Experimental and Clinical Transplantation最新文献

{"title":"A Rare Case of Inadvertent Insertion of a Plastic Biliary Stent Into the Main Portal Vein: A Serious Endoscopic Retrograde Cholangiopancreatography Complication After Liver Transplant.","authors":"Daniele Ferraro, Federica Falaschi, Alfonso Galeota Lanza, Giuseppe Arenga, Stefano Avenia, Giovanni Vennarecci","doi":"10.6002/ect.2025.0317","DOIUrl":"10.6002/ect.2025.0317","url":null,"abstract":"<p><p>Liver transplantation is the mainstay of treatment for end -stage liver disease. In this setting, endoscopic retrograde cholangiopancreatography is commonly used to assist T tube removal or to treat anastomotic biliary strictures. Iatrogenic portobiliary fistula is a rare but serious complication of endoscopic retrograde cholangiopancreatography, especially in the post-transplant setting. We describe the case of a 44 -year -old male patient with an iatrogenic Iatrogenic portobiliary fistula after an endoscopic retrograde cholangiopancreatography -assisted T tube removal and plastic biliary stent insertion. The plastic biliary stent was inadvertently and unknowingly inserted within the portal vein. Once identified, given the high probability of catastrophic bleeding or portal vein thrombosis, a combined surgical and endoscopic approach was chosen. The stent was endoscopically removed under direct control in the operating room, and the fistulous tract between the portal vein and the common bile duct was ligated and divided. This case highlights the critical risks of posttransplant endoscopic maneuvers and suggests that, unlike spontaneous fistulas, iatrogenic vascular damage might require an immediate combined surgical -endoscopic approach to guarantee vascular control and a safe outcome.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"282-284"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730485","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":"Racial, Ethnic and Sex Disparities in Lupus Patients With Kidney Transplant: A UNOS Database Analysis.","authors":"Macrae Kozody, Jorge Ortiz, Shriya Endlaw, Meng-Hao Li, Yang Yu, Naoru Koizumi, Giovanni Faddoul","doi":"10.6002/ect.2025.0275","DOIUrl":"https://doi.org/10.6002/ect.2025.0275","url":null,"abstract":"<p><strong>Objectives: </strong>Lupus nephritis disproportionately affects women and the Black population. Kidney transplantation is the gold standard treatment for patients who progress to end -stage kidney disease. We investigated whether disparities continue after transplant, through analysis of differences in outcomes in lupus kidney recipients stratified by sex and by race and ethnicity.</p><p><strong>Materials and methods: </strong>We conducted a retrospective United Network for Organ Sharing database analysis (January 1, 2010, through December 31, 2024 ) to include kidney transplant recipients with systemic lupus erythematosus as the primary diagnosis. We assessed donor and recipient characteristics, graft failure, and mortality by sex and by race and ethnicity and analyzed data with Kaplan -Meier survival curves and multivariate Cox regression.</p><p><strong>Results: </strong>Of the 8726 transplants with a lupus nephritis etiology, 81.7% were female patients (n =7133 ), with racial composition of 41.7% Black, 25.3% non -Hispanic White, 23.1% Hispanic, and 7.7% Asian. Lupus nephritis 1 -year graft failure rate was 10.2% (n =893/8718 ) and 1 -year mortality was 8.7% (n = 760/8726 ). Male sex correlated with higher graft failure (hazard ratio 1.20; P = .018 ) and mortality (hazard ratio 1.30; P = .009 ). Graft failure was highest among Black recipients (22.4% ). Mortality was highest in non-Hispanic White (11.7% ) and Black recipients (11.0% ). Black race correlated with higher odds of death in both lupus (hazard ratio 1.60 ) and nonlupus (hazard ratio 1.14 ) deceased donor kidney transplants.</p><p><strong>Conclusions: </strong>Male sex correlated with increased death and graft loss in deceased donor kidney transplant recipients. These outcomes were also worse among the Black population, with higher odds of death in the lupus group compared with the group without lupus. Additional investigation is required to understand the discrepancies in access to transplant and outcomes in relation to lupus.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"210-219"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730507","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":"Attitude of Mexican University Students Toward Organ Donation and Transplantation.","authors":"Mario I Ortiz, Karla Jimenez Oliver, Carlo Medina Solis, Isi Ordonez VelAzquez","doi":"10.6002/ect.2025.0287","DOIUrl":"10.6002/ect.2025.0287","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we evaluated the willingness to donate organs after death among Mexican university health students using a validated psychometric instrument. Our aim was to identify sociodemographic, religious, and psychosocial factors associated with positive donation attitudes.