Transplantation Reviews最新文献

{"title":"Complement and complement regulatory protein in allogeneic and xenogeneic kidney transplantation","authors":"Yoichi Kakuta ,&nbsp;Shuji Miyagawa ,&nbsp;Soichi Matsumura ,&nbsp;Yoko Higa-Maegawa ,&nbsp;Shota Fukae ,&nbsp;Ryo Tanaka ,&nbsp;Shigeaki Nakazawa ,&nbsp;Kazuaki Yamanaka ,&nbsp;Takuji Kawamura ,&nbsp;Shunsuke Saito ,&nbsp;Shigeru Miyagawa ,&nbsp;Norio Nonomura","doi":"10.1016/j.trre.2024.100885","DOIUrl":"10.1016/j.trre.2024.100885","url":null,"abstract":"<div><div>Kidney transplantation is the most optimal treatment for patients with end-stage renal disease, offering significant improvements in patient outcomes over dialysis. However, the potential for immune rejection, where the recipient's immune system attacks the transplanted kidney, can compromise transplant success. The complement system, a key component of the immune response, plays a crucial role in both acute and chronic rejection, including T-cell- and antibody-mediated rejection. Understanding and controlling the complement system is essential for managing rejection and enhancing graft survival and overall success of kidney transplantation. In allogeneic transplantation, complement activation through various pathways contributes to graft damage and failure. Recent advancements in genetic engineering enable the development of transgenic pigs expressing human complement regulatory proteins, which display potential for reducing rejection in xenotransplantation. Despite these advances, the complex mechanisms of complement activation and regulation are not fully understood, necessitating further research. This review examines the role of the complement system in kidney transplantation, explores the latest developments in complement regulatory strategies, and discusses potential therapeutic approaches to improve transplant outcomes.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 1","pages":"Article 100885"},"PeriodicalIF":3.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty serves as an adverse predictor for mortality in liver transplant candidates: A systematic review and meta-analysis","authors":"Fei Zhang ,&nbsp;Ying Yan ,&nbsp;Baifeng Li ,&nbsp;Chunlin Ge","doi":"10.1016/j.trre.2024.100884","DOIUrl":"10.1016/j.trre.2024.100884","url":null,"abstract":"<div><h3>Background</h3><div>Physical frailty increases susceptibility to stressors and has been associated with increased mortality among liver transplant candidates. However, evidence about this population's frailty prevalence and mortality is inconsistent and needs to be clarified. This study aimed to quantitatively synthesize the prevalence of frailty and the role of frailty on mortality in liver transplant candidates.</div></div><div><h3>Methods</h3><div>All eligible studies published in Embase, PubMed, Scopus, and Web of Science from inception until March 5, 2024, were included. The pooled prevalence and hazard ratio (HR) corresponding to 95 % confidence intervals (CI) in mortality estimates were conducted. The random-effects model was used for the calculations.</div></div><div><h3>Results</h3><div>A total of 17 studies containing 4509 patients with liver transplant waitlist candidates were included. The prevalence of frailty in liver transplant waitlist candidates was 32 % (95 % CI = 25–38; <em>p</em> &lt; 0.01). In this population, frailty was associated with an increased hazard ratio for mortality (8 studies) (HR = 2.49; 95 % CI = 1.77–3.51; <em>p</em> &lt; 0.01). Furthermore, subgroup analysis showed that frailty was associated with a higher mortality in the USA (HR = 4.03; 95 % CI = 1.77–3.51; <em>p</em> &lt; 0.01) compared with the non-USA area (HR = 2.03; 95 % CI = 1.51–2.72; <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Our results suggest that frailty is prevalent in patients awaiting liver transplants, which strongly predicts waitlist mortality among this population. These findings highlight the importance of frailty in the decision of transplantation and in designing studies that consider frailty. Reducing the severity or impact of frailty on this population may improve prognosis.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100884"},"PeriodicalIF":3.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of kidney replacement therapies after kidney transplant failure: A systematic review and meta-analysis","authors":"Xingge Sun ,&nbsp;Stephen O'Neill ,&nbsp;Helen Noble ,&nbsp;Jia Zeng ,&nbsp;Sarah Chanakarn Tuan ,&nbsp;Clare McKeaveney","doi":"10.1016/j.trre.2024.100883","DOIUrl":"10.1016/j.trre.2024.100883","url":null,"abstract":"<div><h3>Background</h3><div>Following kidney transplant failure, patients generally have three kidney replacement therapy (KRT) options: peritoneal dialysis (PD), haemodialysis (HD), or pre-emptive kidney re-transplantation. This review aims to explore KRT options after kidney transplant failure and compare clinical outcomes.