Transplantation最新文献

{"title":"The Economic Value of Volunteers Directing and Managing the US Organ Donation and Transplantation System.","authors":"Macey L Levan, Tessa L Flower, Allan B Massie, Dianne LaPointe Rudow, Carolyn N Sidoti, Richard N Formica, Lloyd E Ratner","doi":"10.1097/TP.0000000000005293","DOIUrl":"10.1097/TP.0000000000005293","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"e184-e185"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048003","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":"Five-day Wearable Respiratory Support With a Novel Ambulatory Pulmonary Assist System in an Awake Ovine Model.","authors":"Yeahwa Hong, Suji Shin, Umar Nasim, Helen M Scala, Kalliope G Roberts, Alexander S Potchernikov, Brian E Woolley, David J Skoog, Matthew Bacchetta, Keith E Cook","doi":"10.1097/TP.0000000000005165","DOIUrl":"10.1097/TP.0000000000005165","url":null,"abstract":"<p><strong>Background: </strong>The pulmonary assist system (PAS) is a wearable respiratory support system that is currently under development for patients with chronic lung disease as a bridge to lung transplantation or as destination therapy. This study evaluates the long-term performance and biocompatibility of the PAS in a 5-d awake, ovine model.</p><p><strong>Methods: </strong>The PAS was attached to normal sheep in venovenous configuration. Components of the PAS included a 0.9 m 2 surface area oxygenator and a lightweight, battery-powered axial flow pump. The system was also tested using the Abbott PediMag as the control pump. Each sheep was supported on the PAS for 5 d with 2 L/min blood flow and 4 L/min sweep gas. Activated clotting times of 200-240 s were maintained using intravenous heparin. Pump performance, oxygen transfer, oxygenator resistance, and hematologic parameters were measured throughout the support.</p><p><strong>Results: </strong>The PAS, either using the axial flow pump or PediMag (n = 4 each), was well tolerated by the sheep without signs of device-related organ damage or hemolysis. All the studies achieved the full, 5-d study duration. The oxygenator resistance remained consistent without significant clot formation in all experiments with an average resistance of 2.55 ± 0.10 mm Hg/(L/min). The system achieved an average oxygen transfer rate of 116.4 ± 5.5 mL/min, with an average Hb concentration of 9.2 ± 0.6 g/dL. White blood cell, platelet, and hematocrit levels also remained stable and within normal limits throughout the study period.</p><p><strong>Conclusions: </strong>The PAS provided 5 d of uncomplicated ambulatory respiratory support with minimal clot formation, stable gas exchange, blood flow resistance, and hematologic parameters.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"467-475"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005394","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":"Immune Monitoring Assays: Predicting Cytomegalovirus and Other Infections in Solid Organ Transplant Recipients.","authors":"Bradley J Gardiner, Glen P Westall, Martina Sester, Julian Torre-Cisneros, Camille N Kotton","doi":"10.1097/TP.0000000000005218","DOIUrl":"10.1097/TP.0000000000005218","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":"109 3","pages":"395-398"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450432","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":"Downregulation of Tumor Suppressor Gene LKB1 During Severe Primary Graft Dysfunction After Human Lung Transplantation: Implication for the Development of Chronic Lung Allograft Dysfunction.","authors":"Mohammad Rahman, Davide Scozzi, Natsuki Eguchi, Rachel Klein, Narendra V Sankpal, Angara Sureshbabu, Timothy Fleming, Ramsey Hachem, Michael Smith, Ross Bremner, Thalachallour Mohanakumar","doi":"10.1097/TP.0000000000005172","DOIUrl":"10.1097/TP.0000000000005172","url":null,"abstract":"<p><strong>Background: </strong>Severe primary graft dysfunction (PGD) after lung transplantation (LTx) is a significant risk factor for the development of bronchiolitis obliterans syndrome (BOS). Recent data from our group demonstrated that small extracellular vesicles (sEVs) isolated from the plasma of LTx recipients with BOS have reduced levels of tumor suppressor gene liver kinase B1 ( LKB1 ) and promote epithelial-to-mesenchymal transition (EMT) and fibrosis. Here, we hypothesized that early inflammatory responses associated with severe PGD (PGD2/3) can downregulate LKB1 levels in sEVs, predisposing to the development of chronic lung allograft dysfunction (CLAD).