Experimental and Clinical Transplantation最新文献

{"title":"Programmed Death-Ligand 1 in Renal Allografts With Antibody-Mediated Rejection.","authors":"Binnaz Handan Özdemir, Bilkay Baştürk, Cihat Burak Sayın, Mehmet Haberal","doi":"10.6002/ect.2024.0166","DOIUrl":"https://doi.org/10.6002/ect.2024.0166","url":null,"abstract":"<p><strong>Objectives: </strong>Despite its known role in promoting tolerance, the function of programmed cell death protein 1/programmed death ligand 1 in antibody-mediated rejection is less clear. We aimed to clarify this role by examining expression of programmed cell death protein 1/programmed death ligand 1 in renal allografts diagnosed with antibody-mediated rejection.</p><p><strong>Materials and methods: </strong>We examined 110 patients: 68 with pure antibody-mediated rejection (group 1) and 42 with both antibody-mediated rejection and T-cell mediated rejection (group 2). Renal immune cell infiltration, cytokine expression, and programmed cell death protein 1/programmed death ligand 1 expres-sion were examined immunohistochemically.</p><p><strong>Results: </strong>Expression of programmed cell death protein 1/programmed death ligand 1 in endothelial and inflammatory cells was higher in group 2 versus in group 1 (P < .001). Expression of programmed cell death protein 1/programmed death ligand 1 increased with immune cell infiltration. An inverse relationship existed between peritubular capillary DR expression and programmed cell death protein 1/programmed death ligand 1 interaction, with a positive correlation with tubular HLA-DR. Development of interstitial fibrosis was shown in 52.3% of patients with endothelial programmed cell death protein 1/programmed death ligand 1 interaction compared with 12.1% without this interaction (P < .001). Ten-year survival rate was 27.3% in patients with versus 66.7% in patients without endothelial programmed cell death protein 1/programmed death ligand 1 (P < .001) and 31.3% in patients with and 66.1% in patients without inflammatory cell programmed cell death protein 1/programmed death ligand 1 expression (P < .001).</p><p><strong>Conclusions: </strong>Heightened immunological nature in antibody-mediated rejection may influence the unexpected functions of programmed death ligand 1. Inhibitory functions of the programmed cell death protein 1/programmed death ligand 1 pathway may be less effective under strong T-cell activation with high immunological costimulation in antibody-mediated rejection.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"192-201"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006553","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":"Lessons Learned From Management of Bilateral Renal Abscesses Caused by Invasive Aspergillosis in a Lung Transplant Recipient: A Case Report.","authors":"Byung Min Ye, Byung Hyun Choi, Seo Rin Kim, Il Young Kim, Dong Won Lee, Soo Bong Lee, Woo Hyun Cho","doi":"10.6002/ect.2025.0026","DOIUrl":"https://doi.org/10.6002/ect.2025.0026","url":null,"abstract":"<p><p>This study presents a rare case of bilateral renal abscess caused by Aspergillus fumigatus in a 50-year-old male patient who underwent lung transplant for interstitial lung disease. The abscess developed as an opportunistic fungal infection as a result of immunosuppression from posttransplant therapy. Imaging studies revealed abscesses in both kidneys. Although percutaneous aspiration was attempted, the patient could not have the procedure because of the small size of the abscesses, requiring surgical intervention for drainage. Aspergillus fumigatus was identified as the causative pathogen. Despite receipt of antifungal therapy and other supportive measures, the patient ultimately did not survive the infection. Fungal infections in transplant recipients require prompt management, including timely administration of antifungal agents and early abscess drainage. This case highlights the importance of considering early aggressive surgical intervention among other treatments to prevent complications when percutaneous drainage is not feasible.