Transplant immunology最新文献

{"title":"“Virtual crossmatch reveals donor-specific MICA antibodies in antibody mediated rejection: First established Indian case”","authors":"Machiraju Sai Ravi Shankar ,&nbsp;Mamidi Neeraja ,&nbsp;Mohit Chowdhry ,&nbsp;Ayushi Yadav ,&nbsp;Sriya Machiraju ,&nbsp;Meenakshi Singh ,&nbsp;Swarnalata Gowrishanker","doi":"10.1016/j.trim.2025.102229","DOIUrl":"10.1016/j.trim.2025.102229","url":null,"abstract":"<div><div>Kidney transplantation is the best treatment for patients with End-stage renal disease (ESRD), offering significant improvements in their survival and quality of life. However, immune-mediated rejection of the graft remains a critical challenge. Anti-Human Leukocyte Antigen (HLA) antibodies are well-recognized mediators of acute and chronic rejection. In contrast, the role of non-HLA antibodies particularly donor-specific Anti-MHC class I-related chain A (MICA) antibodies (dsMICA Abs) requires further investigation.</div><div>We report the first documented case in India of acute antibody-mediated rejection (AMR) in renal transplant recipients attributed to dsMICA. The patient, an 18-year-old male, developed graft dysfunction post-transplant despite a negative HLA Complement dependent Cytotoxicity crossmatch (CDCXM) and Lysate based Luminex Crossmatch (LumXm) results performed prior to transplantation. A more detailed diagnostic workup revealed the presence of dsMICA Abs, implicating them in the observed AMR. After a targeted treatment regimen of plasmapheresis and intravenous immunoglobulin (IVIG) therapy, the patient showed substantial clinical improvement, marked by declining creatinine levels and then restoration of renal function. This study underscores the clinical significance of dsMICA antibodies in AMR and advocates for the need for routine non-HLA antibody screening in addition to anti-HLA screening post-transplant immunological monitoring.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102229"},"PeriodicalIF":1.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874286","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":"Outcomes of CMV infection in the setting of gastrointestinal graft-vs.-host disease in the era of pre-emptive and prophylactic antiviral therapy","authors":"Meera Patel ,&nbsp;Supriya Singh ,&nbsp;Puneet Dhillon ,&nbsp;Sofia Molina Garcia ,&nbsp;Michael Sheu ,&nbsp;Sonya Kothadia ,&nbsp;Ali Mushtaq ,&nbsp;Aneela Majeed","doi":"10.1016/j.trim.2025.102232","DOIUrl":"10.1016/j.trim.2025.102232","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Concurrent cytomegalovirus infection (CMVi) and gastrointestinal graft-versus-host disease (GI-GVHD) poses significant risks for increased morbidity and mortality in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Primary prophylaxis with letermovir therapy has been shown to decrease the risk of CMV reactivation, but studies examining this relationship after GI-GVHD are lacking. We reviewed our center's outcomes associated with concomitant CMVi and GI-GVHD before and after our adopting the use of letermovir therapy for CMV prophylaxis in 2017.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a single-center, retrospective study of allo-HCT patients who developed GI-GVHD and CMVi between June 2013 and June 2021. CMVi was defined as detection of CMV in the blood or detection of CMV in sampled tissue. CMV colitis was defined as biopsy-proven tissue-invasive CMV disease. The primary outcome was one year survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We evaluated 43 allo-HCT patients who had concomitant CMVi and GI-GVHD. Out of 43 patients, 40 of them (93 %) had a high risk serostatus for CMVi (recipient seropositive). CMV colitis was confirmed by biopsy in 18 patients (42 %) and was clinically suspected in 20 patients (47 %). Twenty-five patients (58 %) developed CMV viremia, and 18 of them developed concomitant biopsy proven CMV colitis. Nine patients (21 %) received letermovir therapy for primary CMV prophylaxis, and 7 of these 9 patients (78 %) developed breakthrough CMVi while receiving prophylaxis. The median time from HCT to CMVi was similar between the group that received letermovir prophylaxis and the group that did not. Median peak CMV levels were lower in the prophylaxis group. Overall survival rates at one and five years were 65 % and 21 %, respectively, with the mortality reaching 25 % at 164 days and 50 % at 480 days. There was no statistically significant difference in one year survival between patients with CMV viremia but without colitis compared to those with CMV viremia and colitis (&lt;em&gt;p&lt;/em&gt; = 0.648, 95 % CI 0.3–1.57). One-year survival was also not statistically different between patients who received letermovir prophylaxis compared to those who did not (&lt;em&gt;p&lt;/em&gt; = 0.250, 95 % CI 0.60–6.97) or between patients with high grade GI-GVHD (grade 3–4) and low-grade GI-GVHD (grade 1–2; &lt;em&gt;p&lt;/em&gt; = 0.277, 95 % CI 0.64–4.83).