Frontiers in transplantation最新文献

{"title":"Terry B. Strom: not just a pillar but a foundation.","authors":"Manikkam Suthanthiran","doi":"10.3389/frtra.2024.1519975","DOIUrl":"10.3389/frtra.2024.1519975","url":null,"abstract":"","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1519975"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840542","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}

{"title":"Exploring the relationship between website quality and equity in living donor kidney transplant.","authors":"Lisa M McElroy, Joy E Obayemi, Brian I Shaw, Christine Park, Keenan Caddell, LaShara A Davis, Nicole DePasquale, Dinushika Mohottige, L Ebony Boulware","doi":"10.3389/frtra.2024.1490876","DOIUrl":"10.3389/frtra.2024.1490876","url":null,"abstract":"<p><strong>Background: </strong>Health system websites are important resources to guide health care decisions and may be useful tools to improve racial equity in access to living donor kidney transplant (LDKT).</p><p><strong>Methods: </strong>We performed a cross-sectional study of adult LDKT programs in the United States. We created an assessment tool for website quality across three domains: accessibility (access to LDKT specific information from the transplant center website), readability (ease of reading and clarity), and educational content (appropriateness and presentation of information, LDKT-specific content, program-specific characteristics, and adherence to equity-centered principles of web design).</p><p><strong>Results: </strong>Among the 185 transplant center websites reviewed, only 14.6% of LDKT sites could be accessed directly from the transplant center webpage. The median suitability assessment of materials (SAM)-a validated measure of website content for chronic kidney disease (CKD)-was 45 out of 86 (IQR 4) and the median Flesch-Kincaid grade level and ease score were 9.1 (IQR 0.8) on a scale of 0-18 and 51.2 (IQR 5) on a scale of 0-100, respectively.</p><p><strong>Conclusion: </strong>These results indicate that LDKT websites are currently not available, accessible, and understandable for many potential transplant candidates and donors. Optimizing the content and design of transplant center websites may be a promising and effective strategy for improving equity in access to LDKT.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1490876"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804408","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}

{"title":"Detailed surgical description of porcine vascularized thymus lobe transplantation.","authors":"M Esad Gunes, Sho Fujiwara, Daniel H Wolbrom, Alexander Cadelina, Susan Qudus, Dilrukshi Ekanayake-Alper, Dominik Hajosi, David H Sachs, Greg Nowak","doi":"10.3389/frtra.2024.1499844","DOIUrl":"10.3389/frtra.2024.1499844","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in immunosuppressive therapies, chronic rejection and immunosuppression-related complications remain significant challenges in transplantation. Developing transplantation tolerance through thymus transplantation may offer a solution. This paper details our technique for procuring and transplanting porcine vascularized thymic lobes (VTL), which can be utilized to study and research allogeneic and xenogeneic transplantation models in large animals.</p><p><strong>Methods: </strong>GalT-KO miniature swine (<i>n</i> = 16) and baboons (<i>n</i> = 12) were used for VTL transplantation. The right or left cervical thymic lobe was dissected, harvested with its artery and veins, and flushed with cold lactated Ringer's solution. VTL graft was transplanted intraabdominally in all animals.</p><p><strong>Results: </strong>We performed non-survival (<i>n</i> = 2) and survival (<i>n</i> = 2) VTL autotransplants in pigs and xeno-VTL and kidney transplants in baboons (<i>n</i> = 12). All grafts immediately turned pink after reperfusion and had good blood inflow and outflow. Pigs in the survival autotransplant group were euthanized immediately post-operatively due to complications related to VTL donation. One baboon lost its graft due to antibody-mediated rejection, and another lost it due to venous thrombosis. Other baboons had no complications and survived until the endpoint.</p><p><strong>Conclusion: </strong>Here, we describe our approach and experience in swine vascularized thymic lobe procurement and transplantation. The technique requires moderate surgical skills to achieve reproducible results. Living-donor VTL donation in pigs is not recommended due to the high risk of surgical complications related to the harvesting procedure.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1499844"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796716","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}

