Journal of Transplantation最新文献

{"title":"Association Between Early Posttransplant Graft Perfusion and CLAD-Free Survival After Single Lung Transplantation.","authors":"Shin Tanaka, Megumi Ishihara, Yujiro Kubo, Haruchika Yamamoto, Kumi Nakajima, Hidejiro Torigoe, Shuji Okahara, Kazuhiko Shien, Ken Suzawa, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka","doi":"10.1155/joot/7647492","DOIUrl":"10.1155/joot/7647492","url":null,"abstract":"<p><strong>Background: </strong>The physiological relevance of postoperative perfusion distribution after single lung transplantation (SLT) remains poorly defined, as asymmetric blood flow toward the graft is often regarded as an inherent consequence of the remaining native lung. This study aimed to determine whether the graft-directed perfusion ratio assessed by quantitative lung perfusion scintigraphy (QLPS) in the early postoperative period serves as an early physiological marker after SLT.</p><p><strong>Methods: </strong>We retrospectively analyzed SLT recipients who underwent surgery at Okayama University Hospital between 1998 and 2021 and completed QLPS approximately 3 months posttransplant. The graft perfusion ratio (graft flow/total pulmonary flow × 100%) was quantified, and recipients were classified into high (≥ 80%) and low (< 80%) perfusion groups. CLAD-free survival, overall survival, and longitudinal perfusion changes were compared using Kaplan-Meier analysis and repeated-measures ANOVA.</p><p><strong>Results: </strong>Recipients with higher graft perfusion demonstrated significantly better CLAD-free survival (<i>p</i> = 0.027). Overall survival was higher in the high-perfusion group, although the difference did not reach statistical significance (<i>p</i> = 0.075). Repeated-measures ANOVA revealed a significant group-by-time interaction (<i>p</i> = 0.019): recipients who developed CLAD had lower graft perfusion as early as 3 months after transplantation, followed by a progressive decline, whereas those who did not develop CLAD maintained stable perfusion. In the multivariable Cox analysis, higher graft perfusion was associated with a lower hazard of reaching the composite CLAD-free survival endpoint.</p><p><strong>Conclusions: </strong>Early postoperative graft perfusion assessed by QLPS may serve as a noninvasive physiological marker after SLT. Higher graft-directed perfusion was associated with a lower hazard of reaching the composite CLAD-free survival endpoint and may aid early risk stratification and posttransplant surveillance.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"7647492"},"PeriodicalIF":1.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217003","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":"Right Ventricular Stroke Work Index and Its Prognostic Value in a Lung Transplant Population With Group 3 Pulmonary Hypertension.","authors":"Yann Marquet, Sébastien Jacqmin, Julien Fessler, Edouard Sage, Pierre Hammoum, Morgan Le Guen","doi":"10.1155/joot/1628090","DOIUrl":"https://doi.org/10.1155/joot/1628090","url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation requires meticulous preoperative assessment. Recipients with Group 3 pulmonary hypertension can be at higher risk of mortality and primary graft dysfunction (PGD). We conducted a study to determine whether the right ventricular stroke work index (RVSWI), a right-heart catheterisation haemodynamic indicator assessing right ventricle function, could predict 1-year survival in this setting.</p><p><strong>Methods: </strong>Monocentric, retrospective, observational cohort study approved by our local ethics review board, between January 2013 and December 2023. We included lung transplant recipients who underwent preprocedural right-heart catheterisation assessment and presented with Group 3 pulmonary hypertension. We first determined a clinically relevant RVSWI threshold. The primary endpoint was mortality at 1 year amongst two groups of patients according to this threshold.</p><p><strong>Results: </strong>66 patients (age 57.0 ± 11.4 years, male 56%) were included amongst a study population of 699 patients. Double-lung transplantations represented most of the procedures (91%). In univariate analysis, RVSWI was statistically associated with PGD Grade 3 at Day 3 and intraoperative veno-arterial extracorporeal membrane oxygenation (ECMO) at a threshold of RVSWI = 13.5. Mortality at 1 year did not differ between the groups RVSWI ≤ 13.5 (6 patients, 14.6%) and RVSWI > 13.5 (6 patients, 24%) even after accounting for potential confounding factors.</p><p><strong>Conclusions: </strong>In our lung transplant population with Group 3 pulmonary hypertension, RVSWI was not associated with mortality at 1 year. A higher RVSWI seemed associated with significant events such as intraoperative ECMO and PGD Grade 3. Further studies are needed to assess RVSWI's prognostic value in this setting.