Experimental and Clinical Transplantation最新文献

{"title":"Prognostic Significance of HALP 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.MESOT2025.P38","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P38","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 circumstance, related not only to the infection itself but also to underlying immunosuppression, concomitant diseases, and organ dysfunction. Here, we evaluated the effect of the immunonutritional /inflammatory biomarker known as the HALP score (calculated from hemoglobin, albumin, lymphocytes, and platelets ) 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 treated at our hospital's chest diseases outpatient clinic between April 2020 and April 2025 to discover patients who had been diagnosed with pneumonia on thoracic computed tomography scans. We exported data (age, sex, laboratory tests at diagnosis, length of hospital stay, and mortality rates ) to a database spreadsheet file (Excel, Microsoft ) and compared HALP scores of patients who died versus survived. We analyzed disease severity according to the Pneumonia Severity Index and the CURB -65 (calculated from confusion, uremia, respiratory rate, blood pressure, and age ≥65 years ) scores.</p><p><strong>Results: </strong>Among 178 included patients (100 female, 78 male ), 148 (83.1 %) survived and 30 (16.9 % ) died. Patients who died had HALP scores lower than patients who survived. Patients with higher Pneumonia Severity Index scores had significantly lower HALP scores.</p><p><strong>Conclusions: </strong>The HALP score is a biomarker based on easily calculable, low -cost, and accessible parameters and may be a potential tool to evaluate prognosis in the general patient population. Prospective and multicenter studies with larger sample groups are needed to better evaluate the role of the HALP score for prognosis determination related to infections in kidney transplant recipients.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"275-282"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649846","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":"Obstetrical and Perinatal Outcomes of Posttransplant Pregnancy in Kidney and Liver Transplant Recipients.","authors":"Murat Aykut Özek, Nihal Şahin Uysal, Esra Kuşçu, Mehmet Haberal","doi":"10.6002/ect.2025.0311","DOIUrl":"https://doi.org/10.6002/ect.2025.0311","url":null,"abstract":"<p><strong>Objectives: </strong>Pregnancy after transplant still confers increased risks of various complications. This study analyzed obstetrical and perinatal outcomes of posttransplant pregnancy in kidney and liver transplant recipients.</p><p><strong>Materials and methods: </strong>We included kidney and liver transplant recipients with posttransplant pregnancy who were followed in our institution from 2011 to 2025. Patients were monitored simultaneously in the transplant outpatient clinic and obstetrics and gynecology clinics. We retrospectively analyzed the obstetrical complications, perinatal outcomes, and the effect of pregnancy on allograft function.</p><p><strong>Results: </strong>We analyzed 18 kidney and 13 liver transplant recipients with posttransplant pregnancy. Mean mater-nal age of kidney transplant recipients was 31.1 years at the birth of the child. In the kidney transplant group, 7 patients (35 % ) delivered live birth at term, 7 patients (35 % ) experienced pregnancy complications of ges-tational hypertension or preeclampsia, and 1 patient experienced graft rejection during the postpartum period. In the liver transplant group, 8 patients (61.5 % ) delivered live birth at term. One patient had intrahepatic cholestasis of pregnancy, 1 patient had preterm premature rupture of membranes, 1 patient had preeclampsia, and 1 patient had gestational diabetes. There were no graft rejections in the liver transplant group. Mean maternal age and rate of nulliparity were higher in the kidney transplant versus the liver transplant group (P = . ⁰³² and P = . ⁰¹³, respectively ). No significant differences were shown for gestational age at delivery, preterm birth rate, birth weights of the newborns, and rates of neonatal intensive care unit hospitalizations.</p><p><strong>Conclusions: </strong>Pregnancy after solid -organ transplant is associated with potential risks for the mother, newborn, and the allograft. We observed higher rates of adverse obstetrical outcomes in the kidney transplant group versus the liver transplant group. We believe that a multidisciplinary approach during the antenatal and postpartum periods is essential to improve outcomes and minimize complications.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 7","pages":"553-557"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671179","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":"Posterior Urethral Valves and Kidney Transplantation: Optimizing the Lower Urinary Tract to Protect the Allograft.","authors":"Pavel Navratil, Ivo Novak, Jaroslav Pacovsky, Pavel Navratil","doi":"10.6002/ect.2026.0117","DOIUrl":"https://doi.org/10.6002/ect.2026.0117","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to review the current evidence on kidney transplant in patients with posterior urethral valves, focusing on transplant-specific lower urinary tract assessment, bladder optimization, graft outcomes, infection burden, and long-term follow-up.