A. Niroomand, G. Hirdman, N. Bèchet, H. Ghaidan, M. Stenlo, Sven Kjellström, Marc Isaksson, E. Broberg, Leif Pierre, S. Hyllén, F. Olm, Sandra Lindstedt
{"title":"Proteomic Analysis of Primary Graft Dysfunction in Porcine Lung Transplantation Reveals Alveolar-Capillary Barrier Changes Underlying the High Particle Flow Rate in Exhaled Breath","authors":"A. Niroomand, G. Hirdman, N. Bèchet, H. Ghaidan, M. Stenlo, Sven Kjellström, Marc Isaksson, E. Broberg, Leif Pierre, S. Hyllén, F. Olm, Sandra Lindstedt","doi":"10.3389/ti.2024.12298","DOIUrl":"https://doi.org/10.3389/ti.2024.12298","url":null,"abstract":"Primary graft dysfunction (PGD) remains a challenge for lung transplantation (LTx) recipients as a leading cause of poor early outcomes. New methods are needed for more detailed monitoring and understanding of the pathophysiology of PGD. The measurement of particle flow rate (PFR) in exhaled breath is a novel tool to monitor and understand the disease at the proteomic level. In total, 22 recipient pigs underwent orthotopic left LTx and were evaluated for PGD on postoperative day 3. Exhaled breath particles (EBPs) were evaluated by mass spectrometry and the proteome was compared to tissue biopsies and bronchoalveolar lavage fluid (BALF). Findings were confirmed in EBPs from 11 human transplant recipients. Recipients with PGD had significantly higher PFR [686.4 (449.7–8,824.0) particles per minute (ppm)] compared to recipients without PGD [116.6 (79.7–307.4) ppm, p = 0.0005]. Porcine and human EBP proteins recapitulated proteins found in the BAL, demonstrating its utility instead of more invasive techniques. Furthermore, adherens and tight junction proteins were underexpressed in PGD tissue. Histological and proteomic analysis found significant changes to the alveolar-capillary barrier explaining the high PFR in PGD. Exhaled breath measurement is proposed as a rapid and non-invasive bedside measurement of PGD.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Yoshiyasu, Rei Matsuki, Masaaki Sato, H. Urushiyama, E. Toda, Yasuhiro Terasaki, Masaki Suzuki, A. Shinozaki-Ushiku, Y. Terashima, Jun Nakajima
{"title":"Disulfiram, an Anti-alcoholic Drug, Targets Macrophages and Attenuates Acute Rejection in Rat Lung Allografts","authors":"N. Yoshiyasu, Rei Matsuki, Masaaki Sato, H. Urushiyama, E. Toda, Yasuhiro Terasaki, Masaki Suzuki, A. Shinozaki-Ushiku, Y. Terashima, Jun Nakajima","doi":"10.3389/ti.2024.12556","DOIUrl":"https://doi.org/10.3389/ti.2024.12556","url":null,"abstract":"Macrophages contribute to post-transplant lung rejection. Disulfiram (DSF), an anti-alcoholic drug, has an anti-inflammatory effect and regulates macrophage chemotactic activity. Here, we investigated DSF efficacy in suppressing acute rejection post-lung transplantation. Male Lewis rats (280–300 g) received orthotopic left lung transplants from Fisher 344 rats (minor histocompatibility antigen-mismatched transplantation). DSF (0.75 mg/h) monotherapy or co-solvent only (50% hydroxypropyl-β-cyclodextrin) as control was subcutaneously administered for 7 days (n = 10/group). No post-transplant immunosuppressant was administered. Grades of acute rejection, infiltration of immune cells positive for CD68, CD3, or CD79a, and gene expression of monocyte chemoattractant protein and pro-inflammatory cytokines in the grafts were assessed 7 days post-transplantation. The DSF-treated group had significantly milder lymphocytic bronchiolitis than the control group. The infiltration levels of CD68+ or CD3+ cells to the peribronchial area were significantly lower in the DSF than in the control groups. The normalized expression of chemokine ligand 2 and interleukin-6 mRNA in allografts was lower in the DSF than in the control groups. Validation assay revealed interleukin-6 expression to be significantly lower in the DSF than in the control groups. DSF can alleviate acute rejection post-lung transplantation by reducing macrophage accumulation around peripheral bronchi and suppressing pro-inflammatory cytokine expression.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140729423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyu-Sun Lee, Hyungseop Kim, Sun Hwa Lee, D. Choi, M. Yoon, Eun-Seok Jeon, Jin-Oh Choi, Jeehoon Kang, Hae-Young Lee, S. Jung, Jaewon Oh, Seok-Min Kang, Soo Yong Lee, Min Ho Ju, Jae-Joong Kim, M. Kim, Hyun-Jai Cho
