Experimental and Clinical Transplantation最新文献

{"title":"Factors Leading to Exclusion of Living Kidney Donors: A Single-Center Analysis.","authors":"Manel Aoun, Samia Barbouch, Nada Sellami, Meriam Mbarek, Meriam Hajji, Ezzedine Abderrahim","doi":"10.6002/ect.MESOT2025.P72","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P72","url":null,"abstract":"<p><strong>Objectives: </strong>Living kidney donation is a critical option to overcome the global organ shortage, yet many potential donors are excluded during evaluation. Understanding the reasons is important for optimizing donor selection, improving candidate outcomes, and increasing the living donor pool. We aimed to identify principal factors for exclusion of potential living kidney donors and compare baseline demographic and clinical characteristics between accepted donors and excluded candidates.</p><p><strong>Materials and methods: </strong>We performed a retrospective analysis of 82 consecutive potential living kidney donors evaluated for 70 recipients with end-stage renal disease between January 2020 and December 2024. Donor evaluations followed clinical practice guidelines of Kidney Disease: Improving Global Outcomes. Exclusion criteria were medical (obesity [body mass index >30], diabetes, impaired renal function, hypertension, and undiagnosed renal structural anomalies), immunological, and uncategorized causes.</p><p><strong>Results: </strong>Of 82 donor candidates, 36 (43.9%) were excluded. Medical contraindications were the leading cause (26 cases; 72.2% of exclusions). The most frequent medical subcategories were undiagnosed renal structural anomalies (9 cases, 34.6% ), which included 7 vascular anatomic variants (26.9% ), 1 horseshoe kidney (3.8% ), and 1 renal artery stenosis (3.8% ); other exclusions were obesity (5 cases; 19.2% ), diabetes (3; 11.5% ), impaired renal function (2; 7.7% ), and hypertension (1; 3.8% ). Immunological incompatibilities contributed 8 cases (22.2% ); uncategorized reasons accounted for 2 cases (5.5%). No significant sex-based difference in exclusion rates was observed (P = . ⁵⁸ ). Excluded and approved candidates were comparable in age and baseline estimated glomerular filtration rate, indicating rejection was predominantly driven by other factors, particularly comorbidities (P = . ⁰⁴⁶ ) Donor-recipient relationships were predominantly fraternal (45.1% ), parental (34.1%), and spousal (14.6% ).</p><p><strong>Conclusions: </strong>Medical contraindications constituted the major barriers to living kidney donation. These findings highlight the need for early screening and management of modifiable comorbidities to safely increase donor eligibility and expand the living donor pool in resource-limited settings.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"304-309"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649637","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":"Microbiological Evaluation of Diarrhea in Pediatric Kidney Transplant Recipients: A Retrospective Analysis.","authors":"Özlem Yüksel Aksoy, Esra Baskın, Meraj Alam Siddiqui, Alara Akdeniz, Figen Özçay, Adem Şafak, Emre Karakaya, Sedat Yıldırım, Mehmet Haberal","doi":"10.6002/ect.MESOT2025.O60","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O60","url":null,"abstract":"<p><strong>Objectives: </strong>Diarrhea often occurs in pediatric kidney transplant recipients and can result from infectious or noninfectious causes. Identifying underlying issues can allow for proper management and prevent complications such as dehydration, graft dysfunction, and prolonged hospital stay.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated stool samples of 204 pediatric kidney transplant recipients seen at the Başkent University Hospital with complaint of diarrhea. Direct microscoping evaluation, bacterial cultures, and viral antigen testing for rotavirus and adenovirus were performed. Presence of cytomegalovirus and Clostridium difficile were evaluated in selected patients. In 18 patients, a comprehensive viral panel was performed based on clinical suspicion.</p><p><strong>Results: </strong>One patient each showed Shigella species and enteropathogenic Escherichia coli. Candida species was isolated in 1 sample. Rotavirus was detected in 4 patients, adenovirus in 2 patients, and Clostridium difficile toxin in 0 patients. Among the 18 patients who underwent detailed panel testing, norovirus was detected in 2 patients and sapovirus in 1 patient. Forty -seven stool culture samples showed reduced or absent normal intestinal flora, suggesting possible intestinal dysbiosis. Entamoeba was detected in 7 patients. Cytomegalovirus was positive in 24 of 204 patients (11 % ). On direct microscopic examination, 19 patients showed minimal findings, and 24 patients had moderate findings. Fourteen patients had high numbers of leukocytes and erythrocytes in their stool. Because amebic colitis and Clostridium difficile infection could not be excluded, patients with moderate to severe findings were treated with metronidazole.