Transplant International最新文献_第6页

Aortobifemoral Bypass in Kidney Transplant Candidates: A Ten-Year Experience 肾移植候选者的主动脉股骨旁路术：十年经验

Transplant International Pub Date : 2024-02-06 DOI: 10.3389/ti.2024.12085

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":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139859550","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}

引用次数: 0

Multi-Centre UK Analysis of Simultaneous Pancreas and Kidney (SPK) Transplant in Recipients With Type 2 Diabetes Mellitus 英国多中心对 2 型糖尿病受体胰肾（SPK）同时移植的分析

Transplant International Pub Date : 2024-02-02 DOI: 10.3389/ti.2023.11792

Ruth V. Owen, Harry J Carr, C. Counter, S. Tingle, Emily R. Thompson, Derek M. Manas, James A. Shaw, Colin H. Wilson, Steven A White

{"title":"Multi-Centre UK Analysis of Simultaneous Pancreas and Kidney (SPK) Transplant in Recipients With Type 2 Diabetes Mellitus","authors":"Ruth V. Owen, Harry J Carr, C. Counter, S. Tingle, Emily R. Thompson, Derek M. Manas, James A. Shaw, Colin H. Wilson, Steven A White","doi":"10.3389/ti.2023.11792","DOIUrl":"https://doi.org/10.3389/ti.2023.11792","url":null,"abstract":"90% of the UK diabetic population are classified as T2DM. This study aims to compare outcomes after SPK transplant between recipients with T1DM or T2DM. Data on all UK SPK transplants from 2003–2019 were obtained from the NHSBT Registry (n = 2,236). Current SPK transplant selection criteria for T2DM requires insulin treatment and recipient BMI < 30 kg/m2. After exclusions (re-transplants/ambiguous type of diabetes) we had a cohort of n = 2,154. Graft (GS) and patient (PS) survival analyses were conducted using Kaplan-Meier plots and Cox-regression models. Complications were compared using chi-squared analyses. 95.6% of SPK transplants were performed in recipients with T1DM (n = 2,060). Univariate analysis showed comparable outcomes for pancreas GS at 1 year (p = 0.120), 3 years (p = 0.237), and 10 years (p = 0.196) and kidney GS at 1 year (p = 0.438), 3 years (p = 0.548), and 10 years (p = 0.947). PS was comparable at 1 year (p = 0.886) and 3 years (p = 0.237) and at 10 years (p = 0.161). Multi-variate analysis showed comparable outcomes in pancreas GS (p = 0.564, HR 1.221, 95% CI 0.619, 2.406) and PS(p = 0.556, HR 1.280, 95% CI 0.563, 2.911). Comparable rates of common complications were demonstrated. This is the largest series outside of the US evaluating outcomes after SPK transplants and shows similar outcomes between T1DM and T2DM recipients. It is hoped dissemination of this data will lead to increased referral rates and assessment of T2DM patients who could benefit from SPK transplantation.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"13 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139868995","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}

引用次数: 0

Multi-Centre UK Analysis of Simultaneous Pancreas and Kidney (SPK) Transplant in Recipients With Type 2 Diabetes Mellitus 英国多中心对 2 型糖尿病受体胰肾（SPK）同时移植的分析

Transplant International Pub Date : 2024-02-02 DOI: 10.3389/ti.2023.11792

Ruth V. Owen, Harry J Carr, C. Counter, S. Tingle, Emily R. Thompson, Derek M. Manas, James A. Shaw, Colin H. Wilson, Steven A White