</p><p><strong>Materials and methods: </strong>A cross - sectional study was conducted among 2447 health science students from 7 academic programs at a Mexican public university. Student participants completed the \" PCID -DTO -RIOS \" questionnaire via direct interview. We collected data on age, sex, socioeconomic status, religion, academic field, social interactions, knowledge of brain death, and attitudes toward donation, which we analyzed using descriptive statistics, t tests, and Χ ² tests (P < .05 ).</p><p><strong>Results: </strong>The sample consisted of 72.4 % female students, with a mean age of 20.2 years. Overall, 75.6 % of students expressed willingness to donate their organs after death. Positive attitudes were significantly more frequent among women than men (78.1 % vs 68.9 %; P < .001 ) and non-practicing religious individuals than among practicing religious individuals (78.5% vs 76.1%; P = .001 ). Willingness to donate after death correlated significantly with discussing donation with family and friends, knowing family members' opinions, and understanding brain death (all P < .05). Only 18.3% were current blood donors.</p><p><strong>Conclusions: </strong>Most Mexican health science students demonstrated favorable attitudes toward deceased organ donation, influenced by social interaction, religious practice, and knowledge of brain death. These findings underscore the importance of targeted educational interventions during university training to enhance donation advocacy, particularly in contexts where cardiovascular and other organ shortages persist.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"274-281"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730536","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":"Successful Living Donor Liver Transplant Following Roux-en-Y Gastric Bypass in a Patient With Super Obesity With Hepatitis B Virus-Related Cirrhosis: A 7-Year Follow-Up Case Report.","authors":"Adem Tuncer, Mehmet Zeki Ogut, Sertac Usta, Volkan İnce, Cuneyt Kayaalp, Sezai Yilmaz","doi":"10.6002/ect.2025.0147","DOIUrl":"10.6002/ect.2025.0147","url":null,"abstract":"<p><p>Living donor liver transplant remains the only viable treatment for some patients with cirrhosis in countries with low deceased donor organ donation rates. However, morbid obesity limits the feasibility of living donor liver transplant because of increased perioperative risks and poor graft -to -recipient weight ratios. This report presents a case of living donor liver transplant following Roux -en -Y gastric bypass in a patient with super obesity (ie, body mass index ≥50, measured as kilograms per meter squared ) with hepatitis B virus -related cirrhosis. A 44 -year -old female with a body mass index of 54.5 (130 kg ) was diagnosed with hepatitis B virus -related cirrhosis. Despite 1 year on the transplant wait list and supervised weight loss efforts, her body mass index increased to 56. Laparoscopic Roux -en -Y gastric bypass was performed. One year after surgery, her weight reduced to 78 kg (body mass index 34.2 ), enabling a right lobe living donor liver transplant from her 24 -year -old son. Postoperative recovery was uneventful, and 7 years after transplant, the patient remains healthy, with no graft rejection or hepatitis B virus recurrence. Roux -en -Y gastric bypass may serve as a feasible bridge to living donor liver transplant in patients with super obesity and compensated cirrhosis, especially in regions with limited deceased donation.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"285-288"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730557","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":"Long-Term Outcome of Integrative Care for Biliary Atresia: 17 Years of Experience in a Single Center.","authors":"Masashi Kadohisa, Yukihiro Inomata, Keita Shimata, Seiichi Kawabata, Daiki Yoshii, Kaori Isono, Masaki Honda, Shintaro Hayashida, Yuki Ohya, Taizo Hibi","doi":"10.6002/ect.2025.0201","DOIUrl":"10.6002/ect.2025.0201","url":null,"abstract":"<p><strong>Objectives: </strong>Integration of the treatment for biliary atresia, including Kasai portoenterostomy and liver transplant, has had an important role in the marked improvement of the prognosis. We reviewed our experience with Kasai portoenterostomy and living donor liver transplant, both performed by the same pediatric surgical team and described the clinical features and outcomes of patients with biliary atresia.</p><p><strong>Materials and methods: </strong>We reviewed 41 patients with biliary atresia who underwent Kasai portoenterostomy at Kumamoto University from August 2000 to March 2017.