Experimental and Clinical Transplantation最新文献

{"title":"Carriers of m.3243A>G Who Receive Transplant Must be Closely Monitored for Possible Mitochondrial Toxicity of Required Immunosuppressants.","authors":"Josef Finsterer","doi":"10.6002/ect.2025.0099","DOIUrl":"https://doi.org/10.6002/ect.2025.0099","url":null,"abstract":"","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 8","pages":"569-570"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030793","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 Biliary Complications in Acute-on-Chronic Liver Failure: A Single Center Study.","authors":"Rachel Davis Bouvette, Rylee Barber, Zoona Sarwar, Paulo N Martins, Narendra R Battula, Maheswaran Pitchaimuthu","doi":"10.6002/ect.2025.0076","DOIUrl":"https://doi.org/10.6002/ect.2025.0076","url":null,"abstract":"<p><strong>Objectives: </strong>Liver transplantation is the only curative treatment for end-stage liver disease. Biliary complications, such as strictures, bile leaks, and stones, occur in up to 25% of cases and are a major source of morbidity. Biliary complication rates have been shown to be increased in high-acuity liver transplants. Here, we assessed biliary complications at a single institution (University of Oklahoma Health, Oklahoma, USA), focusing on patients with acute-on-chronic liver failure.</p><p><strong>Materials and methods: </strong>Our retrospective analysis included liver transplant recipients seen from July 1, 2020, to June 30, 2023; we compared outcomes between those with and without acute-on-chronic liver failure. Patients were followed for at least 1 year posttransplant.</p><p><strong>Results: </strong>Among 116 included patients, 21 (18.1%) developed biliary complications. Complications included 7 biliary leaks and 15 biliary strictures requiring intervention. Of 56 patients (48%) with acute-on-chronic liver failure, 8 (14.2%) developed biliary complications, compared with 13 (21.7%) without acute-on-chronic liver failure. Cold ischemia time was significantly longer (P = .05) and Model for End-Stage Liver Disease scores were significantly lower (P = .03) in patients with versus without biliary complications. Patients with complications also had higher preoperative cannabis use (19% vs 5%; P = .05) and postoperative readmission rates (3.0 vs 1.0; P = .01) versus patients without biliary complications. One-year graft and patient survival rates were 95.7% and 95.7%, respectively.</p><p><strong>Conclusions: </strong>Despite an almost 50% rate of acute-on-chronic liver failure in our cohort, 18.1% of patients had posttransplant biliary complications, similar to the literature. Remarkably, patients with acute-on-chronic liver failure experienced fewer biliary complications than those without, potentially because of a multidisciplinary team approach and the strategic use of adjunct treatments like plasma exchange and continuous renal replacement therapy. This highlights the critical role of comprehensive, individualized care in improving outcomes for transplant patients with high-risk of complications.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"466-472"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977147","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":"Efficacy of the Near-Infrared Ray Fluorescent Ureteral Catheter for Prevention of Transplant Ureteral Injury in Laparoscopic Surgery after Kidney Transplant.","authors":"Satoshi Kitamura, Yoji Hyodo, Takahito Endo, Naoki Yokoyama, Kotaro Suzuki, Takuto Hara, Jun Teishima, Koji Chiba, Yoshito Terai, Hideaki Miyake","doi":"10.6002/ect.2025.0023","DOIUrl":"https://doi.org/10.6002/ect.2025.0023","url":null,"abstract":"<p><p>The increasing adoption of minimally invasive surgery has led to more kidney transplant patients undergoing laparoscopic procedure. However, these surgeries rely heavily on visual feedback due to the lack of tactile sensation, placing the transplanted ureter (located outside the peritoneum) at high risk of iatrogenic injury. The near-infrared ray catheter is a fluorescent ureteral catheter designed to emit light visible under near-infrared irradiation, offering a novel solution for enhancing ureteral visibility. Although its utility has been demonstrated in general abdominal and pelvic surgeries, its application in renal transplant cases remains underreported. In this study, we reviewed our experience with 4 cases of laparoscopic pelvic surgery in kidney transplant recipients: 1 case of lymphocele fenestration and 3 cases of bilateral salpingo-oophorectomy with or without total abdominal hysterectomy. These surgeries posed important challenges because of the anatomical complexity and proximity of the ureter to the surgical field. In each case, the transplanted ureter, barely visible under natural light, was clearly delineated under near-infrared illumination, enabling precise and safe dissection. This approach not only minimized the risk of ureteral injury but also reduced surgical stress and potentially enhanced patient outcomes. Our findings highlighted the substantial safety and efficiency benefits of near-infrared ray catheters in laparoscopic surgeries for kidney transplant patients. Further research with larger patient cohorts and varied surgical settings are essential to fully validate its clinical impact.