{"title":"Impact of Everolimus Initiation and Corticosteroid Weaning During Acute Phase After Heart Transplantation on Clinical Outcome: Data from the Korean Organ Transplant Registry (KOTRY)","authors":"Kyu-Sun Lee, Hyungseop Kim, Sun Hwa Lee, D. Choi, M. Yoon, Eun-Seok Jeon, Jin-Oh Choi, Jeehoon Kang, Hae-Young Lee, S. Jung, Jaewon Oh, Seok-Min Kang, Soo Yong Lee, Min Ho Ju, Jae-Joong Kim, M. Kim, Hyun-Jai Cho","doi":"10.3389/ti.2024.11878","DOIUrl":"https://doi.org/10.3389/ti.2024.11878","url":null,"abstract":"The effect of changes in immunosuppressive therapy during the acute phase post-heart transplantation (HTx) on clinical outcomes remains unclear. This study aimed to investigate the effects of changes in immunosuppressive therapy by corticosteroid (CS) weaning and everolimus (EVR) initiation during the first year post-HTx on clinical outcomes. We analyzed 622 recipients registered in the Korean Organ Transplant Registry (KOTRY) between January 2014 and December 2021. The median age at HTx was 56 years (interquartile range [IQR], 45–62), and the median follow-up time was 3.9 years (IQR 2.0–5.1). The early EVR initiation within the first year post-HTx and maintenance during the follow-up is associated with reduced the risk of primary composite outcome (all-cause mortality or re-transplantation) (HR, 0.24; 95% CI 0.09–0.68; p < 0.001) and cardiac allograft vasculopathy (CAV) (HR, 0.39; 95% CI 0.19–0.79; p = 0.009) compared with EVR-free or EVR intermittent treatment regimen, regardless of CS weaning. However, the early EVR initiation tends to increase the risk of acute allograft rejection compared with EVR-free or EVR intermittent treatment.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"3 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Uhl, T. Waeckel, E. Seizilles De Mazancourt, F. Taha, K. Kaulanjan, A. Goujon, A. Beretta, J. Papet, H. Dupuis, A. Panis, A. Peyrottes, A. Lemaire, C. Larose, L. Bettler, M. Pues, C. Joncour, G. Stempfer, T. Ghestem, P. De Sousa
{"title":"Impact of Transplantation Timing on Renal Graft Survival Outcomes and Perioperative Complications","authors":"M. Uhl, T. Waeckel, E. Seizilles De Mazancourt, F. Taha, K. Kaulanjan, A. Goujon, A. Beretta, J. Papet, H. Dupuis, A. Panis, A. Peyrottes, A. Lemaire, C. Larose, L. Bettler, M. Pues, C. Joncour, G. Stempfer, T. Ghestem, P. De Sousa","doi":"10.3389/ti.2024.12202","DOIUrl":"https://doi.org/10.3389/ti.2024.12202","url":null,"abstract":"Nighttime organ transplantation aims to decrease cold ischemia duration, yet conflicting data exists on its impact on graft function and perioperative complications. This multicenter TRANSPLANT’AFUF study including 2,854 patients, transplanted between 1 January 2011, and 31 December 2022, investigated nighttime kidney transplantation’s impact (8:00 p.m.–8:00 a.m.) versus daytime (8:00 a.m.–8:00 p.m.) on surgical complications and graft survival. Overall, 2043 patients (71.6%) underwent daytime graft, while 811 (28.4%) underwent nighttime graft. No impact was observed of timing of graft surgery on graft survival with a median survival of 98 months and 132 months for daytime and nightime grafting, respectively (p = 0.1749). Moreover, no impact was observed on early surgical complications (Clavien I-II = 20.95% for DG and 20.10% for NG; Clavien III-IV-V = 15.42% for DG and 12.94% for NG; p = 0.0889) and late complications (>30 days) (Clavien I-II = 6.80% for DG and 5.67% for NG; Clavien III-IV-V = 12.78% for DG and 12.82% for NG; p = 0.2444). Noteworthy, we found a significant increase in Maastricht 3 donors’ rates in nighttime transplantation (5.53% DG vs. 21.45% NG; p < 0.0001). In conclusion, nighttime kidney transplantation did not impact early/late surgical complications nor graft survival.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"406 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139839443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Uhl, T. Waeckel, E. Seizilles De Mazancourt, F. Taha, K. Kaulanjan, A. Goujon, A. Beretta, J. Papet, H. Dupuis, A. Panis, A. Peyrottes, A. Lemaire, C. Larose, L. Bettler, M. Pues, C. Joncour, G. Stempfer, T. Ghestem, P. De Sousa
