Transplantation最新文献

{"title":"Risk Factors for Solid Organ Graft Failure and Death in Solid Organ Transplant Recipients Undergoing Hematopoietic Cell Transplantation: A Retrospective Center for International Blood and Marrow Transplant Research (CIBMTR) and Organ Procurement and Transplantation Network (OPTN) Study.","authors":"Meera Gupta, Michelle L Schoettler, Gabriel Orozco, Ruta Brazauskas, Stephanie Bo-Subait, 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, Matthew Levine, Peter L Abt","doi":"10.1097/TP.0000000000005377","DOIUrl":"10.1097/TP.0000000000005377","url":null,"abstract":"<p><strong>Background: </strong>There is a growing population of solid organ transplant (SOT) survivors who subsequently require a hematopoietic cell transplant (HCT), although there are limited data on survival, risk factors for SOT graft loss, and death in this cohort.</p><p><strong>Methods: </strong>This retrospective Center for International Blood and Marrow Transplant Research study included recipients of SOT followed by HCT between 1989 and 2017. HCT data were merged with organ transplant data from the Organ Procurement and Transplantation Network.</p><p><strong>Results: </strong>Eighty-three patients with an SOT underwent an HCT. Organs transplanted included heart/lung (thoracic, n = 15), kidney (n = 42), and liver (n = 26); 24 patients (29%) received a living donor graft and 59 (71%) a deceased graft. Forty-one patients (49.4%) received an allogeneic HCT and 42 (50.6%) an autologous HCT. Three-year overall survival (OS) from HCT in the entire cohort was 38.6%. There were no significant differences in OS by SOT type, although 3-y OS appeared lowest in the kidney SOT group at 29.9%, compared with liver SOT at 40.6% and thoracic SOT at 58.2%. The incidence of SOT graft failure 3 y post-HCT was 59.1%. There were no significant differences in SOT graft failure by organ type: 3-y failure probability 67.2% for kidney, 56.5% for liver, and 46.2% for thoracic. Shared risk factors for death and graft failure included HCT indication (leukemia, lymphoma, and nonmalignant diseases), HCT type (allogeneic), and SOT type (kidney).</p><p><strong>Conclusions: </strong>Although some SOT recipients may benefit from HCT, the incidence of SOT graft failure was high and OS was poor, particularly after allogeneic HCT.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1611-1625"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369221","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}

{"title":"Solid Organ Transplantation After Hematopoietic Cell Transplantation: Is the Evidence Solid Enough?","authors":"Chethan M Puttarajappa","doi":"10.1097/TP.0000000000005366","DOIUrl":"10.1097/TP.0000000000005366","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1572-1573"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369222","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}

{"title":"Ultrastructural Insights in Renal Allograft Biopsies: Enhancing Early Diagnosis and Prognostication of Antibody-mediated Rejection.","authors":"Yalong Zhang, Jiangwei Man, Li Yang","doi":"10.1097/TP.0000000000005477","DOIUrl":"10.1097/TP.0000000000005477","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e620"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529634","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":"Liver Discard Rate Attributable to Conservative Estimations of Steatosis: An Inference-based Approach.","authors":"Hao Guo, Boris L Gala-Lopez, Ian P J Alwayn, Kevin C Hewitt","doi":"10.1097/TP.0000000000005401","DOIUrl":"10.1097/TP.0000000000005401","url":null,"abstract":"<p><strong>Background: </strong>On-site conservative estimations of steatosis could result in the unnecessary discard of donor livers. This study applied the body mass index as an independent statistical indicator to determine the extent of this problem. We aimed to quantitatively evaluate if decisions based nonbiopsy donor liver assessments are more conservative (inclined to reject marginal fatty livers) than biopsy-based evaluations.</p><p><strong>Methods: </strong>The study processed intradatabase comparisons using 177 081 datasets from Organ Procurement and Transplantation Network spanning 2004 to 2022 September in the United States. Postmatching body mass index was applied as an independent indicator of statistical risk of hepatic steatosis (HS).</p><p><strong>Results: </strong>A total of 7420, 4990, 5994, and 7523 pair of donors with/without biopsy records were matched in 2004-2010, 2011-2014, 2015-2018, and 2019-2022 September, respectively. Consistent with our hypothesis, absent biopsies and evaluations before and during organ procurement were observed to be more conservative, leading to the discard of 16.4% (2004-2010), 16.9% (2011-2014), 10.6% (2015-2018), and 10.3% (2019-2022 September) of potential donor livers.</p><p><strong>Conclusions: </strong>The study concludes that there was a significant (10.3%-16.9%) disparity caused by on-site nonbiopsy assessments of HS, leading to the unnecessary discard of potential donor livers. The findings emphasize the need to develop more accurate intraoperative techniques for assessing HS to optimize donor liver procurement.