Transplant immunology最新文献

{"title":"Efficacy and safety of everolimus with reduced tacrolimus versus standard tacrolimus in liver transplant recipients: A systematic review and meta-analysis of randomized controlled trials","authors":"Akash Kumar ,&nbsp;Mateen Ahmad ,&nbsp;Amna Hussain ,&nbsp;Khadija Mohib ,&nbsp;Muhammad Asjad Saleem ,&nbsp;Muhammad Saad ,&nbsp;Muhammad Ansab ,&nbsp;Ram ,&nbsp;Pinkey Kumari ,&nbsp;Nisha Kumari","doi":"10.1016/j.trim.2025.102317","DOIUrl":"10.1016/j.trim.2025.102317","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation (LT) requires immunosuppression to prevent rejection while minimizing adverse effects. Tacrolimus (TAC) is standard but linked to nephrotoxicity and leukopenia. Everolimus (EVR) with reduced-dose TAC (rTAC) offers a potential alternative, potentially improving safety while preserving efficacy.</div></div><div><h3>Objectives</h3><div>To compare everolimus with reduced-dose tacrolimus (EVR + rTAC) versus standard tacrolimus (sTAC) in liver transplant recipients, assessing composite efficacy as the primary outcome, with graft loss, peripheral edema, mortality and evaluating safety via incidence of adverse events.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane Library, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> were systematically searched from inception until 1st March 2025. Randomized controlled trials (RCTs) comparing everolimus with reduced-dose tacrolimus (EVR + rTAC) versus standard tacrolimus (TAC) in liver transplant (LT) recipients were included. A random-effects model was used for meta-analysis to calculate pooled risk ratios with 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>A total of seven studies encompassing 1853 liver transplant recipients (EVR + rTAC: 1167; sTAC: 1174) were included. EVR + rTAC significantly reduced the risk of treated biopsy-proven acute rejection (tBPAR) compared to sTAC (RR: 0.67; 95 % CI: 0.47–0.94; <em>p</em> = 0.02; I² = 1 %). Renal function, assessed by estimated glomerular filtration rate (eGFR), was significantly better in the EVR + rTAC group (MD: 8.41; 95 % CI: 2.37–14.44; <em>p</em> = 0.006; I² = 86 %). Additionally, EVR + rTAC was associated with a significantly higher risk of peripheral edema (RR: 1.56; 95 % CI: 1.25–1.95; <em>p</em> &lt; 0.0001; I² = 0 %) and leukopenia (RR: 2.87; 95 % CI: 1.99–4.13; <em>p</em> &lt; 0.00001; I² = 0 %).</div><div>No significant differences were observed between the EVR + rTAC and sTAC groups regarding the composite efficacy outcome (RR: 0.79; 95 % CI: 0.62–1.00; <em>p</em> = 0.05; I² = 0 %), graft loss (RR: 1.25; 95 % CI: 0.73–2.14; <em>p</em> = 0.41; I² = 0 %), mortality (RR: 1.30; 95 % CI: 0.87–1.96; <em>p</em> = 0.20; I² = 0 %), or the incidence of serious adverse events (RR: 1.03; 95 % CI: 0.94–1.12; <em>p</em> = 0.52; I² = 79 %). Furthermore, no significant differences were noted regarding diarrhea, abdominal pain, headache, or hypertension.</div></div><div><h3>Conclusion</h3><div>Everolimus with reduced-dose tacrolimus (EVR + rTAC) showed comparable efficacy to standard tacrolimus, with no significant differences in graft loss or mortality. It significantly reduced the risk of acute rejection and improved renal function (higher eGFR) but increased the risk of leukopenia and peripheral edema. Further studies are needed to optimize this renal-sparing regimen.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102317"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329972","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":"Women recipients are at high risk for biopsy-proven acute rejection in spouse kidney transplantation","authors":"Sulin Luo ,&nbsp;Meifang Wang ,&nbsp;Xingxia Wang ,&nbsp;Tianlu Zhang ,&nbsp;Luying Guo ,&nbsp;Pengpeng Yan ,&nbsp;Junhao Lv ,&nbsp;Hongfeng Huang ,&nbsp;Wenhan Peng ,&nbsp;Jianyong Wu ,&nbsp;Jingyi Zhou ,&nbsp;Jianghua Chen ,&nbsp;Rending Wang","doi":"10.1016/j.trim.2025.102324","DOIUrl":"10.1016/j.trim.2025.102324","url":null,"abstract":"<div><h3>Background</h3><div>Spouse kidney transplantation represents a significant source of kidney donations. However, gender dynamics often result in husbands being recipients and wives being donors. Research on the immunological rejection and prognosis in wife recipients—who may develop immune memory due to pregnancy or sexual contact but lack preformed antibodies before transplantation—remains limited.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 164 patients who underwent living spousal kidney transplantation at the First Affiliated Hospital of Zhejiang University between July 2007 and December 2021, with follow-up until December 2023.