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"1628090"},"PeriodicalIF":1.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197062","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":"Three Decades of Living Liver Donor Outcomes: A National Cohort Analysis of Patterns in Mortality and Recovery.","authors":"Morgan E Kelly, Tianna M Truby, Jennifer C Lai, Sharad I Wadhwani","doi":"10.1155/joot/2545887","DOIUrl":"10.1155/joot/2545887","url":null,"abstract":"<p><p>Living donor liver transplantation offers significant benefits to recipients, yet risks to donors remain incompletely characterized. We examined short- and intermediate-term outcomes associated with living liver donation using the Scientific Registry of Transplant Recipients. This retrospective cohort study included 8619 donors aged 18-65 years who donated between 1989 and 2023, of whom 8314 had follow-up data for secondary outcomes. Donors were categorized by era: early (1989-2006) and contemporary (2007-2023). Primary outcomes were 90-day and 2-year mortality; secondary outcomes were changes in physical capacity, functional status, and employment. Mean donor age was 36 years, and 53% were female. Eight donors (0.1%) died within 90 days and 18 (0.2%) within 2 years. Mortality was lower in the contemporary era at both 90 days (HR: 0.14, 95% CI: 0.03-0.70) and 2 years (HR: 0.06, 95% CI: 0.02-0.18). Reduced physical capacity at 6 months was more common among contemporary-era donors (aOR: 3.25, 95% CI: 1.32-8.00) and Hispanic donors (aOR: 2.07, 95% CI: 1.29-3.32). Reduced employment was more common among non-White donors at 6 months and 1 year (aOR: 2.04, 95% CI: 1.40-2.97 at 1 year), and among female donors at all timepoints (aOR: 1.71, 95% CI: 1.29-2.25 at 1 year). Living liver donor mortality has declined over the past three decades, and long-term physical impairments are uncommon. Reduced employment following donation is disproportionately reported by female and non-White donors. These findings provide a benchmark for center-level assessment of donor outcomes and may inform donor counseling that addresses occupational circumstances alongside surgical risk.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"2545887"},"PeriodicalIF":1.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115731","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":"Thoracoabdominal Normothermic Regional Perfusion Attenuates the Protective Effect of Hypothermic Machine Perfusion on Delayed Graft Function in DCD Kidney Transplantation.","authors":"Ayham Asassfeh, Jiro Kimura, Enida Luma, Matthew Harris, Emre Arpali, Ty B Dunn, Matthew Cooper, Badi Rawashdeh","doi":"10.1155/joot/8082011","DOIUrl":"https://doi.org/10.1155/joot/8082011","url":null,"abstract":"<p><strong>Background: </strong>Thoracoabdominal normothermic regional perfusion (TA-NRP) and hypothermic machine perfusion (HMP) reduce ischemia-reperfusion injury after donation after circulatory death (DCD) kidney transplantation, but their combined effects remain unclear.</p><p><strong>Methods: </strong>Adult DCD kidney-only recipients undergoing pretransplant dialysis in the OPTN registry (2020-2025) were stratified by TA-NRP and HMP. The primary outcome was delayed graft function (DGF). Multivariable logistic regression included a TA-NRP × HMP interaction and adjusted for recipient and donor factors. Death-censored graft survival (DCGS) was evaluated by Kaplan-Meier analysis.</p><p><strong>Results: </strong>Among 3502 recipients, DGF differed by preservation strategy. In the non-TA-NRP cohort, HMP significantly reduced DGF compared with static cold storage (SCS) (44.2% vs 53.8%; <i>p</i> = 0.001) and remained independently protective (adjusted OR 0.56; 95% CI 0.44-0.71; <i>p</i> < 0.001). In the TA-NRP cohort, DGF rates were similar between HMP and SCS (26.7% vs 27.0%; <i>p</i> = 0.98), with no independent association after adjustment (adjusted OR 0.82; 95% CI 0.62-1.08; <i>p</i> = 0.16). A significant TA-NRP × HMP interaction was observed (<i>p</i> = 0.039). In the absence of HMP, TA-NRP was strongly protective against DGF (adjusted OR 0.30; 95% CI 0.22-0.42; <i>p</i> < 0.001). At 3 years, DCGS was 93.9% (95% CI 91.5-96.4) for TA-NRP-HMP, 94.3% (90.9-97.9) for TA-NRP-SCS, 93.5% (91.5-95.6) for non-TA-NRP-HMP, and 92.7% (89.1-96.6) for non-TA-NRP-SCS, with no difference between groups (log-rank <i>p</i> = 0.73).</p><p><strong>Conclusion: </strong>TA-NRP was associated with lower DGF than conventional DCD procurement. Within the TA-NRP cohort, HMP was not associated with additional reductions in DGF. These findings should be interpreted in light of the surrogate definition used to identify TA-NRP in the OPTN registry and warrant prospective validation.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"8082011"},"PeriodicalIF":1.