Estella Y Huang , Kamyar Afshar , Eugene Golts , Ryan C Broderick , Graham J Spurzem , Daniel Chung , Josefin Holmgren , Bryan J Sandler , Garth R Jacobsen , David C Kunkel , Santiago Horgan
{"title":"Magnetic sphincter augmentation: A promising alternative to fundoplication for preserving lung function and protecting against chronic lung transplant rejection","authors":"Estella Y Huang , Kamyar Afshar , Eugene Golts , Ryan C Broderick , Graham J Spurzem , Daniel Chung , Josefin Holmgren , Bryan J Sandler , Garth R Jacobsen , David C Kunkel , Santiago Horgan","doi":"10.1016/j.tpr.2024.100156","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100156","url":null,"abstract":"<div><h3>Background</h3><p>Early laparoscopic fundoplication (LF) has been shown to slow lung function decline in chronic lung disease (CLD) patients and lung transplant (LTx) recipients. Magnetic sphincter augmentation (MSA) has emerged as an effective minimally invasive alternative to LF for the treatment of GERD. We evaluate the safety and efficacy of MSA compared to LF for GERD in CLD and LTx.</p></div><div><h3>Methods</h3><p>A retrospective review identified CLD and LTx patients undergoing LF or MSA for GERD. Primary outcome was change in percent predicted FEV<sub>1</sub>. Secondary outcomes were 30d morbidity, mortality, operative time, and length of stay (LOS).</p></div><div><h3>Results</h3><p>77 patients met inclusion criteria, 45 (58.5 %) were LTx recipients. 35 (45.5 %) underwent Nissen, 23 (29.9 %) underwent Toupet, and 19 (24.7 %) underwent MSA. Average age was 54.2 years, 54.5 % were female, and average BMI at ARS was 24.9 kg/m<sup>2</sup>. Median FEV<sub>1</sub> % change between pre-ARS and post-ARS was 0 % with no significant differences between groups. MSA had faster operative times at 50.5 min than Nissen (83.5 min, <em>p</em> = 0.002) and Toupet (72.6 min, <em>p</em> = 0.003) and shorter LOS at 0.8 days than Nissen (3.7 days, <em>p</em> = 0.002) and Toupet (2.1 days, <em>p</em> = 0.0008). MSA and Nissen had higher reintervention rates than Toupet, though this was not statistically significant. There were no differences in 30-day morbidities or 30-day ED visits between groups. There were no mortalities.</p></div><div><h3>Conclusion</h3><p>MSA is an advantageous alternative to LF in the CLD and LTx population with stabilization of percent predicted FEV<sub>1</sub>, equivalent safety profile, shorter operative times, and shorter length of hospital stay.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000076/pdfft?md5=615f7e4ce32952281c356bf54d213471&pid=1-s2.0-S2451959624000076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141482870","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}
Maryam Rahbar , Marzieh Latifi , Elahe Pourhosein , Ebrahim Mahmoudi , Iman Seyhoun , Sanaz Dehghani
{"title":"Long-term graft survival in a kidney transplant recipient with glioblastoma: Case report","authors":"Maryam Rahbar , Marzieh Latifi , Elahe Pourhosein , Ebrahim Mahmoudi , Iman Seyhoun , Sanaz Dehghani","doi":"10.1016/j.tpr.2024.100158","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100158","url":null,"abstract":"<div><p>Long-term immunosuppression after transplantation can increase the risk of cancer development in recipient patients. This case report describes the treatment approach for glioblastoma in a kidney transplant recipient after transplantation. The patient, a 61-year-old woman, received a living donor kidney transplant 24 years ago due to congenital nephrotic syndrome. The patient was on various immunosuppressive medications, including cyclosporine, prednisolone, and mycophenolate mofetil.</p><p>After 16 years of follow-up, the patient presented with symptoms of brain tumor, leading to further tests. Subsequent examination revealed the presence of a tumor that had spread to frontal region within the brain.</p><p>A surgical procedure was subsequently conducted to extract the tumor cells and alleviate the resulting pressure within the brain. Based on pathology results, it was determined that the patient had glioblastoma.</p><p>Methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter was detected, indicating the potential response to chemotherapy. Chemotherapy was initiated, along with radiation therapy.</p><p>After the diagnosis and surgery, the patient's medications for the kidney transplant were modified. Rapamycin replaced the previous medications, and the dose of mycophenolate mofetil and prednisolone was decreased. After 7 years, the patient's kidney is functioning well, with a creatinine level of 1.5, and brain imaging showed no abnormalities. After kidney transplantation, there is an increased risk of various cancers.</p><p>Overall, this case report demonstrates a successful treatment approach for glioblastoma after kidney transplantation, emphasizing the need for close monitoring and individualized management in transplant recipients at risk for cancer development.