Experimental and Clinical Transplantation最新文献

{"title":"Three-Dimensional Computed Tomography-Magnetic Resonance Cholangiopancreatography Imaging Fusion for Computer-Assisted Surgery Planning in Full Graft Living Donor Liver Transplant: A Single Centre Experience.","authors":"Arnold Radtke, George Sgourakis, Ernesto P Molmenti, Massimo Malagó, Susanne Beckebaum, Alfred Königsrainer, Christoph Steidle","doi":"10.6002/ect.2024.0244","DOIUrl":"10.6002/ect.2024.0244","url":null,"abstract":"<p><strong>Objectives: </strong>Computed tomography and magnetic resonance cholangiopancreatography are core components of living donor liver transplant. Here, we described our 3-dimensional computed tomography-magnetic resonance cholangiopancreatography, fusion-derived computer-assisted surgical planning system to evaluate its usefulness in full graft living donor liver transplant.</p><p><strong>Materials and methods: </strong>Among 17 consecutive full graft left living donor liver transplants, 14 were planned with the 3-dimensional computed tomography-magnetic resonance cholangiopancreatography computer-assisted surgical planning system. The system allowed us to estimate liver volume compliance, allowing for individualized graft size enlargement by means of virtual-to-real resection line modifications. Virtual graft hepatectomy obviated the need for intraope-rative cholangiography in 93% of cases.</p><p><strong>Results: </strong>Graft and recipient survival rates were 82% and 77% at 1 year and 94% and 82% at 5 years, respectively. Small-for-size and high-risk small-for-size grafts constituted 44% and 31% of cases, with rate of small-for-size syndrome of 18%. We observed a 12.6 ± 9.8% discrepancy between estimated and intraoperative graft-weight-body-weight ratio, reflecting either volume compliance (overcalculation) or graft enlargement (undercalculation). Graft-to-remnant congestion volume index excluded 1 middle hepatic vein graft. Ninety-four percent single arterial and 100% single ductal biliary reconstructions were associated with 12% hepatic artery thrombosis and 18% biliary anastomotic leaks, respectively.</p><p><strong>Conclusions: </strong>Our 3-dimensional computed tomography-magnetic resonance cholangiopancreatography computer-assisted surgical planning system enabled (1) virtual navigation of the hilar passage with no need of intraoperative cholangiography in risky anatomy cases and (2) prevention of small-for-size syndrome in extremely small grafts by computed risk analysis.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 1","pages":"29-42"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366774","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":"Miniaturization of Porcine Hindlimb Model for Vascularized Composite Tissue Allotransplantation: Anatomic Research and Technical Note.","authors":"Yanhai Zuo","doi":"10.6002/ect.2024.0269","DOIUrl":"https://doi.org/10.6002/ect.2024.0269","url":null,"abstract":"","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"964-966"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985371","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":"Acinetobacter baumannii Bloodstream Infections in Hematopoietic Stem Cell Transplant Recipients: A Worldwide Systematic Review.","authors":"Mohammad Reza Balali, Faris Anad Muhammad, Rafid Jihad Albadr, Mariem Alwan, Mojgan Falaki, Fatemeh Hassani, Elham Ranjbar, Azad Khaledi","doi":"10.6002/ect.2024.0234","DOIUrl":"10.6002/ect.2024.0234","url":null,"abstract":"<p><strong>Objectives: </strong>Bloodstream infection is one of the main causes of death in hematopoietic stem cell transplant recipients. Acinetobacter baumannii is a bacteria associated with bloodstream infection and subsequent death from high antibiotic resistance in this group of patients. We evaluated bloodstream infections of Acinetobacter baumannii in hematopoietic stem cell transplant recipients.</p><p><strong>Materials and methods: </strong>Using the PRISMA protocol, we searched MEDLINE, Scopus, and Web of Science databases from January 1, 2000, through November 1, 2023, to detect possibly pertinent studies reporting A baumannii prevalence and A baumannii bloodstream infections related to mortality. We used the following Medical Subject Headings and text words: Acinetobacter, Acinetobacter species, Acinetobacter baumannii, A baumannii, mortality, death, and bloodstream infection. We used SPSS software for data analyses.</p><p><strong>Results: </strong>The reported rate of total bacterial related-bloodstream infections among hematopoietic stem cell transplant recipients was 32.1%, whereas bloodstream infections caused by A baumannii was reported at 5.9%. The reported rate of bloodstream infection-related deaths was 21.2%, of which rates of bloodstream infection-related deaths caused by A baumannii ranged from 6.3% to 7.5%.