Experimental and Clinical Transplantation最新文献

{"title":"Safe and Easy Method to Prevent Bile Leakage in Biliary Reconstruction: Placing a Double J Catheter.","authors":"Mehmet Haberal, Emre Karakaya, Sedat Yıldırım, Adem Şafak, Ozan Okyay, Fatih Boyvat, Özgür Özen","doi":"10.6002/ect.MESOT2025.O92","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O92","url":null,"abstract":"<p><strong>Objectives: </strong>Bile leak remains an important complication after biliary reconstruction, particularly in living donor liver transplant. We evaluated the effect of routine intraoperative placement of a double J stent across the biliary anastomosis on postoperative bile leak in patients undergoing biliary reconstruction.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 63 patients who underwent biliary reconstruction with intraoperative double J stent placement at Başkent University Hospital between November 2021 and January 2025. Fifty-five patients were liver transplant recipients, and 8 patients underwent hepatopancreatobiliary surgery for tumor resection, trauma, or complex benign biliary disease. We analyzed demographic characteristics, biliary anatomy, number of bile ducts, type and number of biliary anastomoses, and postoperative biliary complications.</p><p><strong>Results: </strong>Of 63 patients, 35 were male and 28 were female. Among the liver transplant recipients, 51 underwent living donor liver transplant and 4 underwent auxiliary liver transplant; 30 were pediatric and 25 were adult recipients. Duct-to-duct anastomosis was the most commonly used reconstruction technique, followed by Roux-en-Y hepaticojejunostomy and hepaticoduodenostomy. Multiple bile ducts were present in 17 patients. Early bile leak developed in 6 of 63 patients (9.52% ). Among living donor liver transplant recipients, bile leak occurred in 5 of 51 patients (9.8% ). All patients with bile leak had more than 1 bile duct. Four patients were managed endoscopically with stent removal, sphincterotomy, and internal biliary stent placement, and 2 patients underwent percutaneous drainage. No patient required reoperation, and no mortality related to bile leak was observed. No clinically significant stent migration, severe cholangitis, or stent-related obstruction developed during follow-up.</p><p><strong>Conclusions: </strong>Intraoperative placement of a double J stent during biliary reconstruction appears to be a safe and practical adjunct in both liver transplant and complex hepatopancreatobiliary surgery, particularly in patients with multiple bile ducts. Prospective controlled studies are needed to better define its role.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"225-230"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649578","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":"Organ Transplantation in Kazakhstan and Central Asia.","authors":"Gani Kuttymuratov, Nurzhan Bikhanov, Timur Suleimenov, Bagdat Alatayev, Akimzhan Zainalov, Dinmukhamed Tulegenov, Temirlan Bagitzhanov, Telman Amirkhan, Aigul Karabayeva, Askar Ayaganov","doi":"10.6002/ect.MESOT2025.P175","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P175","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the current landscape of deceased organ donation across the 5 Central Asian nations ( Kazakhstan, Uzbekistan, Tajikistan, Kyrgyzstan, and Turkmenistan ) and identified the multifactorial causes behind the regional \"transplant gap.\" The study specifically focused on renal transplant programs, which constitute the vast majority of transplant activities and waiting lists in the region.</p><p><strong>Materials and methods: </strong>We conducted a comprehensive analysis using a multidisciplinary approach, which included an audit of national legislative frameworks and official health ministry reports from 1972 to 2024. We performed qualitative synthesis on expert discourse from theologians, health care professionals ( including urologists and transplant surgeons ), and bioethicists to identify informal socio - cultural barriers. The study conformed to the 1975 Helsinki Declaration guidelines.</p><p><strong>Results: </strong>Despite modern legal frameworks permitting deceased donation, clinical implementation remains nonexistent in most of the 5 republics, with activity almost exclusively limited to living related kidney and liver donation. Kazakhstan is the only nation with a sustained deceased donor program, where kidney transplants represent approximately 90 % of the national waiting list. However, the region faces a staggering 88 % family refusal rate. Religious misconceptions and the enduring influence of Tengrist \"intact body\" taboos were identified as pivotal factors hindering the transition from living to deceased donation.