Transplantology最新文献

The Impact of Early-to-Moderate Stage Chronic Kidney Disease on Hospitalization Outcomes in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplant: A Nationwide Analysis Using the National Inpatient Sample Database (2002–2019) 早中期慢性肾病对异体造血干细胞移植患者住院结果的影响：利用全国住院患者样本数据库进行的全国性分析（2002-2019年）

Transplantology Pub Date : 2024-07-23 DOI: 10.3390/transplantology5030014

Mohammad Ammad Ud Din, Qurratul Ain, Muhammad Shan Ul Abedin, M. Shahzad, M. Mushtaq

{"title":"The Impact of Early-to-Moderate Stage Chronic Kidney Disease on Hospitalization Outcomes in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplant: A Nationwide Analysis Using the National Inpatient Sample Database (2002–2019)","authors":"Mohammad Ammad Ud Din, Qurratul Ain, Muhammad Shan Ul Abedin, M. Shahzad, M. Mushtaq","doi":"10.3390/transplantology5030014","DOIUrl":"https://doi.org/10.3390/transplantology5030014","url":null,"abstract":"Many patients with a hematologic malignancy have other pre-existing conditions at the time of consideration of an allogeneic stem cell transplant (allo-HSCT). Among these, mild-to-moderate chronic kidney disease (CKD) is a common comorbid condition that can potentially impact the rates of non-relapse mortality among transplant patients. While the risk of severe CKD on allo-HSCT is well recognized, there remains a paucity of data in terms of the impact of mild-to-moderate CKD on patient outcomes in this setting. Using data from the National Inpatient Sample database, we aimed to investigate the impact of mild-to-moderate CKD on hospitalization outcomes for patients undergoing an allo-HSCT. Multivariate analysis revealed that CKD patients had a 31% higher risk of all-cause mortality (OR = 1.31, 95% CI: 1.01–1.70; p = 0.04) and a higher risk of other common hospitalization complications, including acute kidney injury, acute pulmonary edema, cardiac arrhythmias, and septic shock. While this study has limitations, including its retrospective nature and lack of specific medication data, it underscores the importance of considering CKD as a significant risk factor in allo-HSCT outcomes.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"69 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Embolization of a Hepatic Arterio-Portal Venous Fistula to Treat Portal Hypertension in a Liver Transplant Recipient 栓塞肝动脉-门静脉瘘以治疗肝移植受者的门静脉高压症

Transplantology Pub Date : 2024-06-11 DOI: 10.3390/transplantology5020011

Ji Ae Yoon, Cherng Chao, Z. Lominadze

引用次数: 0

Histocompatibility Testing: A Fundamental Aspect of Renal Transplant Workup 组织相容性测试：组织相容性测试：肾移植检查的基本要素

Transplantology Pub Date : 2024-05-15 DOI: 10.3390/transplantology5020009

V. Mishra, Dinesh Chandra, V. Raina

{"title":"Histocompatibility Testing: A Fundamental Aspect of Renal Transplant Workup","authors":"V. Mishra, Dinesh Chandra, V. Raina","doi":"10.3390/transplantology5020009","DOIUrl":"https://doi.org/10.3390/transplantology5020009","url":null,"abstract":"Histocompatibility testing is pivotal in any renal transplantation workup, aimed at enhancing prospective donor recipient compatibility and improving transplant outcomes. The evolution and advancement of histocompatibility testing, particularly HLA typing, have significantly improved its precision. This study outlines the historical progression from serologic to DNA-based HLA typing, emphasizing the role of HLA proteins in immune response. Anti-HLA antibodies, targeting HLA proteins, pose challenges in renal transplantation. Monitoring and managing these antibodies are critical for renal transplant success. Complement-dependent cytotoxicity crossmatch and flow cytometry crossmatch are essential techniques for assessing donor–recipient compatibility. Panel-reactive antibody assesses antibodies against a panel of donor antigens, often HLA. Higher PRA levels (percentage) complicate donor matching, requiring specialized protocols. Virtual crossmatch evaluates recipient anti-HLA antibodies against potential donors through synthetic beads. This approach predicts crossmatch outcomes by comparing antibody profiles, offering a valuable tool for the risk assessment of renal transplantation. Despite advancements, a comprehensive understanding of alloreactive immune responses requires a combination of assays, emphasizing the importance of a multifaceted approach in histocompatibility testing. This is an attempt to compile the relevant information, providing a basis for comparison in a clear and foundational format for histocompatibility testing laboratories.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"48 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140973955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Normal Renal Function to Renal Replacement Therapy after Liver Transplantation: A Case Report 肝移植后从肾功能正常到肾脏替代治疗：病例报告

