Experimental and Clinical Transplantation最新文献

{"title":"Erythema Multiforme after Liver Transplant: A Rare Pediatric Case Report.","authors":"İrem Nacakgediği Turgay, Resmiye Ebru Tirali, Burcu Belen Apak, Pamir Işık, Azize Ceren Kılcı, Kenan Araz, Mehmet Haberal","doi":"10.6002/ect.2026.0023","DOIUrl":"https://doi.org/10.6002/ect.2026.0023","url":null,"abstract":"<p><p>This case report presents a 3-year-old female patient with erythematous lesions in the mouth and lips. She initially showed symptoms such as abdominal pain, vomiting, pale stools, and dark urine. Imaging revealed a large hepatic mass, diagnosed as alveolar rhabdomyosarcoma via biopsy. Chemotherapy began while metastasis was under evaluation. After 3 cycles of chemotherapy, she underwent tumor resection and liver transplant, followed by continued chemotherapy. Oral lesions that shifted from yellow-white to purple-brown appeared during treatment and were preliminarily diagnosed as erythema multiforme. Adjuvant therapy was administered accordingly.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"744-747"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted Radical Prostatectomy in Kidney Transplant Recipients: an Updated Systematic Review and Surgical Perspective>.","authors":"Pavel Navratil, Hanka Princlova, Olec Izmaylov, Minh Nguyet Tranova","doi":"10.6002/ect.2026.0122","DOIUrl":"10.6002/ect.2026.0122","url":null,"abstract":"<p><strong>Objectives: </strong>Persistent hyperparathyroidism and calcitriol deficiency coexist in most long -term kidney transplant recipients, yet the combined skeletal effects of these presentations have not been formally quantified.</p><p><strong>Materials and methods: </strong>In this cross -sectional analytical study at People's Hospital 115 (Ho Chi Minh City, Vietnam ), we studied 135 kidney transplant recipients (mean age 51.0 ± 11.3 years; 66.7 % male; mean time posttransplant 71.4 ± 28.1 months ) who underwent simultaneous measurement of serum intact parathyroid hormone, 1,25 -dihydroxyvitamin D, and dual -energy x -ray absorptiometry at 3 skeletal sites. A prespecified piecewise ordinary least -squares model characterized the relationship between parathyroid hormone and bone mineral density; a confirmatory sensitivity analysis used KDIGO -motivated breakpoint of 65 pg /mL for parathyroid hormone. We evaluated parathyroid hormone -to -vitamin D ratio as a prespecified secondary exposure measure.</p><p><strong>Results: </strong>Bone loss (worst -site T score of < -1.0 ) was present in 103 participants (76.3 % ) and osteoporosis in 27 (20.0 % ). The confirmatory piecewise model at 65 pg /mL demonstrated that above -threshold parathyroid hormone was inversely associated with T -score composite ( β = -0.00367 per pg /mL; bootstrap 95 % CI, -0.0066 to -0.0013; P < .001 ), a 100 pg /mL increment above the threshold corresponded to a -0.37 T -score decrement. Body mass index was the strongest predictor (β = +0.129 per kg /m ²; P < .001 ). The ratio of parathyroid hormone to vitamin D (ρ = -0.262; P = .002 ) provided modestly better model fit than parathyroid hormone alone (R ² = 0.247 vs 0.229; change in Akaike Information Criterion = 3.2 ).</p><p><strong>Conclusions: </strong>Parathyroid hormone exerted a threshold -dependent inverse effect on bone mineral density in long -term kidney transplant recipients, confirmed at the KDIGO lower boundary of 65 pg /mL. The ratio of parathyroid hormone to vitamin D captured the combined mineral burden more efficiently than parathyroid hormone level alone, warranting further prospective evaluation as a monitoring target in posttransplant mineral disease.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"664-675"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic Pathologies Requiring Surgical or Interventional Management in Solid-Organ Transplant Recipients.","authors":"Ayse Ugurum Yucemen, Sinan Issi, Adem Safak, Emre Karakaya, Sedat Yildirim, Dalokay Kilic, Mehmet Haberal","doi":"10.6002/ect.2026.0249","DOIUrl":"https://doi.org/10.6002/ect.2026.0249","url":null,"abstract":"<p><strong>Objectives: </strong>Thoracic pathologies are important causes of morbidity in solid-organ transplant recipients because of chronic immunosuppression, transplant-related complications, and diverse underlying etiologies. We aimed to evaluate thoracic pathologies requiring surgical or interventional management after solid-organ transplantation, present our clinical outcomes, and propose an anatomical management framework for these complex conditions.