Transplant International最新文献_第4页

The Impact of Post-Operative Phrenic Nerve Dysfunction on Lung Function Parameters and Long-Term Outcomes After Lung Transplantation. 术后膈神经功能障碍对肺移植术后肺功能参数及远期预后的影响。

IF 3 3区医学

Transplant International Pub Date : 2025-07-30 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14691

Keita Nakanishi, Caroline Hillebrand, Thomas Schweiger, Stefan Schwarz, Shahrokh Taghavi, Peter Jaksch, Alberto Benazzo, Toyofumi Fengshi Chen-Yoshikawa, Konrad Hoetzenecker

{"title":"The Impact of Post-Operative Phrenic Nerve Dysfunction on Lung Function Parameters and Long-Term Outcomes After Lung Transplantation.","authors":"Keita Nakanishi, Caroline Hillebrand, Thomas Schweiger, Stefan Schwarz, Shahrokh Taghavi, Peter Jaksch, Alberto Benazzo, Toyofumi Fengshi Chen-Yoshikawa, Konrad Hoetzenecker","doi":"10.3389/ti.2025.14691","DOIUrl":"10.3389/ti.2025.14691","url":null,"abstract":"A rare but important complication after lung transplantation (LTx) is postoperative phrenic nerve dysfunction (PND). Diaphragmatic plication (DP) is a well-established treatment option for PND, however, the long-term effect of PND and DP on lung function parameters and survival after LTx are currently unknown. We retrospectively reviewed 1400 LTx recipients transplanted at Medical University of Vienna between 01/2003 and 12/2022. Fluoroscopy and/or phrenic nerve conduction studies confirmed PND when chest radiographs after extubation showed a unilateral heightened diaphragm. We identified 25 patients with post-operative PND, of whom 12 underwent DP. The remaining 1,375 patients served as a control group. Median ICU-stay and hospital-stay were significantly longer in the PND groups (DP: 20 and 57 days; non-DP: 27 and 43 days; control group: 7 and 25 days; P = 0.001/P < 0.001). PND led to consistently lower %TLC in lung function tests performed within the first three years after LTx. DP was associated with lower %FEV1.0 early after LTx but it aligned to %FEV1.0 of the other groups during follow-up. Although PND significantly affected postoperative recovery after LTx, it did not impair long-term survival outcomes.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14691"},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849188","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

Experimental Swine Models for Vascularized Composite Allotransplantation and Immunosuppression: A Systematic Review and Case Report of a Novel Heterotopic Hemifacial Swine Model. 血管化复合异体移植和免疫抑制实验猪模型：一种新型异位半面猪模型的系统回顾和病例报告。

IF 3 3区医学

Transplant International Pub Date : 2025-07-29 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14520

Leonard Knoedler, Felix J Klimitz, Lioba Huelsboemer, Tobias Niederegger, Thomas Schaschinger, Samuel Knoedler, Sam Boroumand, Stav Brown, Bohdan Pomahac, Martin Kauke-Navarro

{"title":"Experimental Swine Models for Vascularized Composite Allotransplantation and Immunosuppression: A Systematic Review and Case Report of a Novel Heterotopic Hemifacial Swine Model.","authors":"Leonard Knoedler, Felix J Klimitz, Lioba Huelsboemer, Tobias Niederegger, Thomas Schaschinger, Samuel Knoedler, Sam Boroumand, Stav Brown, Bohdan Pomahac, Martin Kauke-Navarro","doi":"10.3389/ti.2025.14520","DOIUrl":"10.3389/ti.2025.14520","url":null,"abstract":"Lifelong immunosuppression is necessary to prevent rejection in vascularized composite allotransplantation (VCA). Animal models play a pivotal role in developing innovative immunosuppressive strategies. This systematic review and case report focuses on the most impactful swine VCA models while offering insights gained from the Yale Swine Allotransplantation Vascularized Experiment (Y-SAVE). 22 studies on swine VCA models were included. Key swine breeds included SLA-matched and mismatched MGH miniature swine, Yucatan miniature swine, and outbred domestic swine. Transplantation models varied, with 10 (45%) using osteomyocutaneous flaps and only 2 (9%) involving hemifacial flaps. While 16 (73%) studies utilized heterotopic models, 5 (23%) relied on orthotopic models. Novel strategies such as preconditioning and localized drug delivery emerged, alongside immunosuppression regimens combining tacrolimus with experimental therapies. We further introduced a modified heterotopic hemiface VCA model, demonstrating its feasibility for studying immune dynamics in facial transplants while preserving oral function and enabling serial skin and mucosal biopsies. Overall, our review highlights a notable gap in models that specifically investigate facial VCAs. Given the unique immunological environment of facial allografts, models such as the heterotopic hemiface transplant may offer critical insights into immune mechanisms and may provide a platform for refining targeted immunosuppressive strategies.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14520"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837913","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

