Transplant immunology最新文献

{"title":"CXCL11 as potential predictive biomarker and therapeutic target of acute rejection after kidney transplantation.","authors":"Jie Zhang, Chengjun Yu, Huyu Wang, Hanyu Xiao, Sheng Wen, Yi Hua, Guanghui Wei","doi":"10.1016/j.trim.2025.102306","DOIUrl":"https://doi.org/10.1016/j.trim.2025.102306","url":null,"abstract":"<p><p>Kidney transplantation is the optimal treatment method for chronic kidney disease. Although the short-term and long-term survival rates of transplanted kidneys have been significantly improved with the development of immunosuppressive agents, acute rejection remains the main risk factor threatening the survival of the allografts and patient. We utilized bioinformatics analysis to identify the predictive and therapeutic target of acute rejection after kidney transplantation. In the results, cytokines were considered as critical role in allografts acute rejection, and most cytokines were increased in the process of AR. According to the machine learning algorithm analysis and receiver operating characteristic curve results, CXCL11 was identified as the most valued cytokine in prediction of AR. Single-gene GSEA results showed CXCL11 was strongly associated with AR-related biological behavior. Subsequent analysis results showed the gene RELA regulate the expression of CXCL11 and mainly distribute in renal tubular epithelial cells. In cell experiments, LPS as the activator of NF-κB signaling pathway induced the expression of CXCL11. In animal experiments, compared to syn group, severe acute rejection occurs in allo group, and companied with severe inflammatory reaction and the expression of CXCL11, as the activation of NF-κB signaling pathway. CXCR3 specifically recognizes CXCL11 as one of its ligands, single cell analysis demonstrated CXCR3 and CD8 were co-expression on the T cells in the microenvironment of allografts. Finally, we demonstrated in allo group of rat kidney transplantation, there were a large number of CXCR3 + CD8+ T cells infiltrated the allografts. Conclusion, we utilized bioinformatics analysis tools, finally identified CXCL11 as the potential target for prediction and treatment in acute rejection after kidney transplantation.</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102306"},"PeriodicalIF":1.4,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245179","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":"Diagnostic value of dd-cfDNA and CXCL-10 in kidney allograft recipients for identifying acute rejection.","authors":"Qi Yu, Yan Zhang, Zijian Gao, Boqian Wang, Hongwei Yang, Long He","doi":"10.1016/j.trim.2025.102307","DOIUrl":"https://doi.org/10.1016/j.trim.2025.102307","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Acute rejection (AR) remains a major challenge in kidney transplantation. Current methods used to diagnose acute rejection are either invasive or not sufficiently sensitive. Thus, in this study, we aimed to develop a novel and sensitive diagnostic tool for predicting acute rejection after kidney transplantation. We investigated if donor-derived cell-free DNA (dd-cfDNA) in the serum and C-X-C motif chemokine 10 (CXCL-10) levels were closely related to the occurrence of AR after renal transplantation.</p><p><strong>Methods: </strong>We collected data and tested the serum levels of dd-cfDNA and CXCL-10 in AR patients and patients who underwent kidney transplantation during the same period. Logistic analysis was used to verify risk factors associated with AR. The analysis of the receiver operating characteristic curve(ROC) was used to reveal correlation between dd-cfDNA，CXCL-10 levels and AR patients.</p><p><strong>Results: </strong>We included 13 AR patients and 18 patients without acute rejection. The AR group had a lower BMI (P = 0.006), and higher levels of eGFR (P = 0.006) and CysC (P = 0.009). Additionally, ln dd-cfDNA percentage and ln CXCL-10 content were higher in the AR group compared to the control group (P = 0.007, P = 0.004).The results of logistic analysis suggested CysC(OR:2.562[95 % CI:1.377-4.766]，P = 0.003),ln dd-cfDNA percent (OR: 10.521 [95 % CI: 2.091-52.938]，P = 0.004), and ln CXCL-10 content(OR:49.052 [95 % CI: 1.730-1391.073]，P = 0.023) can indicate the risk of AR and were independently correlated with the occurrence of acute rejection of the kidney graft. The AUC of serum dd-cfDNA (AUC = 0.723, P = 0.0348) percent and CXCL-10 content (AUC = 0.814, P = 0.0029) showed significant diagnostic performance. The combined dd-cfDNA and CXCL-10 diagnosis showed higher AUC and specificity.</p><p><strong>Conclusions: </strong>Serum dd-cfDNA and CXCL-10 levels were significantly elevated in patients with acute rejection. Thus, dd-cfDNA and CXCL-10 can play suggestive roles in detecting graft injury after kidney transplantation.