</div></div><div><h3>Results</h3><div>The study included 33 husband-to-wife transplant cases (Group W) and 131 wife-to-husband cases (Group H). Donors in Group W were older, had higher serum creatinine (SCr) levels, and donated heavier kidneys compared with donors in Group H (<em>p</em> &lt; 0.05). Group W recipients had a significantly higher incidence of biopsy-proven acute rejection within two years post-transplant than Group H. The rejection reversal rate in Group W (5/6, 83.3 %) was also higher than in Group H (2/7, 28.6%) during the same period. Postoperative follow-up revealed that Group H had significantly higher SCr levels and relatively lower estimated glomerular filtration rate (eGFR) than Group W. Additionally, Group H exhibited a slightly higher mortality rate.</div></div><div><h3>Conclusions</h3><div>Wife recipients experienced a higher incidence of biopsy-proven acute rejection but demonstrated lower SCr levels and higher eGFR within two years post-transplant. This outcome may be largely explained by the greater kidney weight of male donors.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102324"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439318","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 ,&nbsp;Andreas A. Rostved ,&nbsp;Nikolai Kirkby ,&nbsp;Allan Rasmussen ,&nbsp;Ulrik Lassen ,&nbsp;Claus L. Andersen ,&nbsp;Bo-Göran Ericzon ,&nbsp;Carl Jorns ,&nbsp;Helena Zhao ,&nbsp;William Bennet ,&nbsp;Fredrik Åberg ,&nbsp;Arno Nordin ,&nbsp;Jens G. Hillingsø ,&nbsp;Susanne D. Nielsen ,&nbsp;Hans-Christian Pommergaard","doi":"10.1016/j.trim.2025.102309","DOIUrl":"10.1016/j.trim.2025.102309","url":null,"abstract":"<div><div>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) <em>any</em> 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 (<em>p</em> = 0.004). TTV load was not significantly associated with <em>any</em> 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.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102309"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","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":"Racial and ethnic disparities in kidney transplantation","authors":"Macrae Kozody ,&nbsp;Roberta Buccilli ,&nbsp;Giovanni Faddoul ,&nbsp;Jorge Ortiz","doi":"10.1016/j.trim.2025.102289","DOIUrl":"10.1016/j.trim.2025.102289","url":null,"abstract":"<div><div>Social determinants of health, bias and genetic predisposition contribute to racial inequities in chronic kidney disease (CKD) and kidney transplant (KTX) allocation. Recognizing and addressing these complex factors leads to improvement in outcomes. This narrative review aims to discuss the current state of racial disparities surrounding KTX and identify where future efforts should be concentrated. The discussion focuses on data from the past 10 years (2015–2025). Overall mortality and graft loss is lowest in Hispanics and Asians and highest in Native Americans, perhaps due to the unique protective or detrimental social factors in these populations. Blacks have equal to better mortality than Whites, but worse graft survival. In an effort to identify paucities in the current literature, KTX outcomes by specific CKD etiologies are reviewed, including: diabetic nephropathy, focal segmental glomerulosclerosis, membranous nephropathy, lupus nephritis, vasculitis and polycystic kidney disease. Graft survival and mortality patterns for disease specific kidney transplant generally mirrors that of all cause KTX, but available data is limited. In recent years, racial disparities in CKD and transplant have improved, but still persist, representing the need for continued investigation and improvement. Future work should focus on continued identification and implementation of successful mitigation strategies and investigation where current literature is insufficient, such as diabetic nephropathy.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102289"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055869","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 ,&nbsp;Berk Mizrak ,&nbsp;Zeynep Y. Yilmaz ,&nbsp;Mustafa Guldan ,&nbsp;Derya G. Fidan ,&nbsp;Sama Mahmoud Abdel-Rahman ,&nbsp;Mehmet Kanbay","doi":"10.1016/j.trim.2025.102308","DOIUrl":"10.1016/j.trim.2025.102308","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102308"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","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":"Prevalence and determinants of frailty–sarcopenia comorbidity in hospitalized patients undergoing liver transplantation for hepatic echinococcosis","authors":"Sujun Wang ,&nbsp;Huanhuan Wei ,&nbsp;Yiliyaer Aihemaiti ,&nbsp;Lijun Ma ,&nbsp;Ying Tong ,&nbsp;Fang Li","doi":"10.1016/j.trim.2025.102327","DOIUrl":"10.1016/j.trim.2025.102327","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to examine the prevalence and influencing factors of comorbid frailty and sarcopenia in hospitalized patients with hepatic echinococcosis undergoing liver transplantation, thereby providing evidence for targeted clinical interventions.