</p><p><strong>Methods: </strong>sEVs were isolated from the plasma of human participants by Exosome Isolation Kit followed by 0.20-µm filtration and characterized by NanoSight and immunoblotting analysis. Lung self-antigens (K alpha 1 tubulin, Collagen V), LKB1 , nuclear factor kappa B, and EMT markers in sEVs were compared by densitometry analysis between PGD2/3 and no-PGD participants. Neutrophil-derived factors and hypoxia/reperfusion effects on LKB1 levels and EMT were analyzed in vitro using quantitative real-time polymerase chain reaction and Western blotting.</p><p><strong>Results: </strong>LKB1 was significantly downregulated in PGD2/3 sEVs compared with no-PGD sEVs. Within PGD2/3 participants, lower post-LTx LKB1 was associated with CLAD development. Hypoxia/reperfusion downregulates LKB1 and is associated with markers of EMT in vitro. Finally, lower LKB1 levels in PGD2/3 are associated with increased markers of EMT.</p><p><strong>Conclusions: </strong>Our results suggest that in post-LTx recipients with PGD2/3, downregulation of LKB1 protein levels in sEVs is associated with increased EMT markers and may result in the development of CLAD. Our results also suggest that ischemia/reperfusion injury during LTx may promote CLAD through the early downregulation of LKB1 .</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"476-483"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126763","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":"Proposed US Legislation to Pay Kidney Donors: Counter-productive and Against Global Ethical Standards.","authors":"Alexander M Capron, Gabriel M Danovitch, Matthew Cooper, Nancy L Ascher, Francis L Delmonico","doi":"10.1097/TP.0000000000005265","DOIUrl":"10.1097/TP.0000000000005265","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"403-405"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547674","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":"HLA Mismatches Identified by a Novel Algorithm Predict Risk of Antibody-mediated Rejection From De Novo Donor-specific Antibodies.","authors":"Xiaohai Zhang, Nancy L Reinsmoen, Jon A Kobashigawa","doi":"10.1097/TP.0000000000005140","DOIUrl":"10.1097/TP.0000000000005140","url":null,"abstract":"<p><strong>Background: </strong>The development of de novo donor-specific antibodies (dnDSA) and antibody-mediated rejection (AMR) remains a barrier to long-term graft and patient survival. Most dnDSA are directed against mismatched donor HLA-DQ antigens. Here, we describe a novel algorithm, which we have termed categorical amino acid mismatched epitope, to evaluate HLA-DQ mismatches.</p><p><strong>Methods: </strong>In this algorithm, amino acid residues of HLA-DQ protein were categorized into 4 groups based on their chemical characteristics. The likelihood of categorically mismatched peptides presented by the recipient's HLA-DRB1 was expressed as a normalized value, %Rank score. Categorical HLA-DQ mismatches were analyzed in 386 heart transplant recipients who were mismatched with their donors at the HLA-DQB1 locus.</p><p><strong>Results: </strong>We found that the presence of DQB1 mismatches with %Rank score ≤1 was associated with the development of dnDSA ( P  = 0.002). Furthermore, dnDSA increased the risk of AMR only in recipients who had DQ mismatches with %Rank score ≤1 (hazard ratio = 5.8), but the freedom from AMR was comparable between recipients with dnDSA and those without dnDSA if %Rank scores of DQ mismatching were >1.</p><p><strong>Conclusions: </strong>These results suggest that HLA-DQ mismatches evaluated by the categorical amino acid mismatched epitope algorithm can stratify the risk of development of dnDSA and AMR in heart transplant recipients.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":"519-526"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761172","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":"Unraveling Molecular and Functional Responses Across 3 Lung Injury Models to Expand the Donor Lung Pool.","authors":"Gabriel Hirdman, Martin Stenlo, Nicholas Burdon Bèchet, Anna Niroomand, Margareta Mittendorfer, Qi Wang, Dag Edström, Haider Ghaidan, Sven Kjellström, Leif Pierre, Franziska Olm, Snejana Hyllén, Sandra Lindstedt","doi":"10.1097/TP.0000000000005353","DOIUrl":"https://doi.org/10.1097/TP.0000000000005353","url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation remains hampered by a scarcity of viable donor lungs, partially attributed to donor lung injuries.</p><p><strong>Methods: </strong>Three porcine lung injury models were studied: infection-induced using lipopolysaccharide (n = 7), aspiration-induced using endotracheal gastric content (n = 7), and injury using lavage and harmful ventilation (ventilator-induced lung injury; n = 7). Molecular and functional changes from before and after the establishment of lung injury were examined with histopathology, immunohistochemistry, cytokine levels, hemodynamics, and mass spectrometric analysis of lung tissue. The respiratory tract lining fluid was analyzed using exhaled breath particles.