Transplant International最新文献_第2页

The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes. 早期移植物功能、供体类型与长期肾移植结果的关系。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-16 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14197

Karthik Venkataraman, Georgina L Irish, Michael G Collins, Philip A Clayton

{"title":"The Association Between Early Graft Function, Donor Type and Long-Term Kidney Transplant Outcomes.","authors":"Karthik Venkataraman, Georgina L Irish, Michael G Collins, Philip A Clayton","doi":"10.3389/ti.2025.14197","DOIUrl":"10.3389/ti.2025.14197","url":null,"abstract":"Delayed graft function (DGF), is associated with inferior graft outcomes. Whether poor graft function without dialysis, termed slow graft function (SGF), affects outcomes is unclear. We investigated associations between SGF (serum creatinine dropping by less than 30% between days 1 and 2), DGF and graft outcomes by donor type in a cohort of 17,579 Australian and New Zealand kidney transplant recipients from 2001-2021. The primary outcomes were graft survival and death-censored graft survival Compared with immediate graft function, both SGF (Adjusted hazard ratio [aHR] 1.48 (95% CI 1.14-1.91) and DGF [aHR 1.97 (1.42-2.73)] were associated with reduced graft survival in living donor and donation after brain death (DBD) recipients [SGF aHR 1.13 (1.01-1.27); DGF aHR 1.37 (1.24-1.51)]. In donation after circulatory death (DCD) recipients, DGF [(aHR 1.52 (1.13-2.04)] but not SGF [(aHR 1.55 (1.13-2.13)] was associated with reduced graft survival. Findings were similar for death-censored graft survival. In secondary analyses, SGFwas associated with reduced patient survival in living donor recipients. SGF and DGF were associated with lower 12-month eGFR for all donor types. DGF increased the odds of rejection for all donor types; for SGF this association was significant only for DBD recipients. SGF is associated with adverse outcomes in live donor and DBD kidney recipients.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14197"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200063","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

Targeting CD38 in Antibody-Mediated Rejection. 靶向CD38抗体介导的排斥反应

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-15 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14343

Katharina A Mayer, Klemens Budde, Matthias Diebold, Philip F Halloran, Georg A Böhmig

{"title":"Targeting CD38 in Antibody-Mediated Rejection.","authors":"Katharina A Mayer, Klemens Budde, Matthias Diebold, Philip F Halloran, Georg A Böhmig","doi":"10.3389/ti.2025.14343","DOIUrl":"10.3389/ti.2025.14343","url":null,"abstract":"Antibody-mediated rejection (AMR) remains a major challenge in clinical transplantation. Current therapies have yielded inconsistent outcomes, highlighting the need for innovative approaches. CD38, a multifunctional glycoprotein, is highly expressed on plasma cells and natural killer (NK) cells, potentially offering a dual mechanism of action that could intervene in the pathophysiologic course of AMR: depleting alloantibody-producing plasma cells and NK cells. This review focuses on recent results from CD38-targeted therapies, with felzartamab emerging as a promising option. Previous case reports and series suggested that off-label daratumumab treatment could effectively reverse AMR. Felzartamab has now demonstrated safety and efficacy in a phase 2 trial for late AMR. Reductions in microvascular inflammation, downregulation of rejection-associated transcripts, and decreases in donor-derived cell-free DNA paralleled a substantial decrease in NK cell counts. However, felzartamab did not significantly affect donor-specific antibodies, which may reflect its distinct mechanism of action, primarily involving antibody-dependent cellular cytotoxicity and phagocytosis. The effects on rejection activity may have a rapid onset, but are transient. The potential benefits of prolonged therapy are currently being investigated in a recently launched phase III trial. Future studies may expand the applications of CD38 targeting to early AMR or broader indications, such as DSA-negative microvascular inflammation.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14343"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183504","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

Transplant Trial Watch. 移植试验观察。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-15 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14820

John O'Callaghan, John Fallon, Simon Knight

引用次数: 0

Factors Influencing the Information Support Provided by Health Care Professionals to Patients in a Dialysis Center Regarding Kidney Transplantation: A Nationwide Study. 影响透析中心医护人员对肾移植患者提供信息支持的因素：一项全国性研究。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-14 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14159

