Transplant immunology最新文献

{"title":"Exposure to ischemia-related neoepitopes exacerbates secondary ischemia–reperfusion injury in mice","authors":"Min Min ,&nbsp;Jiyuan Wang ,&nbsp;Xiao Fang ,&nbsp;Yu Chen ,&nbsp;Yawei Wang","doi":"10.1016/j.trim.2026.102360","DOIUrl":"10.1016/j.trim.2026.102360","url":null,"abstract":"<div><div>Ischemia is a common clinical condition, characterized by reduced blood supply to tissues or organs owing to blockage or constriction of blood vessels. In this study, we hypothesized that the humoral immune response is activated by ischemia-related neoepitopes. Upon detection of these newly exposed or modified antigens, the immune system mounts a humoral response involving the production of specific antibodies. These antibodies may then contribute to amplification of the inflammatory cascade, ultimately exacerbating tissue damage during secondary ischemia–reperfusion (I/R) injury in mice. To test this hypothesis, we conducted a series of experiments using a well-established murine model of two sequential I/R injuries. Our findings indicated that the presence of these neoepitopes was associated with the formation of germinal center B cells and subsequent immunoglobulin isotype switching. Consequently, mice exhibited more severe tissue injury during the secondary I/R event, as demonstrated by greater histopathological damage and elevated serum enzyme levels (<em>p</em> &lt; 0.05). Furthermore, administration of tacrolimus following the first I/R injury significantly attenuated secondary injury, reducing its severity to a level comparable to that observed during the primary event (<em>p</em> &lt; 0.05). This intervention was also associated with a marked decrease in IgG and complement C4d deposition within the affected kidney (∼50% reduction). Collectively, these findings indicate the presence of neoepitopes and the humoral immune response they elicit, offering insights into the development of novel clinical interventions.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"95 ","pages":"Article 102360"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133003","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":"Temporal dynamics of cPRA levels and their categorical impact on waitlist longevity in Ecuadorian kidney transplant candidates: A 2011–2022 Nationwide cohort analysis","authors":"David Garrido ,&nbsp;Verónica Jeréz ,&nbsp;Jorge Huertas","doi":"10.1016/j.trim.2025.102329","DOIUrl":"10.1016/j.trim.2025.102329","url":null,"abstract":"<div><div>Background: Chronic kidney disease is a major public health concern for which kidney transplantation offers the best survival benefit. Patients with high calculated panel-reactive antibody (cPRA) levels often face extended waiting times owing to donor compatibility challenges.</div><div>Methods: We conducted a descriptive, cross-sectional analysis of all 724 kidney transplant candidates on Ecuador's national waiting list between 2011 and 2022, using anonymized INDOT data. cPRA values were obtained with solid-phase, bead-based luminometric assays. We applied descriptive statistics, Joinpoint regression to assess temporal trends, Spearman correlation for cPRA versus waiting time, chi-square tests for categorical comparisons, and logistic regression to estimate odds ratios (ORs) for prolonged waiting time (&gt;5 years).</div><div>Results: Overall, 166 candidates (22.9 %) had cPRA ≥20 %. Of these, 86 (51.8 %) exhibited cPRA ≥75 %. The number of sensitized patients with cPRA ≥75 % rose from one in 2011 to nineteen in 2022 (annual percent change 10.4 %). Median waiting time was 54.5 months for candidates with cPRA ≥75 % versus 51.5 months for those with cPRA 20–74 %; there was no linear correlation between cPRA and waiting time (ρ = 0.11, <em>p</em> = 0.18). However, candidates with cPRA ≥75 % were more likely to wait &gt;5 years than those below this threshold (44.2 % vs. 25.0 %; OR 2.38; <em>p</em> = 0.01), and a similar pattern was observed for candidates with cPRA ≥70 % (OR 2.98; <em>p</em> = 0.003).