Transplantation Reports最新文献

{"title":"Combined liver and kidney transplantation: Experience and outcomes at Baskent university","authors":"Adem Şafak ,&nbsp;Emre Karakaya ,&nbsp;Sedat Yildirim ,&nbsp;Nedim Çekmen ,&nbsp;Adnan Torgay ,&nbsp;Figen Özçay ,&nbsp;Sıdıka Esra Baskin ,&nbsp;Mehmet Haberal","doi":"10.1016/j.tpr.2025.100191","DOIUrl":"10.1016/j.tpr.2025.100191","url":null,"abstract":"<div><h3>Introduction</h3><div>Combined liver and kidney transplantation (CLKT) is a complex but essential procedure in selected patients with dual organ failure. We present our single-center experience with CLKT in children and adults.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively analyzed 11 patients who underwent CLKT at our center between 1988 and 2024 regarding demographic and clinical data, including age, sex, transplant type (simultaneous/sequential), etiology, dialysis status, graft/patient survival, rejection, and oxalate levels. We also evaluated lymphocyte cross-match, panel reactive antibody screening, and complement-dependent cytotoxicity testing.</div></div><div><h3>Results</h3><div>Patients included 7 female and 4 male patients (mean age 18 years); 8 were pediatric and 3 were adult recipients. One patient with primary hyperoxaluria underwent a simultaneous liver-kidney transplant, and 10 patients received sequential transplants. Six patients were diagnosed with primary hyperoxaluria. The patient with simultaneous deceased donor transplant experienced early graft loss due to oxalate deposition and humoral rejection. Four patients experienced kidney graft rejection (1 cellular, 3 humoral). One patient with cryptogenic cirrhosis and persistent hepatorenal syndrome died from sepsis in the early postoperative period. A patient with progressive familial intrahepatic cholestasis later developed focal segmental glomerulosclerosis, which was potentially related to long-term tacrolimus exposure. Another patient required graft nephrectomy following thrombotic microangiopathy. The remaining 8 patients had favorable long-term outcomes without significant complications.</div></div><div><h3>Conclusions</h3><div>Our experience supports the staged transplant approach for hyperoxaluria and highlights the importance of individualized immunosuppressive strategies. Renal grafts were more susceptible, underscoring the need for vigilant immunologic assessment. Further multicenter studies are warranted to optimize transplant timing and improve outcomes in this complex patient population.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"11 1","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765857","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}

{"title":"Cardiopulmonary resuscitation does not affect donation in uncontrolled donation after circulatory death procedures","authors":"Alonso A Mateos Rodriguez ,&nbsp;Fernando Neria Serrano ,&nbsp;Jose Maria Navalpotro Pascual ,&nbsp;Maria Jose Polonio Anguas ,&nbsp;Cristina de la Torre Toyos ,&nbsp;Carlos Rubio Chacón","doi":"10.1016/j.tpr.2025.100185","DOIUrl":"10.1016/j.tpr.2025.100185","url":null,"abstract":"<div><h3>Introduction</h3><div>The uncontrolled donation after circulatory death process is started upon cardiac arrest (CA). Although the initial objective of all emergency services is to recover a pulse after said CA, if this is not possible there is a possibility of initiating uncontrolled donation after circulatory death procedures. The aim of this study is to evaluate the actions implemented to resolve CA and how they may affect subsequent donation.</div></div><div><h3>Materials and methods</h3><div>A double-perspective observational study to study the association between the actions carried out to revert CA and the efficacy of donors in uncontrolled asystole. Data were collected between 2018 and November 2023. Patients who experienced an out-of-hospital CA with no response to advanced cardiopulmonary resuscitation, and who complied with all inclusion criteria and none of the exclusion criteria, were included. The following information was collected: age, sex, initial heart rate, adrenalin, amiodarone, serum therapy, inotropics, bicarbonate, magnesium sulfate, rapid intubation sequence, fibrinolysis, acetylsalicylic acid, atropine, number of defibrillations, use of an automatic defibrillator and discharges thereof, transitory recovery of pulse and initial heart rate. The statistical analysis was carried out using the R software package (ver. 4.1). An effective donor was defined as one from whom at least one organ was extracted and transplanted, and a non-effective donor as one from whom no organs were transplanted.</div></div><div><h3>Results</h3><div>A total of 69 patients, with a mean age of 49 years (43–52), the majority of whom were male (88.4 %), were collected. A total of 43 of these patients were non-effective donors and 26 were effective, with a statistically significant difference being found in terms of younger age (51 vs 46; <em>p</em> = 0.020). In the case of non-effective donors, eight adrenalin doses were administered compared with seven for the effective donor group, with the difference being statistically significant (<em>p</em> = 0.012). Fibrinolysis was used in eight cases (11.8 %), with two of these being non-effective donors and six effective; this difference was also statistically significant (<em>p</em> = 0.044). The remaining variables did not differ significantly.</div></div><div><h3>Conclusion</h3><div>On the basis of our series, only a lower use of adrenaline and the use of fibrinolytic agents appear to result in an effective donation if a pulse cannot be recovered. The other variables do not affect the efficacy of donation after uncontrolled circulatory death.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 4","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624340","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}