Paulina Kurleto, Lucyna Tomaszek, Irena Milaniak, Grażyna Dębska, Edyta Turkanik, Barbara Siekierska, Roman Danielewicz, Alicja Dębska-Ślizień

{"title":"Factors Influencing the Information Support Provided by Health Care Professionals to Patients in a Dialysis Center Regarding Kidney Transplantation: A Nationwide Study.","authors":"Paulina Kurleto, Lucyna Tomaszek, Irena Milaniak, Grażyna Dębska, Edyta Turkanik, Barbara Siekierska, Roman Danielewicz, Alicja Dębska-Ślizień","doi":"10.3389/ti.2025.14159","DOIUrl":"10.3389/ti.2025.14159","url":null,"abstract":"For patients undergoing renal replacement therapy, kidney transplantation (KTx) is the preferred therapeutic method. The aim of this study was to investigate selected factors affecting the information support provided by healthcare professional to patients in dialysis center regarding KTx. A multiple logistic regression was carried out to assess the relationship between information support, socio-demographic factors, life satisfaction (Satisfaction with Life Scale), self-esteem (Self-Esteem Scale), perceived self-efficacy (General Self-Efficacy), attitude, knowledge about organ transplantation. Of the 1,093 respondents aged 22-72 years, 501 respondents (45.8%) always informed patients about the possibility of treatment with KTx. Physicians vs. nurses (OR = 1.79; Cl 95%: 1.48-2.16), and those who supported legalization of unspecified living kidney donation in Poland (OR = 1.30; Cl 95%: 1.07-1.59) and believed that blood donation is safe (OR = 1.29; Cl 95%: 1.12-1.47) were more likely to provide informational support. Knowledge level (OR = 1.32; Cl 95%: 1.18-1.47) and self-esteem (OR = 1.06; Cl95%: 1.03-1.10) correlated positively with information support. Male participants were less likely to provide informational support than females (OR = 0.78; Cl 95%: 0.62-0.99). The results reveal inadequate information provided by healthcare professional to patients about KTx. This highlights the urgent need for comprehensive educational programs.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14159"},"PeriodicalIF":2.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174513","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

Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients. 淋巴细胞减少在肝硬化患者原位肝移植后感染早期预测中的作用。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-12 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14372

Mikhael Giabicani, Clara Timsit, Léa Copelovici, Pauline Devauchelle, Marion Guillouët, Marina Hachouf, Sylvie Janny, Juliette Kavafyan, Stéphanie Sigaut, Tristan Thibault-Sogorb, Safi Dokmak, Federica Dondero, Mickael Lesurtel, Olivier Roux, François Durand, Emmanuel Weiss

{"title":"Role of Lymphopenia in Early prediction of Infection Following Orthotopic Liver Transplantation in Cirrhotic Patients.","authors":"Mikhael Giabicani, Clara Timsit, Léa Copelovici, Pauline Devauchelle, Marion Guillouët, Marina Hachouf, Sylvie Janny, Juliette Kavafyan, Stéphanie Sigaut, Tristan Thibault-Sogorb, Safi Dokmak, Federica Dondero, Mickael Lesurtel, Olivier Roux, François Durand, Emmanuel Weiss","doi":"10.3389/ti.2025.14372","DOIUrl":"10.3389/ti.2025.14372","url":null,"abstract":"Infections remain a main cause of morbidity and mortality following orthotopic liver transplantation (OLT). Patients with end-stage liver cirrhosis exhibit a deregulation of their immune response, making them more susceptible to infections. From a prospective database, we retrospectively assessed the ability of preoperative lymphopenia, as a marker of this immune dysregulation, to predict the occurrence of early postoperative bacterial infections during post-OLT ICU hospitalization in patients with cirrhosis. Between January 2011 and December 2021, we included 445 patients. Post-OLT infections occurred in 92 patients (21%) and were mainly represented by bacteriemia (39%), pneumonia (37%) and surgical site infection (30%). Preoperative lymphocyte count ≤1.150 × 109/L was identified as an independent risk factor, as well as preoperative encephalopathy, intraoperative RBC transfusion >2 and intraoperative maximum norepinephrine dose >0.5 μg.kg-1.min-1 (all p < 0.05). Bootstrap analysis validated these results (p < 0.05). The risk factors were integrated into the PRELINFO score which was associated with the risk of infection (p < 0.05). The depth of preoperative lymphopenia was also associated with the risk of infection and postoperative correction of lymphopenia was slower in patients who developed an infection than in those who did not. Preoperative blood lymphocyte count should be incorporated into the assessment of the risk of early post-OLT bacterial infections.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14372"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151627","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

