Transplantation最新文献

{"title":"Changing the Conversation From Should to How: It Is Time to Implement Normothermic Regional Perfusion as the Standard Procurement Procedure for Donation After Circulatory Death in the United States.","authors":"Anji Wall, Giuliano Testa","doi":"10.1097/TP.0000000000005533","DOIUrl":"https://doi.org/10.1097/TP.0000000000005533","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125981","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":"Physical Frailty and Sarcopenia in Liver Transplantation: How Should They Be Assessed and Addressed?","authors":"Chiemelie Ngonadi, Laurence J Hopkins, Felicity R Williams, Matthew J Armstrong","doi":"10.1097/TP.0000000000005519","DOIUrl":"https://doi.org/10.1097/TP.0000000000005519","url":null,"abstract":"<p><p>Physical frailty and sarcopenia are increasingly associated with morbidity and 2-fold mortality in patients with advanced chronic liver disease awaiting liver transplantation (LT). Furthermore, they significantly affect post-LT recovery and patients' ability to return to independent daily living, including employment. The increased prevalence of metabolic risk factors (ie, obesity, diabetes) and the aging population have contributed to the prevalence of physical frailty and the complexity of the multidisciplinary team decision-making that surrounds LT. Therefore, it is essential that physical frailty is identified early in the LT clinical pathway to provide targeted nutritional (1.2-2.0 g/kg protein intake, pancreatic exocrine replacement therapy) and individualized exercise (both aerobic and resistance) interventions in the form of (p)rehabilitation. A variety of clinical tools currently exist to assess the nutritional status of LT recipients, sarcopenia, and physical frailty, including patient questionnaires (ie, Royal Free Hospital Global Assessment, Duke Activity Status Index), easy-to-use \"by the bedside\" tests (ie, liver frailty index, 6-min walk test), and the more specialist investigations (ie, computer tomography, cardiopulmonary exercise testing). This overview aims to briefly summarize these tools, focusing on their varying ease of use, accessibility, and efficacy in a field that lacks consensus and continuity among LT centers. In addition, the overview highlights the benefits and future challenges of implementing pre- and post-LT rehabilitation programmes.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114110","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":"Fatemeh Mohammadi, Xunrong Luo","doi":"10.1097/TP.0000000000005523","DOIUrl":"https://doi.org/10.1097/TP.0000000000005523","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330075","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":"Is There Hope With Hypothermic Oxygenated Perfusion?","authors":"Howard J Eisen, Abigail Bent","doi":"10.1097/TP.0000000000005524","DOIUrl":"https://doi.org/10.1097/TP.0000000000005524","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076256","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":"Orthotopic Liver Transplantation During Pregnancy: The Role of Surgical Technique.","authors":"Ying Chen, Nicholas Rothbard, Matthew Wright, Mary Thomson, Vinh Nguyen, Abraham J Matar","doi":"10.1097/TP.0000000000005528","DOIUrl":"https://doi.org/10.1097/TP.0000000000005528","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076274","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":"Unique Immune Polarization of the Lung Allograft: Implications for Organ-specific Immunoregulation and Tolerance Induction.","authors":"Erica Leyder, Mojtaba Taheri, Michael Neschis, Anirban Banerjee, Elizabeth A Jacobsen, Andrew Gelman, Daniel Kreisel, Alexander Sasha Krupnick, Zhongcheng Mei","doi":"10.1097/TP.0000000000005521","DOIUrl":"10.1097/TP.0000000000005521","url":null,"abstract":"<p><p>Technological innovations have improved many barriers in lung transplantation, but high rates of acute and chronic rejection still limit lung allograft survival. This may be explained by the unique environment of the lung. As a mucosal barrier organ, the lung is constantly exposed to the external environment, leading to unique immunological features that are not seen in other transplantable solid organ allografts such as hearts, kidneys, and livers. Thus, the higher rates of rejection and poor long-term survival of lung transplant recipients may stem from the global immunosuppression strategies that are indiscriminately used for all solid organ grafts. Data from our laboratory, and others, have demonstrated that the unique immunoregulatory pathways of the lung may require different strategies for long-term graft survival. For example, depletion of CD8+ T cells typically contributes to the acceptance of transplanted organs. However, these cells facilitate lung allograft acceptance through interferon gamma mediated nitric oxide production. Interestingly CD8+ T cells modify and polarize eosinophils to produce nitric oxide as a means of tolerance induction. Such eosinophils also function to maintain long-term lung allograft acceptance by interfering with humoral alloimmunity. For most other organs eosinophils are suspected to contribute to graft rejection. In this review, we aim to describe the cytokine pathways involved in lung allograft rejection or tolerance, contrast such pathways to those evident in other solid organs, and discuss the need for further studies that can be used to design rational methods for altering the cytokine environment to improve lung allograft survival.