Experimental and Clinical Transplantation最新文献

{"title":"Quality Performance Management in the Tuscany Procurement and Transplant System: A Reporting and Monitoring Approach.","authors":"Chiara Lazzeri, Michela Maielli, Federico Gelli, Marco Bombardi, Giuseppe Feltrin, Adriano Peris","doi":"10.6002/ect.2025.0064","DOIUrl":"10.6002/ect.2025.0064","url":null,"abstract":"<p><strong>Objectives: </strong>The Tuscany Region has an annual number of donors of about 100 donors per million population, whereas transplant activity is about 80 per million population. We aimed to describe the reporting and monitoring approach for assessment of quality performance implemented since 2022 by the Tuscany Procurement and Transplant Center and the effects of this reporting and monitoring approach on donation and transplant activity in 2024. The goal of this approach was to maintain donation activity and increase transplant activity.</p><p><strong>Materials and methods: </strong>For the Tuscany reporting approach, the Tuscany Procurement and Transplant Center measures indicators, which are transmitted monthly to hospital management staff, transplant coordinators, and transplant centers. Data sources are donor electronic files.</p><p><strong>Results: </strong>From January to November 2024, 352 donors were assessed (utilization rate 92%). Donation activity in the Tuscany Region was comparable in 2024 versus in 2023 (101.2 vs 103 per million population). Controlled donations after circulatory death increased (+13). The number of actual donors and utilization rate of organs showed an increase compared with 2023. In 2024, 336 transplants were performed by Tuscany transplant centers, 74 transplants more than in 2023. Transplant activity was therefore 91.3 per million population versus 80 per million population in the Tuscany Region in 2023.</p><p><strong>Conclusions: </strong>The reporting and monitoring approach led to the maintenance of a high donation activity (about 100 donors per million population) and an increase in transplant activity in Tuscany. This approach was shown to be effective and efficacious for the solid-organ donation and transplant system in Tuscany.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 4","pages":"247-251"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112687","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 Retrospective Comparison of TECAM and BEAM Conditioning Regimens Before Autologous Hematopoietic Stem Cell Transplant in Lymphoma Patients: Efficacy and Toxicity.","authors":"Pusem Patir, Nur Soyer, Isabel Raika Durusoy, Fahri Sahin, Guray Saydam, Mahmut Tobu, Murat Tombuloglu, Filiz Vural","doi":"10.6002/ect.2017.0274","DOIUrl":"10.6002/ect.2017.0274","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of our study was to evaluate the efficacy and toxicity of TECAM (thiotepa, etoposide, cyclophosphamide, cytarabine, and melphalan) and BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning regimens before autologous hematopoietic stem cell transplant in patients with lymphoma.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 108 relapsed/refractory lymphoma patients who had high-dose treatments followed by autologous hematopoietic stem cell transplant between October 2012 and February 2017.</p><p><strong>Results: </strong>At a median follow-up period of 16 months, the estimated 2-year progression-free survival rates for the TECAM and BEAM groups were 55.7% and 52.9%, respectively (P = .811). The estimated 2-year overall survival rate in the TECAM group (55.9%) was relatively inferior to that shown in the BEAM group (67%), but the differences were not significant (P = .238). No differences were observed for time to hematopoietic recovery and duration of hospitalization. Incidences of transplant-related infectious and noninfectious complications were similar for each conditioning regimen.</p><p><strong>Conclusions: </strong>Our experience shows that the TECAM regimen is an effective high-dose chemotherapy for lymphoma patients before autologous hematopoietic stem cell transplant.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":" ","pages":"299-305"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36280989","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 and Postoperative Endogenous Melatonin and Anxiety Levels and Their Correlation in Living Liver Donors.","authors":"Mehmet Ali Erdogan, Muharrem Ucar, Ulku Ozgul, Selim Erdogan, Yusuf Ziya Colak, Onural Ozhan, Rukiye Yaman, Yilmaz Ugur, Songul Aydemir, Hakan Parlakpinar","doi":"10.6002/ect.2021.0060","DOIUrl":"10.6002/ect.2021.0060","url":null,"abstract":"<p><strong>Objectives: </strong>High anxiety levels may lead to mental and physical changes that may affect quality of life. Melatonin has anxiolytic properties. It has been reported that administration of melatonin reduces anxiety. In this study, we examined the preoperative and postoperative anxiety levels of living liver donors and the correlation between anxiety levels and endogenous melatonin levels.