Transplant immunology最新文献

{"title":"Decreased circulating CD39+ regulatory T cell frequencies following non-traumatic brain death","authors":"Sedighe Poursaleh Amiri ,&nbsp;Fattah Sotoudeh Nejad ,&nbsp;Maryam Karamigolbaghi ,&nbsp;Ehsan Jafari ,&nbsp;Behrouz Robat-Jazi ,&nbsp;Ahmadreza Sadeghi ,&nbsp;Seyed Ghasem Poursaleh Amiri ,&nbsp;Haideh Namdari ,&nbsp;Ali Akbar Saboor-Yaraghi","doi":"10.1016/j.trim.2025.102219","DOIUrl":"10.1016/j.trim.2025.102219","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Regulatory T cells (Tregs) are thought to modulate immune responses during Brain death (BD), However findings on their role remain controversial. This study aimed to assess the frequency of circulating Tregs in the peripheral blood of non-traumatic BD cases, specifically focusing on CD4⁺CD25⁺CD127^low/-CD39⁺ Tregs and the levels of inflammatory cytokine mRNA in BD individuals.</div></div><div><h3>Methods</h3><div>The percentage of CD4⁺CD25⁺CD127^low/-CD39⁺ Tregs was measured using flow cytometry in BD patients upon admission and in control subjects. Additionally, mRNA expression levels of interleukin <em>(IL)-1β</em>, <em>IL-6</em>, <em>IL-8</em>, <em>IL-17</em>, tumor necrosis factor (<em>TNF</em>)-<em>α</em> and Interferon (<em>IFN</em>)-<em>γ</em> were quantified in peripheral blood mononuclear cells (PBMCs) from 28 BD individuals and 28 controls using real-time polymerase chain reaction.</div></div><div><h3>Results</h3><div>CD39⁺ Tregs were significantly reduced in non-traumatic BD cases compared with control group (<em>P</em> &lt; 0.0001). Moreover, the expression levels of <em>IL-1β</em>, <em>IL-6</em>, <em>IL-8</em>, <em>IL-17a</em>, <em>IFN-ɣ</em>, and <em>TNF-α</em> were significantly elevated in non-traumatic BD cases compared to the control group (<em>P</em> &lt; 0.01, <em>P</em> &lt; 0.05, <em>P</em> &lt; 0.01, <em>P</em> &lt; 0.0001, <em>P</em> &lt; 0.0001, <em>P</em> &lt; 0.001 respectively).</div></div><div><h3>Conclusion</h3><div>This study provides novel evidence of reduced CD39⁺ Tregs in the peripheral blood of non-traumatic BD patients, accompanied by increased inflammatory cytokine gene expression. Further investigations are needed to explore the underlying mechanisms and potential therapeutic implications.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102219"},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674080","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":"Mycobacterium haemophilum diagnosed via Karius test in a heart transplant recipient: A case report","authors":"Zachary Malaussena ,&nbsp;Michelle Lippincott ,&nbsp;Francesca Dimou","doi":"10.1016/j.trim.2025.102221","DOIUrl":"10.1016/j.trim.2025.102221","url":null,"abstract":"<div><h3>Background</h3><div><em>Mycobacterium haemophilum</em> is a rare, slow-growing nontuberculous mycobacterium known to cause infections primarily in immunocompromised individuals. <em>M. haemophilum</em> infections typically present as skin and soft tissue infections; however, infections may progress to disseminated disease involving multiple organ systems. Diagnosing <em>M. haemophilum</em> infections can be challenging due to its slow growth in conventional culture methods and its resemblance to other mycobacterial species. As a result, it may be misidentified or overlooked, leading to delays in diagnosis and appropriate treatment. The prognosis of <em>M. haemophilum</em> infections can vary depending on factors such as the extent of the disease, the timeliness of diagnosis, and the patient's underlying health condition.</div></div><div><h3>Summary</h3><div>In this case report, we provide a detailed clinical presentation, diagnostic workup, and treatment course of a heart transplant patient with <em>M. haemophilum</em> infection. Our patient presented with worsening generalized pain in multiple skin lesions. After extensive rheumatologic and infectious workup leading to nodule biopsies, the patient was diagnosed with <em>M. haemophilum</em> by Karius test and started on appropriate treatment.