Transplantation最新文献

{"title":"Meta-analysis of short-term clinical and survival outcomes of full-left-full-right split liver transplantation for two recipients: Erratum.","authors":"Shahin Hajibandeh, Shahab Hajibandeh, Farhan Ahmad, Debashis Haldar, Rebeca Sanabria-Mateos, Nikolaos Chatzizacharias, Bobby V M Dasari, David C Bartlett, Keith J Roberts","doi":"10.1097/TP.0000000000005949","DOIUrl":"https://doi.org/10.1097/TP.0000000000005949","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184545","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}

{"title":"Immunosuppression and Long-term Survival After Single Living-donor Lobar Lung Transplantation From the Same Donor as Prior Hematopoietic Stem Cell Transplantation: An All-Japan Study.","authors":"Tatsuaki Watanabe, Takashi Hirama, Tsuyoshi Ryuko, Satona Tanaka, Daisuke Nakajima, Mitsuaki Kawashima, Seiichiro Sugimoto, Shinichi Toyooka, Masaaki Sato, Takeshi Shiraishi, Toyofumi Fengshi Chen-Yoshikawa, Hiroshi Date, Yoshinori Okada","doi":"10.1097/TP.0000000000005935","DOIUrl":"https://doi.org/10.1097/TP.0000000000005935","url":null,"abstract":"<p><strong>Background: </strong>Single living-donor lobar lung transplantation (LDLLT) from the same donor as prior hematopoietic stem cell transplantation (HSCT) represents a unique immunologic setting because of donor-cell chimerism. However, data regarding immunosuppressive management and long-term outcomes in this setting remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter observational study of all patients in Japan who underwent single LDLLT from the same donor as in their prior HSCT. Between November 2006 and December 2024, 9 patients underwent this procedure at 5 centers.</p><p><strong>Results: </strong>All recipients received immunosuppressive therapy for at least 3 mo after LDLLT. During follow-up, immunosuppression was successfully discontinued in 3 patients, whereas the remaining 6 were maintained on individualized reduced-dose maintenance immunosuppression. One patient died 39 mo after LDLLT, with respiratory dysfunction presumed to be associated with severe malnutrition. At a median follow-up of 154 mo for the entire cohort, 8 patients were alive with acceptable graft function.</p><p><strong>Conclusions: </strong>In this highly selected case series, acceptable long-term survival was observed after single LDLLT from the same donor as prior HSCT under reduced immunosuppression, and immunosuppression was successfully withdrawn in 3 patients.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184532","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}

{"title":"Deciphering Myocardial Energy Metabolism in the Transplanted Heart.","authors":"Elric Zweck","doi":"10.1097/TP.0000000000005941","DOIUrl":"https://doi.org/10.1097/TP.0000000000005941","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184549","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}

{"title":"Impact of Donor Obesity on Outcomes in Living Donor Liver Transplantation: A Systematic Review and Meta-analysis.","authors":"Artem Monakhov, Konstantin O Semash, Mikhail Boldyrev, Dmitri Bezinover","doi":"10.1097/TP.0000000000005930","DOIUrl":"https://doi.org/10.1097/TP.0000000000005930","url":null,"abstract":"<p><strong>Background: </strong>Living donor liver transplantation increasingly faces the question of whether otherwise healthy candidates with a body mass index ≥30 kg/m2 can be safely accepted. Available evidence is uneven: large registry datasets sit alongside heterogeneous single-center series, none quantifying the risk accepted by the donors themselves. We therefore synthesized contemporary comparative evidence in living donor liver transplantation, evaluating donor obesity against donor, recipient, and graft outcomes.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science, and Google Scholar from January 2000 to June 30, 2026, for comparative cohorts of living liver donors reporting donor and recipient outcomes by donor body mass index (≥30 versus <30 kg/m2). Random-effects meta-analysis used restricted maximum likelihood with Hartung-Knapp-Sidik-Jonkman 95% confidence intervals (CIs); risk of bias and certainty of evidence were assessed with Risk Of Bias In Nonrandomized Studies of Interventions and Grading of Recommendations, Assessment, Development, and Evaluation.</p><p><strong>Results: </strong>Nine comparative cohorts comprising 6652 donors from North America, Europe, and Asia were included. Donor obesity was not associated with overall complications (risk ratio [RR], 1.09; 95% CI, 0.89-1.34; P = 0.31) or major complications (RR, 1.02; 95% CI, 0.62-1.67; P = 0.93). However, obese donors had higher rates of wound complications (RR, 2.05; 95% CI, 1.25-3.37; P = 0.012) and hospital readmission (RR, 1.34; 95% CI, 1.07-1.69; P = 0.026). Recipient 1-y patient survival, graft survival, and biliary complications were comparable.</p><p><strong>Conclusions: </strong>In carefully screened candidates, obesity alone should not preclude living liver donation. The excess wound morbidity and readmission argue for enhanced prophylaxis and surveillance after discharge rather than for donor exclusion.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167927","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}

