Transplant immunology最新文献

{"title":"Clinical application of biological agents in rheumatoid arthritis","authors":"Lianying Cheng ,&nbsp;Xiaofeng Rong","doi":"10.1016/j.trim.2025.102187","DOIUrl":"10.1016/j.trim.2025.102187","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder primarily distinguished by synovial inflammation, which, as the disease evolves, can lead to bone erosion and destruction. Consequently, the pivotal strategy in preventing joint damage and fostering functional recovery lies in the effective management of synovial inflammation. Disease-modifying antirheumatic drugs (DMARDs) and prednisone therapy remain the first-line treatments for RA. However, in instances of refractory RA, these medications may fall short in adequately controlling inflammation, and they are often accompanied by several adverse effects, including limited bioavailability, therapeutic resistance, and potentially toxic side effects. Given these challenges, the identification of targeted therapies to manage disease activity and diminish inflammation becomes imperative.Recently, biologic agents for the treatment of RA have garnered significant attention owing to their minimal side effect profile, reduced potential for drug dependence, and their precise therapeutic action directly on target cells. This review provides a comprehensive exploration of advancements in biologics that target and inhibit inflammatory cytokine receptors, specifically TNF-α, IL-6, and IL-1β, as well as B lymphocyte receptors, TLR4, nanodrugs, and Janus kinase (JAK) inhibitors in the context of RA. By providing innovative perspectives and strategies for the treatment of this condition, this review contributes to the ongoing efforts to refine and improve the therapeutic landscape for RA.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102187"},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the urobiome and associated metabolic profiles during acute rejection in renal transplant patients: A pilot study","authors":"David Harriman ,&nbsp;Alex Ng ,&nbsp;Monica Bronowski ,&nbsp;Herman Kazakov ,&nbsp;Christopher Nguan ,&nbsp;Thien Dang ,&nbsp;Karen Sherwood ,&nbsp;Aaron Miller ,&nbsp;Dirk Lange","doi":"10.1016/j.trim.2024.102170","DOIUrl":"10.1016/j.trim.2024.102170","url":null,"abstract":"<div><div>Characteristic alterations in the urinary microbiome, or urobiome, are associated with renal transplant pathology. To date, there has been no direct study of the urobiome during acute allograft rejection. The goal of this study was to determine if unique urobiome alterations are present during acute rejection in renal transplant recipients. We performed shotgun metagenomic sequencing of 32 mid-stream urine samples obtained from 15 transplant recipients pre-transplant, 1- and 3-months post-transplant, and at time of rejection discovered with for-cause biopsy. Within individuals, there was a 40–60 % difference in urobiome composition from pre-to-post-transplant in both rejectors and non-rejectors. The taxa Ureaplasma was enriched in rejectors compared to non-rejectors. However, a greater number of microbial genes were enriched in non-rejectors compared to rejectors, except for genes associated with tetracycline resistance, the lysophosphatidic acid synthesis pathway, and tryptophanyl-tRNA synthetase. Together, our findings suggest that the urobiome is significantly altered post-transplant with certain taxa and/or microbial genes potentially associated with acute allograft rejection/inflammation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102170"},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955673","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":"Lower basophil count after anti-thymocyte globulin induction is associated with lower incidence of acute cellular rejection in heart transplant recipients","authors":"Boško Skorić ,&nbsp;Petra Mjehović ,&nbsp;Mia Dubravčić Došen ,&nbsp;Andrija Nekić ,&nbsp;Dora Fabijanović ,&nbsp;Nina Jakuš ,&nbsp;Jure Samardžić ,&nbsp;Ivo Planinc ,&nbsp;Maja Čikeš ,&nbsp;Hrvoje Gašparović ,&nbsp;Davor Miličić","doi":"10.1016/j.trim.2025.102173","DOIUrl":"10.1016/j.trim.2025.102173","url":null,"abstract":"<div><h3>Introduction</h3><div>While lymphodepletion is considered a therapeutic effect of rabbit anti-thymocyte globulin (rATG), a concomitant decrease in basophil count (BC) has unknown clinical effect.