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e609-e618"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043657","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":"Global Immune Biomarkers and Donor Serostatus Can Predict Cytomegalovirus Infection Within Seropositive Lung Transplant Recipients.","authors":"Bradley J Gardiner, Sue J Lee, Allisa N Robertson, Gregory I Snell, Glen P Westall, Anton Y Peleg","doi":"10.1097/TP.0000000000005422","DOIUrl":"10.1097/TP.0000000000005422","url":null,"abstract":"<p><strong>Background: </strong>Predicting which lung transplant recipients (LTR) will develop cytomegalovirus (CMV) infection remains challenging. The aim of this retrospective cohort study was to further explore the predictive utility of global immune biomarkers within recipient seropositive (R + ) LTRs, focusing on the mitogen component of the QuantiFERON (QF)-CMV assay and the absolute lymphocyte count (ALC).</p><p><strong>Methods: </strong>R + LTR with QF-CMV testing performed at 5 mo posttransplant were included. ALC and mitogen were evaluated as predictors of CMV infection (>150 IU/mL) in plasma and/or bronchoalveolar lavage fluid using Cox regression, controlling for antiviral prophylaxis. Optimal cutoffs were calculated with receiver-operating characteristic curves.</p><p><strong>Results: </strong>CMV infection occurred in 111 of 204 patients (54%) and was associated with donor seropositivity (80/111 [72%] versus 42/93 [45%], P  < 0.001), lower ALC (median 1.1 versus 1.4 × 1000 cells/μL, P  = 0.004), and lower mitogen (2.8 versus 4.6, P  = 0.03) values. Adjusted for serostatus and prophylaxis, each unit decrease in ALC (hazard ratio, 1.56 per 1000 cells/μL; 95% confidence interval, 1.19-2.08; P  = 0.002) and mitogen (hazard ratio, 1.09 per 1 IU/mL; 95% confidence interval, 1.03-1.14; P  = 0.001) were independently associated with CMV. Combining these 2 biomarkers did not substantially improve model performance.</p><p><strong>Conclusions: </strong>In R + LTRs, donor serostatus, ALC values, and the mitogen component of the QF-CMV assay were able to predict postprophylaxis CMV infection. Combining serostatus with either biomarker alone improved predictions, but using both tests together did not increase predictive utility further. These values could be used to risk stratify patients and inform decision-making regarding the duration of antiviral prophylaxis and frequency of virologic monitoring.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1656-1664"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133251","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":"dd-cfDNA Interpretation: Same Sample, Different Story?","authors":"Changhong Xu, Yun Deng, Jiangwei Man, Liyun Ding, Li Yang","doi":"10.1097/TP.0000000000005474","DOIUrl":"10.1097/TP.0000000000005474","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e619"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369253","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":"Heart Valve Replacement in Children: Homografts to Partial Heart Transplantation.","authors":"Dathe Benissan-Messan, John A Kucera, Navin Vigneshwar, Douglas M Overbey, Joseph W Turek","doi":"10.1097/TP.0000000000005407","DOIUrl":"10.1097/TP.0000000000005407","url":null,"abstract":"<p><p>Congenital valvular abnormalities in pediatric patients represent a complex surgical problem that carries with it significant morbidity and mortality. Repair of native valves may not always be feasible, leading to requisite surgical intervention. This has led to the development of mechanical valves, bioprosthetic valves, homografts, stented valves, the Ross operation, and finally, the ultimate development of partial heart transplantation. Each technique carries with it potential benefits and limitations. A comprehensive literature search in concert with expert opinion was completed. This yielded a total of 35 applicable references, with the goal to describe the indications, benefits, and risks associated with each approach. Pediatric patients present a unique problem when considering intervention for irreparable valvular abnormalities. Each technique provides a unique opportunity for mitigation of extant pathology but carries with it potential for risks that are inherent to the approach and must be considered. Partial heart transplant is the only technique which provides the opportunity for definitive valvular replacement in pediatric patients. Although each technique does provide an opportunity to resolve congenital valvular disease, the development of partial heart transplantation is a revolutionary technique that is unique in its ability to grow with the patient. The remaining techniques, at a minimum, require further intervention as the patient grows and develops. Although the literature is clear that there are a variety of options available to surgeons, there is only 1 which can resolve congenital valvular disease with 1 operation.