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"494-497"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977160","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":"Renal Transplantation in Pediatric Patients: Surgical Outcomes of 15 Years of Single-Center Experience.","authors":"Hakan Sözen, Ramazan Kozan, Behruz Hüseyn, Kibriya Fidan, Aydın Dalgıç","doi":"10.6002/ect.2025.0066","DOIUrl":"https://doi.org/10.6002/ect.2025.0066","url":null,"abstract":"<p><strong>Objectives: </strong>Renal transplant is the most appropriate treatment for adult and pediatric patients with end-stage renal failure.</p><p><strong>Materials and methods: </strong>Fifty-one pediatric kidney transplants were performed in 49 pediatric recipients from a total of 263 kidney recipients at the Gazi University Transplantation Center (Türkiye) between January 2006 and January 2021. We gathered and analyzed data retrospectively from hospital medical records of pediatric transplant recipients.</p><p><strong>Results: </strong>Kidney grafts were obtained from 18 deceased (35%) and 33 living donors (65%). Among 51 pediatric renal transplants, 10 (19.6%) had complications, with 6 early and 4 late complications. Among 6 early complications posttransplant, 5 were surgical complications (9.8%) and 1 (1.9%) was urologic (1.9%), but no vascular complications were seen. Among 5 surgical complications, 3 (5.8%) were lymphocele and 2 were (3.9%) bleeding complications. Among 4 patients with late complications, 2 had renal artery stenosis and 2 had ureter stenosis. Two patients required re-transplantation because of graft loss from BK virus nephropathy and chronic allograft nephropathy. Among 51 pediatric kidney transplants, 15 recipients (29.4%) presented with 27 cases of infection. Twenty-one acute rejection episodes were seen in 14 of 51 pediatric transplant procedures (27.4%), and 4 humoral rejections occurred in 3 of 51 pediatric transplant procedures (5.8%). In addition, 27 renal transplant patients (52.9%) had normal graft functions at median follow-up of 95 months (98.7 ± 57.7; range, 58-233 mo). Twenty-eight of 51 patients (54.9%) lost kidney grafts over a 15-year follow-up. No graft loss or patient deaths occurred because of surgical complications.</p><p><strong>Conclusions: </strong>In analysis of 15 years of experience in pediatric renal transplants, our results were within results of other series. Pediatric renal transplant is a safe procedure in our department, based on patient and graft survivals, with no graft loss from surgical complications.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"460-465"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977222","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":"Clinical Outcomes of Living Donor Kidney Transplant in Older Recipients: A Retrospective Single-Center Analysis.","authors":"Hany M El Hennawy, Saad Muzaffar Azeem, Omar Safar, Abdullah S Al Faifi, Eisa Al Atta, Mahmoud Z El Madawie, Galal A El Gamal, Sadia Azeem, Ibrahim Tawhari, Osama Shalkamy","doi":"10.6002/ect.2025.0108","DOIUrl":"https://doi.org/10.6002/ect.2025.0108","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated living donor kidney transplant outcomes in older recipients (≥65 years) at Armed Forces Hospitals in the Southern Region from September 2017 to January 2025 and compared results versus younger recipients (<65 years).</p><p><strong>Materials and methods: </strong>This was a retrospective analysis of 68 older patients (group A) and 316 younger patients (group B) who received tacrolimus, mycophenolate mofetil, and prednisone, with basiliximab induction in 94.1% of group A and 92% of group B. Retransplant occurred in 5.9% of group A and 7.9% of group B.</p><p><strong>Results: </strong>Older recipients had longer dialysis durations versus younger recipients (4 vs 2 years; P < .001), longer surgeries (230 vs 180 minutes; P < .001), and longer hospital stays (7.5 vs 6.2 days; P < .001), higher rates of delayed graft function (8.8% vs 0.6%; P < .001), and lower immediate graft function (91.1% vs 97.7%; P = .006). At 1 year in group A and group B, graft survival rates (95.5% vs 97.1%; P = .501) and patient survival rates (95.5% vs 98.1%; P = .545) were similar. However, by 3 years, graft survival was lower in group A (86.7%) versus group B (92%) as was patient survival (85.2% vs 93.6%; P < .001). Graft loss within 3 years occurred in 4.4% of older versus 1.89% of younger recipients, and death with a functioning graft was more common in group A (7.3%) than in group B (2.2%). Group A also had higher rates of complications than group B (infections: 13.2% vs 6.3%; surgical site infections: 5.9% vs 0.6%).