Journal of Transplantation最新文献

{"title":"Effectiveness and Safety of Reduced Thymoglobulin Dosing in Low-Risk Kidney Transplant Recipients.","authors":"Eiman Wazwaz, Nina Joiner","doi":"10.1155/joot/4987172","DOIUrl":"10.1155/joot/4987172","url":null,"abstract":"<p><strong>Introduction: </strong>Thymoglobulin, a lymphocyte-depleting agent, is widely used for induction immunosuppression in kidney transplantation. Despite guideline support, there is no standardized dosing recommendation, resulting in variability across centers. In April 2022, our institution reduced its institutional practice thymoglobulin dose from 4.5 to 3 mg/kg for low-risk kidney transplant recipients. This study aimed to evaluate the noninferiority of the reduced dose compared to the prior regimen in terms of effectiveness and safety.</p><p><strong>Methods: </strong>This single-center retrospective noninferiority cohort study of low-risk kidney transplant recipients was conducted from April 2020 to April 2024. Patients received either 3 or 4.5 mg/kg of thymoglobulin. The primary outcome was a composite of biopsy-proven or suspected acute rejection, graft loss, or death within 6 months posttransplant. Secondary outcomes included leukopenia, thrombocytopenia, infections, delayed graft function, eGFR, malignancies, and hospital length of stay.</p><p><strong>Results: </strong>A total of 196 patients were included (116 in 4.5 mg/kg; 80 in 3 mg/kg). The primary outcome occurred in 11% and 3% of patients, respectively (risk difference -8.7%, 95% CI -15.4 to -2.0; <i>p</i> = 0.024). The reduced-dose group experienced significantly lower rates of leukopenia, thrombocytopenia, and viral infections.</p><p><strong>Conclusion: </strong>A 3 mg/kg thymoglobulin dose is noninferior to 4.5 mg/kg and is associated with improved safety in low-risk kidney transplant recipients.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"4987172"},"PeriodicalIF":2.2,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913363","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":"Incidence, Risk Factors, and Treatment of Autoimmune Cytopenia Following Pediatric Allogeneic Hematopoietic Stem Cell Transplantation.","authors":"Changlan Chen, Yingying Wang, Yan Meng, Ying Dou, Luying Zhang, Xianmin Guan, Xiaoying Lei, Jie Yu","doi":"10.1155/joot/3676059","DOIUrl":"10.1155/joot/3676059","url":null,"abstract":"<p><p>Autoimmune cytopenia (AIC) following pediatric allogeneic hematopoietic stem cell transplantation (allo-HSCT) is relatively rare but it is a challenging complication, and standardized treatment guidelines are lacking. We retrospectively analyzed 436 pediatric patients undergoing allo-HSCT; 37 (8.5%) developed AIC, characterized by autoimmune hemolytic anemia (<i>n</i> = 13), immune thrombocytopenia (<i>n</i> = 11), and Evans syndrome (<i>n</i> = 13). Risk factor analysis revealed that younger age at HSCT, nonmalignant diseases, unrelated donor transplantation, and chronic graft-versus-host disease (cGVHD) were significantly associated with the development of AIC. Through multivariate analysis, cGVHD was identified as an independent risk factor for AIC. In our study, the first-line treatment for AIC involved steroids and/or intravenous immunoglobulin, with a complete remission rate of 48.6%. Additional therapeutic strategies included rituximab, which led to complete remission in 5 of 12 patients we treated, and sirolimus, with 3 of 7 patients achieving complete remission. Three patients achieved partial remission, while 9 patients died due to complications, such as severe infections, extensive GVHD, and multiorgan bleeding. Our findings suggest that cGVHD is an independent risk factor for post-transplant AIC and is typically associated with adverse outcomes, highlighting the critical importance of timely and effective interventions.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"3676059"},"PeriodicalIF":2.2,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913324","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":"Evaluation of Intraoperative Gentamicin Bladder Irrigation for Mitigation of Urinary Tract Infections After Kidney Transplantation: A Propensity Score-Matched Analysis of a Randomized Controlled Trial.","authors":"Aviad Gravetz, Vladimir Tennak, Mais Khamis, Vadym Mezhybovsky, Michael Gurevich, Sigal Eisner, Tasnim Lubani, Dana Bielopolski, Alaa Atamna, Fahim Kanani, Eviatar Nesher","doi":"10.1155/joot/9377493","DOIUrl":"10.1155/joot/9377493","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) remain the leading infectious complication after kidney transplantation. We evaluated intraoperative gentamicin bladder irrigation as a novel preventive strategy.