Life After Kidney Transplantation: The Time for a New Narrative. 肾移植后的生活：一个新的叙事时代。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-12 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14074

Kevin John Fowler

引用次数: 0

Urinary NGAL Outperforms ^99mTc-MAG3 Renography in Predicting DCD Kidney Graft Function. 尿NGAL在预测DCD肾移植功能方面优于99mTc-MAG3肾造影。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-12 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.13818

Esther N M de Rooij, Tirsa T van Duijl, Ellen K Hoogeveen, Fred P H T M Romijn, Friedo W Dekker, Cees van Kooten, Christa M Cobbaert, Johan W de Fijter

{"title":"Urinary NGAL Outperforms 99mTc-MAG3 Renography in Predicting DCD Kidney Graft Function.","authors":"Esther N M de Rooij, Tirsa T van Duijl, Ellen K Hoogeveen, Fred P H T M Romijn, Friedo W Dekker, Cees van Kooten, Christa M Cobbaert, Johan W de Fijter","doi":"10.3389/ti.2025.13818","DOIUrl":"10.3389/ti.2025.13818","url":null,"abstract":"Recipients of donation after circulatory death (DCD) kidneys are at high risk for delayed graft function (DGF) due to severe ischemia-reperfusion injury. We compared urinary biomarkers in predicting the duration of DGF with the tubular function slope (TFS) as the gold standard. In 89 DCD kidney transplant recipients, urinary TIMP-2, IGFBP7, B2M, NGAL, KIM1, CXCL9, and UMOD were quantified by LC-MS/MS analysis on postoperative days (PODs) 1, 4 and 10. Interstitial fibrosis and tubular atrophy (IF/TA) were assessed with protocol biopsies at POD 10. TFS was calculated with 99mTc-MAG3 renography. Predictive performance was compared with AUCs from ROC analyses. Of all 89 recipients, 22% experienced no (<7), 22% mild (≥7-14), 29% moderate (≥14-<21) and 26% severe (≥21 days) fDGF. The OR for the presence of IF/TA was 1.9 (95% CI:0.4; 10.0) for mild to moderate and 15.0 (95% CI:2.7; 84.8) for severe compared to no fDGF. At POD 4, urinary NGAL and fractional NGAL excretion (FE-NGAL) outperformed TFS and other biomarkers in predicting fDGF with AUCs of 0.97, 0.98 and 0.92, respectively. At POD10, FE-NGAL and PCR best predicted severe vs. mild to moderate fDGF, with AUCs of 0.74 and 0.76 versus 0.65 for TFS. Therefore, urinary NGAL and FE-NGAL may provide a viable alternative to 99mTcMAG3 renography for monitoring fDGF clearance or guiding kidney transplant biopsy to exclude additional acute rejection.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"13818"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151666","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 Impact of Patient Age on Causes of Graft Loss After Renal Transplantation. 患者年龄对肾移植术后移植物丢失原因的影响。

IF 2.7 3区医学

Transplant International Pub Date : 2025-05-02 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14544

Susanne Winkler, Min-Jeong Kim, Andrea Fisler, Stefan Farese, Felix Burkhalter, Seraina von Moos, Christian Forster, Caroline Wehmeier, Michael Dickenmann, Stefan Schaub

{"title":"The Impact of Patient Age on Causes of Graft Loss After Renal Transplantation.","authors":"Susanne Winkler, Min-Jeong Kim, Andrea Fisler, Stefan Farese, Felix Burkhalter, Seraina von Moos, Christian Forster, Caroline Wehmeier, Michael Dickenmann, Stefan Schaub","doi":"10.3389/ti.2025.14544","DOIUrl":"10.3389/ti.2025.14544","url":null,"abstract":"The interplay of recipient age and graft loss causes is underexplored, despite its relevance for patient management and endpoint definition in clinical trials. This study aimed to investigate the impact of recipient age on graft loss causes. In this retrospective single-center cohort study with 1743 kidney transplantations between 1995 and 2022, graft losses were assigned to either death with graft function (DwGF) or graft failure (GF). Additionally, causes of death and GF were determined by reviewing all available clinical/histological information. Data were analyzed across recipient age groups (≤40, 41-60 and >60 years) and across three time periods (1995-2004, 2005-2014, 2015-2022). Among 816 graft losses, 56% were attributed to DwGF and 44% to GF. The proportion of DwGF increased stepwise with age (21% in young vs. 52% in middle-aged vs. 76% in elderly patients; p < 0.0001), with similar proportions across the three time periods. Rejection alone or in combination with other events caused GF in 76% of young, 51% of middle-aged, and 34% of elderly patients (p < 0.0001). Main death-causes were cardiovascular events (23%), infections (23%) and malignancies (23%). Graft loss causes are strongly age-related. This might have significant implications for clinical study design and patient management.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14544"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093578","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