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116398","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":"Effects of Timing of Everolimus Transition on Renal Outcomes in Liver Transplant Recipients.","authors":"Mary Leick, Hannah Belleau, Timothy McCashland","doi":"10.1155/joot/3462901","DOIUrl":"10.1155/joot/3462901","url":null,"abstract":"<p><strong>Introduction: </strong>Everolimus is often used in liver transplant recipients to minimize calcineurin inhibitors and their associated renal toxicity. This study aimed to evaluate the effects of the timing of everolimus transition on renal outcomes in adult liver transplant recipients.</p><p><strong>Materials and methods: </strong>This retrospective subgroup analysis included adult isolated liver transplant recipients who transitioned to everolimus-containing immunosuppression at a single academic medical center between February 1, 2013, and May 31, 2018. Timing of everolimus transition from transplant determined patient groups: Group 1 (≤ 90 days), Group 2 (91-180 days), Group 3 (181-365 days), and Group 4 (> 365 days). Creatinine clearance at time of everolimus transition was compared to 1-month and 12-months post-transition using paired <i>t</i>-test analysis. Biopsy-proven acute cellular rejection was also assessed.</p><p><strong>Results: </strong>Eighty patients were included in this subgroup analysis. Group 1 (<i>n</i> = 25) and Group 2 (<i>n</i> = 20) had renal improvement at 1-month and 12-months post-transition (45.4 versus 69.6 and 61.6 mL/min, <i>p</i> = 0.004 and 0.035; 43.9 versus 60.7 and 57.5 mL/min, <i>p</i> = 0.02 and 0.008). Group 3 (<i>n</i> = 19) had renal improvement at 1 month but not at 12 months (52.6 versus 63.8 and 55.2 mL/min, <i>p</i> = 0.0004 and 0.43). Group 4 (<i>n</i> = 16) did not show renal improvement at 1 month or 12 months (54.5 versus 58.6 and 49.6 mL/min, <i>p</i> = 0.2 and 0.84). Biopsy-proven acute cellular rejection rate in each group was 40%, 20%, 10.5%, and 6.25%, respectively.</p><p><strong>Conclusion: </strong>These data suggest that early transition to everolimus provides sustained renal function improvement in liver transplant recipients while late transition may not. Early transition poses a high risk of rejection. Timing of everolimus transition was observed to affect clinical outcomes and should be considered when adjusting immunosuppression.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"3462901"},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082309","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":"Substance Use-Related Admissions in Liver Transplant Recipients: A National Inpatient Sample Analysis.","authors":"Alex Dobos Ferreira, Spencer R Goble, Thomas M Leventhal","doi":"10.1155/joot/8700177","DOIUrl":"10.1155/joot/8700177","url":null,"abstract":"<p><strong>Introduction: </strong>While chronic complications of substance use are well-recognized in liver transplant recipients, the ramifications of acute complications of substance use in this population are less well characterized.</p><p><strong>Methods: </strong>Using the National Inpatient Sample from 2016 to 2022, we assessed hospitalizations in liver transplant recipients for intoxication or withdrawal from any of the following: alcohol, opioids, sedatives, and stimulants. We compared these substance use-related admissions to all other liver transplant recipient admissions. Clinical outcomes were also assessed.</p><p><strong>Results: </strong>Of the 299,350 hospitalizations for liver transplant recipients, acute substance use-related complications accounted for 2375 (0.8%), with alcohol being the most common (<i>n</i> = 1455). Patients admitted for substance use-related complications were younger (mean age 52.6 vs. 60.2 years, <i>p</i> < 0.001), more likely to be white (79.1% vs. 70.6%, <i>p</i> < 0.001), and had increased rates of homelessness (2.1% vs. 0.2%, <i>p</i> < 0.001), major depressive disorder (37.7% vs. 16.7%, <i>p</i> < 0.001), and generalized anxiety disorder (37.3% vs. 13.6%, <i>p</i> < 0.001). ICU-level care was required in 44 per 1000 substance use-related admissions, while 141 per 1000 such admissions required skilled nursing facility placement. Mean length of stay was 5.2 days, and mean cost of hospitalization was $9637.</p><p><strong>Conclusion: </strong>Liver transplant recipients admitted for substance use-related issues tend to have high rates of mental health conditions and other signals of social vulnerability. Critical illness appears uncommon in these admissions, although there is significant utilization with admission stays averaging over five days and nearly $10,000.