Transplantation Reviews最新文献

{"title":"Tacrolimus intra-patient variability measures and its associations with allograft clinical outcomes in kidney transplantation","authors":"Wenmin Xie ,&nbsp;Shupan Fan ,&nbsp;Ruolin Liu ,&nbsp;Wencheng Yan ,&nbsp;Chengxin Su ,&nbsp;Kaile Zheng ,&nbsp;Xuebin Wang ,&nbsp;Zhuo Wang","doi":"10.1016/j.trre.2024.100842","DOIUrl":"10.1016/j.trre.2024.100842","url":null,"abstract":"<div><h3>Aims</h3><p>Tacrolimus (Tac) is commonly prescribed in solid organ transplantation to prevent immune-mediated damage to the graft. However, its pharmacokinetics show substantial variability between and within patients. Intra-patient variability of tacrolimus (Tac-IPV) has emerged as a novel marker to predict transplant outcomes. Numerous studies report varying associations between Tac-IPV and clinical outcomes, with Tac-IPV measures showing wide discrepancies among these studies. This inconsistency could be a significant factor that influences the various outcomes reported in different studies. Our review comprehensively assesses the relationship between various Tac-IPV measures and their associations with clinical outcomes in transplant patients.</p></div><div><h3>Methods</h3><p>A comprehensive literature search was conducted using the PubMed and Embase databases, covering the period from 2004 to March 31, 2023. The search focused on studies that examined the relationship between Tac-IPV and clinical outcomes in kidney transplantation (KT). The inclusion criteria were specific to studies addressing Tac-IPV, including measures such as standard deviation (SD), coefficient of variation (CV), time-weighted coefficient of variability (CV), mean absolute deviation (MAD), and Tac variability score (TVS). Clinical outcomes included the development of de novo donor-specific antibodies (dnDSA), rejection episodes, graft loss, and graft failure.</p></div><div><h3>Results</h3><p>Among the 33 studies that met the inclusion criteria, a notable proportion presented conflicting findings in their assessment of various Tac-IPV measures regarding dnDSA, rejection episodes, graft loss, and graft failure.</p></div><div><h3>Conclusions</h3><p>Most studies have identified a correlation between high Tac-IPV and poor clinical outcomes; however, this relationship is multifactorial. Influencing factors include the metabolic status of KT patients, the timing of Tac-IPV calculations, and the criteria for defining high and low Tac-IPV thresholds, including the size and selection method. CV, MAD, and TWCV are the metrics that are most frequently used to determine Tac-IPV. Additionally, most of the methods for establishing Tac-IPV thresholds typically employ receiver operating characteristic (ROC) curves and median values. It is also notable that studies examining the clinical significance of Tac-IPV often include tacrolimus levels measured six months after kidney transplantation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100842"},"PeriodicalIF":4.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280005","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":"Diet and physical activity interventions to improve cardiovascular disease risk factors in liver transplant recipients: Systematic review and meta-analysis","authors":"Lynsey N. Spillman ,&nbsp;Emily Stowe ,&nbsp;Angela M. Madden ,&nbsp;Kirsten L. Rennie ,&nbsp;Linda M. Oude Griep ,&nbsp;Michael Allison ,&nbsp;Leia Kenney ,&nbsp;Ciara O'Connor ,&nbsp;Simon J. Griffin","doi":"10.1016/j.trre.2024.100852","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100852","url":null,"abstract":"<div><h3>Background and aims</h3><p>Cardiovascular disease, associated risk factors and obesity are prevalent after liver transplant and modifiable through lifestyle changes. Understanding what lifestyle interventions and their respective components are effective is essential for translation to clinical practice. We aimed to investigate the effects of diet and physical activity interventions on weight, body mass index and other cardiovascular disease risk factors in liver transplant recipients, and systematically describe the interventions.</p></div><div><h3>Methods</h3><p>We systematically searched Embase, MEDLINE, Psycho Info, CINAHL, Cochrane central register of controlled trials, PeDro, AMED, BNI, Web of Science, OpenGrey, <span>ClinicalTrials.gov</span><svg><path></path></svg> and the international clinical trials registry from inception to 31 May 2023. Search results were screened by two independent reviewers: randomised control trials with interventions that targeted diet and physical activity behaviours in liver transplant recipients were considered eligible. Two independent reviewers extracted and synthesised data for study, participant and intervention details and results. We used the Revised Cochrane Risk of Bias Tool for Randomised Trials to assess risk of bias for outcomes and the GRADE approach to rate the quality of the body of evidence. When two or more studies reported findings for an outcome, we pooled data using random-effects meta-analysis.