</p><p><strong>Methods: </strong>In this randomized, double-blind controlled trial at a tertiary transplant center (January-December 2021), 147 kidney transplant recipients were randomized to receive intraoperative bladder irrigation with gentamicin (160 mg/250 mL) or saline during ureteroneocystostomy. Due to baseline imbalances, propensity score matching yielded 49 matched pairs. The primary endpoint was UTI incidence within 30 days post-transplant, defined by both microbiological (≥ 10⁵ CFU/mL) and clinical criteria.</p><p><strong>Results: </strong>UTI incidence was 26.5% (13/49) in controls versus 16.3% (8/49) with gentamicin (absolute risk reduction 10.2%, <i>p</i>=0.325). The number needed to treat was 10 overall. Striking sex-specific differences emerged: females demonstrated 40.7% baseline UTI risk versus 14.1% in males (<i>p</i>=0.004). Gentamicin efficacy varied markedly by sex, with the NNT of 5 for females (50.0%-30.8%) versus 17 for males (17.1%-11.1%). Living donor recipients showed greater benefit (NNT = 7) than deceased donor recipients (NNT = 23). No adverse events were attributable to gentamicin, with similar rates of bacteremia and surgical site infections between groups.</p><p><strong>Conclusions: </strong>Intraoperative gentamicin bladder irrigation safely reduced early post-transplant UTIs by 38.5%, with efficacy in female recipients. While underpowered for statistical significance, the clinically meaningful effect size and excellent safety profile support considering this intervention for high-risk recipients, especially females, pending larger confirmatory trials.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"9377493"},"PeriodicalIF":2.2,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702133","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":"Liver Transplantation Outcomes in Younger Versus Older Adult Recipients: The Edmonton Experience.","authors":"U Mathuram Thiyagarajan, B Marfil-Garza, Khaled Dajani, Blair Anderson, David Bigam, Aldo Montano-Loza, A M James Shapiro","doi":"10.1155/joot/8889823","DOIUrl":"10.1155/joot/8889823","url":null,"abstract":"<p><strong>Introduction: </strong>Liver transplantation (LT) offers a lifesaving treatment for patients with end-stage liver disease (ESLD). There have been conflicting reports of outcomes in younger and elderly patients undergoing LT. This study assesses the outcomes of younger and elderly LT recipients by complications and graft survival at early and late time-points, up to 10 years.</p><p><strong>Patients and methods: </strong>This retrospective study was conducted on a prospectively collected database of patients who underwent LT between January 2011 and December 2021 at the University of Alberta Hospital in Edmonton, Canada.</p><p><strong>Results: </strong>A total of 696 patients who were 18 years and older were included and then classified into two groups: the younger adult group (YG; <i>n</i> = 631, < 65 years old) and the older adult group (OG; <i>n</i> = 65, > 65 years old). The YG was sicker, with a high model for ESLD (MELD) score, while the OG had a high incidence of coronary artery disease (CAD), hypertension, smoking, and hepatocellular carcinoma. The YG had a higher incidence of postoperative pleural effusion requiring drainage (108/631 [17%] versus 4/65 [6%]; <i>p</i> value < 0.02) and more rejection episodes (202/631 [32%] versus 10/65 [15%]; <i>p</i> value < 0.04). However, the OG had more hepatic artery thrombosis (HAT) (4/65 [6.1%] versus 10/631 [1.6%]; <i>p</i> value 0.03). CAD and smoking history were associated with lower patient and graft survivals; acute rejection episodes were also associated with significantly lower graft survival.</p><p><strong>Conclusion: </strong>The patient and graft survival between the YG and OG are comparable at 30 days, 90 days, 1, 5 and 10 years. A history of CAD, smoking and rejection episodes decreased graft survival and age alone should not be a contraindication for LT.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"8889823"},"PeriodicalIF":2.2,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606447","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":"A Retrospective Analysis of National Kidney Registry Integration at a Single Center in the Northern Great Plains.","authors":"Els Reuvekamp, Benjamin Limburg, Kaleb Dobbs, Sujit Vijay Sakpal","doi":"10.1155/joot/6424483","DOIUrl":"10.1155/joot/6424483","url":null,"abstract":"<p><strong>Background: </strong>Despite the National Kidney Registry's (NKR) widespread adoption, limited data exist to explain center-specific trends in live kidney donation (LKD) in rural areas.</p><p><strong>Methods: </strong>A retrospective review of 1776 referrals (894 before and 882 after NKR integration on February 1, 2018) for LKD at our center between June 1, 2012, and May 31, 2022, was performed. LKD referrals were comparatively analyzed between pre- and post-NKR phases and followed through subsequent evaluation, donation, or termination of donor candidacy.