Transplant immunology最新文献

{"title":"Successful use of belumosudil in a patient with chronic ocular GVHD: A case report","authors":"Xiaoli Lv ,&nbsp;Huibo Li ,&nbsp;Zhijian Li ,&nbsp;Di Jin ,&nbsp;Fei Leng ,&nbsp;Jie Liu ,&nbsp;Dan Guo ,&nbsp;Shengjin Fan ,&nbsp;Sheng Su","doi":"10.1016/j.trim.2025.102271","DOIUrl":"10.1016/j.trim.2025.102271","url":null,"abstract":"<div><h3>Background</h3><div>Belumosudil is a selective ROCK2 inhibitor approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients who have failed at least two prior systemic therapies. By inhibiting ROCK2, Belumosudil can down-regulate the secretion of IL-21 and IL-17, and up-regulate regulatory T cells (Tregs), which serve to attenuate the inflammatory response. In addition, it can act as an antifibrotic by inhibiting the Rho-ROCK-MRTF pathway, as well as down-regulating the expression of pro-fibrotic genes and TGF-β signaling. Selective inhibition of ROCK2 also reduces M2-like macrophages and choroidal neovascularization, which further exerts antifibrotic effects. Therefore, belumosudil shows great potential in the treatment of chronic Graft-Versus-Host-Disease (cGVHD).</div></div><div><h3>Case presentation</h3><div>We report the clinical course of a 39-year-old man with severe progressive chronic ocular GVHD (oGVHD), who showed significant improvement in ocular surface damage, including damage to the cornea and meibomian glands, as well as dry eye symptoms, after oral administration of belumosudil. Corneal leukoplakia and neovascularization were significantly reduced after treatment. Moreover, the patient's ocular surface symptoms remained stable without deterioration after cataract surgery. The patient's quality of life was significantly enhanced.</div></div><div><h3>Conclusion</h3><div>We report the clinical outcomes of a patient with chronic oGVHD treated with belumosudil. The patient's clinical symptoms significantly improved, especially inflammation of the meibomian gland, corneal leukoplakia, and neovascularization. This highlights its application value in patients with cGVHD and provides a promising treatment option for patients with oGVHD.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"92 ","pages":"Article 102271"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761452","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":"Serum PD-L1 and CTLA-4 levels as biomarkers of acute rejection and renal dysfunction in kidney transplant recipients","authors":"Angelica Canossi ,&nbsp;Fabio Vistoli ,&nbsp;Pierluigi Sebastiani ,&nbsp;Alessia Colanardi ,&nbsp;Tiziana Del Beato ,&nbsp;Alessandra Panarese","doi":"10.1016/j.trim.2025.102250","DOIUrl":"10.1016/j.trim.2025.102250","url":null,"abstract":"<div><h3>Purpose</h3><div>Acute rejection in kidney transplantation is a critical barrier to long-term graft survival and the PD-1/PD-L1 and CTLA-4 molecules are crucial for the tolerance of alloreactive T cells against tubular epithelial cells. Our study aims to assess the role of these soluble PD-L1 and CTLA-4 molecules as biomarkers for <em>non-invasive</em> immunosurveillance after renal transplantation.</div></div><div><h3>Methods</h3><div>Blood samples from 65 recipients were investigated for serum sPD-L1 and sCTLA-4 molecules at the time of kidney transplantation (baseline), in 3 time-points (15, 60 and 365 days) post-transplant, and when acute rejection (ACR) was suspected. Samples and standards were processed in duplicate using sandwich ELISA.</div></div><div><h3>Results</h3><div>We revealed dynamic changes in serum expression over time, with a significant decrease from the time of kidney transplantation to the various monitoring points, except at the time of acute rejection when the levels increased. Multivariable logistic regression revealed that the sPD-L1 15-day post-transplant is an independent variable for ACR onset (AOR = 1.196 <em>p</em> = 0.020), and with a moderate discriminatory power (AUC = 0.717, <em>p</em> = 0.031), together with PD-L1 60 days, for the occurrence of rejection within 1 year from transplant. sPD-L1 after 15 days shows a predictive role also for DGF (AUC = 0.738, <em>p</em> = 0.001) and graft dysfunction at 60 days (AUC = 0.672, <em>p</em> = 0.022). Furthermore, a higher 15-day expression of sCTLA-4 in patients with ACR compared with those with stable graft (114.8 pg/mL vs. 67.8 pg/mL, <em>p</em> = 0.018) was reported.