</p><p><strong>Conclusions: </strong>Although the prevalence of A baumannii in hematopoietic stem cell transplant recipients was low, mortality rates were high, which is probably because of the prevalence of multidrug resistant or carbapenem-resistant Acinetobacter strains, and appropriate control and prevention measures should be taken.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"893-899"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984129","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":"Respiratory Multiplex Polymerase Chain Reaction Could Predict Morbidity and Mortality in Solid-Organ Transplant Patients: Başkent University Experience.","authors":"Dorina Esendagli, Fidan Layijova, Emre Karakaya, Gaye Ulubay, Mehmet Haberal","doi":"10.6002/ect.2024.0203","DOIUrl":"10.6002/ect.2024.0203","url":null,"abstract":"<p><strong>Objectives: </strong>Respiratory tract infections are commonly seen and compose a great burden on health care. The causing pathogens might be either bacteria or viruses. Because treatment is different for each, prompt diagnosis and early treatment are crucial, especially in immunocompromised patients like solid-organ transplant recipients who often present with obscure findings. The aim of this study was to compare the respiratory multiplex polymerase chain reaction results of solid-organ transplant recipients with results of other hospitalized patients (control group) and to analyze whether results played a role in morbidity and mortality prediction.</p><p><strong>Materials and methods: </strong>The study was approved by the ethical committee of Başkent University (KA23/233) and included all patients who were hospitalized from January 1, 2023, to December 31, 2023, and who underwent multiplex polymerase chain reaction for diagnosis of respiratory tract infection.</p><p><strong>Results: </strong>Among analyses of 192 polymerase chain reaction samples performed in 177 patients (45 solid-organ transplant patients and 132 controls), no differences in frequency or pathogen type were shown between the groups. A positive result was associated with increased mortality in transplant patients but not in controls. Kaplan-Meier survival analysis showed no difference for survival time within 6 months of follow-up between the groups. Logistic regression analysis showed an increase of 4.28-fold in mortality for transplant patients if a positive polymerase chain reaction result was present.</p><p><strong>Conclusions: </strong>Respiratory multiplex polymerase chain reaction is a tool for fast diagnosis and prompt initiation of the right treatment. A positive result in transplant patients was associated with increased mortality.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"940-946"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985379","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 Bibliometric Analysis of Transplantation and Non-Pharmacology.","authors":"Sevinç Meşe","doi":"10.6002/ect.2024.0056","DOIUrl":"10.6002/ect.2024.0056","url":null,"abstract":"<p><strong>Objectives: </strong>Organ transplant rates are increasing every year. A successful transplant is associated with many factors. Among these factors, non-pharmacological factors are noteworthy. In this study, a bibliometric and visual analyses were performed with the aim of investigating the relationship between transplant and non-pharmacological treatment in the published literature.</p><p><strong>Materials and methods: </strong>The bibliometric analysis was conducted with Biblioshiny and VOSviewer. Visual analysis of countries/regions, institutions, authors, references cited, and keywords for 2010 to 2022 via Biblioshiny and VOSviewer were based on the Web of Science core database.</p><p><strong>Results: </strong>Web of Science data showed meta-information of 616 published articles on transplantation and non-pharmacological treatment. Bradford law results showed that 209 articles published in 11 journals were in zone 1. Results showed that the United States produced the most publications on transplantation and non-pharmacological treatment. The authors Waterman (n = 281), Gordon (n = 254), and Mathur (n = 202) had the most total citations. The author Merli (2019) was cited the most. The most frequently used key words were \"quality-of-life,\" \"transplantation,\" \"survival,\" \"mortality,\" \"physical activity,\" \"performance,\" and \"recipients.\"</p><p><strong>Conclusions: </strong>This article analyzed the status and trends of studies in transplantation and non-pharmacological methods through bibliometric analysis. Several studies showed that non-pharmacological studies have a positive effect on transplantation. The results of this research may provide researchers with useful information, such as research frontiers, potential collaborators, and cooperative institutions.