{"title":"Quality of life, anxiety, and depression improve at one-year after liver transplantation in patients with advanced liver disease.","authors":"Rosana Cordoba-Alvarado, Valentina Romero-Fonnegra, Nicolas Cortes-Mejia, Diana Fernanda Bejarano-Ramirez, Valentina Maldonado-Hoyos, Sandra Janeth Sanchez-Garcia, Alonso Vera-Torres","doi":"10.3389/frtra.2024.1476952","DOIUrl":"10.3389/frtra.2024.1476952","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation (LT) improves survival in end-stage liver disease. Several reports have addressed the impact of LT on patients' lives, beyond purely medical outcomes. Although the quality of life and mental health have been demonstrated to improve with this procedure, such studies are still missing in Latin America.</p><p><strong>Methods: </strong>Patients who received LT at the Fundación Santa Fe de Bogotá between 2017 and 2019 were assessed for quality of life (QoL), anxiety, and depression and they were followed up for one year after the procedure. Pre-transplant data were gathered at inclusion on the waiting list, while post-transplant data at 3- and 12 months after LT. European Quality of Life-5 Dimensions (EQ-5D) and European Quality of Life-Visual Analog Scale (EQ-VAS) instruments were used to evaluate QoL. The Hospital Anxiety and Depression Scale (HADS) was used for evaluating anxious and depressive symptoms.</p><p><strong>Results: </strong>115 recipients met the inclusion criteria. Mean pre-transplant EQ-VAS was 70.78, rising to 87.16 and 92.56 at 3- and 12-months, respectively. Improvements in all EQ-5D dimensions were found in response to LT. According to the HADS questionnaire, anxiety was reduced by 2.35 points and depression by 1.63 points after LT.</p><p><strong>Conclusion: </strong>in the short term, LT is a successful strategy for enhancing QoL, anxiety, and depression in patients with liver disease. Long-term benefits must be assessed.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1476952"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788330","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}

{"title":"A review of cell-free DNA and epigenetics for non-invasive diagnosis in solid organ transplantation.","authors":"Alizée Sebastian, Monique Silvy, Benjamin Coiffard, Martine Reynaud-Gaubert, Frédérique Magdinier, Jacques Chiaroni, Christophe Picard, Pascal Pedini","doi":"10.3389/frtra.2024.1474920","DOIUrl":"https://doi.org/10.3389/frtra.2024.1474920","url":null,"abstract":"<p><strong>Introduction: </strong>Circulating cell-free DNA (cfDNA) is emerging as a non-invasive biomarker in solid organ transplantation (SOT) monitoring and data on its diagnostic potential have been increasing in recent years. This review aims to summarize the main advances in technologies, clinical applications and future perspectives of cfDNA for transplantation, and to approach the contribution of epigenetics to improve the specific detection of rejection.</p><p><strong>Methods: </strong>Published literature investigating cfDNA as a biomarker for the diagnosis of transplant rejection was systematically reviewed, specifically clinical trials evaluating the test performance of algorithms predicting rejection based on cfDNA fraction. Literature highlighting epigenetic features in transplant rejection was also reviewed to outline the potential contribution of the epigenomic analysis to the needs of rejection-specific diagnosis.</p><p><strong>Results: </strong>40 articles were reviewed, and results were extracted and summarized. 16 met the inclusion criteria by evaluating the diagnostic performance of a predictive test for the discrimination of rejection vs. non-rejection patients (2 heart, 3 liver, 4 kidney, and 7 lung transplantations). The recurring conclusion is the kinetics of dd-cfDNA levels, strongly increasing immediately after transplantation and reaching basal levels after days to weeks and remaining stable in non-rejection patients. On the other hand, rejection is characterized by an increase in dd-cfDNA levels, depending on the transplanted organs. In addition, the epigenetic signature can help improve the specificity of the diagnosis of rejection by searching for specific epigenetic features that are by the clinical status of patients.</p><p><strong>Conclusion: </strong>Cell-free DNA is a promising non-invasive biomarker but still needs standardization of technologies and protocols to be used for diagnostic purposes. Moreover, the lack of specificity of this marker can be compensated by the contribution of epigenetic analysis for which data are growing, although progress is still needed for its use in a clinical context.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1474920"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776285","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}

