Transplant International最新文献_第9页

Long-term HLA-incompatible kidney transplant outcomes. 长期hla不相容肾移植结果。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-16 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16478

Maria Kahanpää, Jouni Lauronen, Marko Lempinen, Kaisa Ahopelto, Ville Sallinen, Ilkka Helanterä

{"title":"Long-term HLA-incompatible kidney transplant outcomes.","authors":"Maria Kahanpää, Jouni Lauronen, Marko Lempinen, Kaisa Ahopelto, Ville Sallinen, Ilkka Helanterä","doi":"10.3389/ti.2026.16478","DOIUrl":"10.3389/ti.2026.16478","url":null,"abstract":"Many centers avoid human leukocyte antigen (HLA) -incompatible kidney transplantations due to increased risk of graft loss, although it may be the only option for highly sensitized patients. We assessed the association of pre-transplant donor-specific HLA-antibodies (DSAs) with biopsy-proven acute rejection (BPAR), antibody mediated rejection (AMR), and death-censored graft survival (DCGS). All deceased donor kidney transplantations in Finland between 2006 and 2021 were included (n = 3209), with 226 DSA-positive recipients. DSA characteristics, including specificity and mean fluorescence intensity (MFI), were collected. DSAs were associated with worse DCGS, higher risk of BPAR (HR 3.22, 95% CI 2.57-4.04), and especially AMR (HR 35.1, CI 22.4-55.1). Higher cumulative MFI was associated with lower 10-year DCGS (no-DSA 83%, ≥10,000 66%). A similar trend was seen in multivariable models (HR 1.81, CI 0.995-3.27 for MFI ≥10,000). Class II DSAs indicated higher risk for BPAR (HR 4.2 vs. HR 3.1), and AMR (HR 32.3 vs. HR 21.9), than class I DSAs. Collectively, pretransplant DSAs and higher cumulative MFI were associated with poorer graft survival, and especially class II DSAs were associated with higher risk of AMR. However, DCGS with even very high-level pretransplant DSA could be considered acceptable, supporting consideration of HLA-incompatible transplantations for highly sensitized patients.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16478"},"PeriodicalIF":3.6,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631615","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

AI in transplantation: levelling the playing field and raising the methodological standards. 移植中的人工智能：公平竞争环境和提高方法标准。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-14 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.17015

Nina Pilat, Maria Irene Bellini, Thierry Berney, Olivier Aubert

引用次数: 0

Nurturing a Sustainable Transplantation Journey: the best of ESOT Congress 2025. 培育可持续的移植之旅：2025年ESOT大会的最佳成果。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-14 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.17127

Olivier Thaunat, Colin Wilson

引用次数: 0

Living kidney donation prior to euthanasia: medical, psychological and ethical considerations. 安乐死前的活体肾脏捐献：医学、心理和伦理考虑。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-14 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16594

Emma K Massey, Eline Bunnik, Louise Maasdam, Frank J M F Dor, Jacqueline van de Wetering

{"title":"Living kidney donation prior to euthanasia: medical, psychological and ethical considerations.","authors":"Emma K Massey, Eline Bunnik, Louise Maasdam, Frank J M F Dor, Jacqueline van de Wetering","doi":"10.3389/ti.2026.16594","DOIUrl":"10.3389/ti.2026.16594","url":null,"abstract":"Living kidney donation prior to euthanasia has never previously been reported and is not incorporated into current clinical guidelines. This study aims to discuss the unique medical, procedural, psychological and ethical considerations of living donation prior to euthanasia based on 3 Dutch cases. Of the 3 candidates, 2 successfully donated without detrimental effects to physical or mental health; one was declined for medical reasons. In two cases, euthanasia has been performed; in one case donation was transformative and the request for euthanasia was withdrawn after donation. Medically, normal life-expectancy after donor nephrectomy should be presumed as euthanasia remains uncertain. Procedurally, timing can create tension between these two processes as postponing euthanasia could be harmful. Psychologically, potential exacerbation in psychopathology should be weighed against the impact of being declined for donation. Ethically, autonomy, capacity to consent and risk-benefit ratio must be rigorously assessed, especially given the degree of suffering in these cases. We conclude that living donation and euthanasia should be seen as independent processes and a euthanasia request should not be considered an absolute contra-indication for living donation. Our initial experiences underscore the need for international dialogue and policy development.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16594"},"PeriodicalIF":3.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607914","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

Bidirectional portal vein reconstruction for type C anatomy in living donor liver transplant. 活体供肝移植中C型解剖的双向门静脉重建。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-13 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16600

Shams-Ud-Din, Bigyan Acharya, Abdul Wahab Dogar, Mohammad Arsalan, Muhammad Umar, Syed Hasnain Abbas

引用次数: 0

Acceptance of deceased donor livers in the United Kingdom - development of a liver "donor utilisation index". 在英国接受死者捐献的肝脏-肝脏“捐赠者利用指数”的发展。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-10 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16484

Jennifer Mehew, Helen Thomas, Peter Friend, Simon Knight

引用次数: 0

Simultaneous kidney-islet transplantation from a donor after circulatory death using normothermic regional perfusion. 循环性死亡后供体肾-胰岛同时移植使用常温区域灌注。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-09 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16830

