Experimental and Clinical Transplantation最新文献

{"title":"Navigating Immunological Barriers in Xenotransplantation: Recent Advances and Promising Strides.","authors":"B Handan Özdemir","doi":"10.6002/ect.2023.0351","DOIUrl":"https://doi.org/10.6002/ect.2023.0351","url":null,"abstract":"<p><p>The review introduces the challenges and potential solutions in xenotransplantation, focusing on pig-to-human organ transplant. Xenotransplantation, mainly with the use of pig organs, is a promising solution because of the reproductive capacity, size, and physiological resemblance of pigs to humans. However, immunological barriers, especially humoral and cellular immune responses, pose substantial challenges. The humoral immune response, involving antibodies targeting xenoantigens, is a substantial barrier. Anti-α-galactose antibodies, targeting α-Gal epitopes, are crucial in hyperacute rejection and acute humoral xenograft rejection. Genetic modifications, including CRISPR/Cas9 technology, aim to eliminate xenoantigens like α-Gal, potentially overcoming these challenges. This review discusses the use of genetically modified pigs for xenotransplantation, emphasizing the removal of xenoantigens, expression of human complement regulatory proteins, and transgenic expres-sion of human regulatory factors. Recent advancements, such as the world's first porcine-to-human heart transplant, highlight the potential of genetic manipu-lation in overcoming immune rejection barriers.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"421-430"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585551","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":"Baseline Lung Allograft Dysfunction: Real-World Data for an Emerging Early Posttransplant Clinical Phenotype.","authors":"René Hage, Carolin Steinack, Macé M Schuurmans","doi":"10.6002/ect.2025.0097","DOIUrl":"https://doi.org/10.6002/ect.2025.0097","url":null,"abstract":"<p><strong>Objectives: </strong>Baseline lung allograft dysfunction reflects suboptimal graft recovery and development after lung transplant and is characterized by a persistent low lung function in the first year. Despite its potential prognostic value, baseline lung allograft dysfunction remains insufficiently characterized or defined and thus underreported.</p><p><strong>Materials and methods: </strong>In this retrospective cohort study, we analyzed 80 adult double-lung transplant recipients for the period January 2021 to December 2023. Baseline lung allograft dysfunction was defined as failure to reach a peak forced expiratory volume in 1 second and/or forced vital capacity ≥80% predicted on ≥2 pulmonary function tests at least 3 months apart within the first year. Patients with and without baseline lung allograft dysfunction were compared using demog-raphic, serial functional, and postopera-tive variables.</p><p><strong>Results: </strong>Baseline lung allograft dysfunction occurred in 58.8% of patients. These individuals were younger (P = .044) and had significantly worse lung function at 12 months in absolute values for forced expiratory volume in 1 second (2.12 ± 0.65 vs 3.11 ± 0.82 L; P < .001) and predicted values (67.3 ± 16.2% vs 103.8 ± 23.8%; P < .001). Durations of intensive care unit stays and total hospital stays were longer in the group with baseline lung allograft dysfunction (P = .006), reflecting more complex early postoperative recovery. No significant differences were found in body mass index, sex, underlying diagnosis, acute rejection, or donor-specific antigen presence.</p><p><strong>Conclusions: </strong>Baseline lung allograft dysfunction is a highly prevalent yet underrecognized early allograft dysfunction phenotype that is associated with impaired clinical recovery and prolonged intensive care unit stay and hospital stay. Systemic identification of baseline lung allograft dysfunction phenotype using serial pulmonary function testing enables early risk stratification and may inform future intervention strategies aimed to optimize graft recovery and long-term survival.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"409-414"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585531","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":"Myelitis After Liver Transplant: A Case Report.","authors":"Fuat Aksoy, Halit Ziya Dundar, Aylin Bican Demir, Murat Kiyici, Ekrem Kaya","doi":"10.6002/ect.2020.0278","DOIUrl":"10.6002/ect.2020.0278","url":null,"abstract":"<p><p>We report a case of neurotoxicity as a side effect of a calcineurin inhibitor (tacrolimus), which is used as an immunosuppressive drug after liver transplant. Our patient had chronic hepatic failure due to Budd-Chiari syndrome and underwent a liver transplant after an appropriate deceased donor organ was obtained. After organ transplant surgery, he was kept under the effect of an immunosuppressive drug (tacrolimus) with daily control of the level of drug in his blood to avoid drug toxicity. Despite the level of drug in his blood being within the ideal range, the patient developed neurotoxicity that presented as weakness of his extremities. Appropriate diagnostic tests were done, and all proved that these signs and symptoms were related to the use of tacrolimus.Therefore,the drug was changed to cyclosporine. After a few months, the patient regained normal neurological functions of his extremities. We should take precautions to monitor neurological symptoms and signs while we administer calcineurin inhibitors.