Transplantation最新文献

{"title":"\"How I Do it\": Caring for Solid Organ Transplant Recipients and Candidates who Need Immune Checkpoint Inhibitors.","authors":"Hiroyuki Arai, Darren Cullinan, Maen Abdelrahim, Germaine Wong, Naoka Murakami","doi":"10.1097/TP.0000000000005814","DOIUrl":"10.1097/TP.0000000000005814","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1975-e1980"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707277","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":"Tissue-Engineered Tracheal Transplantation: Retraction.","authors":"Silvia Baiguera, Martin A Birchall, Paolo Macchiarini","doi":"10.1097/TP.0000000000005878","DOIUrl":"10.1097/TP.0000000000005878","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":"110 10","pages":"e2150"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018034","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":"Suppression of Costimulation Blockade-Resistant Memory CD8+ T cell-Mediated Rejection by TIGIT Agonism.","authors":"Christina R Hartigan, Catherine D Martinez, Maylene E Wagener, Julia M R Bazzano, Katie L Alexander, Mandy L Ford","doi":"10.1097/TP.0000000000005922","DOIUrl":"https://doi.org/10.1097/TP.0000000000005922","url":null,"abstract":"<p><strong>Background: </strong>Costimulation blockade-based immunosuppression with belatacept confers improved renal function compared with calcineurin inhibitors, but comes at a cost of increased incidence and severity of early acute rejection. Strategies to limit costimulation blockade-resistant immune cells are needed. We have previously shown that the coinhibitory receptor T-cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domains (TIGIT) is expressed on memory T-cell subsets associated with costimulation blockade-resistant rejection in humans. Here, we aimed to determine the functional impact of TIGIT agonism on donor-reactive memory T-cell responses in the presence of costimulation blockade in a murine model of transplantation.</p><p><strong>Methods: </strong>We used an experimental transplant model in which murine recipients possess donor-reactive CD8+ T cells before transplantation and were treated with either cytotoxic T-lymphocyte antigen 4 immunoglobulin (CTLA-4Ig) alone or CTLA-4Ig in the presence of an agonistic anti-TIGIT antibody.</p><p><strong>Results: </strong>Results demonstrated that a significant prolongation in graft survival was observed in mice treated with CTLA-4Ig plus the TIGIT agonist compared with CTLA-4Ig alone. Furthermore, the number of graft-infiltrating donor-reactive CD8+ T cells was significantly decreased, and the number of splenic forkhead box P3+ CD4+ regulatory T cells was significantly increased, in animals treated with CTLA-4Ig + TIGIT agonist compared with CTLA-4Ig alone. Finally, CTLA-4Ig + TIGIT agonist treatment resulted in the suppression of inflammatory transcriptional programs within donor-reactive CD8+ memory T cells.</p><p><strong>Conclusions: </strong>These data suggest that agonism of the TIGIT coinhibitory pathway may effectively inhibit costimulation blockade-resistant memory T-cell responses.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115330","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":"Propensity Score-Matched Comparison of Normothermic Machine Perfusion and Normothermic Regional Perfusion in Donation After Circulatory Death Liver Transplant.","authors":"Steven A Wisel, Tiffany Y Lim, Michael Luu, Georgios Voidonikolas, Todd V Brennan, Kambiz Kosari, Tsuyoshi Todo, Nicholas N Nissen, David C H Kwon, Irene K Kim, Justin A Steggerda","doi":"10.1097/TP.0000000000005870","DOIUrl":"https://doi.org/10.1097/TP.0000000000005870","url":null,"abstract":"<p><strong>Background: </strong>Normothermic regional perfusion (NRP) and normothermic machine perfusion (NMP) have rapidly expanded donation after circulatory death (DCD) liver transplant, but comparative real-world data are lacking.</p><p><strong>Methods: </strong>Adult liver transplants performed in the advanced perfusion era (December 2021-June 2025) were analyzed via the Organ Procurement and Transplant Network/Standard Transplant Analysis and Research database. DCD grafts were stratified by advanced perfusion modality (DCD+NMP, DCD+NRP, or DCD+NRP+NMP) or static cold storage (DCD+SCS), and compared with donation after brain death (DBD) transplants. \"Back-to-base\" machine perfusion cases were excluded. Primary outcome was 2-y graft survival.