Frontiers in Transplantation最新文献_第2页

Retrospective analysis of the incidence and outcome of late acute and chronic graft-versus-host disease—an analysis from transplant centers across Europe 晚期急性和慢性移植物抗宿主疾病发病率和预后的回顾性分析--来自欧洲各地移植中心的分析报告

Frontiers in Transplantation Pub Date : 2024-03-18 DOI: 10.3389/frtra.2024.1332181

Ronja Langer, A. Lelas, M. Rittenschober, A. Piekarska, Alicja Sadowska-Klasa, Ivan Sabol, L. Desnica, Hilde Greinix, Anne Dickinson, M. Inngjerdingen, A. Lawitschka, R. Vrhovac, D. Pulanić, Sibel Güneş, Stefan Klein, Jan Moritz Middeke, M. Grube, M. Edinger, Wolfgang Herr, Daniel Wolff

{"title":"Retrospective analysis of the incidence and outcome of late acute and chronic graft-versus-host disease—an analysis from transplant centers across Europe","authors":"Ronja Langer, A. Lelas, M. Rittenschober, A. Piekarska, Alicja Sadowska-Klasa, Ivan Sabol, L. Desnica, Hilde Greinix, Anne Dickinson, M. Inngjerdingen, A. Lawitschka, R. Vrhovac, D. Pulanić, Sibel Güneş, Stefan Klein, Jan Moritz Middeke, M. Grube, M. Edinger, Wolfgang Herr, Daniel Wolff","doi":"10.3389/frtra.2024.1332181","DOIUrl":"https://doi.org/10.3389/frtra.2024.1332181","url":null,"abstract":"Chronic graft-versus-host disease (cGvHD) is a serious late complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT).This multicenter analysis determined the cumulative incidence (CI) of cGvHD and late acute GvHD (laGvHD) and its impact on transplantation-related mortality (TRM), relapse (R), and overall survival (OS) in 317 patients [296 adults, 21 pediatrics (<12 years of age)] who underwent their first allo-HSCT in 2017.The CI of laGvHD was 10.5% in adults and 4.8% in pediatrics, and the CI of cGvHD was 43.0% in all adult transplant patients and 50.2% in the adult at-risk cohort at the study end. The onset of cGvHD was de novo in 42.0% of patients, quiescent in 52.1%, and progressive in 5.9%. In adults, prophylactic use of antithymocyte globulin or posttransplant cyclophosphamide was associated with a significantly lower incidence of cGvHD (28.7%) vs. standard prophylaxis with calcineurin inhibitors (30.6%) and methotrexate/mycophenolate mofetil (58.4%) (all p < 0.01). TRM was significantly higher in patients with aGvHD (31.8%) vs. cGvHD (12.6%) and no GvHD (6.3%) (all p = 0.0001). OS in the adult at-risk cohort was significantly higher in patients with cGvHD (78.9%) vs. without (66.2%; p = 0.0022; HR 0.48) due to a significantly lower relapse rate (cGvHD: 14.5%; without cGvHD: 27.2%; p = 0.00016, HR 0.41). OS was also significantly higher in patients with mild (80.0%) and moderate (79.2%) cGvHD vs. without cGvHD (66.2%), excluding severe cGvHD (72.7%) (all p = 0.0214).The negative impact of severe cGvHD on OS suggests a focus on prevention of severe forms is warranted to improve survival and quality of life.","PeriodicalId":317938,"journal":{"name":"Frontiers in Transplantation","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140234416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The transformative potential of artificial intelligence in solid organ transplantation 人工智能在实体器官移植中的变革潜力

Frontiers in Transplantation Pub Date : 2024-03-15 DOI: 10.3389/frtra.2024.1361491

Mouhamad Al Moussawy, Zoe S. Lakkis, Zuhayr A. Ansari, Aravind R. Cherukuri, Khodor I. Abou-Daya

引用次数: 0

Adequacy to immunosuppression management guidelines in kidney transplant recipients with severe COVID-19 pneumonia: a practice survey 患有严重 COVID-19 肺炎的肾移植受者是否充分遵守免疫抑制管理指南：一项实践调查