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":" ","pages":"442-444"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39061443","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":"Kidney Retransplant in Situs Inversus Totalis: A Case Report.","authors":"Taqi T Khan, Dujana Mousa, Qaisar Iqbal, Muneeb Hassan, Sajid Shakeel, Naveed Khan, Lajward Asnath, Sohail Khan","doi":"10.6002/ect.2025.0085","DOIUrl":"https://doi.org/10.6002/ect.2025.0085","url":null,"abstract":"<p><p>Few cases of kidney transplant have been reported in patients with situs inversus totalis. We present a 35-year old female patient with situs inversus totalis and chronic kidney disease of unknown origin who received a third graft after failure of 2 previous transplants. The first living related transplant was performed on the right side and failed after 3 years. A second related transplant was then performed on the left side, butthis thrombosed graft was removed in the first week. The patient then underwent a third related transplant on the left side. Retransplant in patients with situs inversus totalis is no different than in patients with normal anatomy, provided that attention is given to the altered vascular anatomy.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"435-437"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585532","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":"Persistence of HLA-DQ Antibodies in Transplant Patients Following Desensitization Treatment.","authors":"Begüm Yavaşcaoğlu Üney, Miray Kavuzlu, Caner İncekaş, Bilkay Baştürk, Atilla Sezgin, Mehmet Haberal","doi":"10.6002/ect.2025.0094","DOIUrl":"https://doi.org/10.6002/ect.2025.0094","url":null,"abstract":"<p><strong>Objectives: </strong>The functionality of the transplanted graft is considered the most important step in transplant. Both HLA tissue compatibility between recipients and donors and the presence of antibodies against the HLA structure in the recipient's serum play essential roles. The presence of these antibodies can be ascertained either before or after transplant. Although desen-sitization treatment provides the chance of transplant to immunized patients, it also prolongs graft survival in antibody-mediated rejection that develops after transplant. In this retrospective study, we aimed to determine treatment-related responses of anti-HLA antibodies in heart and renal transplant patients diagnosed with antibody-mediated rejection.</p><p><strong>Materials and methods: </strong>We evaluated 60 samples from 18 patients who were followed in our center for at least 4 years and who had treatment before and after desensitization (plasmapheresis, intravenous immunoglobulin, and/or rituximab). Serum samples of the patients were tested for panel reactive antibody screening class I and II (One Lambda, Inc) test by Luminex method and single antigen class I and/or II (One Lambda, Inc) results by Luminex method. Mean fluorescence intensity ≥1000 was considered positive. To determine the presence of donor-specific antibodies, HLA tissue group samples of donors were studied by high-resolution method.</p><p><strong>Results: </strong>Studied antibodies, particularly those with mean fluorescence intensity >10 000 against class II HLA-DQ, remained resistant to treatment.</p><p><strong>Conclusions: </strong>Our study results showed that the class II HLA-DQ tissue group and anti-HLA antibodies against it play an important role in reducing the need for desensitization therapy and maintaining graft tissue functionality.