</div></div><div><h3>Method</h3><div>This review included studies from five databases: Medline, PubMed, Embase, Cochrane, and CINAHL. The study protocol was registered at PROSPERO [CRD42024514346]. Causes of kidney transplant failure were explored. Survival and re-transplantation rates among three groups after kidney transplant failure were compared: patients starting PD (TX-PD group), patients starting HD (TX-HD group), and patients re-transplanted without bridging dialysis (TX-TX group). Causes of death were also explored. The quality of the included studies was assessed using the CASP checklist and the meta-analysis was assessed using the GRADE approach.</div></div><div><h3>Results</h3><div>Of 6405 articles, eight articles were included in the systematic review. Chronic damage was identified as the primary cause of kidney transplant failure. The TX-TX group had a lower mortality rate than the TX-HD group and TX-PD group, though this difference was only statistically significant in comparison to the TX-HD group (OR: 2.57; 95 % CI:1.58, 4.17; I² = 79 %; <em>P</em> = 0.0001). Additionally, the TX-PD group had a significantly lower mortality rate (OR: 0.83; 95 % CI:0.76, 0.90; I² = 88 %; <em>P</em> &lt; 0.0001) and higher re-transplantation rate (OR: 1.56; 95 % CI:1.41, 1.73; I² = 0 %; P &lt; 0.00001) compared to the TX-HD group. Cardiovascular disease, infection, and cancer were the leading causes of death.</div></div><div><h3>Conclusion</h3><div>The TX-TX group had better survival than the TX-HD group. Survival and re-transplantation rates were higher in the TX-PD group than the TX-HD group. However, age and comorbidities may impact survival and re-transplantation rates between the TX-PD and TX-HD groups, which should be explored further.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100883"},"PeriodicalIF":3.6,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous squamous cell carcinoma in solid organ transplant recipients: Current therapeutic and screening strategies","authors":"Ann-Kristin Struckmeier ,&nbsp;Martin Gosau ,&nbsp;Ralf Smeets","doi":"10.1016/j.trre.2024.100882","DOIUrl":"10.1016/j.trre.2024.100882","url":null,"abstract":"<div><div>Solid organ transplant recipients (SOTRs) are particularly prone to developing malignancies, often manifesting multiple tumors and tumors with a heightened susceptibility to metastasis, resulting in much lower survival rates when compared to the general population. Among these, cutaneous squamous cell carcinoma (CSCC) respresent a major challenge in terms of morbidity and mortality following organ transplantation. The management of post-transplant CSCC requires expertise from various disciplines, including dermatology, maxillofacial surgery, transplant medicine, radiation oncology, and medical oncology. Furthermore, the unique behaviors and prevalence of tumors in SOTRs necessitate tailored pathways for screening and treatment, distinct from those designed for immunocompetent patients. Despite the proven efficacy of immune checkpoint inhibitors (ICIs) in several cancers, SOTRs have often been systematically excluded from clinical trials due to concerns about potential allograft rejection and loss. Consequently, most data on the safety and efficacy of ICIs in SOTRs are derived from case series and reports. Given the significant risks involved, alternative therapeutic options should be thoroughly discussed with patients before considering ICI therapy. This literature review aims to provide an overview of CSCC in SOTRs, with a specific emphasis on therapeutic and screening strategies, particularly highlighting immunotherapy.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100882"},"PeriodicalIF":3.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors and interventions affecting tacrolimus intrapatient variability: A systematic review and meta-analysis","authors":"Hongsheng Chen ,&nbsp;Shuang Liu ,&nbsp;Lingling Yu ,&nbsp;Xiaofei Hou ,&nbsp;Rongsheng Zhao","doi":"10.1016/j.trre.2024.100878","DOIUrl":"10.1016/j.trre.2024.100878","url":null,"abstract":"<div><h3>Backgrounds</h3><p>Tacrolimus is a cornerstone of posttransplantation immunosuppressive regimens. Despite routine monitoring, the efficacy of its trough concentrations in reflecting drug concentration fluctuations is limited. Intrapatient variability (IPV) emerges as a novel monitoring marker for predicting clinical outcomes. However, understanding the factors affecting IPV and assessing interventions to address it remain enigmatic, posing a conundrum in clinical management.</p></div><div><h3>Objectives</h3><p>This systematic review aimed to investigate a spectrum of factors affecting IPV and assess the effect of strategic interventions, thereby charting a course for enhanced clinical stewardship.