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study at a tertiary referral center of solid-organ transplant recipients who underwent surgical or interventional treatment for thoracic pathologies between 2010 and 2025. Patients who were managed conservatively or patients who had incomplete clinical data were excluded. Demographic characteristics, transplant-related variables, thoracic pathology type, surgical or interventional procedures, histopathological findings, postoperative complications, and clinical outcomes were analyzed descriptively.</p><p><strong>Results: </strong>Twenty-one transplant recipients underwent 28 thoracic interventions during the study period. The cohort included 12 liver, 8 kidney, and 1 heart transplant recipient, with a mean age of 42.0 ± 22.2 years; 66.7% were male. Thoracic pathologies involved pleural, parenchymal, and mediastinal compartments and required individualized management using tube thoracostomy, video-assisted thoracoscopic surgery, thoracotomy, or mediastinoscopy. Histopathological evaluation demonstrated a broad spectrum of infectious, inflammatory, and malignant diseases, including aspergilloma, tuberculosis, primary lung carcinoma, hepatocellular carcinoma metastasis, inflammatory pseudotumor, and polymorphic post-transplant lymphoproliferative disease. Postoperative complications occurred in 2 patients (9.5% ). One patient required 2 subsequent thoracotomies for prolonged air leak caused by a parenchymal fistula and postoperative hemothorax, whereas another underwent rethoracotomy for recurrent hemorrhage after initial surgical treatment of hemothorax.</p><p><strong>Conclusions: </strong>Thoracic pathologies following solid-organ transplant comprise a heterogeneous group of conditions requiring individualized multidisciplinary management. Surgical and interventional procedures play a pivotal role in both establishing definitive diagnoses and providing effective treatment. Early recognition, careful patient selection, and pathology-specific management strategies may improve clinical outcomes in this complex and high-risk population.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"738-743"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Liver Variations in a Pediatric Donor With Heterotaxy Syndrome: Should This Organ be Utilized?","authors":"David Walls, Om Prakash, Piyush Gupta, Brian Nguyen, Thomas Fishbein, Gabriel Gondolesi","doi":"10.6002/ect.2026.0233","DOIUrl":"https://doi.org/10.6002/ect.2026.0233","url":null,"abstract":"","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"755-758"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Virus Recurrence After Liver Transplant for Hepatitis B Virus-Related Liver Disease: A Retrospective Analysis of Hepatitis B Immunoglobulin Discontinuation.","authors":"Hakan Aktuna, Nilay Daniş, Hüseyin Döngelli, Aylin Bacakoğlu, Tarkan Ünek, Vildan Avkan Oğuz, Tufan Egeli, Cihan Ağalar, Mücahit Özbilgin, Mesut Akarsu","doi":"10.6002/ect.2026.0025","DOIUrl":"https://doi.org/10.6002/ect.2026.0025","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatitis B virus recurrence after liver transplant remains a clinically relevant issue, but the optimal duration and safety of hepatitis B immunoglobulin therapy, particularly its discontinuation, remain unclear. Here, we evaluated the incidence and risk factors of posttransplant hepatitis B virus recurrence and assessed outcomes following elective discontinuation of hepatitis B immunoglobulin in a real-world cohort.</p><p><strong>Materials and methods: </strong>We conducted a retrospective single-center cohort study of consecutive adult patients who underwent liver transplant for hepatitis B virus-related liver disease between 1997 and 2023. Hepatitis B virus recurrence was defined as the reappearance of hepatitis B surface antigen and/or detectable hepatitis B virus DNA. We used Cox proportional hazards models to identify factors associated with recurrence and overall survival. We conducted a predefined subgroup analysis to evaluate patients who underwent elective discontinuation of hepatitis B immunoglobulin during antiviral therapy.