Transplantation Reports最新文献

{"title":"Xenotransplantation: The next quarter century","authors":"A. Joseph Tector ,&nbsp;Matt Tector ,&nbsp;Rodrigo Vianna ,&nbsp;Andrew Adams","doi":"10.1016/j.tpr.2025.100177","DOIUrl":"10.1016/j.tpr.2025.100177","url":null,"abstract":"<div><div>Transplantation has become a preferred therapy for the treatment of end stage organ failure, improving the quality and duration of recipients lives. The major limitation of organ transplantation is the shortage of suitable donor organs available for clinical use. Xenotransplantation using genetically modified pig organs could provide an unlimited source of organs, allowing all patients in need to receive a transplant in a timely fashion. Xenotransplantation was limited to the experimental realm because of the presence of anti-pig antibodies that are present in the blood of every human (1, 2).</div><div>The development of genetic engineering tools, especially CRISPR/Cas9 and somatic cell nuclear transfer made it possible to create pigs missing key glycan pig antigens so that the antibodies did not bind to the new pig (3-5). Preclinical results using kidneys from new donor pigs has improved to the point where nonhuman primate recipients are living for more than 4 years (Andrew Adams personal communication). The improvements in survival seen in preclinical models has led to clinical attempts at heart and kidney xenotransplantation (6, 7). Thus far in the first 5 clinical xenotransplant cases success has been modest, with only one graft (kidney) functioning past 60 days to date. The other patients receiving pig xenografts (2 hearts and 2 kidneys) succumbed to early antibody mediated rejection (AMR) (7-9). Nevertheless, the developments in preclinical and compassionate use xenotransplantation have resulted in the first FDA approved clinical trial with renal xenotransplantation. This article will deal with the issues that are likely to be the focus of the next 25 years with regards to development of clinical xenotransplantation.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 2","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Ischemia-reperfusion injury in liver transplant rejuvenation","authors":"Kenneth J. Dery,&nbsp;Fady Kaldas,&nbsp;Jerzy W. Kupiec-Weglinski","doi":"10.1016/j.tpr.2025.100176","DOIUrl":"10.1016/j.tpr.2025.100176","url":null,"abstract":"<div><h3>Background</h3><div>Hepatic ischemia-reperfusion injury (HIRI) is a multifaceted pathophysiological process involving a cascade of interconnected cellular events. The initial ischemic stress, followed by the reestablishment of blood circulation to the liver, triggers a feed-forward innate immune-driven response that exacerbates the hepatocellular injury. HIRI poses a significant clinical challenge in liver transplantation (LT), as it can result in tissue damage, organ dysfunction, and poor clinical outcomes.</div></div><div><h3>Methods and results</h3><div>This review highlights current key issues in HIRI translational research, as revealed by recent bibliometric studies. It examines the mechanisms that facilitate homeostatic regulation after HIRI. Additionally, it addresses refined pharmacological strategies aimed at mitigating oxidative stress and inflammation. Hot topic areas in HIRI research include autophagy, donation after circulatory death, and NLRP3-dependent inflammasome activation following LT. New pharmacological agents, such as anti-oxidative compounds, metabolic modulators, and plant-derived compounds, are being explored to influence inflammatory responses. There is a strong clinical emphasis on broadening the donor pool by utilizing marginal donor grafts and advanced machine perfusion techniques. Enhancing translational research through the development of human-relevant organoids or ex vivo liver perfusion systems is essential for connecting laboratory discoveries with clinical practices in life-saving surgical procedures.</div></div><div><h3>Conclusion</h3><div>A comprehensive approach that emphasizes the regulatory mechanisms of cellular responses to oxygen stress and immune cell activation, alongside innovative donor organ preservation, like machine perfusion, will shape the future direction of HIRI research by enhancing graft viability and revitalizing suboptimal donor organs.