</div></div><div><h3>Conclusion</h3><div>These analyses suggest the potential role of these serum molecules as dynamic biomarkers of inflammation and immunoregulation in AKI and acute rejection; they may indicate new immunotherapy targets, useful for modulating tolerance and assist the clinician in identifying patients at risk of rejection or kidney failure.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"92 ","pages":"Article 102250"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240887","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 treatment of very severe aplastic anemia with double unrelated umbilical cord blood transplantation in a donor-specific antigen positive adult patient: A case report and review","authors":"Meng Lu ,&nbsp;Jia-yan Leng ,&nbsp;Chen-yun Xu ,&nbsp;Chao-ran Lv ,&nbsp;Zhen Qian ,&nbsp;Yan Zhou ,&nbsp;Di Yu ,&nbsp;Jun Qian","doi":"10.1016/j.trim.2025.102241","DOIUrl":"10.1016/j.trim.2025.102241","url":null,"abstract":"<div><div>To overcome the cell-dose barrier of cord blood, double unrelated umbilical cord blood transplantation (UCBT) has become increasingly common in adults with severe aplastic anemia (SAA). Pre-existing donor-specific anti-HLA antibodies (DSAs) represent a risk factor for graft failure (GF). Desensitization therapy should be conducted to reduce circulating DSA levels, thereby decreasing the risk of GF. This report details a case of a female patient with acquired SAA and pre-transplantation anti-HLA antibodies. Desensitization with rituximab, intravenous immunoglobulin (IVIG), and plasma exchange (PE) was performed before transplantation with a conditioning regimen of fludarabine (30 mg/m² for six days) and cyclophosphamide (50 mg/kg/d for four days). DSA titers were significantly reduced; the patient was successfully treated with double unrelated UCBT. Currently, complete remission (CR) status has been maintained for over a year after UCBT, with no signs of graft-vs-host disease. Our findings support the use of double-unit unrelated UCBT in adult patients with SAA when cell doses of single-unit UCB are inadequate. Monitoring and reducing DSA levels before and after UCBT is an efficient way to reduce the risk of GF.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"91 ","pages":"Article 102241"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080299","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":"Rapamycin-modified CD169low/-tolDC promotes skin graft survival in mice via IL-10+Breg","authors":"Xi Lu ,&nbsp;Yu-di Han ,&nbsp;Xiao-ran Zu ,&nbsp;Jin-can Huang ,&nbsp;Li Li ,&nbsp;Meng Wang ,&nbsp;Yu-Ting Wang ,&nbsp;Ling-li Guo ,&nbsp;Lin Zhou ,&nbsp;Yan Han","doi":"10.1016/j.trim.2025.102244","DOIUrl":"10.1016/j.trim.2025.102244","url":null,"abstract":"<div><div>Skin allografts are prone to rejection because of their high immunogenicity. By achieving immune tolerance, the long-term survival of skin allografts can be extended without the need for immunosuppressants or with only short-term low-dose dependency. Tolerogenic dendritic cells (tolDCs) show a strong potential for graft tolerance. We explored the mechanism whereby rapamycin-modified CD169low/-tolDCs regulate interleukin-10 (IL-10) B regulatory (IL-10+ Breg) cell production and mediate the long-term survival of skin allografts in mice. CD169low/-tolDCs were obtained through flow cytometry sorting after treating the mesenchymal stem cell (MSC)-derived dendritic cells with a low dose of GM-CSF. A treatment regimen combining preoperative stimulation and postoperative adoptive infusion of CD169low/-tolDCs was used to treat an acute rejection (AR) mouse skin