Transplantation ReportsPub Date : 2024-12-01Epub Date: 2024-10-09DOI: 10.1016/j.tpr.2024.100162
Jordan Leal, William Wesson, Liza Rodriguez, Jason Gray, Kelly Bosak, Joseph McGuirk, Kristin Grdinovac
{"title":"Implementing a standardized workflow for early detection of steroid-induced hyperglycemia in allogeneic stem cell transplant recipients: A quality improvement project","authors":"Jordan Leal, William Wesson, Liza Rodriguez, Jason Gray, Kelly Bosak, Joseph McGuirk, Kristin Grdinovac","doi":"10.1016/j.tpr.2024.100162","DOIUrl":"10.1016/j.tpr.2024.100162","url":null,"abstract":"<div><h3>Background</h3><div>Steroid-induced hyperglycemia (SIH) worsens overall outcomes in the allo-SCT population. Currently, there is no standardized workflow for monitoring SIH. To address this need, a quality improvement (QI) initiative was implemented, as part of a Doctor of Nursing Practice project for the University of Kansas School of Nursing, to standardize glucose monitoring after the initiation of glucocorticoids (CGs) for the treatment of acute or chronic graft-versus-host-disease (GVHD).</div></div><div><h3>Objective</h3><div>This QI initiative aimed to decrease the median time to identification of SIH and the initiation of treatment in allo-SCT recipients on GCs for GVHD.</div></div><div><h3>Study Design</h3><div>The study took place at a large Midwestern blood and marrow transplant program. Patients diagnosed with acute or chronic GVHD and prescribed ≥0.5 mg kg<sup>-1</sup>/day prednisone equivalent (PE) steroids were requested to monitor postprandial blood glucose values for 14 days. A control group (retrospective chart review) was used for comparison. Time to the identification of SIH was compared between the two groups, as well as the time to treatment of hyperglycemia.</div></div><div><h3>Results</h3><div>Over 9 weeks, 19 patients enrolled in the QI initiative. The control group consisted of 21 patients. The median PE steroid dose was 1 mg kg<sup>-1</sup>/day in both groups (<em>p</em> = 0.8100). Eighteen of the 19 patients (95 %) had at least 1 blood glucose (BG) > 180 mg/dL and only 6 of 21 patients (29 %) had at least 1 BG > 180 mg/dL (<em>p</em> < 0.0001). The median time to a BG > 180 mg/dL was 1.5 days in the QI group and 7 days in the control group (<em>p</em> = 0.0232). The median time to insulin was 2 days in the QI group and 10 days in the control group (<em>p</em> = 0.0355).</div></div><div><h3>Conclusion</h3><div>This project demonstrated that daily postprandial blood glucose monitoring is superior for the earlier identification and treatment of SIH when compared to monitoring at routine clinic visits alone.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434332","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}
Transplantation ReportsPub Date : 2024-12-01Epub Date: 2024-11-19DOI: 10.1016/j.tpr.2024.100164
Jade M Kozuch , Alicia Lichvar , Dana Abraham , Eugene Golts , Christine M Lin , Aarya Kafi , Gordon Yung , Kamyar Afshar
{"title":"A national survey of immunosuppression adjustment in elderly lung transplant recipients","authors":"Jade M Kozuch , Alicia Lichvar , Dana Abraham , Eugene Golts , Christine M Lin , Aarya Kafi , Gordon Yung , Kamyar Afshar","doi":"10.1016/j.tpr.2024.100164","DOIUrl":"10.1016/j.tpr.2024.100164","url":null,"abstract":"<div><div>The proportion of elderly lung transplant recipients has increased substantially in recent years. The immunosuppressants required significantly increase the risk for infection and malignancy in the elderly population. However, there is a paucity of data on immunosuppression management practices in this group. Herein, we report results of the first national aggregation of immunosuppressant strategies in elderly lung transplant recipients within the US.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698140","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}
Transplantation ReportsPub Date : 2024-12-01Epub Date: 2024-11-19DOI: 10.1016/j.tpr.2024.100163
Lorenzo Olivero , Hong Liang , Ian A. Makey , Si M. Pham , Jorge Sinclair , Stephen Aniskevich III , Sadia Z. Shah , Dana K. Perry , Wesley L. Allen , Nathan H. Waldron , Liu Yang , Pramod K. Guru , Candido E. Rivera , Pablo Moreno Franco , Tathagat Narula
{"title":"Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report","authors":"Lorenzo Olivero , Hong Liang , Ian A. Makey , Si M. Pham , Jorge Sinclair , Stephen Aniskevich III , Sadia Z. Shah , Dana K. Perry , Wesley L. Allen , Nathan H. Waldron , Liu Yang , Pramod K. Guru , Candido E. Rivera , Pablo Moreno Franco , Tathagat Narula","doi":"10.1016/j.tpr.2024.100163","DOIUrl":"10.1016/j.tpr.2024.100163","url":null,"abstract":"<div><div>Combined lung and liver transplantation (CLLT) is a rare intervention for end-stage lung and liver diseases. It poses a challenge for patients with increased bleeding risk due to Hemophilia A and liver coagulopathy. We present the first documented case of CLLT in an elderly male with Hemophilia A, HCV-associated cirrhosis, and Idiopathic Pulmonary Fibrosis (IPF). Despite the patient exhibiting stable liver function and hemophilia, his lung condition rapidly deteriorated, prompting the listing for transplant. The patient underwent a successful CLLT with perioperative management coordinated by the multidisciplinary team to address the unique challenges of Hemophilia A, resulting in intra-operative correction of coagulopathy. The patient exhibited a favorable recovery, with no requirement for Factor FVIII replacement therapy postoperatively. This case demonstrates that CLLT can address three diseases with distinct pathophysiologies: end-stage lung and liver disease, and correct the hemophilia A phenotype. Our report contributes to the limited literature on the suitability of CLLT in patients with hemophilia A.