{"title":"Serum biomarkers in cardiac allograft vasculopathy: A systematic review","authors":"Farhan Ishaq ,&nbsp;Nadia Fida ,&nbsp;Rajarajan A. Thandavarayan ,&nbsp;Stefano Casarin ,&nbsp;Ashrith Guha","doi":"10.1016/j.tpr.2025.100186","DOIUrl":"10.1016/j.tpr.2025.100186","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac Allograft Vasculopathy (CAV) is a progressive manifestation of chronic allograft rejection in heart transplant recipients. While current diagnostic tools involve invasive and non-invasive imaging of coronary arterial anatomy and blood flow, circulating biomarkers can lead to earlier detection non-invasively.</div></div><div><h3>Objective</h3><div>The aim of this systematic review is to synthesize existing literature of prognostic and diagnostic circulating peripheral biomarkers of CAV.</div></div><div><h3>Methods</h3><div>A thorough literature search was performed on Pubmed, CINAHL, Scopus and Medline using the terms “cardiac allograft vasculopathy,” “CAV,” and “biomarkers.”</div></div><div><h3>Results</h3><div>The search yielded 1648 studies; 109 were included for the final review. Quality of evidence and risk of bias varied across the studies.</div></div><div><h3>Conclusion</h3><div>Multiple circulating biomarkers could help diagnose and prognosticate in the presence of CAV with variable diagnostic accuracy and predictability. The role of incorporating these biomarkers in traditional coronary imaging diagnostic paradigm of CAV remains to be studied.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 4","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691466","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}

{"title":"Prostaglandin E1 (PGE1) in renal transplantation","authors":"Markus Dehnhardt ,&nbsp;Bettina Leber ,&nbsp;Gerd Wawrik ,&nbsp;Philipp Stiegler","doi":"10.1016/j.tpr.2025.100188","DOIUrl":"10.1016/j.tpr.2025.100188","url":null,"abstract":"<div><div>Prostaglandin E1 (PGE₁), also known as Alprostadil, has been widely studied for its positive effects in solid organ transplantation. This pharmacological agent offers notable benefits in heart, lung, and particularly liver and kidney transplants, leading to improved outcomes such as reduced ischaemia-reperfusion injury (IRI), better graft viability, and increased patient survival.</div><div>Evidence suggests that PGE₁ is effective in organ preservation, reducing IRI, preventing primary graft dysfunction, improving both short- and long-term survival, shortening stays in the intensive care unit (ICU), and decreasing the risk of acute kidney failure, especially after liver transplantation.</div><div>The principal biological actions of PGE₁, which make the compound a valuable tool in organ transplantation are the following: it acts as a vasodilator, improving organ perfusion by reducing peripheral vascular resistance in the kidney and liver. Furthermore, it provides cytoprotection and has anti-inflammatory effects, shielding cells and tissues from IRI, lowering oxidative stress, and moderating immune responses. Finally, PGE₁ has established anti-platelet and fibrinolytic properties: it inhibits platelet aggregation and promotes fibrinolysis, further protecting the graft, impacting the platelet activation, and especially their release of potassium ions during activation. These combined effects—vasodilation, cytoprotection, anti-inflammation, and anti-platelet activity—lead to better clinical outcomes, including faster organ function recovery, improved graft and patient survival, and a reduced risk of acute rejection.</div><div>In kidney transplantation, PGE₁ has been shown to protect organs when administered during machine perfusion (but not during cold storage). It enhances renal function during reperfusion, lowers vascular resistance, and limits IRI, when given immediately after reperfusion. By reducing oxidative stress and inflammation, PGE₁ supports quicker graft recovery and better overall results.</div><div>PGE₁’s rapid metabolism and widespread distribution of its receptors, along with well-understood receptor-mediated effects, make it a promising option for perioperative management in solid organ transplantation. Its capacity to reduce IRI, suppress inflammation, and support vascular function is supported by strong pre-clinical and clinical evidence.</div><div>In the present review, we summarize available evidence that position PGE₁ as a valuable therapeutic adjunct for improving transplantation outcomes.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 4","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624339","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}