</p><p><strong>Conclusions: </strong>Despite higher risks, group A demon-strated 1-year graft and patient survival rates that were comparable with group B, highlighting feasibility of kidney transplant in well-selected older adults. However, nonadherence was associated with higher infection rates but did not significantly affect long-term outcomes.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"445-452"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977234","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":"Can Tuberculosis Infection After Liver Transplant Induce Lung Squamous Cell Carcinoma from Squamous Metaplasia of Alveolar Epithelium?","authors":"Jingjing Yao, Jianying Chen, Hongfang Yin","doi":"10.6002/ect.2024.0315","DOIUrl":"https://doi.org/10.6002/ect.2024.0315","url":null,"abstract":"<p><p>This case report describes a 65-year-old male patient with hepatocellular carcinoma who received an orthotopic liver transplant. One month after surgery, the patient was treated for tuberculosis due to the fever. At 16 months after the operation, a chest computed tomography scan revealed a mixed ground-glass nodule at the apex of the right upper lobe, which gradually grew from 5 mm to 10 mm and then was removed via thoracoscopy. Pathology examination revealed extensive squamous metaplasia of the alveolar lumen, with focal areas of malignant transformation of the squamous epithelium into moderately differentiated squamous cell carcinoma. This study highlighted the increased risks of tuber-culosis infection and lung cancer in liver transplant recipients because of use of immunosuppressive drugs, which presented as a rare case of carcino-genesis based on alveolar epithelial squamous metaplasia.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"501-504"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977244","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":"Atypical Presentation of Recurrent Hepatocellular Carcinoma After Liver Transplant.","authors":"Shiva Kumar","doi":"10.6002/ect.2025.0024","DOIUrl":"https://doi.org/10.6002/ect.2025.0024","url":null,"abstract":"<p><p>Liver transplantation remains the optimal treatment modality for patients with early-stage hepatocellular carcinoma who meet criteria for transplant. With continued expansion of criteria for liver transplantation in hepatocellular carcinoma, tumor recurrence after transplant remains a major concern, with lung and bones being the most common sites of extrahepatic recurrence after liver transplant. Cardiac metastasis of hepatocellular carcinoma that is not contiguous with the primary liver lesion is extremely rare. We describe the first reported case of recurrent hepatocellular carcinoma after transplant presenting with left atrial cardiac metastasis. As was the case in our patient, prognosis of hepatocellular carcinoma with cardiac metastases is poor. This rare manifestation of advanced hepatocellular carcinoma should be considered in the differential diagnosis of patients with recurrent hepatocellular carcinoma after transplant presenting with cardiac symptoms or imaging evidence of left atrial soft tissue mass. This observation is of added relevance in the context of ongoing efforts to expand access to liver transplant for patients with hepatocellular carcinoma using immunotherapy to downstage tumors that exceed conventional criteria.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"498-500"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977196","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":"Outcome of Children With Intestinal Failure Due to Waardenburg Syndrome From an Intestinal Transplant Center: A Case Series.","authors":"Yeliz Cagan Appak, Tuba Tinastepe, Betul Aksoy, Soysal Turhan, Cem Tugmen, Ismail Sert, Masallah Baran","doi":"10.6002/ect.2020.0166","DOIUrl":"10.6002/ect.2020.0166","url":null,"abstract":"<p><p>Waardenburg syndrome is a genetic disease char-acterized by hearing loss and pigmentation abnor-malities. Waardenburg syndrome type 4 is very rare, and children with Waardenburg syndrome type 4 present with intestinal aganglionosis. The associated findings and severity of Waardenburg syndrome type 4 may also differ significantly between cases. Intestinal insufficiency is probable and creates difficulties in terms of treatment; intestinal transplant may be required. In this case report, we present 4 cases of patients with Waardenburg syndrome who have intestinal issues, 2 of whom underwent small bowel transplant. Appropriate surgical and nutritional management should be provided for patients with Waardenburg syndrome type 4 who have gastro-intestinal manifestations.