</div><div>Conclusion: The proportion of highly sensitized candidates has increased substantially between 2011 and 2022. Patients with cPRA levels ≥75 % were associated with prolonged waitlist time to obtain a kidney transplant. Prospective studies are warranted to explore underlying mechanisms and inform allocation strategies.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102329"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651724","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":"mRNA vaccine for human cytomegalovirus in immunocompromised hosts: An immunoinformatics approach","authors":"Muhammad Zeeshan Ahmed ,&nbsp;Sana Dilbar ,&nbsp;Syeda Masooma Zahra Bukhari ,&nbsp;Zareena Ali ,&nbsp;Binyamin Wattoo ,&nbsp;Sayra Tariq ,&nbsp;Zeeshan Mutahir ,&nbsp;Noreen Samad","doi":"10.1016/j.trim.2025.102342","DOIUrl":"10.1016/j.trim.2025.102342","url":null,"abstract":"<div><div>Human cytomegalovirus (HCMV) poses a significant threat to immunocompromised individuals, including transplant recipients, neonates, and patients with immunosuppression. Despite extensive research, no effective vaccine exists—especially one leveraging mRNA technology. This study aimed to design a safe and immunogenic multi-epitope mRNA vaccine against HCMV using a comprehensive immunoinformatics approach. Glycoprotein B (gB), a highly conserved and immunodominant antigen, was selected as the vaccine target. B-cell, MHC-I, and MHC-II epitopes were predicted based on their antigenicity, immunogenicity, non-allergenicity, and non-toxicity. Of these, three B-cell binding epitopes, 3 MHC-II, and 4 MHC-I binding epitopes of T-cells, along with a toll-like receptor (TLR) agonist and an MHC I- targeting domain (MITD), were rationally assembled to design an mRNA vaccine construct (HCMVV). This construct was evaluated for physicochemical properties, population coverage, structural stability, interactions with innate receptors (TLR 2/4), and simulated immune responses. The vaccine showed high stability and favorable expression profiles, including ten conserved epitopes with broad MHC coverage, especially in South Asian populations. Docking studies indicated a stronger binding affinity for HCMVV–TLR 4 (− 19. 6 kcal/mol) compared to HCMVV–TLR 2 (− 14. 1 kcal/mol), characterized by high affinity and structural complementarity. Normal mode analysis confirmed complex stability, with average deformability per atom index for HCMVV, HCMVV–TLR 2, and HCMVV–TLR 4. Furthermore, molecular dynamics simulation (MDS) over 100 ns using GROMACS confirmed the stability of HCMVV–TLR2 and HCMVV–TLR4 complexes, with RMSD values below 2 Å (HCMVV–TLR4 more stable at &lt;1.3 nm), low RMSF indicating rigidity (except specific flexible regions in TLR4), consistent hydrogen bonds (400–540), compact RoG (&lt;2.7 nm for TLR4), stable SASA (370–430 nm² with slight reduction in TLR4), and PCA revealing dominant conformational motions. Immune simulations predicted strong IgG and T-cell responses, as well as memory formation and efficient antigen clearance. This study introduces a promising mRNA vaccine candidate against HCMV with substantial immunogenic potential, especially for high-risk groups. However, experimental validation, including in vitro expression, in vivo immunogenicity, and protective efficacy studies, is essential to translate these computational findings into clinical applications.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102342"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744822","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":"Rituximab-based antibody mediated rejection therapy modestly reduces Xenoreactive antibodies: Implications for pig-to-human xenotransplantation","authors":"Szu-Tsen Yeh ,&nbsp;Nicole A. Marshall ,&nbsp;Brent P. Lehman ,&nbsp;C. Dustin Rubinstein ,&nbsp;Dhanansayan Shanmuganayagam ,&nbsp;Jennifer J. Meudt ,&nbsp;Robert R. Redfield III ,&nbsp;Luis G. Hidalgo ,&nbsp;Tanja Dominko ,&nbsp;David D. Aufhauser","doi":"10.1016/j.trim.2025.102343","DOIUrl":"10.1016/j.trim.2025.102343","url":null,"abstract":"<div><h3>Background</h3><div>Anti-pig antibodies, including those targeting porcine glycans and swine leukocyte antigens, present a significant challenge to pig-to-human xenotransplantation. Current strategies for managing these antibodies are limited. We examine the impact of standard antibody-mediated rejection (ABMR) therapy in human kidney transplant recipients on the levels of xenoreactive anti-pig antibodies.