</p><p><strong>Conclusions: </strong>The failure of deceased donation programs in Central Asia is rooted in a unique synthesis of \"Folk Islam\" and ancestral nomadic traditions. Because the regional transplant capacity is primarily centered around urological and nephrological care, national strategies must integrate cultural resonance into these clinical settings. Success depends on reframing organ donation as a modern manifestation of traditional nomadic values through partnerships between medical specialists and religious leaders.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"32-38"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649764","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":"Preoperative Nutritional Indices Predicting Delayed Graft Function in Pediatric Kidney Transplantation.","authors":"Meraj Alam Siddiqui, Esra Baskın, Özlem Yüksel Aksoy, Alara Akdeniz, Ozan Okyay, Adem Şafak, Emre Karakaya, Mehmet Haberal","doi":"10.6002/ect.MESOT2025.O61","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O61","url":null,"abstract":"<p><strong>Objectives: </strong>The Prognostic Nutritional Index, which combines serum albumin and lymphocyte count, captures protein reserves and immune competence in a single, easily obtained metric. Whether this index can predict delayed graft function among pediatric kidney transplant recipients has not been thoroughly evaluated. Here, we examined whether use of this index pretransplant can predict delayed graft function in this population.</p><p><strong>Materials and methods: </strong>We reviewed children (aged 1 -18 years )who received kidney transplants at Başkent University Hospital from January 2013 to December 2024. Patients were stratified by delayed graft function status. We collected recipient and donor demographics, clinical characteristics, and routine preoperative laboratory values. The Prognostic Nutritional Index and other inflammatory indices (neutrophil -to -lymphocyte ratio, platelet -to -lymphocyte ratio, and systemic inflammatory index derived from the same preoperative blood counts ) were calculated.</p><p><strong>Results: </strong>Twenty -eight of 162 children (17.3 % ) experienced delayed graft function. In regression analysis, each 1 -point increase in the Prognostic Nutritional Index, which reflects better nutritional and immune status, was linked to an 8 % lower chance of developing delayed graft function (odds ratio 0.92; 95 % CI, 0.85 -0.99; P = .042 ). Higher neutrophil -to -lymphocyte ratio indicated significantly greater risk of delayed graft function (odds ratio 1.30; 95 % CI, 1.05 -1.61; P = .016 ), and a 1 -unit rise in the platelet -to -lymphocyte ratio provided a small but meaningful protective effect (odds ratio 0.99; 95 % CI, 0.993 -0.999; P = .041 ). Higher systemic inflammatory index indicated a slightly lower risk of delayed graft function (odds ratio 0.9997 /unit increase; P =.049 ). Recipient characteristics did not differ between those with and without delayed graft function.</p><p><strong>Conclusions: </strong>Among the study patients, the Prognostic Nutritional Index emerged as a strong predictor of delayed graft function. Integrating this index with simple inflammatory indices into preoperative assessments may enable early identification of high -risk children, inform donor selection, and guide perioperative management to improve graft outcomes.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"177-182"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649782","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":"Navigating Pediatric Organ Transplant: Nurses' Perspectives on Challenges and Coping.","authors":"Halil Ibrahim Tasdemir, Deniz Tasdemir","doi":"10.6002/ect.MESOT2025.P186","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P186","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to explore the experiences, challenges, and coping strategies of nurses working in pediatric organ transplant clinics in Türkiye. We investigated emotional stressors, ethical dilemmas, communication challenges, and the effectiveness of institutional support to address these challenges.