{"title":"Impact of Transplantation Timing on Renal Graft Survival Outcomes and Perioperative Complications","authors":"M. Uhl, T. Waeckel, E. Seizilles De Mazancourt, F. Taha, K. Kaulanjan, A. Goujon, A. Beretta, J. Papet, H. Dupuis, A. Panis, A. Peyrottes, A. Lemaire, C. Larose, L. Bettler, M. Pues, C. Joncour, G. Stempfer, T. Ghestem, P. De Sousa","doi":"10.3389/ti.2024.12202","DOIUrl":"https://doi.org/10.3389/ti.2024.12202","url":null,"abstract":"Nighttime organ transplantation aims to decrease cold ischemia duration, yet conflicting data exists on its impact on graft function and perioperative complications. This multicenter TRANSPLANT’AFUF study including 2,854 patients, transplanted between 1 January 2011, and 31 December 2022, investigated nighttime kidney transplantation’s impact (8:00 p.m.–8:00 a.m.) versus daytime (8:00 a.m.–8:00 p.m.) on surgical complications and graft survival. Overall, 2043 patients (71.6%) underwent daytime graft, while 811 (28.4%) underwent nighttime graft. No impact was observed of timing of graft surgery on graft survival with a median survival of 98 months and 132 months for daytime and nightime grafting, respectively (p = 0.1749). Moreover, no impact was observed on early surgical complications (Clavien I-II = 20.95% for DG and 20.10% for NG; Clavien III-IV-V = 15.42% for DG and 12.94% for NG; p = 0.0889) and late complications (>30 days) (Clavien I-II = 6.80% for DG and 5.67% for NG; Clavien III-IV-V = 12.78% for DG and 12.82% for NG; p = 0.2444). Noteworthy, we found a significant increase in Maastricht 3 donors’ rates in nighttime transplantation (5.53% DG vs. 21.45% NG; p < 0.0001). In conclusion, nighttime kidney transplantation did not impact early/late surgical complications nor graft survival.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"57 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139779443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dimitri Stylemans, M. Vandecruys, S. Leunis, Sofie Engelborghs, Davide Gargioli, D. Monbaliu, Véronique Cornelissen, A. V. Van Craenenbroeck, S. De Smet
{"title":"Physical Exercise After Solid Organ Transplantation: A Cautionary Tale","authors":"Dimitri Stylemans, M. Vandecruys, S. Leunis, Sofie Engelborghs, Davide Gargioli, D. Monbaliu, Véronique Cornelissen, A. V. Van Craenenbroeck, S. De Smet","doi":"10.3389/ti.2024.12448","DOIUrl":"https://doi.org/10.3389/ti.2024.12448","url":null,"abstract":"An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the ‘gift of life’ are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"75 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139780304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dimitri Stylemans, M. Vandecruys, S. Leunis, Sofie Engelborghs, Davide Gargioli, D. Monbaliu, Véronique Cornelissen, A. V. Van Craenenbroeck, S. De Smet
{"title":"Physical Exercise After Solid Organ Transplantation: A Cautionary Tale","authors":"Dimitri Stylemans, M. Vandecruys, S. Leunis, Sofie Engelborghs, Davide Gargioli, D. Monbaliu, Véronique Cornelissen, A. V. Van Craenenbroeck, S. De Smet","doi":"10.3389/ti.2024.12448","DOIUrl":"https://doi.org/10.3389/ti.2024.12448","url":null,"abstract":"An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the ‘gift of life’ are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139840271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Rodrigues, W. Y. van der Plas, Camilo G. Sotomayor, A. van der Vaart, D. Kremer, Robert A. Pol, S. Kruijff, I. Heilberg, Stephan J. L. Bakker, M. D. de Borst
{"title":"Pre-Transplant Hyperparathyroidism and Graft or Patient Outcomes After Kidney Transplantation","authors":"F. Rodrigues, W. Y. van der Plas, Camilo G. Sotomayor, A. van der Vaart, D. Kremer, Robert A. Pol, S. Kruijff, I. Heilberg, Stephan J. L. Bakker, M. D. de Borst","doi":"10.3389/ti.2024.11916","DOIUrl":"https://doi.org/10.3389/ti.2024.11916","url":null,"abstract":"The impact of pre-transplant parathyroid hormone (PTH) levels on early or long-term kidney function after kidney transplantation is subject of debate. We assessed whether severe hyperparathyroidism is associated with delayed graft function (DGF), death-censored graft failure (DCGF), or all-cause mortality. In this single-center cohort study, we studied the relationship between PTH and other parameters related to bone and mineral metabolism, including serum alkaline phosphatase (ALP) at time of transplantation with the subsequent risk of DGF, DCGF and all-cause mortality using multivariable logistic and Cox regression analyses. In 1,576 kidney transplant recipients (51.6 ± 14.0 years, 57.3% male), severe hyperparathyroidism characterized by pre-transplant PTH ≥771 pg/mL (>9 times the upper limit) was present in 121 patients. During 5.2 [0.2–30.0] years follow-up, 278 (15.7%) patients developed DGF, 150 (9.9%) DCGF and 432 (28.6%) died. A higher pre-transplant PTH was not associated with DGF (HR 1.06 [0.90–1.25]), DCGF (HR 0.98 [0.87–1.13]), or all-cause mortality (HR 1.02 [0.93–1.11]). Results were consistent in sensitivity analyses. The same applied to other parameters related to bone and mineral metabolism, including ALP. Severe pre-transplant hyperparathyroidism was not associated with an increased risk of DGF, DCGF or all-cause mortality, not supporting the need of correction before kidney transplantation to improve graft or patient survival.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"286 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139857351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Rodrigues, W. Y. van der Plas, Camilo G. Sotomayor, A. van der Vaart, D. Kremer, Robert A. Pol, S. Kruijff, I. Heilberg, Stephan J. L. Bakker, M. D. de Borst