Frontiers in Transplantation Pub Date : 2024-03-12 DOI: 10.3389/frtra.2024.1305152

Amélie Jacq, Christelle Auvray, Mathieu Blot, B. Bouhemad, Alice Casenaz, B. Lamarthée, Mathieu Legendre, J. Quenot, Gilbert Zanetta, C. Tinel

{"title":"Adequacy to immunosuppression management guidelines in kidney transplant recipients with severe COVID-19 pneumonia: a practice survey","authors":"Amélie Jacq, Christelle Auvray, Mathieu Blot, B. Bouhemad, Alice Casenaz, B. Lamarthée, Mathieu Legendre, J. Quenot, Gilbert Zanetta, C. Tinel","doi":"10.3389/frtra.2024.1305152","DOIUrl":"https://doi.org/10.3389/frtra.2024.1305152","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) poses an important risk of morbidity and of mortality, in patients after solid organ transplantation. Recommendations have been issued by various transplantation societies at the national and European level to manage the immunosuppressive (IS) regimen upon admission to intensive care unit (ICU).The aim of this study was to evaluate the adequacy of IS regimen minimization strategy in kidney transplant recipients hospitalized in an ICU for severe COVID-19, in relation to the issued recommendations.The immunosuppressive therapy was minimized in all patients, with respectively 63% and 59% of the patients meeting the local and european recommendations upon admission. During ICU stay, IS was further tapered leading to 85% (local) and 78% (european) adequacy, relative to the guidelines. The most frequent deviation was the lack of complete withdrawal of mycophenolic acid (22%). Nevertheless, the adequacy/inadequacy status was not associated to the ICU- or one-year-mortality.In this single-center cohort, the only variable associated with a reduction in mortality was vaccination, emphasizing that the key issue is immunization prior to infection, not restoration of immunity during ICU stay.","PeriodicalId":317938,"journal":{"name":"Frontiers in Transplantation","volume":"10 S3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140251130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immunosuppressive strategies in face and hand transplantation: a comprehensive systematic review of current therapy regimens and outcomes 面部和手部移植中的免疫抑制策略：对当前治疗方案和结果的全面系统回顾

Frontiers in Transplantation Pub Date : 2024-03-06 DOI: 10.3389/frtra.2024.1366243

Lioba Huelsboemer, Sam Boroumand, Alejandro Kochen, Alna Dony, Jake Moscarelli, Sacha C. Hauc, Viola-Antonia Stögner, Richard N Formica, Bohdan Pomahac, Martin Kauke-Navarro

{"title":"Immunosuppressive strategies in face and hand transplantation: a comprehensive systematic review of current therapy regimens and outcomes","authors":"Lioba Huelsboemer, Sam Boroumand, Alejandro Kochen, Alna Dony, Jake Moscarelli, Sacha C. Hauc, Viola-Antonia Stögner, Richard N Formica, Bohdan Pomahac, Martin Kauke-Navarro","doi":"10.3389/frtra.2024.1366243","DOIUrl":"https://doi.org/10.3389/frtra.2024.1366243","url":null,"abstract":"Recipients of Vascularized Composite Allotransplants require effective immunosuppressive therapy to prevent graft rejection. This systematic review summarizes the current body of literature on immunosuppressive regimens used in face and hand transplants while summarizing their outcome in terms of rejection, renal failure, and infections.A systematic search of electronic databases was conducted to identify relevant studies from 1998 until July 1st, 2023. We included all studies that discussed immunosuppressive strategies in face and hand transplant recipients according to PRISMA.The standard triple maintenance therapy was mostly adjusted due to nephrotoxicity or high incidence of rejection. The most common alternative treatments utilized were sirolimus (25/91; 27.5%) or everolimus (9/91; 9.9%) following hand- and photophoresis (7/45; 15.6%), sirolimus (5/45; 11.1%) or belatacept (1/45; 2.2%) following face transplantation. Episodes of rejection were reported in 60 (65.9%) of hand- and 33 (73%) of face transplant patients respectively. Graft loss of 12 (13.2%) hand and 4 (8.9%) face transplants was reported. Clinical CMV infection was observed in 6 (6.6%) hand and 7 (15.5%) face transplant recipients.Based on the herein presented data, facial grafts exhibited a heightened incidence of rejection episodes and CMV infections. Facial mucosa adds complexity to the immunological graft composition highlighting the need of individualized immunosuppressive regimens and further research.","PeriodicalId":317938,"journal":{"name":"Frontiers in Transplantation","volume":"22 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140262406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The impact of socioeconomic deprivation on liver transplantation 社会经济贫困对肝移植的影响