</p><p><strong>Materials and methods: </strong>A qualitative descriptive study design was employed. Data were collected through semi -structured face -to -face interviews with 20 organ transplant nurses from various hospitals in Türkiye. We used a purposive sampling method to select the participants. We used qualitative data analysis software (NVivo; version 12 ) to identify recurring themes related to emotional distress, ethical concerns, communication issues, and coping strategies. Ethical approval was obtained from the relevant institutional review board, and informed consent was secured from all participants.</p><p><strong>Results: </strong>Thematic analysis revealed 4 main categories: emotional challenges, ethical dilemmas, communication challenges, and coping strategies. Nurses reported experiencing high levels of stress and burnout due to prolonged exposure to critically ill children. Ethical dilemmas related to organ allocation decisions created additional moral distress. Communication challenges were primarily linked to breaking bad news to patients' families and managing unrealistic expectations from families. Coping mechanisms included reliance on peer support, use of previously established personal resilience strategies, and access to institutional psychological support.</p><p><strong>Conclusions: </strong>Pediatric organ transplant nurses encounter important emotional, ethical, and communication challenges. Enhancing institutional support structures, providing targeted psychological counseling, and improving communication training programs could alleviate these concerns and thereby improve both nurse well -being and patient care outcomes. Future multicenter studies would expand the generalizability of these findings and identify best practices for institutional support of transplant nurses.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"389-394"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649796","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 Algerian Experience in Enhancing Kidney Transplant Safety and Eligibility via Combined Crossmatch Techniques.","authors":"Saliha Boutennoune, Ali Benziane, Soumia Missoum, Fethi Meçabih, Besma Sifi, Yacine Khanfri, Lilya Meriem Berkani, Abdelkarim Baha, Ibtissem Fellahi, Amel Gazit","doi":"10.6002/ect.MESOT2025.P7","DOIUrl":"10.6002/ect.MESOT2025.P7","url":null,"abstract":"<p><strong>Objectives: </strong>Crossmatch testing detects donor-specific anti -HLA antibodies to stratify immunological risk before living -donor kidney transplant, preventing antibody -mediated rejection. This study optimized a tiered strategy combining complement -dependent cytotoxicity, flow cytometry, and Luminex single antigen assays for precise pathogenicity assessment of donor -specific antibodies in resource -constrained Algerian centers lacking routine deceased -donor programs.</p><p><strong>Materials and methods: </strong>This prospective ongoing study (initiated in 2021 ) enrolled 90 sensitized patients (mean age 35 years; range, 9 -61 years; sex ratio: 0.6 ) at Bab El Oued and Batna University Hospitals. Sensitizing events included transfusions (41 %), pregnancy (13 % ), prior transplant (6 % ), and unknown (40 % ). Full 3 -assay stratification was applied to 45 patients: category 1 (all positive tests ) were excluded from transplant; category 2 (negative complement -dependent cytotoxicity crossmatch /positive flow cytometry crossmatch /positive Luminex single antigen assay ) underwent desensitization to achieve negative flow cytometry crossmatch; category 3 (negative complement -dependent cytotoxicity crossmatch/negative flow cytometry crossmatch /positive Luminex single antigen assay ) were subdivided into categories 3a (Luminex single antigen mean fluorescence intensity >3000, preventive desensitization ) and 3b (mean fluorescence intensity <3000, direct transplant ); and category 4 (all assays negative ).</p><p><strong>Results: </strong>Stratification was as follows: 1 patient in category 1, 4 patients in category 2 (1 transplanted after desensitization, others ongoing ), 9 patients in category 3a, 24 patients in category 3b, and 7 patients in category 4. Of 31 transplanted patients, 90 % reached 3 -month and 60 % reached 12 -month follow -up, with mean serum creatinine of 1.4 mg /dL. Donor -specific antibody cleared in 80 % (category 3b ); 20 % had persistent low mean fluorescence intensity donor-specific antibodies. No patients had acute antibody-mediated rejection on 12 -month protocol biopsies.