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"947-956"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985297","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 Ex Situ Reduction During Hypothermic Oxygenated Machine Perfusion in a Severely Steatotic Graft From a Donor After Brain Death: An Anecdote?","authors":"Karem O Pichardo Merejildo, Nair S Fernándes Montes, Mireia Caralt Barba, Cristina Dopazo Toboada, Laura Vidal Piñeiro, Maria T Salcedo Allende, Ernest Hidalgo Llompart","doi":"10.6002/ect.2024.0224","DOIUrl":"10.6002/ect.2024.0224","url":null,"abstract":"<p><p>Marginal liver grafts, such as those from cardiac death donors and donors with steatotic organs, are highly vulnerable to ischemia-reperfusion injury. In addition, ex situ graft alteration, either by reduction or splitting, will prolong the static cold storage time and amplify the ischemia-reperfusion injury. Hypothermic oxygenated machine perfusion has the potential to end the oxygen deprivation during preservation and accordingly improve outcomes in some marginal grafts that have been traditionally discarded. We present a case of a severely steatotic graftfrom a donor after brain death for which the graft was reduced ex situ during hypothermic oxygenated machine perfusion via the portal vein to shorten static cold storage duration. The liver was successfully transplanted into a 67-year-old adult recipient. Despite having a high donor risk index (10.8) and macrosteatosis of 50%, the graft showed early good function, and the recipient was discharged home with no complications and normal liver function tests in less than 2 weeks. Although this represents an anecdotal observation, we believe, in this case,thatthe possibility to provide oxygen during hypothermic organ storage enabled graft reduction without prolonging the cold ischemia time. The endischemic hypothermic oxygenated machine perfusion has the potential to transform the traditional established strategies for organ selection and preservation.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"957-960"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985396","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":"Effect of Transplanted Liver Fat Percentage on Organ Survival: A Retrospective Review.","authors":"Sakineh Amoueian, Mohsen Aliakbarian, Golnaz Ghayyem Hassankhani, Mohammad Bahadoripour, Behnoush Bahadoripour","doi":"10.6002/ect.2024.0263","DOIUrl":"10.6002/ect.2024.0263","url":null,"abstract":"<p><strong>Objectives: </strong>Liver transplant is the most effective therapeutic option for patients with end-stage liver disease, nonalcoholic steatohepatitis, and acute liver failure. We evaluated whether the percentage of hepatic fat percentage affected transplant outcomes to determine whether livers with varying severity of macrosteatosis should be considered suitable for donation.</p><p><strong>Materials and methods: </strong>We analyzed data from 381 patients with liver failure who received liver transplant at Montaseriyeh Hospital in Mashhad, Iran, between 2013 and 2022. Clinical and demographical data were collected, and we examined frozen-section slides of pretransplant biopsy specimens from donor livers. Liver allograft macrosteatosis was categorized into 4 groups according to severity of steatosis: <10%, 10% to 20%, 20% to 30%, and >30%.</p><p><strong>Results: </strong>The mean age of recipients was 49 years; mean age of donors was 37 years. The mean liver survival rate was approximately 56 months. A total of 115 recipients (30%) died after liver transplant, with graft rejection as the leading cause of death (38%). Grafts with hepatic macrosteatosis <10% contributed to the largest share (87%). No significant differences were observed in the indication for liver transplant, life outcome, cause of death after liver transplant, or mean rate of liver survival among the 4 groups. Also, there was no significant correlation between the severity of liver macrosteatosis and graft or patient survival.</p><p><strong>Conclusions: </strong>Our findings suggest that livers with varying degrees of macrosteatosis are safe for transplant and should not be excluded from the donor pool.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"921-926"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985280","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":"Cytomegalovirus Reactivation in Seropositive Kidney Transplant Recipients: A Retrospective Analysis of a UK Cohort.","authors":"Zain Ul Abideen, Muhammad Shahzar Malik, Anna Marie Price, Emily Ko, Andrew Connor","doi":"10.6002/ect.2024.0194","DOIUrl":"10.6002/ect.2024.0194","url":null,"abstract":"<p><strong>Objectives: </strong>Cytomegalovirus infection is the most common opportunistic infection affecting organ transplant recipients and is associated with detrimental allograft and patient outcomes. In recipients previously seronegative for cytomegalovirus, acquired infection is termed primary infection, whereas infection acquired in recipients with previously confirmed seropositivity is called reactivation. Cytomegalovirus seropositivity carries a great risk of reactivation, and management for these patients may vary, from dug prophylaxis to pre emptive viral monitoring.We soughtto determine the incidence of cytomegalovirus reactivation in kidney recipients with cytomegalovirus seropositivity and to assess risk factors.