Frontiers in Transplantation Pub Date : 2024-02-27 DOI: 10.3389/frtra.2024.1352220

Paolo De Simone, G. Germani, Quirino Lai, J. Ducci, F. Russo, Stefano Gitto, Patrizia Burra

{"title":"The impact of socioeconomic deprivation on liver transplantation","authors":"Paolo De Simone, G. Germani, Quirino Lai, J. Ducci, F. Russo, Stefano Gitto, Patrizia Burra","doi":"10.3389/frtra.2024.1352220","DOIUrl":"https://doi.org/10.3389/frtra.2024.1352220","url":null,"abstract":"Despite global expansion, social disparities impact all phases of liver transplantation, from patient referral to post-transplant care. In pediatric populations, socioeconomic deprivation is associated with delayed referral, higher waitlist mortality, and reduced access to living donor transplantation. Children from socially deprived communities are twice as much less adherent to immunosuppression and have up to a 32% increased incidence of graft failure. Similarly, adult patients from deprived areas and racial minorities have a higher risk of not initiating the transplant evaluation, lower rates of waitlisting, and a 6% higher risk of not being transplanted. Social deprivation is racially segregated, and Black recipients have an increased risk of post-transplant mortality by up to 21%. The mechanisms linking social deprivation to inferior outcomes are not entirely elucidated, and powered studies are still lacking. We offer a review of the most recent evidence linking social deprivation and post-liver transplant outcomes in pediatric and adult populations, as well as a literature-derived theoretical background model for future research on this topic.","PeriodicalId":317938,"journal":{"name":"Frontiers in Transplantation","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140425075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Mentee's perspective on Dr. Anthony Monaco: the quiet giant of transplantation 被指导者眼中的安东尼-摩纳哥博士：默默无闻的移植巨人

Frontiers in Transplantation Pub Date : 2024-02-27 DOI: 10.3389/frtra.2024.1375316

S. Nadig

引用次数: 0

Are face transplant candidates choosing autonomously? A preliminary method to evaluate autonomous choosing in psychosocial and bioethical assessments 面部移植候选人是否自主选择？在社会心理和生物伦理评估中评估自主选择的初步方法

Frontiers in Transplantation Pub Date : 2024-02-27 DOI: 10.3389/frtra.2024.1346667

Anneke Farías-Yapur

引用次数: 0

The value of organ and tissue biovigilance: a cross-sectional analysis 器官和组织生物警戒的价值：横断面分析

Frontiers in Transplantation Pub Date : 2024-02-20 DOI: 10.3389/frtra.2024.1307946

Aurora Navarro, Oscar Len, Eduardo Muñiz-Diaz, Joan-Lluis Vives Corrons, Beatriz Dominguez-Gil, Anna Vilarrodona, Jaume Tort

{"title":"The value of organ and tissue biovigilance: a cross-sectional analysis","authors":"Aurora Navarro, Oscar Len, Eduardo Muñiz-Diaz, Joan-Lluis Vives Corrons, Beatriz Dominguez-Gil, Anna Vilarrodona, Jaume Tort","doi":"10.3389/frtra.2024.1307946","DOIUrl":"https://doi.org/10.3389/frtra.2024.1307946","url":null,"abstract":"Biovigilance (BV) systems aim to improve the quality and safety of tissues and organs for transplantation. This study describes the Catalan BV system and analyzes its utility.It is a retrospective analysis of notifications on serious adverse events (SAEs) and reactions (SARs) since the implementation of the BV system (2008 for tissues and 2016 for organs) until 2020. Variables are presented to describe the most common critical steps of the pathway and complications associated with the quality and safety of tissues and organs.A total of 154 and 125 notifications were reported to the Tissue and the Organ BV systems, respectively. Most SAEs were related to unexpected donor diseases and implemented actions were assured on those deemed preventable. Regarding SARs, donor-transmitted infections and malignancies (only organs) were the most common, followed by graft failure (tissues) and process-related (organs). The incidence of SAEs and SARs related to tissue was 3.44‰ and 0.22‰, respectively. The corresponding figures for organs were 31.48‰ and 8.8‰, respectively.The analysis of the notifications to the Catalan BV systems has provided useful information about existing risks associated with the quality and safety of tissues and organs, and enabled the implementation of actions targeted to diminish risks and mitigate damage.","PeriodicalId":317938,"journal":{"name":"Frontiers in Transplantation","volume":"160 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140449140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immunogenicity and tolerance induction in vascularized composite allotransplantation 血管化复合异体移植的免疫原性和耐受诱导