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In this high-risk cohort with GI-GVHD and CMVi, the peak viral load was lower in the group that received letermovir prophylaxis, but the median time to onset of CMVi and survival were not statistically different. The majority of patients in the letermovir prophylaxis group developed CMVi while on letermovir. Further investigations with larger sample sizes may better assess the impact of letermovir therapy on patient survival and the development of CMVi outcomes in the setting of GI-GVHD in the era of pre-emptive prophyl","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102232"},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874285","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":"Drug-induced acute pancreatitis following dose increase of mycophenolate mofetil in a kidney transplant recipient: A case report and literature review","authors":"Maroun Abou-Jaoude ,&nbsp;Ahmed Elsidig ,&nbsp;Sara Abdel-Samad ,&nbsp;Ibrahim Tfayli","doi":"10.1016/j.trim.2025.102230","DOIUrl":"10.1016/j.trim.2025.102230","url":null,"abstract":"<div><h3>Background</h3><div>Mycophenolate Mofetil (MMF) is widely used as an immunosuppressive agent in transplant recipients but is rarely associated with acute pancreatitis.</div></div><div><h3>Case presentation</h3><div>We report the case of a 25-year-old male kidney transplant recipient with juvenile cystinosis who developed acute pancreatitis following an increase in MMF dosage from 500 mg to 750 mg twice daily. The patient had previously experienced complications post-transplant, including posterior reversible encephalopathy syndrome and BK virus-related urethral stricture. A recent episode of acute antibody-mediated rejection, confirmed by biopsy, led to the reintroduction and escalation of MMF alongside Tacrolimus. One month later, the patient presented with severe epigastric pain, vomiting, and diarrhea. Laboratory tests revealed markedly elevated lipase levels (2269 U/L), meeting the Atlanta criteria for acute pancreatitis. Imaging excluded alternative etiologies. The patient's symptoms and lipase levels improved immediately after reducing the MMF dose.</div></div><div><h3>Conclusion</h3><div>This case highlights the potential for MMF-induced pancreatitis, particularly following dose escalation, and underscores the importance of cautious dosing and close monitoring in transplant recipients.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102230"},"PeriodicalIF":1.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859365","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":"Allogenic stem cell transplantation response for relapsed or refractory Hodgkin lymphoma patients: An experience in Iran","authors":"Amineh Salem ,&nbsp;Mahshid Mehdizadeh ,&nbsp;Sayeh Parkhideh","doi":"10.1016/j.trim.2025.102228","DOIUrl":"10.1016/j.trim.2025.102228","url":null,"abstract":"<div><div>Stem cell transplantation (SCT) is a potentially curative therapeutic approach for patients diagnosed with high-risk classic Hodgkin Lymphoma (cHL), a rare lymphoproliferative disorder. This study presents a comprehensive retrospective analysis of 273 patients with relapsed or refractory cHL referred to Taleghani Hospital in Tehran, Iran, over a 14-year period (2007–2021). The results indicated that 63 % of individuals receiving autologous-SCT achieved a complete response. However, approximately 4 % of the study population (10 patients) experienced treatment failure after autologous-SCT and proceeded to allogeneic-SCT (Group I). Additionally, in ten other cases, autologous-SCT was not feasible, and treatment was exclusively managed through allogeneic-SCT (Group II). Demographic and clinical characteristics, including gender, cHL subtype, history of radiotherapy, presence of bulky disease, and incidence of graft-versus-host disease (GVHD), were collected and analyzed to assess treatment outcomes. The overall survival (OS) was 42.1 months for Group I and 17.3 months for Group II. Although the overall complete response (CR) for the entire cohort was 45 %, the corresponding CR for Groups I and II were 60 and 30 %, respectively. In conclusion, allogenic-SCT appears to be a viable therapeutic strategy for at least 50 % of patients experiencing autologous-SCT failure. The efficacy of allogenic-SCT may be influenced by factors such as cHL subtype, and prior auto-SCT therapy. Notably, individuals in Group I who experienced graft-versus-host disease (GVHD) exhibited prolonged survival.