</div></div><div><h3>Conclusion</h3><div>Early recognition and appropriate treatment are essential for improving outcomes and reducing morbidity and mortality associated <em>M. haemophilum</em>. This case underscores the clinical utility of the Karius test in identifying unusual pathogens in a heart transplant patient with a complex medical history, emphasizing the role of next generation sequencing tests in aiding in earlier diagnosis to guide treatment and improve patient outcomes in challenging infectious disease cases.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102221"},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664596","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":"Comprehensive up-to-date analysis on TCRαβ/CD19-depleted hematopoietic stem cell transplantation in pediatric hematological malignancies","authors":"Hussien Ahmed H. Abdelgawad ,&nbsp;Heba Aboeldahab ,&nbsp;Mohamed Mohamed Belal ,&nbsp;Mohamed Nabih Bashir ,&nbsp;Holly K. Miller ,&nbsp;Rupert Handgretinger ,&nbsp;Mario Otto","doi":"10.1016/j.trim.2025.102220","DOIUrl":"10.1016/j.trim.2025.102220","url":null,"abstract":"<div><div>This meta-analysis assesses the efficacy of TCRαβ+/CD19+ depleted hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematological malignancies, bridging the gap in the heterogeneous results of published studies. We analyzed post-HSCT complications and survival outcomes in 1068 children across 14 studies, using both aggregated and patient-level data from acute myeloid leukemia/myelodysplastic syndromes (AML/MDS) and acute lymphoblastic leukemia (ALL) studies, employing the IPDfromKM technique for time-to-event data reconstruction. The analysis reveals a 95 % engraftment success rate (95 % CI: 93–97) and 6-year overall survival and disease-free survival (DFS) rates of 67.2 % and 66.3 %, respectively, with no significant differences in DFS between haploidentical and unrelated donors (hazard ratio = 0.9, 95 % CI: 0.53–1.55). Acute graft-versus-host disease (GvHD) grades III-IV and chronic GvHD incidences were 8 % (95 % CI: 6–11) and 17 % (95 % CI: 10–27). The relapse rate was 27 % (95 % CI: 21–33), with relapse-related mortality at 21 % (95 % CI: 15–28) and HSCT-related mortality at 12 % (95 % CI: 7–19). Relapse was significantly lower in patients (mostly ALL) receiving total body irradiation (risk ratio = 0.53, <em>P</em> = 0.04). These findings underscore TCRαβ/CD19-depleted HSCT as a valuable option for patients without HLA-matched donors, highlighting the need for larger, multicenter studies.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102220"},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664488","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":"Swertianolin regulates immunosuppression of myeloid suppressor cells in septic mice by inhibiting NF-κB and P38 signaling","authors":"Haoran Tang ,&nbsp;Chen Liao ,&nbsp;Lingling Wang ,&nbsp;Wei Fang ,&nbsp;Ning Tang ,&nbsp;Linjun Wan ,&nbsp;Zongfang Ren","doi":"10.1016/j.trim.2025.102217","DOIUrl":"10.1016/j.trim.2025.102217","url":null,"abstract":"<div><h3>Background</h3><div>Swertianolin is one of the main components of Gentianaceae Swertia plants, a traditional Chinese medicine used for the treatment of infection, fever, viral hepatitis, and pneumonia. An expansion of myeloid-derived suppressor cells (MDSCs) contributes to sepsis induced immunosuppression. We investigated the mechanism by which Swertianolin regulates MDSCs in a mouse model of sepsis.</div></div><div><h3>Methods</h3><div>Severe sepsis was induced in mice using caecal ligation and puncture. These mice received an intraperitoneal injection of Swertianolin. MDSCs were isolated and analyzed by flow cytometry; serum concentrations of immunosuppressive factors were detected by ELISA; and mitogen-activated protein kinase and nuclear factor-κB (NFκB) were detected by Western blots.