Frontiers in transplantation最新文献

Case Report: Lessons learned from large animal implantation of an all-natural tissue engineered vascular graft. 病例报告：大型动物移植全天然组织工程血管的经验教训。

Frontiers in transplantation Pub Date : 2025-10-07 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1676566

Alexandru I Dumitru, Bryan T Wonski, Renée A Cole, Mitchell R Weaver, Kelsey C Carpenter, Loay S Kabbani, Mai T Lam

{"title":"Case Report: Lessons learned from large animal implantation of an all-natural tissue engineered vascular graft.","authors":"Alexandru I Dumitru, Bryan T Wonski, Renée A Cole, Mitchell R Weaver, Kelsey C Carpenter, Loay S Kabbani, Mai T Lam","doi":"10.3389/frtra.2025.1676566","DOIUrl":"10.3389/frtra.2025.1676566","url":null,"abstract":"Cardiovascular disease continues to be the number one cause of morbidity and mortality across the world. Coronary artery bypass graft (CABG) procedures are the most commonly performed major surgery in the U.S. Grafts are difficult to source as patients do not have many sites from which to harvest donor tissues as autografts. Plastic grafts have issues of infection and are only used as a last resort. Tissue engineered vascular grafts have potential to solve the need for all-natural vascular grafts in the clinic. In this study, we evaluate the feasibility of a completely biological engineered vascular graft for implantation in a large animal model of a rabbit. An all-biological tissue engineered graft was grown in our laboratory, composed of a tunica adventitia derived from human dermal fibroblasts and a tunica media made from human aortic smooth muscle cells. The all-biological engineered graft exhibited the \"look and feel\" of a natural vessel. The engineered graft was implanted into the abdominal aorta of a New Zealand rabbit. The graft easily anastomosed to the native abdominal aorta and showed no leakages. Once reperfused, the graft was able to withstand blood flow briefly, prior to exhibiting dissection between the media and adventitia. Color doppler ultrasound showed flow through the abdominal aorta, however, not through the graft region due to the dissected layers creating a blockage. These results support a shift from the traditional paradigm of designing vascular grafts to mimic the multi-layered native structure. The two-layer engineered graft tested here exhibited dissection between the layers, a phenomenon that has yet to be reported in the field to our knowledge. Based on these findings, we recommend a single layer engineered graft to best prevent dissection.","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1676566"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Case Report: Organ procurement in a DCD donor with ovarian thecoma: abdominal NRP enabled timely and safe resection, pathological confirmation, and successful kidney transplantation. 病例报告：一个DCD供体卵巢囊肿的器官获取：腹部NRP使及时和安全的切除，病理确认，成功的肾移植。

Frontiers in transplantation Pub Date : 2025-10-02 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1680491

Benjamin Assouline, Timothée Olivier, Anne-Laure Rougemont, Philippe Compagnon, Charles-Henri Wassmer, Hervé Quintard, Karim Bendjelid, Franz Immer, Raphaël Giraud

{"title":"Case Report: Organ procurement in a DCD donor with ovarian thecoma: abdominal NRP enabled timely and safe resection, pathological confirmation, and successful kidney transplantation.","authors":"Benjamin Assouline, Timothée Olivier, Anne-Laure Rougemont, Philippe Compagnon, Charles-Henri Wassmer, Hervé Quintard, Karim Bendjelid, Franz Immer, Raphaël Giraud","doi":"10.3389/frtra.2025.1680491","DOIUrl":"10.3389/frtra.2025.1680491","url":null,"abstract":"Background: Donation after circulatory death (DCD) may be complicated by incidental findings, including tumor lesions that require urgent diagnosis. Here, we describe the case of a DCD donor with a large adnexal mass. Abdominal normothermic regional perfusion (A-NRP) enabled the safe resection of the mass, real-time pathological analysis, and subsequent kidney transplantation.Case summary: A 60-year-old woman suffered a hypoxic cardiac arrest and subsequently remained in a deep coma with poor neurological prognostic indicators. In accordance with her presumed wishes, life support was withdrawn, and a controlled DCD procedure with A-NRP was initiated. Imaging revealed a 27-cm adnexal mass. Laboratory markers showed elevated cancer antigen 125 (CA 125) but low cancer antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA), and cytology was negative. Bilateral oophorectomy was performed under A-NRP, and the frozen section excluded malignancy, with final pathology confirming an ovarian thecoma. Both kidneys were procured; only the left kidney was transplanted successfully. The recipient experienced immediate diuresis and regained stable renal function at 1 month.Discussion: This case illustrates how A-NRP provides oxygenated perfusion while allowing time for surgical excision and a pathological diagnosis of incidental tumors. It prevented unnecessary donor exclusion and enabled transplantation.Conclusion: In selected DCD donors with incidental lesions, A-NRP can safely bridge the diagnostic process, preserve organ viability, and expand the donor pool.","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1680491"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multiple center listing for organ transplantation in the United States: time to reform? 美国器官移植多中心上市：改革时机已到？