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1576-1580"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000048","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":"Association of Ultrastructural Changes in Renal Allograft Biopsies With Diagnostic Elements of Antibody-mediated Rejection and Graft Outcomes.","authors":"Abdolreza Haririan, Zakieh Zare, John C Papadimitriou, Richard Ugarte, Hiba M A Ahmed, Silke V Niederhaus, Cinthia B Drachenberg","doi":"10.1097/TP.0000000000005416","DOIUrl":"10.1097/TP.0000000000005416","url":null,"abstract":"<p><strong>Background: </strong>The role of electron microscopy (EM) in the diagnosis of kidney allograft pathologies, particularly immunologic injury has not been well studied.</p><p><strong>Methods: </strong>In this retrospective, single-center cohort study, we examined EM features in 796 biopsies from 623 patients at high risk for antibody-mediated rejection, with glomerular abnormalities in light microscopy, presence of donor-specific antibody (DSA), or any degree of albuminuria/proteinuria.</p><p><strong>Results: </strong>Glomerular endothelial cell enlargement (GECE) > 50% was present in 29.1%, subendothelial expansion/basement membrane duplication in 24.5%, and peritubular basement membrane multilamellation > 4 (PTCML) in 18.5%. There was an incremental odds of worsening GECE from no DSA to class I DSA (odds ratio [OR], 2.75, P < 0.001; 95% confidence interval [CI], 1.7-4.5), class II DSA (OR, 3.44, P < 0.001, 95% CI, 2.5-4.7) and both classes (OR, 6.3, P < 0.001; 95% CI, 4.1-9.8). Moreover, the increase in number of antibodies was predictive of higher likelihood of worsening GECE (OR, 2.81, P < 0.001; 95% CI, 2.1-3.8 for 1 DSA; OR, 5.29, P < 0.001; 95% CI, 3.5-7.9 for 2-3; and OR, 8.45, P < 0.001; 95% CI, 4.7-15.3 for ≥4). Similar association was observed with PTCML. In multivariate analysis including DSA, subendothelial expansion/basement membrane duplication, and GECE >50%, but not PTCML were independently predictive of graft failure over mean follow-up of 63 mo (hazard ratio [HR], 1.6, P = 0.006, 95% CI, 1.2-2.3; HR, 2.0, P < 0.001; 95% CI, 1.4-2.9, respectively). Among a cohort with g, ptc, cg, and C4d scores 0, GECE >50% was independently associated with graft failure (HR, 2.58, P < 0.001, 95% CI, 1.6-4.3).</p><p><strong>Conclusions: </strong>These observations support the wider use of EM in kidney transplant biopsies to help with earlier diagnosis of antibody-mediated rejection and to risk stratify the graft outcome.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1646-1655"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047950","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":"Comprehensive Analysis of Lysine β-Hydroxybutyrylation Modification in Ischemia-reperfusion Injury in Mouse Heart Transplantation.","authors":"Cheng Chen, Yang Meng, Yuxin Pan, Yang Zhang, Shaoyu He, Krishna Baral, Mingyi Zhao","doi":"10.1097/TP.0000000000005432","DOIUrl":"10.1097/TP.0000000000005432","url":null,"abstract":"<p><strong>Background: </strong>Ischemia-reperfusion (I/R) is an inevitable adverse outcome after heart transplantation, ultimately leading to graft dysfunction and affecting patient survival. Lysine β-hydroxybutyrylation (Kbhb) is a newly identified form of posttranslational modification that has been shown to be correlated with several cardiovascular diseases. This research sought to analyze the changes in Kbhb protein expression in myocardial tissues of mice with cold ischemia and reperfusion of the heart and to investigate its potential mechanisms.</p><p><strong>Methods: </strong>The myocardial cold ischemia-reperfusion model was constructed using heterotopic abdominal heart transplantation in syngeneic C57/BL6J mice, and the myocardial tissue samples from 6 mice were examined using a combination of liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>After I/R, 43 upregulated and 18 downregulated proteins were identified. Among these, there were 50 upregulated and 18 downregulated Kbhb sites, including Ttn_K16192, Septin9_K355, and Auh_K186. Kyoto Encyclopedia of Genes and Genomes and protein-protein interaction network analyses indicated significant enrichment of differentially modified proteins in myocardial contraction and energy metabolism.</p><p><strong>Conclusions: </strong>The differential expression of Kbhb-modified proteins revealed their potential roles in cold I/R injury after cardiac transplantation, laying the foundation for further exploration of the biological functions and clinical relevance.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e583-e595"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267297","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":"Transplant After Transplant: Outcomes Unraveled.","authors":"Jeff Szer","doi":"10.1097/TP.0000000000005398","DOIUrl":"10.1097/TP.0000000000005398","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"1570-1571"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638170","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}