</p><p><strong>Materials and methods: </strong>We searched peer-reviewed literature indexed in PubMed and major guideline sources through March 2026, focusing on studies that addressed posterior urethral valves, valve bladder dysfunction, and kidney transplantation. Contemporary cohort studies, critical reviews, pediatric urology and transplant literature, and guideline-based statements were prioritized. In accordance with journal policy, donors considered in the reviewed transplant literature were either deceased donors or living related donors.</p><p><strong>Results: </strong>Available evidence indicated that posterior urethral valves are not a contraindication to kidney transplant when the lower urinary tract is systematically evaluated and optimized. Low-pressure urine storage and reliable bladder emptying are central determinants of graft protection. Vesicoureteral reflux should be actively assessed and, when clinically significant, treated in the context of native kidney function, infection burden, and bladder strategy; in poorly functioning refluxing native kidneys, native nephroureterectomy may be more appropriate than anti-reflux correction. Clean intermittent catheterization, with or without a catheterizable channel, is often graft-protective, whereas augmentation cystoplasty should be reserved for selected hostile bladders refractory to conservative treatment. The timing of reconstruction and native upper-tract surgery should be individualized according to bladder phenotype, residual urine output, donor type, and anticipated wait time.</p><p><strong>Conclusions: </strong>Kidney transplant in patients with posterior urethral valves can achieve durable allograft function when bladder phenotyping, stepwise optimization, reflux management, infection prevention, donor-specific surgical planning, and lifelong follow-up are integrated into care. Clinically significant vesicoureteral reflux should prompt consideration of anti-reflux surgery or native nephroureterectomy according to kidney function, residual diuresis, and reconstructive timing. A multidisciplinary strategy extending through transition to adult services offers the best opportunity to protect the allograft.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 7","pages":"505-512"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671189","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":"HLA Class II Matched Parathyroid Allotransplantation: 5-Year Follow-Up of Panel Reactive Antibody and Crossmatch.","authors":"Beyza Goncu, Harika Salepcioglu Kaya, Rumeyza Kazancioglu, Yeliz Emine Ersoy, Adem Akcakaya","doi":"10.6002/ect.MESOT2025.P132","DOIUrl":"10.6002/ect.MESOT2025.P132","url":null,"abstract":"<p><strong>Objectives: </strong>Parathyroid allotransplantation has been a curative option for patients with severe permanent hypoparathyroidism for more than 50 years. Despite advancements, parathyroid allotransplant outcomes still depend on reliable parameters, including HLA-allele matching criteria. Here, we report 2 cases of parathyroid allotransplant between ABO/Rh-compatible donors and recipients with HLA-DR and HLA-DQ allele match.</p><p><strong>Materials and methods: </strong>The recipients, aged 39 and 43 years, had been on the parathyroid allotransplant wait list for 5 years. Both experienced persistent hypocalcemia-related symptoms despite daily supplementation with intensive supplementation therapy. Ineffectiveness and side effects of increasing supplementation doses resulted in parathyroid allotransplant. The living unrelated donors, both with chronic kidney disease, underwent subtotal parathyroidectomy. Half of the retrieved parathyroid tissue was cryopreserved. After histopathological approval, parathyroid allotransplant was performed laparoscopically by transplanting parathyroid cells over the omentum. Preoperative assessments were negative, including panel reactive antibody and T-cell/B-cell crossmatch tests. Postoperatively, recipients received 10 mg/day methylprednisolone for 1 month. Outcomes were monitored for 5 years.</p><p><strong>Results: </strong>After parathyroid allotransplant, recipient 1 showed reduced symptoms and medication requirements, decreasing to 600 mg calcium and 400 IU cholecalciferol daily, which were maintained for 4 years. However, by year 5, oral supplementation returned to initial levels. Recipient 2 exhibited similar improvements, with symptoms relieved and oral supplementation halved to half doses. Serum calcium levels at year 5 were 8.6 mg/dL and 9.0 mg/dL for recipients 1 and 2, respectively.</p><p><strong>Conclusions: </strong>Our cases, to our knowledge, are the first to document panel-reactive antibody and T-cell and B-cell crossmatch-negative parathyroid allotransplant with HLA class II allele matching. HLA matching may enhance survival rates posttransplant. Only parathyroid cells were transplanted in both cases, and recipients received short-term immunosuppression with steroids. Further studies with larger cohorts are needed to establish the relationship between HLA allele matching and posttransplant survival rates.