.1016/j.transproceed.2025.02.048","url":null,"abstract":"<div><h3>Background and aims</h3><div>End-stage kidney disease is a global health challenge that has greatly affected low-income and middle-income countries. While a living donor kidney transplant (LDKT) is the most optimal treatment for end-stage kidney disease, many medical and nonmedical barriers persist which hinder transplant rates. This study aims to identify the various medical, psychological, and socioeconomic barriers to LDKT among patients in urban hemodialysis centers in Pakistan.</div></div><div><h3>Methods</h3><div>A cross-sectional study of patients undergoing hemodialysis in urban hospitals across three urban cities in Pakistan was conducted. Participants were given a structured questionnaire addressing demographics, medical history, socioeconomic status, and transplantation awareness.</div></div><div><h3>Results</h3><div>The median age was 54 years (IQR 20), with 56.2% male participants. Barriers were identified as socioeconomic (61.4%), medical (32.6%), and psychological (6%). Significant differences in median age were observed across groups (<em>P</em> &lt; .01), with socioeconomic barriers associated with younger patients (median age 49 years) compared to medical (median 63 years) and psychological (59 years) barriers. Patients with socioeconomic barriers were younger (<em>P</em> ≤ .01), had lower income (<em>P</em> = .02), and had relatively lower rates of marriage (<em>P</em> = .02) compared to those in other categories. Lack of donors and lack of financial resources were the most common barriers, cited by 50.2% and 50% of participants, respectively.</div></div><div><h3>Conclusions</h3><div>Socioeconomic barriers are the leading obstacles to LDKT in Pakistan. Efforts must be made to address these barriers, such as a deceased donor program, financial aid, and improving patient knowledge about LDKT. Further studies should explore rural populations and psychological barriers in greater depth.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 552-557"},"PeriodicalIF":0.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660231","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":"Current Applications and Developments of Natural Language Processing in Kidney Transplantation: A Scoping Review","authors":"René Gatsinga ,&nbsp;Rachel Shu-En Lau ,&nbsp;Benjamin Jia Han Lim ,&nbsp;Khi Yung Fong ,&nbsp;Marc Zhen Guo Yeong ,&nbsp;Amber Hwa Hwa Chung ,&nbsp;Lay Guat Ng ,&nbsp;Edwin Jonathan Aslim ,&nbsp;Valerie Huei Li Gan ,&nbsp;Ee Jean Lim","doi":"10.1016/j.transproceed.2025.02.027","DOIUrl":"10.1016/j.transproceed.2025.02.027","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Natural language processing (NLP) is a subfield of artificial intelligence that enables computers to process human language. As most human interactions today involve the internet and electronic devices, NLP tools quickly become indispensable to modern life. The use of NLP tools in medical practice and research is growing fast. This scoping review evaluates the current and potential future applications of NLP in kidney transplantation medicine.</div></div><div><h3>Design</h3><div>We conducted an electronic literature search on NLP in the setting of kidney transplantation on PubMed, EMBASE, and Scopus from inception to August 26, 2024. Two independent investigators conducted the search strategy and reviewed abstracts and full texts; conflicts were resolved after discussion with a third and fourth author. A total of ten studies were included in the study.</div></div><div><h3>Results</h3><div>The most commonly studied clinical applications of NLP in kidney transplantation are its use as an adjunct tool to facilitate early diagnosis of renal disease and as an effective predictor of graft loss and complications among kidney transplant recipients. Some researchers were able to predict organs at risk of delayed implant or discard by analyzing donors’ EHR; this has the potential to improve organ utilization significantly. In clinical research, NLP tools can be tailored to perform specific tasks of interest on unstructured text. By studying n comments from social media and news websites, 1 group was able to gauge public perception of transplant policies and identify potential actions to improve access to transplant care.</div></div><div><h3>Conclusions</h3><div>NLP tools have only recently been introduced into medical research, but they are already significantly impacting kidney transplantation medicine. The literature demonstrates the potential to improve early diagnosis of renal failure, predict renal transplantation outcomes, improve organ utilization, and support advocacy and policymaking. With more widespread use of EHR globally and the continued development of NLP technology, these tools are poised to revolutionize the practice of renal transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 558-568"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639956","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":"4-Color Flow Cytometric Cytotoxicity Crossmatch Using Whole Blood Lysis","authors":"Dong Il Won ,&nbsp;Jeong-Hoon Lim ,&nbsp;Jang-Hee Cho ,&nbsp;Chan-Duck Kim ,&nbsp;Seung Huh","doi":"10.1016/j.transproceed.2025.02.034","DOIUrl":"10.1016/j.transproceed.2025.02.034","url":null,"abstract":"<div><h3>Background</h3><div>The conventional lymphocyte crossmatch (XM) assay necessitates mononuclear cell isolation. In our previous work, we introduced a novel 3-laser, 4-color flow cytometric (FC) XM protocol utilizing whole blood lysis (WBL) and CD45 fluorescence-triggered acquisition to detect human leukocyte antigen (HLA) antibody binding. Building on this, we aimed to adapt these advancements for complement-dependent cytotoxicity (CDC) XM using FC (FCCDC).