</p></div><div><h3>Methods</h3><p>We electronically searched of PubMed, Embase, and the Cochrane Library databases for studies investigating factors and interventions affecting IPV up to October 2023. Two reviewers independently screened literature, extracted data, and assessed quality, using RevMan 5.4.1 software for meta-analysis.</p></div><div><h3>Results</h3><p>A total of 15 randomized controlled trials (RCTs), 34 cohort studies, and 20 self-controlled studies were included. The results indicated that IPV was significantly higher in cytochrome P450 3A5 (<em>CYP3A5</em>) expressers, nonadherent patients, patients taking proton pump inhibitors or statins, and Black or African American recipients, whereas recipients consuming extended-release formulation exhibited lower IPV. Additionally, the participation of pharmacists had a positive effect on improving IPV.</p></div><div><h3>Conclusions</h3><p>Factors affecting IPV encompassed genotype, formulation, adherence, drug combinations, and ethnicity, with each factor exerting varying degrees of effect. Identifying these factors was crucial for developing targeted intervention strategies. While the participation of pharmacists held a promise in improving IPV, further investigation of interventions such as mobile technology, educational measures to enhance adherence, and personalized dosing regimens was warranted.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100878"},"PeriodicalIF":3.6,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of single photon emission computed tomography myocardial perfusion imaging for the prediction of MACE in pre- kidney transplant recipients: A systematic review and meta-analysis","authors":"Niels T. Bloemendal ,&nbsp;Niek H.J. Prakken ,&nbsp;Barzi Gareb ,&nbsp;Stan Benjamens ,&nbsp;Jan Stephan F. Sanders ,&nbsp;Riemer H.J.A. Slart ,&nbsp;Robert A. Pol","doi":"10.1016/j.trre.2024.100879","DOIUrl":"10.1016/j.trre.2024.100879","url":null,"abstract":"<div><h3>Background</h3><p>Kidney transplantation provides substantial benefits in extending survival and improving quality of life for patients with end-stage renal disease. The incidence of major adverse cardiac events (MACE) increases with a decline of kidney function in patients with chronic kidney disease. After kidney transplantation, the incidence of MACE remains high. The objective of this study was to assess the prognostic significance of pre-transplant single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in kidney transplant recipients.</p></div><div><h3>Methods</h3><p>A systematic literature search was performed between January 1st 2015 and March 26th 2024 in PubMed, EMBASE, Web of Science and The Cochrane Library to identify the prognostic value of SPECT MPI for developing MACE (primary outcome) and mortality (secondary outcome) in kidney transplant recipients (PROSPERO CRD42020188610). Risk of bias was assessed. Meta-analyses and subgroup analyses were performed using random-effects models.</p></div><div><h3>Results</h3><p>Six studies comprising 2090 SPECT MPI scans were included. Abnormal SPECT MPI scans were associated with an increased risk of MACE post-transplantation (HR 1.62, 95% CI 1.27–2.06, <em>p</em> &lt; 0.001). Subgroup analyses showed consistent findings across various patient populations and methodological differences. Sensitivity analyses supported the robustness of our findings.</p></div><div><h3>Conclusions</h3><p>Current evidence showed that pre-transplant SPECT MPI has significant prognostic value in identifying kidney transplant candidates at risk for MACE post-transplantation. Integrating SPECT MPI into preoperative assessments might enhance risk stratification and guide clinical decision-making. Prospective studies are needed to refine risk prediction models.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100879"},"PeriodicalIF":3.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000624/pdfft?md5=6c04c0c5206bc922b0ec873e612c3ebb&pid=1-s2.0-S0955470X24000624-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maribavir treatment for resistant cytomegalovirus disseminated disease in kidney transplant recipients: A case-based scoping review of real life data in literature","authors":"Silvia Corcione ,&nbsp;Tommaso Lupia ,&nbsp;Davide Vita ,&nbsp;Francesca Sidoti ,&nbsp;Elisa Zanotto ,&nbsp;Paolo Solidoro ,&nbsp;Luigi Biancone ,&nbsp;Cristina Costa ,&nbsp;Roberto Balagna ,&nbsp;Francesco Giuseppe De Rosa","doi":"10.1016/j.trre.2024.100873","DOIUrl":"10.1016/j.trre.2024.100873","url":null,"abstract":"&lt;div&gt;&lt;p&gt;The treatment of refractory CMV is often associated with high toxicity. Maribavir (MBV) is a novel oral antiviral, known for its favourable safety profile in fragile patients. We describe a case of CMV disease with end organ damage following kidney