Transplantation最新文献

{"title":"The 2026 Brent and Monaco Awards: Perfusion From Mechanism to Practice.","authors":"Natasha M Rogers, Paolo Cravedi","doi":"10.1097/TP.0000000000005901","DOIUrl":"https://doi.org/10.1097/TP.0000000000005901","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913640","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":"When a Better Kidney Is not Worth the Wait.","authors":"Madeline Petrikas, Joel T Adler","doi":"10.1097/TP.0000000000005900","DOIUrl":"https://doi.org/10.1097/TP.0000000000005900","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920254","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":"Junsheng Ye, Xunrong Luo","doi":"10.1097/TP.0000000000005905","DOIUrl":"https://doi.org/10.1097/TP.0000000000005905","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881916","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":"Evidence- and Consensus-based European Guideline for Immunosuppressive Therapy After Pediatric Kidney Transplantation.","authors":"Anna Grünewald, Thurid Ahlenstiel-Grunow, Zainab Arslan, Nina Battelino, Andreea-Liana Bot Rachisan, Antonia Bouts, Marco Busutti, Elisabeth Cornelissen, Huib de Jong, Jan Dudley, Ali Düzova, Fabian Eibensteiner, Alexander Fichtner, Svitlana Fomina, Mercedes Lopez Gonzalez, Bora Gulhan, Carl Grabitz, Julien Hogan, Britta Höcker, Stefanie Jeruschke, Nele Kanzelmeyer, Jon Jim Kim, Uwe Korst, Raffaela Labbadia, Mieczysław Litwin, Stephen Marks, Anette Melk, Gregor Novljan, Lukasz Obrycki, Jun Oh, Nils Pape, Andrea Pasini, Christian Patry, Martin Pohl, Evgenia Preka, Agnieszka Prytula, Susanne Rieger, Mario Schiffer, Raphael Schild, Tomas Seeman, Jelena Stojanovic, Sara Testa, Burkhard Tönshoff, Diletta Domenica Torres, Lutz T Weber, Monika Nothacker, Lars Pape","doi":"10.1097/TP.0000000000005772","DOIUrl":"10.1097/TP.0000000000005772","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of robust evidence regarding immunosuppressive therapy in children and adolescents after kidney transplantation (KTx), and as such, international practice is highly variable. Recent clinical practice recommendations advocating individualized immunosuppressive strategies that incorporate newer agents are often not implemented. This can potentially contribute to reduced patient and renal allograft survival.</p><p><strong>Methods: </strong>The guideline was developed between January 1, 2024, and December 12, 2025, according to the Guidance Manual of the German Association of Scientific Medical Societies by the German Societies for Pediatric Nephrology, Nephrology, Transplantation, and Pediatrics, the German Kidney Association, the International Pediatric Transplant Association, the European Society for Pediatric Nephrology and the Members of the Cooperative European Pediatric Renal Transplant Initiative.</p><p><strong>Results: </strong>This evidence- and consensus-based guideline provides up-to-date, state-of-the-art recommendations for immunosuppressive therapy after KTx in pediatric kidney transplant recipients. It is based on the best available evidence and the consensus of the relevant German Medical Societies, Members of the Cooperative European Paediatric Renal Transplant Initiative, and the working group on transplantation of the European Society for Paediatric Nephrology, and the International Pediatric Transplant Association.</p><p><strong>Conclusions: </strong>The formal consensus reached is particularly significant in cases of weak or inconclusive evidence and where recommendations are based solely on expert opinion.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1889-e1915"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273137","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":"Survival Benefit of Liver Transplantation in Low Model for End-stage Liver Disease Score Patients: Interpretation and Implications.","authors":"Seoung Hoon Kim","doi":"10.1097/TP.0000000000005707","DOIUrl":"10.1097/TP.0000000000005707","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1957"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609861","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":"Antiobesity Interventions in Living Organ Donor Candidates: Ethical and Policy Considerations.","authors":"Ali B Abbasi, Alan Zambeli-Ljepovic, Peter G Stock, Laura Kimberly, Babak J Orandi","doi":"10.1097/TP.0000000000005719","DOIUrl":"10.1097/TP.0000000000005719","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1761-e1764"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729966","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 Profiles and Outcomes in Living Donor Liver Transplantation Recipients Aged 70 y and Older: A Korean National Registry Analysis.","authors":"Deok-Gie Kim, Mun Chae Choi, Shin Hwang, Kwang-Woong Lee, Jongman Kim, Donglak Choi, Je Ho Ryu, Bong-Wan Kim, Dong-Sik Kim, Hae Won Lee, Yang Won Nah, Man Ki Ju, Tae-Seok Kim, Soo Jin Na Choi, Young Kyoung You, Dong Jin Joo","doi":"10.1097/TP.0000000000005716","DOIUrl":"10.1097/TP.0000000000005716","url":null,"abstract":"<p><strong>Background: </strong>As the global population ages, older-aged candidates increasingly undergo living donor liver transplantation (LDLT). Outcomes and risk factors in recipients aged ≥70 y remain unclear. This study assessed graft survival and age-specific risk factors using nationwide registry data.