</p><p><strong>Results: </strong>Among 26 021 liver transplants, 20 765 were DBD and 5256 were DCD (2695 DCD+NMP, 861 DCD+NRP, 645 DCD+NRP+NMP, and 1055 DCD+SCS). Hazard of 2-y graft loss was not statistically different from DBD transplants for DCD+NMP (hazard ratio [HR], 1.15; 95% confidence interval [CI], 0.99-1.35; P = 0.069), DCD+NRP (HR, 1.14; 95% CI, 0.87-1.49; P = 0.3), and DCD+NRP+NMP (HR, 1.04; 95% CI, 0.73-1.49; P = 0.8) cohorts. DCD+SCS demonstrated increased hazard of 2-y graft loss (HR, 1.79; 95% CI, 1.52-2.10; P < 0.001). Propensity score matching to DBD cohorts revealed no difference in 2-y graft survival after DCD+NMP (P = 0.11), DCD+NRP (P = 0.12), or DCD+NRP+NMP (P = 0.6), with inferior graft survival after DCD+SCS (P < 0.001). Comparison of DCD+NMP and DCD+NRP by propensity score matching showed no difference in 2-y graft survival (P = 0.3). Hazard of ischemic cholangiopathy was increased over DBD liver transplants for DCD+SCS (HR, 5.51; 95% CI, 2.94-10.3; P < 0.001) and DCD+NMP (HR, 2.11; 95% CI, 1.02-4.23; P = 0.038) but not DCD+NRP (HR, 1.27; 95% CI, 0.29-4.02; P = 0.7) or DCD+NRP+NMP (HR, 1.04; 95% CI, 0.15-4.11; P > 0.9).</p><p><strong>Conclusions: </strong>Advanced perfusion with NMP and/or NRP in DCD liver transplant demonstrates superior graft survival compared with traditional SCS, with 2-y graft survival approaching DBD outcomes. Advanced perfusion should be routinely considered in DCD liver transplant.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040920","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":"Development and Validation of an Ultra-low-cost, Open-source Normothermic Ex Vivo Organ Perfusion Platform.","authors":"Heiko Yang, Nicholas Higgins, Simon Chu, Jean Lee, Natalie Meyer, Keith Hansen, Mustafa Saeed, Ryan Ferreira, Thomas A Sorrentino, Jorge Mena, Pablo Suarez, Feres Camargo Maluf, Wilson Sui, Maria C Velasquez, Uday Mann, Hillary Braun, Juan Du, Jacob Elmer, Thomas Chi, Shuvo Roy, Alan Flake, James M Gardner, Marshall Stoller","doi":"10.1097/TP.0000000000005888","DOIUrl":"10.1097/TP.0000000000005888","url":null,"abstract":"<p><strong>Background: </strong>Normothermic machine perfusion (NMP) promises to catalyze organ preservation, therapeutic discovery, and disease modeling. Commercial organ perfusion devices remain inaccessible for research because of restricted access, high costs, and steep technical learning curves.</p><p><strong>Methods: </strong>To overcome these barriers, an NMP circuit was developed using recycled, repurposed, and low-cost components. Porcine kidneys and autologous blood were used for iterative optimization. A porcine kidney autotransplantation protocol was adapted to evaluate in vivo kidney function after NMP. Nontransplantable human donor kidney, spleen, and pancreas specimens were perfused using human blood products.</p><p><strong>Results: </strong>This effort resulted in an ultra-low-cost (~$2000) NMP system capable of perfusing porcine kidneys and human organs (kidney, pancreas, and spleen) for up to 24 h with evidence of both function and viability. Key innovations included a mechanism to permit low-flow perfusion in nonheparinized organs and a containment bag with adjustable magnets to provide stabilization. Porcine kidneys perfused on this platform demonstrated in vivo function upon autotransplantation with survival for 30 d.</p><p><strong>Conclusions: </strong>We conclude that an ultra-low-cost NMP platform can be constructed from readily available materials. This financially sustainable and scalable model provides a road map to advance ex vivo discovery.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064548","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":"Neurocognitive Recovery After Liver Transplantation Is Driven by Metabolite-mediated Reactivation of Cortical Networks.","authors":"Héloïse Giudicelli, Nicolas Weiss, Dominique Thabut","doi":"10.1097/TP.0000000000005919","DOIUrl":"https://doi.org/10.1097/TP.0000000000005919","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991533","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":"Impaired Lung Function in Liver Transplant Recipients Compared With the General Population: A Nationwide Matched Cohort Study.","authors":"Nicoline Arentoft, Shoaib Afzal, Hans-Christian Pommergaard, Safura-Luise Heidari, Rebekka Faber Thudium, Paul Suno Krohn, Jens-Ulrik Stæhr Jensen, Ask Bock, Jesper Rømhild Davidsen, Niels Kristian Aagaard, Børge Grønne Nordestgaard, Michael Perch, Ken M Kunisaki, Allan Rasmussen, Annette Dam Fialla, Susanne Dam Nielsen","doi":"10.1097/TP.0000000000005916","DOIUrl":"https://doi.org/10.1097/TP.0000000000005916","url":null,"abstract":"<p><strong>Background: </strong>Liver transplant recipients have elevated risk of acute pulmonary infections, but the burden of chronic pulmonary diseases in liver transplant recipients remains largely unknown. We aimed to determine the association between living with a transplanted liver and both spirometry abnormalities and patient-reported dyspnea.