transplantation at high risk, for recipient-donor serological mismatch. A 54-year-old female with history of obesity, hypertension, and chronic kidney disease, on prednisone and tacrolimus after kidney transplantation in November 2022, soon after developed primary CMV infection, treated with Valganciclovir and CMV Ig. In January 2023 the patient presented with fever and dyspnea. Pulmonary miliary opacities and right-upper lobe consolidation were found at CT-scan along with CMV-DNA positivity on BAL and serum. Lung biopsy confirmed CMV infection. Antiviral was switched to Ganciclovir. Despite initial benefit, fever and respiratory failure happened 8 days later, leading to intubation at day 15. Due to slow decrease serum CMV-DNA and detection of UL97 mutation, conferring resistance to valganciclovir and ganciclovir, the patient was started on foscarnet and letermovir. She was extubated after a gradual respiratory improvement and discharged from ICU to rehabilitation department with HFNC; reduction in serum CMV-DNA, but persistently elevated CMV-DNA on BAL were documented. At week 8, MBV was started and letermovir continued, for a 8 weeks course, without notable adverse effects. Respiratory function improved but soon after septic shock occurred. A bone marrow biopsy resulted in lymphoma, without indications for treatment: the patient developed coma and died 6 months after admission. MBV has recently been approved in Europe for treatment of R/R CMV in HSCT and SOT recipients. MBV showed superior rates of viraemia clearance after 8 weeks compared to SOC, demonstrating also a favourable safety profile with fewer patients discontinuing treatment and being affected by nephrotoxicity and neutropenia. Its main side effects are taste impairment, gastro-intestinal symptoms and asthenia. Based on actual promising perspectives regarding antiviral stewardship, more data are required to corroborate benefit of MBV in terms of toxicity and impact on mortality in highly fragile populations as SOT recipients.&lt;/p&gt;&lt;p&gt;MBV received approval for the treatment of refractory or resistant CMV infections to other antiviral agents. Nevertheless, real-life data on efficacy and safety of MBV are still lacking.&lt;/p&gt;&lt;p&gt;We conducted a narrative review of the current literature on MBV as treatment for CMV infection in kidney transplant recipients to understand clinical characteristics, safety and outcomes of MBV in this population. A search was run on the main scientific databases. 194 papers were identified, of which 188 were excluded by title and abstract evaluation. Subsequently, 6 papers were included. We performed descriptive statistics on the entire study population. The studies included in our analysis showed a higher preva","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100873"},"PeriodicalIF":3.6,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water/fluid intake in Kıdney transplant recipients: An underrated topic","authors":"Baris Afsar,&nbsp;Rengin Elsurer Afsar,&nbsp;Yasar Caliskan,&nbsp;Krista L. Lentine","doi":"10.1016/j.trre.2024.100876","DOIUrl":"10.1016/j.trre.2024.100876","url":null,"abstract":"<div><p>Although kidney transplantation (KT) is the best treatment option for end-stage kidney disease, long-term complications such as chronic kidney allograft dysfunction and cardiovascular disorders are observed. To decrease these complications, preventive measures must be applied in kidney transplant recipients (KTRs). One of these common measures is the increase of water/fluid intake although this is not evidence-based practice. Indeed, surprisingly very limited studies evaluated the impact of increased water/fluid intake on graft function, with small number of KTRs and short term follow-up. We suggest that the water/fluid intake should be personalized based on baseline graft function, time onset after KT (which water homeostasis changes), presence of hyponatremia and hypervolemia, concomitant medications, and patient willingness. Methods for estimating water/fluid intake (direct measurement, 24-h urine volume measurement, urine osmolarity) has both advantages and drawbacks and the best method has not been identified. Increase of water/fluid intake in specific conditions (in hot, and humid weather, before exercise, during Ramadan fasting) or in distinct KTRs (KTRs with de novo nephrolithiasis, frequent urinary tract infections) is not tested. Furthermore, the relationship between water/fluid intake and major cardiovascular adverse events are not known. There is no doubt that minimum amount of water/fluid intake is necessary for graft function (the amount is not known) but there is no evidence for a particular target level of water/fluid intake. In the current review, we summarize the studies assessing fluid/water intake in KTR, explained the pathophysiologic basis of water disorders in early period of KT and late after KT, elucidate conflicts and unknown issues of water intake in KTRs and suggest future research needs.