</div></div><div><h3>Methods</h3><div>We analyzed serum samples from 25 kidney transplant recipients with biopsy-proven ABMR treated with corticosteroids, intravenous immunoglobulin (IVIG), and rituximab. Anti-pig IgG and IgM titers were measured by flow cytometry. We assessed changes in anti-pig antibody mean fluorescence intensity (MFI) at baseline, 3, and 6 months post-treatment. We also correlated changes in anti-pig antibody levels with donor-specific anti-HLA antibodies (DSA).</div></div><div><h3>Results</h3><div>Rituximab-based ABMR therapy resulted in a modest reduction (∼21–29 % reduction) of anti-pig IgG levels at 3 months (<em>p</em> &lt; 0.01) and at 6 months (<em>p</em> &lt; 0.05). Anti-pig IgM levels demonstrated a similar but less consistent trend. Higher baseline DSA levels, particularly anti-HLA Class II, were associated with increased anti-pig IgG binding. However, the reductions in anti-pig antibodies did not correlate with changes in DSA levels post-treatment.</div></div><div><h3>Conclusions</h3><div>ABMR therapy that includes rituximab, IVIG, and corticosteroids leads to a modest decrease in anti-pig IgG levels, even when DSA levels are effectively neutralized. These findings highlight the limitations of current desensitization therapies and underscore the need for improved humoral-targeted therapies to support safe and durable clinical xenotransplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102343"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769049","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":"Corrigendum to “Natural killer cell KIR genotype and NKG2C phenotype in correlation to BKV infection following kidney transplantation” [Transpl Immunol. Dec 2025;93;102303]","authors":"Shubo Tan ,&nbsp;Xiaobin Lin ,&nbsp;Xueqi Li ,&nbsp;Jianhua Long ,&nbsp;Yuan Luo ,&nbsp;Yao Xiao ,&nbsp;Jianjun Li","doi":"10.1016/j.trim.2025.102319","DOIUrl":"10.1016/j.trim.2025.102319","url":null,"abstract":"","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102319"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402153","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":"Corrigendum to “Pre-transplant sensitization and its effect on heart transplant rejection and survival outcomes”[Transplant Immunology 92 (2025) 102264]","authors":"Kyung-Hwa Shin ,&nbsp;Soo Yong Lee ,&nbsp;Min Ho Ju ,&nbsp;Hyun-Ji Lee","doi":"10.1016/j.trim.2025.102320","DOIUrl":"10.1016/j.trim.2025.102320","url":null,"abstract":"","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102320"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422878","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":"Recovery of CMV immunity after allogeneic haematopoietic stem cell transplant — Insight from an in-depth analysis of a small cohort of patients with clinical correlation","authors":"Yeh-ching Linn,&nbsp;Kirubavathy Sundar Raj","doi":"10.1016/j.trim.2026.102344","DOIUrl":"10.1016/j.trim.2026.102344","url":null,"abstract":"<div><h3>Background</h3><div>We conducted an evaluation of the IFN-g ELISpot assay with the primary objective of exploring its clinical use after allogeneic haematopoietic stem cell transplant (allo-HSCT). Here we analysed its correlation with occurrence of clinically-significant CMV infection (cs-CMVi) and risk factors.</div></div><div><h3>Method</h3><div>Frozen mononuclear cells collected at 2, 3, 4 and 5 months after allo-HSCT were tested against CMV pooled peptide pp65 and IE1 in an IFN-g ELISpot assay. Spot forming cells (SFC) per 250,000 cells were correlated with clinical course.