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"415-420"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585552","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":"A New Percutaneous Biliary Path With a Biodegradable Stent for Intrahepatic Biliary Stenosis After Living Donor Pediatric Liver Transplant.","authors":"Leonardo Montes, Florencia Fernandez, Florencia Agostinelli, Lucia Novellis, Juan Fasolo, Maria Solaegui, Carolina Rumbo, Diego Ramisch, Gabriel Gondolesi, Pablo Barros Schelotto","doi":"10.6002/ect.2025.0106","DOIUrl":"10.6002/ect.2025.0106","url":null,"abstract":"<p><p>Biliary tract complications are a significant source of morbidity following living donor liver transplant, especially in pediatric patients. These complications are influenced by graft type, bile duct anatomy, and reconstruction techniques. For a hepaticojejunostomy, percutaneous intervention is the first option preferred. Here, we present a case report of the successful use of a percutaneous biodegradable stent to manage an intrahepatic biliary stricture in an 8-month-old patient who had previously undergone living donor liver transplant for biliary atresia, thereby creating a new biliary path. The patient developed a dominant biliary stricture of segment S2 postoperatively, which was refractory to conventional internal drainage. We created a new biliary path via a novel connection between the intrahepatic duct and the intestinal loop with minimally invasive surgery. The biodegradable stent provided temporary structural support while gradually degrading, which eliminated the need for removal and minimized long-term complications. At 18 month follow-up, the patient remained asymptomatic with satisfactory liver function tests and no evidence of restenosis. This case illustrates the feasibility, safety, and potential benefits of biodegradable stents in pediatric liver transplant recipients. The findings suggest that biodegradable stents could represent a significant advancement in the management of complex biliary tract complications in children, although further studies are necessary to establish the long-term efficacy of this treatment and standardize the protocols.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"438-441"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585529","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":"Living Donor Left Hepatectomy as a Risk Factor for Extremely Severe Bile Leakage Requiring Nonconservative Treatment: A Retrospective Analysis.","authors":"Masashi Kadohisa, Yukihiro Inomata, Tomoaki Irie, Keita Shimata, Seiichi Kawabata, Kaori Isono, Masaki Honda, Shintaro Hayashida, Yuki Ohya, Taizo Hibi","doi":"10.6002/ect.2025.0061","DOIUrl":"https://doi.org/10.6002/ect.2025.0061","url":null,"abstract":"<p><strong>Objectives: </strong>The safety of donors is the most important principle in living-donor liver transplant. However, some donors experience postoperative bile leakage of varying severity. In this study, we aimed to evaluate the charac-teristics of patients with severe bile leakage (Clavien-Dindo ≥grade IIIa) following donor hepatectomy.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 453 living donor liver transplant donors at Kumamoto University Hospital from August 2000 to March 2017.</p><p><strong>Results: </strong>The number of donor hepatectomies was as follows: 173 with right hepatectomy, 149 with left hepatectomy, and 131 with left lateral segmen-tectomy. The overall incidence of severe bile leakage requiring any endoscopic or surgical intervention was 4.6%. Although no differences in the incidence of bile leakage were found among the types of hepatectomy, extremely severe bile leakage caused by injury of the major remnant bile duct requiring endoscopic retrograde biliary drainage or surgical revision was observed with left hepatectomy only (n = 6).</p><p><strong>Conclusions: </strong>Left hepatectomy is considered a potential risk factor for extremely severe bile leakage. Preoperative anatomical evaluation of the branching pattern and running course of the biliary tree of the right lobe and careful transection of the hepatic parenchyma near the hilar plate are important.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"393-399"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585533","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":"Association of Carbohydrate Antigen 19-9 Elevation Among Patients With Alcohol-Related Liver Disease Undergoing Liver Transplant.","authors":"Lynette M Sequeira, Merve Gurakar, Ahmet Gurakar, Anjali D'Amiano, Omna Hayyat, Natarajan Ravendhran","doi":"10.6002/ect.2025.0098","DOIUrl":"https://doi.org/10.6002/ect.2025.0098","url":null,"abstract":"<p><strong>Objectives: </strong>Carbohydrate antigen 19-9 is a tumor marker with high sensitivity and specificity for pancreaticobiliary malignancies. However, an increase in carbohydrate antigen 19-9 has also been reported in non-neoplastic diseases and in some circumstances has been associated with environmental exposures. We evaluated the levels of carbohydrate antigen 19-9 in patients with alcohol-related liver disease and whether these levels differ in patients with recent alcohol use versus remote alcohol use.</p><p><strong>Materials and methods: </strong>We evaluated a cohort of patients with alcohol-related liver disease undergoing liver transplant who presented with levels of carbohydrate antigen 19-9 in the absence of other pancreaticobiliary pathologies known to cause carbohydrate antigen 19-9 elevation.