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100876"},"PeriodicalIF":3.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods to prevent lymphocele after kidney transplantation: Seeking the optimal technique for avoiding a preventable complication","authors":"Mohammadsadegh Sabagh ,&nbsp;Nastaran Sabetkish ,&nbsp;Sanam Fakour ,&nbsp;Ali Ramouz ,&nbsp;Sanaz Weber ,&nbsp;Markus Mieth ,&nbsp;Georg Lurje ,&nbsp;Mohammad Golriz ,&nbsp;Martin Zeier ,&nbsp;Arianeb Mehrabi ,&nbsp;Elias Khajeh","doi":"10.1016/j.trre.2024.100877","DOIUrl":"10.1016/j.trre.2024.100877","url":null,"abstract":"<div><h3>Background</h3><p>There are multiple methods for preventing lymphocele formation after kidney transplantation (KTx). However, lymphoceles still develop in up to one third of patients and the effectiveness of these different methods in preventing lymphocele is not well described. Here, we summarize the current strategies for preventing lymphocele after KTx.</p></div><div><h3>Methods</h3><p>We conducted searches across several literature databases, including Medline (<em>via</em> PubMed), Web of Science, EMBASE, and Cochrane Central. Lymphocele formation after KTx was the outcome of interest. A random-effects model was applied to evaluate pooled estimates, which were presented as hazard ratios (HRs) and odds ratios (ORs), along with the random pooled estimate (ES), 95% confidence interval (95% CI), and <em>P</em> value. We calculated the pooled rate of lymphocele formation after KTx with the following preventive methods: LigaSure, haemostatic materials, prophylactic drainage, ligation, peritoneal fenestration, and bipolar cautery techniques.</p></div><div><h3>Results</h3><p>The literature search retrieved 87 unique studies after excluding duplicates. Twenty papers reporting on 5445 patients were incorporated in the qualitative analysis. The pooled lymphocele rate was 3.0% (95% CI = 0.6–13.7) for the LigaSure method, 8.3% (95% CI = 6.4–10.7) for drainage, 9.2% (95% CI = 5.9–14.1) for haemostatic materials, 12.2% (95% CI = 9.2–16.1) for ligation, 14.4% (95% CI = 12.0–17.3) for peritoneal fenestration, and 20.5% (95% CI = 10.2–36.8) for bipolar sealing.</p></div><div><h3>Conclusion</h3><p>Despite preventive methods, the incidence of lymphocele following KTx remains high. The use of LigaSure appears to be the most effective method for preventing lymphocele. However, given the broad range of reported lymphocele rates and lack of control groups, further validation of these findings is necessary.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100877"},"PeriodicalIF":3.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000600/pdfft?md5=b0422cadf57c41c58fd407623b230a04&pid=1-s2.0-S0955470X24000600-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of cytomegalovirus in adult solid organ transplant patients: GESITRA-IC-SEIMC, CIBERINFEC, and SET recommendations update","authors":"Elisa Ruiz-Arabi ,&nbsp;Julian Torre-Cisneros ,&nbsp;Victoria Aguilera ,&nbsp;Rodrigo Alonso ,&nbsp;Marina Berenguer ,&nbsp;Oriol Bestard ,&nbsp;Marta Bodro ,&nbsp;Sara Cantisán ,&nbsp;Jordi Carratalà ,&nbsp;Juan José Castón ,&nbsp;Elisa Cordero ,&nbsp;Carme Facundo ,&nbsp;María Carmen Fariñas ,&nbsp;Mirian Fernández-Alonso ,&nbsp;Mario Fernández-Ruiz ,&nbsp;Jesús Fortún ,&nbsp;Maria Dolores García-Cosío ,&nbsp;Sabina Herrera ,&nbsp;David Iturbe-Fernández ,&nbsp;Oscar Len ,&nbsp;José María Aguado","doi":"10.1016/j.trre.2024.100875","DOIUrl":"10.1016/j.trre.2024.100875","url":null,"abstract":"<div><p>Cytomegalovirus (CMV) infection remains a significant challenge in solid organ transplantation (SOT). The last international consensus guidelines on the management of CMV in SOT were published in 2018, highlighting the need for revision to incorporate recent advances, notably in cell-mediated immunity monitoring, which could alter the current standard of care. A working group including members from the Group for the Study of Infection in Transplantation and the Immunocompromised Host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Transplantation (SET), developed consensus-based recommendations for managing CMV infection in SOT recipients. Recommendations were classified based on evidence strength and quality using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The final recommendations were endorsed through a consensus meeting and approved by the expert panel.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100875"},"PeriodicalIF":3.6,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000582/pdfft?md5=921bac6bf46668e5dd82f84cf79a56a2&pid=1-s2.0-S0955470X24000582-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}