Transplant International最新文献

Current Techniques of Gene Editing in Pigs for Xenotransplantation. 猪异种器官移植基因编辑技术的现状。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-27 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.13807

Cesare Galli

{"title":"Current Techniques of Gene Editing in Pigs for Xenotransplantation.","authors":"Cesare Galli","doi":"10.3389/ti.2025.13807","DOIUrl":"10.3389/ti.2025.13807","url":null,"abstract":"Shortage of human organs for transplantation has created a demand for alternative solutions of which xenotransplantation is amongst the most promising one in the short term. However, the immune reaction following transplantation of a pig organ is greater than the one elicited during allotransplantation. Genetic engineering of the pig is required so that pig organs or tissues are made less immunogenic to humans by eliminating some antigens and by expressing human proteins that can reduce the damage by the host immune system. To generate founder animals with the desired mutations genetic engineering of somatic cells with multiplexed mutations combined with somatic cell nuclear transfer (SCNT) is the best solution with the technology available today. Safety concerns include potential zoonosis, primarily porcine endogenous retroviruses (PERVs). Ethical considerations might arise from the use animals involved in research. Genome editing techniques based CRISPR-Cas9, have greatly facilitated the modification of pig's genome to address coagulation and inflammation issues, to mention just a few, arising after the pig organ is transplanted into a human. However, further research is needed to ensure safety and efficacy of the genome edits introduced in the pig genome are compatible with the health and welfare of the pigs.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"13807"},"PeriodicalIF":2.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Proenkephalin A 119-159 in Kidney Transplantation: A Novel Biomarker for Superior Tracking of Graft Function Trajectories. Proenkephalin A 119-159在肾移植中：一种新的生物标志物，用于更好地跟踪移植物功能轨迹。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-22 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14366

Louise Benning, Marvin Reineke, Camila Eleuterio Rodrigues, Florian Kälble, Claudius Speer, Claudia Sommerer, Christoph F Mahler, Felix C F Schmitt, Markus Mieth, Martin Zeier, Christoph Michalski, Arianeb Mehrabi, Oliver Hartmann, Markus Zorn, Sophie C Anker, David Czock, Markus A Weigand, Zoltan Endre, Christian Morath, Christian Nusshag

{"title":"Proenkephalin A 119-159 in Kidney Transplantation: A Novel Biomarker for Superior Tracking of Graft Function Trajectories.","authors":"Louise Benning, Marvin Reineke, Camila Eleuterio Rodrigues, Florian Kälble, Claudius Speer, Claudia Sommerer, Christoph F Mahler, Felix C F Schmitt, Markus Mieth, Martin Zeier, Christoph Michalski, Arianeb Mehrabi, Oliver Hartmann, Markus Zorn, Sophie C Anker, David Czock, Markus A Weigand, Zoltan Endre, Christian Morath, Christian Nusshag","doi":"10.3389/ti.2025.14366","DOIUrl":"10.3389/ti.2025.14366","url":null,"abstract":"Accurate assessment of graft function trajectories after kidney transplantation is essential for optimizing patient management. Slow graft function (SGF) and delayed graft function (DGF) are associated with impaired recovery, yet current diagnostic tools lack granularity for timely risk stratification. Proenkephalin A 119-159 (penKid) may improve graft function assessment, enhancing risk stratification for SGF, DGF, and associated outcomes. This prospective study evaluated 159 kidney transplant recipients at Heidelberg University Hospital to compare plasma penKid levels with current risk-indicators for poor (functional) graft trajectories. Validation was conducted using an independent transplant cohort from Sydney. Clinical relevance of biomarker-indicated changes in graft function was assessed using multivariable regression models and AUROC analyses. From day one post-transplant, penKid outperformed serum creatinine (SCr) in identifying functional trajectories associated with DGF (AUROC penKid: 0.87 vs. SCr: 0.56) and differentiated SGF from DGF (AUROC penKid: 0.79 vs. SCr: 0.33) up to eight days earlier. PenKid further demonstrated superior granularity in assessing DGF severity and 30-day outcomes. After adjustment for common risk factors, penKid remained the strongest risk stratifier for all tested outcomes. PenKid is a superior biomarker for earlier assessment of graft function trajectories, offering potential to enhance personalized care and clinical trial designs in kidney transplantation.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14366"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CTLA4 Single-Nucleotide Polymorphisms Influence the Risk of HSV and VZV Infection in Kidney Transplant Recipients: A Prospective Cohort Study. CTLA4单核苷酸多态性影响肾移植受者HSV和VZV感染的风险：一项前瞻性队列研究