Transplantology Pub Date : 2024-04-11 DOI: 10.3390/transplantology5020007

Samuel Mangold, G. Albu, J. Maillard, Florence Aldenkortt, Eduardo Schiffer

引用次数: 0

Wasted Potential: Decoding the Trifecta of Donor Kidney Shortage, Underutilization, and Rising Discard Rates 浪费潜力：解密捐肾短缺、利用率不足和弃肾率上升的三部曲

Transplantology Pub Date : 2024-03-28 DOI: 10.3390/transplantology5020006

Ceilidh McKenney, Julia Torabi, Rachel Todd, M. Z. Akhtar, F. Tedla, Ron Shapiro, Sander Florman, M. Holzner, L. V. van Leeuwen

{"title":"Wasted Potential: Decoding the Trifecta of Donor Kidney Shortage, Underutilization, and Rising Discard Rates","authors":"Ceilidh McKenney, Julia Torabi, Rachel Todd, M. Z. Akhtar, F. Tedla, Ron Shapiro, Sander Florman, M. Holzner, L. V. van Leeuwen","doi":"10.3390/transplantology5020006","DOIUrl":"https://doi.org/10.3390/transplantology5020006","url":null,"abstract":"Kidney transplantation is a life-saving intervention for end-stage renal disease; yet, the persistent gap between organ demand and supply remains a significant challenge. This paper explores the escalating discard rates of deceased donor kidneys in the United States to assess trends, discard reasons, demographical differences, and preservation techniques. Data from the Scientific Registry of Transplant Recipients from 2010 to 2021 was analyzed using chi-squared tests for trend significance and logistic regression to estimate odds ratios for kidney discard. Over the last decade, discard rates have risen to 25% in 2021. Most discarded kidneys came from extended criteria donor (ECD) donors and elevated kidney donor profile index (KDPI) scores. Kidney biopsy status was a significant factor and predictor of discard. Discard rates varied greatly between Organ Procurement and Transplantation Network regions. Of reasons for discard, “no recipient located” reached a high of 60%. Additionally, there has been a twofold increase in hypothermic machine perfusion (HMP) since 2010, with transportation difficulties being the main reason for the discard of perfused kidneys. Our findings suggest a need to recalibrate organ utilization strategies, optimize the use of lower-quality kidneys through advanced preservation methods, and address the evolving landscape of organ allocation policies to reduce kidney discard rates.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"143 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel Study of SARS-CoV-2 RNA in Post-Reperfusion Liver Biopsies after Transplantation Using COVID-19-Positive Donor Allografts 使用 COVID-19 阳性供体异体移植后再灌注肝活检中 SARS-CoV-2 RNA 的新研究

Transplantology Pub Date : 2024-03-16 DOI: 10.3390/transplantology5010005

Jenna N. Whitrock, Michela M. Carter, Adam D. Price, A. Delman, Catherine G. Pratt, Jiang Wang, Divya Sharma, R. Quillin, Shimul A. Shah

{"title":"Novel Study of SARS-CoV-2 RNA in Post-Reperfusion Liver Biopsies after Transplantation Using COVID-19-Positive Donor Allografts","authors":"Jenna N. Whitrock, Michela M. Carter, Adam D. Price, A. Delman, Catherine G. Pratt, Jiang Wang, Divya Sharma, R. Quillin, Shimul A. Shah","doi":"10.3390/transplantology5010005","DOIUrl":"https://doi.org/10.3390/transplantology5010005","url":null,"abstract":"The utilization of COVID-19-positive donors has expanded the donor pool for transplantation since the initiation of COVID allograft utilization protocols. However, the biopsy-proven PCR transmission rate of COVID-19 from these allografts has not been well documented. In August 2021, an institutional COVID-19-positive allograft protocol was implemented for liver and kidney transplants. Post-reperfusion liver biopsies were obtained intra-operatively to evaluate for COVID-19 RNA, and post-operative day 7 nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR) swabs were collected. The primary endpoints evaluated included COVID-19 RNA on biopsy and COVID-19 detected via nasopharyngeal RT-PCR swab on post-operative day 7. A total of 20 vaccinated recipients underwent transplantation (17 liver only, 3 simultaneous liver and kidney) with whole liver allografts from 20 COVID-19-positive deceased donors between August 2021 and April 2022. 95% (19/20) of donors were asymptomatic at the time of donation. On post-reperfusion liver allograft biopsies, COVID-19 RNA was found in 10% (2/20) of the samples. All the recipients were COVID-19-negative on post-operative day 7 nasopharyngeal RT-PCR, showing a 0% transmission rate of COVID-19 from the positive allografts. The use of COVID-19 allografts appears to be a safe practice, with no PCR-detectable transmission of COVID-19 despite 10% of the liver allografts having COVID-19 RNA present on post-reperfusion biopsy.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"10 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140236134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pre-Emptive Kidney Retransplantation from Deceased Donors 从已故捐献者处进行先天性肾脏再移植