transplantation model—the adoptive infusion group. An equivalent dose of saline was administered to the control group. Survival and graft rejection rates were assessed. Mixed lymphocyte culture, flow cytometry, immunohistochemistry (IHC), and western blotting (WB) were used to elucidate the expression of different IL-10+ Breg subsets in mice treated with adoptive infusion therapy and the molecular mechanisms whereby CD169low/-tolDCs induce IL-10+ Breg production to mediate tolerance. Adoptive infusion of CD169low/−tol DCs markedly prolonged the rejection time after skin transplantation in mice and promoted graft survival. A significant increase was observed in local blood flow signals in the transplanted skin, along with mild local inflammation. Flow cytometric analysis revealed a positive correlation between high expression of IL-10+ Breg and the changes in Foxp3+ Tregs in vivo, primarily enriched in the CD19 + CD24 + CD27+ mBreg and CD19 + CD23 + CD27-CD24+ Breg subsets, with higher levels of IgM expression. Significant differences were observed compared with control mice. CD79b/NF-κB pathway was found to be involved in Breg production. CD24, CD23, CD79, BTK, NF-κB p50/p65, CD40, and IKKα levels in the adoptive infusion group were significantly increased compared with those in the control group. Adoptive infusion of CD169low/-MSCs/tolDCs may activate the NF-κB pathway through CD79/BTK-dependent and CD40/IKKα-independent pathways, inducing high expression of IL-10 + Breg and promoting graft survival of mouse skin transplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"91 ","pages":"Article 102244"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143617","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 impact of ABO compatibility/incompatibility between donor and recipient of allogeneic bone marrow transplant on transplant outcomes","authors":"Ehsan Yazdandoust ,&nbsp;Abbas Hajifathali ,&nbsp;Amir Teimourpour ,&nbsp;Sedigheh Amini-Kafiabad ,&nbsp;Elham Roshandel","doi":"10.1016/j.trim.2025.102231","DOIUrl":"10.1016/j.trim.2025.102231","url":null,"abstract":"<div><h3>Background</h3><div>ABO blood group mismatch between donor and recipients is not considered as a major contraindication to allogeneic hematopoietic stem cell transplantation (allo-HSCT). Nevertheless, there is still conflicting reports on the impact of ABO incompatibility on allo-HSCT outcomes, including the risk of graft-versus-host disease (GVHD), relapse of underlying disease, and patient survivals.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study in 157 patients who underwent HSCT from October 1st 2019, to September 30th 2023, to determine the effect of ABO compatibility on allo-HSCT outcomes, as evaluating for pure red cell aplasia, engraftment time/status, chronic/acute allo-GVHD, and non-relapse mortality.</div></div><div><h3>Results</h3><div>Overall, 50.3 % of HSCT patients were ABO incompatible and 49.7 % of allo-HSCT patients were ABO compatible. Our findings suggest that the risk of pure red cell aplasia was significantly higher in cases with the major and bidirectional ABO incompatibility (<em>P</em> &lt; 0.001) with odds ratio (OR): 19.8 [95 % confidence interval (CI): 2.3–2578.9; P &lt; 0.001), and anti-A isohemagglutinin against donor red blood cells (RBCs) in the recipient serum is an important risk factor for this complication. Our results do not show any significant relationship between ABO incompatibility/compatibility on engraftment time and graft failure. The ABO incompatibility increased RBC transfusion burden but did not affect platelet consumption, the incidence and severity of acute and chronic GVHD, patient survivals and non-relapse mortality.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that allo-HSCT with bidirectional ABO incompatibility with anti-A isohemagglutinins are associated with the occurrence of pure erythroid aplasia. However, ABO incompatibility did not affect the risk for acute and chronic GVHD, survival of patients, and all-HSCT engraftment status.