</p><p><strong>Methods: </strong>From the Korean Organ Transplantation Registry, 4802 adult LDLT recipients were categorized into age <70 (n = 4660) and age ≥70 (n = 142) groups. Graft survival was analyzed using Kaplan-Meier and multivariable Cox regression to evaluate real-world outcomes. Propensity score matching was additionally performed as a sensitivity analysis to confirm the robustness of the findings. Subgroup analyses were used to identify risk factors specific to the age ≥70 group.</p><p><strong>Results: </strong>In unmatched analyses, recipients aged ≥70 y demonstrated significantly lower graft survival than younger recipients (5-y survival: 74.4% versus 87.2%; P  < 0.001). However, after multivariable adjustment, age ≥70 was not an independent predictor of graft loss (adjusted hazard ratio [HR], 1.24; 95% confidence interval [CI], 0.83-1.87; P  = 0.29). Similar findings were observed in the propensity-matched cohort. Subgroup analyses demonstrated that, among recipients aged ≥70 y, pretransplant hospitalization (adjusted hazard ratio [aHR], 1.94; 95% CI, 1.14-3.29), graft steatosis ≥5% (aHR, 1.74; 95% CI, 1.03-2.95), and vascular complications (aHR, 3.11; 95% CI, 1.31-7.43) were each associated with significantly elevated risk of graft failure.</p><p><strong>Conclusions: </strong>Chronological age alone did not independently predict graft failure, but age ≥70 y may amplify risk when combined with steatosis, pretransplant hospitalization, or vascular complications. Therefore, LDLT eligibility in elderly candidates may be better guided by clinical risk profiling rather than age alone.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1852-e1860"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843285","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":"Higher Medical Urgency Is Associated With Greater Psychosocial Risk Tolerance in Liver Transplant Listing and Selection.","authors":"Emily Robitschek, Asal Bastani, Savyon Lev, Kathryn Horwath, Jennifer C Lai, Mark J Pletcher, Irene Y Chen, Jin Ge","doi":"10.1097/TP.0000000000005800","DOIUrl":"10.1097/TP.0000000000005800","url":null,"abstract":"<p><strong>Background: </strong>The Model for End-Stage Liver Disease (MELD) score guides liver transplant (LT) allocation, but transplant programs also evaluate psychosocial risks that may affect outcomes such as graft survival, adherence, and follow-up. How medical urgency influences consideration of these risks remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 2959 adults listed for LT at a large academic center (2012-2023). Using a validated large language model-based techniques, we extracted 23 predefined psychosocial factors from clinical documentation. We compared the prevalence of these factors across MELD categories and assessed associations with successful transplantation.</p><p><strong>Results: </strong>Among listed patients, 10 psychosocial factors increased significantly with higher MELD scores. Low transplant knowledge rose from 3.1% (MELD <15) to 13.3% (MELD >35; adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.22-1.51), history of nonadherence from 7.8% to 22.2% (aOR, 1.25; 95% CI, 1.16-1.35), and past trauma from 5.4% to 12.2% (aOR, 1.19; 95% CI, 1.09-1.30). Among LT recipients, 11 factors showed similar trends, including low transplant knowledge (1.8%-11.1%; aOR, 1.43; 95% CI, 1.23-1.68), nonadherence (5.2%-22.2%; aOR, 1.37; 95% CI, 1.23-1.53), and past trauma (5.2%-13.9%; aOR, 1.22; 95% CI, 1.08-1.37). Adjusting for demographics minimally changed results.</p><p><strong>Conclusions: </strong>Transplant teams appear to tolerate greater psychosocial risk as medical urgency increases. This suggests psychosocial criteria are applied more flexibly at higher MELD scores. Standardized frameworks that explicitly incorporate medical urgency may improve equity and transparency in transplant decision-making.