</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102307"},"PeriodicalIF":1.4,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245201","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":"High torque Teno virus load is associated with increased all-cause mortality risk in liver transplant recipients: a multicenter cohort study.","authors":"Delal Akdag, Andreas A Rostved, Nikolai Kirkby, Allan Rasmussen, Ulrik Lassen, Claus L Andersen, Bo-Göran Ericzon, Carl Jorns, Helena Zhao, William Bennet, Fredrik Åberg, Arno Nordin, Jens G Hillingsø, Susanne D Nielsen, Hans-Christian Pommergaard","doi":"10.1016/j.trim.2025.102309","DOIUrl":"https://doi.org/10.1016/j.trim.2025.102309","url":null,"abstract":"<p><p>Liver transplant recipients have twice the cancer risk than the general population, and de novo cancer is a leading cause of mortality after transplantation. Torque Teno Virus (TTV) is a potential marker of immune function. However, its association with long-term outcomes such as all-cause mortality and de novo cancer remains unexplored. In this Scandinavian multicenter cohort biobank study, plasma samples collected one year after transplantation were analyzed for TTV load to investigate its association with (1) all-cause mortality, (2) any de novo cancer, (3) de novo cancer excluding non-melanoma skin cancer (NMSC), and (4) NMSC using Cox regression analyses. Survival curves were plotted using Kaplan-Meier analysis. We analyzed the data of 625 liver transplant recipients. During a median follow-up of four years, 83 (13 %) recipients developed cancer (105 cancers). Of these, 39 were de novo cancers, excluding NMSC, and 66 were NMSCs. Overall, 47 recipients (8 %) died (all-cause mortality). Recipients with a high versus a low TTV load had an increased risk of all-cause mortality in the adjusted model (aHR, 5.31 [95 %CI 1.05-26.83]). The 5-year survival rates were 81 % and 100 % in the high- and low-TTV groups, respectively (p = 0.004). TTV load was not significantly associated with any de novo cancer or de novo cancer, excluding NMSC and NMSC. A high TTV load was associated with an increased risk of all-cause mortality in liver transplant recipients. With further validation, the TTV load can potentially serve as a risk stratification tool.</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102309"},"PeriodicalIF":1.4,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245222","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":"Pretreatment hemoglobin, myeloma subtype, and induction regimens as independent prognostic factors for survival after autologous stem cell transplantation in multiple myeloma: A retrospective cohort study.","authors":"Yong Zhang, Guangzhong Yang, Wen Gao, Wenming Chen","doi":"10.1016/j.trim.2025.102305","DOIUrl":"https://doi.org/10.1016/j.trim.2025.102305","url":null,"abstract":"<p><strong>Background: </strong>Autologous hematopoietic stem cell transplantation (auto-HSCT) is a standard of care for eligible patients with multiple myeloma (MM). However, outcomes vary significantly. While cytogenetics and the International Staging System (ISS) are established prognostic markers, the independent predictive roles of pretreatment hemoglobin (Hb) levels, myeloma subtype, and specific induction regimens remain less defined. This study aimed to evaluate these factors to refine risk stratification and improve prognostication.</p><p><strong>Methods: </strong>We retrospectively analyzed 350 MM patients who underwent a first auto-HSCT between 2001 and 2019 at Beijing Chao-Yang Hospital. We evaluated the prognostic impact of baseline variables, including Hb level (<10 g/dL vs. ≥10 g/dL), myeloma subtype (IgG vs. non-IgG), bone marrow plasma cell infiltration, and induction regimen type (bortezomib-based vs. others), on progression-free survival (PFS) and overall survival (OS). Survival analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression models.</p><p><strong>Results: </strong>The median follow-up was 58 months. Median PFS and OS for the entire cohort were 42 months (95 % CI 36-48) and 98 months (95 % CI 83-113), respectively. Baseline Hb levels were inversely correlated with both bone marrow plasma cell infiltration (r = -0.45, P < 0.001) and serum creatinine (r = -0.38, P < 0.001). In multivariate Cox regression analysis, three factors independently predicted superior PFS: pretreatment Hb ≥10 g/dL (HR = 0.65, 95 % CI 0.47-0.91, P = 0.012), IgG myeloma subtype (HR = 0.72, 95 % CI 0.54-0.95, P = 0.018), and receipt of a bortezomib-based induction regimen (HR = 0.58, 95 % CI 0.40-0.84, P = 0.004). Patients who achieved a deep response (complete response [CR] or very good partial response [VGPR]) post-transplant had significantly longer PFS (median 55 months) compared to those with a partial response or less (median 37 months, P = 0.044).