TransplantationPub Date : 2025-04-01Epub Date: 2024-08-28DOI: 10.1097/TP.0000000000005183
Hao Zhou, Merih Gizlenci, Yao Xiao, Friederike Martin, Keita Nakamori, Elizabeth M Zicari, Yuko Sato, Stefan G Tullius
{"title":"Obesity-associated Inflammation and Alloimmunity.","authors":"Hao Zhou, Merih Gizlenci, Yao Xiao, Friederike Martin, Keita Nakamori, Elizabeth M Zicari, Yuko Sato, Stefan G Tullius","doi":"10.1097/TP.0000000000005183","DOIUrl":"10.1097/TP.0000000000005183","url":null,"abstract":"<p><p>Obesity is a worldwide health problem with a rapidly rising incidence. In organ transplantation, increasing numbers of patients with obesity accumulate on waiting lists and undergo surgery. Obesity is in general conceptualized as a chronic inflammatory disease, potentially impacting alloimmune response and graft function. Here, we summarize our current understanding of cellular and molecular mechanisms that control obesity-associated adipose tissue inflammation and provide insights into mechanisms affecting transplant outcomes, emphasizing on the beneficial effects of weight loss on alloimmune responses.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"588-596"},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TransplantationPub Date : 2025-04-01Epub Date: 2024-11-06DOI: 10.1097/TP.0000000000005255
Parissa Tabrizian
{"title":"Advances in Understanding the Complexities of Recurrent HCC Following Liver Transplantation.","authors":"Parissa Tabrizian","doi":"10.1097/TP.0000000000005255","DOIUrl":"10.1097/TP.0000000000005255","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e190-e191"},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TransplantationPub Date : 2025-04-01Epub Date: 2024-11-06DOI: 10.1097/TP.0000000000005240
Christian T J Magyar, Sheron Perera, Luckshi Rajendran, Zhihao Li, Fahad A Almugbel, Sophie Feng, Woo Jin Choi, Laia Aceituno, Arndt Vogel, Robert C Grant, Nazia Selzner, Elmar Jaeckel, Nazanin Falla-Rad, Jennifer J Knox, Eric X Chen, Gonzalo Sapisochin, Grainne M O'Kane
{"title":"Comparative Outcome Analysis of Lenvatinib Versus Sorafenib for Recurrence of Hepatocellular Carcinoma After Liver Transplantation.","authors":"Christian T J Magyar, Sheron Perera, Luckshi Rajendran, Zhihao Li, Fahad A Almugbel, Sophie Feng, Woo Jin Choi, Laia Aceituno, Arndt Vogel, Robert C Grant, Nazia Selzner, Elmar Jaeckel, Nazanin Falla-Rad, Jennifer J Knox, Eric X Chen, Gonzalo Sapisochin, Grainne M O'Kane","doi":"10.1097/TP.0000000000005240","DOIUrl":"10.1097/TP.0000000000005240","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) recurs after liver transplantation (LT) in ~17% of patients. We aimed to retrospectively compare the outcomes of patients treated with different tyrosine kinase inhibitors (TKIs) for recurrent HCC post-LT.</p><p><strong>Methods: </strong>Patients with recurrent HCC post-LT between 2006 and 2019 were included. The impact of sorafenib and lenvatinib treatment for recurrent disease was assessed using survival analysis with an a priori multivariable Cox regression (alpha-fetoprotein [AFP] at recurrence, recurrence lesion diameter, single-site versus multisite metastases).</p><p><strong>Results: </strong>Seven hundred fifty-four patients underwent LT for HCC, of whom 120 (15.9%) developed recurrence. Of these patients, 56 received TKIs: sorafenib (n = 42) or lenvatinib (n = 14). The median age at LT was 60.8 y (interquartile range, 54.0-66.2); 52 (93%) were men and 26 (46%) were within Milan criteria at listing. Baseline characteristics at recurrence were comparable between the 2 groups, including largest tumor diameter ( P = 0.15), receipt of local therapies before TKI ( P = 0.33), and single-site recurrence ( P = 0.75), and time from interventional treatment to start of TKI ( P = 0.44). The AFP at recurrence was higher in the sorafenib group (95.0 versus 3.0 µg/L, P < 0.001). The median overall survival (OS) after initiation of TKI treatment was longer in the lenvatinib group (15.0 mo [95% confidence interval [CI], 11.5-31.5] versus 7.8 mo [95% CI, 4.0-15.4]; P = 0.02) with a 2.3-fold a priori adjusted effect on OS (adjusted hazard ratio 2.32 [95% CI, 1.03-5.20], P = 0.04).</p><p><strong>Conclusions: </strong>Our findings suggest lenvatinib is a valuable treatment option for patients with HCC recurrence after LT.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"681-690"},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TransplantationPub Date : 2025-04-01Epub Date: 2024-10-23DOI: 10.1097/TP.0000000000005246