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"434-440"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649595","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":"Long-Term Clinical Outcomes and Dynamics of Immunosuppressive Therapy in Kidney Transplant Recipients in Uzbekistan: A Retrospective Study.","authors":"Aziz Ismatov, Dmitry Kim, Farxod Siyabaev, Zafar Urazmetov, Jurat Djuraev, Muhammadaziz Aliev, Shamsiddinov Javoxir, Pulat Sultanov","doi":"10.6002/ect.MESOT2025.O53","DOIUrl":"10.6002/ect.MESOT2025.O53","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the long -term clinical outcomes and dynamics of immunosuppressive therapy in kidney transplant recipients in Uzbekistan, which was compared with international data.</p><p><strong>Materials and methods: </strong>This retrospective multicenter cohort study included 3437 kidney transplant recipients. Data were obtained from the national transplant registry. Follow -up ranged from 1 to 30 years. Clinical outcomes, graft survival, recipient survival, and immunosuppressive therapy parameters were analyzed. Repeated -measures analysis of variance and life -table analysis were used for statistical evaluation.</p><p><strong>Results: </strong>A gradual reduction in tacrolimus dose was observed from 6.68 mg /day at year 1 to 5.58 mg /day at year 10, accompanied by a decrease in mean blood concentration from 8.28 to 6.55 ng /mL. Mycophenolate mofetil dosing decreased significantly over time (P < .001 ), whereas mycophenolic acid dosing remained stable (P > .05 ). The incidence of graft loss requiring return to hemodialysis was 2.88 %. A biphasic pattern of graft loss was identified, with peaks within the first 3 years and after 10 years posttransplant. Recipient survival rates were 98.8 % at 1 year and 96.9 % at 10 years.</p><p><strong>Conclusions: </strong>Kidney transplantation in Uzbekistan demonstrates favorable long -term outcomes comparable to international benchmarks. Immunosuppressive therapy shows a trend toward controlled minimization. The identified biphasic risk of graft loss highlights the importance of long -term monitoring and individualized management strategies.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"137-142"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649707","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":"Therapeutic Plasma Exchange in Pediatric Transplant and Organ Failure: Analysis of Indications, Adverse Events, and Clinical Outcomes.","authors":"Esra Baskın, Utku Dönger, Meraj Alam Siddiqui, Figen Özçay, Elif Sahin Eroglu, Adem Şafak, Emre Karakaya, Mehmet Haberal","doi":"10.6002/ect.MESOT2025.O58","DOIUrl":"10.6002/ect.MESOT2025.O58","url":null,"abstract":"<p><strong>Objectives: </strong>Therapeutic plasma exchange has become an increasingly important extracorporeal therapy in pediatric intensive care and transplant settings. However, evaluations in large real-world pediatric cohorts of its effectiveness and safety across multiple indications remain limited. In this 5 -year single -center study, we provided our experience with therapeutic plasma exchange in critically ill children and assessed clinical outcomes, indications, and procedure -related complications.</p><p><strong>Materials and methods: </strong>This retrospective observational study included 88 pediatric patients who underwent 702 therapeutic plasma exchange sessions in the pediatric transplant and nephrology intensive care unit of Başkent University Hospital (Ankara, Turkey) between December 2018 and December 2023. Indications were classified according to new American Society for Apheresis categories. We analyzed demographic data, indications, replacement fluids, treatment response, and adverse events.</p><p><strong>Results: </strong>Median age of the 88 pediatric patients who underwent 702 therapeutic plasma exchange sessions was 7.5 years (range, 0 -18 y ), and 52.3 % of patients were male. Fresh frozen plasma was used in 89.8 % of sessions and albumin in 23.9 %. The most frequent indications for therapeutic plasma exchange were posttransplant hepatic dysfunction (36.4 % ) and acute or chronic liver failure (28.4 % ), followed by antibody -mediated renal disease (13.6 % ) and multiorgan failure or sepsis (8 % ). Overall, 73 of 88 patients achieved complete or partial improvement, corresponding to a favorable response rate of 82.9 %. Renal transplant-related indications demonstrated higher response rates compared with liver -related conditions (91 % vs 78.9 % ). No life-threatening or procedure -terminating complications occurred; minor adverse events included hypotension, fever, allergic reactions, and thrombosis.</p><p><strong>Conclusions: </strong>Therapeutic plasma exchange is a safe and effective supportive therapy for critically ill pediatric patients across a wide range of indications. When performed in experienced centers with close monitoring, complication rates are low. Multicenter prospective studies are needed to establish standardized protocols and further clarify disease-specific outcomes.