</p><p>Considering the current stability of the patient's condition after a change in medication regimen, patients who have been using the drug Cyclosporine for a long time should be included in future evaluations due to its carcinogenic properties.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S245195962400009X/pdfft?md5=c85d0d1fcf492b0b46327a05eb4cce26&pid=1-s2.0-S245195962400009X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540399","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":"Erratum regarding missing Declaration of Competing Interest statements and Informed consent statements in previously published articles","authors":"","doi":"10.1016/j.tpr.2024.100155","DOIUrl":"10.1016/j.tpr.2024.100155","url":null,"abstract":"","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000064/pdfft?md5=63e957c9a0101c0b343a0e73edc0b1a1&pid=1-s2.0-S2451959624000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044988","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":"Frailty assessments and changes in frailty over time in elderly veteran Kidney Transplant candidates: Effects on transplant evaluations","authors":"Cassie Cederberg , Cara Joyce , Manpreet Samra , Anuradha Wadhwa , Rupunder Sodhi , Oswaldo Aguirre , Reynold I. Lopez-Soler","doi":"10.1016/j.tpr.2024.100153","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100153","url":null,"abstract":"<div><h3>Background and hypothesis</h3><p>Frailty has emerged as an important factor in the pre-transplant evaluation process as studies have shown that it is associated with increased waitlist mortality, lower rates of transplant listing, and higher rates of delisting. There have not been many studies on frailty in elderly pre-transplant patients. In this study, we determined the common frailty phenotypes in an elderly population, and its effects on transplant success.</p></div><div><h3>Methods</h3><p>Over a 3-year period, frailty was determined for all patients evaluated at our center. Patient characteristics were summarized using descriptive statistics, overall and by level of frailty. Differences in patient characteristics by level of frailty were assessed for statistical significance using analysis of variance for age and chi-square or Fisher's exact test. Transplant outcomes such as listing success, transplant rates and post-transplant outcomes were tied to initial frailty assessments as well as the changes in frailty over time.</p></div><div><h3>Results</h3><p>A total of 375 patients were evaluated over the study period. The mean age was 64±9 years. African American patients were less likely to be frail. After adjusting for age and race, the most significant predictors of listing were the walk test (aOR: 0.42, 95 % CI: 0.22–0.79) and physical activity (aOR: 0.45, 95 % CI: 0.28–0.74). A total of 30 patients (8 %) with a pre-listing frailty evaluation died prior to transplantation. Frail walk test and physical activity assessment led to a 2-fold increase in pre-transplant mortality (7 % vs 17 %; 6 % vs 13 %).</p></div><div><h3>Conclusion</h3><p>Our study is the first to focus on a purely geriatric population and shows the importance of frailty on listing success, transplant rates and mortality prior to listing. These data point to the need for the development of tools to target frailty as a guide for improving transplant success in elderly patients.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000040/pdfft?md5=302b1753c9f4dcb93d8943354186eddd&pid=1-s2.0-S2451959624000040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094907","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":"Toxic effects of heavy metal exposure in solid organ transplant recipients","authors":"Daniel Glicklich , Muhamad Mustafa , Kevin Wolfe","doi":"10.1016/j.tpr.2024.100151","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100151","url":null,"abstract":"<div><p>Heavy metal toxicity has recently been described in solid organ transplant recipients. Allograft dysfunction or failure associated with arsenic, cadmium, chromium, cobalt and lead exposure have been reported, largely in renal transplant recipients, but also in small numbers of heart transplant recipients and a few liver and lung recipients. Conclusions: [<span>1</span>] In kidney transplant patients, highest tertile arsenic, cadmium and lead plasma levels were associated with increased allograft loss, compared to lower tertile levels; [<span>2</span>] Deteriorating metal hip prostheses may rarely cause heart failure due to cobalt and chromium cardiac toxicity in heart transplant and non-heart transplant patients, which resolves with prosthesis replacement; [<span>3</span>] Heavy metal testing should be considered in patients with multiple risk factors including occupational and environmental exposure, lower socioeconomic status, and multiple morbidities which could be associated with heavy metal toxicity; [<span>4</span>] Chelation therapy, used successfully in some non-transplant patients with chronic renal failure, has not been used systematically in transplant patients and studies are needed</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 2","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000027/pdfft?md5=7843540612855e4d6d6df5c9cf366766&pid=1-s2.0-S2451959624000027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140605195","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}