</p><p><strong>Results: </strong>T-cell proliferation and suppression of complement activation were unique to the gastric injury, whereas the ventilator-induced lung injury group displayed a unique activation of monocyte chemotaxis. The lipopolysaccharide injury exhibited an activation of stress response proteins. Alterations in the extracellular matrix, particularly the degradation of collagen type IV and increased elastin expression, were identified as a consistent indicator of acute lung injury. Additionally, increases in exhaled particles and differential expression of proteins in the respiratory tract lining fluid correlated with deteriorating lung function.</p><p><strong>Conclusions: </strong>Molecular analysis of the lung indicated distinct key differences and similarities of donor lung injury phenotypes. Analysis of various donor lung injuries suggests a heightened emphasis on the extracellular matrix for the restoration and rejuvenation of damaged donor lungs.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450427","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":"Commentary on \"Human Papillomavirus (HPV) Infection and Cytological Atypia in Female Allogeneic Hematopoietic Stem Cell Transplantation Recipients\".","authors":"M Veronica Dioverti, Robin K Avery","doi":"10.1097/TP.0000000000005344","DOIUrl":"https://doi.org/10.1097/TP.0000000000005344","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450393","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":"Mucosal Mixed Lymphocyte Reaction Assay Using Intestinal Lymphocytes as a Biomarker for Intestinal Transplant Tolerance Development.","authors":"M Esad Gunes, Satyajit Patwardhan, Julie Hong, Elin Manell, Philip Jordache, Ishit Chauhan, Ahmed Almesallmy, Jianing Fu, Megan Sykes, Joshua Weiner","doi":"10.1097/TP.0000000000005348","DOIUrl":"https://doi.org/10.1097/TP.0000000000005348","url":null,"abstract":"<p><strong>Background: </strong>Intestinal transplantation (ITx) has the highest rate of rejection among solid organ grafts. We aimed to study the pathophysiology of rejection after ITx but lacked a tool for assessing cellular responses within the graft. Therefore, we developed a novel mixed lymphocyte reaction (MLR) assay to investigate immune responses in the graft.</p><p><strong>Methods: </strong>Intestinal samples were collected, decontaminated, and processed into single-cell suspensions from 9 swine and 2 patients that underwent ITx. Debris was removed using gradient centrifugation. The cells were plated with corresponding stimulator cells and incubated for 6 d before data acquisition and analysis.</p><p><strong>Results: </strong>Tolerant animals showed no anti-donor or anti-recipient responses in their graft mucosa but maintained strong anti-third-party responses, even after weaning immunosuppression. An animal with graft-versus-host disease displayed robust anti-recipient and anti-third-party responses but no anti-donor response. The animals with graft rejection maintained anti-donor responses at all timepoints. Finally, some tolerant animals developed \"split tolerance,\" with anti-donor responses in the peripheral blood but donor-specific hyporesponsiveness in the mucosal MLR, which regulatory T cells depletion suggested was attributable to local regulatory tolerance. When applied to human sample, this mucosal MLR reliably demonstrated self-tolerance with normal anti-third-party responsiveness.</p><p><strong>Conclusions: </strong>The novel mucosal MLR assay presented herein ± CD25 depletion serves as a useful adjunct for assessing immune responses within the intestinal graft mucosa. This could help elucidate immune responses after ITx in future studies, including our own, and could represent a promising tool for studying ITx tolerance development, guiding immunosuppression strategies, and advancing personalized transplant medicine.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450423","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":"Undirected Donor Pools Lifesaving Approach for Acute Liver Failure.","authors":"Mamdouh Alenazi, Dimitri A Raptis, Elizabeth A Pomfret, Dieter C Broering","doi":"10.1097/TP.0000000000005357","DOIUrl":"https://doi.org/10.1097/TP.0000000000005357","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442183","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}