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-21 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14648

Natalia Redondo, Isabel Rodríguez-Goncer, Tamara Ruiz-Merlo, Francisco López-Medrano, Esther González, Natalia Polanco, Ana Hernández-Vicente, Rafael San Juan, Amado Andrés, José María Aguado, Mario Fernández-Ruiz

{"title":"CTLA4 Single-Nucleotide Polymorphisms Influence the Risk of HSV and VZV Infection in Kidney Transplant Recipients: A Prospective Cohort Study.","authors":"Natalia Redondo, Isabel Rodríguez-Goncer, Tamara Ruiz-Merlo, Francisco López-Medrano, Esther González, Natalia Polanco, Ana Hernández-Vicente, Rafael San Juan, Amado Andrés, José María Aguado, Mario Fernández-Ruiz","doi":"10.3389/ti.2025.14648","DOIUrl":"10.3389/ti.2025.14648","url":null,"abstract":"Herpesviruses are able to modulate adaptive T-cell-mediated responses to establish latency within the host. Reactivation of herpes simplex virus (HSV)-1/2 and varicella zoster virus (VZV) is a frequent and potentially serious complication among kidney transplant recipients (KTRs). The ability of clinical criteria to identify KTRs at increased risk of α-herpesvirus (HSV/VZV) infection is limited. We investigated the effect of two single nucleotide polymorphisms (SNPs) in the cytotoxic T-lymphocyte antigen 4 (CTLA4) gene in a single-center cohort of 204 KTRs. After a median follow-up of 3.1 years, 34 of them (16.7%) experienced 22 episodes of zoster and 15 episodes of HSV-1/2 infection. Homozygous carriers of the minor allele of rs231775 had a higher cumulative incidence of α-herpesvirus infection (23.5% for GG versus 7.6% for AA/AG carriers; P-value = 0.011) and a lower infection-free survival (log-rank P-value = 0.037). After multivariable adjustment by clinical factors (including use of valganciclovir prophylaxis and acute rejection as time-dependent variables), the GG genotype of CTLA4 (rs231775) SNP was associated to the study outcome (adjusted hazard ratio: 3.21; 95% confidence interval: 1.44-7.16). In conclusion, genetic polymorphisms in the co-inhibitory T-cell receptor CTLA-4 may be detrimental for the immune control of latent HSV/VZV infection in KTRs.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14648"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9-5.0 kg) Pediatric Donors: A Decade of Single-Center Experience. 极低体重（0.9-5.0公斤）儿童供体的整体肾移植：十年的单中心经验。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-20 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14451

Xianpeng Zeng, Qiuxiang Xia, Heng Li, Miao Wang, Hanying Li, Liang He, Hua Su, Chun Zhang, Zhendi Wang

{"title":"En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9-5.0 kg) Pediatric Donors: A Decade of Single-Center Experience.","authors":"Xianpeng Zeng, Qiuxiang Xia, Heng Li, Miao Wang, Hanying Li, Liang He, Hua Su, Chun Zhang, Zhendi Wang","doi":"10.3389/ti.2025.14451","DOIUrl":"10.3389/ti.2025.14451","url":null,"abstract":"En-bloc kidney transplantation from low-weight pediatric donors (≤5 kg) is a challenging procedure performed only in limited transplant centers. We retrospectively analyzed the data from 42 en-bloc kidney transplants from donors weighing less than 5 kg between September 2014 and September 2023. The mean donor body weight was found to be 3.1 ± 1.0 kg, and the minimum weight was 0.9 kg. At a mean follow-up period of 1,481 days, the graft survival rate was 76.2% and the recipient survival rate was 100.0%. Thrombosis and acute rejection were the major complications responsible for the short-term graft loss. Male recipients were more likely to experience graft loss than female ones (P < 0.05). Recipients with long-term (>1 year) graft survival were observed to have a high prevalence (31.3%) of delayed graft function. However, they still had satisfactory long-term graft function and limited proteinuria. Continuous graft volume growth took more than 1 year to reach a stable level. Lower donor/recipient body surface area may lead to higher delayed graft function and slower estimated glomerular filtration rate recovery (P < 0.05). Kidney transplant from low-weight pediatric donors is associated with a high incidence of short-term graft loss, while long-term outcomes are generally acceptable.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14451"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Belatacept in Kidney Transplantation: Reflecting on the Past, Shaping the Future. 肾移植中的Belatacept：反思过去，塑造未来。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-20 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14412