</p></div><div><h3>Results</h3><p>Six studies were included, reporting three physical activity and three combined diet and physical activity interventions. Participants were 2 months-4 years post-transplant. Interventions lasted 12 weeks-10 months and were delivered remotely and/or in-person, most commonly delivered to individual participants by health care or sports professionals. Five studies described individual tailoring, e.g. exercise intensity. Adherence to interventions ranged from 51% to 94%. No studies reported fidelity. Intervention components were not consistently reported. In meta-analysis, diet and physical activity interventions did not significantly reduce weight or body mass index compared to control groups, however no studies targeted participants with obesity. Diet and physical activity interventions reduced percentage body fat and triglycerides compared to control groups but did not reduce total cholesterol or increase activity. The GRADE quality of evidence was low or very low.</p></div><div><h3>Conclusion</h3><p>Diet and physical activity interventions reduced percentage body fat and triglycerides in liver transplant recipients. Further good quality research is needed to evaluate their effect on other cardiovascular disease risk factors, including weight and BMI. Interventions need to be better described and evaluated to improve evidence base and inform patient care.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100852"},"PeriodicalIF":4.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000351/pdfft?md5=84af9ad5e2279d500f4a54e0f7f8e0bc&pid=1-s2.0-S0955470X24000351-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140548534","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":"miRNA as potential biomarkers after liver transplantation: A systematic review","authors":"Pia F. Koch ,&nbsp;Kristina Ludwig ,&nbsp;Felix Krenzien ,&nbsp;Karl H. Hillebrandt ,&nbsp;Wenzel Schöning ,&nbsp;Johann Pratschke ,&nbsp;Nathanael Raschzok ,&nbsp;Igor M. Sauer ,&nbsp;Simon Moosburner","doi":"10.1016/j.trre.2024.100831","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100831","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Liver transplantation is a life-saving therapy for end-stage liver disease patients, but </span>acute cellular rejection (ACR) and graft complications remain significant postoperative challenges. Early and accurate diagnosis is crucial for timely intervention and improved patient outcomes, but their diagnosis rely currently on invasive biopsy sampling, thus prompting the search for non-invasive Biomarkers. </span>MicroRNA (miRNA) have emerged as promising biomarkers in various pathological conditions, and their potential utility in diagnosing acute cellular rejection after liver transplantation has gained significant interest.</p></div><div><h3>Methods</h3><p><span>This systematic review of PubMed, Web of Science, and the </span><span>ClinicalTrials.gov</span><svg><path></path></svg><span> registry analyzes studies exploring miRNA as biomarkers for ACR and graft dysfunction in liver transplantation (PROSPERO ID CRD42023465278). The Cochrane Collaboration tool for assessing risk of bias was employed. Population data, identified miRNA and their dynamic regulation, as well as event prediction were compared. Data extraction and quality assessment were performed independently by two reviewers.</span></p></div><div><h3>Results</h3><p>Thirteen studies were included in this systematic review. Various investigated miRNAs were upregulated in association with acute cellular rejection, like miR-122, miR-155, miR-181, miR-483-3p, and miR-885-5p, demonstrating great biomarker potential. Additionally, several studies conducted target gene analysis, revealing insights into cellular mechanisms linked to ACR. Moreover, various miRNA were also capable of predicting different organ complications following transplantation, expanding their versatility. Remaining challenges include the standardization of miRNA profiling, the need for functional validation, and the necessity for long-term studies.</p></div><div><h3>Conclusion</h3><p>The results highlight the potential of miRNA as specific, non-invasive biomarkers for ACR and graft dysfunction following liver transplantation. However, further research is needed to validate these findings and establish standardized diagnostic panels to incorporate them into clinical practice and explore miRNA-based therapies in the future.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100831"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139487854","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":"Prehabilitation in patients awaiting liver transplantation","authors":"Amine Benmassaoud ,&nbsp;Myriam Martel ,&nbsp;Franco Carli ,&nbsp;Olivia Geraci ,&nbsp;Stella S. Daskalopoulou ,&nbsp;Giada Sebastiani ,&nbsp;Amal Bessissow","doi":"10.1016/j.trre.2024.100835","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100835","url":null,"abstract":"<div><h3>Background</h3><p>Frailty, malnutrition and sarcopenia lead to a significant increase in morbidity and mortality before and after liver transplantation (LT). Prehabilitation attempts to optimize physical fitness of individuals before major surgeries. To date, little is known about its impact on patients awaiting LT.