</p><p><strong>Results: </strong>The median age at Kasai portoenterostomy was 63 days (IQR, 54-75 days). Jaundice clearance was achieved by 23 patients (56.1%) at any time during the postoperative course. The 1-year, 5-year, 10-year, and 20-year native liver survival rates were 51.2%, 46.3%, 43.0%, and 38.3%, respectively. Of 41 patients, 24 eventually underwent living donor liver transplant. Of these, 22 patients underwent transplant during infancy or early childhood; their median age and body weight at living donor liver transplant were 6.5 months (IQR, 5.3-8.0 months) and 7.0 kg (IQR, 6.4-8.0 kg), respectively. The most common indication for living donor liver transplant was jaundice-induced liver cirrhosis; other indications included portal hyper-tension and recurrent cholangitis. The 15-year overall survival rate of 22 patients was 90.9%.</p><p><strong>Conclusions: </strong>Patients with biliary atresia treated by our team capable of both Kasai portoenterostomy and living donor liver transplant have shown good long-term outcomes. However, further improvement of Kasai portoenterostomy and timely living donor liver transplant remain crucial.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"243-251"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730462","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":"Tidal Volume Challenge to Predict Fluid Responsiveness in Liver Transplant Recipients Ventilated Using Low Tidal Volume.","authors":"Ganesh Ramaji Nimje, Akash Mishra, Vipin Kumar Goyal, Gaurav Goyal, Pankaj Singh","doi":"10.6002/ect.2025.0205","DOIUrl":"10.6002/ect.2025.0205","url":null,"abstract":"<p><strong>Objectives: </strong>The low tidal volume ventilatory technique poses limitations on the application of dynamic indices, like pulse pressure and stroke volume variations, in determining fluid responsiveness. This study investigated whether shifts in pulse pressure variation and stroke volume variation following a tidal volume challenge could predict fluid responsiveness in liver transplant recipients facing low tidal volume.</p><p><strong>Materials and methods: </strong>We conducted a prospective intervention study in liver transplant recipients ventilated with low tidal volume. Patients received tidal volume challenge (transiently increasing the tidal volume from 6 to 8 mL /kg predicted body weight) at a single time frame, when the patient developed hypotension before administration of fluid bolus or any vasopressor agents, and changes in pulse pressure variation and stroke volume variation were noted. Patients were classified as fluid responders or nonresponders based on whether fluid challenge resulted or did not result in increased stroke volume index of >10 %.</p><p><strong>Results: </strong>Among the 28 included patients, 12 (42.9 % ) were fluid responders and 16 (57.1 % ) were fluid nonresponders. During the tidal volume challenge, mean changes in pulse pressure and stroke volume variations were 2.00 ± 0.60 and 2.33 ± 0.77 in responders and 1.06 ± 0.44 and 0.87 ±0.62 in nonresponders, respectively. Change in pulse pressure variation with area under the curve was 0.87 (95 % CI, 0.73 -1.00; P = .001 ), with optimal cut-off value of 1.5 indicating sensitivity and specificity of 83.3 % and 87.5 %; change in stroke volume variation with area under the curve was 0.91 (95 % CI: 0.79-1.00, P = < .001 ), with the same cut -off value of 1.5 indicating sensitivity and specificity of 83.3 % and 87.5 %.</p><p><strong>Conclusions: </strong>Changes in pulse pressure and stroke volume variations after tidal volume challenge have good predictability of fluid responsiveness in liver transplant recipients ventilated with lung protective ventilation strategy.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"252-259"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730639","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":"Cumulative Incidence of Mortality in the Liver Transplant Wait List in Iran: A Competing Risk Analysis.","authors":"Mohsen Aliakbarian, Vahid Ghavami, Fahimeh Hoseinzadeh, Rozita Khodashahi","doi":"10.6002/ect.2025.0188","DOIUrl":"10.6002/ect.2025.0188","url":null,"abstract":"<p><strong>Objectives: </strong>For liver transplant candidates, trans-plantation or death on wait lists can be competing risks. This study used competing risk analysis to estimate the probability of death among patients on wait lists for liver transplant.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed liver transplant candidates registered at the Montaseriyeh Transplant Center Registry of Mashhad University of Medical Sciences (Iran) from 2013 to 2024. We followed patients from listing through transplant, death, or end of study. We collected demographic, clinical, laboratory, and follow-up details. We used Gray's test to assess cumulative incidence of death across different listing periods, orthotopic liver transplant groups, and Model for End -Stage Liver Disease severity levels. To estimate the effects of various covariates while accounting for transplantation as a competing event, we conducted a competing risk regression using the Fine and Gray subdistribution hazard model. We used R software (cmprsk and cuminc packages ) for statistical analyses.