</p><p><strong>Conclusion: </strong>This study identifies pretreatment hemoglobin, IgG subtype, and bortezomib-based induction as significant and independent predictors of survival outcomes following auto-HSCT in MM patients. Our findings highlight the prognostic utility of baseline hemoglobin, a simple and universally available marker that reflects both tumor burden and renal function, which complements established risk factors like ISS stage and cytogenetics. These results support the integration of these factors into prognostic models to better tailor therapeutic strategies and manage patient expectations.</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102305"},"PeriodicalIF":1.4,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245154","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":"Association between interleukin 6, C-reactive protein, and kidney transplantation outcomes: A systematic review and meta-analysis.","authors":"Lasin Ozbek, Berk Mizrak, Zeynep Y Yilmaz, Mustafa Guldan, Derya G Fidan, Sama Mahmoud Abdel-Rahman, Mehmet Kanbay","doi":"10.1016/j.trim.2025.102308","DOIUrl":"https://doi.org/10.1016/j.trim.2025.102308","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant recipients experience heightened systemic inflammation, and biomarkers such as interleukin-6 (IL-6), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP) have been proposed as prognostic indicators.</p><p><strong>Objective: </strong>This meta-analysis evaluates the associations between IL-6, CRP, and hsCRP levels and all-cause mortality, cardiovascular events, and graft dysfunction in kidney transplant recipients.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Web of Science, Scopus, Ovid MEDLINE, and the Cochrane Library until October 11, 2024, identified eligible studies reporting associations between IL-6, CRP, or hsCRP and clinical outcomes in adult kidney transplant recipients.</p><p><strong>Results: </strong>The systematic review included 40 studies, with 18 meeting criteria for meta-analysis. Elevated IL-6 was associated with a higher risk of graft dysfunction (HR 1.53, 95 % CI 1.28-1.83; I² = 0 %) and all-cause mortality (HR 1.66, 95 % CI 1.05-2.61; I² = 97.2 %), but not cardiovascular events. CRP was associated with all-cause mortality (HR 2.07, 95 % CI 1.59-2.70; I² = 0 %) and cardiovascular events (HR 6.89, 95 % CI 2.52-18.85; I² = 0 %), but not cardiovascular mortality or graft dysfunction. Elevated hsCRP was associated with all-cause mortality (HR 1.29, 95 % CI 1.15-1.44; I² = 61 %), but not with cardiovascular events or graft dysfunction.</p><p><strong>Conclusions: </strong>Among kidney transplant recipients, elevated levels of IL-6, CRP, and hsCRP were significantly associated with increased all-cause mortality, though the association of IL-6 with all-cause mortality showed substantial heterogeneity and should be interpreted with caution. IL-6 also emerged as a predictor of graft dysfunction, while CRP demonstrated a strong association with cardiovascular events. These findings highlight the potential role of inflammatory biomarkers, particularly IL-6 and CRP, in post-transplant risk stratification; however, further studies are needed to establish causality and clarify their clinical utility.</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102308"},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239938","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":"Macrophage activation via the NTPDase1-adenosine pathway and associated injury in acute antibody-mediated rejection.","authors":"Pu Yan, Yong Zhang, Zhongbao Zhou, Yongjin Huang, Peng Xue, Xiaoyan Wang","doi":"10.1016/j.trim.2025.102302","DOIUrl":"https://doi.org/10.1016/j.trim.2025.102302","url":null,"abstract":"<p><strong>Background: </strong>Nucleoside triphosphate diphosphohydrolase 1 (NTPDase1) is a calcium- and magnesium-dependent nucleoside triphosphate diphosphohydrolase. NTPDase1, expressed in mature immune cells to hydrolyze ATP and ADP into adenosine. The NTPDase1and its function in an adenosine pathway plays an important role in suppressing inflammation, immune responses, cell proliferation, and other processes. We investigated the effects and mechanisms of macrophage activation through the NTPDase1-adenosine pathway and the resulting damage from acute antibody-mediated rejection (AMR).</p><p><strong>Methods: </strong>We established an acute AMR skin-graft model by transplanting MHC-mismatched B10.A ear skin onto BALB/c nude mice and inducing rejection with 100 μg anti-H-2Kk IgG. Mice were grouped as wild-type, NTPDase1-knockout, and NTPDase1-overexpression, with isotype-IgG controls. Outcomes were compared across groups, and statistical analyses were performed using SPSS 16.0.