Preservation Fluid Bacteriology in Kidney Transplantation: Comparing Uncontrolled Donation After Circulatory Death With Donation After Brain Death. 肾移植中的保存液细菌学：比较循环死亡后无控制捐赠与脑死亡后捐赠。

IF 3 3区医学

Transplant International Pub Date : 2025-07-25 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14855

Alberto Costa Silva, Teresa Pina-Vaz, Ana Pinho, Inês Ferreira, Ana Cerqueira, Manuela Bustorff, Susana Sampaio, Roberto Roncon-Albuquerque, Margarida Rios, Manuel Pestana, Carlos Martins-Silva, Tiago Antunes-Lopes, João Alturas Silva

{"title":"Preservation Fluid Bacteriology in Kidney Transplantation: Comparing Uncontrolled Donation After Circulatory Death With Donation After Brain Death.","authors":"Alberto Costa Silva, Teresa Pina-Vaz, Ana Pinho, Inês Ferreira, Ana Cerqueira, Manuela Bustorff, Susana Sampaio, Roberto Roncon-Albuquerque, Margarida Rios, Manuel Pestana, Carlos Martins-Silva, Tiago Antunes-Lopes, João Alturas Silva","doi":"10.3389/ti.2025.14855","DOIUrl":"10.3389/ti.2025.14855","url":null,"abstract":"Infectious complications remain a significant concern in organ transplantation, and preservation fluid (PF) has been identified as a potential source of microbial contamination. However, the clinical relevance of positive PF cultures, especially in kidney transplants from uncontrolled donation after circulatory death (uDCD), is not clearly established. This study aims to evaluate and compare the incidence and clinical implications of positive PF cultures in kidney transplants from uDCD and donation after brain death (DBD) donors. A prospective, single-center study was conducted, involving 497 kidney transplants-147 from uDCD and 350 from DBD donors. PF samples were systematically collected at the time of transplantation, cultured, and analyzed. The type of bacteria identified guided antibiotic treatment decisions. Recipients were monitored for the development of bacteremia within the first post-transplant week. Positive PF cultures were significantly more frequent in uDCD transplants (32.0%) compared to DBD (13.7%) (p < 0.001). Coagulase-negative staphylococci predominated in both groups. Despite this, bacteremia rates were comparable-8.5% in uDCD and 6.3% in DBD (p = 0.673)-with no culture-concordant cases. Antibiotics were administered to 10.6% of uDCD and 22.9% of DBD recipients (p = 0.110). Although uDCD kidneys had higher PF contamination, the clinical impact was minimal.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14855"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817509","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

Should Systematic HSV Serological Screening of Donors Be Implemented to Manage Mismatched HSV D+/R- Liver Transplants? 是否应该对供者进行系统的HSV血清学筛查以管理错配的HSV D+/R-肝移植？

IF 3 3区医学

Transplant International Pub Date : 2025-07-21 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14835

J Besombes, V Thibault, A Bacle, C Bressollette-Bodin, C Camus, B Giguet, P Houssel-Debry, C Pronier

引用次数: 0

The Future of Pig Liver Xenotransplantation. 猪肝异种移植的未来。

IF 3 3区医学

Transplant International Pub Date : 2025-07-18 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.13622

Ahmad Karadagi, Gabriel C Oniscu

引用次数: 0

Comparative Analysis of Islet Auto-Transplantation Outcome Classification Systems: Evaluating Concordance, Feasibility, and a Data-Driven Approach. 胰岛自体移植结果分类系统的比较分析：评估一致性、可行性和数据驱动方法。

