Transplantation Reviews最新文献_第4页

Impact of donor-recipient size mismatch on post-transplant outcomes in kidney transplant recipients: A systematic review 供体-受体大小不匹配对肾移植受者移植后预后的影响：一项系统综述

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-12-01 Epub Date: 2025-09-05 DOI: 10.1016/j.trre.2025.100965

Sabaa Asif , Christie Rampersad , Ani Orchanian-Cheff , S. Joseph Kim

{"title":"Impact of donor-recipient size mismatch on post-transplant outcomes in kidney transplant recipients: A systematic review","authors":"Sabaa Asif , Christie Rampersad , Ani Orchanian-Cheff , S. Joseph Kim","doi":"10.1016/j.trre.2025.100965","DOIUrl":"10.1016/j.trre.2025.100965","url":null,"abstract":"<div><h3>Background</h3><div>Donor-recipient size mismatch builds on the nephron dosing concept, but studies suggest unclear associations with kidney allograft outcomes.</div></div><div><h3>Methods</h3><div>We systematically searched, critically appraised, and summarized associations between donor-recipient size mismatch and primary outcome of death-censored graft failure, secondary outcomes of kidney function, all-cause graft failure, and mortality. The study protocol was registered a priori on PROSPERO (ID CRD42023455394). We searched MEDLINE, Embase, and Cochrane Databases from 1946 to 2025 for studies evaluating adult kidney transplant recipients. We excluded non-English or unavailable full texts, and studies with donors <16 years old. Risk of bias was assessed using Risk of Bias in Non-randomized Studies – of Exposure tool. Studies were narratively synthesized; marked heterogeneity precluded quantitative meta-analysis.</div></div><div><h3>Results</h3><div>From 1521 citations, 56 studies were included. Sample sizes ranged from 23 to 238,895 donor-recipient pairs (median 214, IQR [95, 807]), with follow-up from 1 week to >20 years. Studies varied in size mismatch definitions, exposure subgrouping, outcomes, patient populations, and follow-up period. Overall, 32 % demonstrated worse kidney allograft outcomes with unfavorable size mismatch, 9 % showed no association, and 59 % reported mixed findings. All studies had high or very high risk of bias.</div></div><div><h3>Conclusions</h3><div>Available studies do not provide strong evidence to support or reject the idea of nephron underdosing, however existing reports were generally of poor quality, with high or very high risk of bias. Due to data heterogeneity, quantitative meta-analysis was not performed. Well-designed studies with clear exposure definitions, standardized outcome assessments, appropriate confounder control, adequate follow-up, and robust statistical analyses remain a priority.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 4","pages":"Article 100965"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048596","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}

引用次数: 0

Harnessing the TNF-TNFR pathway for graft tolerance: Selective immunomodulation in islet transplantation 利用TNF-TNFR通路促进移植物耐受：胰岛移植中的选择性免疫调节

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-12-01 Epub Date: 2025-09-08 DOI: 10.1016/j.trre.2025.100962

Qibin Wu , Yinglin Yuan , Hongji Yang , Qiang Fu

{"title":"Harnessing the TNF-TNFR pathway for graft tolerance: Selective immunomodulation in islet transplantation","authors":"Qibin Wu , Yinglin Yuan , Hongji Yang , Qiang Fu","doi":"10.1016/j.trre.2025.100962","DOIUrl":"10.1016/j.trre.2025.100962","url":null,"abstract":"<div><div>Islet transplantation represents a promising treatment for patients with insulin-dependent diabetes or unstable glycemic control. However, its widespread application faces two major challenges: a severe shortage of donor organs and persistent immune rejection. Recent studies consistently indicate that broad blockade of the TNFR signaling pathway is insufficient for controlling autoimmune inflammation. Instead, selectively attenuating the pro-inflammatory TNFR1 pathway while enhancing the anti-inflammatory TNFR2 pathway may offer a more effective strategy. This review is the first to explore, from an islet transplantation perspective, the potential of selective TNFR pathway targeting to promote graft tolerance. We specifically highlight the emerging role of regulatory B cells (Bregs) as key mediators in this process, and propose that targeted enhancement of their immunosuppressive function—particularly through the TNF-TNFR2 signaling axis—represents a promising therapeutic strategy to promote the induction of regulatory T cells (Tregs) and achieve durable transplant tolerance.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 4","pages":"Article 100962"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060255","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}