</div></div><div><h3>Objective</h3><div>To investigate the association between BC following rATG induction and acute cellular rejection (ACR) during the first post-HTx year.</div></div><div><h3>Methods</h3><div>Retrospective single-center study included 183 HTx recipients receiving rATG induction between 2010 and 2021 (mean age 52 ± 13 years, 23 % female). Absolute lymphocyte count (ALC), platelet (PLT) count and BC were assessed on days 0, 7, 14, and 21 following HTx. The primary outcome was the first ACR (grade ≥1B) within the first post-HTx year.</div></div><div><h3>Results</h3><div>Patients with ACR had significantly higher BC on day 14 (17/μL (IQR 9–43/μL) vs. 10/μL (IQR 4–19/μL), <em>p</em> = 0.050) and higher PLT on day 7 (143 × 10³/μL (IQR 103–168 × 10³/μL) vs. 105 × 10³/μL (IQR 68–141 × 10³/μL), <em>p</em> = 0.02), with higher ALC on day 14 (308/μL (IQR 171–530/μL) vs. 180/μL (IQR 93–317/μL), <em>p</em> = 0.016) and on day 21 (529/μL (IQR 240–610/μL) vs. 225/μL (IQR 121–328/μL), <em>p</em> &lt; 0.001). In univariate analysis, ACR was associated with higher BC on day 14 (<em>p</em> = 0.004), higher PLT on day 7 (p = 0.02), higher ALC on days 14 (<em>p</em> = 0.04) and 21 (p &lt; 0.001). Multivariable regression model showed the most significant association between higher BC on day 14 and ACR (<em>p</em> = 0.015).</div></div><div><h3>Conclusion</h3><div>Lower BC two weeks after rATG induction is associated with less ACR during the first post-HTx year.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102173"},"PeriodicalIF":1.6,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012452","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":"Effectiveness of complement inhibitors against refractory antibody-mediated rejection of lung transplantation: Two clinical cases","authors":"Hadrien Mallet ,&nbsp;Laurent Razat ,&nbsp;Quentin Perrier ,&nbsp;Amandine Briault ,&nbsp;Christel Saint Raymond ,&nbsp;Loic Falque ,&nbsp;Lionel Rostaing ,&nbsp;Bruno Degano ,&nbsp;Pierrick Bedouch","doi":"10.1016/j.trim.2025.102174","DOIUrl":"10.1016/j.trim.2025.102174","url":null,"abstract":"<div><div>Antibody-mediated rejection (AMR) has been recognized as a significant cause of acute and chronic lung allograft dysfunction after lung transplantation. Some treatments, eculizumab, an anti-complement (C)5 component monoclonal antibody (Mab), seem to have a promising effect in the management of some patients with AMR. We present two patients with acute AMR after lung transplantation who received the anti-C5 Mab therapy. In both cases, we identified the presence of C4d deposition in the peritubular capillaries on trans-alveolar biopsies, which suggested activation of complement in AMR. Prior to eculizumab therapy, both patients had also received immunoadsorption, courses of intravenous immunoglobulins (IVIG) and rituximab. For the first patient, we have shown that eculizumab can serve as an effective bridge to re-transplantation. For the second patient, we observed the absence of clinical and biological efficacy, and without a clear therapeutic efficacy the therapy with eculizumab had been discontinued after two months.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102174"},"PeriodicalIF":1.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma high-sensitivity C-reactive protein measured prior to transplant is related to prediabetes in first-year kidney transplant recipients: A single-center cross-sectional study in Vietnam","authors":"Ha Nguyen Thi Thu ,&nbsp;Dung Nguyen Thi Thuy ,&nbsp;Thuy Pham Vu ,&nbsp;Toan Pham Quoc ,&nbsp;Duc Nguyen Van ,&nbsp;Ha Do Manh ,&nbsp;Van Diem Thi ,&nbsp;Doan Tran Thi ,&nbsp;Khoa Le Ha ,&nbsp;Kien Truong Quy ,&nbsp;Kien Nguyen Trung ,&nbsp;Thang Le Viet","doi":"10.1016/j.trim.2024.102149","DOIUrl":"10.1016/j.trim.2024.102149","url":null,"abstract":"<div><h3>Aim</h3><div>To determine the rate of prediabetes among and the pre-transplant plasma high-sensitivity C-reactive protein (hs-CRP) value predictive of prediabetes in patients during their first year post-living donor kidney transplant.