{"title":"Organ transplantation in brain-dead patients: Integrating immunology, life support, case studies, legal, and ethical considerations for future therapeutics","authors":"Carola Ginevra Ciarlini,&nbsp;Konrad Fischer","doi":"10.1016/j.tpr.2025.100187","DOIUrl":"10.1016/j.tpr.2025.100187","url":null,"abstract":"<div><div>This review explores the use of brain-dead organ recipients for transplantation studies, focusing on recent advancements and the scientific rationale behind this approach. Brain-dead patients serve as a crucial pre-clinical model to test the safety and feasibility of xenotransplantation, allowing researchers to assess surgical complications, immune responses, and organ function without the ethical concerns associated with living human subjects. Notable studies from the University of Alabama at Birmingham, the New York University, the University of Pennsylvania and the Air Force Medical University in Xi'an have demonstrated the potential of genetically modified pig organs, such as kidneys, hearts and livers, to reduce immune rejection and improve graft survival. These experiments highlight the complexities of managing systemic physiological responses and the need for sophisticated extracorporeal life support systems. Additionally, the ethical and legal implications of using brain-dead patients for such experimental procedures are considered, underscoring the importance of informed consent and regulatory oversight. This review underscores the promise of xenotransplantation in addressing organ shortages and advancing transplant medicine.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 4","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624422","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}

{"title":"Xenotransplantation in India: Ethical challenges, historical lessons, and future prospects","authors":"Soumyadip Sain ,&nbsp;Trisha Chattoraj","doi":"10.1016/j.tpr.2025.100184","DOIUrl":"10.1016/j.tpr.2025.100184","url":null,"abstract":"<div><div>India faces an acute shortfall in organ donations, with a deceased donor rate of approximately 0.5 per million population—one of the lowest globally. Xenotransplantation—the transplantation of organs or tissues across species—has re-emerged internationally as a viable solution to organ shortages, particularly with advances in genetic engineering of pigs. However, its application in India is fraught with ethical complexities, religious sensitivities, biosafety concerns, and regulatory limitations. A pivotal moment in Indian medical history occurred in 1997 when Dr. Dhaniram Baruah conducted an unauthorized pig-to-human heart transplant in Assam. The operation ended in the patient's death and raised serious ethical and legal questions, shaping the Indian public and institutional attitude toward xenotransplantation. This review examines India’s current position in the global xenotransplantation landscape by critically analyzing historical precedents, sociocultural dynamics, ethical imperatives, infrastructural readiness, and regulatory gaps. It argues for a measured and inclusive approach involving the reform of legal frameworks, scientific infrastructure development, and public engagement through culturally sensitive discourse. Drawing on international guidelines and experiences, the article proposes a detailed roadmap for India’s preparedness to responsibly embrace xenotransplantation. Ethical and scientific vigilance, alongside cross-sectoral cooperation, will be key to ensuring that this frontier of medicine serves public health without compromising safety, equity, or public trust.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 4","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145500418","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}