引用次数: 0

Disparities while listing for orthotopic heart transplantation: A systematic review and meta-analysis 列出原位心脏移植的差异：一项系统回顾和荟萃分析。

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-12-01 Epub Date: 2025-10-15 DOI: 10.1016/j.trre.2025.100968

Somkiat Phutinart , Akaravit Thamthanaruk , Noppachai Siranart , Watsapon Chuanchai , Walit Sowalertrat , Yanisa Chumpangern , Patavee Pajareya

{"title":"Disparities while listing for orthotopic heart transplantation: A systematic review and meta-analysis","authors":"Somkiat Phutinart , Akaravit Thamthanaruk , Noppachai Siranart , Watsapon Chuanchai , Walit Sowalertrat , Yanisa Chumpangern , Patavee Pajareya","doi":"10.1016/j.trre.2025.100968","DOIUrl":"10.1016/j.trre.2025.100968","url":null,"abstract":"<div><h3>Background</h3><div>Disparities in orthotopic heart transplant (OHT) listing exist due to race, gender, insurance access, socioeconomic status (SES) and access to healthcare. This study aims to investigate the impact of these factors on the inequities encountered within the pre-transplantation process.</div></div><div><h3>Methods</h3><div>Literature search was conducted up to July 2024, focusing on disparities in organ transplant outcomes. The primary endpoint was the recipient acceptance rate. Secondary endpoints were donor acceptance, waitlist urgency (status 1, 1A, or 1A exception), waitlist mortality (death while on the list), and waitlist duration (time from listing to transplantation).</div></div><div><h3>Results</h3><div>A total of 40 studies involving 506,459 patients at listing for OHT were included. Disparities in education level, gender, and insurance were not associated with recipient acceptance rate. However, black patients have a significantly lower recipient acceptance rate compared to the white patients (HR 0.86, 95 % CI: 0.84–0.89, I<sup>2</sup> = 15.8 %). For waitlist urgency, black patients were more likely to be listed for status 1 (OR 1.24, 95 % CI: 1.11–1.39, I<sup>2</sup> = 85.2 %). For waitlist mortality, there was no significant association with race, gender, insurance, income and education level, but the introduction of the 2018 policy led to a significantly lower waitlist mortality (HR 0.61, 95 % CI: 0.52–0.72, I<sup>2</sup> = 0.0 %).</div></div><div><h3>Conclusion</h3><div>Race remains a primary determinant of inequity in transplant access. Addressing racial disparity is crucial for achieving equitable access to care for all patients with end-stage heart disease.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 4","pages":"Article 100968"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319061","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}

引用次数: 0

The comparative performance of models predicting patient and graft survival after kidney transplantation: A systematic review 预测肾移植后患者和移植物生存的模型的比较性能：一项系统综述

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-07-01 Epub Date: 2025-05-02 DOI: 10.1016/j.trre.2025.100934

Joris van de Klundert , Francisco Perez-Galarce , Marcelo Olivares , Liset Pengel , Annelies de Weerd

{"title":"The comparative performance of models predicting patient and graft survival after kidney transplantation: A systematic review","authors":"Joris van de Klundert , Francisco Perez-Galarce , Marcelo Olivares , Liset Pengel , Annelies de Weerd","doi":"10.1016/j.trre.2025.100934","DOIUrl":"10.1016/j.trre.2025.100934","url":null,"abstract":"<div><h3>Background</h3><div>Cox proportional hazard models have long been the model of choice for survival prediction after kidney transplantation. In recent years, a variety of novel model types have been proposed. We investigate the prediction performance across different model types, including machine learning models and traditional model types.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following PROBAST and CHARMS, also considering extensions to TRIPOD+AI and PROBAST+AI, for data collection and risk of bias assessment. The review only included publications that reported on prediction performance for models of different types. A comparative analysis tested performance differences between the model types.</div></div><div><h3>Results</h3><div>The review included 37 publications which presented 134 comparative studies. The designs of many studies left room for improvement and most studies had high risk of bias. The collected data admitted testing of performance differences for 22 pairs of model types, ten of which yielded significant differences. Support Vector Machines and Logistic Regression were never found to outperform other model types. Other comparisons, however, provide inconclusive comparative performance results and none of the model types performed consistently and significantly better than alternatives.</div></div><div><h3>Conclusions</h3><div>Rigorous review of current evidence and comparative performance evidence finds no significant kidney transplant survival prediction performance differences that Cox Proportional Hazard models are being outperformed. The design of many of the studies implies high risk of bias and more and better designed studies which reutilize best performing models are needed. This enables to resolve model biases, reporting issues, and to increase the power of comparative performance analysis.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 3","pages":"Article 100934"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913062","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}

