Transplantation最新文献

{"title":"Frailty in Kidney Transplant Candidates: Bridging Evidence to Practice.","authors":"Fan Zhang","doi":"10.1097/TP.0000000000005394","DOIUrl":"https://doi.org/10.1097/TP.0000000000005394","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657910","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":"A New Approach to Mitigate Donor Liver Ischemia/Reperfusion Injury.","authors":"Hanwen Yang, Yujun Zhao","doi":"10.1097/TP.0000000000005379","DOIUrl":"https://doi.org/10.1097/TP.0000000000005379","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657234","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":"Sharon L Ford, Natasha M Rogers","doi":"10.1097/TP.0000000000005376","DOIUrl":"https://doi.org/10.1097/TP.0000000000005376","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625983","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":"Pregnancy After Solid Organ Transplantation: Review of the Evidence and Recommendations.","authors":"Goni Katz-Greenberg, Yalda Afshar, Julie Bonn, Jillian Casale, Serban Constantinescu, Ersilia M DeFilippis, Roshan P George, Ana Iltis, Shilpanjali Jesudason, Michelle Kittleson, Deborah J Levine, Michael J Moritz, Monika Sarkar, Silvi Shah, Kimberly Uccellini, Lisa A Coscia, Ana P Rossi","doi":"10.1097/TP.0000000000005341","DOIUrl":"10.1097/TP.0000000000005341","url":null,"abstract":"<p><p>Solid organ transplantation (SOT) offers people with end-stage organ disease an increased quality of life, which includes the return of fertility and the potential for pregnancy. Although the number of pregnancies has increased, definitive recommendations have been lacking. To address reproductive health in SOT recipients, the American Society of Transplantation Women's Health Community of Practice held a virtual Controversies Conference with subject matter experts gathered to discuss topics of contraception, immunosuppression, and pregnancy in SOT recipients and pregnancy post-living donation. This publication is a synthesis of expert guidance and available data regarding pregnancy management and outcomes after all types of SOTs.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617366","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":"Matthew Tunbridge, Xunrong Luo","doi":"10.1097/TP.0000000000005375","DOIUrl":"https://doi.org/10.1097/TP.0000000000005375","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617424","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":"Identifying the Unmet Healthcare Needs of Kidney Transplant Recipients Who Experience Graft Loss: Learning From Patients' Experience.","authors":"Anita Marie Slominska, Elizabeth Anne Kinsella, M Khaled Shamseddin, Saly El Wazze, Kathleen Gaudio, Amanda Vinson, Ann Bugeja, Marie-Chantal Fortin, Marcelo Cantarovich, Julie Ho, Shaifali Sandal","doi":"10.1097/TP.0000000000005364","DOIUrl":"https://doi.org/10.1097/TP.0000000000005364","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant recipients with graft loss (KTR-GL) are an increasing group of patients whose care needs are largely unmet. The lack of patient perspectives is a key research gap. We conducted an in-depth exploration of the experiences of KTR-GL to identify their healthcare needs.</p><p><strong>Methods: </strong>This qualitative study adopted an interpretive descriptive methodology. Data collection entailed semistructured narrative interviews conducted until data saturation was achieved and was analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>Our sample included 23 KTR-GL (women: 34.8%; mean age, 54.3 y). Six themes were identified that represent areas in which participants' needs may be inadequately acknowledged and/or met: (1) setting expectations (longevity of the graft, transplant is not a cure, risk of graft failure, anticipating transplant loss, and balancing hope and realism), (2) communicating with care team (support and empathy and clarifying the cause of graft failure), (3) support for transition to dialysis (shaped by prior experience, preparedness for the initiation of dialysis, lack of options, and dialysis requires adjustment), (4) navigating the path to retransplantation (understanding patient preferences, clarity and transparency, addressing ineligibility, preemptive transplant, and living donation), (5) psychosocial resources (access to psychological services, specific and adequate psychological support, reliable social worker, and peer support), and (6) lessons learned (building mutual trust, self-advocacy, defining a successful transplant, and gaining resilience).</p><p><strong>Conclusions: </strong>In this in-depth exploration of the experiences of KTR-GL, we have identified several unmet healthcare needs that have practice and policy implications. Incorporating a patient-centered approach is needed to improve the healthcare experiences and, potentially, the outcomes of KTR-GL.