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723158","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":"Report on living liver donor risk and outcomes: Single center experience","authors":"Jamilya Saparbay , Abylaikhan Sharmenov , Chokhan Aytbayev , Assylmurat Zhumukov , Bekkhozha Yeskendirov , Zhanat Spatayev , Asan Zhexembayev","doi":"10.1016/j.tpr.2024.100166","DOIUrl":"10.1016/j.tpr.2024.100166","url":null,"abstract":"<div><div>Introduction Donor hepatectomy is considered as a major surgical procedure and can lead to severe complications. Since 2012, 64 deceased donor liver transplantation (DDLT) and 420 living donor liver transplantation were performed in Kazakhstan. Efforts to increase deceased liver donation have shown no success. In this study, we analyzed major and minor complications among living liver donor after left and right liver lobe donation, performed in our center. Patients and methods This retrospective study was conducted in compliance with the principles of the Declaration of Helsinki. The Local Ethics Committee of NROC approved this study. All data regarding living liver donors, who underwent donor hepatectomy between 2016 and 2023 were retrieved from electronic records. Results The mean age of living donors was 32 years (range 18–61).Male/female ratio was 51(70.8 %)/21(29.2). 4 left liver grafts;2 left lateral grafts and 66 right liver grafts. Bile leak occurred in 9 cases (12.5 %), 2 cases of bile leakage in living donors required surgery (Clavien grade III). Bleeding totally occurred in 3 living donors (4.2 %), in 2 cases it required surgery. PHLF occurred in 15(20.8 %) cases after right liver lobe donation. No living liver donor death was encountered in our study. Conclusions Our experience in living donor hepatectomy was not fully safe procedure. However, complication occurrence was comparable with other reports from transplant centers.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723159","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}
Transplantation ReportsPub Date : 2024-12-01Epub Date: 2024-11-22DOI: 10.1016/j.tpr.2024.100165
Mahdi Awwad , Nasim Afif AbuKaresh , Hamza A. Abdul-Hafez , Ma'moun Qawasmeh , Mohanad Jaber , Ahmad Thiab Albaw , Mohammad Alnees
{"title":"Management challenges in primary hyperoxaluria type 1 with end-stage kidney disease: A case report","authors":"Mahdi Awwad , Nasim Afif AbuKaresh , Hamza A. Abdul-Hafez , Ma'moun Qawasmeh , Mohanad Jaber , Ahmad Thiab Albaw , Mohammad Alnees","doi":"10.1016/j.tpr.2024.100165","DOIUrl":"10.1016/j.tpr.2024.100165","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Primary hyperoxaluria (PH) is a metabolic condition that leads to oxalate production, resulting in kidney failure and oxalate nephropathy. Posttransplant mobilization of oxalate poses a risk of recurrence. This case emphasizes the importance of measures in cases of end-stage kidney disease (ESKD) with unknown origins.</div></div><div><h3>Case presentation</h3><div>A 53-year-old man with a history of hypothyroidism, recurring kidney stones, and a family background of renal disease and stomach cancer presented with high blood pressure and elevated creatinine levels (2 mg/dL). A subsequent renal biopsy confirmed PH1. Despite initiating hemodialysis, his kidney function deteriorated, necessitating a liver and kidney transplant. Following the transplant, the patient developed lymph node enlargement. Experienced humoral rejection, leading to the resumption of hemodialysis.</div></div><div><h3>Clinical discussion</h3><div>The case discussion highlights the treatment complexities associated with PH1, emphasizing the importance of detection and vigilant monitoring post transplantation and multidisciplinary care for managing complications effectively.</div></div><div><h3>Conclusion</h3><div>Early detection, thorough diagnostics, and customized posttransplant care play roles in managing hyperoxaluria. Future research should focus on enhancing methods, refining transplantation techniques, and developing strategies to prevent and manage complications effectively.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748087","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}
Transplantation ReportsPub Date : 2024-09-01Epub Date: 2024-06-18DOI: 10.1016/j.tpr.2024.100155