{"title":"Are we Asking the Right Questions When Assessing Glomerular Filtration Rate in Living Kidney Donors?","authors":"Artur Quintiliano, Andrew J Bentall","doi":"10.1097/TP.0000000000005926","DOIUrl":"https://doi.org/10.1097/TP.0000000000005926","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171002","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}

{"title":"Prolonged Donor Warm Ischemia in Pure Laparoscopic Donor Right Hepatectomy Is Associated With Increased Recipient Biliary Stricture Risk: A Retrospective Cohort Study.","authors":"Gayoung Kim, Kwang-Woong Lee, Min Kyoung Kim, Sang Hyuk Park, Minseob Kim, Jae-Yoon Kim, Su Young Hong, Suk Kyun Hong, YoungRok Choi","doi":"10.1097/TP.0000000000005928","DOIUrl":"https://doi.org/10.1097/TP.0000000000005928","url":null,"abstract":"<p><strong>Background: </strong>Pure laparoscopic donor right hepatectomy has been increasingly adopted because of its minimally invasive nature and established donor safety. However, its impact on recipient biliary complications remains uncertain. This study aimed to evaluate biliary outcomes after pure laparoscopic donor right hepatectomy using accumulated single-surgeon experience and assess the effect of donor warm ischemic time (DWIT).</p><p><strong>Methods: </strong>We reviewed 264 living donor liver transplantations performed by a single surgeon between 2011 and 2023. Donor hepatectomies were categorized as open (group O; n = 103) or laparoscopic, which was subdivided into early (group EL; n = 49) and late (group LL; n = 112) periods. All recipients were ABO-compatible, underwent duct-to-duct reconstruction, and were followed up for ≥1 y. DWIT was defined as the interval between hepatic artery ligation and cold perfusion. The primary outcome was biliary strictures requiring intervention.</p><p><strong>Results: </strong>Biliary stricture-free survival did not differ significantly between groups (P = 0.278). Receiver operating characteristic analysis identified a DWIT cutoff of 12.5 min as a potential reference point for increased biliary stricture risk (area under the curve, 0.543; P = 0.043). In the multivariate analysis, DWIT ≥13 min was an independent predictor (hazard ratio, 1.88; P = 0.020).</p><p><strong>Conclusions: </strong>Prolonged DWIT appears to increase the risk of recipient biliary strictures, suggesting that minimizing DWIT in laparoscopic donor hepatectomy could help optimize outcomes.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171086","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}