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"231-234"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990527","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":"Tacrolimus-Associated Leukoencephalopathy Following a Living Donor Kidney Transplant for Autosomal Recessive Alport Syndrome: A Case Report.","authors":"Shota Inoue, Yuki Nakamura, Katsuyuki Miki, Takayoshi Yokoyama, Manabu Kamiyama, Yasuo Ishii","doi":"10.6002/ect.2024.0098","DOIUrl":"https://doi.org/10.6002/ect.2024.0098","url":null,"abstract":"<p><p>A 20-year-old male patient diagnosed with chronic renal failure owing to autosomal recessive Alport syndrome underwent kidney transplant, with his mother as the donor. After transplant, the patient's renal function was enhanced; however, owing to preoperative nonadherence, he required sedation and mechanical ventilation. Sedation and mechanical ventilation were discontinued on postoperative day 5. The next day, the patient experienced impaired consciousness. On day 7, magnetic resonance imaging of the head revealed posterior reversible encephalopathy syndrome. Tacrolimus was immediately discontinued, and steroid pulse therapy was initiated. The patient gradually gained consciousness and reached preoperative levels by day 10. Autosomal recessive Alport syndrome, a rare form of Alport syndrome, constitutes 15% of all cases. This report documents a case of tacrolimus-associated posterior reversible encephalopathy syndrome after living donor kidney transplant.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"227-230"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048498","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":"Frequency and Risk Factors of Bowel Perforation in Pediatric Liver Transplant Recipients: A Retrospective Study.","authors":"Seyyed Mohsen Dehghani, Seyyedeh Rabie Seifi, Masoud Tahani, Kourosh Kazemi, Siavash Gholami, Maryam Ataollahi, Iraj Shahramian, Gholam Reza Sivandzadeh, Seyed Ali Malek-Hosseini","doi":"10.6002/ect.2025.0022","DOIUrl":"https://doi.org/10.6002/ect.2025.0022","url":null,"abstract":"<p><strong>Objectives: </strong>Liver transplant is the standard treatment for end-stage liver disease in children, although it carries inherent risks, including complications like bowel perforation. In this retrospective study, we assessed the frequency of bowel perforation in pediatric liver transplant recipients and identified potential risk factors associated with this complication. Our comparison involved pediatric liver transplant recipients who experienced bowel perforation after transplant versus those who did not develop bowel perforation after transplant.</p><p><strong>Materials and methods: </strong>Our retrospective cross-sectional study analyzed 317 children who underwent liver transplant at Shiraz Organ Transplant Center between 2012 and 2020. We reviewed patient records for demographics, surgical history, and perioperative details. We categorized the study population into 2 groups: those with bowel perforation posttransplant and those without bowel perforation posttransplant. We used analyses to identify significant differences between the groups.</p><p><strong>Results: </strong>Among the 317 patients, 16 (5%) developed bowel perforation. Risk factors, including previous surgery, young age, low weight, and Epstein-Barr virus infection, were associated with bowel perforation. Seven patients with reperforation had a 50% survival rate, and mortality was directly linked to perforation.</p><p><strong>Conclusions: </strong>Bowel perforation after pediatric liver transplant is influenced by several risk factors, including previous surgery, young age, low weight, and Epstein-Barr virus infection. Early identification of these risk factors is crucial for timely intervention. Further studies are needed to delve into preventive measures and enhance patient outcomes.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"202-206"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038716","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":"Psychosocial Wellbeing in Lung Transplants Before and After the COVID-19 Vaccine.","authors":"Carolin Steinack, Michèle Krapf, Jutta Ernst, Thomas Gaisl, Macé Schuurmans, Roland von Känel, Katja D Jordan","doi":"10.6002/ect.2024.0243","DOIUrl":"https://doi.org/10.6002/ect.2024.0243","url":null,"abstract":"<p><strong>Objectives: </strong>Lung transplant recipients are vulnerable to respiratory infections because of their compromised immune response. Limited research has been published on mental health as a result of the COVID-19 pandemic on lung transplant recipients, and uncertainty remains whether the COVID-19 vaccine affected mental health in lung transplant recipients.</p><p><strong>Materials and methods: </strong>In this longitudinal, retrospective study, we assessed the psychosocial wellbeing of lung transplant recipients during the COVID-19 pandemic at 2 different time points (before and after COVID-19 vaccination). We measured wellbeing with the Hospital Anxiety and Depression Scale (cutoff of 11 points indicated anxiety and depression) and the Symptom Checklist consisting of 9 questions.