</div></div><div><h3>Methods</h3><div>A total of 538 patients underwent living donor kidney transplantation between January 2018 and December 2020, 413 of whom met the inclusion criteria for this study. All patients underwent oral glucose tolerance tests (OGTTs) with 75 g glucose/200 mL solution, starting 3 months post-transplant and repeating the test every 3 months for the first year. Clinical and paraclinical indicators and plasma hs-CRP concentrations were quantified the day prior to the transplant. Prediabetes was diagnosed according to the American Diabetes Association 2018 criteria as a 2-h OGTT result between 140 mg/dL (7.8 mmol/L) and 199 mg/dL (11.0 mmol/L).</div></div><div><h3>Results</h3><div>The rate of prediabetes among the study subjects was 38.3 % (158/413). Body mass index (BMI) and pre-transplant plasma triglycerides, high-density lipoprotein cholesterol (HDL<img>C), and hs-CRP levels were related factors predictive of prediabetes in patients within the first year post-kidney transplant based on multivariate logistic regression and receiver operative characteristic curve models. Hs-CRP was the factor with the best predictive value (area under the curve = 0.89; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Pre-transplant plasma hs-CRP levels were a good predictor of prediabetes in the first year post-living donor kidney transplant.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"88 ","pages":"Article 102149"},"PeriodicalIF":1.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717283","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":"Utilization of kidneys from tuberculosis-infected donors in renal transplantation: A case report","authors":"Lu Yifan ,&nbsp;Liu Yiting ,&nbsp;Zhou Jiangqiao ,&nbsp;Qiu Tao","doi":"10.1016/j.trim.2024.102151","DOIUrl":"10.1016/j.trim.2024.102151","url":null,"abstract":"<div><div>Tuberculosis (TB) infection in solid organ transplantation is a non-negligible problem in TB-endemic countries, and none of the existing guidelines recommend using organs from individuals with active TB infections. Here, we describe three cases of utilization of kidneys from TB-infected donors in renal transplantation at our center, two of whom had active TB. In these three cases, all recipients had good graft function and negative TST results during the 1–4 year follow-up period. This case report emphasizes the critical role of early diagnosis, prophylaxis and treatment of TB in renal transplantation, demonstrates the potential for utilizing kidneys from donors with active TB, and opens up a new possibilities for solid organ transplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"88 ","pages":"Article 102151"},"PeriodicalIF":1.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688885","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":"Clinical characteristics and outcomes of invasive pulmonary aspergillosis in renal transplant recipients: A single-center experience","authors":"Jilin Zou,&nbsp;Zeya Jin","doi":"10.1016/j.trim.2024.102150","DOIUrl":"10.1016/j.trim.2024.102150","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the clinical features, early diagnostic methods, and therapeutic approaches for invasive pulmonary aspergillosis (IPA) in patients after renal transplantation (RT).</div></div><div><h3>Methods</h3><div>We retrospectively examined 22 patients who were diagnosed with IPA post-RT and treated at our institution between 2005 and 2024.</div></div><div><h3>Results</h3><div>Patients had an average age of 46.4 ± 9.4 years, with a predominance of men (72.7 %). The incidence of IPA after RT was 1.29 %. The median time of IPA onset after transplantation was 12 months. Fever was the predominant symptom (72.7 %), followed by cough and expectoration (31.8 %) and hemoptysis (13.6 %). Frequent computed tomography findings included consolidations (68.2 %) and cavities (45.5 %) with halo signs, multiple nodules, and air crescent signs. Neutropenia was noted in five patients, including one case of agranulocytosis. Impaired renal function was observed in 59.1 % of the cases. Serum 1,3-β-D-glucan and galactomannan (GM) assays were positive in 45.5 % of patients, with bronchoalveolar lavage fluid GM tests confirming IPA in 83.3 % of those tested. Next-generation sequencing confirmed <em>Aspergillus</em> infection in 11 patients. Ultimately, 68.2 % of the patients recovered, whereas 31.8 % succumbed to the infection, with the deceased demonstrating a significantly high rate of complications.