</p></div><div><h3>Aims</h3><p>The aim of our scoping review was to describe whether prehabilitation in patients awaiting LT is feasible and safe, and whether it leads to a change in clinical parameters before or after transplantation.</p></div><div><h3>Methods</h3><p>We performed a systematic review of the literature from 1946 to November 2023 to identify prospective studies and randomized controlled trials of adult LT candidates who participated in an exercise training program.</p></div><div><h3>Results</h3><p>Out of 3262 citations initially identified, six studies were included. Studies were heterogeneous in design, patient selection, intervention, duration, and outcomes assessed. All studies were self-described as pilot or feasibility studies and had a sample size ranging from 13 to 33. Two studies were randomized controlled trials. Two study restricted to patients with cirrhosis who were eligible for liver transplantation or on the transplant list. Exercise programs lasted between 6 and 12 weeks. In terms of feasibility, proportion of eligible patients that were recruited was between 54 and 100%. Program completion ranged between 38 and 90%. Interventions appeared safe with 9 (9.2%) adverse events noted. In the intervention group, improvements were generally noted in peak oxygen consumption and workload, 6-min walking distance, and muscle strength. One study suggested a decrease in post-transplant hospital length of stay.</p></div><div><h3>Conclusions</h3><p>Overall, it appears that prehabilitation with exercise training is feasible, and safe in patients awaiting LT. Higher quality and larger studies are needed to confirm its impact on pre- and post-transplantation-related outcomes.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100835"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139748773","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":"Recurrent C3 glomerulopathy after kidney transplantation","authors":"Shota Obata ,&nbsp;Pedro A.S. Vaz de Castro ,&nbsp;Leonardo V. Riella ,&nbsp;Paolo Cravedi","doi":"10.1016/j.trre.2024.100839","DOIUrl":"10.1016/j.trre.2024.100839","url":null,"abstract":"<div><p>The complement system is part of innate immunity and is pivotal in protecting the body against pathogens and maintaining host homeostasis. Activation of the complement system is triggered through multiple pathways, including antibody deposition, a mannan-binding lectin, or activated complement deposition. C3 glomerulopathy (C3G) is a rare glomerular disease driven by complement dysregulation with high post-transplantation recurrence rates. Its treatment is mainly based on immunosuppressive therapies, specifically mycophenolate mofetil and glucocorticoids. Recent years have seen significant progress in understanding complement biology and its role in C3G pathophysiology. New complement-tergeting treatments have been developed and initial trials have shown promising results. However, challenges persist in C3G, with recurrent post-transplantation cases leading to suboptimal outcomes. This review discusses the pathophysiology and management of C3G, with a focus on its recurrence after kidney transplantation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100839"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139924443","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":"Assessing quality of life in solid organ transplant recipients: A systematic review of the development, content, and quality of available condition- and transplant-specific patient-reported outcome measures","authors":"Ben Rimmer ,&nbsp;Rebeka Jenkins ,&nbsp;Siân Russell ,&nbsp;Dawn Craig ,&nbsp;Linda Sharp ,&nbsp;Catherine Exley","doi":"10.1016/j.trre.2024.100836","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100836","url":null,"abstract":"<div><h3>Purpose</h3><p>We aimed to identify the condition- and transplant-specific patient-reported outcome measures (PROMs) available to measure quality of life (QoL) in solid organ transplant (SOT) recipients, examine their development and content, and critically appraise the quality of their measurement properties, to inform recommendations for clinical and research use.</p></div><div><h3>Methods</h3><p>We systematically searched MEDLINE, Embase, CINAHL, PsycINFO, Cochrane CENTRAL, and Scopus from inception to 27th January 2023. Search hits were screened for eligibility by two independent reviewers; papers reporting the development and/or validation of condition- and transplant-specific PROMs measuring QoL in adult SOT recipients were considered eligible. We abstracted and synthesised data on PROM characteristics, development (item generation and/or reduction), and content (QoL dimensions). Quality appraisal and synthesis were informed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, and included methodological and quality assessment of measurement properties, GRADE levels of evidence, feasibility and interpretability.