Transplant International最新文献_第2页

Correction: Landscape of current practices and future perspectives in living donor kidney donation in Europe: proceedings of a pan-European symposium by the European kidney transplant association section of the European Society for Organ Transplantation. 更正：欧洲活体肾脏捐赠的当前实践和未来前景：欧洲器官移植学会欧洲肾脏移植协会分会泛欧研讨会的会议记录。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-28 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.17772

引用次数: 0

Nutritional strategies in kidney transplantation: optimising outcomes beyond surgery. 肾移植的营养策略：优化手术后的结果。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-24 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16322

Lara Caldiroli, Paolo Molinari, Simone Vettoretti, Anna Regalia, Simona Verdesca, Giuseppe Castellano, Maurizio Gallieni, Carlo Alfieri

{"title":"Nutritional strategies in kidney transplantation: optimising outcomes beyond surgery.","authors":"Lara Caldiroli, Paolo Molinari, Simone Vettoretti, Anna Regalia, Simona Verdesca, Giuseppe Castellano, Maurizio Gallieni, Carlo Alfieri","doi":"10.3389/ti.2026.16322","DOIUrl":"10.3389/ti.2026.16322","url":null,"abstract":"Although kidney transplantation (KTx) remains the optimal therapy for end-stage kidney disease, long-term graft survival and patient outcomes continue to be limited by cardiometabolic complications and chronic allograft dysfunction. Nutritional management has evolved from supportive care to a core component of post-transplant follow-up. The early post-transplant phase is marked by catabolism, high-dose immunosuppression, and metabolic instability, leading to increased protein requirements but also potential susceptibility to hyperfiltration injury. In the stable post-transplant phase, a moderate protein intake similar to that recommended for chronic kidney disease (CKD) may support graft longevity, although evidence in kidney transplant recipients (KTRs) remains limited and inconsistent. Plant-forward dietary models, including Mediterranean and DASH patterns, consistently improve cardiometabolic risk, inflammation, oxidative stress, and dietary acid load, with potential benefits for graft outcomes. Predominantly plant-based diets may further reduce uremic toxin generation and improve mineral metabolism, though careful monitoring for micronutrient deficiencies is required. Low-protein approaches, such as PLADO, remain largely theoretical in transplant populations, while ketogenic or very low-carbohydrate diets raise concerns regarding acid-base balance, renal hemodynamics, and long-term tolerability. Overall, personalised nutritional strategies tailored to graft function, immunosuppression, and metabolic profile are essential to optimise long-term transplant health.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16322"},"PeriodicalIF":3.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138357","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

Bortezomib in combination with standard-of-care for late active antibody-mediated rejection with de novo donor-specific antibodies after kidney transplantation: a multicenter randomized trial. 硼替佐米联合标准治疗肾移植后晚期活动性抗体介导的新供者特异性抗体排斥反应：一项多中心随机试验

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-23 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16702

Renaud Snanoudj, Fabienne Marquant, Karine Renaudin, Valérie Dubois, Alice Koenig, Nadia Arzouk, Sophie Caillard, Magali Giral, Arwa Jalal Eddine, Hakim Mazouz, Nassim Kamar, Vincent Pernin, Marie Matignon, Nacera Ouali, Dany Anglicheau, Caroline Elie