</p><p><strong>Materials and methods: </strong>This prospective clinical study included 56 living liver donors who underwent right hepatectomy (39 women, 17 men; average age of 29 ± 7 years). The anxiety levels were evaluated by using the Spielberger State-Trait Anxiety Inventory Test with a form for this test used to measure the current state of anxiety score and another form used to measure the underlying anxiety score of the patient. These forms were applied preoperatively and postoperatively. Blood samples were taken simultaneously for melatonin levels. Melatonin levels were measured using high-pressure liquid chromatography. Our primary outcomes were to determine the preoperative and postoperative endogenous melatonin and anxiety levels of living liver donors and to investigate their correlations.</p><p><strong>Results: </strong>A statistically significant difference was observed between preoperative and postoperative state of anxiety scores. The preoperative and postoperative underlying anxiety scores were similar. A statistically significant difference was found between the preoperative endogenous melatonin level and postoperative endogenous melatonin level. A significant correlation was not observed between the preoperative and postoperative current and underlying anxiety levels or endogenous melatonin levels.</p><p><strong>Conclusions: </strong>Living liver donors had high anxiety levels during the preoperative and postoperative periods. A significant decrease was identified in the postope-rative hour 24 endogenous melatonin level. These results may lay the foundation for interventions that can identify emotional changes as well as control and improve the mental health of living liver donors.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":" ","pages":"278-284"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39190237","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 Between Higher Intraoperative Oxygen Exposure and Worse Patient and Organ Outcomes in Liver Transplantation.","authors":"Jeremy Fabes, Andrew Milne, Madeleine Wells, Amanpreet Sarna, Maximilian Neun, Michael Spiro","doi":"10.6002/ect.2024.0296","DOIUrl":"10.6002/ect.2024.0296","url":null,"abstract":"<p><strong>Objectives: </strong>Hemodynamic instability (postreperfusion syndrome) at reperfusion of the liver graft during transplant is common and represents the acute phase of ischemia-reperfusion injury. Both phenomena involve reactive oxygen species generation and are associated with worse patient and graft outcomes. Unwarranted hyperoxia is increasingly recognized as a harmful intervention among different clinical settings. We sought to determine the association between intraoperative oxygen exposure, during liver transplant, and patient and graft outcomes to inform clinical management strategies.</p><p><strong>Materials and methods: </strong>We conducted a retrospective, observational cohort study of 185 adult patients undergoing deceased donor liver transplant at a single UK transplant center between February 2017 and June 2019. Primary endpoints were severity of postreperfusion syndrome and early allograft dysfunction. Secondary endpoints were critical care and hospital length of stay. We calculated time-weighted oxygen exposure by the area under the curve method from serial blood gas measurements. Univariate and multivariate associations between donors, patients, and process risk factors, as well as oxygen exposures, were calculated for the predefined endpoints.</p><p><strong>Results: </strong>Among 185 included patients, 93 (51.4%) had postreperfusion syndrome and 26.0% had early allograft dysfunction. Total anhepatic oxygen exposure (kPa.h) was shown to independently increase the risk of moderate to severe postreperfusion syndrome (odds ratio = 1.041; P = .007). Total oxygen exposure (kPa.h) throughout surgery was shown to independently increase the severity of postoperative early allograft dysfunction (coefficient 0.174; P = .011). Early allograft dysfunction was independently associated with pro-longed intensive care unit (odds ratio = 3.045; P = .005) and hospital stay (odds ratio = 7.738; P < .001).</p><p><strong>Conclusions: </strong>Hyperoxia during liver transplant was independently associated with increased risk of adverse patient and graft outcomes, similar to data from other clinical settings. Intraoperative oxygenation strategies to minimize unnecessary hyperoxia may lead to clinical benefits and cost savings.