</p><p><strong>Results: </strong>Our study included 83 patients (mean age 52.4 ± 14.5 years, 55.4% male). Among the patients, 3.8% and 4.8% of patients with cystic fibrosis had abnormal values for anxiety before and after the vaccine, respectively; abnormal values for depression were shown in 0% and 2.4% of patients with cystic fibrosis before and after the vaccine, respectively. Sex, age, level of education, time since transplant, and chronic allograft dysfunction were not significantly associated with psychosocial wellbeing. Vaccination against COVID-19 was not associated with a change in psychosocial wellbeing.</p><p><strong>Conclusions: </strong>We found no evidence that the COVID-19 vaccine affected the psychosocial wellbeing of lung transplant recipients. However, it may be important to monitor wellbeing closely during a pandemic, especially in patients with cystic fibrosis.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"220-226"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023160","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":"COVID-19 in Kidney Transplant Recipients: Report of 22 Cases.","authors":"Rihab Manaa, Meriem Ben Salem, Manel Ben Salah, Nouha Ben Mahmoud, Mouna Hamouda, Jamel Saad, İnsaf Handous, Sabra Aloui, Ahmed Letaief, Habib Skhiri","doi":"10.6002/ect.2024.0100","DOIUrl":"https://doi.org/10.6002/ect.2024.0100","url":null,"abstract":"<p><strong>Objecitves: </strong>COVID-2019 is a respiratory infection disease that was first identified in Hubei province, China, at the end of 2019. In this study, we analyzed patient characteristics, management strategies, and prognosis of COVID-19 in a cohort of kidney transplant recipients followed at our center in Tunisia.</p><p><strong>Materials and methods: </strong>In this retrospective, descriptive, and analytic study, we included all kidney transplant recipients diagnosed with COVID-19 and hospitalized in our department between March 2020 and December 2021.</p><p><strong>Results: </strong>Our study included 22 patients. Median age at the time of detection of SARS-CoV-2 positivity was 43.5 years. Patients were predominantly men (78.3%). Hypertension was the most common comorbidity (54.5%). Median time from transplant to COVID-19 infection was 8 years. The most common symptoms were fatigue and myalgia reported by 19 patients (86.4%), followed by anorexia, cough, and headache in 13 (59%), 15 (68.2%), and 10 (45.5%) patients, respectively. On admission, the most prevalent biologic findings were lymphopenia (77.3%), elevated C-reactive protein (77.3%), and increased levels of ferritin (77.3%). On admission, 18 patients (81.8%) had worsening graft function with a median serum creatinine level of 168 μmol/L. Ground-glass opacity was the most common radiologic finding. Immuno-suppressive treatments were adjusted in 17 patients (77.3%). Nine patients (41%) were given oxygen supplementation. Severe SARS-CoV-2 infection was noted in 6 patients (27.3%). During the study period, 2 patients died (9%), 4 were discharged with home monitoring program (19%), and the remainder (72%) completely recovered.</p><p><strong>Conclusions: </strong>Kidney transplant recipients with SARS-CoV-2 pneumonia may present with a heterogeneous range of diseases. Kidney transplant recipients, who are immunocompromised, had high mortality and acute kidney injury rates. To date, the ideal therapeutic modalities remain unclear.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 3","pages":"182-191"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020151","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":"Effects of L-Theanine on Hepatic Ischemia-Reperfusion Injury in Rats.","authors":"Hakan Küçükaslan, Arif Usta, Mehmet Uluşahin, Mustafa Emre Ercin, Huriye Patan, Birgül Vanizor Kural, Etem Alhan","doi":"10.6002/ect.2021.0290","DOIUrl":"10.6002/ect.2021.0290","url":null,"abstract":"<p><strong>Objectives: </strong>The effects of L-theanine on hepatic microcirculation during hepatic ischemia-reperfusion injury have not yet been investigated. The aim of this study was to investigate the influence of L-theanine on hepatic ischemia-reperfusion injury in rats.</p><p><strong>Materials and methods: </strong>Thirty-two male Sprague Dawley rats weighing 250 to 300 g were used. Rats were divided into 4 groups: sham + saline, sham + L-theanine, hepatic ischemia-reperfusion injury + saline, and hepatic ischemia-reperfusion injury + L-theanine. Hepatic ischemia-reperfusion injury in rats was induced by 60 minutes of 70% ischemia and 4 hours of reperfusion. The extent of hepatic cell injury, functional capillary density, hepatic functions, and changes in some enzyme markers in hepatic tissue were investigated in the 4 groups.