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 2","pages":"Article 100176"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing drug-drug interactions of Tacrolimus with Fluconazole and/or Verapamil and developing the predictive model for Tacrolimus concentrations in kidney transplant recipients","authors":"Mingkwan Na Takuathung ,&nbsp;Kajohnsak Noppakun ,&nbsp;Chotiwit Sakuludomkan ,&nbsp;Nahathai Dukaew ,&nbsp;Nuttapong Chailungkar ,&nbsp;Naruemon Suyayai ,&nbsp;Nut Koonrungsesomboon","doi":"10.1016/j.tpr.2025.100175","DOIUrl":"10.1016/j.tpr.2025.100175","url":null,"abstract":"<div><div>Maintaining optimal tacrolimus serum concentrations is crucial for kidney transplant recipients due to its narrow therapeutic window and pharmacokinetic variability. The use of CYP3A4/5 inhibitors, such as fluconazole and verapamil, can increase tacrolimus serum concentrations. Understanding these interactions is vital for predicting and optimizing tacrolimus levels. This study aimed to investigate the impact of co-administering fluconazole, verapamil, or their combination on tacrolimus concentration/dose (C/D) in kidney transplant recipients and develop a predictive model for these scenarios. This retrospective study involved kidney transplant recipients treated with tacrolimus and co-administered fluconazole and/or verapamil. The Generalized Estimating Equations (GEE) approach was used to explore predictive variables associated with tacrolimus C/D. A total of 177 kidney transplant recipients were included. Repeated measure correlation analysis revealed positive correlations between tacrolimus C/D and dosages of fluconazole (<em>b</em> = 0.37, 95 % CI = 0.29 to 0.45, <em>p</em> &lt; 0.001) and verapamil (<em>b</em> = 0.15, 95 % CI = 0.07 to 0.23, <em>p</em> &lt; 0.001). This study offers a predictive model for optimizing tacrolimus levels when fluconazole and/or verapamil are co-administered in kidney transplant recipients.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 2","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine evaluation among solid organ transplant recipients at a single academic center","authors":"Kristen Lay ,&nbsp;Marina Feffer ,&nbsp;David Slade ,&nbsp;Fritzie S. Albarillo","doi":"10.1016/j.tpr.2025.100174","DOIUrl":"10.1016/j.tpr.2025.100174","url":null,"abstract":"<div><h3>Background</h3><div>Solid organ transplant recipients (SOTRs) may have a higher risk of serious disease and death due to COVID-19. It is necessary to determine the main motivators and demotivators for SOTRs to receive COVID-19 vaccinations to improve patient education.</div></div><div><h3>Methods</h3><div>A voluntary and anonymous survey was created using questions adopted from the Center for Disease Control COVID-19 Vaccine Confidence: Rapid Community Assessment. Questions included demographics, vaccination status and opinions in multiple choice and free response format. The survey was distributed in July 2023 and was open for one month.</div></div><div><h3>Results</h3><div>A total of 127 SOTRs responded which included patients 18 years and older who received one of the following transplants: heart (12.6 %), lung(s) (37.01 %), liver (31.5 %), kidney (11.81 %), and liver and kidney (7.09 %). The overwhelming majority of respondents received a primary vaccination series (97.64 %). Among the vaccinated, 68.55 % received a bivalent booster vaccination and 32.28 % have received a second booster vaccination. The greatest motivating factors among vaccinated were “protecting my health” (84.68 %) “protecting the health of family and friends” (66.13 %), and “to protect the health of the community” (36.29 %). Only 3 SOTRs were unvaccinated, all of whom reported that they felt the vaccine was unsafe.</div></div><div><h3>Conclusion</h3><div>While the overwhelming majority of SOTRs were vaccinated against COVID-19 to protect their health and the health of others, a minority have hesitations about receiving booster vaccinations. Targeting patient education towards these concerns will improve the protection of the SOTR community.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 2","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current state of artificial intelligence in liver transplantation","authors":"Ashley E. Montgomery ,&nbsp;Abbas Rana","doi":"10.1016/j.tpr.2025.100173","DOIUrl":"10.1016/j.tpr.2025.100173","url":null,"abstract":"<div><div>Over the past few decades, substantial progress has been made in the field of liver transplantation. Yet, challenges remain in the field due to an increasing organ allograft shortage as well as significant waitlist mortality. With these challenges, organ allocation policies have been developed and are constantly being modified to result in more efficient organ allocation. One tool that has been explored to improve the field of liver transplantation is artificial intelligence, which is an umbrella term for techniques such as machine learning and deep learning. This review article explores the use of artificial intelligence in the field of liver transplantation. Specifically, studies have shown potential applications of artificial intelligence in improving waitlist mortality