Bartira de Aguiar Roza , Sibele Maria Schuantes-Paim , Priscilla Caroliny Oliveira , Janine Schirmer , Ana Menjivar Hernandez , Mauricio Beltrán Durán
{"title":"Biovigilance systems: Cells, tissues, and organs donation and transplantation","authors":"Bartira de Aguiar Roza , Sibele Maria Schuantes-Paim , Priscilla Caroliny Oliveira , Janine Schirmer , Ana Menjivar Hernandez , Mauricio Beltrán Durán","doi":"10.1016/j.tpr.2024.100152","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100152","url":null,"abstract":"<div><p>Objective: to describe Biovigilance Systems and their associated management tools among member countries of the World Health Organization. Method: overview conducted following the population, concept, and context strategy to develop the research question and objective. Structured searches were conducted in PubMed, CINAHL, Embase, and Scopus. Snowballing procedure in Google Scholar and health authorities’ websites as World Health Organization and Pan American Health Organization during the first semester of 2023. Language and time restrictions were not applied. Results: we examined more than 70 studies and non-scientific works. Biovigilance systems were identified in 12 countries members of WHO in 3 of 6 regions: Pan-American Region (Brazil and Colombia, Canada), Europe (England, France, Germany, Italy, Netherlands, Poland, Portugal, and Spain), and Western Pacific Region (Australia). Conclusion: This overview achieved its objective by describing biovigilance systems and their management tools among World Health Organization member countries. This research, designed as an overview, refrains from generalizing results but holds significance for countries and health authorities developing biovigilance systems, offering benchmark opportunities and supporting system improvement. The study contributes directly to the biovigilance discourse, guiding efforts to enhance safety and quality globally.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 2","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000039/pdfft?md5=16fbafc6d9d252bc990ab7a966e1061e&pid=1-s2.0-S2451959624000039-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140619169","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}
Carrie Burt , Georgina Waldman , Linda Awdishu , Kamyar Afshar , Mark Mariski , Jade Kozuch , Gordon Yung , Eugene Golts , Ashley Feist
{"title":"Improved kidney function and one-year survival with transitioning from intravenous to enteral tacrolimus in lung transplant recipients","authors":"Carrie Burt , Georgina Waldman , Linda Awdishu , Kamyar Afshar , Mark Mariski , Jade Kozuch , Gordon Yung , Eugene Golts , Ashley Feist","doi":"10.1016/j.tpr.2024.100150","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100150","url":null,"abstract":"<div><h3>Background</h3><p>Acute kidney injury (AKI) is common after lung transplant and may increase risk of chronic kidney disease (CKD). Calcineurin inhibitors (CNIs) such as tacrolimus contribute to AKI risk. This study evaluated outcomes among lung transplant recipients administered enteral or oral versus intravenous (IV) tacrolimus immediately post-lung transplant.</p></div><div><h3>Methods</h3><p>We performed a single-center retrospective study of lung transplant recipients from 2011 to 2019. Tacrolimus concentrations, rates of perioperative AKI, CKD, and one-year survival were compared between those that received IV versus oral tacrolimus post-LT.</p></div><div><h3>Results</h3><p>A total of 153 patients were included; 110 and 43 received IV tacrolimus and enteral or oral tacrolimus, respectively. AKI within 14 days post-LT occurred more frequently in patients that received IV tacrolimus versus enteral administration (84.5 vs 44.1 %, <em>p</em> = <0.001). Additionally, those patients that received IV tacrolimus had supratherapeutic tacrolimus concentrations for more days than those that received enteral (3 days, IQR 1–5 vs 1 day, IQR 0–1; <em>p</em> < 0.001). CKD rates at 1 year were not significantly different between groups. One year survival was 97.7 % in group that received enteral tacrolimus compared to 82.7 % in IV tacrolimus group (<em>p</em> = 0.01)</p></div><div><h3>Conclusion</h3><p>IV tacrolimus in the initial period post-LT was associated with higher AKI rates and lower 1-year survival compared to enteral tacrolimus. There was no difference in CKD rates at 1 year.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 2","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000015/pdfft?md5=111c963adcc76d01230ac06b1d937852&pid=1-s2.0-S2451959624000015-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140557999","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}