Leah McLaughlin, Nicholas Mays
{"title":"What Does the Evaluation of the Organ Donation (Deemed Consent) Act 2019 in England Tell Us About the Effectiveness of Deemed Consent Systems for Deceased Organ Donation?","authors":"Leah McLaughlin, Nicholas Mays","doi":"10.1097/TP.0000000000005246","DOIUrl":"10.1097/TP.0000000000005246","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"561-564"},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TransplantationPub Date : 2025-04-01Epub Date: 2025-01-13DOI: 10.1097/TP.0000000000005311
Helen Stark, Quan Yao Ho, Amy Cross, Alessandro Alessandrini, Alice Bertaina, Daniel Brennan, Stephan Busque, Anthony Demetris, Luke Devey, Gilbert Fruhwirth, Ephraim Fuchs, Peter Friend, Ed Geissler, Carole Guillonneau, Joanna Hester, John Isaacs, Elmar Jaeckel, Tatsuo Kawai, Fadi Lakkis, Joseph Leventhal, Megan Levings, Josh Levitsky, Giovanna Lombardi, Marc Martinez-Llordella, James Mathew, Aurélie Moreau, Petra Reinke, Leonardo V Riella, David Sachs, Alberto Sanchez Fueyo, Katharina Schreeb, Megan Sykes, Qizhi Tang, Angus Thomson, Timothy Tree, Piotr Trzonkowski, Koichiro Uchida, Jeffrey Veale, Josh Weiner, Thomas Wekerle, Fadi Issa
{"title":"Meeting Report: The Sixth International Sam Strober Workshop on Clinical Immune Tolerance.","authors":"Helen Stark, Quan Yao Ho, Amy Cross, Alessandro Alessandrini, Alice Bertaina, Daniel Brennan, Stephan Busque, Anthony Demetris, Luke Devey, Gilbert Fruhwirth, Ephraim Fuchs, Peter Friend, Ed Geissler, Carole Guillonneau, Joanna Hester, John Isaacs, Elmar Jaeckel, Tatsuo Kawai, Fadi Lakkis, Joseph Leventhal, Megan Levings, Josh Levitsky, Giovanna Lombardi, Marc Martinez-Llordella, James Mathew, Aurélie Moreau, Petra Reinke, Leonardo V Riella, David Sachs, Alberto Sanchez Fueyo, Katharina Schreeb, Megan Sykes, Qizhi Tang, Angus Thomson, Timothy Tree, Piotr Trzonkowski, Koichiro Uchida, Jeffrey Veale, Josh Weiner, Thomas Wekerle, Fadi Issa","doi":"10.1097/TP.0000000000005311","DOIUrl":"10.1097/TP.0000000000005311","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"569-579"},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TransplantationPub Date : 2025-04-01Epub Date: 2024-12-11DOI: 10.1097/TP.0000000000005274
Caroline Aspord, Zuzana Macek Jílková, Agnes Bonadona, Theophile Gerster, Mickael Lesurtel, Edouard Girard, Philippe Saas, Thomas Decaens
{"title":"Hypothermic Oxygenated Machine Perfusion and Static Cold Storage Drive Distinct Immunomodulation During Liver Transplantation: A Pilot Study.","authors":"Caroline Aspord, Zuzana Macek Jílková, Agnes Bonadona, Theophile Gerster, Mickael Lesurtel, Edouard Girard, Philippe Saas, Thomas Decaens","doi":"10.1097/TP.0000000000005274","DOIUrl":"10.1097/TP.0000000000005274","url":null,"abstract":"<p><strong>Background: </strong>Organ injury is a major problem in liver transplant. Prolonged liver ischemia may result in ischemia/reperfusion injury (IRI), leading to inadequate activation of innate immunity. Hypothermic oxygenated machine perfusion (HOPE) of the graft emerges as a more physiologic method for liver preservation compared with static cold storage (SCS) by reducing IRI, which improves the quality of the graft. Despite being crucial, the immunological aspects of IRI in liver transplantation remained poorly explored.</p><p><strong>Methods: </strong>We designed a pilot study to assess intrahepatic immune responses to HOPE compared with SCS (6 patients in each group). We explored immunologic and inflammatory pathways using both bulk RNA-sequencing and single-cell multiparametric flow cytometry analyses from liver biopsies performed on the graft before and after transplantation.