</p><p><strong>Results: </strong>Among 254 liver transplant recipients, 39 (15.4% ) developed posttransplant hepatitis B virus recurrence. In multivariable analysis, pretransplant hepatitis B virus DNA levels >5 log10 copies/mL (hazard ratio 3.68; 95% CI, 1.82-7.46) and hepato-cellular carcinoma at transplant (hazard ratio 2.38; 95% CI, 1.22-4.65) were independently associated with recurrence, whereas hepatitis D virus coinfection was inversely associated (hazard ratio 0.18; 95% CI, 0.08-0.43). Elective hepatitis B immunoglobulin discontinuation was not associated with increased hepatitis B virus recurrence and was primarily performed in clinically selected low-risk patients. Posttransplant hepatitis B virus recurrence was associated with reduced overall survival.</p><p><strong>Conclusions: </strong>In this long-term, real-world cohort, posttransplant hepatitis B virus recurrence was mainly driven by the pretransplant viral burden and oncological factors. Elective hepatitis B immunoglobulin discontinuation in carefully selected patients was not associated with increased recurrence, likely reflecting the underlying risk stratification rather than a causal protective effect. These findings support the use of individualized risk-based hepatitis B immunoglobulin strategies after liver transplant.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"728-737"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polytetrafluoroethylene Patch Angioplasty for the Salvage of Near-Hilar Renal Artery Intimal Injury in Living Donor Kidney Transplant: A Case Report and Literature Review.","authors":"Hany M El Hennawy, Mostafa Marzouk, Tariq Jaber, Abdullah M Alharthi, Ghaleb Abo Alsameh, Turki A Banamah, Majed M Alharthi, Nashat Al Otibi, Omar Safar, Fadil Hassan","doi":"10.6002/ect.2026.0100","DOIUrl":"10.6002/ect.2026.0100","url":null,"abstract":"<p><strong>Objectives: </strong>Renal artery intimal injury during kidney transplant is infrequent but potentially devastating, especially when situated near the hilar trifurcation, where standard reconstruction techniques are frequently unfeasible. Prompt identification is difficult because the arterial pulse may persist despite significant luminal obstruction. We report a case involving a 24-year-old female living donor whose left kidney was transplanted into a 54-year-old male recipient with end-stage renal disease. Although initial reperfusion appeared satisfactory, the graft gradually became cyanotic and soft during the procedure. Doppler signals remained preserved, and there was no response to vasodilatory interventions. We suspected arterial inflow impairment, and so we proceeded with inspection of the vascular anastomoses and revealed intimal disruption with significant luminal narrowing at the hilar trifurcation. Given the lack of a reconstructible distal arterial segment, patch angioplasty was performed using an expanded polytetrafluoroethylene graft, thereby forming a composite arterial conduit while preserving the posterior native wall. Following reimplantation, graft perfusion improved, showing satisfactory intraoperative Doppler findings. The graft produced immediate urine output, although the postoperative course was complicated by severe acute tubular necrosis due to prolonged warm ischemia time (87 minutes). At 6 weeks, the patient remained independent from dialysis with a serum creatinine of 300 μmol/L (estimated glomerular filtration rate 21 mL/min/1.73 m2). Doppler ultrasonography confirmed sustained graft patency without evidence of stenosis or thrombosis, and a renal allograft biopsy showed no rejection. Further functional recovery remains possible but uncertain. To our knowledge, this is among the first reports of polytetrafluoroethylene patch angioplasty for treatment of near-hilar intimal injury in a living donor transplant. Polytetrafluoroethylene patch angioplasty constitutes a viable salvage methodology for near-hilar renal artery intimal injury in living donor kidney transplant. Polytetrafluoroethylene patch angioplasty achieves graft patency and dialysis-independent survival, even in cases with extended duration of warm ischemia time that may delay functional recovery.