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"166-171"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649679","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":"From First Presentation to Transplantation: Risk Factors for Severe Outcome in Pediatric Autoimmune Hepatitis.","authors":"Özlem Sümer Coşar, Hakan Öztürk, Sinan Sarı, Ödül Eğritaş Gürkan, Güldal Esendağlı, Gülen Akyol, Buket Dalgıç, Aydın Dalgıç","doi":"10.6002/ect.MESOT2025.P104","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P104","url":null,"abstract":"<p><strong>Objectives: </strong>Our aim was to identify the potential predictors of liver transplant in patients with autoimmune hepatitis based on data at initial presentation.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated records of children diagnosed with autoimmune hepatitis between 2000 and 2025. We excluded 21 patients with de novo autoimmune hepatitis (n =5) and incomplete data (n = 16). We compared demographic, clinical, biochemical, and histopathological data in 2 study groups: transplanted (n = 9) and not transplanted (n = 81).</p><p><strong>Results: </strong>Of 90 included patients, 63 (70% ) were female. Median age at diagnosis was 115 months (range, 8-215 months). Among included patients, 70 had type 1 autoimmune hepatitis, 13 had type 2 autoimmune hepatitis, and 7 had seronegative autoimmune hepatitis. Nine patients underwent liver transplant (5 with type 1 autoimmune hepatitis, 4 with type 2 autoimmune hepatitis). Rate of transplant was significantly higher in patients with type 2 autoimmune hepatitis (P = . ⁰³ ). Compared with the nontransplant group, patients in the transplant group were more likely to have type 2 autoimmune hepatitis; higher gamma-glutamyl transferase, bilirubin, international normalized ratio, and immunoglobulin levels; and lower albumin and platelet levels. In addition, this group was more likely to have relapsing disease and moderate-to-severe fibrosis at diagnosis. Multivariate analysis showed that moderate-to-severe fibrosis and total bilirubin level were significant predictors of liver transplant (odds ratio: 21.84, 95%CI, 1.34-355.25; P = . ⁰³⁰ and odds ratio: 1.22, 95% CI, 1.02-1.47; P = . ⁰²⁹, respectively). Autoimmune hepatitis type 2 was not found to be associated with outcome (P = . ⁸³⁹). ).</p><p><strong>Conclusions: </strong>Systematic risk assessment at diagnosis is important to identify high-risk patients who may benefit from close monitoring, early escalation of therapy, and timely referral for transplant evaluation. Tailoring management strategies based on these predictive factors may improve long-term outcomes in pediatric autoimmune hepatitis.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"321-326"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649588","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":"Literature Review: Literature Review: Nutritional Management in Hemodialysis Patients.","authors":"Zemfira Hasanova","doi":"10.6002/ect.MESOT2025.P189","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P189","url":null,"abstract":"<p><p>Protein energy wasting is a highly prevalent and clinically significant complication in patients receiving maintenance hemodialysis, affecting approximately 30 % to 50 % of this population worldwide. Protein energy wasting is associated with substantially increased risk of all -cause and cardiovascular mortality, reduced functional capacity, impaired immune function, and poor quality of life. The pathogenesis of protein energy wasting is multifactorial and involves reduced dietary intake, chronic inflammation, metabolic acidosis, dialysis -related nutrient losses, hormonal and metabolic disturbances, and comorbid disease burden. This narrative literature review synthesized contemporary evidence (2020 -2025) on the epidemiology, pathophysiology, assessment, and nutritional management of protein energy wasting in patients receiving hemodialysis. We highlighted limitations of traditional biochemical markers such as serum albumin and emphasized the importance of multidimensional nutritional assessment using validated clinical tools, including the Subjective Global Assessment and Malnutrition-Inflammation Score, complemented by objective body composition techniques. We also discussed current guideline -recommended targets for protein and energy intake, as well as real -world barriers to achieving these targets. We reviewed and examined evidence supporting oral nutritional supplementation as first -line therapy, along with indications for intradialytic parenteral nutrition in selected patients with severe or refractory protein energy wasting, and the role of micronutrient management, vitamin D repletion, and targeted trace element supplementation. Emerging adjunctive strategies, including omega -3 fatty acids, gut microbiome modulation, and exercise -nutrition synergy, were also addressed. Overall, effective management of protein energy wasting requires early identification, individualized dietary strategies, and integration within multidisciplinary dialysis care models. Future research should prioritize pragmatic trials focused on hard clinical outcomes and personalized approaches to nutritional therapy in this high -risk population.