Intraparenchymal Enzyme Injections in Islet Isolations With Incomplete Ductal Perfusion of Enzymes. 肝实质内酶注射在胰岛导管酶灌注不完全分离中的应用。

IF 2.7 3区医学

Transplant International Pub Date : 2025-04-30 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.13507

Maarten C Tol, Dirk-Jan Cornelissen, Yun Suk Chae, Ezra J van der Wel, Jeroen C Sijtsma, Jason B Doppenberg, Corine J Vermeulen, Maaike A J Hanegraaf, Evelien H van Rossenberg, J Sven D Mieog, Bert A Bonsing, Volkert A L Huurman, Eelco J P de Koning, Marten A Engelse

引用次数: 0

Tremors and Health-Related Quality of Life in Liver Transplant Recipients: Post-hoc Analysis of a Multicenter, Randomized, Controlled Trial Comparing a Life Cycle Pharma-Tacrolimus Regimen and Extended-Release Tacrolimus Regimen. 肝移植受者的震颤和健康相关生活质量：一项多中心、随机、对照试验的事后分析，比较生命周期药物-他克莫司方案和缓释他克莫司方案。

IF 2.7 3区医学

Transplant International Pub Date : 2025-04-28 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14189

M B Mulder, J J Busschbach, B van Hoek, W G Polak, I P J Alwayn, B C M de Winter, S Darwish Murad, E Verhey-Hart, L Elshove, N S Erler, D A Hesselink, C M den Hoed, H J Metselaar

{"title":"Tremors and Health-Related Quality of Life in Liver Transplant Recipients: Post-hoc Analysis of a Multicenter, Randomized, Controlled Trial Comparing a Life Cycle Pharma-Tacrolimus Regimen and Extended-Release Tacrolimus Regimen.","authors":"M B Mulder, J J Busschbach, B van Hoek, W G Polak, I P J Alwayn, B C M de Winter, S Darwish Murad, E Verhey-Hart, L Elshove, N S Erler, D A Hesselink, C M den Hoed, H J Metselaar","doi":"10.3389/ti.2025.14189","DOIUrl":"https://doi.org/10.3389/ti.2025.14189","url":null,"abstract":"We investigated whether life cycle pharma (LCP)-tacrolimus compared to extended-release (ER)-tacrolimus results in a difference in severity of tremors and HRQoL. In this multi-center, open-label, randomized, controlled trial, 108 patients were randomized in a 1:1 ratio to either LCP-tacrolimus regimen or ER-tacrolimus regimen after transplantation. HRQoL was assessed with the EQ-5D-5L and SF-36 questionnaire (two generic HRQoL instruments) and the quality of life in essential tremor (QUEST) questionnaire (domain specific HRQoL instrument). The EQ-5D-5L scores were translated to the societal values. We examined the HRQoL over the course of the study by fitting generalized mixed effect models. In total, 105 patients were included, 53 to the LCP- and 52 to the ER-tacrolimus regimen. Baseline questionnaires were available for every LT recipient. At 12 months 25% [10/40], 95% confidence interval (CI) 14.2%-40.2% of the LT recipients in the LCP-tacrolimus regimen group experienced tremors compared to 30.4% [14/46], 95%-CI 19.1%-44.8% of the LT recipients in the ER-tacrolimus regimen group; risk difference: 0.054; 95%-CI -0.151-0.249; p = 0.63. No statistically significant differences in HRQoL were seen between the two regimens. We could not demonstrate differences in the HRQoL or occurrence of tremors between LCP-tacrolimus and ER-tacrolimus regimens.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14189"},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001383","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