{"title":"Anterior retroperitoneal approach in constructing thymokidney organs in swine for xenotransplantation.","authors":"M Esad Gunes, Daniel H Wolbrom, Sho Fujiwara, Susan Qudus, Alexander Cadelina, Greg Nowak","doi":"10.3389/frtra.2024.1473281","DOIUrl":"10.3389/frtra.2024.1473281","url":null,"abstract":"<p><strong>Introduction: </strong>Thymokidneys (TK) have been constructed to transplant life-supporting kidney grafts containing donor thymic tissue to induce transplant tolerance. Historically, TKs were constructed by inserting pieces of thymus tissue under the kidney capsule using an intra-abdominal or posterior retroperitoneal (lateral/flank) approach. The intra-abdominal approach is technically easier but causes intra-abdominal adhesions and makes kidney procurement more challenging. The posterior retroperitoneal approach causes fewer complications, but thymus tissue implantation is technically demanding due to limited visibility and exposure of the kidney. We herein describe the anterior retroperitoneal approach that overcomes these challenges.</p><p><strong>Methods: </strong>8-week-old GalTKO-swine (<i>n</i> = 2) were sedated, intubated, and draped. Cervical thymus lobes were isolated and excised. Via a small midline abdominal incision, the peritoneum was dissected bilaterally from the abdominal muscles, identifying both kidneys without entering the peritoneal cavity. Multiple thymus pieces were inserted under the kidney capsule. After 8 weeks, TKs were recovered for flow cytometric and histopathological analysis.</p><p><strong>Results: </strong>In all kidneys, we successfully constructed TKs with functional thymus tissue under the kidney capsule, verified by histopathology and flow cytometry. No surgical complications were observed, and no adhesions were observed intra-abdominally nor around the kidney, as the peritoneum covered the implanted tissue.</p><p><strong>Conclusion: </strong>The anterior retroperitoneal approach to constructing thymokidneys is easy to perform, offers excellent kidney exposure, allows a larger volume of thymus tissue to be implanted, and decreases the risk of intra-abdominal adhesions. Such constructed TKs are easy to procure with minimal risk of injury to the vascularized thymus as the prerenal peritoneum covers it.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1473281"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752760","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}

{"title":"Paul I. Terasaki, Ph.D: a pioneer in transplant medicine and a dedicated philanthropist.","authors":"Jon Kobashigawa","doi":"10.3389/frtra.2024.1500493","DOIUrl":"10.3389/frtra.2024.1500493","url":null,"abstract":"<p><p>In the last five decades, remarkable surgical and medical advances ensued within the field of organ transplantation. These strides were marked by significant breakthroughs in transplant immunology, with Dr. Paul I. Terasaki standing as a true pillar of the field. This article highlights major milestones in Dr. Terasaki's life, his groundbreaking accomplishments in the field of transplant medicine, and his enduring philanthropic contributions to numerous medical and community organizations.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1500493"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684093","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}

{"title":"Status of islet transplantation and innovations to sustainable outcomes: novel sites, cell sources, and drug delivery strategies.","authors":"Jordan M Wong, Andrew R Pepper","doi":"10.3389/frtra.2024.1485444","DOIUrl":"10.3389/frtra.2024.1485444","url":null,"abstract":"<p><p>Islet transplantation (ITx) is an effective means to restore physiologic glycemic regulation in those living with type 1 diabetes; however, there are a handful of barriers that prevent the broad application of this functionally curative procedure. The restricted cell supply, requisite for life-long toxic immunosuppression, and significant immediate and gradual graft attrition limits the procedure to only those living with brittle diabetes. While intraportal ITx is the primary clinical site, portal vein-specific factors including low oxygen tension and the instant blood-mediated inflammatory reaction are detrimental to initial engraftment and long-term function. These factors among others prevent the procedure from granting recipients long-term insulin independence. Herein, we provide an overview of the status and limitations of ITx, and novel innovations that address the shortcomings presented. Despite the marked progress highlighted in the review from as early as the initial islet tissue transplantation in 1893, ongoing efforts to improve the procedure efficacy and success are also explored. Progress in identifying unlimited cell sources, more favourable transplant sites, and novel drug delivery strategies all work to broaden ITx application and reduce adverse outcomes. Exploring combination of these approaches may uncover synergies that can further advance the field of ITx in providing sustainable functional cures. Finally, the potential of biomaterial strategies to facilitate immune evasion and local immune modulation are featured and may underpin successful application in alternative transplant sites.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1485444"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650309","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}