</p><p><strong>Results: </strong>The induction of hepatic ischemia-reperfusion injury resulted in significant increases in hepatic necrosis; serum activity of alanine aminotransferase, lactate dehydrogenase, gamma-glutamyltransferase, and tumor necrosis factor alpha; tissue activity of inducible nitric oxide synthase, myeloperoxidase, and malondialdehyde, and oxide glutathione; and H score for hypoxia-inducible factor 1-alpha in the liver. In the liver, there were significant reductions in reduced glutathione, ratio of reduced glutathione-to-oxide glutathione, and functional capillary density. The use of L-theanine improved these changes.</p><p><strong>Conclusions: </strong>L-theanine demonstrated protective effects on hepatic injury after ischemia-reperfusion injury in rats. However, new studies are needed to confirm the preventive or reducing effects of L-theanine on hepatic ischemia-reperfusion injury.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":" ","pages":"214-219"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39612271","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":"Continuous Monitoring of Donor-Derived Cell-Free DNA: Guiding Diagnosis and Management of Subclinical Rejection.","authors":"Dongrui Cheng, Cuello Garcia Haider, Xue Li, Kenan Xie, Xuefeng Ni, Yang Zhou, Sicheng Wu, Xiaohui Xu, Tingya Jiang, Jinsong Chen","doi":"10.6002/ect.2024.0256","DOIUrl":"10.6002/ect.2024.0256","url":null,"abstract":"<p><p>Diagnosis of subclinical renal rejection for early treatment can be difficult due to the stable serum creatinine levels. Although regarded as the gold standard, biopsy is not deemed ideal for cases where continuous monitoring is required due to its invasiveness. Here, we present a case report of a renal transplant recipient with a stable serum creatinine level but elevated donor-derived cell-free DNA (5.1%) who was monitored for rejection and response to treatment, guided by donor-derived cell-free DNA testing during an extended period. Antibody testing revealed de novo donor-specific antibodies (A11, mean florescence intensity of 1600) that were confirmed by allograft biopsy as subclinical antibody-mediated rejection. The patient was treated with rituximab, and the therapeutic efficacy was assessed every 6 months with donor-derived cell-free DNA and biopsy analysis. Eight months after treatment, a decrease in donor-derived cell-free DNA levels was observed (3.61%), which approached reference levels (<1%) Twenty-eight months after the first treatment, donor-derived cell-free DNA increased, and biopsy analysis of last donor-derived cell-free DNA monitoring time showed antibody-mediated rejection, which subsequently decreased following the second rituximab treatment. Subsequent follow-ups revealed the donor-derived cell-free DNA level was stabilized after the second treatment. This finding suggested that donor-derived cell-free DNA could serve as a valuable diagnostic marker for continuous subclinical antibody-mediated rejection monitoring and for evaluation of treatment responses.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 2","pages":"158-161"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651831","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 Rare Case of Piggyback Syndrome Following Orthotopic Liver Transplant.","authors":"Kelvin Liao, Kevin Kim, Chandra Bhati, Neha Jakhete","doi":"10.6002/ect.2024.0324","DOIUrl":"10.6002/ect.2024.0324","url":null,"abstract":"<p><p>Piggyback syndrome is a rare complication of orthotopic liver transplant performed via the piggyback technique. Where conventional orthotopic liver transplant involves anastomosis of both the donor and recipient inferior vena cava, piggyback orthotopic liver transplant instead involves anastomosis between the donor inferior vena cava and recipient hepatic veins. Piggyback syndrome is hepatic vein outflow obstruction as a result of anastomotic stenosis after piggyback orthotopic liver transplant. We present a case of piggyback syndrome successfully treated with percutaneous stenting and balloon angioplasty and discuss the etiology, diagnosis, and treatment of this syndrome.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 2","pages":"151-153"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651827","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: Luis Horacio Toledo-Pereyra, MD, PhD.","authors":"Mehmet Haberal","doi":"10.6002/ect.2025.toledo-pereyra","DOIUrl":"https://doi.org/10.6002/ect.2025.toledo-pereyra","url":null,"abstract":"","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"23 2","pages":"85-86"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651834","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}