Johan Noble, Juliette Leon, Arnaud Del Bello, Dany Anglicheau, Gilles Blancho, Simon Ville, Lionel Couzi, Philippe Grimbert, Yannick Le Meur, Bruno Moulin, Nassim Kamar, Lionel Rostaing, Florence Herr, Antoine Durrbach, Dominique Bertrand

{"title":"Belatacept in Kidney Transplantation: Reflecting on the Past, Shaping the Future.","authors":"Johan Noble, Juliette Leon, Arnaud Del Bello, Dany Anglicheau, Gilles Blancho, Simon Ville, Lionel Couzi, Philippe Grimbert, Yannick Le Meur, Bruno Moulin, Nassim Kamar, Lionel Rostaing, Florence Herr, Antoine Durrbach, Dominique Bertrand","doi":"10.3389/ti.2025.14412","DOIUrl":"10.3389/ti.2025.14412","url":null,"abstract":"Calcineurin inhibitors (CNIs) are a cornerstone of post-transplant immunosuppressive regimens. However, their use is associated with adverse effects, most notably chronic nephrotoxicity, which remains a leading cause of long-term allograft dysfunction. Belatacept, a selective costimulation blocker, offers a promising alternative to CNIs by aiming to reduce nephrotoxicity while maintaining efficacy in preventing acute rejection. While its use in de novo transplantation has been associated with improved graft and patient survival, it has also been linked to a higher incidence of acute rejection. Early post-transplantation conversion to belatacept has demonstrated significant improvements in renal function (eGFR gains ranging from +8.8 to +38.2 mL/min/1.73 m2 at 1 year post-conversion) but carries a higher risk of opportunistic infections. Late conversion protocols, typically initiated beyond 6 months post-transplantation, have shown sustained-although less pronounced-eGFR improvements and better long-term graft survival compared to CNI-based regimens. Additionally, belatacept appears to reduce the incidence of donor-specific antibodies. Future directions for the use of belatacept need further exploration, including its role in rescuing poor renal function, its combination with low-dose CNIs, mTOR inhibitors, or tocilizumab, and its application in desensitization protocols. By potentially striking a balance between efficacy and safety, belatacept may redefine the future landscape of transplant immunosuppression.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14412"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

12-Month Outcomes of a Prospective Randomized Trial Investigating Effects of IVIG on Top of rATG Versus rATG Alone in Pre-Sensitized Kidney Transplant Recipients: The INHIBIT Study. 一项前瞻性随机试验的12个月结果：在预致敏肾移植受者中，IVIG对rATG的影响与单独使用rATG的影响：抑制研究

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-19 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14312

Ondrej Viklicky, Ivan Zahradka, Jan Mares, Janka Slatinska, Alena Parikova, Vojtech Petr, Matej Roder, Katerina Jaklova, Klara Osickova, Libor Janousek, Petra Hruba