Frontiers in transplantation Pub Date : 2025-10-01 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1677463

Emmanouil Giorgakis, Keren Ladin, Sher-Lu Pai, Dimitrios Moris, Esteban Calderon, Oya Andacoglu, Nazia Selzner, Paulo N Martins

引用次数: 0

Decision regret and long-term weight evolution following laparoscopic sleeve gastrectomy as bridge to kidney transplantation. 腹腔镜袖式胃切除术后肾移植的决定后悔和长期体重变化。

Frontiers in transplantation Pub Date : 2025-10-01 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1627504

Xin Yu Yang, Pamela Brazeau-Porrello, Roy Hajjar, David Badrudin, Radu Pescarus, Gabriel Chan

{"title":"Decision regret and long-term weight evolution following laparoscopic sleeve gastrectomy as bridge to kidney transplantation.","authors":"Xin Yu Yang, Pamela Brazeau-Porrello, Roy Hajjar, David Badrudin, Radu Pescarus, Gabriel Chan","doi":"10.3389/frtra.2025.1627504","DOIUrl":"10.3389/frtra.2025.1627504","url":null,"abstract":"Introduction: Laparoscopic sleeve gastrectomy (LSG) is effective for rapid weight loss in kidney transplant (KT) candidates. This study aims to evaluate satisfaction or regret with the decision to undergo LSG in preparation for KT and the long-term durability of this approach to weight loss.Methods: From 2012 to 2019, all patients who underwent LSG prior to waitlisting for KT were included. The Decision Regret Scale (DRS) was assessed regarding the decision to undergo LSG before KT. The long-term weight evolution was also collected.Findings: Forty-six subjects completed the DRS survey at a median follow-up of 8 years post-LSG: 67% reported absolutely no regret, 22% mild regret, and 11% moderate to strong regret. Successful surgical weight loss was achieved in 36 patients and was significantly associated with lower levels of regret (p = 0.005). Body mass index reductions after LSG were highly significant compared to baseline values at all time points over 10 years (p = 0.0001) and remained significantly lower for up to 7 years post-KT. Thirty-two patients received KT, yet this had no significant association with decision regret.Conclusion: Laparoscopic sleeve gastrectomy as a pre-transplantation weight loss strategy is associated with very low levels of regret, regardless of the KT status. LSG has demonstrated long-term, durable weight loss.","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1627504"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The perioperative management of geriatric patients in transplantation surgery-clinical, immunological, and translational considerations. 老年移植手术患者的围手术期管理——临床、免疫学和翻译考虑。

Frontiers in transplantation Pub Date : 2025-09-26 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1566466

Leonard Knoedler, Sam Boroumand, Christopher A Hinze, Samuel Knoedler, Alexandre G Lellouch, Bhagvat J Maheta, Jasper Iske, Adriana C Panayi