</p><p><strong>Conclusions: </strong>Among pediatric kidney transplant patients with diarrhea, the rate of intestinal pathogens was slow but reduced normal flora in stool cultures was common, indicating microbiota -related etiologies. The high rate of cytomegalovirus infection among patients suggested that cytomegalovirus infection should be considered as a potential etiological factor in pediatric transplant patients presenting with diarrhea. Noninfectious causes should also be considered in differential diagnosis of diarrhea in solid -organ transplant recipients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"172-176"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649662","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":"Bibliometric Analysis of Kidney Transplant Recipients and Quality of Life Between 1987-2025 Using VOSviewer.","authors":"Nilgün Aksoy, Büşra Nur Temür, Ayşe Meydanlıoğlu","doi":"10.6002/ect.MESOT2025.P23","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P23","url":null,"abstract":"<p><strong>Objectives: </strong>Kidney transplantation is the gold standard kidney replacement therapy for patients with end -stage renal disease, prolonging the lifespan and improving quality of life of recipients by offering both emotional and psychological benefits. However, comorbid conditions, fear of rejection, drug side effects, and hospitalization can negatively affect health -related quality of life. Here, we performed a quantitative analysis of research addressing quality of life in kidney transplant recipients between 1987 and 2025.</p><p><strong>Materials and methods: </strong>We used descriptive and bibliometric analysis methods to analyze publications that addressed quality of life in kidney transplant recipients in the Web of Science Core Collection database. We used the VOSviewer software program to analyze publications by year, co -authorship networks; citations by author, country, and institution; author key words; bibliographic matching analysis of authors and networks of publications, and co -citation analysis of authors.</p><p><strong>Results: </strong>From 816 publications identified during the analysis period, 743 were ultimately related to quality of life in kidney transplant recipients. According to publication year, the highest concentration was observed in 2025 (88 works ), 2024 (69 works ), and 2023 (64 works ). Authors Johnathan C. Craig, Stefan P. Berger, and Stephan J. L. Bakker had 24, 21, and 21 publications respectively, with the University of Groningen being the most active institution (41 publications ). Most publications were from the United States (n = 202 ), The Netherlands (n =70 ), and Italy (n = 69 ). Transplantation Proceedings had the most publications (n = 67 ). Most publications were in English. The most frequently used author key words were \"kidney transplantation\" (n = 252 ), \"quality of life\" (n = 105 ), and \"kidney transplant\" (n = 89 ).</p><p><strong>Conclusions: </strong>Our results demonstrated the increasing interest among researchers in studying quality of life in kidney transplant recipients and revealed the diversity of issues and perspectives related to this field.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"241-251"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649694","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 and Sleep Outcomes in Living Kidney Donors: Preliminary Results From a Monocentric North African Study.","authors":"Rihem Dahmane, Nada Chniti, Wissal Sahtout, Ahmed Loghmari, Asma Zguem, Narjess Ben Aicha, Nesrine Thabet, Yosra Guedri, Awatef Azzabi, Dorsaf Zellama","doi":"10.6002/ect.MESOT2025.P44","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P44","url":null,"abstract":"<p><strong>Objectives: </strong>Living kidney donation provides substantial therapeutic benefit to recipients but may have lasting psychosocial consequences for donors. Sleep quality, which is closely linked to psychological well -being, remains insufficiently studied in North African populations. This study aimed to evaluate quality of life, self -esteem, body image, and sleep quality among living kidney donors in Tunisia.</p><p><strong>Materials and methods: </strong>We conducted a cross -sectional, monocentric descriptive study at the Nephrology Department of Sahloul University Teaching Hospital, Sousse, Tunisia, for the period 2007 -2024. Data were collected from medical records and standardized interviews. Quality of life was assessed via the 12 -Item Short Form Health Survey, self -esteem via the Rosenberg Self -Esteem Scale, body image via the Body Image Scale, and sleep quality via the Pittsburgh Sleep Quality Index. The study remains ongoing.</p><p><strong>Results: </strong>Preliminary data from 15 living kidney donors were analyzed. The mean age was 55 years, and the female -to -male ratio was 2. The mean time since donation was 7.9 years. The mean physical and mental component scores of the 12 -Item Short Form Health Survey were 48.5 and 33.7, respectively, with approximately 30 %of donors demonstrating clinically relevant psychological distress. Self -esteem was low in 25 %, moderate in 50 %, and high in 25 % of participants. Body image impairment was moderate to severe in 70 % of donors. The mean Pittsburgh Sleep Quality Index score was 4.6; however, 27 %of participants had scores >5, indicating poor sleep quality. High follow -up dropout was observed, largely due to limited access to structured health care resources.