Shelby Tungate , Chrissy Doligalski , Anita Yang , Roxanne McKnight , Raymond Coakley , L. Jason Lobo
{"title":"Impact of a bone health protocol on adult lung transplant recipients","authors":"Shelby Tungate , Chrissy Doligalski , Anita Yang , Roxanne McKnight , Raymond Coakley , L. Jason Lobo","doi":"10.1016/j.tpr.2023.100149","DOIUrl":"10.1016/j.tpr.2023.100149","url":null,"abstract":"<div><p>Corticosteroids are a critical component of immunosuppressive regimens following lung transplantation; however, their use is associated with known deleterious effects on bone health. Protocolized preventative therapies and screening may improve bone health in this population. We retrospectively reviewed all adult lung transplant recipients (LTRs) at a single center before and after implementation of a bone health protocol. Fifty-eight LTRs were included; 38 pre-protocol and 20 post-protocol. Significant differences were noted for patients following a bone health protocol including dual x-ray absorptiometry (DEXA) completion (16 % vs. 70 %, <em>p</em> = <0.001), less significant decline in femur Z- and T-scores (<em>p</em> = 0.05 and 0.04, respectively), and were more likely to be prescribed anti-resorptive therapy (11 % vs 40 %, <em>p</em> = 0.008) and calcium therapy (24 % vs. 70 %, <em>p</em> = <0.001). Incidence of non-procedural fracture at two years was numerically lower in the post-protocol group (21 % vs. 15 %, <em>p</em> = 0.58). Our data suggests that institution of a bone health protocol for lung transplant recipients improves screening, bone health pharmacotherapy, improved bone density as measured by DEXA and may reduce risk of clinically significant fractures at two years post-transplant.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 1","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959623000240/pdfft?md5=ff0cb304d840419e38ae2c639c78641e&pid=1-s2.0-S2451959623000240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139193320","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":"Donation after circulatory death: An international view","authors":"Barry D. Kahan","doi":"10.1016/j.tpr.2023.100137","DOIUrl":"10.1016/j.tpr.2023.100137","url":null,"abstract":"<div><p>The blossoming transplantation enterprise has increased the demand for human organs beyond those available from living donors. While individuals undergoing donation after brain death (DBD) continue to yield the vast majority of cadaveric organs recovered worldwide, a growing practice recruits donors among patients displaying severe brain injury but not meeting the criterion of electrosilence. These patients include a cohort who cannot maintain their circulation after withdrawal of machine-assisted ventilation and whose families consent to organ retrieval – subjects for donation after cardiocirculatory death (DCD). Expositions in this collection of articles in <em><u>Transplantation</u> <u>Reports</u></em> reveal variable practices worldwide, not only in surgical procedures to recover DCD organs, but also to overcome the ischemia-reperfusion injuries (IRi) consequent to retrieval. The contributions reveal center, national and international guidelines for, as well as outcomes of kidney, liver, lung, cardiac and pancreas transplantations of DCD organs in The United States, South America, Europe, Asia and The Middle East.</p><p>On the one hand, there is little concern about the use of <em><u>ex vivo</u></em> machine perfusion to diagnose, mitigate and treat IRI in DCD organs. On the other hand, <em><u>in vivo</u></em> donor re-vitilization by cardiopulmonary bypass after declaration of death has incited considerable controversy even among medical professionals. Bioethical and biophilosophical considerations as well as public opinion and social consensus must inform forthcoming deliberations of The United States Uniform Determination of Death Act (UDDA) Commission in order to place DCD procedures on a firm footing to meet burgeoning patient needs.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"8 4","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959623000124/pdfft?md5=892d43c881a713c94741929928ad2e41&pid=1-s2.0-S2451959623000124-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43648488","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}