Transplantology Pub Date : 2024-02-28 DOI: 10.3390/transplantology5010004

A. Franco Esteve, P. Más-Serrano, Fransico Manuel Marco, Eduardo Garin Cascales, Francisco Javier Pérez Contreras

{"title":"Pre-Emptive Kidney Retransplantation from Deceased Donors","authors":"A. Franco Esteve, P. Más-Serrano, Fransico Manuel Marco, Eduardo Garin Cascales, Francisco Javier Pérez Contreras","doi":"10.3390/transplantology5010004","DOIUrl":"https://doi.org/10.3390/transplantology5010004","url":null,"abstract":"There is uncertainty about the best approach to replacement treatment for kidney transplant recipients with chronic terminal graft dysfunction, since a retransplant could be performed before the resumption of dialysis, thus avoiding this treatment and the dilemma of whether or not to suspend immunosuppressive therapy. However, there is limited experience in pre-emptive repeat transplantations, and none from deceased donors. This study aims to assess the results of a pre-emptive retransplantation program with brain-dead deceased donors. We designed a retrospective matched cohort study, including 36 recipients in the pre-dialysis group and 36 controls who were already on dialysis, matched for donor age and transplant date, which could not differ by more than 7 days between pairs. The variables used to standardize the cohorts were donor and recipient age and sex, blood group, duration of the first graft, time on the waitlist to receive the second graft, cold ischemia time, induction and maintenance of immunosuppression, and HLA antibodies (-) prior to retransplantation. The efficacy variables were early graft loss, acute rejection, delay in graft function, renal function at the end of follow-up, survival time, and recipient and graft survival at 24 and 48 months’ follow-up. The pre-dialysis group presented a significantly shorter waitlist time, lower immunization status, and a significantly longer duration of the first graft than the control group. The percentage of recipients who presented early graft loss, delayed renal function, or acute rejection was similar between groups. No significant differences were observed in kidney function or in the survival of the recipient or graft. Retransplantation yields good outcomes in patients with terminal chronic dysfunction, helping to avoid recurrence to dialysis, shortening the time spent on the waitlist, reducing the risk of producing antibodies, and resolving the dilemma of whether or not to stop immunosuppression.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"82 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140422883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Availability of Deceased Donors for Uterus Transplantation in the United States: Perception vs. Reality 美国用于子宫移植的死亡供体的可用性：观念与现实

Transplantology Pub Date : 2024-02-04 DOI: 10.3390/transplantology5010003

Kathleen O'Neill, Elliott G. Richards, Jessica Walter, Sharon West, Richard Hasz, Giuliano Testa, Shreya Kalra, Tommaso Falcone, R. Flyckt, Nawar Latif, A. Tzakis, L. Johannesson

{"title":"Availability of Deceased Donors for Uterus Transplantation in the United States: Perception vs. Reality","authors":"Kathleen O'Neill, Elliott G. Richards, Jessica Walter, Sharon West, Richard Hasz, Giuliano Testa, Shreya Kalra, Tommaso Falcone, R. Flyckt, Nawar Latif, A. Tzakis, L. Johannesson","doi":"10.3390/transplantology5010003","DOIUrl":"https://doi.org/10.3390/transplantology5010003","url":null,"abstract":"Uterus transplantation (UTx) is a rapidly evolving treatment for uterine factor infertility. New centers offering this treatment must decide whether to utilize living donors, deceased donors, or both. Although limiting UTx to deceased donors eliminates the surgical risks for living donors, an adequate supply of suitable deceased uterus donors in the United States is an emerging concern. Previous studies describing the paucity of deceased uterus donors failed to consider key donor characteristics, potentially overestimating the available organ pool. To estimate the United States’ supply of deceased donor uteri; we extrapolated detailed clinical and demographic information from the regional donor datasets available from three organ procurement organizations to the national Organ Procurement and Transplantation Network donor pool. We estimate there are approximately 3700 possible and 400 optimal uterus donors annually in the United States. Given these projections and the number of women with uterine factor infertility in the U.S. who pursue parenthood through alternative strategies, we conclude that, as uterus transplant transitions from research to established clinical care, demand could quickly exceed the deceased donor supply. The liberalization of deceased donor selection criteria may be insufficient to address this imbalance; therefore, fulfilling the anticipated increased demand for uterus transplantation may require and justify greater use of living donors.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"10 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Availability of Deceased Donors for Uterus Transplantation in the United States: Perception vs. Reality 美国用于子宫移植的死亡供体的可用性：观念与现实