models, assessing allograft characteristics, using large language models for research question development and patient education, developing post-transplant models, as well as predicting multiple risk factors such as cardiovascular disease, infection, graft failure, malignancy, graft fibrosis, and pneumonia. However, even with these studies, several limitations for the use of artificial intelligence exist such as biased data sets leading to biased model development, lack of extensive validation of the artificial intelligence models, and the need for large datasets for model development. With additional studies evaluating the use of artificial intelligence and wide-scale validation of these studies highlighted, the use of artificial intelligence may transform the field of transplantation in the future.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 2","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-target combination of antibiotics as salvage therapy for severe infection caused by pan-resistant Burkholderia cenocepacia following lung transplantation","authors":"Nadim Cassir ,&nbsp;Benjamin Coiffard ,&nbsp;Linda Hadjadj ,&nbsp;Julien Bermudez ,&nbsp;Liliane Okdah ,&nbsp;Lucile Ailhaud ,&nbsp;Sophie Alexandra Baron ,&nbsp;Martine Reynaud-Gaubert ,&nbsp;Xavier Benoit D'Journo ,&nbsp;Sami Hraiech ,&nbsp;Jean-Marc Rolain","doi":"10.1016/j.tpr.2024.100170","DOIUrl":"10.1016/j.tpr.2024.100170","url":null,"abstract":"<div><div><em>Burkholderia cepacia</em> complex (Bcc) is an important group of opportunistic pathogens most frequently affecting patients with cystic fibrosis and responsible for life-threatening infections. Therapeutic options are limited owing to high levels of resistance of the organism, either intrinsic or acquired, to many antimicrobial agents. We describe here the successful treatment of a patient with cystic fibrosis who developed post-transplant lung abscesses and sternal osteitis caused by pan-resistant <em>Burkholderia cenocepacia.</em> He was treated with a combination of ceftazidime-avibactam, ciprofloxacin, meropenem, minocycline, sulfadiazine, and tobramycin. Repurposing multitarget drugs including old and new antibiotics, and their combinations with synergistic effects is a promising strategy to overcome clinical therapeutic impasses with difficult-to-treat-resistance (DTR) bacteria.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 1","pages":"Article 100170"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143181457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergent management of severe post-TIPS bleed in patient with end-stage liver disease and coronary artery disease","authors":"Mohammad Arammash ,&nbsp;Barbara Hamilton ,&nbsp;Charles Rickert","doi":"10.1016/j.tpr.2024.100168","DOIUrl":"10.1016/j.tpr.2024.100168","url":null,"abstract":"<div><div>Liver transplantation has become widely available but remains a high-risk operation not suitable in the presence of severe comorbidities. Pre-operative planning to address potential challenges is key to ensuring optimal outcomes. In this report, we highlight a challenging clinical situation in which a patient with severe portal vein thrombosis and coronary artery disease developed a significant bleed post TIPS, necessitating emergent ligation of the portal structures and urgent liver transplantation. The patient successfully underwent coronary artery bypass grafting after liver transplantation. This case demonstrates an unconventional method for remediating inaccessible portal vein hemorrhage secondary to transjugular intrahepatic portosystemic shunting and the ability to perform coronary artery bypass grafting post-liver transplantation.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 1","pages":"Article 100168"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observed vs. Expected organs transplanted in pediatric donors at Saint Francis hospital","authors":"R. Goodwin ,&nbsp;K. Champlin ,&nbsp;B. Cloud ,&nbsp;C. Yancey ,&nbsp;C. Hendrix ,&nbsp;S. Parikh ,&nbsp;M. Howell ,&nbsp;R. Ketcham ,&nbsp;A. Milam ,&nbsp;B. Nave ,&nbsp;T. Campbell ,&nbsp;M. Cheruvu","doi":"10.1016/j.tpr.2024.100169","DOIUrl":"10.1016/j.tpr.2024.100169","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective case study aims to clarify the roles played by various factors in determining the actual versus expected number of organs procured from pediatric trauma patients.</div></div><div><h3>Significance</h3><div>Trauma patients often have injuries so extensive that there is no hope of recovery. However, if they are stabilized, they may be able to save lives through organ donation. The more organs are procured, the more lives may be saved.