IF 3 3区医学

Transplant International Pub Date : 2025-07-18 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14714

Davide Catarinella, Paola Magistretti, Raffaella Melzi, Alessia Mercalli, Stefano Tentori, Chiara Gremizzi, Vera Paloschi, Simona Sala, Libera Valla, Francesca Aleotti, Sabrina Costa, Francesco De Cobelli, Rossana Caldara, Lorenzo Piemonti

{"title":"Comparative Analysis of Islet Auto-Transplantation Outcome Classification Systems: Evaluating Concordance, Feasibility, and a Data-Driven Approach.","authors":"Davide Catarinella, Paola Magistretti, Raffaella Melzi, Alessia Mercalli, Stefano Tentori, Chiara Gremizzi, Vera Paloschi, Simona Sala, Libera Valla, Francesca Aleotti, Sabrina Costa, Francesco De Cobelli, Rossana Caldara, Lorenzo Piemonti","doi":"10.3389/ti.2025.14714","DOIUrl":"10.3389/ti.2025.14714","url":null,"abstract":"A standardized approach to assessing islet autotransplantation outcomes is crucial for evaluating graft function and guiding clinical decisions. This study compares the performance of existing classification systems-Milan, Minneapolis, Chicago, Leicester, Igls, and a novel Data-Driven approach-by evaluating their ability to differentiate transplant outcomes using metabolic and insulin secretion parameters. Our analysis shows strong concordance among Milan, Minneapolis, Chicago, and Igls, primarily due to minor variations in C-peptide thresholds. The Leicester and Data-Driven systems, however, exhibit greater divergence, with the Leicester system simplifying assessment by excluding severe hypoglycemic events and HbA1c, and the Data-Driven approach offering a more dynamic framework without predefined thresholds. Fasting C-peptide levels emerged as a highly reliable predictor of graft function, with the arginine test proving more effective than Mixed Meal Tolerance Test for additional evaluation. The Data-Driven approach provided superior stratification of outcomes, highlighting the importance of residual insulin secretion in metabolic control. These findings suggest that refining classification systems, particularly by considering insulin sensitivity and residual secretion, could enhance long-term patient monitoring and improve our understanding of beta-cell replacement therapies. Further validation across diverse cohorts is essential for broader clinical adoption.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14714"},"PeriodicalIF":3.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776269","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

Risk Prediction and Management of BKPyV-DNAemia in Kidney Transplant Recipients: A Multicenter Analysis of Immunosuppressive Strategies. 肾移植受者bkpyv - dna血症的风险预测和管理：免疫抑制策略的多中心分析

IF 3 3区医学

Transplant International Pub Date : 2025-07-17 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14738

Jin-Myung Kim, Hye Eun Kwon, Ahram Han, Youngmin Ko, Sung Shin, Young Hoon Kim, Kyo Won Lee, Jae Berm Park, Hyunwook Kwon, Sangil Min

{"title":"Risk Prediction and Management of BKPyV-DNAemia in Kidney Transplant Recipients: A Multicenter Analysis of Immunosuppressive Strategies.","authors":"Jin-Myung Kim, Hye Eun Kwon, Ahram Han, Youngmin Ko, Sung Shin, Young Hoon Kim, Kyo Won Lee, Jae Berm Park, Hyunwook Kwon, Sangil Min","doi":"10.3389/ti.2025.14738","DOIUrl":"10.3389/ti.2025.14738","url":null,"abstract":"BK polyomavirus (BKPyV) DNAemia remains a major complication in kidney transplantation (KT), requiring nuanced adjustments to immunosuppressive regimens to control viral replication while minimizing rejection risk. This retrospective multicenter cohort study included 8,027 KT recipients, of whom 1,102 developed BKPyV-DNAemia within the first year. Among them, 927 patients with complete therapeutic drug monitoring (TDM) data were categorized into three groups based on post- BKPyV-DNAemia immunosuppressive strategies: mycophenolic acid (MPA) control, sirolimus, and leflunomide. Multivariate logistic regression and Cox analyses identified risk factors for BKPyV-DNAemia treatment failure, acute rejection, and graft loss. Tacrolimus trough levels below 5 ng/mL and complete withdrawal of calcineurin inhibitors (CNIs) significantly increased rejection risk (OR = 2.65, P = 0.033). Maintaining tacrolimus levels between 5 and 7 ng/mL was associated with optimal viral control and lower rejection rates. Leflunomide substitution reduced BKPyV burden but increased rejection risk (OR = 2.14, P < 0.001). Sirolimus-based regimens with CNI withdrawal led to the highest rejection risk (OR = 6.00, P = 0.044) and a trend toward increased graft failure (HR = 4.37, P = 0.07). A tacrolimus target of ≥5 ng/mL emerged as optimal for balancing BKPyV-DNAemia suppression and long-term graft survival. While leflunomide is effective for viral control, its immunological risks warrant careful patient selection and monitoring.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14738"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795641","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