</p><p><strong>Results: </strong>In our patients with a diagnosis of alcohol-related liver disease, carbohydrate antigen 19-9 levels were overall elevated beyond the upper limit of the reference range. Furthermore, these levels were significantly higher in patients with recent alcohol use versus remote alcohol use.</p><p><strong>Conclusions: </strong>This elevation could be a result of biliary ductal epithelial cell inflammation caused by alcohol, subsequently causing increased secretion of carbohy-drate antigen 19-9. Carbohydrate antigen 19-9 levels should be interpreted with caution, and treatment should be individually tailored to address individual patient-specific situations.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"406-408"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585530","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":"Relationship Between Pulse Wave Velocity and Cognitive Impairment in Kidney Transplant Recipients.","authors":"Ahmet Kürşat Soyer, Necmi Eren, Şeyda Gül Özcan, Metin Ergül, Nuriye Yıldız, Sibel Gökçay Bek, Erkan Dervişoğlu, Betül Kalender Gönüllü","doi":"10.6002/ect.2024.0293","DOIUrl":"https://doi.org/10.6002/ect.2024.0293","url":null,"abstract":"<p><strong>Objectives: </strong>Kidney transplant recipients are at higher risk of developing atherosclerosis compared with the general population. Arterial stiffness, a key feature of atherosclerosis, is common in these patients. Cognitive impairment is also more prevalent among kidney transplant recipients and may be linked to the atherosclerotic process. We evaluated the relationship between arterial stiffness and cognitive impairment in kidney transplant recipients.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 112 kidney transplant recipients and 112 healthy controls aged 18 years or older. Arterial stiffness was assessed using pulse wave velocity measured between the carotid and femoral arteries. Cognitive function was evaluated with the Montreal-Cognitive Assessment and the Mini-Mental State Examination. We analyzed demographic data, comorbidities, medical history, medications, and laboratory results for transplant recipients.</p><p><strong>Results: </strong>Cognitive impairment was detected in 14% of kidney transplant recipients based on the Mini-Mental State Examination and in 31% based on the Montreal-Cognitive Assessment; no people in the control group showed impairment on MMSE, and only 7% scored below normal on MoCA. A significant correlation was observed between pulse wave velocity and cognitive function test scores. Higher pulse wave velocity was independently associated with an increasedrisk of cognitive impairment, as determined by the Mini-Mental State Examination.</p><p><strong>Conclusions: </strong>To our knowledge, this study is the first to demonstrate a relationship between pulse wave velocity and cognitive function as measured by the Mini-Mental State Examination and the Montreal-Cognitive Assessment in kidney transplant recipients. These results suggest that cerebrovascular disease may contribute to cognitive impairment in this population.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"400-405"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585553","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":"Male Breast Cancer After Kidney Transplant: Case Report and Literature Revue.","authors":"Hanen Chaker, Soumaya Yaich, Hanen Abid, Souhir Khemiri, Slim Charfi, Mondher Masmoudi, Mohamed Ben Hmida, Tahya Boudawara, Afef Khanfir, Khawla Kammoun","doi":"10.6002/ect.2025.0083","DOIUrl":"https://doi.org/10.6002/ect.2025.0083","url":null,"abstract":"<p><p>Long-term immunosuppression can lead to malignant tumors after kidney transplant. In this case study, we report a rare case of breast cancer occurring in a man after 33 years of kidney transplant. This 55-year-old kidney transplant patient presented with a right breast mass. The biopsy showed an infiltrating carcinoma. The immunohistochemical study was positive for estrogen. The patient underwent a right mastectomy with axillary dissection. Chemotherapy based on docetaxel and radiotherapy was started. Adjuvant treatment with tamoxifen and a switch from azathioprine to sirolimus were conducted. Follow-up showed that the patient died 24 months after presentation. Through this case, we emphasize the importance of vigilance about this rare cancer, often diagnosed at a late stage, which can negatively affect prognosis. Screening for risk factors is crucial.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 6","pages":"431-434"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585534","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}