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"91 ","pages":"Article 102231"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927462","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 use of cemiplimab in a high immunologic risk kidney transplant recipient with metastatic squamous cell carcinoma","authors":"Elena-Bianca Barbir ,&nbsp;Abdullah Jalal ,&nbsp;Joseph Grande ,&nbsp;Svetomir N. Markovic ,&nbsp;Aleksandra Kukla ,&nbsp;Itunu Owoyemi","doi":"10.1016/j.trim.2025.102242","DOIUrl":"10.1016/j.trim.2025.102242","url":null,"abstract":"<div><div>The widespread use of immunotherapy in the management of cancers has led to improved overall survival and progression free survival. Due to increased risk of allograft rejection, organ transplant recipients are often excluded in clinical trials or offered immunotherapy only as salvage therapy. We report a case of successful use of Cemiplimab, an immune checkpoint inhibitor, in a high immunologic risk kidney transplant recipient who was diagnosed with metastatic squamous cell carcinoma (SCC) twenty-five months post-transplant. He started Cemiplimab five months post diagnosis of SCC, as third line therapy, after demonstrating progression of metastatic skull-based disease on prior lines of therapy. His maintenance immunosuppression was changed from triple immunosuppression with tacrolimus, mycophenolate and prednisone to sirolimus with a high trough target of 10–15 ng/mL and steroid therapy. He tolerated the high sirolimus trough and continued on Cemiplimab for six months with clinically stable allograft function and a good quality of life. Notably, he demonstrated response of his previously chemotherapy refractory metastatic disease. He passed away from radiation necrosis of the brain at sixty-eight months post-transplant.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"91 ","pages":"Article 102242"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143624","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":"Survey of prevalence of BKV and JCV infections in pediatric heart transplant recipients","authors":"Fatemeh Gabeleh ,&nbsp;Mohammad Mahdavi ,&nbsp;Mohammad Hadi Karbalaie Niya ,&nbsp;Mehri Amiri ,&nbsp;Mehrdad Ravanshad","doi":"10.1016/j.trim.2025.102243","DOIUrl":"10.1016/j.trim.2025.102243","url":null,"abstract":"<div><h3>Background</h3><div>The Administration of anti-rejection medications in solid organ recipients may increase the risk of acquiring multiple infections. This study aimed to diagnose and monitor BKV and JCV viral infections in pediatric heart transplant recipients.</div></div><div><h3>Methods</h3><div>A cohort of 28 children, all under 18 years old, undergoing heart transplants was studied. Plasma and urine samples were collected, followed by DNA extraction and molecular testing to quantify viral loads. Demographic and clinical information were recorded and analyzed.</div></div><div><h3>Results</h3><div>The BK and JC viruria frequency among the cohort was 41.7 % and 12.5 %, respectively. No instances of BKV and JCV viremia were detected. The BKV DNA viral loads ranged from 3.1 × 10² to 11.8 × 10⁶ copies/mL, while the JC viruria viral load ranged from 1.1 × 10² to 13.6 × 10⁶ copies/mL. BKV-JCV co-infection was identified in 12.5 % of patients.</div></div><div><h3>Conclusions</h3><div>Considering a high prevalence of BKV viruria in the recruited patients, clinicians should be well acquainted with the steps involved in the diagnosis and management of polyomaviral infections.