{"title":"12-Month Outcomes of a Prospective Randomized Trial Investigating Effects of IVIG on Top of rATG Versus rATG Alone in Pre-Sensitized Kidney Transplant Recipients: The INHIBIT Study.","authors":"Ondrej Viklicky, Ivan Zahradka, Jan Mares, Janka Slatinska, Alena Parikova, Vojtech Petr, Matej Roder, Katerina Jaklova, Klara Osickova, Libor Janousek, Petra Hruba","doi":"10.3389/ti.2025.14312","DOIUrl":"10.3389/ti.2025.14312","url":null,"abstract":"Intravenous immunoglobulins (IVIG) are commonly used in peri-transplant desensitization, but evidence supporting their efficacy is limited. We conducted a prospective, randomized single-center, open-label, Phase IIIb non-inferiority clinical pilot trial to compare the efficacy of IVIG (administered at a dose of 3 × 0.5 g/kg) versus no IVIG, in conjunction with rabbit anti-thymocyte globulin (5-7 mg/kg) induction, in pre-sensitized patients with donor-specific antibodies who had negative pre-transplantation Flow- and CDC-crossmatches, between July 2020 and November 2022. The primary endpoint was the rate of efficacy failure, defined as biopsy-proven rejection within 12-month post-transplant. Secondary endpoints included the incidence of rejection at protocol biopsies, evaluated by histology and biopsy-based transcripts diagnostics. Of the screened patients, 53 (72.6%) were excluded due to crossmatch positivity. Ten patients were randomized to the IVIG+, and 7 to the IVIG-arm. The trial was prematurely terminated due to futility at interim analysis. In the IVIG-arm, 3 patients (43%) experienced the primary endpoint compared to none in the IVIG+ arm (p = 0.026). MMDx identified one molecular ABMR in the IVIG+ and 2 in the IVIG-arm in 12-month protocol biopsies. There was one graft loss in the IVIG-arm. The results of this pilot study, although not definitive, do not support the use of IVIG-sparing regimens in HLA-incompatible kidney transplantation (NCT04302805). This study is registered on ClinicalTrials.gov under the identifier NCT04302805.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14312"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ex-Vivo Perfusion of Limb Vascularized Composite Allotransplants: A Systematic Review of Published Protocols. 肢体血管化复合异体移植的体外灌注：对已发表方案的系统回顾。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-19 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14132

Tessa E Muss, Eleni M Drivas, Amanda H Loftin, Yinan Guo, Yichuan Zhang, Christopher D Lopez, Alisa O Girard, Isabel V Lake, Bashar Hassan, Richa Kalsi, Byoung Chol Oh, Gerald Brandacher

{"title":"Ex-Vivo Perfusion of Limb Vascularized Composite Allotransplants: A Systematic Review of Published Protocols.","authors":"Tessa E Muss, Eleni M Drivas, Amanda H Loftin, Yinan Guo, Yichuan Zhang, Christopher D Lopez, Alisa O Girard, Isabel V Lake, Bashar Hassan, Richa Kalsi, Byoung Chol Oh, Gerald Brandacher","doi":"10.3389/ti.2025.14132","DOIUrl":"10.3389/ti.2025.14132","url":null,"abstract":"Vascularized composite allotransplantation (VCA) has revolutionized restorative surgery of devastating injuries. Unfortunately, these grafts undergo significant injury during prolonged cold ischemia and subsequent reperfusion. Ex-vivo machine perfusion (EVMP) is a technique that has shown significant promise in solid organ transplant, but study of its utility in VCA has been limited. A systematic review was conducted to identify preclinical publications investigating perfusion in limb VCAs. Articles published through June 2023 were screened. 29 articles met inclusion criteria, comprising 370 VCA limbs from swine, rats, canines, and humans. EVMP was conducted under normothermic (n = 6), near-normothermic (n = 11), sub-normothermic (n = 3), or hypothermic (n = 13) conditions. While each study used a unique perfusate recipe, most were based on a premade medium. Many incorporated additives, including antibiotics and red blood cells. The duration varied from 3 to over 24 h. Multiple studies showed improved or equivalent biomarkers, histology, and outcomes for normothermic or near-normothermic EVMP (n = 4) and hypothermic EVMP (n = 8) compared to static cold storage, suggesting that EVMP may be a superior storage method to SCS. While there is no definitive evidence regarding the optimal temperature, perfusate composition, or perfusion time for VCAs, each perfusion factor should be chosen and adapted based on the individual goals of the study. This review offers a summary of the current literature to serve as an accessible reference for the design of future protocols in this field.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14132"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study. 成人肾移植受者（LECOCYT）抗巨细胞病毒（CMV）预防治疗相关的临床和经济负担：一项观察性研究