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1870-e1878"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266333","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":"Sexual Intercourse and Alloimmunity. Influence on Reproduction and Solid Organ Transplantation.","authors":"Bastien Poitier, Emmanuel Zorn, Paolo Cravedi, J C Madsen, Gilles Benichou","doi":"10.1097/TP.0000000000005808","DOIUrl":"10.1097/TP.0000000000005808","url":null,"abstract":"<p><p>Sexual intercourse is associated with recognition of partner-derived major histocompatibility complex (MHC) and minor histocompatibility alloantigens (MiHAs) by females. Male sperm-associated MHC antigens, expressed on spermatozoa and leukocytes, as well as MiHAs including sperm-specific antigens (SPAGs), are recognized by female T lymphocytes infiltrating the cervicovaginal region. This can occur via direct presentation of male MHC molecules on male antigen presenting cells and indirect presentation of male antigen peptides (MHC and MiHAs) bound to female MHC molecules on female antigen presenting cells. This process along with the presence of anti-inflammatory chemokines and cytokines and sHLA-G present in seminal fluid leads to activation of male antigen-specific FOXP3 + Treg locally and in regional lymph nodes. This regulatory response has been shown to promote survival and progression of spermatozoa within the cervical mucus as well as implantation of the embryo. Most important, it is believed to set the stage for fetal-maternal tolerance during pregnancy. Conversely, under certain circumstances, alloresponses to male antigens can lead to the production of anti-MHC and anti-sperm-specific antigens antibodies resulting in infertility. Altogether, these observations show that alloimmunity induced after sexual intercourse plays an essential role in reproduction. In addition, while the influence of pregnancy in transplantation is well established, some studies suggest that repeated sexual exposure to male antigens can increase the risk of solid organ transplant rejection.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1773-e1778"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536915","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":"Preformed Anti-DQ Alpha Donor-specific Antibodies and the Risk of Antibody-mediated Rejection After Kidney Transplantation.","authors":"Cindy Ursule-Dufait, Olivier Aubert, Marie Matignon, Dany Anglicheau, Alexandre Hertig, Sarah Tortonese, Cédric Usureau, Romain Lhotte, Magali Devriese, Jean-Luc Taupin, Renaud Snanoudj","doi":"10.1097/TP.0000000000005797","DOIUrl":"10.1097/TP.0000000000005797","url":null,"abstract":"<p><strong>Background: </strong>Anti-DQ donor-specific antibodies (DSAs) are associated with an increased risk of antibody-mediated rejection (AMR) after kidney transplantation, but previous studies focused on antibodies targeting the β-chain, neglecting the also polymorphic α-chain.</p><p><strong>Methods: </strong>This study aimed to assess the frequency, characteristics, and pathogenicity of preformed anti-DQα DSAs in 2041 patients receiving a kidney transplant between 2010 and 2015 across 3 French transplantation centers. Donor and recipient 4-digit human leucocyte antigen typing and single-antigen bead mean fluorescence intensity data were compared with determine the specificity of anti-DQ antibodies. Associations between preformed anti-DQα DSAs and AMR were analyzed using Cox proportional hazard models. Patients with preformed anti-DQα DSAs were then matched to a control group of patients without preformed DSAs, to compare microvascular inflammation in 3-mo biopsies.</p><p><strong>Results: </strong>After analysis of single-antigen bead data, we found that 122 kidney transplant recipients had preformed anti-DQα and anti-DQβ DSAs. Anti-DQα DSAs accounted for 35.2% of anti-DQ DSAs, with a median peak mean fluorescence intensity of 1331 (IQR 677-2896), targeting most frequently the DQA1*05 antigen (83.7%), and consistently the donor α/β heterodimer. In multivariable analyses, the presence of anti-DQα DSAs was associated with a higher risk of AMR, independently of DSAs targeting other loci (HR = 2.61; 95% CI, 1.31-6.01; P = 0.025). Moreover, patients with preformed anti-DQα DSAs had higher microvascular inflammation scores in their 3-mo biopsy than matched patients without DSAs ( P < 0.001).</p><p><strong>Conclusions: </strong>Anti-DQα DSAs are independently associated with AMR after kidney transplantation, underscoring the importance of considering them in transplant allocation of and management of immunosuppression.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e1946-e1956"},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362529","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}