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"39-43"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649559","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":"Hepatitis B Virus Reactivation in Kidney Transplant Recipients With Core Antibody Seropositivity: Effects of Preemptive Therapy.","authors":"Bengü Tatar, Adam Uslu, Alpay Arı, Selçuk Kavak, Esra Altıngöz, Gökalp Okut, Erhan Tatar","doi":"10.6002/ect.MESOT2025.P130","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.P130","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatitis B virus reactivation, particularly when occurring under immunosuppressive therapy, poses a risk for patients with chronic or resolved hepatitis B virus infections. This study aimed to evaluate the incidence and clinical outcomes of hepatitis B virus reactivation in kidney transplant recipients with resolved hepatitis B virus infection.</p><p><strong>Materials and methods: </strong>We retrospectively screened patients who underwent kidney transplant between 2012 and 2023 seen at our center (Izmir, Türkiye ). We included transplant recipients with resolved hepatitis B virus infection. We analyzed risk factors associated with reactivation and the clinical course of patients who developed hepatitis B virus reactivation.</p><p><strong>Results: </strong>Our analyses included 95 kidney transplant recipients; mean follow -up period was 70 ± 31 months. Baseline serology revealed that 9.4 % of patients had isolated anti -HBc positivity, whereas 90.6 % were positive for both anti -HBc and anti -HBs. None of the patients received antiviral prophylaxis at baseline; however, 14 patients received prophylaxis during the follow -up period. Among the 81 transplant recipients who did not receive prophylaxis, hepatitis B virus reactivation occurred in 3 patients (3.7 % ). No serious adverse outcomes, such as liver failure, liver transplant, or death due to hepatitis B virus reactivation were observed.</p><p><strong>Conclusions: </strong>Although hepatitis B virus reactivation is uncommon in hepatitis B surface antigen -negative /anti -HBc -positive patients after kidney transplant, reactivation remains a potential risk. In patients not scheduled for long -term prophylaxis, careful assessment regarding the necessity, efficacy, and safety of antiviral intervention is critical for optimal management.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"340-344"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649563","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":"Quantitative Renal Scintigraphy for Differentiating Ischemic and Nonischemic Transplant Complications: A Biopsy-Controlled Study.","authors":"Samaneh Hosseinzadeh, Mohsen Nafar, Fatemeh Poorrezagholi, Ahmad Firouzan, Fariba Samadian, Shiva Samavat, Nooshin Dalili, Sahand Ameri, Mahsa Hosseini Chimeh, Fatemeh Kaghazchi, Mahmoud Parvin","doi":"10.6002/ect.MESOT2025.O47","DOIUrl":"https://doi.org/10.6002/ect.MESOT2025.O47","url":null,"abstract":"<p><strong>Objectives: </strong>Tc -99m -diethylenetriaminepentaacetic acid renal scintigraphy is a noninvasive method for assessment of graft function. Here, we evaluated the diagnostic accuracy of quantitative scintigraphy parameters in differentiating ischemic complications (acute tubular necrosis ) from nonischemic complications (acute rejection, tubulointerstitial nephritis ), using tissue biopsy as the reference standard.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 63 kidney transplant recipients who underwent Tc -99m -diethylenetriaminepentaacetic acid renal scintigraphy followed by renal biopsy within 6 months posttransplant. Quantitative parameters derived from time -activity curves included delta peak, peak perfusion activity, plateau perfusion activity, peak perfusion activity -to -plateau perfusion activity ratio, peak function activity, peak perfusion activity -to peak function activity ratio, and the 20 /3 ratio. We compared scintigraphy findings with biopsy results categorized as ischemic, nonischemic, or normal. For statistical analysis, we used the Mann -Whitney test and receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Of the 63 patients, 59 had abnormal biopsy findings (5 ischemic, 54 nonischemic ). Scintigraphy findings were concordant with biopsy results in 61 cases. Delta peak (P = .043 ) and peak perfusion activity -to peak function activity ratios (P = .015 ) differed significantly between ischemic and nonischemic groups. Receiver operating characteristic curve analysis showed that delta peak was a good predictor of nonischemic complications (area under curve = 0.772 ), whereas peak perfusion activity -to peak function activity ratio was a strong predictor of ischemic complications (area under curve = 0.822 ). A delta peak cutoff value of 6.5 seconds yielded 63 %sensitivity and 80 % specificity for identifying nonischemic complications, whereas a peak perfusion activity -to peak function activity ratio cutoff of 1.31 provided 80 % sensitivity and 82 % specificity for detecting ischemic complications.</p><p><strong>Conclusions: </strong>Quantitative parameters derived from Tc -99m -diethylenetriaminepentaacetic acid renal scintigraphy are useful for differentiating ischemic from nonischemic renal transplant complications and correlate well with biopsy findings. These parameters may aid in the early diagnosis and management of posttransplant graft dysfunction.</p>","PeriodicalId":50467,"journal":{"name":"Experimental and Clinical Transplantation","volume":"24 Suppl 2","pages":"125-131"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649580","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}