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 4","pages":"269-277"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112603","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":"In Memoriam: David Sutherland, MD, PhD.","authors":"Mehmet Haberal","doi":"10.6002/ect.2025.davidsutherland","DOIUrl":"https://doi.org/10.6002/ect.2025.davidsutherland","url":null,"abstract":"","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"163-164"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027221","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 Management of a Refractory Scedosporium (Pseudallescheria) boydii Keratitis With Sclerokeratoplasty.","authors":"Seray Şahin, Süleyha Hilmioglu Polat, Özlem Barut Selver","doi":"10.6002/ect.2024.0122","DOIUrl":"https://doi.org/10.6002/ect.2024.0122","url":null,"abstract":"<p><p>Here, we present the successful sclerokeratoplasty surgery in resistant Scedosporium (Pseudallescheria) boydii keratitis. A 47-year-old male patient presented with complaints of 4-mm corneal infiltration and 1-mm hypopyon after an eye injury with organic material. Topical treatments with vancomycin (50 mg/mL), ceftazidime (50 mg/mL), voriconazole (10 mg/mL), and amphotericin B (0.5 mg/mL) were started hourly. Because of the significant progression despite the treatment, emergency therapeutic penetrating keratoplasty was performed. In this patient, in whom Scedosporium boydii growth was detected in mycological examination, although the infection appeared under control after keratoplasty, recurrence occurred on day 30. Hence, because of the rapid progression of the infection to the corneoscleral junction despite intensive treatment, emergency sclerocorneal transplant was performed. Globe integrity was preserved, and the patient had no recurrence in the 5-month follow-up. In severe S. boydii keratitis that causes infiltration up to the limbus border, removal of infected corneal tissue by wide excision and sclerocorneal transplant along with medical treatment may offer a successful treatment option. To the best of our knowledge, this is the first case in which sclerokeratoplasty was performed to successfully treat S. boydii keratitis.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"235-238"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054645","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":"Investigation of the Effectiveness of Oleuropein in a Three-Dimensional In Vitro Hepatocellular Tumor Sphere Model.","authors":"Cagla Tekin, Melis Ercelik, Secil Ak Aksoy, Mine Camlibel, Sena Ferah, Melisa Gurbuz, Fuat Aksoy, Ekrem Kaya, Berrin Tunca","doi":"10.6002/ect.2023.0020","DOIUrl":"10.6002/ect.2023.0020","url":null,"abstract":"<p><strong>Objectives: </strong>This study was conducted to examine the dose-related effects over time of oleuropein on the proliferation and area of tumor spheroids in hepatocellular carcinoma cells.</p><p><strong>Materials and methods: </strong>We examined the possible effects of 100 to 500 μM dose concentrations of oleuropein on HepG2 cell proliferation using a real-time cell analyzer. A 3-dimensional hepatocellular carcinoma tumor spheroid model was established by seeding HepG2 cells at a density of 160 cells/well in custom 96-well microplates with low attachment surfaces and culturing for 3 days. Tumor spheres were treated with increasing oleuropein doses for 72 hours, and images were captured every 24 hours. The dose-dependent effects of oleuropein on tumor sphere size were analyzed by measuring the area of tumor spheres with ImageJ software. We conducted oleuropein viability and cytotoxicity analyses using calcein acetoxymethyl ester-based and propidium iodide-based staining in the tumor model.</p><p><strong>Results: </strong>Oleuropein inhibited cell proliferation; as the dose concentration of oleuropein increased, so did its capacity to inhibit cell proliferation (P < .001). The size of untreated tumor spheres increased at 72 hours (P < .001). However, treatment with 100 to 500 μM oleuropein reduced tumor size by 63.56% to 88.06% compared with untreated cells at the end of 72 hours (P < .001). With increasing concentrations, oleuropein inhibited the viability of tumor spheres, eliminating necrotic death caused by tumor hypoxia.</p><p><strong>Conclusions: </strong>Overall, oleuropein reduced the size of tumors by inhibiting tumor proliferation and viability. In this context, oleuropein could be a candidate molecule for further extensive studies to reduce hepatocellular carcinoma tumors to meet Milan criteria for liver transplant.