</p></div><div><h3>Results</h3><p>We identified 33 papers reporting 26 QoL PROMs validated in SOT recipients (kidney <em>n</em> = 10 PROMs; liver <em>n</em> = 6; lung <em>n</em> = 3; heart <em>n</em> = 2; pancreas n = 1; multiple organs <em>n</em> = 4). Patient discussions (<em>n</em> = 17 PROMs) and factor analysis (<em>n</em> = 11) were the most common item generation and reduction techniques used, respectively. All PROMs measured ≥3 of nine QoL dimensions (all measured emotional functioning); KDQoL-SF and NIDDK-QA measured all nine. Methodological quality was variable; no PROM had low evidence or better for all measurement properties. All PROMs were COSMIN recommendation category ‘B', primarily because none had sufficient content validity.</p></div><div><h3>Conclusions</h3><p>There are many condition- and transplant-specific QoL PROMs validated in SOT recipients, particularly kidney. These findings can help inform PROM selection for clinicians and researchers. However, caution is required when adopting measures, due to the substantial heterogeneity in development, content, and quality. Each PROM has potential but requires further research to be recommendable. Greater consideration of patient and professional involvement in PROM development in this setting is needed to ensure sufficient content validity.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100836"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000193/pdfft?md5=df47eb91c5cd1108c5f4a4fc2517357d&pid=1-s2.0-S0955470X24000193-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139738112","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":"Latest advances in frailty in kidney transplantation: A narrative review","authors":"Ruth Fergie ,&nbsp;Alexander P. Maxwell ,&nbsp;Emma L. Cunningham","doi":"10.1016/j.trre.2024.100833","DOIUrl":"10.1016/j.trre.2024.100833","url":null,"abstract":"<div><p>Frailty is a clinical syndrome that is characterised by decline in multiple systems with associated decreased physiological reserve and ability to respond to stressor events. It is associated with greater healthcare burden. It is common in patients with end-stage renal disease (ESRD). Kidney transplantation is considered the optimal form of renal replacement therapy for suitable patients with ESRD. However, surgery and immunosuppression are physiological stresses that can disproportionately affect frail individuals. Frailty is emerging as a potentially important risk factor in patients waitlisted for kidney transplantation. Most of the published research to date in this area comes from a single transplant centre in the USA. Frailty, as measured using the Physical Frailty Phenotype (FP), is prevalent in waitlisted patients and has been associated with early hospital re-admission, prolonged length of stay, delayed graft function and increased mortality after kidney transplantation. However, although kidney transplantation is a substantial physiological stress to a patient's reserve, by restoring kidney function, kidney transplantation has also been shown to improve a patient's frailty status. The FP is the most studied tool in patients waitlisted for transplantation, but it has not been able to distinguish those whose frailty is improved by kidney transplantation.</p><p>In summary, there remain significant gaps in knowledge and uncertainties as to how to effectively use existing frailty measures to inform decision-making around kidney transplantation. Further research is needed to address these important gaps in the literature.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100833"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000168/pdfft?md5=d87f31ad7793c75e8420bf137961e746&pid=1-s2.0-S0955470X24000168-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139578131","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":"The effect of goal-directed fluid therapy on delayed graft function in kidney transplant recipients: A systematic review and meta-analysis","authors":"Michael P. Klonarakis ,&nbsp;Mannat Dhillon ,&nbsp;Emir Sevinc ,&nbsp;Meghan J. Elliott ,&nbsp;Matthew T. James ,&nbsp;Ngan N. Lam ,&nbsp;Kevin J. McLaughlin ,&nbsp;Paul E. Ronksley ,&nbsp;Shannon M. Ruzycki ,&nbsp;Tyrone G. Harrison","doi":"10.1016/j.trre.2024.100834","DOIUrl":"10.1016/j.trre.2024.100834","url":null,"abstract":"<div><p>Delayed graft function (DGF) is a common post-operative complication with potential long-term sequelae for many kidney transplant recipients, and hemodynamic factors and fluid status play a role. Fixed perioperative fluid infusions are the standard of care, but more recent evidence in the non-transplant