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"91 ","pages":"Article 102243"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120941","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":"Plasma-circulating miR-638, miR-6511b-5p, miR-3613-5p, miR-455-3p, miR-5787, and miR-548a-3p as noninvasive biomarkers of immune reconstitution post-allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia patients","authors":"Marzieh Izadifard ,&nbsp;Mohammad Ahmadvand ,&nbsp;Bahram Chahardouli ,&nbsp;Mohammad Vaezi ,&nbsp;Ghasem Janbabai ,&nbsp;Ghazal Seghatoleslami ,&nbsp;Mehran Bahrami ,&nbsp;Marjan Yaghmaie ,&nbsp;Maryam Barkhordar","doi":"10.1016/j.trim.2025.102240","DOIUrl":"10.1016/j.trim.2025.102240","url":null,"abstract":"<div><h3>Introduction</h3><div>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a viable treatment option for acute myeloid leukemia (AML), though it carries risks including delayed immune reconstitution and hematopoietic reconstitution failure. This study aimed to explore the potential of circulating miRNA levels as biomarkers for post-transplant immune reconstitution.</div></div><div><h3>Methods</h3><div>This observational study was carried out on de novo non-M3 AML patients receiving allo-HSCT from HLA-matched sibling donors at Shariati Hospital, Iran in 2020–2023. Accordingly, the immunophenotype of NK cells, T cells, and B cells was determined by ten-color multiparameter flow cytometry on blood samples collected pre-transplantation and at day +30 post-transplantation. Concurrently, plasma levels of miR-638, miR-6511b-5p, miR-3613-5p, miR-455-3p, miR-5787, and miR-548a-3p were quantified using quantitative reverse transcription–polymerase chain reaction (RT qPCR).</div></div><div><h3>Results</h3><div>The expression of miR-638, miR-3613-5p, miR-455-3p, and miR-548a-3p positively correlated with CD4⁺ T cells, CD4⁺/CD8⁺ T cell ratio, CD3⁻/16⁺/56⁻ cells, and platelet count. Elevated miR-455-3p and miR-3613-5p expressions were associated with higher CD3⁻/16⁺/56⁻ cells (<em>P</em> = 0.0475 and <em>P</em> = 0.0325, respectively). Similarly, miR-638 upregulation correlated with increases in CD4⁺ T cells (<em>P</em> = 0.0112) and the CD4⁺/CD8⁺ T cell ratio (<em>P</em> = 0.006), while miR-548a-3p upregulation was associated with increases in the CD4⁺/CD8⁺ T cell ratio (<em>P</em> = 0.0353) and platelet count (<em>P</em> = 0.0191). Conversely, miR-3613-5p and miR-6511b-5p had considerable negative correlations with CD8⁺ T cells (P = 0.03 and <em>P</em> = 0.0246, respectively), whereas miR-5787 negatively correlated with CD3⁺/16⁻/56⁺ cells (<em>P</em> = 0.025).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that differentiation of cell subpopulations is regulated by specific miRNAs. Furthermore, miRNA-based strategies may be developed for immunotherapeutic treatments of AML.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"91 ","pages":"Article 102240"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033467","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":"Pre-transplant and transplant parameters predict long-term survival after hematopoietic cell transplantation using machine learning","authors":"Panagiotis G. Asteris ,&nbsp;Amir H. Gandomi ,&nbsp;Danial J. Armaghani ,&nbsp;Ahmed Salih Mohammed ,&nbsp;Zoi Bousiou ,&nbsp;Ioannis Batsis ,&nbsp;Nikolaos Spyridis ,&nbsp;Georgios Karavalakis ,&nbsp;Anna Vardi ,&nbsp;Leonidas Triantafyllidis ,&nbsp;Evangelos I. Koutras ,&nbsp;Nikos Zygouris ,&nbsp;Georgios A. Drosopoulos ,&nbsp;Nikolaos A. Fountas ,&nbsp;Nikolaos M. Vaxevanidis ,&nbsp;Abidhan Bardhan ,&nbsp;Pijush Samui ,&nbsp;George D. Hatzigeorgiou ,&nbsp;Jian Zhou ,&nbsp;Konstantina V. Leontari ,&nbsp;Eleni Gavriilaki","doi":"10.1016/j.trim.2025.102211","DOIUrl":"10.1016/j.trim.2025.102211","url":null,"abstract":"<div><h3>Background</h3><div>Allogeneic hematopoietic stem transplantation (allo-HSCT) constitutes a curative treatment for various hematological malignancies. However, various complications limit the therapeutic efficacy of this approach, increasing the morbidity and decreasing the overall survival of allo-HSCT recipients. In everyday clinical practice, various laboratory and clinical biomarkers and scorning systems have been developed and implemented focusing on the recognition of high-risk patients for organ dysfunction-related complications and those who might experience low overall survival. However, the predictive accuracy of developed scores has been reported deficient in some studies. The aim of the current retrospective study is to develop a machine learning (ML) model to predict the long-term survivorship of patients who receive allo-HSCT based on clinical pre- and post-allo-HSCT variables, and on transplantation-related characteristics.