</div></div><div><h3>Strategy and Implementation</h3><div>In this retrospective study, we reviewed the records of pediatric organ donors from Saint Francis Children's Hospital from 2018 to 2022 and identified seven interesting cases involving children younger than 15 years old that showed the actual and expected numbers of organs transplanted. We examined the number of organs that we expected to transplant compared with how many organs were actually transplanted and which clinical data may have affected the ability to transplant.</div></div><div><h3>Outcomes</h3><div>The data analysis included but was not limited to the observed-to-expected ratio, donor management goals, hospital lab and biometric values before the time of referral, cause of death, age, sex, race, body mass index, blood type, kidney donor profile index, referral timeliness, donation conversations, donation conversation outcomes, hospital attending, pre-mentions of donation to potential families, referral and donation milestone date-time stamps, donor outcomes, organs recovered, organs transplanted, organs discarded, organs submitted to research, and survey responses. Based on the seven identified cases, this study shows that an observed-to-expected ratio greater than 1 is achievable.</div></div><div><h3>Implications for Practice</h3><div>Identifying factors that affect increased observed organ procurement will increase the potential of transplantable organs, thus leading to a higher number of lives saved.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 1","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing deep variant phenotyping of mitochondrial enzyme complexes for precision medicine in allogeneic hematopoietic stem-cell transplantation","authors":"Jing Dong ,&nbsp;Michael T. Zimmermann ,&nbsp;Neshatul Haque ,&nbsp;Shahram Arsang-Jang ,&nbsp;Wael Saber ,&nbsp;Xiaowu Gai ,&nbsp;Raul Urrutia","doi":"10.1016/j.tpr.2025.100171","DOIUrl":"10.1016/j.tpr.2025.100171","url":null,"abstract":"<div><div>Allogeneic hematopoietic stem-cell transplantation (allo-HCT), an early developed methodology for precision medicine, remains the only curative therapy for myelodysplastic syndromes (MDS). However, allo-HCT carries significant risks of morbidity and mortality due to relapse and transplant-related complications. Recurrent mutations in mitochondrial DNA (mtDNA) have been identified as significant prognostic indicators for MDS outcomes following allo-HCT. However, the biological mechanisms of mtDNA mutations remain unclear. Thus, here we performed deep variant phenotyping by integrating computational biophysics and structural genomics approaches to reveal the molecular mechanisms underlying mtDNA variant dysfunction. This emerging genomics discipline employs structural models, molecular mechanic calculations, and accelerated molecular dynamic simulations to analyze gene products, focusing on their structures and motions that determine their function. We applied this methodology on the variants in the mitochondria-encoded complex I genes that are associated with MDS pathobiology and prognosis after allo-HCT. Our results demonstrate that this approach significantly outperforms conventional analytical methods, providing enhanced and more accurate information to support the potential pathogenicity of these variants and better infer their dysfunctional mechanisms. We conclude that the adoption and further expansion of computational structural genomics approaches, as applied to the mitochondrial genome, have the potential to significantly increase our understanding of molecular mechanisms underlying the disease. Our study lays a foundation for translating mitochondrial biology into clinical applications, which will advance the integration of precision medicine with allo-HCT.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 1","pages":"Article 100171"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary central nervous system post-transplant lymphoproliferative Disorder in a lung transplant recipient despite reduction of immunosuppression","authors":"K Afshar ,&nbsp;JM Kozuch ,&nbsp;M Don ,&nbsp;C Gaissert ,&nbsp;E Golts","doi":"10.1016/j.tpr.2025.100172","DOIUrl":"10.1016/j.tpr.2025.100172","url":null,"abstract":"<div><div>Lymphomas arising in the setting of immune deficiency and/or dysregulation, also known as post-transplant lymphoproliferative disorder (PTLD) is frequently associated with immunosuppressive therapies and the Epstein Barr Virus after solid organ transplantation. Primary central nervous system PTLD (PCNS-PTLD) is extremely rare. Our group presents only the third reported case of PCNS-PTLD in the setting of lung transplantation.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 1","pages":"Article 100172"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}