population has suggested benefit with goal-directed fluid strategies based on hemodynamic targets. We searched MEDLINE, EMBASE, Cochrane Controlled Trials Registry and Google Scholar through December 2022 for randomized controlled trials comparing risk of DGF between goal-directed and conventional fluid therapy in adults receiving a living or deceased donor kidney transplant. Effect estimates were reported with odds ratios (OR) and pooled using random effects meta-analysis. We identified 4 studies (205 participants) that met the inclusion criteria. The use of goal-directed fluid therapy had no significant effect on DGF (OR 1.37 95% CI, 0.34–5.6; <em>p</em> = 0.52; I² = 0.11). Subgroup analysis examining effects among deceased and living kidney donation did not reveal significant differences in the effects of fluid strategy on DGF between subgroups. Overall, the strength of the evidence for goal-directed versus conventional fluid therapy to reduce DGF was of low certainty. Our findings highlight the need for larger trials to determine the effect of goal-directed fluid therapy on this patient-centered outcome.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100834"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X2400017X/pdfft?md5=1d194adabec20ab884a91886e2d974d8&pid=1-s2.0-S0955470X2400017X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713612","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":"Research progress on anatomy reconstruction of rat orthotopic liver transplantation","authors":"Weikang Wu ,&nbsp;Juzheng Yuan ,&nbsp;Fuyuan Liu ,&nbsp;Lu Liu ,&nbsp;Xudan Wang ,&nbsp;Xiao Li ,&nbsp;Kaishan Tao","doi":"10.1016/j.trre.2024.100841","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100841","url":null,"abstract":"<div><p>Rat orthotopic liver transplantation (ROLT) serves as an ideal animal model and has gained popularity in addressing complications and perioperative treatments related to clinical liver transplantation. Through extensive research on ROLT model construction, the conventional “two-cuff” method has gradually become established. However, traditional methods still present challenges including limited visual field during vascular suturing, vascular torsion, biliary tract injuries, and prolonged anhepatic periods. Consequently, this paper aims to review the latest advancements and various techniques in this field, providing a valuable reference for individuals interested in constructing ROLT models.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100841"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187191","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":"Was antiviral prophylaxis necessary after kidney transplantation utilizing HBcAb+ donors? A systematic review and meta-analysis","authors":"Saifu Yin ,&nbsp;Xiaoting Chen ,&nbsp;Xingxing Li ,&nbsp;Fan Zhang ,&nbsp;Jiapei Wu ,&nbsp;Tao Lin","doi":"10.1016/j.trre.2024.100840","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100840","url":null,"abstract":"<div><h3>Background</h3><p>Current guidelines lack consensus on whether antiviral prophylaxes should be administered after kidney transplantation from HBcAb+ donors. This systematic review and meta-analysis aimed to evaluate the incidence and risk factors of de novo HBV (DNH) infection, as well as graft and patient survival.</p></div><div><h3>Methods</h3><p>We searched PubMed, Embase, and the Cochrane Library up to December 31, 2023. We included relevant studies that assessed clinical outcomes following transplantation utilizing HBcAb+ kidneys. Summary measures of effect and 95% confidence intervals (CI) for prevalence, risk factors, as well as graft and patient survival were estimated using random-effects meta-analysis.</p></div><div><h3>Results</h3><p>Thirteen studies were included for the final analysis. The DNH incidence was at 0.36% (9/2516) with low heterogeneity (I² = 6%). HBsAb+ recipients (OR: 0.78, 95%CI: 0.25–2.38), HBcAb+ recipients (OR: 3.11, 95%CI: 0.91–10.66, <em>P</em> = 0.071), and recipients not receiving any antiviral prophylaxis (OR: 1.26, 95%CI: 0.15–10.58) were not associated with higher DNH risk. Specifically, HBsAb-/HBcAb+ recipients had the highest DNH incidence (4.65%), followed by HBsAb-/HBcAb- (0.49%), HBsAb+/HBcAb- recipients (0.45%), and HBsAb+/HBcAb+ (0%). Furthermore, recipients receiving HBcAb+ kidneys had comparable graft survival (HR: 1.06, 95%CI: 0.94–1.19, <em>P</em> = 0.55) and patient survival (HR:1.16, 95%CI: 0.98–1.38, <em>P</em> = 0.090) compared with recipients receiving HBcAb- kidneys.</p></div><div><h3>Conclusion</h3><p>Kidney transplantation utilizing HBcAb+ kidneys contributed to comparable graft and patient survival with an extremely low risk of HBV transmission. Antiviral prophylaxes may only be administered in HBsAb-/HBcAb+ recipients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100840"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140135130","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}