{"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":"2024-09-01","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":"2024-09-01","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}
Transplantation ReportsPub Date : 2024-09-01Epub Date: 2024-06-26DOI: 10.1016/j.tpr.2024.100159
Omaya Al Salkini , Mohammad Alsultan , Kassem Basha , Qussai Hassan
{"title":"Prevalence of proteinuria after living donor kidney transplantation and related risk factors: A retrospective cohort study from Syria","authors":"Omaya Al Salkini , Mohammad Alsultan , Kassem Basha , Qussai Hassan","doi":"10.1016/j.tpr.2024.100159","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100159","url":null,"abstract":"<div><h3>Introduction</h3><p>proteinuria is associated with poor allograft and patient survival in kidney transplant recipients (KTRs). This study aims to investigate the prevalence and risk factors of proteinuria in KTRs and its impact on kidney function during the first two years after kidney transplantation (KT).</p></div><div><h3>Materials and methods</h3><p>200 KTRs were included in this retrospective cohort study from living donors, performed in two University hospitals in Syria, from January 2018 to March 2021. Demographic and immunological characteristics were analyzed depending on the 24 h urine protein (Up) excretion that was classified into three groups: Up I (150–500 mg/day), Up II between (0.5–1 g/day), and Up III (>1 g/day).</p></div><div><h3>Results</h3><p>Up was increased subsequently as the transplant progressed, where the greatest excretion of the Up was reported 2 years after KT. At 6 months after KT; the cold ischemic time (CIT), serum creatinine (Cr), using angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin II receptor blockers (ARBs), and GFR showed strong significant differences between Up groups (<em>P</em> = 0.00003, 0.0001, 0.00001, and 0.026; respectively). The CIT and Cr were higher in the Up III group compared to Up I and UP II groups. At 12 months after KT; Cr, using ACEIs/ARBs, and GFR showed strong significant differences between Up groups (<em>P</em> = 0.00009, <0.0001, and <0.0001; respectively). The mean Cr was higher in Up II and Up III groups (1.7 mg/dL; for each) compared to the Up I group (1.0 mg/dL). At 24 months after KT; CIT, using ACEIs/ARBs, Cr, and GFR showed strong significant differences between Up groups (<em>P</em> = 0.02, <0.0001, 0.00008, and <0.0001; respectively).</p></div><div><h3>Conclusion</h3><p>This is the first study from Syria that conducted in KT patients. The prevalence and amount of proteinuria showed subsequently increased as the transplant progressed. Serum Cr, GFR, CIT, and using ACEIs/ARBs showed differences between Up groups at 6 months, 1 year, and 2 years after KT. Our data suggest that the use of ACEIs/ARBs is not a contraindication in early posttransplant period. Due to several known cardiovascular and renal benefits of ACEIs/ARBs future studied in KT population should investigated to determine if these drugs could give beneficial effects on grafts and patients survival.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000106/pdfft?md5=62db12851e39bc8664786b007e90254f&pid=1-s2.0-S2451959624000106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540495","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}
Transplantation ReportsPub Date : 2024-09-01Epub Date: 2024-08-05DOI: 10.1016/j.tpr.2024.100160
Stephanie Almeida , William Snyder , Mita Shah , Jonathan Fisher , Christopher Marsh , Alana Hawkes , Diana Gorial , Sean DeWolf , Dianne B. McKay
{"title":"Revolutionizing deceased donor transplantation: How new approaches to machine perfusion broadens the horizon for organ donation","authors":"Stephanie Almeida , William Snyder , Mita Shah , Jonathan Fisher , Christopher Marsh , Alana Hawkes , Diana Gorial , Sean DeWolf , Dianne B. McKay","doi":"10.1016/j.tpr.2024.100160","DOIUrl":"10.1016/j.tpr.2024.100160","url":null,"abstract":"<div><p>Solid organ transplantation is lifesaving for persons with end-stage organ disease. Thanks to advancements in organ preservation, surgeons are now able to successfully transplant organs that were previously considered high risk for poor graft function. Innovations in perfusion machine types, preservation solutions and additives to preservation solutions have significantly improved the ability to utilize organs previously thought unusable.</p><p>Newer organ preservation techniques are offering a promising outlook for extending graft longevity and improving transplant outcomes. This review explores the impact of deceased donor type on graft quality and highlights emerging strategies designed to improve the function and viability of deceased donor organs.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000118/pdfft?md5=ed685e553841b4cf78318976de9115ff&pid=1-s2.0-S2451959624000118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141985268","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}
Transplantation ReportsPub Date : 2024-09-01Epub Date: 2024-06-25DOI: 10.1016/j.tpr.2024.100156
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":"2024-09-01","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}