{"title":"Multi-Centre UK Analysis of Simultaneous Pancreas and Kidney (SPK) Transplant in Recipients With Type 2 Diabetes Mellitus","authors":"Ruth V. Owen, Harry J Carr, C. Counter, S. Tingle, Emily R. Thompson, Derek M. Manas, James A. Shaw, Colin H. Wilson, Steven A White","doi":"10.3389/ti.2023.11792","DOIUrl":"https://doi.org/10.3389/ti.2023.11792","url":null,"abstract":"90% of the UK diabetic population are classified as T2DM. This study aims to compare outcomes after SPK transplant between recipients with T1DM or T2DM. Data on all UK SPK transplants from 2003–2019 were obtained from the NHSBT Registry (n = 2,236). Current SPK transplant selection criteria for T2DM requires insulin treatment and recipient BMI < 30 kg/m2. After exclusions (re-transplants/ambiguous type of diabetes) we had a cohort of n = 2,154. Graft (GS) and patient (PS) survival analyses were conducted using Kaplan-Meier plots and Cox-regression models. Complications were compared using chi-squared analyses. 95.6% of SPK transplants were performed in recipients with T1DM (n = 2,060). Univariate analysis showed comparable outcomes for pancreas GS at 1 year (p = 0.120), 3 years (p = 0.237), and 10 years (p = 0.196) and kidney GS at 1 year (p = 0.438), 3 years (p = 0.548), and 10 years (p = 0.947). PS was comparable at 1 year (p = 0.886) and 3 years (p = 0.237) and at 10 years (p = 0.161). Multi-variate analysis showed comparable outcomes in pancreas GS (p = 0.564, HR 1.221, 95% CI 0.619, 2.406) and PS(p = 0.556, HR 1.280, 95% CI 0.563, 2.911). Comparable rates of common complications were demonstrated. This is the largest series outside of the US evaluating outcomes after SPK transplants and shows similar outcomes between T1DM and T2DM recipients. It is hoped dissemination of this data will lead to increased referral rates and assessment of T2DM patients who could benefit from SPK transplantation.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"5 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139809185","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}

引用次数: 0

Higher Donor Age and Severe Microvascular Inflammation Are Risk Factors for Chronic Rejection After Treatment of Active Antibody-Mediated Rejection 较高的供体年龄和严重的微血管炎症是治疗活动性抗体介导的排斥反应后出现慢性排斥反应的风险因素

Transplant International Pub Date : 2024-02-02 DOI: 10.3389/ti.2024.11960

Taro Banno, T. Hirai, R. Oki, Takafumi Yagisawa, K. Unagami, Taichi Kanzawa, K. Omoto, Tomokazu Shimizu, Hideki Ishida, Toshio Takagi

{"title":"Higher Donor Age and Severe Microvascular Inflammation Are Risk Factors for Chronic Rejection After Treatment of Active Antibody-Mediated Rejection","authors":"Taro Banno, T. Hirai, R. Oki, Takafumi Yagisawa, K. Unagami, Taichi Kanzawa, K. Omoto, Tomokazu Shimizu, Hideki Ishida, Toshio Takagi","doi":"10.3389/ti.2024.11960","DOIUrl":"https://doi.org/10.3389/ti.2024.11960","url":null,"abstract":"Recent developments in intensive desensitization protocols have enabled kidney transplantation in human leukocyte antigen (HLA)-sensitized recipients. However, cases of active antibody-mediated rejection (AABMR), when they occur, are difficult to manage, graft failure being the worst-case scenario. We aimed to assess the impact of our desensitization and AABMR treatment regimen and identify risk factors for disease progression. Among 849 patients who underwent living-donor kidney transplantation between 2014 and 2021 at our institution, 59 were diagnosed with AABMR within 1 year after transplantation. All patients received combination therapy consisting of steroid pulse therapy, intravenous immunoglobulin, rituximab, and plasmapheresis. Multivariable analysis revealed unrelated donors and preformed donor-specific antibodies as independent risk factors for AABMR. Five-year death-censored graft survival rate was not significantly different between patients with and without AABMR although 27 of 59 patients with AABMR developed chronic AABMR (CABMR) during the study period. Multivariate Cox proportional hazard regression analysis revealed that a donor age greater than 59 years and microvascular inflammation (MVI) score (g + ptc) ≥4 at AABMR diagnosis were independent risk factors for CABMR. Our combination therapy ameliorated AABMR; however, further treatment options should be considered to prevent CABMR, especially in patients with old donors and severe MVI.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"13 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139811081","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}

