Transplant International最新文献_第3页

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

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}

引用次数: 0

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