Laure Esposito, Orianne Villard, Thibault Austry, Christophe Broca, John Devos, Guillaume Ducos, Diane Osinski, Nelly Puech, Cedric Idri, Thibault Boisroux, Stéphanie Ruiz, Chloe Medrano, Thomas Prudhomme, Mokrane Fatima, Nassim Kamar

引用次数: 0

Correction: Transplantation of older DCD livers in the machine perfusion era: a U.S. cohort study. 更正：机器灌注时代老年DCD肝脏移植：美国队列研究。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-08 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.17169

Emmanouil Giorgakis, Ioannis A Ziogas, Dimitrios Moris, Dimitrios N Varvoglis, Charalampos Theocharopoulos, Dor Yoeli, Megan A Adams, Andrew S Barbas, Martin I Montenovo, Melissa Chen, Sorabh Kapoor, Esteban Calderon, Andrew M Moon, Sasha Deutch-Link, Hersh Shroff, Neil D Shah, Oren K Fix, A Sidney Barritt, Amit K Mathur, Trevor L Nydam, Chirag S Desai, Paulo N Martins, Andrea Schlegel

引用次数: 0

Patient perspectives on the ethics and acceptability of perfusion techniques for organ transplantation: a qualitative study. 患者对器官移植灌注技术的伦理和可接受性的看法：一项定性研究。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-08 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16459

Jaden Blazier, Eline M Bunnik, Valerie Kortekaas, Esther W de Bekker-Grob, Maartje H N Schermer, Niels van der Kaaij, Robert Minnee, Olivier Manintveld, Jeroen De Jonge, Emma K Massey

{"title":"Patient perspectives on the ethics and acceptability of perfusion techniques for organ transplantation: a qualitative study.","authors":"Jaden Blazier, Eline M Bunnik, Valerie Kortekaas, Esther W de Bekker-Grob, Maartje H N Schermer, Niels van der Kaaij, Robert Minnee, Olivier Manintveld, Jeroen De Jonge, Emma K Massey","doi":"10.3389/ti.2026.16459","DOIUrl":"10.3389/ti.2026.16459","url":null,"abstract":"Perfusion technologies preserve and/or improve organ viability by restoring circulation to donor organs either outside the body (machine perfusion, MP) or inside the body of the deceased donor (normothermic regional perfusion, NRP). Ethical debates surrounding perfusion raise questions about its acceptability for transplant recipients. This study explores patient perspectives on perfusion techniques and preferences regarding informed consent. Five online focus groups were conducted with 32 kidney, liver, and heart patients, both pre- and post-transplant. Sessions were analyzed using qualitative content analysis in Atlas.ti. Participants were generally accepting of MP and NRP, valuing clinical benefits. However, they were more hesitant toward NRP due to ethical concerns about post-mortem use of the donor's body and potential emotional impacts on donor families. Drivers of acceptance were patients' medical urgency and certainty that donor and donor family were respected. Most participants wanted to receive detailed information about perfusion techniques. While patients were broadly accepting of perfusion techniques, NRP raised more concerns than MP. To ensure ethical implementation and social acceptability as these technologies evolve, patient perspectives should be embedded into perfusion guidelines, informed consent processes, and policy development.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16459"},"PeriodicalIF":3.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563099","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

Allograft nephrectomy: a systematic review of immunological consequences and management of immunosuppressants. 同种异体移植肾切除术：免疫后果和免疫抑制剂管理的系统回顾。

IF 3.6 3区医学

Transplant International Pub Date : 2026-07-03 eCollection Date: 2026-01-01 DOI: 10.3389/ti.2026.16661

Arnaud Del Bello, Anna Goujon, Diana Kassab, Thomas Prudhomme, Alexandre Frontczak, Thibault Culty

{"title":"Allograft nephrectomy: a systematic review of immunological consequences and management of immunosuppressants.","authors":"Arnaud Del Bello, Anna Goujon, Diana Kassab, Thomas Prudhomme, Alexandre Frontczak, Thibault Culty","doi":"10.3389/ti.2026.16661","DOIUrl":"10.3389/ti.2026.16661","url":null,"abstract":"Allograft nephrectomy (AN) is a serious complication of kidney transplantation. Beyond surgical morbidity, AN has important immunological implications. We performed a systematic review to synthesize current evidence on the immunological impact of AN and post-allograft failure immunosuppressive strategies. A systematic review was conducted according to PRISMA guidelines. PubMed/Medline® was searched for studies published from 01/2000 to 03/2026 on transplantectomy indications and surgical techniques. Eligible designs included meta-analyses, randomized trials, and prospective or retrospective studies evaluating the immunological impact of AN and/or immunosuppression management before, during, or after graft removal in adult or pediatric kidney transplant recipients returning to dialysis. Consistent evidence indicates that immunosuppression withdrawal is the principal driver of allosensitization after graft failure. Multiple studies demonstrated marked increases in anti-HLA antibodies following the cessation of immunosuppression, regardless of nephrectomy status. When AN was performed under maintained immunosuppression, its independent effect on sensitization and retransplant outcomes appeared limited. Meta-analyses showed comparable survival after retransplantation, although higher PRA levels, delayed graft function, and acute rejection were more frequent in patients with prior nephrectomy. Allosensitization after graft failure is primarily driven by immunosuppression withdrawal/reduction rather than AN itself. Individualized immunosuppressive management balancing immunological and infectious risks is essential.","PeriodicalId":23343,"journal":{"name":"Transplant International","volume":"39 ","pages":"16661"},"PeriodicalIF":3.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580229","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