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076194","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":"Pregnancy, Where Assisted Reproductive Technology and Transplant Science Intersect.","authors":"Yvonne El Kassis, Michelle A Josephson, Dianne B McKay","doi":"10.1097/TP.0000000000005525","DOIUrl":"https://doi.org/10.1097/TP.0000000000005525","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076268","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":"Response to Letter: Global Immune Biomarkers and Donor Serostatus Can Predict Cytomegalovirus Infection Within Seropositive Lung Transplant Recipients.","authors":"Bradley J Gardiner, Sue J Lee, Gregory I Snell, Glen P Westall, Anton Y Peleg","doi":"10.1097/TP.0000000000005531","DOIUrl":"https://doi.org/10.1097/TP.0000000000005531","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076271","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 Associations Between Individual-Versus Neighborhood-level Incomes and Kidney Transplant Outcomes.","authors":"Tatenda G Mupfudze, Dzhuliyana Handarova, Samantha M Noreen, Sumit Mohan, Jesse D Schold, Darren E Stewart","doi":"10.1097/TP.0000000000005486","DOIUrl":"https://doi.org/10.1097/TP.0000000000005486","url":null,"abstract":"<p><strong>Background: </strong>Disparities in posttransplant outcomes persist and worsened during the COVID-19 pandemic, disproportionately affecting individuals with social risk factors. This study examined the total and residual (ie, direct) associations between individual- and neighborhood-level income and posttransplant outcomes among deceased donor kidney transplant (DDKT) and living donor kidney transplant recipients transplanted in the United States in 2020.</p><p><strong>Methods: </strong>This retrospective cohort study linked Organ Procurement and Transplantation Network data with estimated individual annual income from LexisNexis and neighborhood median annual household income from the American Community Survey. Multivariable Cox models assessed associations between income and 3-y all-cause graft survival, patient survival, and death-censored graft survival.</p><p><strong>Results: </strong>Among 14 091 DDKT recipients, lower individual income was associated with higher all-cause graft failure (adjusted hazard ratio [aHR] for lowest quartile [Q1] versus highest [Q4]: 1.37; 95% confidence interval [CI], 1.20-1.56) and death (aHR, 1.47; 95% CI, 1.26-1.72). Neighborhood income had weaker associations, though Q1 recipients still had higher all-cause graft failure (aHR, 1.17; 95% CI, 1.03-1.33) and death (aHR, 1.21; 95% CI, 1.04-1.41). In models including both income measures, only individual income remained significant. Censoring COVID-19 deaths attenuated associations for individual income, while neighborhood income was no longer significant. Among 4565 living donor kidney transplant recipients, income was not significantly associated with outcomes.</p><p><strong>Conclusions: </strong>Lower individual income predicts higher all-cause graft failure, primarily because of increased mortality in DDKT recipients. Neighborhood income has a weaker effect, particularly when censoring COVID-19 deaths. Targeted interventions are needed to improve equity in kidney transplantation, especially during public health crises.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034180","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":"Post-recurrence Survival After Liver Transplantation for Hepatocellular Carcinoma.","authors":"Marianna Maspero, Carlo Sposito, Chase Wehrle, Marco Bongini, Isabella Pezzoli, Sherrie Bhoori, Valentina Bellia, Andrea Schlegel, Vincenzo Mazzaferro","doi":"10.1097/TP.0000000000005514","DOIUrl":"https://doi.org/10.1097/TP.0000000000005514","url":null,"abstract":"<p><strong>Background: </strong>Mortality after liver transplantation (LT) for hepatocellular carcinoma (HCC) is mainly driven by HCC recurrence. We sought to determine whether post-recurrence survival (PRS) has improved during the last 2 decades.</p><p><strong>Methods: </strong>Using the Scientific Registry of Transplant Recipients, we included all patients who underwent LT for HCC between 2003 and 2020 and experienced HCC recurrence. Patients were divided into 4 eras (2003-2007, 2008-2012, 2013-2016, and 2017-2020) according to their year of recurrence.</p><p><strong>Results: </strong>Of 26 309 patients who underwent LT for HCC, 2518 patients were included: 276 (11%) in era 1; 662 (26.3%) in era 2; 685 (27.2%) in era 3; and 895 (35.5%) in era 4. Patients in later eras were more likely to be outside Milan, but within Metroticket 2.0, and underwent more bridging therapies. Median PRS was 9 mo (95% confidence interval [CI], 8-10 mo) for era 1, 13 (11-15) for era 2, 15 (13.5-16.5) for era 3, and 17 mo (15-19 mo) for era 4 (P < 0.001). After adjusting for time to recurrence, only the comparison between era 1 and era 4 remained significant. At multivariable analysis, only time to recurrence <24 mo (hazard ratio, 1.4; 95% CI, 1.2-1.7; P < 0.0001) and poorly differentiated HCC (hazard ratio, 1.5; 95% CI, 1.2-1.8; P < 0.0001) were associated with PRS, while recurrence era was not.</p><p><strong>Conclusions: </strong>PRS has only modestly improved during the last 2 decades. Despite more patients undergoing bridging therapies in later eras, PRS has not changed compared with eras with more restrictive transplant criteria.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016308","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}