{"title":"Bortezomib in combination with standard-of-care for late active antibody-mediated rejection with de novo donor-specific antibodies after kidney transplantation: a multicenter randomized trial.","authors":"Renaud Snanoudj, Fabienne Marquant, Karine Renaudin, Valérie Dubois, Alice Koenig, Nadia Arzouk, Sophie Caillard, Magali Giral, Arwa Jalal Eddine, Hakim Mazouz, Nassim Kamar, Vincent Pernin, Marie Matignon, Nacera Ouali, Dany Anglicheau, Caroline Elie","doi":"10.3389/ti.2026.16702","DOIUrl":"10.3389/ti.2026.16702","url":null,"abstract":"Bortezomib has been proposed as a treatment for antibody-mediated rejection (AMR) after kidney transplantation; however, its efficacy remains uncertain. We conducted a multicenter, randomized, open-label trial in France between February 2015 and July 2019 in adult kidney transplant recipients with late active AMR associated with de novo donor-specific antibodies (dnDSA). Sixty of the planned 100 patients were randomized 1:1 to receive standard-of-care consisting of corticosteroids, plasmapheresis, and intravenous immunoglobulin, either alone or with bortezomib administered as two cycles of four infusions. The primary endpoint was a composite of a >50% reduction in immunodominant DSA mean fluorescence intensity and stabilization or improvement of microvascular inflammation and transplant glomerulopathy on graft biopsy at 12 months. This endpoint was achieved in 40.0% of patients receiving bortezomib and 33.3% receiving standard-of-care alone in the intention-to-treat analysis (RR = 1.20, 95% CI 0.61-2.34; p = 0.59), and in 50.0% and 42.1%, respectively, in the per-protocol analysis (RR = 1.19, 95% CI 0.60-2.36; p = 0.62). Neither component differed between groups. Serious adverse events occurred in 23 patients (76.7%) receiving bortezomib and 14 patients (46.7%) receiving standard-of-care alone (p = 0.017). Adding bortezomib did not demonstrate a significant efficacy benefit and was associated with a higher incidence of serious adverse events (ClinicalTrials.gov number: NCT02201576).","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16702"},"PeriodicalIF":3.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128363","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

Evolution and interrelation of physical frailty and mild cognitive impairment up to two years after kidney transplantation: a multi-center prospective cohort study. 肾移植后两年身体虚弱和轻度认知障碍的演变和相互关系：一项多中心前瞻性队列研究

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-21 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16175

Nadine Beerli, Manuel Wehrle, Isabelle Binet, Michael Dickenmann, Déla Golshayan, Karine Hadaya, Uyen Huynh-Do, Reto W Kressig, Sabina De Geest, Oliver Mauthner

{"title":"Evolution and interrelation of physical frailty and mild cognitive impairment up to two years after kidney transplantation: a multi-center prospective cohort study.","authors":"Nadine Beerli, Manuel Wehrle, Isabelle Binet, Michael Dickenmann, Déla Golshayan, Karine Hadaya, Uyen Huynh-Do, Reto W Kressig, Sabina De Geest, Oliver Mauthner","doi":"10.3389/ti.2026.16175","DOIUrl":"10.3389/ti.2026.16175","url":null,"abstract":"Kidney transplantation (KT) is the preferred treatment for kidney failure, providing superior survival and quality of life compared with haemodialysis. However, the demand for transplantation exceeds organ availability, underscoring the need to optimize pre- and post-transplant care. Physical frailty and mild cognitive impairment (MCI) are important predictors of post-transplant outcomes, yet their long-term trajectories remain insufficiently understood. This prospective multicentre longitudinal study, nested within the Swiss Transplant Cohort Study, included 230 adult KT recipients followed for up to 2 years after transplantation. Physical frailty was assessed using the adapted Fried Frailty Phenotype and MCI using the Montreal Cognitive Assessment. Physical frailty declined from 8.3% before transplantation to below 2% during follow-up, while pre-frailty decreased from 54.3% to 27.6% at 2 years. MCI prevalence declined from 42.6% to 31.3%. Longitudinal analyses demonstrated that physical frailty was more dynamic than cognitive function. Better cognitive function at earlier time points predicted lower subsequent frailty, whereas frailty did not significantly predict later cognitive function. These findings suggest that cognitive assessment may help identify patients at risk of persistent frailty and support the routine assessment of both physical frailty and cognitive function before and after KT to improve risk stratification and guide individualized patient care.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16175"},"PeriodicalIF":3.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115028","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

Normothermic regional perfusion in controlled donation after circulatory death liver transplantation: an updated systematic review and meta-analysis versus non-NRP and brain-death donors. 循环死亡肝移植后控制捐献的正常区域灌注：一项更新的系统综述和对非nrp和脑死亡供者的荟萃分析。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-21 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.17154

José Ramírez-Esteban, Ezequiel Sarrió, Alberto Ruiz-Pacheco, Ana Cots, Nekane Romero-García, Rafael Badenes