</p><p><strong>Conclusions: </strong>Living kidney donation may be associated with persistent psychosocial vulnerability and sleep disturbances in a subset of donors. These findings highlight the importance of structured long -term psychosocial and sleep monitoring programs in resource -constrained settings.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"283-286"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649818","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":"Psychological Factors Affecting Living Organ Donors: A Study from Preoperative Stage.","authors":"Burcu Pinar Bulut, Huri Gül Bayram Gülaçtı, İlknur Yaren Pala, Osman Aydin, Erkan Ölçücüoğlu, Erdal Birol Bostanci","doi":"10.6002/ect.MESOT2025.O16","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O16","url":null,"abstract":"<p><strong>Objectives: </strong>Organ transplant is the surgical process of removing an organ that cannot fulfill its function despite medical treatment and transplanting the corresponding organ from a donor to a recipient. Our study examined whether demographic variables such as sex, age, education status, or socioeconomic status and psychosocial variables including sensory processing sensitivity, attachment style, resilience, social support, and neuroticism predict depression, anxiety, and stress levels of living donors in the preoperative stage.</p><p><strong>Materials and methods: </strong>Data were collected from potential organ donors aged 18 to 60 years who voluntarily applied to the Ankara Bilkent City Hospital Organ Donation and Transplantation Center Unit. A total of 69 participants (21 kidney, 48 liver ) were included in the analyses.</p><p><strong>Results: </strong>According to the results, sex was the only demographic variable that significantly correlated with depression, anxiety, and stress, showing that female donors feel more depression, anxiety, and stress than male donors. According to regression analyses, the model including sex and other psychosocial variables was significant and explained 37 % of the variance for depression. Higher levels of resilience were linked with lower levels of depression. For anxiety, similarly, the model including sex and other psychosocial variables was significant and explained 33 % of the variance, that is, a higher level of resilience was associated with less anxiety. For stress, the model including sex and other psychosocial variables was significant and explained 40 % of the variance. In addition to resilience, which significantly predicted anxiety, neuroticism was a marginally significant predictor, that is, high resilience and low neuroticism predicted lower levels of anxiety.</p><p><strong>Conclusions: </strong>The findings emphasize the importance of interventions to increase the psychological resilience of potential organ donors and show that psychological support, especially for female donors and donors with high levels of neuroticism, can improve the process.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"63-68"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649823","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":"Prognostic Significance of the Hemoglobin, Albumin, Lymphocyte, and Platelet Score in Patients Who Develop Pneumonia After Kidney Transplant.","authors":"Yildiz Ucar, Aynur Sahin, Dorina Esendagli, Polina Nezalzova, Emre Karakaya, Gaye Ulubay, Mehmet Haberal","doi":"10.6002/ect.2026.0166","DOIUrl":"https://doi.org/10.6002/ect.2026.0166","url":null,"abstract":"<p><strong>Objectives: </strong>Infections, especially pneumonia, are among the significant causes of morbidity and mortality in transplant recipients. Pneumonia leads to a complex clinical picture, related not only to the infection itself but also to underlying immunosuppression, conco -mitant diseases, and organ dysfunction. Here, we evaluated the effect of the HALP score (ie, hemoglobin, albumin, lymphocyte, and platelet ) on prognosis in patients who developed pneumonia after kidney transplant.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed files of kidney transplant recipients in the chest diseases outpatient clinic of our hospital who were diagnosed with pneumonia on thoracic computed tomography scans between April 2020 and April 2025. We exported data (age, sex, laboratory test results at diagnosis, duration of hospitalization, and mortality rate ) to a database spreadsheet file (Excel ) and compared hemoglobin, albumin, lymphocyte, and platelet scores of patients who died versus survived. We analyzed disease severity by classification according to the Pneumonia Severity Index and CURB -65 (ie, confusion, uremia, respiratory rate, blood pressure, and age ≥65 ) scores.</p><p><strong>Results: </strong>Among 178 included patients (100 female, 78 male ), 148 survived (83.1 % ) and 30 died (16.9 % ). Patients who died had lower hemoglobin, albumin, lymphocyte, and platelet scores than patients who survived. Patients with higher Pneumonia Severity Index scores had significantly lower hemoglobin, albumin, lymphocyte, and platelet scores.