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":" ","pages":"207-213"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242536","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":"Relevance of Human Leukocyte Antigen Class C Donor-Specific Antibodies in Kidney Transplant.","authors":"Fedaey Abbas, Mohsen El Kossi, Ihab Sakr Shaheen, Ajay Sharma, Ahmed Halawa","doi":"10.6002/ect.2025.0004","DOIUrl":"https://doi.org/10.6002/ect.2025.0004","url":null,"abstract":"<p><p>Kidney transplant is well known to be the best possible therapy for patients with end-stage kidney failure; however, allograft rejection remains a major obstacle despite the advent of modern immunosuppression regimens. Despite the well-established role of donorspecific antibodies directed at anti-HLA-A, -B, -DR, and -DQ antigens, the particular role of anti-HLA-C donorspecific antibodies in allograft longevity is not yet clear. Recently, preformed anti-native HLA-C donorspecific antibodies were reported to be possibly linked to poor allograft outcome. In addition, inclusion of HLA-C in all transplant allocation regimens has been suggested. Moreover, possible relevance of HLA-C has been shown in other fields (eg, transfusion and obstetrics). Its reduced expression could explain the diminished immunogenicity of the anti-HLA-C antibodies with subsequent lowered strength and prevalence. Furthermore, the\"missed self\" theory has gained interest. Here, we investigated HLA-C donorspecific antibody immunogenicity, pathogenicity, cellsurface expression, antibody heterogenicity, and possible management tools.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"165-173"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059566","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":"Comment on \"Three-Dimensional Computed Tomography-Magnetic Resonance Cholangiopancreatography Imaging Fusion for Computer-Assisted Surgery Planning in Full Graft Living Donor Liver Transplant\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.6002/ect.2025.0030","DOIUrl":"https://doi.org/10.6002/ect.2025.0030","url":null,"abstract":"","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"239"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027220","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 Multiple Peritoneal Fenestrations on Lymphatic Complications After Renal Transplant: A Prospective Randomized Study.","authors":"Lalit Sharma, Manoj Kumar Dokania, Revanth Kumar Reddy Pothapi, Gyan Ranjan Kumar, Madhuri Gautam, Nikhil Gupta, Nitin Agarwal","doi":"10.6002/ect.2025.0007","DOIUrl":"https://doi.org/10.6002/ect.2025.0007","url":null,"abstract":"<p><strong>Objectives: </strong>Lymphatic complications are a common (up to 30%) surgical complication after renal transplant. Both lymphocele and lymphorrhea have been extensively studied, but solutions are still sought. We designed a prospective randomized study to determine the effect of multiple intraoperatively performed peritoneal fenestrations on lymphatic complications after renal transplant.</p><p><strong>Materials and methods: </strong>Over an 18-month period, we randomized eligible recipients for living donor renal transplant into 2 groups: group 1 had small preventive peritoneal fenestrations (10 of 2 cm each) after graft implant, andgroup2hadnofenestrations. We examined lymphatic complications (primary outcome), age, male versus female distribution, hemodialysis duration, body mass index, operation time, acute rejection, delayed graft function, warm ischemia time, and hospital stay. We compared results with t tests or χ2 test/the Fisher exact test.</p><p><strong>Results: </strong>The 2 groups (10 in group 1 and 14 in group 2) were comparable with respect to demographic and clinical parameters, including operation time, warm ischemia time, and cold ischemia time; however, duration of preoperative dialysis was significantly less in group 1 (12.3 ± 2.8 vs 21.0 ± 4.6 mo; P < .001). Lymphocele, lymphorrhea and overall lymphatic complications were not significantly different between the groups, except for postoperative drain output, which was lower in group 1 than in group 2. No intestinal obstruction, ascitic leak, or bowel injury was reported in group 1 or group 2. On univariate analysis, none of the studied factors significantly affected lymphatic complications.</p><p><strong>Conclusions: </strong>Preventive peritoneal fenestrations are a safe, feasible, and effective way of minimizing lymphatic complications; however, more studies with larger sample sizes are required.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"174-181"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013447","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}