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102228"},"PeriodicalIF":1.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847995","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":"Recognition of different subsets of alloreactive T cells by activation-induced markers","authors":"Michiel G.H. Betjes,&nbsp;Mariska Klepper,&nbsp;Guido Smits,&nbsp;Elodie van der Valk,&nbsp;Amy C.J. van der List,&nbsp;Nicolle H.R. Litjens","doi":"10.1016/j.trim.2025.102227","DOIUrl":"10.1016/j.trim.2025.102227","url":null,"abstract":"<div><div>Alloreactive T-cells can be visualized using activation-induced markers (AIMs) including CD69, CD134, CD137 and CD154. Whether these AIMs recognize similar subsets of alloreactive T-cells is largely unknown. AIM-expressing alloreactive CD4+ T cells were analyzed in detail for phenotype by dissecting different T-cell subsets using antibodies directed to CCR7 and CD45RA. Moreover, detailed functional analysis was performed by determining proportions of cytokine producing cells within AIM-expressing CD4+ T cells using multiparameter flowcytometry. CD154 was predominantly expressed by naïve and central-memory alloreactive CD4+ T cells, CD134 by central-memory alloreactive CD4+ T cells and CD137 by CD4+ alloreactive memory T cells. Alloreactive CD8+ T cells could only be recognized by CD137 expression. The majority of alloreactive CD4+ T cells were single AIM-positive (72 %) and co-expression of all AIMs was infrequent. Polyclonal stimulation with anti-CD3/anti-CD28 resulted in a high frequency of CD4+ T cells co-expressing AIMs which was a dose-dependent phenomenon. Alloreactive memory CD4+ T cells expressing &gt;1 AIM showed the highest proportion of polyfunctional cells. Allogeneic stimulation of sorted naïve CD4+ T cells yielded a population of proliferating T cells, progressing to effector-memory T cells expressing &gt;1 AIM. In conclusion, different AIMs are preferentially expressed by different subsets of circulating alloreactive CD4+ T cells and expression of AIMs is determined by proliferation/differentiation and strength of the T cell receptor (TCR)-stimulation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102227"},"PeriodicalIF":1.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808310","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 regulatory mechanism of long non-coding RNAs (lncRNAs) of integrin alpha L (ITGAL) sequences (lncRNA-ITGAL) in CD4+ T cell differentiation during immune rejection of corneal transplants","authors":"Qian Cao ,&nbsp;Yong Li ,&nbsp;Yunchuan Li ,&nbsp;Shuang Tan ,&nbsp;Guojun Gao ,&nbsp;Lan Li","doi":"10.1016/j.trim.2025.102226","DOIUrl":"10.1016/j.trim.2025.102226","url":null,"abstract":"<div><h3>Objective</h3><div>Corneal blindness remains a major global contributor to visual impairment, affecting approximately 6.17 million individuals. High-risk corneal transplantation is associated with rejection rates of up to 50 %, necessitating the development of new therapeutic strategies to complement or enhance conventional immunosuppressive treatments, including corticosteroids and calcineurin inhibitors. This study aimed to examine the regulatory function of long non-coding RNAs (lncRNAs) transcribed from integrin alpha L (ITGAL) sequences (lncRNA-ITGAL) in CD4⁺ T cell differentiation during immune rejection following corneal transplantation.</div></div><div><h3>Methods</h3><div>Sprague Dawley rats (<em>n</em> = 20) were assigned to either a control or rejection group. Corneal rejection indices were assessed two weeks post-transplantation. Histopathological evaluation was performed using hematoxylin and eosin staining. RNA sequencing was conducted to analyze differentially expressed lncRNA and messenger RNA profiles. Flow cytometry was used to quantify Th1, Th2, and Th17 subsets in human peripheral blood mononuclear cells. Quantitative reverse transcription polymerase chain reaction was employed to measure the expression of lncRNA-ITGAL, miR-378a-3p, and tumor necrosis factor receptor-associated factor 1. Spatial interactions were examined through fluorescence in situ hybridization and immunohistochemistry.