Transplantation最新文献

{"title":"Engaging Brain Anti-inflammatory Circuits to Improve the Viability of Transplanted Organs.","authors":"Adam M Kressel, Kevin J Tracey, Michael Brines","doi":"10.1097/TP.0000000000005522","DOIUrl":"https://doi.org/10.1097/TP.0000000000005522","url":null,"abstract":"<p><p>Solid organ transplantation is a life-saving intervention for tens of thousands of patients each year in the United States. A major underlying pathophysiologic process limiting the success of transplantation is inflammation. Since the first transplant >70 y ago, advancements in the fields of surgery and immunosuppression have improved both organ and patient survival. However, inflammation and its damaging effects remain the principal clinical problem limiting enduring organ transplant survival. The discovery of the vagus nerve-mediated inflammatory reflex, an endogenous mechanism attenuating inflammatory processes, has provided novel treatment approaches for patients with autoimmune, neurologic, gastrointestinal, and other immune-mediated disorders. Despite these successes, evaluation of whether the inflammatory reflex can improve graft and patient survival in transplantation has yet to be undertaken. Here, we review the fundamentals of transplant rejection and how the inflammatory reflex may provide potential preemptive therapy in deceased donors before organ recovery, as well as attenuate detrimental inflammatory processes in transplant recipients. With this background, we propose that vagus nerve stimulation could be used to improve organ viability and augment current immunosuppressive medication regimens, thereby improving transplantation outcomes.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201564","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":"Living Donor Liver Transplantation for Alcohol-related Liver Disease: An Intention-to-treat Analysis.","authors":"Christian T J Magyar, Owen Jones, Luckshi Rajendran, Lauren Carrique, Marie-Josée Lynch, Zhihao Li, Marco P A W Claasen, Tommy Ivanics, Woo Jin Choi, Felipe Gaviria, Anand Ghanekar, Erin Winter, Roxana Bucur, Chaya Shwaartz, Trevor Reichman, Blayne A Sayed, Markus Selzner, Mamatha Bhat, Cynthia Tsien, Elmar Jaeckel, Leslie B Lilly, Ian D McGilvray, Mark S Cattral, Gonzalo Sapisochin, Nazia Selzner","doi":"10.1097/TP.0000000000005410","DOIUrl":"10.1097/TP.0000000000005410","url":null,"abstract":"<p><strong>Background: </strong>Alcohol-associated liver disease (ALD) is the leading indication for liver transplantation (LT) in the Western world. Although 6 mo of abstinence is no longer a criterion for patients with ALD, the outcomes of living donor LT (LDLT) versus deceased donor LT (DDLT) are not well established.</p><p><strong>Methodss: </strong>We performed an intention-to-treat analysis to evaluate the impact of listing and pursuing primary LDLT (pLDLT) compared with primary DDLT (pDDLT). The primary endpoint was overall survival from date of listing, evaluated using Cox regression (hazard ratios).</p><p><strong>Results: </strong>Two hundred thirty-three patients with ALD were listed for LT, of which 27 (12%) were pLDLT. The overall median model for end-stage liver disease (MELD) score at listing was 20 and Na-MELD 24, a median abstinence of 4.5 mo, and 128 (55%) underwent transplantation. There was no statistically significant adjusted difference at 3-y overall survival between pLDLT versus pDDLT (adjusted hazard ratio [HR] 0.72; P  = 0.550) and in the as-treated analysis (HR 1.22; P  = 0.741). No patients were delisted in the pLDLT group, whereas 86 (42%) patients were delisted in the pDDLT group; primarily because of death (46 [50%]) and medical improvement (24 [28%]). Alcohol use since the time of listing was documented in 29 (13%) patients; immortal time bias adjusted analysis found no significant difference between pLDLT and pDDLT (adjusted HR 1.07; P  = 0.900) and the as-treated analysis (HR 2.95; P  = 0.130).</p><p><strong>Conclusions: </strong>Patients with ALD benefit from intention pLDLT with lower rates of waitlist dropout and delisting, attributable to mortality or medical deterioration, and should be encouraged to pursue this option.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1601-1610"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983496","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":"Comment on \"G-LERP/miR-374i-b Attenuates IRI and Suppresses Hepatocellular Carcinoma Progression\".","authors":"Abdullah K Malik, Derek A Mann","doi":"10.1097/TP.0000000000005499","DOIUrl":"10.1097/TP.0000000000005499","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e623"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609698","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":"Live Donor Liver Transplantation for Oncologic Indications.","authors":"Matthew M Byrne, Mariana Chávez-Villa, Yutaka Endo, Cristina Jimenez-Soto, Luke Cybulski, Luis I Ruffolo, Roberto Hernandez-Alejandro, Koji Tomiyama","doi":"10.1097/TP.0000000000005427","DOIUrl":"10.1097/TP.0000000000005427","url":null,"abstract":"<p><p>Living donor liver transplantation for oncologic indications is a complex topic that involves transplantation, oncology, and ethical considerations. The incidence of primary and secondary malignancy of the liver is growing. As transplant oncology continues to provide promising outcomes, the patient population that may benefit from transplantation will grow. In this review, we provide evidence that justify attempting transplantation for oncologic indications through the exploration of outcomes in both deceased donor and living donor liver transplants. This will focus on outcomes for patients with hepatocellular carcinoma, cholangiocarcinoma, neuroendocrine liver metastasis, and colorectal liver metastases. This review aims to summarize the current status of transplant oncology and to develop the considerations of living donor liver transplantation for these indications.