</p><p><strong>Results: </strong>Average age of patients was 50.84 ± 13.78 years. Over the follow-up period, 503 patients (60.0 % ) received transplants, 233 (27.8 % ) died while waiting for transplant, and 102 (12.2 % ) were administratively censored. Among transplant patients, 65.9% had Model for End-Stage Liver Disease scores between 10 and 20, with mortality increasing with increased scores. The hazard model showed no significant differences in death risk by age, sex, marital status, year of transplant, or etiology group. However, patients with higher Model for End-Stage Liver Disease scores had significantly greater risk of death than those with lower scores (P < .001 ).</p><p><strong>Conclusions: </strong>Increased Model for End -Stage Liver Disease score emerged as the most significant predictor of mortality among patients waiting for liver transplant. Focusing on candidates with high scores and tackling socioeconomic barriers could improve survival outcomes. These insights can inform future approaches to optimize patient prioritization and transplant allocation.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"260-267"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730533","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":"Use of Banff 2018 Working Group Classes to Predict Outcomes Versus Use of Baseline Parameters of Renal Function and BK Viremia in BK Virus Nephropathy: A Retrospective Institutional Experience.","authors":"Pallav Gupta, Akhilesh Kumar Jaiswal, Tarun Kumar, Rajdeb Saha, Vaibhav Tiwari, Vinant Bhargava, Anurag Gupta, Manish Malik, Ashwani Gupta, Anil Kumar Bhalla, Devinder Singh Rana","doi":"10.6002/ect.2025.0214","DOIUrl":"10.6002/ect.2025.0214","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether Banff 2018 classification of BK polyomavirus nephropathy better predicts graft outcomes compared with baseline graft function and viremia levels, we correlated clinicopathologic features and morphologic BK polyomavirus nephropathy classes with graft outcomes.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 23 cases of biopsy-proven BK polyomavirus nephropathy over 10 years (2014-2023 ). We stratified biopsy cases into polyoma virus nephropathy class 1, 2, or 3 per the Banff 2018 classification, based on intrarenal viral load (pvl score ) and interstitial fibrosis (ci score ). Outcomes included graft function (serum creatinine, estimated glomerular filtration rate) at 6 and 12 months and graft loss.</p><p><strong>Results: </strong>Among classes, class 2 was the most common (60.86 % ), followed by class 1 (26.08 % ) and class 3 (13.04 % ). Baseline serum creatinine level, BK viremia, and acute inflammation scores did not differ significantly across classes. Cases classified as class 3 showed significantly worse renal function at 6 and 12 months than cases classified as class 1 and 2 (6-month serum creatinine level of 6.19 ± 3.72, 2.19 ± 0.54, and 2.15 ± 0.95 mg/dL for class 3, 1, and 2, respectively; P < .001 ). Graft loss occurred in 0 of 6 cases with polyoma virus nephropathy class 1, 1 of 14 cases with class 2, and 1 of 3 with class 3. Mortality was observed in 2 of 14 patients with class 2 (14.28% ). Tubular atrophy (ct score ) was significantly higher in class 2 and 3 cases versus class 1 cases (P = .046 ).</p><p><strong>Conclusions: </strong>The Banff 2018 polyoma virus nephropathy classification is a robust predictor of graft outcomes. Class 3 was strongly associated with worse renal function and increased graft loss, largely driven by extent of interstitial fibrosis and tubular atrophy. Histopathological assessment is critical for prognostication as viral load alone does not predict outcomes and severity of BK virus nephropathy.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"227-236"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730589","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":"The Simplified Pregnancy Risk Score (SPRS): Personalized Preeclampsia Risk Stratification for Living Kidney Donors.","authors":"Hany M El Hennawy, Omar Safar, Ghaleb Aboelsamh, Laila Fahad Sadagah, Menna El Hennawy, Mohamed Elamien Balla, Abdullah Khedr, Mona Ibrahim, Tariq Jaber, Ibrahim Tawahri","doi":"10.6002/ect.2026.0006","DOIUrl":"10.6002/ect.2026.0006","url":null,"abstract":"<p><strong>Objectives: </strong>Pregnancy after living kidney donation is associated with increased risk of preeclampsia and other hypertensive disorders; however, clinical practice and a standardized approach remain unclear. We performed a systematic review and meta-analysis to provide updated risk estimates for adverse pregnancy outcomes after living kidney donation, to allow development and preliminary assessment of the Simplified Pregnancy Risk Score, a structured framework for individualized risk stratification.