</div></div><div><h3>Results</h3><div>Corneal tissues in the rejection group exhibited significant stromal edema and opacity (<em>p</em> &lt; 0.05). RNA sequencing identified 7057 differentially expressed lncRNAs and 5485 differentially expressed mRNAs (<em>p</em> &lt; 0.05). The expression of lncRNA-ITGAL was positively correlated with TRAF1 and negatively correlated with miR-378a-3p. Flow cytometry demonstrated that overexpression of lncRNA-ITGAL increased the proportions of Th1, Th2, and Th17 subsets (<em>p</em> &lt; 0.05), whereas its knockdown reduced these subsets. In corneal tissues, upregulated expression of lncRNA-ITGAL and TRAF1, along with downregulated miR-378a-3p, was observed in the rejection group (<em>p</em> &lt; 0.05). Immunohistochemical analysis confirmed elevated tumor necrosis factor receptor-associated factor 1 (TRAF1) expression in the corneal epithelium (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>lncRNA-ITGAL modulates the differentiation of Th1, Th2, and Th17 subsets through the miR-378a-3p/TRAF1 axis, highlighting its potential as a therapeutic target for improving corneal graft survival.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102226"},"PeriodicalIF":1.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765117","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":"Impacts of high mobility group box protein 1 gene polymorphisms on morbidity and mortality after living donor liver transplantation","authors":"Naofumi Tsukiyama,&nbsp;Yuka Tanaka,&nbsp;Hiroaki Yamane,&nbsp;Naoki Tanimine,&nbsp;Shintaro Kuroda,&nbsp;Hiroyuki Tahara,&nbsp;Masahiro Ohira,&nbsp;Kentaro Ide,&nbsp;Tsuyoshi Kobayashi,&nbsp;Hideki Ohdan","doi":"10.1016/j.trim.2025.102225","DOIUrl":"10.1016/j.trim.2025.102225","url":null,"abstract":"<div><div>We investigated the effect of single-nucleotide polymorphisms (SNPs) in the high mobility group box 1 (HMGB1) gene on morbidity and mortality after liver transplantation (LT). Among 120 LT recipients and their living donors, the genotypes of <em>HMGB1</em>, and the SNPs rs2249825, rs1045411, rs1412125, and rs1360485 were determined. There were no significant associations between these four SNPs and the incidence of rejection or mortality. However, the incidence of early allograft dysfunction (EAD) (<em>n</em> = 43), which presents as functional insufficiency within 1 week of LT, was significantly higher in recipients with the GC + CC allele of rs2249825 (<em>n</em> = 17/34) than in those with the GG allele (<em>n</em> = 26/86) (<em>p = 0.044</em>). Although the impact of donor <em>HMGB1</em> SNPs on the incidence of EAD was not statistically significant, recipients with the GC + CC allele of rs2249825 who received liver grafts from donors with the same genotype had the highest incidence of EAD (<em>p = 0.052</em>). In contrast, the donor TC + CC allele of rs1412125 was an independent risk factor for the development of sepsis (<em>n</em> = 33) in LT recipient (OR = 3.05, 95 % CI = 1.18–7.87, <em>p = 0.021</em>). Thus, the SNPs of the <em>HMGB1</em> gene in either recipients or donors were not associated with mortality but influenced the incidence of EAD and sepsis, likely being a predictive biomarker for the risk of serious complications after LT.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102225"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744045","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":"Transcriptomics-based identification of biomarkers associated with mast cell activation during ischemia-reperfusion injury in kidney transplantation","authors":"Xingyu Pan ,&nbsp;Jin Luo ,&nbsp;Rong Zhu ,&nbsp;Jinpu Peng ,&nbsp;Yuhan Jin ,&nbsp;Li Zhang ,&nbsp;Jun Pei","doi":"10.1016/j.trim.2025.102224","DOIUrl":"10.1016/j.trim.2025.102224","url":null,"abstract":"<div><h3>Background</h3><div>Ischemia-reperfusion injury (IRI) in kidney transplantation can delay graft function recovery and increase the risk of rejection. Mast cell activation releases various bioactive mediators that exacerbate renal IRI. Assessing mast cell activation may be crucial for managing IRI after kidney transplantation.