引用次数: 0

Use of decision algorithms for viscoelastic tests and use of blood products in patients undergoing liver transplantation: A systematic review with meta-analysis 在肝移植患者中使用决策算法进行粘弹性测试和使用血液制品：一项具有荟萃分析的系统综述

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-07-01 Epub Date: 2025-04-18 DOI: 10.1016/j.trre.2025.100932

Gilvandro Lins de Oliveira Júnior , Viviane Maria Bezerra Cavalcanti Lins , Virgínia Maria Bezerra Cavalcanti , Francisco Tustumi , Cassio Virgílio , Wellington Andraus

{"title":"Use of decision algorithms for viscoelastic tests and use of blood products in patients undergoing liver transplantation: A systematic review with meta-analysis","authors":"Gilvandro Lins de Oliveira Júnior , Viviane Maria Bezerra Cavalcanti Lins , Virgínia Maria Bezerra Cavalcanti , Francisco Tustumi , Cassio Virgílio , Wellington Andraus","doi":"10.1016/j.trre.2025.100932","DOIUrl":"10.1016/j.trre.2025.100932","url":null,"abstract":"<div><div>Introduction: Viscoelastic tests (VETs), including thromboelastography (TEG) and rotational thromboelastometry (ROTEM), provide a global assessment of hemostatic function. The use of a TEG or ROTEM system to guide the administration of blood products has been shown to reduce transfusion requirements in certain types of surgeries, but the decision algorithms for Viscoelastic tests needs to be assessed. This review aimed to assess all published evidence on viscoelastic testing in the context the use of decision algorithms for VETs on liver transplantation. Methods: A systematic review was performed in PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Studies assessing VETs for liver transplantation were considered for inclusion, analyzed according to the use or non-use of algorithms for VETs. Results: Out of the 279 studies initially identified, 17 studies were included in this review. Algorithms for VETs reduced red blood cell transfusion (−0.44 (95 % CI -0.62; −0.25; <em>p</em> < 0.01), while there was no significant difference with VETs without algorithms, and the overall measure showed a smaller reduction (−0.33; 95 % CI -0.61 to −0.04; <em>p</em> = 0.02). Conclusion: The results highlight the potential of algorithms for VETs to reduce the use of blood products in liver transplants.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 3","pages":"Article 100932"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873748","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}

引用次数: 0

Liver transplantation in patients with neurological Wilson disease: What can a five-decade systematic literature review teach us? 神经性威尔逊病患者的肝移植：50年的系统文献回顾能告诉我们什么？

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-07-01 Epub Date: 2025-06-07 DOI: 10.1016/j.trre.2025.100939

Aurélia Poujois , Rodolphe Sobesky , Nathalie Dorison , Mickael Alexandre Obadia , Dominique Debray

{"title":"Liver transplantation in patients with neurological Wilson disease: What can a five-decade systematic literature review teach us?","authors":"Aurélia Poujois , Rodolphe Sobesky , Nathalie Dorison , Mickael Alexandre Obadia , Dominique Debray","doi":"10.1016/j.trre.2025.100939","DOIUrl":"10.1016/j.trre.2025.100939","url":null,"abstract":"<div><h3>Background</h3><div>Neurological worsening occurs in up to 20 % of patients with Wilson disease and neurological involvement (neuroWD) despite optimal anti‑copper therapy. This study aimed to analyze the neurological outcomes of patients with neuroWD who underwent liver transplantation (LT) as a rescue therapy for neurological deterioration (Brain group), and to compare them with those who underwent LT for end-stage liver disease (ESLD) (Liver group).</div></div><div><h3>Methods</h3><div>A systematic PubMed search identified studies on neuroWD and LT published from January 1973 to January 2024.</div></div><div><h3>Results</h3><div>A total of 368 patients with neuroWD were identified, including 89 and 279 in the Brain and Liver groups, respectively. Post-LT survival rates were similar between groups (82 % <em>vs.</em> 86.6 %). Sepsis was the primary cause of death in both groups (68.7 % in the Brain group <em>vs.</em> 57.1 % in the Liver group). Among survivors beyond 1 year, 86.3 % in the Brain group and 79.7 % in the Liver group showed improvement or complete recovery from neuroWD. <em>De novo</em> post-LT neurological complications and calcineurin inhibitors-induced neurotoxicity were reported exclusively in the Liver group (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>LT is a viable option for neuroWD unresponsive to medical therapy. Delayed introduction or early minimization of calcineurin inhibitors is recommended for ESLD patients to reduce neurotoxicity. Further studies are needed to confirm these observations, as there are currently no evidence-based medicine criteria or standardized inclusion scales for LT in cases of neuro-WD.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 3","pages":"Article 100939"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271941","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}