</p><p><strong>Results: </strong>Despite a limited number of patients and heterogeneous effects on IRI, we observed immune changes in liver biopsies before and after organ storage and distinct functional modulations of intrahepatic immune cells from the transplanted liver that underwent SCS versus HOPE. A significant increase of infiltrated monocytes, conventional type 2 dendritic cells (cDC2s), and neutrophils ( P < 0.05) and a trend toward reduced immune cell viability were observed after SCS but not after HOPE.</p><p><strong>Conclusions: </strong>This pilot study did not allow us to conclude on IRI but showed that HOPE perfusion dampens liver infiltration of some innate immune cells. It reveals that the inclusion of additional transplanted patients and analysis of later time points after transplantation are needed to draw a definitive conclusion. However, it can guide future studies evaluating the development of new strategies to prevent IRI.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":"109 4","pages":"658-670"},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TransplantationPub Date : 2025-04-01DOI: 10.1097/TP.0000000000005384
Baris Ata, Robert A Montgomery, Yucel Naz Ozyoruk, Brendan Parent, Jesse D Schold
{"title":"Patient Selection for Xenotransplant Human Clinical Trials: A Data-driven Approach.","authors":"Baris Ata, Robert A Montgomery, Yucel Naz Ozyoruk, Brendan Parent, Jesse D Schold","doi":"10.1097/TP.0000000000005384","DOIUrl":"https://doi.org/10.1097/TP.0000000000005384","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
TransplantationPub Date : 2025-04-01Epub Date: 2024-09-04DOI: 10.1097/TP.0000000000005193
Yeahwa Hong, Caitlin D Couper, Nidhi Iyanna, Nicholas R Hess, Luke A Ziegler, Mohamed Abdullah, Michael A Mathier, Gavin W Hickey, Mary E Keebler, Scott C Silvestry, David Kaczorowski
{"title":"Mid-term Waitlist and Posttransplant Outcomes With Hepatitis C-positive Donor Hearts.","authors":"Yeahwa Hong, Caitlin D Couper, Nidhi Iyanna, Nicholas R Hess, Luke A Ziegler, Mohamed Abdullah, Michael A Mathier, Gavin W Hickey, Mary E Keebler, Scott C Silvestry, David Kaczorowski","doi":"10.1097/TP.0000000000005193","DOIUrl":"10.1097/TP.0000000000005193","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the clinical trends and impact of hepatitis C virus-positive (HCV+) donors on waitlist and posttransplant outcomes after heart transplantation.</p><p><strong>Methods: </strong>The United Network for Organ Sharing registry was queried to identify adult waitlisted and transplanted patients from January 1, 2015, to December 31, 2022. In the waitlist analysis, the candidates were stratified into 2 cohorts based on whether they were willing to accept HCV+ donor offers. Waitlist outcomes included 1-y cumulative incidences of transplantation and death/delisting. In the posttransplant analysis, the recipients were stratified into 2 cohorts with and without HCV nucleic acid test (NAT)-positive donors. Outcomes included 1- and 4-y posttransplant survival. Propensity score-matching was performed. Risk adjustment was performed using multivariable Cox regression.</p><p><strong>Results: </strong>During the study period, the number of centers using HCV NAT+ donors increased from 1 to 65 centers, along with the number of transplants. In the waitlist analysis, 26 648 waitlisted candidates were analyzed, and 4535 candidates (17%) were approved to accept HCV+ donors. Approval to accept HCV+ donors was associated with a higher likelihood of transplantation and a lower likelihood of death/delisting within 1 y of waitlisting. In the posttransplant analysis, 21 131 recipients were analyzed, and 997 recipients (4.7%) received HCV NAT+ hearts. The 1- and 4-y posttransplant survival were comparable between the recipients of HCV NAT+ and NAT- donors. Furthermore, the similar 1- and 4-y posttransplant survival persisted in the propensity score-matched comparison and multivariable Cox regression analysis.</p><p><strong>Conclusions: </strong>Utilization of HCV+ donors is rising. Heart transplants using HCV+ donors are associated with improved waitlist and comparable posttransplant outcomes.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"701-714"},"PeriodicalIF":5.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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