</div></div><div><h3>Results</h3><div>We found that Swertianolin reduced the number of MDSCs in the marrow and the spleen while increased the number of CD4+ T cells in the spleen of mice with sepsis in comparison to controls (<em>p</em> &lt; 0.05). Swertianolin reduced lung damage and improved the survival rate in mice with secondary infection of <em>Legionella pneumophila</em> (<em>p</em> &lt; 0.05). Swertianolin inhibited the phosphorylation of p38 and nuclear translocation of p65 in MDSCs (<em>p</em> &lt; 0.05), leading to decreased production of IL-10 and nitric oxide (both p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Swertianolin may improve immunosuppressive function of MDSCs and increased T cell activity by inhibiting p38 phosphorylation and NF-κB activation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102217"},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664613","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":"MicroRNAs in transplant rejection: Emerging roles in immune regulation and applications","authors":"Shaochen Yu ,&nbsp;Jian Lu","doi":"10.1016/j.trim.2025.102222","DOIUrl":"10.1016/j.trim.2025.102222","url":null,"abstract":"<div><div>Organ transplantation is the only effective treatment for patients with end-stage organ failure. Although modern immunosuppressive protocols are very effective and improve quality of life, there is still a need for improvements to eliminate their side effects and to induce transplantation tolerance to allografts. The microRNAs (miRNAs) emerged as promising candidates for regulations of several immune functions. The most advanced research of miRNAs documented that several miRNAs form very complex regulatory networks involved in fine and precise mechanisms of multiple pathophysiological process in cells. This review describes the origin of miRNAs and their action mechanisms by which they regulate several immune and cell biology processes, highlighting the fast progress of miRNA research involved in transplant rejection, recent clinical trials, and describing prospects and possible limitations.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102222"},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664573","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":"Immunotherapy research in the Arab world: A bibliometric analysis","authors":"Ahmad Afyouni ,&nbsp;Jana Kotaich ,&nbsp;Sara Sarout ,&nbsp;Amarelle Chamoun ,&nbsp;Georgia Chkayban ,&nbsp;Saad El Hariri ,&nbsp;Tarek Baroud ,&nbsp;Adnan Fatfat ,&nbsp;Jad El Masri ,&nbsp;Pascale Salemeh","doi":"10.1016/j.trim.2025.102218","DOIUrl":"10.1016/j.trim.2025.102218","url":null,"abstract":"<div><h3>Background</h3><div>Immunotherapy is the concept of leveraging the immune system to treat diseases. Developing countries, including the Arab countries, have continued to lag in terms of biomedical research compared to other nations for several decades. Immunotherapy has been used in several fields, including cancer, transplantation, and vaccination. This article examined the activity and trend of immunotherapy research in the Arab world between 2000 and 2024.</div></div><div><h3>Methods</h3><div>The number of immunotherapy-related articles published by each Arab country, was assessed using the PubMed database between 2000 and 2024. Numbers were normalized with respect to each country's average population and average Gross Domestic Product (GDP).</div></div><div><h3>Results</h3><div>Arab countries contributed to 1.73 % of total immunotherapy papers. The number of immunotherapy publications has grown from 2000 to 2022, then decreased in the past 2 years. In terms of publications per million persons, Qatar ranked first (130.08 per million persons), while in terms of publications per national GDP, Lebanon ranked first (11.09 per billion US dollars). MeSH keywords VOSviewer showed a focus on vaccination, COVID-19, COVID-19 vaccines, and transplantation conditioning in the Arab world.</div></div><div><h3>Conclusions</h3><div>This bibliometric analysis provides insight into the actualities and trends of immunotherapy research in the Arab world. This offers a general background for scientists, clinicians, funders, and decision-makers. Addressing the barriers that face immunotherapy research remains a cornerstone in the plan to improve the Arab world's output and contribution to this field.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102218"},"PeriodicalIF":1.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654806","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":"2025-02-28","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}