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"8700177"},"PeriodicalIF":1.5,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018135","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":"Belatacept and the Risk of Cytomegalovirus, BK Polyomavirus, and Epstein-Barr Virus Post-transplant Lymphoproliferative Disease After Kidney Transplantation: A Meta-Analysis and Systematic Review.","authors":"Cybele Lara R Abad, Raymund R Razonable","doi":"10.1155/joot/3256272","DOIUrl":"10.1155/joot/3256272","url":null,"abstract":"<p><strong>Background: </strong>The long-term risk of cytomegalovirus (CMV), Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD), and BK viral infections from belatacept is unclear. This review aimed to evaluate these outcomes.</p><p><strong>Methods: </strong>Several databases were reviewed from inception through September 2025 using the keywords \"belatacept\" and \"kidney transplant\" or \"safety\" and \"viral infection\". We included case reports, randomized controlled trials (RCTs), and nonrandomized trials (NRTs). Outcomes were prespecified according to dose (more-intense or less-intense), type of infection (CMV, EBV-PTLD, or BK), and follow-up period: short term (1-2 years), medium term (3-5 years), and long-term (> 5 years). RCTs and NRTs were analyzed separately, and case reports were summarized. For binary outcomes, results were presented as risk ratios (RR), with 95% confidence intervals (CI). All statistical analyses were performed using Revman 5.2.</p><p><strong>Results: </strong>Sixty-four studies (23 RCTs, 28 NRTs, and 13 case reports) were included. Of 23 RCTs, 11 were primary studies while the remainder were follow-up reports of original RCTs. Most NRTs (16/28) included a comparator arm. In the meta-analyses of RCTs only, the risks of CMV, EBV-PTLD, and BK virus infection were similar between patients receiving belatacept and those receiving calcineurin inhibitors (CNIs). During medium-term follow-up for RCTs, BK virus infection was twice as likely among those receiving more-intense compared to less-intense belatacept (RR: 2.08 [CI 1.03, 4.20, <i>I</i> ² = 0]). Among NRTs, the risk of CMV infection was two-fold higher among those receiving belatacept versus CNI, with an RR of 2.15 [CI 1.58, 2.93, <i>I</i> ² = 66%]; BK DNAemia or viremia was also greater than two-fold higher, with an RR of 2.59 [CI 1.10-6.11].</p><p><strong>Conclusions: </strong>The risks of CMV and EBV-PTLD after kidney transplantation were not significantly increased by belatacept based on RCTs, though a higher risk of BK polyomavirus infection was observed among patients receiving a more-intense dose of belatacept beyond the second year. The risk of CMV and BK polyomavirus infections may also be increased with real-world belatacept use. However, these observations should be interpreted with consideration for the inherent limitations of NRTs.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"3256272"},"PeriodicalIF":1.5,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956792","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":"Intraoperative Methadone for Postoperative Pain Control in Living Donor Hepatectomy.","authors":"Adam Seibert, Devika Puri, Zachary Whong, Beomchang Kim, Rasha Alsaadawi, Le Kang, Christin Kim, Seung Duk Lee, Vinay Kumaran, Smita Pancholia, Sergio Navarrete","doi":"10.1155/joot/8206764","DOIUrl":"10.1155/joot/8206764","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain control is often suboptimal, with many patients experiencing inadequate relief or side effects. Methadone, a long-acting μ-opioid agonist and NMDA antagonist, provides stable analgesia and reduces postoperative opioid requirements when administered as a single intraoperative dose. However, its use has not been studied in living donor hepatectomy patients.</p><p><strong>Methods: </strong>We conducted a retrospective review of a quality improvement initiative involving 50 living donor hepatectomy patients treated from 2023 to 2025. 32 received usual opioid care and 18 received methadone, stratified into high-dose (≥ 0.2 mg/kg lean body weight) and low-dose (< 0.2 mg/kg) groups. The primary outcome was postoperative morphine milligram equivalents (MMEs) consumed during the hospital stay. Secondary outcomes included intraoperative MME, total MME, ICU and hospital length of stay, bowel recovery, and safety events.</p><p><strong>Results: </strong>Mean age was 39.4 years, 70% female and 72% white. Most patients (66%) underwent a minimally invasive, robotic surgical approach. Methadone was administered to 36%. Intraoperative opioid exposure was significantly higher in methadone groups compared with usual care (<i>p</i> < 0.0001), but postoperative opioid requirements did not increase. There was a trend toward lower postoperative morphine equivalents in patients receiving higher methadone doses (156.7 ± 152.8 vs. 260.4 ± 112.3, <i>p</i> = 0.09). No adverse events occurred; length of stay and bowel recovery were similar across groups.