Transplantation最新文献

{"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}

{"title":"Decarbonizing Lifesaving Care: The Case for Greener Economic Organ Transport.","authors":"Carlos F Gould, Hyoduk Shin, Gabriel T Schnickel","doi":"10.1097/TP.0000000000005912","DOIUrl":"https://doi.org/10.1097/TP.0000000000005912","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931054","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 Transplant Volume: Equity as the Next Measure of Transplant Progress in India.","authors":"Khushboo Saxena, Manish R Balwani, Vivek B Kute","doi":"10.1097/TP.0000000000005903","DOIUrl":"https://doi.org/10.1097/TP.0000000000005903","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921083","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":"International Travel for Organ Transplantation: 2024 Multinational Survey of Routes, Organs, and Donor Types.","authors":"Dominique E Martin, Yashan Jiang, Amy Lundgren, Georgina Soo, Riadh A S Fadhil, Benita Padilla, Jayme E Locke, Maggie Kam-Man Ma, Elmi Muller, Alicia Pérez-Blanco, Lola Perojo Vega, Georgina L Irish","doi":"10.1097/TP.0000000000005893","DOIUrl":"https://doi.org/10.1097/TP.0000000000005893","url":null,"abstract":"<p><strong>Background: </strong>International travel for organ transplantation (ITOT) reportedly affects ≥2% of global solid organ transplant activity, yet detailed information about ITOT participants, organ types, travel configurations, and clinical settings remains scarce. Previous research has focused on living donor (LD) kidney transplantation for adults, often in the context of organ trafficking, leaving significant gaps in understanding of contemporary ITOT activities.</p><p><strong>Methods: </strong>A cross-sectional, international online survey was conducted between September 16 and December 15, 2024. Health professionals with experience caring for organ donors or transplant recipients were recruited via professional societies, social media, and personal networks. Participants reported on their most recent experiences of caring for incoming or outgoing transplant recipients and LDs involved in ITOT between January 1, 2023, and August 31, 2024. Data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Three hundred fifty-three respondents from 64 countries completed the survey; 166 (54%) of the 309 clinically active respondents had cared for ≥1 ITOT patient during the study period. Among 164 recipient cases, most involved adults (74%), kidney transplants (57%), and LD transplants (59%), with 40% occurring in private healthcare settings. Children comprised 23% of recipient cases. At least 164 unique travel routes were identified spanning 45 destination countries, with recipients originating from ≥69 countries and LDs from ≥54 countries.</p><p><strong>Conclusions: </strong>ITOT is a geographically diverse, global phenomenon. The substantive proportion of pediatric cases, deceased donor transplants, and private-sector procedures underscores the need for strengthened national and international data collection, governance frameworks, and equitable access policies to address the ethical and clinical challenges of ITOT.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921138","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":"Two Genomes, one Outcome: Stratifying Donor and Recipient Polygenic Risk Score to Improve Kidney Allograft Longevity.","authors":"Agnieszka Swiatecka-Urban, Nilay Mitash, Alexander F Koeppel, Stephen D Turner","doi":"10.1097/TP.0000000000005908","DOIUrl":"https://doi.org/10.1097/TP.0000000000005908","url":null,"abstract":"<p><strong>Abstract: </strong>Kidney transplantation outcomes arise from complex interactions among donor organ quality, recipient susceptibility, and immunologic compatibility, yet conventional clinical risk models explain only a modest fraction of outcome variability. Polygenic risk scores (PRS) offer a promising framework to enhance transplant risk assessment by integrating genome-wide genetic information from both donor and recipient into biologically informed models. This narrative review examines the mechanistic basis for PRS application in kidney transplantation and variant clustering approaches that link polygenic signals to specific biological pathways underlying alloimmunity, fibrosis, and metabolic dysfunction. We compare current PRS construction methodologies, highlighting their respective strengths and limitations in transplant cohorts. Transplant PRS are distinguished from single-genome disease