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"748-754"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life in Kidney Transplant Recipients: A Single-Center Experience From a Lower-Middle Income Country.","authors":"Nazarul Hassan Jafry, Anum Rizwan, Tajammul Waqar, Nazia Fatima","doi":"10.6002/ect.2026.0052","DOIUrl":"https://doi.org/10.6002/ect.2026.0052","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic kidney disease is a growing global health concern, with kidney transplant recognized as the optimal kidney replacement therapy for improving health -related quality of life in these patients. However, data on health -related quality of life after kidney transplant in lower -middle -income countries like Pakistan remain limited. This study assessed health -related quality of life in kidney transplant recipients at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan ), to evaluate the effects of transplantation on physical, mental, emotional, and social well -being.</p><p><strong>Materials and methods: </strong>Our cross -sectional study included 205 adult kidney transplant recipients ( ≥1 year posttransplant ). We used SF -36 questionnaire responses to analyze sociodemographic data, physical symptoms, psychological status, and social function. We used SPSS version 22 for statistical analysis, with P < .05 considered significant.</p><p><strong>Results: </strong>Among the study group, mean age was 38.1 ± 10.6 years; 78 % of recipients were men. Mean SF -36 score was 99.5 ± 4.81, indicating high health -related quality of life. Physical function (96.8 ± 8.5 ) and social function (95.5 ± 15.7 ) scores were notably high, whereas general health perception score was lower (82.5 ± 22.5 ). Male transplant recipients reported significantly better physical function than female transplant recipients (P = .031 ). No significant associations were found between health -related quality of life and marital status, education, income, or time since transplant (P > .05 ).</p><p><strong>Conclusions: </strong>Kidney transplant significantly improved health -related quality of life, particularly in physical and social domains, among Pakistani transplant recipients. Disparities between male and female patients highlight the need for tailored posttransplant care for females, whereas the minimal impact of other sociodemographic factors suggested the effectiveness of structured transplant programs in lower -middle -income countries. These findings support expanding access to kidney transplant while emphasizing sensitive rehabilitation strategies for female versus male patients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"683-688"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttransplant Tubulointerstitial Nephritis in Kidney Recipients: From Bacteria to BK Virus: A 24-Year Single-Center Analysis of Etiology, Timing, and Graft Survival.","authors":"Merih Tepeoglu, Binnaz Handan Ozdemir, Alev Ok Atılgan, Eda Yilmaz, Mohammadamin Ghaffari Soleimani, Mehmet Haberal","doi":"10.6002/ect.2025.0164","DOIUrl":"https://doi.org/10.6002/ect.2025.0164","url":null,"abstract":"<p><strong>Objectives: </strong>Tubulointerstitial nephritis is a notable cause of graft dysfunction following kidney transplant. We comprehensively evaluated tubulointerstitial nephritis epidemiology, clinical presentation, histopathology, and graft survival outcomes in a single -center cohort over a period of 24 years.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of 209 biopsy -proven tubulointerstitial nephritis cases among 1445 kidney transplant recipients at Başkent University Ankara Hospital (2000-2024 ). Etiologies included bacterial, BK virus -associated nephropathy, granulomatous inflammation, cytomegalovirus, and adenovirus. Clinical symptoms, timing of onset, rejection overlap, and persistence of inflammation or viremia were analyzed, alongside graft survival metrics.