T cell Activation Marker HLA-DR Reflects Tacrolimus-Associated Immunosuppressive Burden and BK Viremia Risk After Kidney Transplantation - An Observational Cohort Study. T细胞活化标志物HLA-DR反映肾移植后他克莫司相关的免疫抑制负担和BK病毒血症风险——一项观察性队列研究

IF 3 3区医学

Transplant International Pub Date : 2025-07-17 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14443

Simon Aberger, Max Schuller, Agnes A Mooslechner, Konstantin A Klötzer, Barbara Prietl, Verena Pfeifer, Alexander H Kirsch, Alexander R Rosenkranz, Katharina Artinger, Kathrin Eller

{"title":"T cell Activation Marker HLA-DR Reflects Tacrolimus-Associated Immunosuppressive Burden and BK Viremia Risk After Kidney Transplantation - An Observational Cohort Study.","authors":"Simon Aberger, Max Schuller, Agnes A Mooslechner, Konstantin A Klötzer, Barbara Prietl, Verena Pfeifer, Alexander H Kirsch, Alexander R Rosenkranz, Katharina Artinger, Kathrin Eller","doi":"10.3389/ti.2025.14443","DOIUrl":"10.3389/ti.2025.14443","url":null,"abstract":"Kidney transplantation (KT) is the current treatment of choice in patients with end-stage kidney disease. Immunosuppression is required to prevent acute rejection but is associated with a high incidence of adverse events. The immunosuppressive burden substantially differs between individuals, necessitating new immune monitoring strategies to achieve personalization of immunosuppression. To compare the evolution of T cell profiles in correlation with immunosuppression and clinical outcomes, 87 kidney transplant recipients were followed for 12 months after KT. Flow cytometry along with assessment of T cell activation markers and clinical data was performed before KT and during study visits 10 days, 2 months and 12 months after KT. Longitudinal T cell phenotyping revealed a significant decrease of T cell activation markers HLA-DR, FCRL3, and CD147 in CD4+ effector T cells after KT. The most pronounced reduction (75%) was found for the activation-proliferation marker HLA-DR, which persisted throughout the observational period. The decrease in HLA-DR expression reflected immunosuppressive burden through strong associations with tacrolimus trough-level exposure (coeff = -0.39, p < 0.01) and BK viremia incidence (coeff = -0.40, p < 0.01) in multivariable regression analysis. T cell activation marker HLA-DR emerges as a potential biomarker for tacrolimus-related immunosuppressive burden in association with BK viremia risk following KT.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14443"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761467","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

Effector-Memory γδ T Lymphocytes Predict CMV Disease After the Withdrawal of Prophylaxis in Kidney Transplant Recipients. 效应记忆γδ T淋巴细胞预测肾移植受者停药后巨细胞病毒疾病

IF 3 3区医学

Transplant International Pub Date : 2025-07-16 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14339

Yoann Abadie, Jonathan Visentin, Elodie Wojciechowski, Manon Charrier, Julie Déchanet-Merville, Isabelle Garrigue, Patrick Blanco, Pierre Merville, Hannah Kaminski, Lionel Couzi