引用次数: 0

Cognitive impairment assessments in kidney transplantation: A review 肾移植患者认知障碍评估综述

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-07-01 DOI: 10.1016/j.trre.2025.100940

Safaa Azzouz , Laurence Coté , Donald Doell , Alessia N. Paparella , Marcelo Cantarovich , Kathleen Gaudio , Shaifali Sandal

{"title":"Cognitive impairment assessments in kidney transplantation: A review","authors":"Safaa Azzouz , Laurence Coté , Donald Doell , Alessia N. Paparella , Marcelo Cantarovich , Kathleen Gaudio , Shaifali Sandal","doi":"10.1016/j.trre.2025.100940","DOIUrl":"10.1016/j.trre.2025.100940","url":null,"abstract":"<div><div>Mild cognitive impairment (CI) is not an absolute contraindication for kidney transplantation (KT). However, clinical assessment has not been standardized, and several practice challenges remain. We synthesized existing evidence on the effect of CI on adult kidney transplant recipients (KTRs) and KT candidates. Of the 1333 titles and abstracts screened, seven studies were eligible; all were observational. Our synthesis included 1035 KTRs and 4659 patients being evaluated for KT. Studies that used the Montreal Cognitive Assessment (38–55 %) reported a higher CI prevalence than those that used the Modified Mini-Mental State Exam (6–10 %). CI decreased the chances of KT waitlisting, however, the association with KT, graft loss and death varied by the cohort characteristics and tests used. The implications of our synthesis are limited by selection bias due to the exclusionary criterion, variability in tests and thresholds used. This may have misclassified participants with normal cognition as having CI and included those with dementia. Overall, additional evidence is needed to standardize the cognitive assessment of KTRs and candidates and inform clinical practice. A comprehensive assessment of cognition and function is indicated for the accurate diagnosis of CI, to determine CI severity, and to assess transplant candidacy.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 3","pages":"Article 100940"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563659","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}

引用次数: 0

Management of multidrug-resistant gram-negative bacilli infections in adult solid organ transplant recipients: GESITRA-IC/SEIMC, CIBERINFEC, and SET recommendations update. 成人实体器官移植受者多重耐药革兰氏阴性杆菌感染的管理：GESITRA-IC/SEIMC， CIBERINFEC和SET建议更新

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-07-01 Epub Date: 2025-05-21 DOI: 10.1016/j.trre.2025.100937

Isabel Rodríguez-Goncer , Elisa Ruiz-Arabi , Sabina Herrera , Nuria Sabé , Ibai Los-Arcos , José Tiago Silva , Elena Pérez-Nadales , Isabel Machuca , Rocío Álvarez , Maricela Valerio , Juan José Castón , Victoria Aguilera , Marta Bodro , Ángela Cano , Rafael Cantón , Purificación Carmona , Jordi Carratalà , Elisa Cordero , Josep María Cruzado , María Carmen Fariñas , José María Aguado