</p><p><strong>Methods: </strong>Adult liver transplant recipients from The Danish Comorbidity in Liver Transplant Recipients study and age- and sex-matched controls from The Copenhagen General Population Study were included. Spirometry was performed in 512 adult liver transplant recipients and 2010 matched controls. Outcomes included forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), airflow limitation, preserved ratio impaired spirometry (PRISm), and modified medical research (mMRC) dyspnea scale.</p><p><strong>Results: </strong>Liver transplant recipients had higher prevalence of airflow limitation (10·7% versus 7·1%, P = 0.01) and PRISm (23·8% versus 11·8%, P < 0.001) than controls. When adjusted for age, sex, ethnicity, cumulative smoking, and educational status, living with a transplanted liver was associated with airflow limitation (adjusted odds ratio [aOR], 2.06; 95% confidence interval [CI], 1·41-3.01), PRISm (aOR, 2.88; 95% CI, 2.08-3.99), lower FEV1 (aOR, 363 mL; 95% CI, 297-430 mL), lower FVC (aOR, 549 mL; 95% CI, 467-632 mL), and worse dyspnea. Previous pulmonary infection was associated with airflow limitation in liver transplant recipients (aOR, 2.23; 95% CI, 1.06-4.66).</p><p><strong>Conclusions: </strong>Living with a transplanted liver was independently associated with airflow limitation and decreased FEV1 and FVC. Liver transplant recipients experienced more severe and frequent dyspnea. Increased awareness of pulmonary comorbidities in liver transplant recipients may be warranted.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991484","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":"Beyond Chronological Age: Biological Aging as the Next Frontier in Transplantation.","authors":"Hao Zhou","doi":"10.1097/TP.0000000000005899","DOIUrl":"https://doi.org/10.1097/TP.0000000000005899","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978040","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":"Research Highlights.","authors":"Aleksandra Djordjevic, Natasha M Rogers","doi":"10.1097/TP.0000000000005907","DOIUrl":"https://doi.org/10.1097/TP.0000000000005907","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978129","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":"Medicaid Expansion and its Association With Liver Transplant Outcomes in Adults.","authors":"Miguel Nunez, Holly P Shifman, Amy M Shui, Jennifer C Lai, Sharad Wadhwani","doi":"10.1097/TP.0000000000005896","DOIUrl":"https://doi.org/10.1097/TP.0000000000005896","url":null,"abstract":"<p><strong>Background: </strong>We previously found that Medicaid expansion improved outcomes in pediatric liver transplantation. In this study, we examined whether Medicaid expansion was associated with improved adult liver transplant outcomes over a 10-y period.</p><p><strong>Methods: </strong>Using the Scientific Registry of Transplant Recipients database, we analyzed adults who received liver transplants between January 1, 2010, and December 31, 2020. The primary outcomes were posttransplant graft survival and patient survival. Medicaid expansion status was treated as a time-varying covariate. Cox regression was used to evaluate the relationship between Medicaid expansion, insurance type, and other socioeconomic factors with all-cause graft failure.</p><p><strong>Results: </strong>65,856 adult transplant recipients were included. Seventy-one percent of recipients were in states that implemented Medicaid expansion during the study period. The median age at transplant was 58 y, 85% were White, and 34% were female. Fifty-three percent of patients had private insurance, 29% Medicare and 15% Medicaid. Medicaid expansion was associated with an 8% decreased risk of graft failure/death (HR 0.92; CI, 0.89-0.96; P < 0.001) after adjustment. This effect was greater in patients who had not yet qualified for Medicare, with a 10% decreased risk of graft failure/death (HR 0.90; CI, 0.86-0.93; P < 0.001). In a sensitivity analysis, comparing pre- and postexpansion outcomes over a 3-y period in states that expanded Medicaid, there was a 15% decrease in the risk of graft failure/death (HR, 0.85; CI, 0.80-0.91; P < 0.001).</p><p><strong>Conclusions: </strong>Medicaid expansion was associated with improved outcomes. This suggests that broader access to comprehensive and continuous health insurance may improve long-term outcomes following liver transplantation.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978115","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}