</div></div><div><h3>Conclusions</h3><div>Patients with IPA had high mortality rates. The symptoms of IPA after RT are usually nonspecific, making diagnosis very difficult. Bronchoalveolar lavage fluid GM testing and next-generation sequencing proved relatively helpful as detection methods for IPA. Antifungal treatments should be initiated as soon as possible to avoid complications.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"88 ","pages":"Article 102150"},"PeriodicalIF":1.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688878","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":"Cyclosporine: Immunosuppressive effects, entwined toxicity, and clinical modulations of an organ transplant drug","authors":"Razan Alqadi ,&nbsp;Amal Alqumia ,&nbsp;Ibrahim S. Alhomoud ,&nbsp;Ahmad Alhowail ,&nbsp;Maha Aldubayan ,&nbsp;Hamdoon A. Mohammed ,&nbsp;Hussam Alhmoud ,&nbsp;Riaz A. Khan","doi":"10.1016/j.trim.2024.102147","DOIUrl":"10.1016/j.trim.2024.102147","url":null,"abstract":"<div><div>The discovery and use of cyclosporine since its inception into the clinics in the ‘70s and up have played a crucial role in advancing transplant therapy, and containment of the immune-based rejections. The drug has improved the high rates of acute rejections and has supported early graft survival. However, the long-term survival of renal allografts is still less prevalent, and an in-depth analysis, as well as reported findings led us to believe that there is a chronic irreversible component to the drug, that is tackled through its metabolites, and that causes toxicity, which has led to new therapies, including monoclonal antibody-based medications. A recap of the immunosuppressive effects, and entwined toxicity of the drug, now relegated primarily to bone marrow early transplants, is being overviewed for the past protocols that were used to minimize, and avoid, or use this calcineurin inhibitor class of drug, cyclosporine, in combination with other drugs. The current review circumvents the cyclosporine's mechanism of action, pathophysiology, cytochrome roles, and other factors associated with acute and chronic toxicity developments. The review also attempts to find conclusive strategies reported in the recent studies to avoid its toxic side effects, and develop a safe-use strategy for the drug. Gastrointestinal decontamination, supporting the airway, monitoring for signs of respiratory insufficiency, monitoring for severe reactions, such as seizures, need for administration of oxygen, and avoiding the administration of drugs, that increase the blood levels of the cyclosporine, are beneficial interventions, when encountering cyclosporine toxicity cases. The constrained therapeutic outcomes have also led to redesign, and making use of combined formulations to reassess the pharmacokinetics of the drug.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"88 ","pages":"Article 102147"},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644319","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":"Identification of mitophagy-related gene signatures for predicting delayed graft function and renal allograft loss post-kidney transplantation","authors":"Kaifeng Mao ,&nbsp;Fenwang Lin ,&nbsp;Yige Pan ,&nbsp;Zhenquan Lu ,&nbsp;Bingfeng Luo ,&nbsp;Yifei Zhu ,&nbsp;Jiaqi Fang ,&nbsp;Junsheng Ye","doi":"10.1016/j.trim.2024.102148","DOIUrl":"10.1016/j.trim.2024.102148","url":null,"abstract":"<div><h3>Background</h3><div>Ischemia-reperfusion injury (IRI) is an unavoidable consequence post-kidney transplantation, which inevitably leads to kidney damage. Numerous studies have demonstrated that mitophagy is implicated in human cancers. However, the function of mitophagy in kidney transplantation remains poorly understood. This study aims to develop mitophagy-related gene (MRGs) signatures to predict delayed graft function (DGF) and renal allograft loss post-kidney transplantation.