</p><p><strong>Results: </strong>Both pre- and post-NKR, donors were most likely to be White (93.2% vs. 89.4%, <i>p</i>=0.33), women (73.0% vs. 66.0%, <i>p</i>=0.51), from South Dakota or neighboring states (97.3% vs. 89.4%, <i>p</i>=0.11), and employed (95.9% vs. 95.7%, <i>p</i>=0.99). Following NKR affiliation, our center experienced a significant increase in LKDs (74 vs. 47, <i>p</i>=0.008), most notably from nondirected (9 vs. 1, <i>p</i>=0.04) and rural (37 vs. 18, <i>p</i>=0.099) donors and those from socioeconomically disadvantaged (Area Deprivation Index: 3 vs. 4 state decile, <i>p</i>=0.055, and 47 vs. 54 national percentile, <i>p</i>=0.056) communities. Post-NKR donor pool showed greater diversity in educational backgrounds and lower rates of tobacco and illicit drug use. Also, post-NKR referrals were evaluated, on average, 10 days sooner (66 vs. 76 days and <i>p</i>=0.01) and were less likely to retract or be lost to follow-up after evaluation (25.1% vs. 32.7% and <i>p</i>=0.04).</p><p><strong>Conclusion: </strong>NKR potentiates expanded LKD at rural transplant centers. Efforts to increase LKD among men and People of Color remain areas of opportunity.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"6424483"},"PeriodicalIF":2.2,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558016","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":"Incidence and Risk Factors of Obesity and Overweight in Kidney Transplant Recipients and Their Effect on Graft Outcome.","authors":"Muhammad Abdul Mabood Khalil, Nihal Mohammed Sadagah, Hinda Hassan Khideer Mahmood, Abdulrahman Ibn Almuataz Wasfi Ezzi, Sultan Abdullah M Alghamdi, Faisal Saud H Alsulami, Ahmed Abdelahad Basha, Mohamed Abdelmonem Said Ahmed, Islam Nabil Sharabas, Hitham Abdallah Ahmed Abdallah Ragab, Aileen Jean Dela Cruz, Ghaleb Anas Aboalsamh, Salem H Al-Qurashi","doi":"10.1155/joot/4990973","DOIUrl":"10.1155/joot/4990973","url":null,"abstract":"<p><strong>Background: </strong>Weight gain is common after kidney transplantation. This study assessed the incidence of overweight and obesity, identified the risk factors, and evaluated their impact on graft function and metabolic outcomes at 1 year.</p><p><strong>Methods: </strong>This retrospective observational study included 179 kidney transplant recipients at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia, between January 2020 and December 2023. The baseline and 12-month BMI were recorded. Associations with demographic, clinical, and metabolic variables, as well as graft function and complications, were analyzed. Logistic regression identified independent predictors of being overweight (BMI ≥ 25 kg/m²) and obese (BMI ≥ 30 kg/m²).</p><p><strong>Results: </strong>At baseline, 83 (46.4%) recipients had BMI < 25 kg/m², 55 (30.7%) were overweight, and 41 (22.9%) were obese. At 12 months, the prevalence of obesity increased to 67 (37.4%), while the normal BMI category decreased to 55 (30.7%), with the overweight category remaining relatively stable at 57 (31.8%). The baseline BMI was the strongest predictor of overweight (OR 1.72, 95% CI 1.45-2.04) and obesity (OR 1.74, 95% CI 1.47-2.05) at 12 months. In sensitivity analysis excluding the baseline BMI, a family history of diabetes predicted obesity (OR 4.41, 95% CI 1.78-10.96). Obese patients had numerically higher creatinine and lower eGFR, but differences were not statistically significant. No differences were observed in CMV infection, prediabetes, new-onset diabetes after transplantation, acute coronary syndrome, or mortality. Overall, patient survival was 100% at 12 months.</p><p><strong>Conclusion: </strong>Posttransplant overweight and obesity are common. The baseline BMI and family history of diabetes are key predictors. The higher BMI is associated with early metabolic changes and trends toward lower graft function, highlighting the need for early monitoring and targeted interventions.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"4990973"},"PeriodicalIF":2.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12615036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543246","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":"Single Versus Dual Kidney Transplants From Marginal Donors: Balancing Survival and Resource Utilization.","authors":"Kaufman D M, J D Perkins, Bakthavatsalam R, Leca N, Sibulesky L","doi":"10.1155/joot/7744010","DOIUrl":"10.1155/joot/7744010","url":null,"abstract":"<p><strong>Background: </strong>With population aging and increasing prevalence of kidney disease, a greater number of older patients could benefit from a kidney transplant. Organ shortage has led to expanding the pool of potential donors, including both kidneys from the same donor as dual transplants into a single recipient. At present, there is no consistent criteria for determining suitability for single versus dual transplant.