</div></div><div><h3>Results</h3><div>Amongst the 18 CMV seropositive recipients including 3 with seronegative donors, 11 of the 14 low responders (&lt; 50 SFC) developed cs-CMVi while all the 4 high responders with &gt;50 SFC were protected. High dose glucocorticoids (1 mg/kg or higher) predisposed to a second episode of cs-CMVi even after acquisition of more than 50 SFC after the first episode, while low dose (20 mg/day or lower) did not matter. Low level CMV viremia resolved spontaneously in 2 of the 4 high responders but progressed to cs-CMVi in the other 11 low responders. Consistent with literature, recipients of T-depleting regimen and cord blood were at a higher risk of cs-CMVi. The median time to first acquisition of more than 50 SFC was 118 days. The 3 recipients of seronegative donors did not recover immunity beyond the monitoring period and 2 had recurrent cs-CMVi.</div></div><div><h3>Conclusion</h3><div>This small series provides in-depth insight into the recovery of CMV immunity and cs-CMVi post allo-HSCT for each recipient and supplements knowledge provided by large series.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102344"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953262","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":"TLR3 stimulation rejuvenates aged mesenchymal stem cells and restores immunosuppressive function in graft-versus-host disease","authors":"Linlin Jin ,&nbsp;Ziqi Hu ,&nbsp;Yuxin Huang ,&nbsp;Haihui Xu ,&nbsp;Nuo Li ,&nbsp;Aoli Zhang ,&nbsp;Yongjuan Duan ,&nbsp;Peng Wu ,&nbsp;Shuhai Lan ,&nbsp;Jiarui Zheng ,&nbsp;Tianyuan Hu ,&nbsp;Yingchi Zhang","doi":"10.1016/j.trim.2026.102346","DOIUrl":"10.1016/j.trim.2026.102346","url":null,"abstract":"<div><div>Graft-versus-host disease (GVHD) remains a major complication of allogeneic hematopoietic stem cell transplantation, particularly in patients who are refractory to corticosteroids. Mesenchymal stem cells (MSCs) possess immunosuppressive properties and are being explored as a treatment for GVHD. However, their therapeutic efficacy declines with extensive in vitro expansion due to cellular aging. Therefore, this study aimed to investigate the effects of MSC aging on GVHD outcomes and explore strategies to rejuvenate aged MSCs. Specifically, we compared the therapeutic efficacies of early (P5) and late passage (P15) human MSCs in a murine model of GVHD. Single-cell RNA sequencing was performed to identify molecular alterations associated with MSC aging. Polyinosinic:polycytidylic acid [poly(I:C)], a Toll-like receptor 3 (TLR3) agonist, was used to stimulate aged MSCs. Early passage MSCs significantly alleviated the severity of GVHD, improved survival, and reduced systemic inflammation (<em>p</em> &lt; 0.05). In contrast, late-passage MSCs showed minimal therapeutic effect. Single-cell transcriptomics revealed that MSC aging is associated with the loss of immunoregulatory subpopulations and downregulation of TLR3 signaling. Notably, poly(I:C) priming partially reversed the senescence phenotypes and restored the immunosuppressive capacity of aged MSCs, resulting in enhanced suppression of T cell proliferation, increased T cell apoptosis and G1 accumulation, and reduced IFN-related readouts (<em>p</em> &lt; 0.05).Mechanistically, replicative senescence impairs the immunoregulatory potency of MSCs by disrupting TLR3-mediated signaling pathways. Overall, TLR3 activation by poly(I:C) rejuvenates aged MSCs and restores their therapeutic function, providing a clinically translatable strategy for enhancing MSC-based immunotherapies for GVHD.