models by their capacity to capture dual-genome interactions, simultaneously quantifying inherited donor organ liability and recipient genetic susceptibility within an integrated framework. This dual-genome architecture requires novel risk stratification paradigms in which combined donor-recipient polygenic profiles inform pretransplant decision-making in ways that neither genome alone can achieve. However, current PRS contribute only incremental variance beyond established clinical predictors, and critical limitations persist, including European ancestry bias, small cohort sizes, incomplete replication, and undefined clinical actionability thresholds. We critically evaluate these implementation barriers and outline future directions for integrating dual-genome PRS with clinical, molecular, and environmental data. The longer-term goal is to advance precision kidney transplantation through applications such as donor selection, immunosuppression tailoring, and individualized posttransplant surveillance. Realizing this potential will require validation in adequately powered, ancestry diverse, prospective transplant cohorts.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931064","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":"Study on the Antirejection Effects of the Dual ICOS and CD28 Antagonist Acazicolcept (ALPN-101) in Mouse Skin and Heart Transplantation Models.","authors":"Leigang Guo, Xiaojingnan Ma, Tingting Ma, Zhen Yang, Lin Li, Yaojuan Liu, Jianxi Wang, Panpan Zhan, Zhongyang Shen","doi":"10.1097/TP.0000000000005897","DOIUrl":"https://doi.org/10.1097/TP.0000000000005897","url":null,"abstract":"<p><strong>Background: </strong>T cell-mediated rejection significantly constrains the success of organ transplantation. T-cell activation relies on the complementary CD28 and ICOS costimulatory pathways. Thus, this research assessed a new dual CD28/ICOS antagonist, acazicolcept, in rigorous allogeneic transplantation models.</p><p><strong>Methods: </strong>Mouse models for allogeneic skin transplantation and abdominal heterotopic heart transplantation were developed. Recipients received acazicolcept, PBS, FK506, or single-pathway antagonists (belatacept or prezalumab). Graft viability, histopathological analysis, and T-cell infiltration were evaluated. Flow cytometry assessed spleen and blood lymphocyte subsets and costimulatory molecules. Donor-specific antibodies and graft C4d deposition were assessed to evaluate humoral responses.</p><p><strong>Results: </strong>Acazicolcept significantly extended the median survival time of skin and heart allografts to 31 d and 42.5 d, respectively, substantially surpassing other groups and mitigated histopathological damage. Mechanistic investigations demonstrated that the drug simultaneously downregulated the surface expression of CD28 and ICOS on T cells; effectively inhibited the development of effector memory T cells (Tem); and reduced the expression of PD-1 and CD69, reflecting a profound attenuation of early T-cell activation. Moreover, acazicolcept markedly inhibited humoral immune responses, as demonstrated by diminished C4d deposition in grafts and lowered levels of donor-specific antibody-IgG/IgM in peripheral blood.</p><p><strong>Conclusions: </strong>Acazicolcept exhibits robust, superior antirejection efficacy compared with single-pathway blockades by concurrently inhibiting CD28 and ICOS signals. This dual mechanism effectively suppresses T-cell activation, effector memory differentiation, and the subsequent antibody-mediated response, offering a robust preclinical justification for its clinical advancement in solid organ transplantation.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921112","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":"Beating Heart Implantation-Added Pain, Little Gain?","authors":"John M Trahanas, Swaroop Bommareddi, Aaron M Williams","doi":"10.1097/TP.0000000000005898","DOIUrl":"https://doi.org/10.1097/TP.0000000000005898","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921061","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":"Target Trial Emulation in Solid Organ Transplantation: Aligning Observational Studies With Randomized, Controlled Clinical Trial Principles.","authors":"Alvaro Assis de Souza, Dennis A Hesselink, David van Klaveren","doi":"10.1097/TP.0000000000005906","DOIUrl":"https://doi.org/10.1097/TP.0000000000005906","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930998","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}