</p><p><strong>Conclusions: </strong>Integrated crossmatch assays enabled safe transplant in 84 % (categories 3b /4 ), reducing desensitization needs amid absent deceased -donor programs and rare paired exchange.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"231-234"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649632","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":"Sleep Problems and Kidney Transplantation: A Bibliometric Analysis.","authors":"Büşra Nur Temur, Nilgün Aksoy, Ayşe Meydanlıoğlu","doi":"10.6002/ect.MESOT2025.P24","DOIUrl":"10.6002/ect.MESOT2025.P24","url":null,"abstract":"<p><strong>Objectives: </strong>Sleep problems are highly prevalent among kidney transplant recipients. In this bibliometric study, we aimed to map the global scientific output related to sleep problems in the context of kidney transplantation.</p><p><strong>Materials and methods: </strong>We conducted a comprehensive literature search on May 14, 2025, using the Web of Science Core Collection database. The search strategy included title -based key words ( \"sleep\" OR \"insomnia\" OR \"sleep -related\" OR \"hypoventilation\" OR \"hypersomn*\" OR \"narcolepsy\" OR \"Kleine -Levin syndrome\" OR \"sleep -wake\" OR \"jet lag\" OR \"nightmare\" OR \"parasomnia\" OR \"confusional arousals\" OR \"exploding head syndrome\" OR \"restless legs syndrome\" OR \"periodic limb movement disorder\" ). Only English -language publications were included, and no year restriction was applied. We retrieved 400 articles, with articles analyzed using VOSviewer software for bibliometric mapping and visualization.</p><p><strong>Results: </strong>Co -authorship and co -citation analyses revealed collaborative networks and influential contributions in the field. Novak (2019 ) emerged as a key author with the strongest collaborative ties. Key word co -occurrence analysis highlighted significant thematic links, particularly between \"renal transplantation\" and \"sleep quality\" and between \"kidney transplantation\" and \"sleep apnea.\" The American Journal of Kidney Diseases received the highest number of citations (n = 1146 ), followed by Nephrology Dialysis Transplantation (n =468 ). These 2 journals also demonstrated a strong co-citation relationship, underscoring their central role in disseminating research in this area. Highly cited studies included Eltzschig (2011 ) with 2611 citations and Younossi (2019 ) with 1506 citations. Bibliographic coupling revealed that Artom (2014 ) and Picerillo (2017 ) shared a significant degree of relatedness based on shared references.</p><p><strong>Conclusions: </strong>Results indicated increasing scientific interest on sleep quality and sleep disorders. The results can inform future interdisciplinary research agendas, support clinical practice improvements, and guide health policy efforts aimed at enhancing the quality of life and outcomes of kidney transplant recipients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"252-259"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649591","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 Transplant in Joubert Syndrome: A Human-Centered Case Series From a Single Center.","authors":"Khalid Abdultawab, Mohamed Badawi, Medhat Alawaday, Mohamed Shaker, Mohamed Adel, Mohamed Balaha, Torki Alotaibi, Osama Gheith","doi":"10.6002/ect.MESOT2025.P55","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P55","url":null,"abstract":"<p><strong>Objectives: </strong>Joubert syndrome is a rare ciliopathy in which kidney disease can quietly progress to end -stage kidney disease, often in children and young adults. For these patients and their families, kidney transplant is a turning point, yet published experience remains limited. Here, we share our center's experience with kidney transplant in 5 patients with Joubert syndrome who progressed to end -stage kidney disease, highlighting medical outcomes and practical challenges.</p><p><strong>Materials and methods: </strong>We conducted a retrospective case series of 5 patients with Joubert syndrome and end -stage kidney disease who received kidney transplants at our center. We reviewed medical records for demographic data, neurological and extrarenal features, renal course, transplant details, immunosuppression, complications, and long -term graft and patient outcomes.