</div></div><div><h3>Methods</h3><div>A total of 164 donor/recipient pairs undergoing transplantation were stratified into 2 groups based on donor-specific HLA alloantibody presence: DSA-positive (DSA+, n = 73) and DSA-negative (DSA−, n = 91). The DSA− group was further subdivided by ABO compatibility into ABO-incompatible (ABOi, n = 52) and ABO-compatible (n = 39) subgroups. Protocol optimization for the WBL FCCDC with CD45 V500-C was conducted using a FACSLyric cytometer (BD Biosciences). T and B cell indices were calculated as delta (test minus control) percentages of dead cells (Δ%DC). WBL FCCDC results were compared with those of conventional FCCDC in each group.</div></div><div><h3>Results</h3><div>WBL FCCDC showed no significant quantitative difference from conventional FCCDC. In the DSA+ group, B cell Δ%DC values were 28.00 ± 27.14 and 19.16 ± 27.74 for WBL FCCDC and conventional FCCDC, respectively (<em>P</em> = .0777). No ABO antibody interference was observed in the ABOi subgroup. Qualitatively, B cell WBL FCCDC sensitivity in the DSA+ group was 69.9%, comparable to conventional FCCDC sensitivity (65.8%, <em>P =</em> .5078). Additionally, WBL FCCDC reduced the turnaround time by 50 minutes relative to conventional FCCDC.</div></div><div><h3>Conclusions</h3><div>WBL FCCDC achieved performance equivalent to conventional FCCDC, similar to WBL FCXM. The absence of adverse effects from the lysis step supports its integration into XM assays. Given its simplicity and maintained sensitivity, the WBL FCCDC protocol presents a viable alternative to conventional methods in histocompatibility laboratories.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 675-682"},"PeriodicalIF":0.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639955","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 Liver Transplantation After Achieving Complete Clinical Remission of Hepatocellular Carcinoma With Combination Therapy of Immune Checkpoint Inhibitors and Targeted Agents: A Case Report","authors":"Shaobo Zhang ,&nbsp;Shugeng Zhang","doi":"10.1016/j.transproceed.2025.02.041","DOIUrl":"10.1016/j.transproceed.2025.02.041","url":null,"abstract":"<div><div>Immunotherapy, primarily with immune checkpoint inhibitors, has become pivotal in the treatment of advanced hepatocellular carcinoma (HCC), leading to significant tumor burden reduction. However, its applicability in liver transplantation remains controversial. Due to the potential risks of rejection limiting large-scale clinical trials and the incomplete understanding of underlying mechanisms, whether transplant recipients can benefit from immunotherapy remains uncertain. This report describes the application of immunotherapy in liver transplantation, wherein two patients achieved complete tumor remission after receiving immunotherapy combined with other treatments before transplantation, enabling successful liver transplantation surgeries. Additionally, one patient received combination therapy with tislelizumab and lenvatinib before transplantation (Case 2), representing the first reported case utilizing this combination therapy as a bridging treatment before LT.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 580-584"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631164","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":"Hypothermic Myocardial Preservation: The Freezing Debate","authors":"Mohammed Quader ,&nbsp;Zachary Kiernan ,&nbsp;Gina Labate ,&nbsp;Qun Chen","doi":"10.1016/j.transproceed.2025.02.035","DOIUrl":"10.1016/j.transproceed.2025.02.035","url":null,"abstract":"<div><h3>Background</h3><div>Storage of hearts in ice for transportation is thought to cause post-transplantation graft dysfunction secondary to freeze injury. We studied the myocardial damage and resulting function in hearts stored at 0 °C, 4 °C and 8 °C for 4 hours.</div></div><div><h3>Methods</h3><div>Rat hearts were procured under general anesthesia and immediately stored in University of Wisconsin solution at 0 °C, 4 °C and 8 °C for 4 hours (n = 6-8/group). Hearts were then re-perfused on a Langendorff apparatus for 90 minutes using oxygenated Kreb-Henseleit buffer (37 °C). Functional parameters were recorded via a balloon tip catheter in the left ventricle. Following reperfusion hearts were collected for infarct size quantification using triphenyltetrazolium chloride staining. A separate group of hearts (n = 2-3) were similarly stored then studied for ultrastructural and biochemical changes.</div></div><div><h3>Results</h3><div>There were no signs of freeze injury in hearts stored at 0 °C by histologic or biochemical analysis. There was no significant difference in infarct size between hearts stored at 0 °C and 4 °C. Cardiac troponin I level, and left ventricle developed pressure in hearts stored at 0 °C, 4 °C, and 8 °C were comparable (all <em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>Hearts stored at 0 °C for 4 hours showed no signs of freeze injury and had similar functional parameters compared to hearts stored at 4 °C or 8 °C.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 4","pages":"Pages 653-662"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631161","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":"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}