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102346"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953305","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":"CD34+/CD3+ cells ratio in the peripheral blood stem cells product and graft-versus-host disease: Is there still room for improvement?","authors":"Ewa Bembnista ,&nbsp;Paula Matuszak ,&nbsp;Anna Łojko-Dankowska ,&nbsp;Dominik Dytfeld ,&nbsp;Magdalena Matuszak ,&nbsp;Anna Wache ,&nbsp;Katarzyna Kaźmierska ,&nbsp;Andrzej Szczepaniak ,&nbsp;Bartosz Małecki ,&nbsp;Patrycja Stawicka ,&nbsp;Joanna Kujawska ,&nbsp;Anna Płotka ,&nbsp;Anna Hoppe ,&nbsp;Justyna Marcinkowska ,&nbsp;Kinga Eling ,&nbsp;Krzysztof Lewandowski ,&nbsp;Lidia Gil","doi":"10.1016/j.trim.2026.102347","DOIUrl":"10.1016/j.trim.2026.102347","url":null,"abstract":"<div><div>Allogeneic hematopoietic stem cell (allo-HSC) transplantation (allo-HSCT) is a therapy of choice for patients requiring total bone marrow replacement. One of the critical issues is optimizing the number of allo-HSCs for successful outcomes, measured by the engraftment time and the incidence/severity of graft versus host disease (GvHD). We evaluated engraftment time and GvHD in comparison to the composition of infused CD34+ immature HSCs and CD3+ T cells in all-HSCTs. The study evaluated 97 patients with allo-HSCT from matched related (group MRD; <em>n</em> = 40), matched unrelated (group MUD; <em>n</em> = 28), mismatched unrelated (group MMUD; <em>n</em> = 6), and haploidentical (group haplo; <em>n</em> = 23) donors. Overall, we did not observe any correlation between the total count of CD34+ allo-HSC and CD3+ T cells or the count of CD34+ and CD3+ calculated per kilogram of body weight (kg) on engraftment as well as GvHD symptoms in all studied groups. However, the CD34+/CD3+ ratio may provide valuable information in the process of a graft quality assessment in haploidentical allo-HCST for the choice of therapeutic options.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102347"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959912","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":"Impact of everolimus-based immunosuppression on transplant rejection or death in lung transplant recipients using the United States Food and Drug Administration Adverse Event Reporting System","authors":"Toru Ogura ,&nbsp;Chihiro Shiraishi ,&nbsp;Aiko Urawa","doi":"10.1016/j.trim.2026.102345","DOIUrl":"10.1016/j.trim.2026.102345","url":null,"abstract":"<div><h3>Background</h3><div>The off-label use of everolimus in lung transplant recipients (LTRs) has increased; however, its safety profile across different immunosuppressive regimens remains insufficiently characterized. This study explored potential safety signals associated with the addition of everolimus to established immunosuppressive regimens using real-world data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS).</div></div><div><h3>Methods</h3><div>A retrospective observational analysis of FAERS data was conducted. To reduce potential confounding from drug–drug interactions, paired comparisons were restricted to regimen pairs that differed only by the presence or absence of everolimus. Reporting odds ratios (RORs) and adjusted RORs (aRORs) were calculated for each regimen, using the corresponding non-everolimus regimen as the reference. Associations were examined for the composite outcome of transplant rejection or death.</div></div><div><h3>Results</h3><div>The everolimus plus tacrolimus regimen showed lower reporting of the composite outcome compared with the tacrolimus regimen (ROR: 0.238 [95% confidence interval (CI): 0.073–0.782], <em>p</em> = 0.018; aROR: 0.258 [95% CI: 0.078–0.860], <em>p</em> = 0.027). For other regimens, including tacrolimus plus prednisone, cyclosporine, and cyclosporine plus prednisone plus mycophenolate mofetil, the addition of everolimus showed a consistent but non-significant trend toward lower reporting (all RORs &lt;1 and aRORs &lt;1).</div></div><div><h3>Conclusions</h3><div>Analysis of FAERS data identified a potential signal of lower reporting of transplant rejection or death associated with the addition of everolimus to certain immunosuppressive regimens in LTRs. These findings warrant cautious interpretation because of the inherent limitations of FAERS and require validation in prospective studies.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102345"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953296","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}