Transplantology Pub Date : 2024-02-04 DOI: 10.3390/transplantology5010003

Kathleen O'Neill, Elliott G. Richards, Jessica Walter, Sharon West, Richard Hasz, Giuliano Testa, Shreya Kalra, Tommaso Falcone, R. Flyckt, Nawar Latif, A. Tzakis, L. Johannesson

{"title":"Availability of Deceased Donors for Uterus Transplantation in the United States: Perception vs. Reality","authors":"Kathleen O'Neill, Elliott G. Richards, Jessica Walter, Sharon West, Richard Hasz, Giuliano Testa, Shreya Kalra, Tommaso Falcone, R. Flyckt, Nawar Latif, A. Tzakis, L. Johannesson","doi":"10.3390/transplantology5010003","DOIUrl":"https://doi.org/10.3390/transplantology5010003","url":null,"abstract":"Uterus transplantation (UTx) is a rapidly evolving treatment for uterine factor infertility. New centers offering this treatment must decide whether to utilize living donors, deceased donors, or both. Although limiting UTx to deceased donors eliminates the surgical risks for living donors, an adequate supply of suitable deceased uterus donors in the United States is an emerging concern. Previous studies describing the paucity of deceased uterus donors failed to consider key donor characteristics, potentially overestimating the available organ pool. To estimate the United States’ supply of deceased donor uteri; we extrapolated detailed clinical and demographic information from the regional donor datasets available from three organ procurement organizations to the national Organ Procurement and Transplantation Network donor pool. We estimate there are approximately 3700 possible and 400 optimal uterus donors annually in the United States. Given these projections and the number of women with uterine factor infertility in the U.S. who pursue parenthood through alternative strategies, we conclude that, as uterus transplant transitions from research to established clinical care, demand could quickly exceed the deceased donor supply. The liberalization of deceased donor selection criteria may be insufficient to address this imbalance; therefore, fulfilling the anticipated increased demand for uterus transplantation may require and justify greater use of living donors.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"1994 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139807426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Personality Changes Associated with Organ Transplants 与器官移植有关的性格变化

Transplantology Pub Date : 2024-01-17 DOI: 10.3390/transplantology5010002

Brian Carter, Laveen Khoshnaw, Megan Simmons, Lisa Hines, Brandon Wolfe, Mitchell Liester

{"title":"Personality Changes Associated with Organ Transplants","authors":"Brian Carter, Laveen Khoshnaw, Megan Simmons, Lisa Hines, Brandon Wolfe, Mitchell Liester","doi":"10.3390/transplantology5010002","DOIUrl":"https://doi.org/10.3390/transplantology5010002","url":null,"abstract":"Personality changes have been reported following organ transplantation. Most commonly, such changes have been described among heart transplant recipients. We set out to examine whether personality changes occur following organ transplantation, and specifically, what types of changes occur among heart transplant recipients compared to other organ recipients. A cross-sectional study was conducted in which 47 participants (23 heart recipients and 24 other organ recipients) completed an online survey. In this study, 89% of all transplant recipients reported personality changes after undergoing transplant surgery, which was similar for heart and other organ recipients. The only personality change that differed between heart and other organ recipients and that achieved statistical significance was a change in physical attributes. Differences in other types of personality changes were observed between these groups but the number of participants in each group was too small to achieve statistical significance. Overall, the similarities between the two groups suggest heart transplant recipients may not be unique in their experience of personality changes following transplantation, but instead such changes may occur following the transplantation of any organ. With the exception of physical attributes, the types of personality changes reported were similar between the two groups. These finding indicate that heart transplant recipients are not unique in their reported experience of personality changes following organ transplantation. Further studies are needed to deepen our understanding of what causes these personality changes.","PeriodicalId":503806,"journal":{"name":"Transplantology","volume":"12 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139527458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0