{"title":"The perioperative management of geriatric patients in transplantation surgery-clinical, immunological, and translational considerations.","authors":"Leonard Knoedler, Sam Boroumand, Christopher A Hinze, Samuel Knoedler, Alexandre G Lellouch, Bhagvat J Maheta, Jasper Iske, Adriana C Panayi","doi":"10.3389/frtra.2025.1566466","DOIUrl":"10.3389/frtra.2025.1566466","url":null,"abstract":"Transplant surgery encompasses two primary branches: solid organ transplantation (SOT) and vascularized composite allotransplantation (VCA). As the global population ages, elderly transplant patients become a more pressing clinical challenge. Elderly transplant recipients require specialized care that addresses their unique needs, including increased comorbidities and frailty. Despite the growing recognition of these challenges, there is a paucity of studies that synthesize the current knowledge on this patient cohort, from immunological changes over translational challenges to tailored clinical care. This review highlights the individual needs of elderly transplant patients, emphasizing the importance of understanding their clinical profiles to develop specialized perioperative management strategies. The clinical need for tailored therapeutic concepts contrasts with the current lack of established, integrated care models specifically designed for older adults undergoing SOT and VCA. Overall, future research is warranted to provide individualized and cross-disciplinary care models for aging transplant patients and broaden the access to transplant surgery for this patient population.","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1566466"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial: Post-transplant monitoring for allograft rejection. 社论：移植后同种异体移植排斥反应的监测。

Frontiers in transplantation Pub Date : 2025-09-19 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1693261

Reut Hod-Dvorai, Reginald Gohh

引用次数: 0

Ischemia-reperfusion injury with a model of porcine whole-blood ex-vivo lung perfusion. 猪全血离体肺灌注模型的缺血再灌注损伤。

Frontiers in transplantation Pub Date : 2025-09-02 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1651671

Jean-Baptiste Menager, Julia Mercier, Justin Issard, Maria-Rosa Ghigna, Jeanne Tran Van Nhieu, Benoit Decante, Julien Guihaire, Elie Fadel, Fabrice Antigny, Olaf Mercier

{"title":"Ischemia-reperfusion injury with a model of porcine whole-blood ex-vivo lung perfusion.","authors":"Jean-Baptiste Menager, Julia Mercier, Justin Issard, Maria-Rosa Ghigna, Jeanne Tran Van Nhieu, Benoit Decante, Julien Guihaire, Elie Fadel, Fabrice Antigny, Olaf Mercier","doi":"10.3389/frtra.2025.1651671","DOIUrl":"10.3389/frtra.2025.1651671","url":null,"abstract":"Introduction: Our objective was to model Ischemia-Reperfusion (IR) injuries by ex-vivo perfusion of porcine lungs with whole blood containing the inflammatory cells.Methods: Lungs and whole blood were collected from 12 pigs and submitted to cold ischemia time (CIT) of 1 or 18 h. The lungs were then ventilated and perfused for 6 h at 37°C using donor whole blood. Pulmonary pressure was 20 mmHg.Results: Compared to the short CIT group, the long CIT group had a lower maximum perfusion flow rate (mean difference in % cardiac output, -39%; 95% CI, -66 to -12; P = 0.005) and higher pulmonary vascular resistance (mean difference, 1,077 dyne·s·cm-⁵; 95% CI, 685-1,469; P < 0.001). Neutrophils decreased more in the long CIT group (mean difference, -744.02 cells/mm3; 95% CI, -1,343.11 to -144.92; P = 0.017), suggesting sequestration in the lung parenchyma. Interleukin-6 and -8 levels after 6 h were significantly higher in the long CIT group (mean differences, 1.1 pg/ml; 95% CI, 0.39-1.8; P = 0.003; and 29.31 pg/ml; 95%CI, 16.00-42.61; P < 0.001; respectively). Progressive microvasculopathy resulting in lymphangiectasia and peribronchovascular inflammatory infiltrates were seen in both groups.Conclusion: After 18 h of CIT, ex-vivo whole-blood perfusion for 6 h replicated features of IR injuries.","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1651671"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Plasma total and donor-derived cell-free DNA predict survival in kidney transplant recipients. 血浆总DNA和供体来源的无细胞DNA预测肾移植受者的生存。

Frontiers in transplantation Pub Date : 2025-09-01 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1624291