</p><p><strong>Results: </strong>Bacterial tubulointerstitial nephritis was most common (50.7 %; prevalence 7.3 % ), with a median onset beyond 1 year in 72.6 ( of cases. Cases of BK virus -associated nephropathy comprised 42.6 % (6.1 % prevalence ), with 41.6 % of cases presenting after 12 months. Granulomatous tubulointerstitial nephritis constituted 5.3 %, whereas cytomegalovirus and adenovirus tubulointerstitial nephritis were rare (1.4 % ). Symptomatic presentation occurred in 62.3 % of bacterial cases and 59.3% overall. Concurrent antibody -mediated rejection and persistent inflammation or viremia significantly reduced 10 -year graft survival across etiologies (bacterial was 60 % vs 90 %, P  < .005; BK virus -associated nephropathy was 40 % vs 70.7 %, P  = .005; persistent inflammation was ~20 % survival for viral tubulointerstitial nephritis ). Postdiagnosis survival for patients with viral tubulointerstitial nephritis averaged 22.9 months, with 0 % 10 -year survival.</p><p><strong>Conclusions: </strong>Tubulointerstitial nephritis after transplant is a heterogeneous and under recognized cause of graft loss. Etiology -specific profiling, prolonged surveillance (including BK polymerase chain reaction results ), early histology evaluation, and individualized immunosuppressive and antimicrobial strategies are essential for outcome optimization.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"689-698"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Memoriam Paul S. Russell, MD.","authors":"Mehmet Haberal","doi":"10.6002/ect.2026.russell","DOIUrl":"https://doi.org/10.6002/ect.2026.russell","url":null,"abstract":"","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"663"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiologies and Independent Risk Architecture of 7-Day Graft Loss in Adult Liver Transplantation: A National Registry Analysis.","authors":"Sohail Khan, Melanie Vugelman, Louis Borsellino, Olzhas Zhorayev, Deric Toro, Giovanni Faddoul, Katherine Connors, Meng-Hao Li, Naoru Koizumi, Jorge Ortiz","doi":"10.6002/ect.2026.0119","DOIUrl":"https://doi.org/10.6002/ect.2026.0119","url":null,"abstract":"<p><strong>Objectives: </strong>Seven -day graft loss (first postoperative week graft failure or recipient death ) has not been systematically characterized at a national scale in adult liver transplantation. We identified etiologies and independent predictors of 7 -day graft loss, primary nonfunction, and 7 -day posttransplant death in adult deceased donor liver transplant recipients.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 54 646 adult deceased donor liver transplant recipients (Organ Procurement and Transplantation Network, 2015 -2024 )and evaluated etiologies and independent predictors of 7 -day graft loss, primary nonfunction, and 7 -day posttransplant death using multivariable logistic regression.</p><p><strong>Results: </strong>Among 1442 events of 7 -day graft loss (2.6 % ), primary nonfunction predominated (43.6 % ), followed by graft thrombosis (10.3 % ) and infection (3.8 % ). Cardiovascular failure (42.6 % ) was the leading cause of 7 -day death. Retransplant (odds ratio 3.72; P < .001 ), Status 1 (odds ratio 2.24; P < .001 ), donation after circulatory death (odds ratio 1.82; P < .001 ), dialysis dependence (odds ratio 1.79; P <.001 ), and Black recipient race (odds ratio 1.74; P < .001 ) independently predicted 7 -day graft loss. Male recipient sex was protective (odds ratio 0.86; P = .01 ). Each additional hour of cold ischemia time increased 7 -day graft loss odds by 10 % (odds ratio 1.10; P < .001 ). The primary nonfunction model identified Hispanic (odds ratio 1.27; P = .03 ) and Asian (odds ratio 1.60; P = .02 ) recipient race as additional predictors, with 34 % lower odds from 2020 onward (odds ratio 0.66; P < .001 ), coincident with acuity circle allocation and expanded machine perfusion adoption. The 7 -day death model added recipient age ≥60 years (odds ratio 1.58; P < .001 ) and elevated Model for End -Stage Liver Disease score (odds ratio 1.01; P = .003 ) as independent contributors.</p><p><strong>Conclusions: </strong>Every predictor is ascertainable before transplant, supporting risk stratification during organ offers, informed donor -recipient matching, and perioperative optimization to reduce early graft loss.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 9","pages":"716-727"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}