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-19 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14342

Nassim Kamar, Hannah Kaminski, Christophe Masset, Claire Castagné, Guilhem Tournaire, Xavier Bourge, Lionel Bensimon, Moustafa Naja, Stéphanie Degroote, Isabelle Durand-Zaleski, Christophe Legendre

{"title":"Clinical and Economic Burden Associated With Anti-Cytomegalovirus (CMV) Prophylaxis Therapies in Adult Kidney Transplant Recipients (LECOCYT): An Observational Study.","authors":"Nassim Kamar, Hannah Kaminski, Christophe Masset, Claire Castagné, Guilhem Tournaire, Xavier Bourge, Lionel Bensimon, Moustafa Naja, Stéphanie Degroote, Isabelle Durand-Zaleski, Christophe Legendre","doi":"10.3389/ti.2025.14342","DOIUrl":"10.3389/ti.2025.14342","url":null,"abstract":"The incidence of leukopenia and neutropenia associated with cytomegalovirus (CMV) prophylaxis in kidney transplant (KT) recipients is not well established. LECOCYT, a prospective observational multicenter study, aimed to investigate the clinical and economic burdens of CMV prophylaxis during the first 6 months post-transplantation. Grade 3 or 4 leukopenia or neutropenia was assessed in CMV-seropositive donors/CMV-seronegative recipients (D+/R-) who received current anti-CMV prophylaxis, and in CMV-seronegative donors/CMV-seronegative recipients (D-/R-) who did not. The economic burden in D+/R- was also evaluated. The adjusted odds ratio for grade 3 or 4 leukopenia or neutropenia was 5.16 [95% confidence interval: 1.97-13.53] for D+/R- group. The median costs, excluding the KT procedure, for D+/R- subgroup patients who experienced at least one episode of severe leukopenia or neutropenia were approximately €4,500 (Q1 = €561; Q3 = €10,000). D+/R- patients with no episode incurred significantly lower costs, with a median of nearly €2,100 (Q1 = €182; Q3 = €6,500) (p = 0.02). D+/R- patients with severe leukopenia or neutropenia had a higher rate of outpatient consultations than those without episode (73.9% vs. 57.6%, p = 0.002), and a higher average number of consultations per patient (5.5 ± 4.1 vs. 4.5 ± 3.3, p = 0.042) than D+/R- patients without. Anti-CMV prophylaxis in D+/R- transplant recipients was significantly associated with a higher rate of severe leukopenia or neutropenia compared to no prophylaxis in D-/R- recipients.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14342"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Retrospective Test-Negative Case-Control Study to Evaluate Influenza Vaccine Effectiveness in Preventing Influenza Among Immunocompromised Adults With a Solid Organ Transplant. 一项回顾性试验阴性病例对照研究评估流感疫苗在实体器官移植免疫功能低下成人中预防流感的有效性。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-16 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14187

Manon L M Prins, Ernst D van Dokkum, Aiko P J de Vries, Maarten E Tushuizen, Danny van der Helm, Edwin M Spithoven, Irene M van der Meer, J H Marc Groeneveld, Leo G Visser, Saskia le Cessie, Albert M Vollaard, Geert H Groeneveld