</div></div><div><h3>Methods</h3><div>For this purpose, a database of 564 allo-HSCT recipients incorporating 16 clinical and laboratory variables and the survivorship status of the patients during follow-up (Alive, Dead, Alive but follow-up less than 24 months) was used. An ML model was developed and tested, based on the previously published Data Ensemble Refinement Greedy Algorithm (DEGRA) algorithm.</div></div><div><h3>Results</h3><div>A predictive ML model was built with 92.02 % accuracy. The eight parameters included in the algorithm were the following: CD34+ cells infused, patients' age and gender, conditioning regimen toxicity, disease risk index (DRI), graft source, and platelet and neutrophil engraftment.</div></div><div><h3>Conclusion</h3><div>To our knowledge, this is the first AI model incorporating post-HSCT variables for the prediction of mortality in adult HSCT recipients. In the era of precision medicine, the recognition of patients who undergo allo-HSCT and face a great risk for mortality and morbidity, with high-accuracy algorithms is crucial.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102211"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lectin affinity plasmapheresis device removes extracellular vesicles and microRNAs from renal perfusates following controlled oxygenated rewarming of discarded donor kidneys","authors":"Rosalia de Necochea Campion,&nbsp;Miguel Pesqueira,&nbsp;Paul Vallejos,&nbsp;Cameron McCullough,&nbsp;Alessio Bloesch,&nbsp;Steven P. LaRosa","doi":"10.1016/j.trim.2025.102215","DOIUrl":"10.1016/j.trim.2025.102215","url":null,"abstract":"<div><div>Kidney transplantation is considered the benchmark treatment for end-stage kidney disease patients, yet the scarcity of suitable kidneys poses a significant hindrance for patients and healthcare providers. One approach is to extend the criteria for the use of kidneys from deceased brain death and deceased circulatory death donors. Use of these organs, especially from these extended criteria donors, is associated with ischemia reperfusion injury and resultant delayed graft function as well as increased rates of allograft rejection. To lessen these complications as well as increase the time of organ viability assessment, machine perfusion has been evaluated on recovered kidneys. In this study we examined the immunogenic molecular content of perfusates from discarded organs that had undergone Controlled Oxygenated Rewarming (COR). Perfusates were analyzed for extracellular vesicles (EVs), DNA (Deoxyribonucleic acid), and microRNAs. These perfusates were then pumped over a plasma separator containing a lectin affinity resin. Following treatment, a significant diminution in extracellular vesicles, dsDNA (double-stranded DNA) associated with EVs, and microRNAs (miRNA) were observed. Specifically, in three out of the four renal perfusates analyzed there was significant removal of small EVs (&lt;200 nm) and vesicles loaded with dsDNA (<em>p</em> &lt; 0.05). Notably, depletion of larger EVs (100-500 nm) was found to be significant in all treated perfusates (<em>p</em> &lt; 0.01). NanoString analysis of miRNA found 5 species potentially involved in renal dysfunction (hsa-let 7a-5p, hsa-miR-148b-3p, hsa-miR-148a-3p, hsa-miR-29b-3pb and hsa-miR-99a5p) to be significantly depleted in treated renal perfusates (<em>p</em> ≤ 0.05). These results support a future study incorporating this treatment method into a dynamic machine perfusion circuit to explore if reduction of these mediators is associated with improved function of retrieved kidneys.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102215"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537623","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}