Alison S Graver, David A Power, John B Whitlam

{"title":"Plasma total and donor-derived cell-free DNA predict survival in kidney transplant recipients.","authors":"Alison S Graver, David A Power, John B Whitlam","doi":"10.3389/frtra.2025.1624291","DOIUrl":"10.3389/frtra.2025.1624291","url":null,"abstract":"Introduction: Studies evaluating cell-free DNA (cfDNA) in kidney allograft dysfunction have primarily focused on detection of rejection by donor-derived cfDNA (ddcfDNA). The utility of ddcfDNA as a marker of longer-term outcomes has not been examined.Methods: This study investigated the prognostic value of plasma total cfDNA, fractional ddcfDNA and absolute ddcfDNA, quantified in 49 adult kidney transplant recipients (KTRs) at the time of indication allograft biopsy between 2014 and 2017. Primary outcomes were death, death-censored graft loss (DCGL), and all graft loss (AGL).Results: During a median follow-up of 6.3 years, 7 patients died, 7 experienced DCGL, and 14 had AGL. Death was predicted by high total cfDNA [>4,034 copies/ml, hazard ratio (HR) 5.94, 95% CI 1.40-25.13, P = 0.008] and low fractional ddcfDNA (<0.67%, HR 10.85, 95% CI 1.32-1,408.19, P = 0.03), and DCGL was predicted by high fractional ddcfDNA (>0.72%, HR 4.93, 95% CI 1.12-21.72, P = 0.04), on univariate analysis. AGL was predicted by high total cfDNA (>4,034 copies/ml, HR 642, 95% CI 1.15-3.56 × 105, P = 0.045) on multivariate analysis. Absolute ddcfDNA was not associated with survival outcomes.Discussion: This study demonstrates potential prognostic utility of total cfDNA and fractional ddcfDNA in KTRs with allograft dysfunction. Incorporation of these biomarkers could enhance personalised care, beyond non-invasive detection of rejection.","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1624291"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disparities in liver transplant waitlist characteristics and outcomes among Hispanic compared to non-Hispanic adults. 西班牙裔与非西班牙裔成人在肝移植等候名单特征和结果上的差异。

Frontiers in transplantation Pub Date : 2025-08-20 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1592516

Monica Tincopa, Jordan L Pace, Fanny Delebecque, Kelly Torosian, Denya Arellano, Maria Elena Martinez, Irine Vodkin, Veeral Ajmera

{"title":"Disparities in liver transplant waitlist characteristics and outcomes among Hispanic compared to non-Hispanic adults.","authors":"Monica Tincopa, Jordan L Pace, Fanny Delebecque, Kelly Torosian, Denya Arellano, Maria Elena Martinez, Irine Vodkin, Veeral Ajmera","doi":"10.3389/frtra.2025.1592516","DOIUrl":"10.3389/frtra.2025.1592516","url":null,"abstract":"Background: Social determinants of health (SDOH) and transplant center characteristics have been associated with access to liver transplantation (LT) for Hispanic individuals. The aim of this study was to identify waitlist characteristics and correlates of odds of LT and waitlist removal by Hispanic ethnicity.Methods: This was a single-center cohort study of adults listed for LT between January 2018-December 2020. Demographic, clinical, and SDOH were analyzed using logistic regression.Results: 375 patients were included. 52.5% (N = 197) were Hispanic. At time of listing, Hispanic patients had significantly higher BMI, prevalence of diabetes and metabolic dysfunction associated steatohepatitis. Rates of substance use were significantly lower and time of last drink to listing was significantly longer (641 vs. 391 days, p = 0.0007) in Hispanic adults. Rates of LT and waitlist removal did not significantly differ by Hispanic ethnicity (46.9% vs. 46.1% and 35% vs. 36.5%, respectively). Hepatocellular carcinoma (OR 3.28) was associated with odds of LT whereas employment status predicted waitlist removal.Conclusions: Distribution on the waitlist, LT and waitlist removal did not differ by Hispanic ethnicity. Hispanic patients had significantly longer time from last drink to listing, suggesting referral bias. Public health interventions to optimize LT referral are needed to increase health equity.","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1592516"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic approach to elevated dd-cfDNA with reassuring EMB in heart transplantation. 心脏移植中dd-cfDNA升高的安心EMB诊断方法。

Frontiers in transplantation Pub Date : 2025-08-14 eCollection Date: 2025-01-01 DOI: 10.3389/frtra.2025.1623514

Rupinder K Bahniwal, Aditya Mehta, Jamie L W Kennedy

引用次数: 0