</p><p><strong>Results: </strong>The cohort included 3 male and 2 female patients who received transplants between 12 and 40 years of age. Two patients had genetically confirmed Joubert syndrome, and 3 patients had a clinical diagnosis. Nephronophthisis was the documented cause of end -stage kidney disease in 2 children, whereas 3 patients had end -stage kidney disease attributed to Joubert syndrome without further histology classification. All patients received calcineurin inhibitor -based triple immunosuppression. Delayed graft function occurred in all 5 recipients. Two patients developed biopsy -proven T -cell -mediated acute rejection, successfully treated with pulse steroids. At last follow -up, 3 patients were alive with functional grafts, 1 patient was alive on dialysis after graft loss due to chronic pyelonephritis, and 1 patient died from severe infection with a functional graft.</p><p><strong>Conclusions: </strong>Kidney transplant is feasible and generally effective in patients with Joubert syndrome, offering durable renal replacement in most cases. However, the universal occurrence of delayed graft function and the effect of infectious complications, which led to 1 graft loss and 1 death, emphasize the need for careful perioperative management, urological assessment, and close long -term follow -up within a multidisciplinary framework.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"291-297"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649644","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":"Are Renal Cysts a Barrier to Donation and Kidney Transplant?","authors":"Adem Şafak, Emre Karakaya, Burak Yağdıran, Sedat Yıldırım, Mehmet Haberal","doi":"10.6002/ect.MESOT2025.O48","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O48","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the long-term outcomes of kidney transplants performed using grafts that contain simple renal cysts, to determine whether these cysts constitute a barrier to kidney donation or transplant.</p><p><strong>Materials and methods: </strong>All kidney transplants performed by our team from February 2012 to May 2025 were retrospectively reviewed. Cases in which the graft contained at least 1 simple renal cyst were included. Demographic characteristics, cyst size, perioperative complications, postoperative renal function, and cyst size during follow-up ultrasonography were recorded. Postoperative serum creatinine levels were analyzed on day 1, week 1, month 1, and year 1. Changes in cyst size and the need for intervention were assessed.</p><p><strong>Results: </strong>A total of 66 kidney transplants involving grafts with simple cysts were included. The mean age of recipients was 50.2 years, and 38 were female recipients. The mean cyst diameter was 14.5 ± 8.3 mm. Eight (12.1%) grafts contained cysts smaller than 5 mm, 18 (27.3% )grafts had cysts between 5 and 10 mm, and 40 (60.6% )grafts had cysts larger than 10 mm. No intraoperative complications occurred in donors or recipients. Early postoperative urinary tract infection developed in 9 patients but resolved completely with intravenous antibiotic therapy. At postoperative month 6, 44 patients demonstrated a decrease in cyst size, whereas 15 patients showed an increase. Only 1 patient required surgical excision due to cyst enlargement exceeding 5 cm. Mean serum creatinine levels on postoperative day 1, week 1, month 1, and year 1 were 2.48, 1.42, 1.23, 1.42 mg/dL, respectively.</p><p><strong>Conclusions: </strong>Simple cysts in kidney grafts do not constitute a contraindication to kidney donation or transplant. When managed in experienced transplant centers and followed regularly, grafts containing simple renal cysts demonstrate favorable outcomes with low complication rates.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"132-136"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649655","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 Donor-Specific Antibodies with Rejection and Graft Outcomes in Pediatric Kidney Transplant Recipients: A Single-Center Retrospective Study.","authors":"Begüm Avcı, Gönül Parmaksız, Aytül Noyan, Kenan Çalışkan, Esra Baskın, Bilkay Baştürk, Mehmet Haberal","doi":"10.6002/ect.MESOT2025.O42","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O42","url":null,"abstract":"<p><strong>Objectives: </strong>De novo donor -specific antibodies are recognized mediators of alloimmune injury after kidney transplant, yet their clinical significance in pediatric recipients remains incompletely defined. We evaluated the incidence of de novo donor -specific antibodies and the associated rejection patterns and graft outcomes in a pediatric kidney transplant cohort.