{"title":"Improving access to minorities with A2 to B kidney transplantation: A systematic review and meta-analysis","authors":"Patricia Viana ,&nbsp;Maria Meritxell Roca Mora ,&nbsp;Jorge Eduardo Persson ,&nbsp;André Milani-Reis ,&nbsp;Harold Cliff Sullivan ,&nbsp;Idelberto Raul Badell ,&nbsp;Juliano Riella","doi":"10.1016/j.tpr.2025.100181","DOIUrl":"10.1016/j.tpr.2025.100181","url":null,"abstract":"<div><h3>Background</h3><div>Studies have shown that A2 kidney transplants for blood group B recipients offer comparable graft and patient survival rates to ABO-compatible transplants, potentially improving transplant access for B recipients. However, the adoption of this strategy has been controversial.</div></div><div><h3>Methods</h3><div>We conducted a Systematic-Review and Meta-Analysis, comparing non-A1to B versus B to B blood type in kidney transplant patients. MEDLINE, Embase, and Cochrane databases were searched for studies that met our inclusion criteria. We analyzed binary and continuous endpoints using odds ratios (OR) and mean difference (MD), respectively, with a 95% confidence interval (CI). P-value &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>We included five studies with 14,959 patients, of whom 2,121 (14.2%) were non-A1 to B blood. No statistically significant differences were found between the groups for patient survival (OR 1.08; 95% CI 0.95 to 1.22; p=0.6), graft survival (OR 1.1; 95% CI 0.99 to 1.23; p=0.96), eGRF (MD 7.8 mL/min/1.73m²; 95% CI -8.27 to 23.87 mL/min/1.73m²; p=1.0), <u>antibody-mediated rejection (OR 1.51; 95% CI 0.43 to 5.28; p = 0.52), and T-cell-mediated rejection (OR 1.12; 95% CI 0.43 to 2.93; p = 0.81)</u>.</div></div><div><h3>Conclusion</h3><div>We found no significant differences in patient and graft survival between non-A1 to B and B to B kidney transplantation. This finding underscores the potential to expand the donor pool without compromising outcomes, which has a profound impact on reducing waiting times and improving equity in renal transplant access.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 3","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757498","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}

{"title":"Effect of tacrolimus formulation on neurocognition in older kidney transplant recipients: A randomized controlled trial","authors":"Hadia Lala Gul ,&nbsp;Macey Sockolov ,&nbsp;Katherine Howes ,&nbsp;Amanpreet Kaur ,&nbsp;Michelle Occhipinti ,&nbsp;Heejung Bang ,&nbsp;Muna Alnimri ,&nbsp;Yihung Huang ,&nbsp;Joy Dray ,&nbsp;Ling-Xin Chen","doi":"10.1016/j.tpr.2025.100178","DOIUrl":"10.1016/j.tpr.2025.100178","url":null,"abstract":"<div><h3>Background</h3><div>Tacrolimus is known to cause neurotoxicities that may be more severe in older individuals. We aimed to compare the neurocognitive side effects of immediate release (IR) and LCP tacrolimus in older kidney transplant recipients in the early post-transplant period.</div></div><div><h3>Methods</h3><div>In this single center, open-label, randomized and controlled trial of 64 kidney transplant recipients aged 60 or above, participants were randomized to LCP tacrolimus or IR tacrolimus between 4- and 8-weeks post-transplantation and followed for 6-weeks. The primary outcome of neurocognitive performance at 6-weeks compared with baseline was assessed by the Montreal Cognitive Assessment (MoCA) and Digit Symbol Substitution Test (DSST). Secondary outcomes included health-related quality of life as measured by the Quality of Life in Essential Tremor Questionnaire (QUEST) and Organ Transplant Symptom and Wellbeing Instrument (OTSWI).</div></div><div><h3>Results</h3><div>32 patients were randomized to IR tacrolimus and 31 to LCP tacrolimus. In the IR tacrolimus arm, the MOCA score increased by 1.2 points (SD 2.1) and the DSST score increased by 1.0 points (SD 7.8). In the LCP tacrolimus arm, the MOCA score increased by 0.2 points (SD 2.9) and the DSST score increased by 1.3 points (SD 7.5). No statistically significant difference was detected between arms in MOCA, DSST, QUEST or OTSWI scores. There was a trend toward improvement in tremor severity in the LCP tacrolimus arm.</div></div><div><h3>Conclusions</h3><div>No improvement was found in MoCA or DSST performance in patients switched to LCP tacrolimus as compared to IR tacrolimus after 6 weeks of exposure in the early post-transplant period.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 3","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241816","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}