</p><p><strong>Conclusions: </strong>The hemoglobin, albumin, lymphocyte, and platelet score is a biomarker based on easily calculable, low -cost, and accessible parameters and may be a potential tool for evaluation of prognosis in the general patient population. Prospective and multicenter studies with larger sample groups are needed to better evaluate the role of the hemoglobin, albumin, lymphocyte, and platelet score for determination of the prognosis related to infections in kidney transplant recipients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 7","pages":"535-546"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671187","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":"Diagnostic Contribution of Multiparametric Magnetic Resonance Imaging in Transplanted Kidneys: A Preliminary 3-Case Series.","authors":"Tijen Cankurtaran, Kemal Murat Haberal, Atakan Işık, Can Uchehara, Sedat Yıldırım, Turan Çolak, Cihat Burak Sayın, Orhan Erdem Haberal, Meriç Yavuz Çolak, Mehmet Haberal","doi":"10.6002/ect.MESOT2025.P51","DOIUrl":"10.6002/ect.MESOT2025.P51","url":null,"abstract":"<p><p>Despite increasing interest in functional magnetic resonance imaging techniques, compartment-specific comparisons between donor kidneys and the same kidneys shortly after implant have remained limited. Therefore, in this preliminary case series, we aimed to explore early postoperative cortex- and medulla-specific multiparametric magnetic resonance imaging patterns in living-donor kidney transplant by directly comparing donor and recipient measurements within matched grafts. We assessed multiparametric magnetic resonance imaging parameters by comparing donor and early postoperative measurements acquired between postoperative days 19 and 23 in 3 transplant recipients. We categorized percent differences in parameters as stable, mild, moderate, or marked according to their magnitude; these classifications were descriptive. In analyses, donor-to-recipient variations were more pronounced in medullary parameters than in cortical measurements across all 3 grafts, and whole kidney values generally paralleled medullary behavior. Perfusion-related metrics, particularly pseudodiffusion and perfusion fraction, demonstrated the most prominent postoperative changes. In radar plots, donor kidneys displayed compact and overlapping medulla-to-cortex profiles, whereas transplanted kidneys showed expansion or distortion of medullary-dominant parameters, particularly in perfusion-related indices. These ratio-based visualizations emphasized redistribution toward medulla-driven physiological alterations in the early postoperative phase. The reproducible compartment-specific patterns observed in this series support the feasibility of multiparametric magnetic resonance imaging as a tool for early physiological monitoring after kidney transplant. Further validation in larger, longitudinal cohorts will be required to determine the clinical utility of corticomedullary metrics as potential biomarkers of early graft status.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"418-424"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649716","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":"Treatment of Portal Biliopathy-Related Bile Duct Stricture Using a Two-Step Approach: Proximal Splenorenal Shunt and Roux-en-Y Hepaticojejunostomy.","authors":"Neslihan Ekşi, Sinan Sarı, Aydın Dalgıç","doi":"10.6002/ect.MESOT2025.P154","DOIUrl":"10.6002/ect.MESOT2025.P154","url":null,"abstract":"<p><p>Portal biliopathy, also referred to as portal cavernoma cholangiopathy, is a biliary complication of extrahepatic portal vein obstruction caused by cavernomatous transformation of the portal vein and resulting biliary compression. Although biliary abnormalities are common in long)standing portal hypertension, only a minority of patients become symptomatic and require intervention. Herein, we present a 13)year)old patient with long)standing extrahepatic portal vein obstruction who developed pruritus, jaundice, and a distal common bile duct stricture with proximal biliary dilatation secondary to portal cavernoma compression. Despite multiple endoscopic interventions, including biliary stenting, the clinical course was complicated by persistent biliary obstruction and procedure)related bleeding. Proximal splenorenal shunt surgery achieved effective portal decompression and resolution of esophageal varices; however, biliary abnormalities persisted during follow)up. Definitive biliary reconstruction with Roux-en-Y hepaticojejunostomy subsequently resulted in complete clinical and biochemical remission without recurrence during long)term follow)up. This case highlights the importance of an individualized staged management strategy in pediatric portal biliopathy, in which portal decompression may facilitate safer biliary reconstruction, although definitive biliary)enteric reconstruction may still be required in selected patients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"446-450"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649720","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 Kidney and Liver Transplant an Obstacle to Becoming a Mother?","authors":"Adem Şafak, Emre Karakaya, Sedat Yıldırım, Hüseyin Akıllı, Mehmet Haberal","doi":"10.6002/ect.MESOT2025.O70","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O70","url":null,"abstract":"<p><strong>Objectives: </strong>Pregnancy posttransplant remains high risk because of potential maternal, fetal, and graft-related complications. We retrospectively evaluated the clinical course, maternal-fetal outcomes, and graft-related events of pregnancies occurring after liver and kidney transplant at our center.