</p><p><strong>Materials and methods: </strong>This retrospective single -center study included pediatric kidney transplant recipients who underwent transplants between 2009 and June 2024. Donor -specific antibody positivity was determined using Luminex -based assays (mean fluorescence intensity >1000 ). Clinical, immunologic, and functional outcomes were compared between patients positive for donor -specific antibodies and patients negative for donor -specific antibodies, including rejection phenotype, estimated glomerular filtration rate, graft loss, and duration of follow -up.</p><p><strong>Results: </strong>Among 78 recipients, 15 recipients (19.2 % ) developed de novo donor -specific antibodies during a mean follow -up of approximately 4 years. Acute rejection occurred more frequently in patients positive for donor -specific antibodies versus patients negative for donor -specific antibodies (80 % vs 32 %, respectively; P = .053 ), predominantly antibody -mediated or mixed phenotypes. Graft loss rates were comparable between groups (13.3 % vs 14.2 %; P = 1.000 ). Although not statistically significant, recipients positive for donor -specific antibodies demonstrated numerically lower eGFR values at 1 year and at last follow -up (49.6 ± 22.2 vs 57.1 ± 29.8 mL /min /1.73 m ² at last visit, respectively; P - .445 ).</p><p><strong>Conclusions: </strong>In this pediatric cohort, de novo development of donor -specific antibodies was associated with a higher tendency toward antibody -mediated rejection, without a significant difference in short -term to mid -term graft survival. Continued surveillance of donor -specific antibodies and longer follow -up are warranted to clarify the long -term clinical effect of donor -specific antibodies in pediatric kidney transplants.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"110-114"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649658","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":"Monoclonal Gammopathies in Kidney Transplant Recipients: A Retrospective Analysis of Incidence, Clinical Characteristics, and Outcomes.","authors":"Nehed Ghenam, Narjess Ben Aycha, Raja Boukadida, Nessrine Thabet, Awatef Azzabi, Yosra Guedri, Nesrine Ben Sayed, Nihed Abdessayed, Wissal Sahtout, Dorsaf Zellama","doi":"10.6002/ect.MESOT2025.O56","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O56","url":null,"abstract":"<p><strong>Objectives: </strong>Monoclonal gammopathies represent a spectrum of clinical and biological abnormalities characterized by monoclonal immunoglobulin production from plasma cell clones. In kidney transplant recipients, monoclonal gammopathies and their identification constitute a complex and multifactorial phenomenon involving immunological alterations and underlying pathologies such as multiple myeloma or lymphoproliferative diseases.</p><p><strong>Materials and methods: </strong>We retrospectively studied patients who underwent kidney transplant at the Nephrology Department of Sahloul University Hospital from November 1, 2007, to December 31, 2024, and who had detection of monoclonal gammopathies during follow -up.</p><p><strong>Results: </strong>Among 332 kidney transplant recipients, 10 (3.0 % ) developed monoclonal gammopathies. Mean age was 42.4 years (range, 27 -58 years ), with male predominance (70 % ). Hypertension was the most frequent comorbidity (50 % ). Only 1 patient had preexisting monoclonal gammopathies before transplant. Chronic interstitial nephropathy was the most common initial nephropathy (62.5 % ). Mean time to diagnosis of monoclonal gammopathies posttransplant was 58.9 months. Serum protein electrophoresis revealed monoclonal peaks in the gamma -globulin region (70 % ), beta -1 globulin (20 % ), and beta -2 globulin (10 % ). Immunofixation showed immunoglobulin G lambda (40 % ), immunoglobulin G kappa, immunoglobulin A lambda and kappa, and isolated light chains. Proteinuria was present in 60 % and anemia in 70 % of cases. Evolution included return to hemodialysis in 3 patients, infectious complications in 4 patients, and 1 death.</p><p><strong>Conclusions: </strong>The effect of monoclonal gammopathies on kidney transplant recipients remains an evolving research domain where diagnostic and therapeutic advances play a key role in improving management of these vulnerable patients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"151-159"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649727","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}