{"title":"Effector-Memory γδ T Lymphocytes Predict CMV Disease After the Withdrawal of Prophylaxis in Kidney Transplant Recipients.","authors":"Yoann Abadie, Jonathan Visentin, Elodie Wojciechowski, Manon Charrier, Julie Déchanet-Merville, Isabelle Garrigue, Patrick Blanco, Pierre Merville, Hannah Kaminski, Lionel Couzi","doi":"10.3389/ti.2025.14339","DOIUrl":"10.3389/ti.2025.14339","url":null,"abstract":"Evaluation of CMV-specific cell-mediated immunity (CMI) has improved strategies to prevent post-transplant CMV disease. This study assessed the association between CMV disease and absolute count of TEMRA γδ T cells at the end of universal prophylaxis in kidney transplant recipients (KTR). We retrospectively analyzed 262 R⁺ and 82 D⁺/R⁻ KTRs who received antiviral prophylaxis and had TEMRA γδ T cells quantified at the end of prophylaxis. The primary endpoint was CMV disease within two years post-transplant. Post-prophylaxis CMV disease occurred in 43/344 (12.5%) patients. A threshold of 4.65/mm³ for TEMRA γδ T-cell count was identified by ROC analysis; higher counts were associated with reduced CMV disease incidence. While no significant association was found in the overall cohort, in R⁺ patients, a count >4.65/mm³ was associated with a 97.7% positive predictive value for protection against CMV disease. Multivariate analysis confirmed its independent association with disease-free survival [HR: 0.27 (95% CI: 0.09-0.85), p = 0.0252]. Measuring TEMRA γδ T-cell counts at the end of prophylaxis may serve as a useful, accessible immune marker to guide CMV prevention strategies in R⁺ kidney transplant recipients.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14339"},"PeriodicalIF":3.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754408","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

Living Kidney Donation Practices in Europe: A Survey of DESCaRTES and EKITA Transplantation Working Groups. 欧洲活体肾脏捐献实践：笛卡尔和EKITA移植工作组的调查。

IF 3 3区医学

Transplant International Pub Date : 2025-07-15 eCollection Date: 2025-01-01 DOI: 10.3389/ti.2025.14802

Marco van Londen, François Gaillard, Gianluigi Zaza, Gabriel C Oniscu, Ilaria Gandolfini, Lucrezia Furian, Jelena Stojanovic, David Cucchiari, Luuk B Hilbrands, Geir Mjøen, Christophe Mariat

{"title":"Living Kidney Donation Practices in Europe: A Survey of DESCaRTES and EKITA Transplantation Working Groups.","authors":"Marco van Londen, François Gaillard, Gianluigi Zaza, Gabriel C Oniscu, Ilaria Gandolfini, Lucrezia Furian, Jelena Stojanovic, David Cucchiari, Luuk B Hilbrands, Geir Mjøen, Christophe Mariat","doi":"10.3389/ti.2025.14802","DOIUrl":"10.3389/ti.2025.14802","url":null,"abstract":"Thorough evaluation of potential kidney donors ensures safety and graft quality, but European data on donor practices are lacking. An online survey was conducted to assess European practices regarding kidney function, risk assessment and follow-up. 56% of respondents (125 practitioners, 16 countries, ∼3700 donations annually) use eGFRCKD-EPI, 34% use creatinine clearance and 70% use measured GFR. Sixty-three percent have no upper age limits, 91% exclude candidates with hypertension with end-organ damage, and 78% candidates on ≥2 antihypertensives. BMI cut-offs of 30 (39%) and 35 kg/m2 (42%) are common. Candidates are excluded for an HbA1c ≥ 53 mmol/mol (46%), glucose ≥7 (57%) or ≥11.1 mmol/L after glucose-tolerance test (59%). ApoL1-testing is not routine in 73%, and 38% perform a kidney biopsy if albuminuria/hematuria is present. Spot and 24-hour urine albumin is assessed in 38%. Hematuria is accepted when urological evaluation (15%), kidney biopsy (16%), or both (57%) are normal. Low-risk stones often do not preclude donation. Written informed consent is obtained by 95% of centers, with 65% asking consent for data. Lifetime follow-up is offered by 83%. This first study on evaluation and follow-up practices of donors in Europe shows variation between centers, suggesting a need for harmonization of donor practices.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"38 ","pages":"14802"},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745167","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