{"title":"Normothermic regional perfusion in controlled donation after circulatory death liver transplantation: an updated systematic review and meta-analysis versus non-NRP and brain-death donors.","authors":"José Ramírez-Esteban, Ezequiel Sarrió, Alberto Ruiz-Pacheco, Ana Cots, Nekane Romero-García, Rafael Badenes","doi":"10.3389/ti.2026.17154","DOIUrl":"10.3389/ti.2026.17154","url":null,"abstract":"Normothermic regional perfusion (NRP) may mitigate ischemic injury in controlled donation after circulatory death (cDCD) liver transplantation. We updated the most recent meta-analysis (search closed June 2023) by incorporating subsequent evidence and comparing NRP with non-NRP cDCD and with donation after brain death (DBD). We performed a systematic review of five databases and random-effects meta-analyses; dichotomous outcomes were pooled as risk ratios, the Mantel-Haenszel estimator was preferred for rare events, pooled incidences used a logit-binomial model, risk of bias was assessed with ROBINS-I and certainty with GRADE. Twenty observational studies were included (1776 NRP-cDCD liver recipients). Versus non-NRP cDCD, NRP reduced ischemic cholangiopathy (risk ratio 0.16, 95% confidence interval 0.09-0.28; number needed to treat 9), graft loss (0.41, 0.32-0.54), recipient death (0.46, 0.34-0.62), hepatic artery thrombosis (0.51, 0.30-0.85), other biliary complications (0.49, 0.32-0.73) and primary non-function (0.51, 0.28-0.94); these reductions persisted after excluding grafts managed with ex situ machine perfusion. Versus DBD, no outcome differed significantly. Pooled ischemic cholangiopathy incidence was 1.8%, 12.7% and 1.2% with NRP, non-NRP and DBD. NRP markedly reduces ischemic cholangiopathy and improves other outcomes versus non-NRP cDCD, approaching DBD; the evidence remains observational, with moderate-to-serious risk of bias.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261404939, identifier PROSPERO CRD420261404939.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"17154"},"PeriodicalIF":3.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115039","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

The INTEGRITY guidelines - ethical guidance for research involving deceased donation and transplantation. INTEGRITY指南-涉及死者捐献和移植研究的伦理指南。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-18 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.17151

Dominique E Martin, Ali Abbasi, Riadh A S Fadhil, John L R Forsythe, Matthieu Le Dorze, Jayme E Locke, Elmi Muller, Gabriel C Oniscu, Helen Opdam, Karen Rockell, Marion J Siebelink, Shih-Ning Then, Emma Tumilty

引用次数: 0

European society for organ transplantation clinical practice guideline on prevention and treatment of chronic lung allograft dysfunction. 欧洲器官移植学会预防和治疗慢性同种异体肺移植功能障碍临床实践指南。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-18 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16959

Saskia Bos, Merel Hellemons, Kavita Dave, Maarten F M Engel, Are Holm, Letizia Morlacchi, Veronika Müller, Stefano Pavanello, Clément Picard, Veronica Rossi, Berta Saez-Gimenez, Jens Gottlieb, Robin Vos

{"title":"European society for organ transplantation clinical practice guideline on prevention and treatment of chronic lung allograft dysfunction.","authors":"Saskia Bos, Merel Hellemons, Kavita Dave, Maarten F M Engel, Are Holm, Letizia Morlacchi, Veronika Müller, Stefano Pavanello, Clément Picard, Veronica Rossi, Berta Saez-Gimenez, Jens Gottlieb, Robin Vos","doi":"10.3389/ti.2026.16959","DOIUrl":"10.3389/ti.2026.16959","url":null,"abstract":"Chronic lung allograft dysfunction (CLAD) is the primary cause of late graft loss after lung transplantation, affecting up to half of lung transplant recipients within 5 years and presenting with heterogeneous phenotypes, most commonly bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome. Prevention and treatment of CLAD are challenging. This European Society for Organ Transplantation (ESOT) clinical practice guideline was developed by a multidisciplinary Task Force, including patient and allied healthcare representation, using systematic reviews and GRADE methodology. Eight key PICO questions addressing prevention and treatment of CLAD were evaluated. In terms of prevention, recommendations are in favor of using tacrolimus over cyclosporine, either mycophenolate or azathioprine, and azithromycin to reduce the risk of CLAD. Regarding treatment, montelukast could be considered in early-stage BOS. Current data are inconclusive in demonstrating benefits of anti-thymocyte globulin, alemtuzumab or extracorporeal photopheresis compared with standard of care, and do not support the use of antifibrotics in BOS. The Task Force emphasizes the urgent need for high-quality clinical trials and standardized care pathways in CLAD management.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16959"},"PeriodicalIF":3.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114902","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