</p><p><strong>Conclusions: </strong>Intraoperative methadone administration in living donor hepatectomy appears safe and demonstrated a trend toward reduced postoperative MME use at higher doses of ≥ 0.2 mg/kg lean body weight. These findings warrant further prospective evaluation.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"8206764"},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921367","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":"Managing the Loss of Right Renal Venous Tissue in Deceased-Donor Organ Procurement.","authors":"Nguefouet Momo Rostand Emmanuel, Riccardo Giuseppe Bertolo, Luigino Boschiero, Alessandro Antonelli","doi":"10.1155/joot/3588832","DOIUrl":"10.1155/joot/3588832","url":null,"abstract":"<p><strong>Background: </strong>Procurement-related injury to the right renal vein (RRV) or renal-caval vein complex (RCVC) may preclude transplantation of an otherwise usable right kidney. We report an expanded single-center experience with the previously described York Plastic technique, focusing on technical feasibility and short-term outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed deceased-donor right kidneys assessed at our center between January 2018 and January 2025. Of 334 kidneys, 17 (5.1%) sustained procurement-related RCVC injury; 15 underwent York Plastic reconstruction and transplantation, whereas 2 were not used because of severe associated graft damage. Of the 15 transplanted cases, 10 were included in our preliminary 2023 technical report and 5 are newly reported.</p><p><strong>Results: </strong>All 15 reconstructed grafts were transplanted successfully. No intraoperative bleeding, renal vein thrombosis, or Doppler evidence of venous stenosis occurred. Mean bench reconstruction time was 35 minutes (range, 20-51), and mean cold ischemia time was 16.4 ± 2.5 h. Median serum creatinine among functioning grafts was 1.58 mg/dL at 1 month, 1.49 mg/dL at 3 months, and 1.36 mg/dL at 12 months. At 12 months, 13 of the 14 surviving recipients had functioning grafts. One recipient died at 3 months with a functioning graft; one surviving recipient returned to dialysis before 12 months because of antibody-mediated rejection associated with severe cytomegalovirus infection.</p><p><strong>Conclusions: </strong>The York Plastic technique appears to be a feasible bench-salvage option for selected procurement-related RCVC injuries and may support organ preservation in carefully chosen cases.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"3588832"},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881990","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":"Does Atherosclerosis Progress Faster After Liver Transplant? A Comparative Study and Analysis of Progression Risk Factors.","authors":"Giulia Pagano, Judit Mestres-Martí, Cautar El Maimouni, Clara Viñals, Jose T Ortiz-Pérez, Pablo Ruiz, Jordi Colmenero, Emilio Ortega, Gonzalo Crespo","doi":"10.1155/joot/1851142","DOIUrl":"10.1155/joot/1851142","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is thought to evolve faster after liver transplantation (LT) due to an increased prevalence of cardiovascular risk (CVR) factors and the use of immunosuppression. The progression of coronary artery calcium score (CACS) in computed tomography is a prognostic biomarker of CVD. There is scarce information about CACS changes after LT or in patients with cirrhosis.</p><p><strong>Methods: </strong>We compared the 5-year progression of CACS in two populations: 75 LT recipients and 20 patients with cirrhosis assessed for LT but who eventually did not undergo LT (non-LT). In both populations, CACS was measured at LT evaluation and 5 years thereafter. Additionally, we studied 1-year post-LT CVR factors and immunosuppression parameters, including cumulative exposure to tacrolimus (CET) as potential predictors of 5-year CACS progression after LT.</p><p><strong>Results: </strong>Both groups were comparable regarding CVR factors, time between CACS, or baseline CACS. CACS increased in both groups, with an annualized progression of 23 Agatston units (AU)/year in LT and 30 AU/year in non-LT (<i>p</i> = 0.833). CVR factors control after LT was optimal, and 80% received standard/minimized CET. Higher pre-LT CACS (<i>p</i> < 0.001) and worse kidney function 12 months after transplantation (<i>p</i> = 0.003) independently predicted progression after LT. No immunosuppression-related variables were associated with CACS progression.</p><p><strong>Conclusion: </strong>In LT recipients with optimized control of CVR factors and standard/minimized CET, CACS progression was not faster than in patients with cirrhosis. The association between posttransplant renal function and CACS progression warrants further investigation.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2026 ","pages":"1851142"},"PeriodicalIF":1.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799297","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}