</p><p><strong>Methods: </strong>We performed a retrospective analysis of the Organ Procurement and Transplantation Network database of all recipients undergoing single or dual kidney transplants from deceased donors from December 4, 2014, to March 31, 2024, excluding en bloc donors. We examined patient and graft survival rates and graft function in dual versus single kidney transplantation. In addition, we analyzed potential survival differences between using a single kidney transplantation over dual transplantation.</p><p><strong>Results: </strong>During the study period, there were a total of 1015 dual kidney transplant recipients and 134,933 single kidney recipients. The donors of the dual transplants were older, had higher KDRI, and had increased rates of glomerulosclerosis, with > 20% glomerulosclerosis seen in 20% of the kidneys. Using 3:1 propensity matching, we did not observe a significant difference in overall patient survival. We did observe a significant increase in graft survival with dual transplants. Transplanting all dual kidneys as single kidneys could result in a 0.9% increase in overall successful transplants and a 3% reduction in waitlist deaths.</p><p><strong>Conclusion: </strong>Careful donor and recipient matching are crucial to optimize outcomes in this population. More emphasis needs to be placed on maximizing survival benefit from each donor kidney.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"7744010"},"PeriodicalIF":2.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432552","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":"Older Kidney Transplant Patients Are Over Immunosuppressed Using Standard Protocols With Differential Sex-Based Complications.","authors":"Inji Alshaer, Rachel K Y Hung, Sumoyee Basu, Gabrielle Goldet, Gareth Jones, Mark Harber, Raymond Fernando, Ciara N Magee, Reza Motallebzadeh, Ben Caplin, Alan D Salama","doi":"10.1155/joot/5547629","DOIUrl":"10.1155/joot/5547629","url":null,"abstract":"<p><strong>Background: </strong>Increasing numbers of older patients are undergoing kidney transplantation. While there is evidence for both sex- and age-related immunological variations increasing the risks of immunosuppression (IS), few centers enforce age- or sex-specific IS adjustments.</p><p><strong>Methods: </strong>We investigated outcomes of 148 kidney transplants performed in our center between April 2009 and March 2019 in recipients aged > 60 years and compared them to outcomes in 272 younger recipients (divided into age groups 18-34, 35-49, and 50-60 years), matched for degree of human leukocyte antigen (HLA) sensitization (calculated reaction frequency, cRF), number of donor-recipient HLA mismatches, and cytomegalovirus (CMV) serostatus, all treated with the same IS protocol. Outcomes were time to (i) first episode of biopsy-proven acute rejection (BPAR), (ii) first CMV viremia within the first 6 months, (iii) incidence of any new-onset malignancy, and (iv) development of donor-specific anti-HLA antibodies (DSAs).</p><p><strong>Results: </strong>Overall rates of BPAR were highest in the recipients under the age of 35, but with no evidence of a difference between older age groups. Conversely, the risk of CMV viremia and malignancy was significantly higher in older recipients; in the > 60-year-old group, CMV viremia HR: 2.66 (95% CI: 1.49-4.75), and malignancy HR: 7.3 (95% CI: 1.7-31.10) versus the youngest group with little evidence was confounded by comorbidity or donor factors on multivariate analysis. The risk of CMV infection was most marked in the oldest female group, while the risk of malignancy was greatest in older males. The development of DSA was equal across all age groups.</p><p><strong>Conclusion: </strong>Our data indicate that older recipient age is associated with increased risk of CMV viremia and malignancy after transplantation, suggesting an age-associated vulnerability to IS, with the risk occurring mostly in older women and older men, respectively. These data support the need to develop age- and sex-specific protocol adjustments.