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":" ","pages":"505-508"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38414461","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":"Anxiety Disorders and Related Sociodemographic and Clinical Characteristics in Kidney Transplant Candidates: A Cross-Sectional Study from a Transplant Center in Turkey.","authors":"Selvi Ceran, Gonca Aşut, Yasemin Hoşgören Alıcı, Jamal Hasanlı, Gamze Özçürümez Bilgili, Cihat Burak Sayın, Mehmet Haberal","doi":"10.6002/ect.2025.0029","DOIUrl":"10.6002/ect.2025.0029","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with chronic kidney disease frequently face psychological challenges and emo-tional strain, increasing the risk of psychiatric conditions like anxiety and depression. This study aimed to assess the prevalence of anxiety disorders in kidney transplant candidates across different stages of chronic kidney disease and to explore related sociodemographic and clinical factors.</p><p><strong>Materials and methods: </strong>We reviewed 5 years of medical records from a transplant center, including 802 adult patients with chronic kidney disease who were referred for transplant evaluations and received at least 1 psychiatric assessment. Sociodemographic and clinical characteristics were compared between patients with and without anxiety disorders.</p><p><strong>Results: </strong>Average age of included patients was 48 ± 14 years, with 76% being male and 74% living in urban areas. Anxiety disorders were identified in 18% of patients, with 5.6% also diagnosed with depression. Independent risk factors for anxiety disorders included being female (odds ratio = 1.96; 95% CI, 1.27-3.01), unemployment (odds ratio = 1.70; 95% CI, 1.045-2.76), history of failed kidney transplant (odds ratio = 24.07; 95% CI, 10.78-53.70), and prior psychiatric history (odds ratio = 2.07; 95% CI, 1.18-3.62).</p><p><strong>Conclusions: </strong>Anxiety disorders are common in patients with chronic kidney disease and can significantly impair quality of life and daily functioning. The results emphasize the need for comprehensive psychosocial evaluations in this group, focusing on factors like sex, employment status, psychiatric background, and previous transplant outcomes.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"488-493"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977115","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":"Assessing the Safety and Efficacy of Non-vitamin K Antagonist Oral Anticoagulants in Solid-Organ Transplant Recipients: A Comprehensive Analysis of a Transplant Center.","authors":"Arzu Nelihan Akgun, Emir Karacaglar, Senem Has Hasirci, Burak Sayin, Atilla Sezgin, Mehmet Haberal","doi":"10.6002/ect.2024.0041","DOIUrl":"https://doi.org/10.6002/ect.2024.0041","url":null,"abstract":"<p><strong>Objectives: </strong>Atrial fibrillation is a common arrhythmia in solid-organ transplant recipients. Oral anticoagulant therapy is essential to prevent stroke and systemic embolism in atrial fibrillation. Warfarin is safe and effective, but non-vitamin K antagonist oral anticoa-gulants are an emerging alternative. We examined the safety/efficacy of non-vitamin K antagonist oral anticoagulants in solid-organ transplant recipients.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated electronic medical records of 52 solid-organ transplant recipients diagnosed with atrial fibrillation and collected information on demographics, electrocardiogram and laboratory data, anticoagulation treatment, and organ transplant. We compared patients with nonvalvular atrial fibrillation who received non-vitamin K antagonist oral anticoagulants versus warfarin and analyzed the incidence of systemic embolic events and major bleeding events. Scores for CHA2DS2-VASc (ie, congestive heart failure, hypertension, age, diabetes, previous stroke/transient ischemic attack) and Anticoagulation and Risk Factors in Atrial Fibrillation bleeding risk were obtained for risk assessment of thrombosis versus bleeding, respectively.</p><p><strong>Results: </strong>Of the 43 patients, most were kidney transplant recipients (76.4%), followed by liver (13.9%) and heart (9.3%). Mean bleeding score was higher in the warfarin group, and mean thrombosis score was higher in the non-vitamin K antagonist oral anticoagulants group but not statistically significant. Incidence of major bleeding events was higher in the warfarin group but not statistically significant. Incidence of systemic embolic events was higher in the non-vitamin K antagonist oral anticoagulant group but not statistically significant.</p><p><strong>Conclusions: </strong>This is the first study to characterize present use of non-vitamin K antagonist oral anticoagulants in solid-organ transplant recipients at a single center in Turkey. We observed that these agents are as effective as warfarin to prevent systemic embolic events and bleeding risks, with no significant difference between therapies. At our institution, we prefer non-vitamin K antagonist oral anticoagulants in patients with appropriate indications according to the benefit-risk profile.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 7","pages":"473-478"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977199","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}