{"title":"Emerging technologies in corneal transplantation: innovations, challenges, and global implications","authors":"Khayry Al-Shami ,&nbsp;Salman Almurabi ,&nbsp;Andreea Pop ,&nbsp;Clara Vincent ,&nbsp;Aniela Popescu ,&nbsp;Iulia Cezara Pop ,&nbsp;Noor S. Bader ,&nbsp;Hala Faour ,&nbsp;Rahaf Barhoush ,&nbsp;Saja Karaja","doi":"10.1016/j.tpr.2025.100180","DOIUrl":"10.1016/j.tpr.2025.100180","url":null,"abstract":"<div><div>Precision, reduction of rejection rates, and reduction of dependency on long-term immune suppression are being advanced by advancements in corneal transplantation (CT) using femtosecond laser-assisted keratoplasty (FLAK), Descemet membrane endothelial keratoplasty (DMEK), and Bowman layer transplantation (BLT). Also, technologies such as bioengineered tissues, CRISPR-Cas9 gene editing, and bioadhesives seek to enhance graft integration and survival in mechanisms to supply a global shortage of donor corneas, particularly in low-income countries with the greatest demand. Despite this, bioengineered corneas represent an alternative to traditional transplants that incur ethical and practical hurdles, including regulation, cost, and biases in resource allocation. The application of artificial intelligence (AI), in particular diagnosis and surgical planning, in ophthalmology in general, and especially in corneal disease management, has great promise. However, the 'black box' decision-making of AI, its biases, and lack of transparency could be barriers to accountability and consistent use in practice. The other obstacle is the high costs that discourage access to and availability of advanced technologies for many low- and middle-income countries (LMICs), whose healthcare infrastructures are also limited. To ensure these innovations can be integrated into mainstream corneal care, particularly serving the needs of underserved populations, we need to address these technological, economic, and ethical issues. However, these technologies require more clinical trials and policy considerations for their optimization for accessible, effective, global eye care.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 3","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223649","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}

{"title":"Voriconazole-induced Periostitis Following Lung Transplantation: Case Series","authors":"Gouji Toyokawa ,&nbsp;Miho Yamaguchi ,&nbsp;Takafumi Yamaya ,&nbsp;Mitsuaki Kawashima ,&nbsp;Chihiro Konoeda ,&nbsp;Koh Okamoto ,&nbsp;Masaaki Sato","doi":"10.1016/j.tpr.2025.100179","DOIUrl":"10.1016/j.tpr.2025.100179","url":null,"abstract":"<div><div>Voriconazole, the first-choice treatment for invasive aspergillosis, can induce periostitis. For unknown reasons, most reports on this rare side effect are in the field of organ transplantation, especially lung transplantation, and mostly from Western countries. However, in Asian countries, including Japan, the incidence of this complication may be underestimated. Herein, we report three Japanese patients who developed voriconazole-induced periostitis after lung transplantation. The patients’ initial symptoms were pain in the left shoulder, bilateral axillae, and left upper arm. The duration of voriconazole treatment before symptom onset ranged from 5 to 59 months. The diagnosis was confirmed by bone scintigraphy in two patients and computed tomography scan in one patient with or without elevation of alkaline phosphatase levels. All three patients experienced symptom relief within 7 days of voriconazole discontinuation, and the bone scintigraphy findings and alkaline phosphatase elevation were reversible.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"10 3","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241817","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}