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1591-1600"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267298","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":"Increasing HOPE for DCD Heart Transplantation.","authors":"Jeanette Villanueva, Yashutosh Joshi, Peter S Macdonald","doi":"10.1097/TP.0000000000005431","DOIUrl":"10.1097/TP.0000000000005431","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1574-1575"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112180","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":"Implementation of Kidney Transplantation in a Low-income Country: Experience of Senegal.","authors":"Bacary Ba, Maria Faye, Baratou Coundoul, Moussa Ndour, Ibrahima L Sarr, Moustapha Faye, Ahmed T Lemrabott, Sidy M Seck, Babacar Mbengue, Babacar Diao, Elhadji F Ka","doi":"10.1097/TP.0000000000005465","DOIUrl":"10.1097/TP.0000000000005465","url":null,"abstract":"<p><p>Chronic kidney disease poses a major health challenge in sub-Saharan Africa, with high morbidity and mortality rates. Kidney transplantation (KT) is the most effective treatment for end-stage kidney disease. However, until recently, this option was not available in Senegal. In response, the government enacted a law authorizing KTs from living donors and also established a supervisory committee called \"Comité National du Don et de la Transplantation d'organe.\" After this approval, the Aristide Le Dantec Hospital and the Ouakam Military Hospital consortium successfully performed the first transplants in November 2023, with the support of international partners. Despite the high cost associated with transplantation, the challenge remains to make it affordable to all patients in need. The creation of a national registry also marks a significant step toward more scientific, transparent, and rigorous management of KT data.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e533-e536"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476872","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":"Recombinant Chitinase 3-like 1 Alleviates Liver Transplantation-induced Cold Ischemia/Reperfusion Injury by Promoting M2 Polarization of Kupffer Cells.","authors":"Yihua Wang, Song Xiang, Dengliang Lei, Dadi Peng, Liqing Jiang, Zuotian Huang, Hang Yang, Kezhen Zong, Tengxiang Chen, Zhongjun Wu, Chao Yu","doi":"10.1097/TP.0000000000005433","DOIUrl":"10.1097/TP.0000000000005433","url":null,"abstract":"<p><strong>Background: </strong>Hepatic cold ischemia/reperfusion injury (IRI) significantly restricts graft utilization and adversely affects the prognosis of liver transplantation recipients. The overactivation of Kupffer cells (KCs) is recognized as a significant cellular response in hepatic IRI. This study aimed to investigate the potential of recombinant chitinase 3-like 1 (rCHI3L1) to regulate M2 polarization of KCs and alleviate hepatic cold IRI.</p><p><strong>Methods: </strong>The differentially expressed genes in hepatic cold IRI were investigated using human liver and serum samples from liver transplantation patients. A rat hepatic cold IRI model was established and treated with adeno-associated virus 9-shChi3l1 and rCHI3L1 to evaluate changes in the degree of liver injury, inflammatory response, and the M2 polarization of KCs. Western blot, immunofluorescence, flow cytometry, RNA sequencing, and coimmunoprecipitation were used to explore the potential role of rCHI3L1 in primary KCs.</p><p><strong>Results: </strong>CHI3L1 was upregulated in human and rat donor livers after cold IRI, with KCs as the primary source. rCHI3L1 treatment alleviated hepatic IRI, as evidenced by lower serum alanine aminotransferase and aspartate aminotransferase levels, along with limited liver damage and apoptosis, whereas adeno-associated virus 9-shChi3l1 treatment exacerbated it. Mechanistically, rCHI3L1 promoted the M2 polarization of KCs by activating Janus kinase 1/signal transducer and activator of transcription 3 via interleukin 13 receptor α 2, thereby alleviating hepatic damage and apoptosis.</p><p><strong>Conclusions: </strong>rCHI3L1 alleviated rat hepatic cold IRI by inducing KCs M2 polarization via activating the Janus kinase 1/signal transducer and activator of transcription 3 axis, potentially providing a research basis for treating clinical hepatic IRI.