Developing European policy on xenotransplantation: instructive findings from the first representative UK sample survey on attitudes and views on animal to human transplants. 欧洲异种器官移植政策的发展：第一次有代表性的英国样本调查对动物到人类移植的态度和观点的有益发现。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-15 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16585

Mustafa Al-Haboubi, Paul Boadu, Agata Pacho, Nicholas Mays, Antonia J Cronin

{"title":"Developing European policy on xenotransplantation: instructive findings from the first representative UK sample survey on attitudes and views on animal to human transplants.","authors":"Mustafa Al-Haboubi, Paul Boadu, Agata Pacho, Nicholas Mays, Antonia J Cronin","doi":"10.3389/ti.2026.16585","DOIUrl":"10.3389/ti.2026.16585","url":null,"abstract":"Recent landmark advances, particularly those related to gene-editing technology and the pioneering pig-to-human transplants currently underway in the USA and China, mean that xenotransplantation (XTx) may become a realistic option for patients waiting for human organ transplants in the foreseeable future. XTx policy needs to be informed by understanding what the public thinks. We undertook what we believe to be the first representative population survey in the United Kingdom of attitudes and views towards XTx. Sixty-five percent of respondents were supportive. Fifty-nine percent would be willing to accept a transplant from a pig. The main concerns related to genetic modification and animal welfare. Public support was subject to rigorous oversight of safety and animal welfare by an independent regulator. There were significant differences in view related to age, sex, ethnicity, educational qualifications and religion with women, people from Black and Asian minority groups and Muslims less supportive of XTx. These findings highlight the importance of demonstrating to the public that XTx can be provided safely while ensuring high standards of animal welfare. We propose reproducing this survey in other European countries would enable comparative analysis and adapting it to incorporate professional opinion may help inform the development of XTx policy and practice in Europe.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16585"},"PeriodicalIF":3.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082322","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

Five years after introduction of an opt-out consent system for organ donation; lessons learned from England and the Netherlands. 器官捐赠自愿退出同意制度实施5年后；英国和荷兰的经验教训。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-15 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16664

Nichon Esther Jansen, Tineke Jentina Wind, Martin B A Heemskerk, Aline C Hemke, Claire Williment, Sue Madden, Dale Gardiner

{"title":"Five years after introduction of an opt-out consent system for organ donation; lessons learned from England and the Netherlands.","authors":"Nichon Esther Jansen, Tineke Jentina Wind, Martin B A Heemskerk, Aline C Hemke, Claire Williment, Sue Madden, Dale Gardiner","doi":"10.3389/ti.2026.16664","DOIUrl":"10.3389/ti.2026.16664","url":null,"abstract":"Five years after changing from opt-in to opt-out consent systems in England and the Netherlands, we examine the impact on donor registrations, consent rates, donor numbers, and reflect on lessons learned. Opt-out legislation was implemented in May 2020 in England and July 2020 in the Netherlands. In England, 44% of the population is now registered; 40% recording an opt-in decision and 4% an opt-out decision. In the Netherlands, mandated donor registration resulted in the entire adult population having their decision recorded: \"Yes, I want to be a donor\" (34%), \"No objection\" (24%), or \"No, I don't want to be a donor\" (31%), while 11% leave the \"Decision to next of kin\". Despite these structural changes, the consent categories created by opt-out legislation (\"deemed\" consent in England and \"No objection\" in the Netherlands) remain challenging in practice, with fewer than 50% of families agreeing to donation. In England, the family consent rate declined from 69% to 57% between 2020 and 2025 and the donor numbers remain below pre-pandemic levels. In contrast, the Netherlands experienced a modest increase in family consent rates and donor numbers compared to the opt-in consent system. Opt-out legislation provides an important policy framework, but sustained system-level commitment remains essential.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16664"},"PeriodicalIF":3.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082290","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

Reshaping the landscape of HLA desensitization through immune engineering. 通过免疫工程重塑HLA脱敏的景观。

IF 3.6 3区医学

Transplant International Pub Date : 2026-09-14 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.17609

Delphine Kervella, Oriol Bestard

引用次数: 0