Transplantation Reviews最新文献

{"title":"Complement and T cell activation in transplantation","authors":"Sara Alibrandi ,&nbsp;Angela Clemens ,&nbsp;Nicholas Chun","doi":"10.1016/j.trre.2024.100898","DOIUrl":"10.1016/j.trre.2024.100898","url":null,"abstract":"<div><div>The complement system plays a critical role in modulating adaptive T cell responses. Coordination of the proinflammatory signaling cascade and complement regulators permits efficient T cell priming and survival, while minimizing off-target damage to healthy host cells. In the context of transplantation, anti-donor T cell immunity remains a barrier to long term graft health and complement-targeted therapies have shown the potential to significantly improve patient outcomes. Here we will review our current understanding of complement-mediated T cell function and how these findings may be harnessed in organ transplantation.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 1","pages":"Article 100898"},"PeriodicalIF":3.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748169","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":"Early and late antibody mediated rejection: Which game is the complement playing?","authors":"Delsante Marco,&nbsp;Gandolfini Ilaria,&nbsp;Palmisano Alessandra,&nbsp;Giuseppe Daniele Benigno,&nbsp;Gentile Micaela,&nbsp;Giovanni Maria Rossi,&nbsp;Fiaccadori Enrico,&nbsp;Maggiore Umberto","doi":"10.1016/j.trre.2024.100889","DOIUrl":"10.1016/j.trre.2024.100889","url":null,"abstract":"<div><div>The role of the complement system in antibody mediated rejection (AMR) emerged in the last decades, and the demonstration of the presence of complement fragments in renal allograft biopsies is a consolidated diagnostic sign of AMR. However, antibodies against donor antigens may lead to microvascular inflammation and endothelial injury even in the absence of complement activation, and growing evidence suggests that complement-independent mechanisms may be prominent in late (i.e., occurring &gt;6 months after transplantation) vs early AMR. Different donor specific antibodies (DSA) with different biological features and complement activation ability may be involved in late or early AMR. Downregulation of tissue complement inhibitors may happen early after transplantation, partially due to ischemia reperfusion injury, and could facilitate complement activation in early vs late AMR. Clinical and histological features of late AMR and C4d negative AMR seem to converge, and this narrative review analyzes the evidence that supports lower complement activation in late vs early AMR, including differential C4d staining prevalence based on the time after transplantation, differential response to anti-complement therapy and other direct and indirect signs of the complement system activation. The therapeutic approach in early vs late AMR should take into account possible differences in the pathophysiological mechanisms of microvascular inflammation and endothelial injury in early vs late AMR.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 1","pages":"Article 100889"},"PeriodicalIF":3.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703687","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":"Successful use of deceased donors with medically complex kidneys","authors":"Mita M. Shah,&nbsp;Clarkson Crane,&nbsp;Robert W. Steiner","doi":"10.1016/j.trre.2024.100888","DOIUrl":"10.1016/j.trre.2024.100888","url":null,"abstract":"<div><div>The number of patients waiting for kidney transplants from deceased organ donors continues to increase. In this context, non-transplantation of acceptable kidneys is especially regrettable. Here, we review successful transplantation of deceased donor kidneys with anatomic abnormalities, intrinsic kidney diseases, and other ostensibly problematic conditions. These scenarios will be encountered infrequently and, with limited time to decide, uncertainty often results in organ refusal. In general, anatomic abnormalities can be overcome, kidney diseases remit in recipients, and systemic donor conditions such as poisonings do not affect the recipient. Acknowledging the risk of publication bias and need for more long-term outcome data, familiarity with these “once in a lifetime” deceased donor kidneys potentially avoids unwarranted refusals and provides insights into many disease processes.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 1","pages":"Article 100888"},"PeriodicalIF":3.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722408","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":"Heart transplantation in adults with congenital heart diseases: A comprehensive meta-analysis on waiting times, operative, and survival outcomes","authors":"Abdulaziz Abdulelah Banaja ,&nbsp;Nicolae Cristian Bulescu ,&nbsp;Caroline Martin-Bonnet ,&nbsp;Marc Lilot ,&nbsp;Roland Henaine","doi":"10.1016/j.trre.2024.100886","DOIUrl":"10.1016/j.trre.2024.100886","url":null,"abstract":"<div><div>The rising prevalence of congenital heart disease (CHD) among adults has led to increased heart transplantation (HT) procedures in this population. However, CHD patients face significant challenges including longer waiting times, higher early mortality rates, and increased risks of complications such as renal dysfunction. This systematic review and meta-analysis examined 50 studies to assess waiting times, postoperative outcomes, and survival rates in CHD patients undergoing HT compared to non-CHD patients. Results revealed that CHD patients experience longer HT waiting times (mean difference [MD]: 53.86 days, 95 % CI: [22.00, 85.72], <em>P</em> = 0.0009) and increased ischemic times (MD: 20.01 min, 95 % CI: [10.51, 29.51], <em>P</em> &lt; 0.0001), which may increase waitlist and early postoperative mortality. Regarding complications, renal dysfunction is more prevalent in CHD patients than in non-CHD patients (RR: 2.05, 95 % CI: [1.61, 2.61], <em>P</em> &lt; 0.00001). Despite these challenges, long-term survival rates for CHD patients are comparable to those of non-CHD recipients, with significant improvements noted in recent allocation systems. Our findings emphasize the need for ongoing refinements in HT allocation systems to improve outcomes for CHD patients, particularly in reducing waiting times and managing post-transplant complications.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 1","pages":"Article 100886"},"PeriodicalIF":3.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703688","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":"Targeting complement in kidney transplantation: Therapeutic approaches based on preclinical and experimental evidence","authors":"Daigo Nakazawa","doi":"10.1016/j.trre.2024.100887","DOIUrl":"10.1016/j.trre.2024.100887","url":null,"abstract":"<div><div>The complement system is implicated in various facets of kidney transplantation, including ischemia-reperfusion injury (IRI), delayed graft function, allograft rejection, and chronic allograft injury. IRI, prevalent in cadaveric renal transplantation, leads to acute tubular necrosis and engages innate immunity, including neutrophils and the complement system, fostering a cycle of inflammation and necrosis. Experimental and preclinical evidence suggest that targeting the complement system could offer therapeutic benefits in IRI during kidney transplantation. This article explores potential therapeutic approaches targeting complement pathways in kidney transplantation, drawing from experimental and preclinical research findings.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 1","pages":"Article 100887"},"PeriodicalIF":3.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748170","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":"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}