</div></div><div><h3>Methods</h3><div>A convenience sampling method was used to recruit 118 patients who underwent liver transplantation and were hospitalized in the hepatobiliary echinococcosis departments of two tertiary grade A hospitals in Urumqi from March 2023 to July 2025. Data were collected using a general information questionnaire, the Liver Frailty Index (LFI), a sarcopenia screening questionnaire, the Social Support Rating Scale (SSRS), and a general health status scale. Univariate analyses were performed using analysis of variance (ANOVA), χ² tests, or non-parametric tests, as appropriate. Logistic regression analysis was conducted to identify factors associated with preoperative comorbidity of frailty and sarcopenia in liver transplant recipients.</div></div><div><h3>Results</h3><div>Valid data were obtained from 114 patients. The prevalence of comorbid frailty and sarcopenia in this patient population was 25.44 %. Logistic regression analysis indicated that older age, a higher number of comorbid chronic diseases, lower hemoglobin levels, and reduced social support were independent determinants (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Comorbid frailty and sarcopenia were relatively prevalent among hospitalized patients with hepatic echinococcosis undergoing liver transplantation. Comprehensive preoperative evaluations should be conducted to identify these comorbidities, and targeted intervention strategies should be implemented promptly based on the identified determinants to mitigate disease progression.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102327"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514169","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":"Case report: Recipient-derived, late-onset post-transplant lymphoproliferative disorder involving a transplanted liver","authors":"Dongmei Zou ,&nbsp;Qiang Ma ,&nbsp;Dandan Wang ,&nbsp;Dongdong Lin ,&nbsp;Hong Zhao ,&nbsp;Wanling Sun","doi":"10.1016/j.trim.2025.102299","DOIUrl":"10.1016/j.trim.2025.102299","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-transplant lymphoproliferative disorders (PTLD) are severe complications of transplantation associated with poor outcomes. Compared to early-onset PTLDs, late-onset PTLDs are much less associated with allograft localization. Herein, we report a case of Epstein-Barr virus (EBV)-negative lymphoma involving a graft 7 years after liver transplantation.</div></div><div><h3>Case presentation</h3><div>A 45-year-old man presented with hepatomegaly 7 years after liver transplantation. Liver puncture biopsy revealed B-cell lymphoma with a high proliferation index and a germinal center B-cell-like subtype. Tissue and other donor information were unavailable. Next-generation sequencing was performed on the tumor and recipient tissues, and the single nucleotide polymorphism (SNP) sites were identical, thereby confirming the recipient origin. The patient received a reduction in immunosuppression and six cycles of rituximab, reduced doses of cyclophosphamide, doxorubicin, vincristine, and prednisone, and achieved complete remission after the fourth cycle of treatment. The patient remained in good condition for 7 months after the last chemotherapy dose.</div></div><div><h3>Conclusion</h3><div>This rare case report describes a late-onset EBV-negative recipient-derived PTLD involving a transplanted liver. SNP analysis is a useful method for determining tumor origin in situations where donor tissue is unavailable.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102299"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065259","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 compatibility testing: Transition from CDCXM to flow cytometry in India","authors":"Kashyap Shubham,&nbsp;Aseem K Tiwari,&nbsp;Chauhan Rajni,&nbsp;Mehra Simmi,&nbsp;Bhardwaj Gunjan,&nbsp;Rani Neha,&nbsp;Kahlon Simran","doi":"10.1016/j.trim.2025.102281","DOIUrl":"10.1016/j.trim.2025.102281","url":null,"abstract":"<div><div>Over 60 % of kidney transplant candidates are non-sensitised while remaining 40 % are sensitised because of previous exposure to human alloantigens during previous transplants, blood transfusions, and pregnancy in women. Pre-transplant compatibility testing is mandatory prior to renal transplantation for detecting the presence of donor-specific antibodies (DSAs), which are associated with early hyperacute/acute and later chronic rejections. Initially, complement-dependent cytotoxicity crossmatch (CDCXM) was used as a traditional method for detecting preformed DSAs. However, its limited sensitivity fails to detect low-level antibodies, and all non-complement-binding antibodies lead to early graft rejection despite a negative CDC-XM result. Flow cytometry crossmatch (FCXM), introduced in 1983, addresses these limitations by offering superior sensitivity in detecting DSAs. FCXM uses indirect immunofluorescence to differentiate T cell (expressing class I HLA) and B cell (expressing class I/II HLAs) reactivities providing a more precise assessment of DSAs, significantly