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e567-e582"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249733","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":"Novel Insights From an Old Technique.","authors":"Emmanuel Zorn, Rex Neal Smith","doi":"10.1097/TP.0000000000005408","DOIUrl":"10.1097/TP.0000000000005408","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e537-e538"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039880","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":"The Efficacy of Ferroptosis Inhibition on Ischemia-reperfusion Injury of Abdominal Organs: A Systematic Review and Meta-analysis.","authors":"Lene Devos, Antoine Dubois, Steffen Fieuws, Tom Vanden Berghe, Jacques Pirenne, Laurens J Ceulemans, Diethard Monbaliu, Ina Jochmans","doi":"10.1097/TP.0000000000005405","DOIUrl":"10.1097/TP.0000000000005405","url":null,"abstract":"<p><p>Solid organ transplantation is hampered by complications that arise after ischemia-reperfusion injury (IRI), a detrimental type of injury for which no adequate treatment options are available. Ferroptosis, an iron-dependent form of regulated cell death, is a major driver of IRI. This systematic review and meta-analysis summarizes the effects of pharmacological ferroptosis inhibition in abdominal organs in the setting of IRI. PubMed, Embase, Web of Science and Cochrane were searched for concepts \"ferroptosis\" and \"IRI\" in August 2023. To allow for meta-analyses, inhibitors were divided into different intervention pathways: (I) lipophilic radical scavengers, (II) iron chelators, (III) antioxidants, (IV) lipid metabolism inhibitors, (V) combination treatments, and (VI) others. When available, organ function and injury effect sizes were extracted and used for random-effects meta-analyses. In total 79 articles were included, describing 59 unique inhibitors in kidney, liver, and intestinal IRI. No studies in pancreas were found. Overall bias and study quality was unclear and average to low, respectively. Apart from 1 clinical study, all inhibitors were tested in preclinical settings. The vast majority of the studies showed ferroptosis inhibition to be protective against IRI under various treatment conditions. In liver and kidney IRI, meta-analyses on standardized effect sizes from 43 articles showed a combined protective effect against IRI compared with a nontreated controls for all analyzed intervention pathways. In conclusion, ferroptosis inhibition protects against abdominal IRI in preclinical research. Important questions regarding optimal intervention pathway, bioavailability, optimal dosage, side effects etc. should be addressed before clinical introduction.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e539-e553"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062176","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":"Risk Factors for Solid Organ Graft Failure and Death in Hematopoietic Cell Transplant Recipients Undergoing Solid Organ Transplantation: A Retrospective Center for International Blood and Marrow Transplant Research and Organ Procurement and Transplantation Network Study.","authors":"Meera Gupta, Michelle L Schoettler, Ruta Brazauskas, Stephanie Bo-Subait, Gabriel Orozco, Minoo Battiwalla, David Buchbinder, Betty K Hamilton, Bipin N Savani, Hélène Schoemans, Mohamed L Sorror, Sairah Ahmed, Sherif M Badawy, Vikas Bhushan, Kelly Birdsey, Daniel Couriel, Erin E Doherty, Michelle Donato, Sherif S Farag, Jonathan Gutman, Mitchell Horwitz, Najla El Jurdi, Joseph E Maakaron, Richard T Maziarz, Luis Pineiro, Gary Schiller, Daniel J Weisdorf, Basem M William, Bronwen E Shaw, Rachel Phelan, David L Porter, Peter L Abt, Matthew Levine","doi":"10.1097/TP.0000000000005397","DOIUrl":"10.1097/TP.0000000000005397","url":null,"abstract":"<p><strong>Background: </strong>There is a growing population of hematopoietic cell transplantation (HCT) survivors who later require a solid organ transplant (SOT). However, there are limited data on survival, risk factors (RFs) for SOT graft loss, and death.</p><p><strong>Methods: </strong>This is a retrospective Center for International Blood and Marrow Transplant Research study that included recipients of HCT followed by SOT between 2001 and 2017. HCT data were merged with data from the Organ Procurement and Transplantation Network.</p><p><strong>Results: </strong>Eighty patients underwent autologous (45%) or allogeneic (55%) HCT followed by single SOT. Common indications for HCT included leukemia/myelodysplastic syndrome (45%) and plasma cell disorders (38.8%). The median time from HCT to SOT was 47.7 mo. There were 49 kidney, 26 thoracic, and 5 liver transplants. Overall survival from SOT was significantly different by organ ( P  = 0.01). Three-year overall survival by organ type was 85% among kidney, 70.7% among thoracic, and 30% among liver SOT recipients. Significant RFs for death included lymphoma versus plasma cell disorders and SOT type; thoracic and liver SOT carried a greater risk of death than kidney SOT. There was no significant difference in SOT failure incidence by SOT type; 3-y overall incidence was 27.8%. RFs for SOT graft loss included lymphoma, liver SOT, and positive recipient cytomegalovirus status at SOT.</p><p><strong>Conclusions: </strong>In this study, liver SOT recipients had inferior outcomes. However, renal and thoracic SOT recipients after HCT have acceptable outcomes compared with those of the general SOT population, and thus, SOT should be considered a viable treatment option in these patients.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1626-1638"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369220","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}