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study at our center to determine the overall incidence of cytomegalovirus reactivation and associated risk factors in kidney transplant recipients with cytomegalovirus seropositivity within 12 months of transplant. For the period January 2015 to January 2021, we studied 97 transplant recipients who were seropositive for cytomegalovirus.</p><p><strong>Results: </strong>Cytomegalovirus reactivation developed in 49 of 97 recipients (50.5%); cytomegalovirus reactivation developed in 63% of recipients ≥65 years versus 42% <65 years (P = .046); and 76% of cytomegalovirus reactivations occurred within the first 3 months after transplant (P <.001). Mean glomerular filtration rate at 12 months was significantly lower in patients with cytomegalovirus reactivation (37.86 mL/min) versus without reactivation (50.85 mL/min; P = .005). Binary logistic regression analysis revealed recipient age ≥65 years as a predictor of cytomegalovirus reactivation on univariate analysis.</p><p><strong>Conclusions: </strong>Kidney transplant recipients ≥65 years were more likely to develop cytomegalovirus reactivation in the first 3 to 6 months posttransplant. Kidney allograft function at 12 months was significantly lower in recipients with cytomegalovirus reactivation. Our results suggest that universal cytomegalovirus drug prophylaxis in kidney recipients with cytomegalovirus seropositivity may help reduce cytomegalovirus reactivation and prevent associated adverse outcomes in older kidney transplant recipients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"915-920"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984761","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":"Liver Transplant Outcome in Chanarin-Dorfman Syndrome: A Rare Lipid Storage Disease.","authors":"Soheila Milani, Kiarash Ashrafzadeh","doi":"10.6002/ect.2024.0280","DOIUrl":"10.6002/ect.2024.0280","url":null,"abstract":"<p><p>Chanarin-Dorfman syndrome is a multisystem inherited metabolic disorder characterized by congenital ichthyosis and lipid droplet accumulation in various organs, including the liver, muscles, and skin. The accumulation of lipids in the liver can lead to cirrhosis, liver failure, and even hepatocellular carcinoma. Here, we present a 17-year-old girl who underwent a deceased donor liver transplant to treat uncompensated cirrhosis due to Chanarin-Dorfman syndrome. She underwent a successful liver transplant in January 2019 and has remained, to date, with a completely normal liver profile, without any posttransplant complications such as infection, rejection, and disease recurrence. There have been a few reported cases of liver transplants in Chanarin-Dorfman syndrome. This unique report presents the 5-year outcome of liver transplant in Chanarin-Dorfman syndrome and aims to improve knowledge about the specific treatment in these rare cases.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"961-963"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055833","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":"Evaluation of the Adherence of Patients to Immunosuppressive Drug Therapy After Liver Transplantation.","authors":"Kübra Bağcı Derinpinar, Öznur Erbay Dallı, Murat Kıyıcı, Ekrem Kaya","doi":"10.6002/ect.2024.0012","DOIUrl":"10.6002/ect.2024.0012","url":null,"abstract":"<p><strong>Objectives: </strong>Adherence of patients to their immunosuppressive treatment protocol after liver transplant is critical for the health and longevity of the transplanted liver. This study aimed to evaluate and determine the factors affecting the adherence of patients to immunosuppressive therapy after liver transplant.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional descriptive study with patients who had undergone liver transplant in a university hospital between June 2021 and June 2022. Data were collected using a \"Patient Identification Form\" and the \"Immunosuppressive Therapy Adherence Scale.\"</p><p><strong>Results: </strong>Among our sample of 150 patients, 19.3% (n = 29) did not adhere to their immunosuppressive therapy. A significant correlation was found between adherence to therapy and active employment status or time since transplant (P < .05). Logistic regression analysis indicated that the employment status of patients had a significant effect (2.73-fold) on their adherence to therapy (P = .046).</p><p><strong>Conclusions: </strong>There is a need for frequent evaluation of patient adherence to immunosuppressive therapy starting from the early posttransplant period and a need for information and education to improve adherence by taking into account factors affecting adherence, such as employment status and time since transplant.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"22 12","pages":"927-932"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985293","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}