{"title":"Management of multidrug-resistant gram-negative bacilli infections in adult solid organ transplant recipients: GESITRA-IC/SEIMC, CIBERINFEC, and SET recommendations update.","authors":"Isabel Rodríguez-Goncer , Elisa Ruiz-Arabi , Sabina Herrera , Nuria Sabé , Ibai Los-Arcos , José Tiago Silva , Elena Pérez-Nadales , Isabel Machuca , Rocío Álvarez , Maricela Valerio , Juan José Castón , Victoria Aguilera , Marta Bodro , Ángela Cano , Rafael Cantón , Purificación Carmona , Jordi Carratalà , Elisa Cordero , Josep María Cruzado , María Carmen Fariñas , José María Aguado","doi":"10.1016/j.trre.2025.100937","DOIUrl":"10.1016/j.trre.2025.100937","url":null,"abstract":"<div><div>Multidrug-resistant (MDR) Gram-negative bacilli (GNB) infections in solid organ transplant (SOT) recipients continue to pose a significant threat despite advances in diagnostics and treatments. The last international consensus guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) on the management of MDR GNB in adult solid organ transplant (SOT) recipients were published in 2018, underscoring the need for an update to incorporate recent advances, particularly the availability of new drugs that may improve the current standard of care. A working group consisting of members from the Study Group of Infection in Transplantation and Immunocompromised Hosts (GESITRA-IC) of SEIMC, the Center for Biomedical Research Network in Infectious Diseases (CIBERINFEC) and the Spanish Society of Transplantation (SET) developed consensus-based recommendations for managing MDR GNB infections during the transplant procedure. Recommendations were categorized based on evidence quality and strength, utilizing 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.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 3","pages":"Article 100937"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124257","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}

引用次数: 0

Effect of donor body weight on en bloc pediatric kidney transplantation in adults: A systematic review and meta-analysis 供体体重对成人整体儿童肾移植的影响：系统回顾和荟萃分析

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-07-01 Epub Date: 2025-03-28 DOI: 10.1016/j.trre.2025.100918

Haichen Yan , Yitian Fang , Jacqueline van de Wetering , Hendrikus J.A.N. Kimenai , Ron W.F. de Bruin , Robert C. Minnee

{"title":"Effect of donor body weight on en bloc pediatric kidney transplantation in adults: A systematic review and meta-analysis","authors":"Haichen Yan , Yitian Fang , Jacqueline van de Wetering , Hendrikus J.A.N. Kimenai , Ron W.F. de Bruin , Robert C. Minnee","doi":"10.1016/j.trre.2025.100918","DOIUrl":"10.1016/j.trre.2025.100918","url":null,"abstract":"<div><h3>Background</h3><div>The shortage of donor grafts for kidney transplantation remains a critical challenge. En bloc kidney transplantation (EBKT) using small deceased pediatric donors has the potential to expand the donor pool. This review aimed to investigate the outcomes of pediatric-donor EBKT in adults compared with standard single kidney transplantation (SKT).</div></div><div><h3>Methods</h3><div>Relevant databases, including Ovid, Web of Knowledge, Google Scholar, Wiley, and Embase, were searched for eligible studies. Demographic data and transplant outcomes were extracted from the included studies. The primary outcome was graft survival. A random-effects model was used for the meta-analysis.</div></div><div><h3>Results</h3><div>Thirteen studies were included. The median 1-year graft survival rates were 83.8 % and 89.2 % for EBKT and SKT, respectively (risk ratio [RR], 0.97; 95 % confidence interval [CI], 0.93–1.01). The median 5-year graft survival rates were 78.7 % and 72.7 % for EBKT and SKT, respectively (RR, 1.05; 95 % CI, 0.93–1.19). For donors with a body weight > 10 kg (EBKT >10 kg) and ≤ 10 kg (EBKT ≤10 kg), the median 1-year graft survival rates were 100.0 % and 90.0 %, respectively (RR, 1.08; 95 % CI, 1.05–1.12). Vascular complications were identified as the primary cause of graft loss.</div></div><div><h3>Conclusions</h3><div>Pediatric-donor EBKT in adults is a safe approach with excellent long-term functional outcomes comparable to those of SKT. EBKT represents an effective option to further utilizing pediatric donor kidneys. Outcomes of EBKT vary based on donor body weight. EBKT ≤10 kg was associated with higher short-term graft failure rates despite long-term performance being comparable to EBKT >10 kg.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"39 3","pages":"Article 100918"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767753","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}

引用次数: 0

Cardiac allograft vasculopathy and the endothelial glycocalyx: a missing link? 异体心脏移植血管病变与内皮糖萼：缺失的一环？

IF 3.6 2区医学

Transplantation Reviews Pub Date : 2025-07-01 Epub Date: 2025-05-18 DOI: 10.1016/j.trre.2025.100936

Mitchell J. Wagner , Michael Khoury , Jennifer Conway , Darren H. Freed

引用次数: 0