{"title":"A Retrospective Test-Negative Case-Control Study to Evaluate Influenza Vaccine Effectiveness in Preventing Influenza Among Immunocompromised Adults With a Solid Organ Transplant.","authors":"Manon L M Prins, Ernst D van Dokkum, Aiko P J de Vries, Maarten E Tushuizen, Danny van der Helm, Edwin M Spithoven, Irene M van der Meer, J H Marc Groeneveld, Leo G Visser, Saskia le Cessie, Albert M Vollaard, Geert H Groeneveld","doi":"10.3389/ti.2025.14187","DOIUrl":"10.3389/ti.2025.14187","url":null,"abstract":"Vaccination may prevent influenza in solid organ transplant (SOT) recipients. This study evaluates the influenza vaccine effectiveness (VE) in this high-risk population in the Netherlands. We also compared disease progression and 30-day mortality between vaccinated and unvaccinated influenza patients. In this multicenter, test-negative case-control study, SOT recipients with respiratory symptoms were included when tested for viral respiratory infections during the respiratory seasons between 1 January 2013 and 1 July 2024. Cases had a positive influenza PCR, while controls tested negative. Influenza vaccination in cases (74/174) and controls (291/602) were compared after adjusting for potential confounders. VE was calculated as (1-adjusted odds ratio) x 100. The overall VE was 6.9% (95% CI -40.9 to 38.4), with considerable variation across seasons. For those aged ≥65 years, VE was higher (32.4%, 95% CI -56.5-70.8) compared to those aged 18-64 years (4.8%, 95% CI -56.5 to 42.1). The adjusted VE against influenza A [7.5% (-46.0 to 41.3)] was higher than against influenza B (-3.8% (-146.7 to 56.3)). No differences in influenza-related complications were observed between the vaccinated and unvaccinated cases. The observed seasonal influenza vaccine effectiveness in adult SOT recipients is limited; further investigation for improvement is warranted.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14187"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tocilizumab-Based Treatment of Microvascular Inflammation in Kidney Transplant Recipients: A Retrospective Study. 托珠单抗治疗肾移植受者微血管炎症的回顾性研究。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-16 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14502

Johan Noble, Giorgia Comai, Valeria Corredetti, Reda Laamech, Celine Dard, Thomas Jouve, Diane Giovannini, Audrey Le Gouellec, Shivani Wadnerkar, Paolo Cravedi, Della Apuzzo, Daniele Vetrano, Marco Busutti, Chiara Abenavoli, Paolo Malvezzi, Lionel Pe Rostaing, Gaetano Lamanna

{"title":"Tocilizumab-Based Treatment of Microvascular Inflammation in Kidney Transplant Recipients: A Retrospective Study.","authors":"Johan Noble, Giorgia Comai, Valeria Corredetti, Reda Laamech, Celine Dard, Thomas Jouve, Diane Giovannini, Audrey Le Gouellec, Shivani Wadnerkar, Paolo Cravedi, Della Apuzzo, Daniele Vetrano, Marco Busutti, Chiara Abenavoli, Paolo Malvezzi, Lionel Pe Rostaing, Gaetano Lamanna","doi":"10.3389/ti.2025.14502","DOIUrl":"10.3389/ti.2025.14502","url":null,"abstract":"Chronic-active antibody mediated rejection (caAMR) is the leading causes of long-term kidney graft failure. Tocilizumab (TCZ), an anti-IL-6 receptor antibody, has been suggested as a treatment, but data are conflicting. We retrospectively studied consecutive adult kidney transplant recipients with caAMR or microvascular inflammation (MVI) without Donor-Specific Antibodies (DSA) and without C4d deposition (MVI + DSA-C4d-), who received TCZ as first-line therapy in two European centers. Estimated glomerular filtration rate (eGFR) and DSA were assessed one-year before and after TCZ initiation. The study included 64 patients who received TCZ between July 2018 and September 2023. The eGFR trajectory significantly decreased after TCZ treatment (-1.2 ± 0.2 vs. 0.03 ± 0.2 mL/min/1.73 m2/month pre- vs. post-TCZ, respectively; p = 0.001). The percentage of patients with DSA decreased from 63.9% to 38.9% (p < 0.001), and the average MFI decreased from 9,537 to 7,250 (p = 0.001). In multivariate analysis, younger age (OR = 0.95, p = 0.02), MVI + DSA-C4d- phenotype (OR = 5.2, p = 0.01), and lower chronic glomerulopathy score (OR = 4.5, p = 0.02) were associated with TCZ response (trajectory ≥0 after TCZ). Patient survival was 98.4%, and graft survival was 93.7% at one-year. First-line TCZ therapy for caAMR or MVI + DSA-C4d- is associated with an improvement of eGFR trajectories, reduced DSA numbers and MFI and histological inflammation in glomeruli. These data suggest a potential benefit of TCZ in these settings.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14502"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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