{"title":"Prophylactic use of eculizumab for ABO-blood type incompatible kidney transplantation with extremely high ABO-blood type antibody titer: A two case report","authors":"Ayaka Mitomo ,&nbsp;Kazunari Tanabe ,&nbsp;Suguru Muraoka ,&nbsp;Mitsuru Yanai ,&nbsp;Sumi Hidaka ,&nbsp;Shuzo Kobayashi","doi":"10.1016/j.trim.2025.102213","DOIUrl":"10.1016/j.trim.2025.102213","url":null,"abstract":"<div><div>We report two cases of ABO-incompatible living-donor kidney transplantation (ABOi KT) performed in patients with exceptionally high ABO antibody titers. Both donor and recipient refused blood transfusions for religious reasons, limiting the use of plasma exchange. The desensitization protocol consisted of plasmapheresis (PP) using albumin solution, rituximab (300 mg), and high-dose intravenous immunoglobulin (IVIg; 4 g/kg). Despite aggressive desensitization procedure, ABO antibody titers did not go down to our acceptable upper limit of 1:64; the titer at transplantation was 1:256 in both cases. Given the high risk of acute antibody-mediated rejection (ABMR), the anti-complement C5 component monoclonal antibody (eculizumab; 900 mg) was administered prophylactically before graft reperfusion in order to inhibit complement activation. For both cases, postoperative courses were unremarkable, without any rejection episodes over one year. No additional doses of eculizumab were administered post-transplantation. We suggest that ABOi KT may be considered safe once early post-transplant ABMR is suppressed, allowing for immunological accommodation. Furthermore, despite the elevated antibody titers, the prophylaxis with eculizumab successfully inhibited early post-transplant complement activation, protecting kidney transplants from ABMR. These findings support the prophylactic use of eculizumab administration at the time of transplantation in high-risk cases of ABOi KT.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102213"},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537810","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 anti-HLA antibodies screening techniques on waiting time on the waiting list and kidney transplant outcomes","authors":"Juan López-Pérez ,&nbsp;Florentino Villanego ,&nbsp;Auxiliadora Mazuecos ,&nbsp;Antonio Nieto","doi":"10.1016/j.trim.2025.102214","DOIUrl":"10.1016/j.trim.2025.102214","url":null,"abstract":"<div><h3>Background</h3><div>Differences in sensitivity and specificity between the techniques used for the detection of anti-HLA antibodies before kidney transplantation (KT) can lead to contradictory results that influence patients' management. Our aim is to analyse whether the technique used, based on complement-mediated-cytotoxicity (CDC) or on microsphere fluorimetry (xMAP), conditions the waiting time until transplantation and its results.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of the KT performed in our centre from 2006 to 2018 whose pre-transplant anti-HLA specificity determination and definition of prohibited antigens was performed by CDC (2006–2011) or by xMAP (2012–2018). Living donor KT recipients were excluded. The influence of each technique on the time on the waiting list and on the outcome of kidney transplantation was analysed, using as indicators the initial function of the graft, the rate of humoral rejection and graft survival.</div></div><div><h3>Results</h3><div>During the period of the study, 622 patients were included (264 were studied by CDC and 358 by xMAP). Recipient and donor age was higher in the xMAP group (<em>p</em> &lt; 0.001). Additionally, most sensitised patients were in the xMAP group (p &lt; 0.001). However, they received a KT earlier. There were no differences in the rate of acute humoral rejection between groups. Nevertheless, graft survival was better in the xMAP group.</div></div><div><h3>Conclusions</h3><div>The introduction of the xMAP technique in our centre has meant an improvement in terms of accessibility to transplantation and the initial management of the patient. However, it does not ameliorate the indicators of graft rejection.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102214"},"PeriodicalIF":1.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529025","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":"2025-02-26","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}