引用次数: 0

Clinical Pig Heart Xenotransplantation—Where Do We Go From Here? 临床猪心异种移植--何去何从？

Transplant International Pub Date : 2024-02-02 DOI: 10.3389/ti.2024.12592

David K. C. Cooper, Emanuele Cozzi

引用次数: 0

Higher Donor Age and Severe Microvascular Inflammation Are Risk Factors for Chronic Rejection After Treatment of Active Antibody-Mediated Rejection 较高的供体年龄和严重的微血管炎症是治疗活动性抗体介导的排斥反应后出现慢性排斥反应的风险因素

Transplant International Pub Date : 2024-02-02 DOI: 10.3389/ti.2024.11960

Taro Banno, T. Hirai, R. Oki, Takafumi Yagisawa, K. Unagami, Taichi Kanzawa, K. Omoto, Tomokazu Shimizu, Hideki Ishida, Toshio Takagi

{"title":"Higher Donor Age and Severe Microvascular Inflammation Are Risk Factors for Chronic Rejection After Treatment of Active Antibody-Mediated Rejection","authors":"Taro Banno, T. Hirai, R. Oki, Takafumi Yagisawa, K. Unagami, Taichi Kanzawa, K. Omoto, Tomokazu Shimizu, Hideki Ishida, Toshio Takagi","doi":"10.3389/ti.2024.11960","DOIUrl":"https://doi.org/10.3389/ti.2024.11960","url":null,"abstract":"Recent developments in intensive desensitization protocols have enabled kidney transplantation in human leukocyte antigen (HLA)-sensitized recipients. However, cases of active antibody-mediated rejection (AABMR), when they occur, are difficult to manage, graft failure being the worst-case scenario. We aimed to assess the impact of our desensitization and AABMR treatment regimen and identify risk factors for disease progression. Among 849 patients who underwent living-donor kidney transplantation between 2014 and 2021 at our institution, 59 were diagnosed with AABMR within 1 year after transplantation. All patients received combination therapy consisting of steroid pulse therapy, intravenous immunoglobulin, rituximab, and plasmapheresis. Multivariable analysis revealed unrelated donors and preformed donor-specific antibodies as independent risk factors for AABMR. Five-year death-censored graft survival rate was not significantly different between patients with and without AABMR although 27 of 59 patients with AABMR developed chronic AABMR (CABMR) during the study period. Multivariate Cox proportional hazard regression analysis revealed that a donor age greater than 59 years and microvascular inflammation (MVI) score (g + ptc) ≥4 at AABMR diagnosis were independent risk factors for CABMR. Our combination therapy ameliorated AABMR; however, further treatment options should be considered to prevent CABMR, especially in patients with old donors and severe MVI.","PeriodicalId":506324,"journal":{"name":"Transplant International","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139871083","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}

引用次数: 0

Clinical Pig Heart Xenotransplantation—Where Do We Go From Here? 临床猪心异种移植--何去何从？

Transplant International Pub Date : 2024-02-02 DOI: 10.3389/ti.2024.12592

David K. C. Cooper, Emanuele Cozzi

引用次数: 0

In Memoriam Sir Roy Yorke Calne December 30th, 1930 to January 6th, 2024 悼念罗伊-约克-卡尔恩爵士 1930 年 12 月 30 日至 2024 年 1 月 6 日

Transplant International Pub Date : 2024-02-01 DOI: 10.3389/ti.2024.12692

Neville Jamieson

引用次数: 0

In Memoriam Sir Roy Yorke Calne December 30th, 1930 to January 6th, 2024 悼念罗伊-约克-卡尔恩爵士 1930 年 12 月 30 日至 2024 年 1 月 6 日

Transplant International Pub Date : 2024-02-01 DOI: 10.3389/ti.2024.12692

Neville Jamieson

引用次数: 0