</div></div><div><h3>Methods</h3><div>We analyzed the dataset GSE43974 from the Gene Expression Omnibus (GEO) to evaluate immune cell infiltration during the IRI phase of kidney transplantation using the CIBERSORT algorithm. Weighted gene co-expression network analysis (WGCNA) was performed to identify genes most strongly correlated with mast cell activation. Hub genes were identified using protein-protein interaction (PPI) network analysis and machine learning algorithms. Model accuracy for identifying hub genes was assessed using receiver operating characteristic (ROC) curve calibration. Clinical utility was evaluated through decision curve analysis (DCA). Correlation analysis was conducted to explore associations between the selected hub genes and immune cell infiltration. Additionally, a hub gene–miRNA regulatory network was constructed.</div></div><div><h3>Results</h3><div>Mast cell activation exhibited the most significant variation among graft-infiltrating immune cells during IRI. WGCNA identified 115 genes closely associated with mast cell activation, from which three hub genes—JUN, MYC, and ALDH2—were selected using a PPI network and machine learning approach. A diagnostic model based on these three genes demonstrated high accuracy, as validated by the Hosmer-Lemeshow test (<em>P</em> = 0.980) and an area under the ROC curve (AUC) of 1. DCA indicated that these hub genes had strong clinical decision-making relevance, while correlation analysis confirmed their associations with multiple immune cell types. Finally, a hub gene–miRNA network provided a theoretical framework for the regulatory mechanisms of the three genes.</div></div><div><h3>Conclusion</h3><div>JUN, MYC, and ALDH2 may serve as biomarkers of mast cell activation during IRI in kidney transplantation. Further studies are warranted to explore their potential in mitigating IRI.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102224"},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704960","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":"Predictive modeling for organ transplant rejection: The promising role of artificial intelligence and machine learning.","authors":"Tarun Kumar Suvvari","doi":"10.1016/j.trim.2025.102223","DOIUrl":"10.1016/j.trim.2025.102223","url":null,"abstract":"","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102223"},"PeriodicalIF":1.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711418","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":"Forty years of kidney transplantation: Insights into malignancies at a single center in Latin America","authors":"Pilar Musalem ,&nbsp;Carolina Sáez-Vera","doi":"10.1016/j.trim.2025.102216","DOIUrl":"10.1016/j.trim.2025.102216","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplantation is the optimal therapy for end-stage kidney disease (ESKD), but lifelong immunosuppression increases malignancy risk, a major cause of mortality in transplant recipients. This study evaluates post-transplant malignancies in a kidney transplant cohort.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 375 kidney transplant recipients at Hospital Las Higueras, Talcahuano (January 1981–July 2024). Demographics, clinical characteristics, and malignancy data were extracted from medical records.</div></div><div><h3>Results</h3><div>Of 375 patients, 33 (8.8 %) developed malignancies, with 27 % experiencing multiple cancers. While the mean age at transplantation was 51.5 years, the mean age of those developing a malignancy was 60.4 years. Non-melanoma skin cancers were most common (55.1 %), followed by solid organ cancers (26.5 %), chronic kidney disease (CKD)-related cancers (8.2 %), and hematologic malignancies (8.2 %). The mean time to malignancy onset was 106 months post-transplant. Cancer-related mortality was 30 %.</div></div><div><h3>Conclusion</h3><div>The high incidence of malignancies, particularly skin cancers, highlights the need for regular clinical and dermatologic surveillance in transplant recipients. Optimizing immunosuppression to balance rejection prevention and cancer risk, along with comprehensive cancer screening, is essential for improving long-term outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102216"},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693416","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}