</p><p><strong>Results: </strong>After the onset of acute AMR, higher NTPDase1 expression in B cells and grafted skin was associated with lower concentration of extracellular ADP, a reduced proportion of CD68+ macrophages, and milder pathological injury in nude mice, and each parameter showing a negative correlation. At 30 min after AMR onset, CD68 + TNF-α + M1 macrophages predominated, whereas CD68 + CD163+ M2 macrophage numbers did not change significantly. Over time, M1 macrophages progressively decreased, and M2 macrophages became increasingly prominent. By day 7 after AMR onset, compared with controls, CD163+ M2 macrophages and the expression of TGF-β1, vimentin, and α-SMA were significantly increased, whereas the epithelial marker E-cadherin was significantly decreased.</p><p><strong>Conclusion: </strong>NTPDase1 constrains acute AMR by limiting extracellular ADP, curbing macrophage expansion, and reducing graft injury. Transgenic overexpression sustained expression, moderated M1-to-M2 dynamics, and attenuated C4d and fibrotic markers, whereas knockout intensified purinergic signaling, inflammation, and fibrosis. Findings position NTPDase1 as a protective regulator and therapeutic target in AMR.</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102302"},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239659","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 intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients: A systematic review","authors":"Maryam Hassanian ,&nbsp;Mojgan Mortazavi ,&nbsp;Firouzeh Moeinzadeh","doi":"10.1016/j.trim.2025.102288","DOIUrl":"10.1016/j.trim.2025.102288","url":null,"abstract":"<div><h3>Background</h3><div>There are limited approved therapeutic options for BK viremia management in kidney transplant patients. We performed the present study to investigate the effect of Intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients.</div></div><div><h3>Methods</h3><div>A systematic search was performed in Web of Science, Embase, PubMed, and Scopus for studies that investigated the effect of IVIG therapy on BK viremia and BKVN in kidney transplant patients. Observational studies and case series were considered eligible for inclusion in this study. Data extraction was performed by two independent investigators by a standard checklist.</div></div><div><h3>Findings</h3><div>Our results indicated that IVIG treatment in patients with BKVN was effective in BK viremia treatment and nephropathy. In addition, preemptive IVIG significantly decreased the risk of BK viremia and BKVN in high-risk patients. However, it does not seem that IVIG treatment has a beneficial impact on allograft function. Because no significant improvement in serum levels of creatinine has been reported in previous studies. In addition, the presence of interstitial fibrosis or tubular atrophy was reported in studies with histopathological examinations of renal biopsies following IVIG treatment.</div></div><div><h3>Conclusion</h3><div>IVIG therapy combined with immunosuppression reduction may be beneficial in treating BK viremia and BKVN, but its impact on graft function and survival remains uncertain. Further studies are needed to clarify its role in kidney transplant outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102288"},"PeriodicalIF":1.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102939","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":"Oral cyclosporine a nanosuspension for improved immunosuppressive efficacy: In vivo cytokine profiling in rats","authors":"Çağman Tan ,&nbsp;Sıla Gülbağ Pınar ,&nbsp;Nevin Çelebi","doi":"10.1016/j.trim.2025.102301","DOIUrl":"10.1016/j.trim.2025.102301","url":null,"abstract":"<div><h3>Background</h3><div>Cyclosporine A (CycA) is a cornerstone immunosuppressant in transplantation, but its poor solubility and variable bioavailability limit therapeutic efficacy. Nanosuspension technology offers an innovative formulation strategy to enhance oral absorption and potentially improve immunomodulatory effects.</div></div><div><h3>Methods</h3><div>Wistar rats (<em>n</em> = 4/group) received oral CycA as coarse powder, physical mixture, commercial product, or nanosuspension. Serum cytokines and chemokines (IL-4, IL-5, IL-10, IL-13, IL-17 A, Eotaxin, GRO-α, IP-10, MCP-1, MCP-3, MIP-1α, MIP-2, Rantes) were quantified on days 7, 14, and 21. Data were expressed as mean ± SD. Statistical analysis was performed using Mann–Whitney <em>U</em> test with Benjamini–Hochberg correction for multiple comparisons.