{"title":"Pre-Transplant Hyperparathyroidism and Graft or Patient Outcomes After Kidney Transplantation","authors":"F. Rodrigues, W. Y. van der Plas, Camilo G. Sotomayor, A. van der Vaart, D. Kremer, Robert A. Pol, S. Kruijff, I. Heilberg, Stephan J. L. Bakker, M. D. de Borst","doi":"10.3389/ti.2024.11916","DOIUrl":"https://doi.org/10.3389/ti.2024.11916","url":null,"abstract":"The impact of pre-transplant parathyroid hormone (PTH) levels on early or long-term kidney function after kidney transplantation is subject of debate. We assessed whether severe hyperparathyroidism is associated with delayed graft function (DGF), death-censored graft failure (DCGF), or all-cause mortality. In this single-center cohort study, we studied the relationship between PTH and other parameters related to bone and mineral metabolism, including serum alkaline phosphatase (ALP) at time of transplantation with the subsequent risk of DGF, DCGF and all-cause mortality using multivariable logistic and Cox regression analyses. In 1,576 kidney transplant recipients (51.6 ± 14.0 years, 57.3% male), severe hyperparathyroidism characterized by pre-transplant PTH ≥771 pg/mL (>9 times the upper limit) was present in 121 patients. During 5.2 [0.2–30.0] years follow-up, 278 (15.7%) patients developed DGF, 150 (9.9%) DCGF and 432 (28.6%) died. A higher pre-transplant PTH was not associated with DGF (HR 1.06 [0.90–1.25]), DCGF (HR 0.98 [0.87–1.13]), or all-cause mortality (HR 1.02 [0.93–1.11]). Results were consistent in sensitivity analyses. The same applied to other parameters related to bone and mineral metabolism, including ALP. Severe pre-transplant hyperparathyroidism was not associated with an increased risk of DGF, DCGF or all-cause mortality, not supporting the need of correction before kidney transplantation to improve graft or patient survival.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"54 s49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139797761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pascaline Bonnin, Salome H Kuntz, Sophie Caillard, N. Chakfé, A. Lejay
{"title":"Aortobifemoral Bypass in Kidney Transplant Candidates: A Ten-Year Experience","authors":"Pascaline Bonnin, Salome H Kuntz, Sophie Caillard, N. Chakfé, A. Lejay","doi":"10.3389/ti.2024.12085","DOIUrl":"https://doi.org/10.3389/ti.2024.12085","url":null,"abstract":"In patients with severe aorto-iliac calcifications, vascular reconstructions can be performed in order to allow kidney transplantation. The aim of this study was to analyze the outcomes of kidney transplant candidates who underwent an aortobifemoral bypass (ABFB) for aorto-iliac calcifications. A retrospective study including all kidney transplant candidates who underwent an ABFB between 2012 and 2022 was performed. Primary outcome was 30-day morbidity-mortality after ABFB. Secondary outcome was accessibility to kidney transplant waiting list. Twenty-two ABFBs were performed: 10 ABFBs in asymptomatic patients presenting severe aorto-iliac circumferential calcifications without hemodynamic consequences, and 12 ABFBs in symptomatic patients in whom aorto-iliac calcifications were responsible for claudication or critical limb threatening ischemia. Overall 30-day mortality was 0%. Overall 30-day morbidity was 22.7%: 1 femoral hematoma and 1 retroperitoneal hematoma requiring surgical drainage in the asymptomatic group, and 2 digestive ischemia requiring bowel resection and 1 femoral hematoma requiring surgical drainage in the symptomatic group. Among the 22 patients, 20 patients could access to kidney waiting list and 8 patients underwent a kidney transplantation, including 3 living-donor transplantations. Aorto-iliac revascularization can be an option to overcome severe calcifications contraindicating kidney transplantation.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"120 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139799883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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