</p><p><strong>Materials and methods: </strong>We evaluated 3538 kidney transplants and 760 liver transplants performed at Başkent University between November 3, 1975, and November 3, 2024. Female recipients who became pregnant posttransplant were identified through hospital electronic medical records, the transplant database, and obstetric archives. We performed a subgroup analysis on pediatric transplant recipients who underwent transplant at age <18 years and later became pregnant in adulthood.</p><p><strong>Results: </strong>Among 41 transplant recipients who experienced pregnancy, 20 were liver transplant and 21 were kidney transplant recipients. Each patient had 1 pregnancy. Mean maternal age at delivery was 31 years (range, 24-38 years), and mean interval between transplant and delivery was 9.9 years (range, 2-22 years). Liver transplant recipients received calcineurin inhibitor-based immunosuppression, whereas kidney transplant recipients received calcineurin inhibitors with prednisone, with azathioprine added in selected patients with history of frequent rejection. One patient delivered vaginally; all others underwent cesarean delivery. Maternal complications included hypertension in 1 patient, gestational diabetes in 3 patients, and lower urinary tract infection in 3 patients. One liver transplant recipient with autoimmune hepatitis developed recurrent disease in the early postpartum period and required retransplant. No other significant maternal complications or graft rejection episodes were observed. Mean gestational age was 35.5 weeks (range, 24-39 weeks). All infants were born healthy except 1, who died at 24 weeks of gestation due to placenta previa.</p><p><strong>Conclusions: </strong>Pregnancy after liver and kidney transplant can be successfully sustained in most patients under appropriate immunosuppressive management and multidisciplinary follow-up. However, these pregnancies should be considered high risk and managed in experienced centers with close obstetric and transplant surveillance.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"200-203"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649620","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":"Living Kidney Donor Transplantation: A Single-Center Analysis of Acceptance Rate, Donor Exclusion Reasons, and Evaluation Timeline.","authors":"Manel Aoun, Samia Barbouch, Hafedh Hedri, Tesnim Ben Ayed, Meriam Hajji, Ezzedine Abderrahim","doi":"10.6002/ect.MESOT2025.P73","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P73","url":null,"abstract":"<p><strong>Objectives: </strong>With limited deceased donor availability, living kidney donor transplantation remains the primary source of grafts in Tunisia. Strict donor selection criteria are essential to ensure donor safety and optimize recipient outcomes. We investigated the acceptance rate of living donor kidney transplant among eligible recipients and potential donors, enumerated the primary causes of donation discontinuation, and characterized the donor evaluation process at a single Tunisian transplant center.</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of 70 patients with end -stage renal disease referred for living donor kidney transplant evaluation and 82 potential related living donors assessed between January 2020 and December 2024. Donor assessments adhered to Kidney Disease: Improving Global Outcomes clinical practice guidelines. The acceptance rate was defined as the proportion of recipient-donor pairs that proceeded to donor nephrectomy and allograft transplant. We computed descriptive statistics with SPSS version 26 software.</p><p><strong>Results: </strong>Among 82 evaluated donors, 11 (13.4 % ) completed nephrectomy and transplant, 35 (42.7 % ) required supplementary diagnostic investigations, and 36 (43.9 % ) were excluded after multidisciplinary committee review. The median number (range ) of donors assessed per recipient was 1 (1 -2 ). In the 11 successful transplants, 8 recipients (72.7 % ) received transplants from the initial donor candidate, whereas 3 recipients (27.3 % ) required sequential evaluation of 2 or more candidates. The mean duration from initial donor workup to transplant was 526.9 ± 192.0 days. Among 36 discontinued cases, donor -related factors accounted for 26 instances (72.2 % ), immunological barriers for 8 instances (22.2 % ), and recipient -related factors for 1 instance (2.8 % ). After discontinuation, 1 of 36 recipients (2.8 % ) underwent deceased -donor transplant and 11 recipients (30.5 % ) remained on the national deceased -donor waiting list.</p><p><strong>Conclusions: </strong>The observed acceptance rate of 13.4 % reflects substantial barriers, predominantly donor -related contraindications identified during rigorous evaluation. Targeted interventions are needed to expand the donor pool in resource -constrained environments.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"310-314"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649666","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}