</div></div><div><h3>Results</h3><div>At day 21, IL-10 levels were significantly higher in the nanosuspension group compared to control and coarse powder (adjusted <em>p</em> = 0.041), confirming nanosuspension-mediated IL-10 upregulation. IL-13 was also elevated in nanosuspension and commercial product groups versus control (p_adj = 0.048). IL-4 was significantly reduced in the nanosuspension group at both day 7 (p_adj = 0.042) and day 21 (p_adj = 0.049). IL-5 levels increased in the nanosuspension group at day 21 compared to control and coarse powder (p_adj = 0.037). No statistically significant differences were detected for IL-17 A or chemokines, although descriptive trends suggested altered profiles in the nanosuspension group.</div></div><div><h3>Conclusion</h3><div>CycA nanosuspension selectively modulates cytokine networks by elevating IL-10, fine-tuning Th2 cytokines (IL-4, IL-5, IL-13), and trending toward chemokine regulation. These findings highlight nanosuspension technology as a promising strategy to enhance CycA's immunosuppressive efficacy, with potential implications for transplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102301"},"PeriodicalIF":1.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092460","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":"Recurrent sarcoidosis in a transplanted kidney: A case report and literature review","authors":"Abd Assalam Qannus ,&nbsp;H. Tahsin Özpolat ,&nbsp;Dory Salazar ,&nbsp;Erica Bracamonte ,&nbsp;Bekir Tanriover ,&nbsp;Venkatesh Ariyamathu","doi":"10.1016/j.trim.2025.102300","DOIUrl":"10.1016/j.trim.2025.102300","url":null,"abstract":"<div><div>Sarcoidosis is a multisystem inflammatory disorder that primarily affects the lungs. However, extra-pulmonary involvement, including the kidneys and heart, is also observed. Kidney involvement may manifest as hypercalcemia or as acute or chronic kidney injury, which could progress to end-stage kidney disease. Patients with sarcoidosis have been reported to successfully undergo kidney transplants, although some have experienced recurrence of sarcoidosis after the transplant, affecting both the kidneys and other organs. Here, we present a case of a patient who underwent a kidney transplant followed by the recurrence of sarcoidosis, which manifested as hypercalcemia five months after the transplant.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102300"},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087666","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":"De novo donor specific antibody (dnDSA) development with tacrolimus versus Belatacept based regimens in kidney transplant recipients","authors":"Cayla Kass ,&nbsp;Goni Katz-Greenberg ,&nbsp;Jason Bodner ,&nbsp;Scott Sanoff ,&nbsp;Alice Parish ,&nbsp;Alaattin Erkanli ,&nbsp;Jennifer Byrns","doi":"10.1016/j.trim.2025.102297","DOIUrl":"10.1016/j.trim.2025.102297","url":null,"abstract":"<div><h3>Purpose</h3><div>Belatacept has been associated with less de novo specific antibody (dnDSA) development, but few publications have compared the incidence of dnDSA development between tacrolimus and belatacept-based immunosuppression regimens. The purpose of this study was to investigate the differences in dnDSA development and clinical outcomes between these two maintenance regimens in kidney transplant.</div></div><div><h3>Methods</h3><div>This was a retrospective, single center, cohort study of patients transplanted between 2013 and 2019 who received a de novo belatacept or tacrolimus-based immunosuppression regimen. The primary outcome was the incidence of dnDSA development (MFI ≥ 1000) at 36 months. Secondary outcomes included renal function, biopsy proven rejection (BPAR), and patient/graft survival.</div></div><div><h3>Results</h3><div>Ninety patients met inclusion criteria. The primary outcome occurred in 4 (8.9 %) belatacept patients and 6 (13.3 %) tacrolimus patients, with an overall median time to dnDSA of 300 days (<em>p</em> = 0.51). Class II dnDSA development occurred in 3 (6.7 %) belatacept patients and 6 (13.3 %) tacrolimus patients. Belatacept patients had a lower, but not significantly different, rate of developing BPAR (4.4 % vs 13.3 %, <em>p</em> = 0.13) and had superior renal function at 36 months (median 66 ml/min vs 53 ml/min, <em>p</em> &lt; 0.01). Overall, there was excellent patient/graft survival at 36 months post-transplant.</div></div><div><h3>Conclusion</h3><div>De novo belatacept use did not result in a statistically significant difference in the development of dnDSAs but did show a numerically lower class II dnDSA and BPAR development. Overall, belatacept was associated with improved renal function as compared to tacrolimus-based regimens.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102297"},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081726","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}