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597897","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":"Access to Transplant for African American and Latino Patients Under the 2014 US Kidney Allocation System.","authors":"Teija Madhusoodanan, David P Schladt, Grace R Lyden, Cinthia Lozano, Jonathan M Miller, Joshua Pyke, Tim Weaver, Ajay K Israni, Warren T McKinney","doi":"10.1097/TP.0000000000005360","DOIUrl":"10.1097/TP.0000000000005360","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant offers better outcomes and reduced costs compared with chronic dialysis. However, racial and ethnic disparities in access to kidney transplant persist despite efforts to expand access to transplant and improve the equity of deceased donor allocation. Our objective was to evaluate after listing the association of race and ethnicity with access to deceased donor kidney transplant (DDKT) after changes to the allocation system in 2014.</p><p><strong>Methods: </strong>This retrospective study evaluated access to DDKT after listing since the implementation of the 2014 kidney allocation system. Waitlist status and transplant outcomes were ascertained from data from the Scientific Registry of Transplant Recipients. Our analysis included every adult kidney transplant candidate on the waiting list in the US from January 1, 2015, through June 30, 2023.</p><p><strong>Results: </strong>A total of 290 763 candidates were on the waiting list for DDKT during the study period. Of these, 36.4% of candidates were African American and 22.2% were Latino. Compared with White non-Latino patients, access to DDKT after listing was reduced for African American (unadjusted hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.92-0.94) and Latino individuals (unadjusted HR, 0.88; 95% CI, 0.87-0.90). After controlling for demographic and clinical factors, these differences in access to transplant widened substantially for African American (HR, 0.78; 95% CI, 0.77-0.80) and Latino patients (HR, 0.73; 95% CI, 0.72-0.74).</p><p><strong>Conclusions: </strong>African American and Latino patients had reduced access to DDKT after listing. More effective approaches to improving access for African American and Latino individuals after listing are needed.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597890","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":"Inactivating the Innate Immune Receptor CD11b With a First-in-Class Monoclonal Antibody Prolongs the Survival of Kidney Allografts in Nonhuman Primates.","authors":"Abbas Dehnadi, Ivy A Rosales, Jian-Ping Xiong, Tatsuo Kawai, Hyshem H Lancia, Gilles Benichou, Robert B Colvin, A Benedict Cosimi, M Amin Arnaout","doi":"10.1097/TP.0000000000005370","DOIUrl":"https://doi.org/10.1097/TP.0000000000005370","url":null,"abstract":"<p><strong>Backgournd: </strong>Peritransplant ischemia/reperfusion injury (IRI) plays a central pathogenic role in nondelayed or delayed kidney allograft function immediately after transplantation and increases the risk of subsequent rejection. Potential therapies targeting specific cytokines or complement proteins to limit IRI have failed in clinical trials. Monoclonal antibody 107 (mAb107), a \"pure\" (nonactivating) inhibitor of the archetypal innate immune receptor integrin CD11b, has been shown to extend the survival of IRI nonhuman primate native kidneys in an in situ model.</p><p><strong>Methods: </strong>Here, we administered mAb107 before allograft revascularization to determine its efficacy for extending the survival of ischemia-damaged donor kidneys transplanted into major histocompatibility complex-mismatched nonhuman primate recipients.</p><p><strong>Results: </strong>We observed a significant delay in the onset of rejection and prolongation of allograft survival in mAb107-treated versus control recipients. Early allograft biopsies suggest this is secondary to the selective suppression of infiltrating neutrophils and macrophages.</p><p><strong>Conclusions: </strong>These observations support the hypothesis that inactivating CD11b with mAb107 may provide an effective strategy for prolonging the survival of ischemia-damaged allografts and increasing the successful use of marginal donor organs.