decreasing the risk of rejection. Studies demonstrate that positive FCXM results, even with negative CDC-XM, correlate with higher rejection rates and reduced graft survival. Various modifications, including pronase treatment and especially streamlined Halifax and Halifaster protocols, have improved the test's specificity and speed. Despite its advantages, FCXM is also susceptible to potential false-positive and false-negative results because of non-HLA antibodies, cross-reactivity with therapeutic agents, and other technical factors. Nonetheless, FCXM remains a gold standard in modern transplantation immunology, enhancing safety of graft outcomes through better identification of immunologically significant DSAs. This review outlines the transition from CDCXM to FCXM in the Indian context, emphasizing its impact on pre-transplant testing and clinical decision-making.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102281"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016240","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":"Lung transplantation in patients with diabetes: A systematic review","authors":"Fatemeh Moosaie ,&nbsp;Shiva Abedinzadeh ,&nbsp;Sepide Javankiani ,&nbsp;Fatemeh Asli ,&nbsp;Prajjwol Luitel ,&nbsp;Seyede Marzie Fatemi Abhari","doi":"10.1016/j.trim.2025.102279","DOIUrl":"10.1016/j.trim.2025.102279","url":null,"abstract":"<div><h3>Background and aim</h3><div>Lung transplantation (LTx) is increasingly performed worldwide, yet post-transplant survival remains lower than for other solid organs. Diabetes mellitus (DM) is common among LTx recipients and impacts outcomes. This systematic review evaluates the effects of DM on LTx outcomes and the influence of diabetes onset timing on survival.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in December 2024 across PubMed, Scopus, and Web of Science to identify original studies or case series involving patients with pre-transplant DM undergoing or waitlisted for LTx. The quality of the included studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS).</div></div><div><h3>Results</h3><div>Eighty-four studies published between 1992 and 2024 were included, with sample sizes ranging from 10 to over 4 million patients and follow-up from 1 to 25 years. Diabetes was present in 8–56 % of lung transplant recipients. Patients with diabetes, including pre-existing diabetes, cystic fibrosis-related diabetes (CFRD), and new-onset diabetes after transplantation (NODAT), showed higher risks of infections, acute kidney injury, thromboembolic events, chronic lung allograft dysfunction, and cardiovascular complications. Diabetes was consistently associated with increased short- and long-term mortality, prolonged mechanical ventilation, and greater hospitalization rates.</div></div><div><h3>Conclusion</h3><div>Diabetes—whether present before or developing after lung transplantation—is a significant predictor of adverse clinical outcomes and mortality. These findings underscore the need for careful perioperative glycemic management, tailored immunosuppression, and vigilant monitoring to reduce complications. Further standardized, prospective research is essential to guide optimal diabetes management and improve survival in lung transplant recipients.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102279"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001147","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":"Case report: Hyperacute rejection of living relative kidney transplantation caused by colony-stimulating factor 2 antibodies","authors":"Qixuan Li ,&nbsp;Zhaoying Pang ,&nbsp;Meng Yang ,&nbsp;Lunli Xiang ,&nbsp;Xulian Hu ,&nbsp;Qin Yang ,&nbsp;Hongwen Zhao ,&nbsp;Jie Li ,&nbsp;Xiaosong Xu","doi":"10.1016/j.trim.2025.102285","DOIUrl":"10.1016/j.trim.2025.102285","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplantation (KT) stands as a highly effective, life-saving intervention for patients with end-stage renal disease, offering substantial improvements in both quality of life and long-term survival. However, one of the most critical challenges that can arise in this procedure is hyperacute rejection (HR). This severe immune response occurs almost immediately after transplantation and can place the patient at a heightened risk of serious complications and even drastically jeopardizes the survival of the transplanted kidney. This study reports a case of HR mediated by colony-stimulating factor 2 (CSF2) antibodies following living-related KT, elaborates on its clinical features, diagnostic workflow, and therapeutic management, and analyzes the role of CSF2 antibodies in KT-related immunity. The findings aim to provide clinical reference for optimizing HR prevention and management in KT practice.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102285"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001128","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}