</div></div><div><h3>Methods</h3><div>Differentially expressed genes (DEGs) were identified and intersected with the MRGs to obtain mitophagy-related DEGs (MRDEGs). Functional enrichment analyses were conducted. Subsequently, random forest and SVM-RFE machine learning were employed to identify hub genes. The DGF diagnostic prediction signature was constructed using LASSO regression analysis. The renal allograft prognostic prediction signature was developed through univariate Cox and LASSO regression analysis. In addition, ROC curves, immunological characterization, correlation analysis, and survival analysis were performed.</div></div><div><h3>Results</h3><div>Nineteen MRDEGs were obtained by intersecting 61 DEGs with 4897 MRGs. Seven hub genes were then identified through machine learning. Subsequently, a five-gene DGF diagnostic prediction signature was established, with ROC curves indicating its high diagnostic value for DGF. Immune infiltration analysis revealed that many immune cells were more abundant in the DGF group compared to the Immediate Graft Function (IGF) group. A two-gene prognostic signature was developed, which accurately predicted renal allografts prognosis.</div></div><div><h3>Conclusions</h3><div>The mitophagy-related gene signatures demonstrated high predictive accuracy for DGF and renal allograft loss. Our study may provide new perspectives on prognosis and treatment strategies post-kidney transplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"87 ","pages":"Article 102148"},"PeriodicalIF":1.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644625","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":"Potential of new 250-nautical mile concentric circle allocation system for improving the donor/recipient HLA matching: Development of new matching algorithm","authors":"Fayeq Jeelani Syed ,&nbsp;Dulat Bekbolsynov ,&nbsp;Robert C. Green II ,&nbsp;Devinder Kaur ,&nbsp;Obi Ekwenna ,&nbsp;Puneet Sindhwani ,&nbsp;Michael Rees ,&nbsp;Stanislaw Stepkowski","doi":"10.1016/j.trim.2024.102146","DOIUrl":"10.1016/j.trim.2024.102146","url":null,"abstract":"<div><h3>Background</h3><div>High-resolution typing of human leukocyte antigen (HLA) may revolutionize the field of kidney transplantation by selection of low immunogenic grafts. The new 250-nautical mile circle allocation system offers a unique opportunity to find low HLA immunogenic donors for eligible recipients.</div></div><div><h3>Methods</h3><div>501 transplant candidates from the University of Toledo Medical Center (UTMC) between 2015 and 2019, registered at the Scientific Registry of Transplant Recipients (SRTR) were virtually matched to 4812 donors procured within 250-nautical miles using an in-house-developed simulation algorithm. Immunogenicity of HMS (hydrophobic mismatch score) ≤10 was measured based on imputed high-resolution HLAs. Simulated “optimal” matches with a KDPI≤50 % were compared with the transplant cohort between 2000 and 2010 with their kidney allograft survivals.</div></div><div><h3>Results</h3><div>Out of 501 recipients 500 (99.8 %) were matched with donors ≤10 HMS and KDPI ≤50 %. The average HMS value for simulated transplants was 1.4 (range 0–10) versus 6.3 (range 0–75) in the retrospective cohort (<em>p</em> &lt; 0.001). The simulated model had a median mismatch number of 3/6, while the reference cohort 4/6 among HLA-A/B/DR antigens (<em>p</em> &lt; 0.001). The estimated median graft survival was 18.2 years for the simulated cohort vs. 13.4 years in the real-life cohort (p &lt; 0.001), gaining 4.9 years per transplant and 2450 survival years for all patients. For year 2014, out of 98 patients and 659 donors, each recipient had a median number of 141 donors (HMS &lt; 10; range 8–378). Similar values were found for patients between 2015 and 2019.</div></div><div><h3>Conclusion</h3><div>Donors within 250-nautical miles proffers excellent and multiple options for finding well-matched low immunogenic HLA kidney donors for UTMC patients, thus significantly improving their chances for long-term allograft survival.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"87 ","pages":"Article 102146"},"PeriodicalIF":1.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628799","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}