{"title":"Urine Ammonium During Normothermic Machine Perfusion as a Marker of Donor Kidney Function.","authors":"Cristina Ballester Bergada, Jesper Frank Andersen, Veerle A Lantinga, Benjamin Kollerup, Tim L Hamelink, Jesper Staulund, Michael Pedersen, Chris Jaynes, Henri Leuvenink, Stine Lohmann, Jens Leipziger, Anna Krarup Keller, Cyril Moers, Peder Berg, Marco Eijken","doi":"10.1097/TP.0000000000005913","DOIUrl":"https://doi.org/10.1097/TP.0000000000005913","url":null,"abstract":"<p><strong>Background: </strong>Optimizing graft selection remains a central priority, and normothermic machine perfusion (NMP) provides a potential platform for pretransplant organ assessment. Kidney ammonium excretion quantifies proximal tubular and interstitial function. This study investigated urine ammonium during NMP as a marker of kidney graft function.</p><p><strong>Methods: </strong>Ammonium concentrations were measured in both perfusate and urine during 4 h of NMP in porcine kidneys exposed to controlled warm ischemia and in discarded human donor kidneys. Using a porcine autotransplant model, NMP urine ammonium was examined in relation to posttransplant outcomes.</p><p><strong>Results: </strong>Urine ammonium during NMP was reduced in ischemic porcine kidneys. At 4 h of NMP, higher urine ammonium concentration correlated with improved posttransplant kidney function, while other NMP parameters showed weaker or no correlation. In discarded human kidneys, NMP urine ammonium was highly variable and independent of kidney donor profile index, glomerulosclerosis, donor type, age, or preservation technique, indicating potential additive value beyond current assessment criteria. The findings remained robust after adjustment for urine flow, urine creatinine, and perfusate pH.</p><p><strong>Conclusions: </strong>Urine ammonium during NMP may provide additional functional information about kidney graft quality. Its association with posttransplant function supports further investigation as a potential adjunct to current assessment criteria.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138214","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}

{"title":"Universal Prophylaxis or Preemptive Treatment for Trypanosoma cruzi-Seropositive Donors: Comparing Strategies Requires Comparable Endpoints.","authors":"Margarita Anders, Laura Barcán, Manuel Mendizabal","doi":"10.1097/TP.0000000000005921","DOIUrl":"https://doi.org/10.1097/TP.0000000000005921","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196896","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}

{"title":"Professor Dr Vivek B. Kute, MD, DM, FISN, FISOT, FRCP (London).","authors":"Fadi Issa","doi":"10.1097/TP.0000000000005932","DOIUrl":"https://doi.org/10.1097/TP.0000000000005932","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149160","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}

{"title":"Determinants of Baseline Lung Allograft Dysfunction and its Long-term Impact on Pulmonary Function After Bilateral Lung Transplantation.","authors":"Eva Revilla-Lopez, Paula Barquero-Dueñas, Arianna Andrade-Bustamante, Sara Salvador-Fernandez, Manuel Lopez-Meseguer, Alvaro Cantero-Acedo, Cristina Alexandra Romero-Espinosa, Marcos Arbiol-Urquizu, Luis Daniel Soto-Fernandez, Victor Monforte, Ana Villar, Susana Gómez-Ollés, Robin Vos, Cristina Berastegui, Berta Sáez-Giménez","doi":"10.1097/TP.0000000000005818","DOIUrl":"10.1097/TP.0000000000005818","url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation (LT) is the definitive treatment for selected end-stage lung diseases, yet some recipients fail to achieve normal pulmonary function posttransplant, a condition known as baseline lung allograft dysfunction (BLAD). Its causes and long-term outcomes remain incompletely understood.</p><p><strong>Methods: </strong>We retrospectively analyzed all adult bilateral LT performed between 2014 and 2019, with follow-up through December 2024. BLAD was defined as failure to achieve forced expiratory volume in 1 s and/or forced vital capacity ≥80% predicted within the first post-LT year. Multivariable logistic regression identified risk factors, and Cox and linear mixed-effects models assessed associations with survival, chronic lung allograft dysfunction (CLAD), and lung function trajectories.</p><p><strong>Results: </strong>Among 325 recipients, BLAD occurred in 65.5% and was independently associated with reduced survival (hazard ratio, 5.25; 95% confidence interval, 3.84-7.18; P  < 0.001). BLAD was associated with increased CLAD risk in the overall cohort (hazard ratio, 1.42; 95% confidence interval, 1.00-2.00; P  = 0.047), although this association was attenuated after excluding recipients with structural or mechanical causes of reduced spirometry. Risk factors included higher body mass index, longer intensive care unit stay, bronchial stenosis, and older donor age. Over 5 y, BLAD recipients exhibited slower spirometry decline than recipients achieving normal baseline function, whereas CLAD was the main determinant of long-term functional deterioration.</p><p><strong>Conclusions: </strong>BLAD is common after LT and is associated with increased mortality and lower long-term pulmonary function. The BLAD-CLAD association may be partly confounded by structural or mechanical causes of reduced spirometry, supporting BLAD as a heterogeneous early post-LT phenotype.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e2135-e2143"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309577","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}