</p><p><strong>Materials and methods: </strong>We followed PRISMA guidelines and searched PubMed, Scopus, Web of Science, and the Cochrane Library through August 2023 to include studies on maternal and fetal outcomes in pregnancies after living kidney donation. We used random-effects models to pool odds ratios and calculate absolute risk differences. We used subgroup and regression analyses to identify key risk modifiers that informed the development of the points-based Simplified Pregnancy Risk Score.</p><p><strong>Results: </strong>Our search identified 15 studies encompassing 4200 pregnancies. Preeclampsia (pooled incidence 7.2%; odds ratio = 2.86; 95% CI, 1.62-5.05; absolute risk difference +4.7% ) and gestational hypertension (odds ratio = 2.53, 95% CI, 1.11-5.74)were significantly increased in donors compared with nondonors. Risk of preterm birth was modestly increased (odds ratio = 1.32; 95% CI, 1.01-1.74). Subgroup analyses identified clinically relevant effect modifiers: donors aged ≥35 years had higher odds of preeclampsia than younger donors, and a donation-to-conception interval of <2 years was associated with increased risk of preterm birth. The Simplified Pregnancy Risk Score integrated 8 evidence-based factors into a simple points-based system, categorizing donors as low (0-2 points), moderate (3-5 points), or high risk (≥6 points).</p><p><strong>Conclusions: </strong>The Simplified Pregnancy Risk Score represents the first structured, evidence-informed framework designed to support individualized pre-conception counseling and risk-aware antenatal management in kidney donors. Although formal validation is required, this system addresses a critical translational gap by converting population-level evidence into actionable clinical risk stratification.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"199-209"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730616","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":"Unveiling the Molecular Symphony: Exploring the Influence of miR-142-5p and miR-192-1 on Renal Transplant Rejection and Fibrosis.","authors":"Binnaz Handan Ozdemir, Begüm Yavascaoglu Uney, Bilkay Basturk, Oktay Sozer, Miray Kavuzlu, Emine Tuba Canpolat, Mehmet Haberal","doi":"10.6002/ect.2025.0103","DOIUrl":"https://doi.org/10.6002/ect.2025.0103","url":null,"abstract":"<p><strong>Objectives: </strong>In the intricate symphony of molecular orchestration within the human body, microRNAs are master conductors, deftly guiding essential biological processes like immune response, inflammation, and tissue repair. Among these virtuosos, the microRNAs miR -142 -5p and miR -192 -1 emerge as stars, with melodies resonating profoundly in renal transplant pathology. We aimed to unravel the complex role of miR -142 -5p and miR -192 -1 in the fate of renal transplants.</p><p><strong>Materials and methods: </strong>We evaluated plasma levels of miR -142 -5p and miR -192 -1 using quantitative real -time polymerase chain reaction in 100 kidney transplant recipients, including 29 with stable graft function, 16 with T -cell-mediated rejection, 28 with antibody-mediated rejection, and 27 with mixed rejection. We analyzed associations between miRNA levels, histopathological features, fibrosis development (>50 % cortical involvement ), and graft outcomes.</p><p><strong>Results: </strong>Both miR -142 -5p and miR -192 -1 were significantly upregulated in patients with acute rejection and interstitial fibrosis (P < .001 ). Elevated levels correlated with interstitial inflammation, eosinophilia, plasma cell infiltration, peritubular capillaritis, glomerulitis, C4d positivity, vascular rejection, thrombotic microangiopathy, and tubular expression of the DR isotype of human leukocyte antigen. The 5 -year interstitial fibrosis incidence was 52 % in patients with high miR -142-5p and 57% with high miR -192 -1, versus 23 %and 21 %in the respective low -expression groups. Graft survival at 5 years was 64% for high miR -142 -5p and 61 % for high miR -192 -1, versus 94 % and 93 %in the respective low-expression groups (P ≤ .001 ).</p><p><strong>Conclusions: </strong>MicroRNAs miR -142 -5p and miR -192 -1 are associated with acute rejection severity, microvascular inflammation, and fibrotic progression. The strong correlation with histological injury and graft loss suggests that these microRNAs serve as noninvasive biomarkers for immune monitoring and risk prediction in kidney transplant.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 3","pages":"220-226"},"PeriodicalIF":0.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730579","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}