{"title":"Single center experience with ABO-incompatible and ABO-compatible pediatric heart transplantation.","authors":"L Lily Rosenthal, Tabea Katharina Spickermann, Sarah Marie Ulrich, Robert Dalla Pozza, Heinrich Netz, Nikolaus A Haas, René Schramm, Michael Schmoeckel, Christian Hagl, Jürgen Hörer, Sebastian Michel, Carola Grinninger","doi":"10.3389/frtra.2024.1452617","DOIUrl":"https://doi.org/10.3389/frtra.2024.1452617","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to analyze the results after pediatric heart transplantation (pHTx) at our single center differentiating between ABO-incompatible (ABOi) and -compatible (ABOc) procedures.</p><p><strong>Methods and patients: </strong>We retrospectively analyzed outcomes of ABO-incompatible HTx procedures performed at our center and compared the data to ABO-compatible HTx of the same era. Eighteen children (<17 months) underwent pediatric HTx and seven of them underwent ABO-incompatible HTx between 2003 and 2015.</p><p><strong>Results: </strong>Mechanical circulatory support as bridge to transplant was necessary in 3/7 patients before ABO-incompatible HTx and in 3/11 patients before ABO-compatible HTx. Mean waiting time on the list was 36 ± 30 days for ABO-incompatible HTx and 86 ± 65 days for ABO-compatible HTx. The 5-years re-transplant free survival was 86% following ABO-incompatible and 91% after ABO-compatible. In the cohort undergoing ABO-incompatible HTx, 2 patients showed an acute cellular rejection, while early graft failure was not observed. In the cohort undergoing ABOcompatible HTx, acute cellular rejection was observed in 9/11 patients, with early graft failure occurring in nine and CVP in two. A total of ten children were listed for ABO-incompatible HTx after 2015; however, all ten underwent an ABO-compatible transplantation.</p><p><strong>Discussion: </strong>This study adds much needed information to the literature on ABOi-HTx by showing with a retrospective single center analysis that it is safe and leads to shorter waiting times. We conclude that strategies for ABOi-HTx should be elaborated further, potentially allowing more timely transplantation and thereby preventing waiting list complications such as the need for mechanical circulatory support and even death.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1452617"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516174","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}

{"title":"Kidney function after liver transplantation: the contrasting roles of inflammation and tubular repair.","authors":"Nina Goerlich, Seunghee Kim-Schulze, Peter Kotanko, Nadja Grobe, Xiaoling Wang, Bjoern Samans, Joe Douglas, Philipp Enghard, Paolo Molinari, Miguel Fribourg, Paolo Cravedi, Josh Levitsky","doi":"10.3389/frtra.2024.1480383","DOIUrl":"https://doi.org/10.3389/frtra.2024.1480383","url":null,"abstract":"<p><p>Kidney injury is a significant complication in end-stage liver disease (ESLD), leading to increased morbidity and mortality. While liver transplant alone (LTA) can promote kidney recovery (KR), non-recovery associates with adverse outcomes, but the underlying pathophysiology is still unclear. We studied 10 LTA recipients with or without kidney failure (KF) and measured serum levels of OPN and TIMP-1 (previously identified predictors of KR), 92 proinflammatory proteins (Olink), and urinary cell populations. Our findings revealed elevated OPN and TIMP-1 levels in KF patients, strongly correlated with tubular epithelial cells in urine. Proteomic analysis showed distinct profiles in KF, non-KF, and healthy donors, indicating an ongoing proinflammatory signature in KF. Cytokines correlated with OPN and TIMP-1 levels. We propose that high pre-LTA OPN and TIMP-1 levels are crucial for tubular regeneration and normalize with kidney recovery. Insufficient pre-LTA OPN levels may lead to persistent kidney failure. Our present data also newly indicate that kidney failure post-LTA is an active condition, in which tubular cells are persistently shed in the urine. The strict association between systemic inflammation and tubular cell loss suggests a pathogenic link that could offer therapeutic opportunities to promote kidney recovery.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"3 ","pages":"1480383"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516173","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}