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587184","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":"Combined Pancreas-Kidney Transplantation After Rescue Allocation: The Eurotransplant Experience: A Retrospective Multicenter Outcome Analysis.","authors":"Volker Assfalg, Felix Stocker, Norbert Hüser, Daniel Hartmann, Edouard Matevossian, Milou van Bruchem, Serge Vogelaar, Lutz Renders, Christoph Schmaderer, Christian Margreiter, Andras Deak, Franka Messner, Michael Kammer, Dirk Ysebaert, Daniel Jacobs-Tulleneers-Thevissen, Dimitri Michalski, Steven van Laecke, Pieter Gillard, Andreas Kahl, Richard Viebahn, Carina Riediger, Bernd Jänigen, Moritz Schmelzle, Friedrich Alexander von Samson-Himmelstjerna, Dirk Stippel, Ana Harth, Martin Nitschke, Dionysios Koliogiannis, Andreas Pascher, Joachim Hoyer, Julia Weinmann-Menke, Mario Schiffer, Sebastian Hinz, Silvio Nadalin, Kai Lopau, Volkert Huurman, Miha Arnol, Gregor Miller","doi":"10.1097/TP.0000000000005354","DOIUrl":"https://doi.org/10.1097/TP.0000000000005354","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous pancreas-kidney transplantation (SPKT) is the therapy of choice for selected patients with complicated type 1 diabetes mellitus and end-stage renal disease. Pancreas rescue allocation was implemented in Eurotransplant allocation algorithms to increase organ utilization, concurrently facilitating transplantation of supposedly inferior quality organs. The aim of this study was to examine whether outcomes of SPKT after rescue allocation, which can either be recipient-oriented extended allocation or competitive rescue allocation, were as good as after standard allocation.</p><p><strong>Methods: </strong>This retrospective multicenter analysis of 1504 SPKT performed from 2013 to 2021 evaluated outcomes by allocation type considering survival of patients, pancreas grafts, and kidney grafts. Multivariable analyses further explored the influence of specific donor-, recipient-, and transplant-related variables on outcomes.</p><p><strong>Results: </strong>Multivariable analyses showed no significant differences in SPKT outcome for standard allocation versus either rescue allocation type regarding patient, pancreas graft, and kidney graft survival. Rescue allocation organ donors were older, had higher body mass index, and were more likely to smoke. Rescue allocation had fewer HLA matches. Cold ischemic times of both pancreas and kidneys were longer in competitive rescue allocation but not in recipient-oriented extended allocation. Rescue allocation pancreas recipients had shorter waiting times. Multivariable analyses showed inferior pancreas and kidney graft survival for higher donor age. Higher recipient age correlated with higher mortality despite better pancreas graft survival.</p><p><strong>Conclusions: </strong>SPKT outcome after rescue allocation is comparable with standard allocation in both patient and graft survival. Age of both donors and recipients essentially influences the success of SPKT.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587172","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":"Incidence and Outcomes of Diaphragmatic Hernia After Living Donor Hepatectomy: The Significance of Bipolar Irrigated Sealer Use.","authors":"Sang-Hoon Kim, Sung-Gyu Lee, Shin Hwang, Chul-Soo Ahn, Ki-Hun Kim, Deok-Bog Moon, Tea-Yong Ha, Gi-Won Song, Gil-Chun Park, Young-In Yoon, Ji Hoon Kim, Woo-Hyoung Kang, Eun-Kyoung Jwa, Byeong-Gon Na, Sung Min Kim, Rak-Kyun Oh, I-Ji Jeong, Hyo Jung Ko, Minha Choi, Dae Hyeon Won, Do Young Lee, Ji Hoon Kang, Dong-Hwan Jung","doi":"10.1097/TP.0000000000005362","DOIUrl":"https://doi.org/10.1097/TP.0000000000005362","url":null,"abstract":"<p><strong>Background: </strong>Acquired diaphragmatic hernia (DH) is a rare and potentially fatal complication after living donor hepatectomy (LDH). This study aimed to assess the incidence and clinical outcomes of DH after LDH.</p><p><strong>Methods: </strong>Four thousand fourteen living donors who underwent LDH at Asan Medical Center, Seoul, between September 2013 and August 2023 were retrospectively reviewed. We analyzed the incidence of DH before and after the introduction of the bipolar irrigated sealer (BIS). Multivariate logistic regression analysis was used to identify the risk factors for DH.</p><p><strong>Results: </strong>Postoperative DH occurred in 18 patients (0.40%). Seventeen patients underwent right LDH and developed right-sided DH, whereas 1 patient underwent left LDH and developed left-sided DH. The incidence of DH was 0.22% in the pre-BIS period and >6-fold to 1.36% in the post-BIS period. The median time of postoperative DH occurrence was 11 (range, 3-95) mo. Ten patients underwent elective surgery for DH repair, whereas 8 patients with severe abdominal pain or bowel obstruction underwent emergency surgery, 1 of whom underwent small bowel resection and anastomosis due to severe bowel incarceration. Using BIS was the only significant risk factor for developing DH (p < 0.001; odd ratio, 6.28; 95% confidence interval, 2.43-16.25).</p><p><strong>Conclusions: </strong>Early recognition and surgical repair of DH after LDH should be considered in living donors with unexplained abdominal or thoracic symptoms. Caution is advised when using peridiaphragmatic hemostasis with BIS in liver surgery. We recommend extending the postoperative follow-up of living donors to at least 3 y, including routine imaging screenings for DH.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587185","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}