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"5547629"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349093","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":"Latent Profiles of Deceased Organ Donation Registrants and Nonregistrants in the United States.","authors":"Ari P Kirshenbaum, Brendan Parent, Landry Goodgame Huffman, Virginia Kelsey, Michael J Sofis","doi":"10.1155/joot/4446435","DOIUrl":"10.1155/joot/4446435","url":null,"abstract":"<p><p>Deceased organ donation is the greatest source of transplantable whole organs, but registration rates are a limiting factor because they remain low among certain populations. A stratified, nonprobability survey was used to identify population characteristics associated with nonregistration in the United States (<i>N</i> = 11,083). Latent profile analysis (LPA) was used to identify multivariate patterns of demographic, socioeconomic, and health-related factors associated with registration. LPA yielded three distinct profiles, which all reported similar average percentages of driver's license possession, medical insurance coverage, and income, indicating that profiles were not distinguished by these variables. Meaningful differences across the profiles included access to healthcare services, satisfaction with those services, general health and well-being, and age; those who are both healthy and young (mean age = 25.9 years) reported the lowest percentage of organ donation registration (35.3%). For this group, 71.48% listed either low priority or distrust in the donation process as the top reasons for nonregistration. Importantly, age as a standalone variable was not uniformly associated with donation and was conditionally dependent upon health status; poorer health in young adults was associated with greater registration. These findings reveal previously unidentified opportunities for tailoring donor registration campaigns to populations with a high potential for registration behavior change.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"4446435"},"PeriodicalIF":2.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733818","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 Versus Left Laparoscopic Donor Nephrectomy and Its Effects on Transplant Outcomes: Experience From Saudi Arabia.","authors":"Ghaleb Anas Aboalsamh, Muhammad Abdul Mabood Khalil, Nihal Mohammed Sadagah, Hinda Hassan Khideer Mahmood, Ahmed Abdelahad Basha, Mohamed Abdelmonem Said Ahmed, Aileen Jean Dela Cruz, Hisham Ismael Mohamed Sakran, Ibrahim Mohammed Nasser Assiri, Salem H Al-Qurashi","doi":"10.1155/joot/1694242","DOIUrl":"10.1155/joot/1694242","url":null,"abstract":"<p><p><b>Background:</b> Live kidney donation is increasingly common due to the shortage of organs. Surgeons prefer the left kidney due to easier access and longer renal vein. There are conflicting reports about the outcomes of right versus left kidney transplants. The objective of this study was to compare the immediate and long-term outcomes of right and left kidney recipients in live donor kidney transplants. <b>Methods:</b> A retrospective analysis of 215 live kidney donors from 2021 to 2023 was conducted to compare outcomes between the recipients of right and left kidneys. Data were collected on donor and recipient demographics, surgical outcomes, and complications. Baseline values were summarized using descriptive statistics, with the quantitative and qualitative data reported as means, medians, interquartile ranges, standard deviations, and frequencies. Differences between the groups were analyzed using the Chi-square test and <i>t</i>-test. <b>Results:</b> Among the 215 donors, 141 (65.6%) were male and 74 (34.4%) were female, with a mean nuclear GFR of 105.89 ± 10.91 mL/min. Left kidneys were donated in 176 cases (81.9%), and right kidneys in 39 cases (18.1%). The most common complications were delayed graft function (DGF) in 15 cases (6.9%), hematoma in six cases (2.7%), seroma in nine cases (4.2%), and rejection in 10 cases (4.7%). There were no significant differences between the groups for gender, cold ischemia time, operation time, hospital stay, intraoperative hemorrhage, blood transfusion, re-exploration, hematoma, seroma, urine leak, or the presence of donor-specific antibodies (DSA), BK or cytomegalovirus viremia, rejections, or death-censored graft loss. Right nephrectomies and re-exploration were identified as independent predictors of DGF. Creatinine levels and estimated glomerular filtration rates at discharge, 6 months, 1 year, and 2 years did not differ significantly between the recipients of the right and left kidneys. <b>Conclusion:</b> Laparoscopic left and right donor nephrectomies show comparable long-term outcomes with no significant differences in creatinine levels at 6 months, 1 year, and 2 years post-transplantation. Despite more DGF in right kidney recipients, both kidneys are suitable for transplantation without compromising long-term outcomes. These findings highlight the feasibility of utilizing the right kidney for donation when required.</p>","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2025 ","pages":"1694242"},"PeriodicalIF":0.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555297","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}