Frontiers in Transplantation Pub Date : 2024-02-13 DOI: 10.3389/frtra.2024.1350546

Jiahui (Angela) Sun, Aisha Adil, Felor Biniazan, S. Haykal

{"title":"Immunogenicity and tolerance induction in vascularized composite allotransplantation","authors":"Jiahui (Angela) Sun, Aisha Adil, Felor Biniazan, S. Haykal","doi":"10.3389/frtra.2024.1350546","DOIUrl":"https://doi.org/10.3389/frtra.2024.1350546","url":null,"abstract":"Vascularized composite allotransplantation (VCA) is the transplantation of multiple tissues such as skin, muscle, bone, nerve, and vessels, as a functional unit (i.e., hand or face) to patients suffering from major tissue trauma and functional deficits. Though the surgical feasibility has been optimized, issues regarding graft rejection remains. VCA rejection involves a diverse population of cells but is primarily driven by both donor and recipient lymphocytes, antigen-presenting cells, macrophages, and other immune as well as donor-derived cells. In addition, it is commonly understood that different tissues within VCA, such as the skin, elicits a stronger rejection response. Currently, VCA recipients are required to follow potent and lifelong immunosuppressing regimens to maximize graft survival. This puts patients at risk for malignancies, opportunistic infections, and cancers, thereby posing a need for less perilous methods of inducing graft tolerance. This review will provide an overview of cell populations and mechanisms, specific tissue involved in VCA rejection, as well as an updated scope of current methods of tolerance induction.","PeriodicalId":317938,"journal":{"name":"Frontiers in Transplantation","volume":"141 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139780521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immunogenicity and tolerance induction in vascularized composite allotransplantation 血管化复合异体移植的免疫原性和耐受诱导

Frontiers in Transplantation Pub Date : 2024-02-13 DOI: 10.3389/frtra.2024.1350546

Jiahui (Angela) Sun, Aisha Adil, Felor Biniazan, S. Haykal

{"title":"Immunogenicity and tolerance induction in vascularized composite allotransplantation","authors":"Jiahui (Angela) Sun, Aisha Adil, Felor Biniazan, S. Haykal","doi":"10.3389/frtra.2024.1350546","DOIUrl":"https://doi.org/10.3389/frtra.2024.1350546","url":null,"abstract":"Vascularized composite allotransplantation (VCA) is the transplantation of multiple tissues such as skin, muscle, bone, nerve, and vessels, as a functional unit (i.e., hand or face) to patients suffering from major tissue trauma and functional deficits. Though the surgical feasibility has been optimized, issues regarding graft rejection remains. VCA rejection involves a diverse population of cells but is primarily driven by both donor and recipient lymphocytes, antigen-presenting cells, macrophages, and other immune as well as donor-derived cells. In addition, it is commonly understood that different tissues within VCA, such as the skin, elicits a stronger rejection response. Currently, VCA recipients are required to follow potent and lifelong immunosuppressing regimens to maximize graft survival. This puts patients at risk for malignancies, opportunistic infections, and cancers, thereby posing a need for less perilous methods of inducing graft tolerance. This review will provide an overview of cell populations and mechanisms, specific tissue involved in VCA rejection, as well as an updated scope of current methods of tolerance induction.","PeriodicalId":317938,"journal":{"name":"Frontiers in Transplantation","volume":"34 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139840335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0