世界移植杂志Pub Date : 2025-06-18DOI: 10.5500/wjt.v15.i2.100065
Hasan M Isa, Shahd T Bucheeri, Jarrah Y Aldoseri, Ayah A Redha, Abdulla F Mubarak, Shaikha A Altamimi, Ameera A AlOraibi, Mohamed I Alshaikh
{"title":"Characteristics and outcomes of Bahraini pediatric patients sent abroad for bone marrow transplantation: A ten-year retrospective cohort study.","authors":"Hasan M Isa, Shahd T Bucheeri, Jarrah Y Aldoseri, Ayah A Redha, Abdulla F Mubarak, Shaikha A Altamimi, Ameera A AlOraibi, Mohamed I Alshaikh","doi":"10.5500/wjt.v15.i2.100065","DOIUrl":"10.5500/wjt.v15.i2.100065","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow transplantation (BMT) is a breakthrough procedure for patients with hematological and oncological conditions, particularly when all other treatments fail. Its indications vary between patients and settings, and its outcomes depend on the donor type, transplantation facility, and center expertise. In countries where transplantation facilities are lacking, sending patients abroad for transplantation might be a safe and effective alternative to leaving the patient to face eventual disease morbidity or even mortality if the procedure is not performed locally. However, studies evaluating BMT abroad are scarce.</p><p><strong>Aim: </strong>To assess the clinical characteristics of patients who underwent BMT overseas and analyze the factors affecting their survival outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all Bahraini pediatric patients who underwent BMT between 2013 and 2024. Medical records from Salmaniya Medical Complex and Overseas Treatment Office were reviewed. Patient demographics, transplant indications, donor type, transplantation type, overseas centers, complications, and outcomes (overall and 5-year survival rates) were analyzed. Clinical characteristics and outcomes were compared using <i>χ</i> <sup>2</sup> test, Student's <i>t</i>-test, Mann-Whitney <i>U</i> test, and Kaplan-Meier method. Univariate and multivariate analyses were used to estimate survival predictors.</p><p><strong>Results: </strong>Of the 75 listed patients, 62 (82.7%) underwent BMT and were included, 10 (13.3%) did not, and 3 (4.0%) were awaiting transplantation. Most patients were male (<i>n</i> = 33, 53.2%). The mean age at transplantation was 7.8 ± 4.9 years. The main indication for treatment was acute myeloid leukemia (AML) (<i>n</i> = 15, 36.6%). Six patients (9.7%) required re-transplantation. Of the 68 transplants, 60 (88.2%) involved conditioning, mostly a combination of fludarabine and total body irradiation (<i>n</i> = 7, 11.7%). Most patients underwent allogeneic transplantation (<i>n</i> = 48, 77.4%), primarily from related donors (<i>n</i> = 47/48, 97.9%). The most common complication was infection (<i>n</i> = 51, 79.7%). Follow-up averaged 3.3 ± 2.5 years. The overall survival rate was 77.4%. Survival odds were better for non-AML patients and Middle Eastern centers (<i>P</i> = 0.015 and <i>P</i> = 0.032, respectively).</p><p><strong>Conclusion: </strong>Bahraini males with AML primarily underwent allogeneic BMT. Non-AML patients and those transplanted in the Middle East had better survival rates, despite high complication rates.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"100065"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327859","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}
世界移植杂志Pub Date : 2025-06-18DOI: 10.5500/wjt.v15.i2.102384
Hye Sung Kim, Wongi Woo, Young-Geun Choi, Ankit Bharat, Young Kwang Chae
{"title":"Novel association between graft rejection and post-transplant malignancy in solid organ transplantation.","authors":"Hye Sung Kim, Wongi Woo, Young-Geun Choi, Ankit Bharat, Young Kwang Chae","doi":"10.5500/wjt.v15.i2.102384","DOIUrl":"10.5500/wjt.v15.i2.102384","url":null,"abstract":"<p><strong>Background: </strong>Advancements in immunosuppressive therapies have improved graft survival by enhancing graft tolerance and preventing organ rejection. However, the risk of malignancy associated with prolonged immunosuppression remains a concern, as it can adversely affect recipients' quality of life and survival. While the link between immunosuppression and increased cancer risk is well-documented, the specific interactions between graft rejection and post-transplant malignancy (PTM) remain poorly understood. Addressing this knowledge gap is crucial for devising immunosuppressive strategies that balance rejection prevention with cancer risk reduction.</p><p><strong>Aim: </strong>To investigate whether immunosuppression in PTM reduces rejection risk, while immune activation during rejection protects against malignancy.</p><p><strong>Methods: </strong>We analyzed data from the United Network for Organ Sharing's Organ Procurement and Transplantation Network database (1987-2023) on adult, first-time, single-organ transplant recipients with no prior history of malignancy (in donors or recipients). Landmark analyses at 1, 2, 3, 5, 10, 15, and 20 years post-transplant, Kaplan-Meier analyses, and time-dependent Cox proportional hazards regression models, each incorporating the temporal dimension of outcomes, assessed the association between rejection-induced graft failure (RGF) and PTM. Multivariate models were adjusted for clinical and immunological factors, including immunosuppression regimens.</p><p><strong>Results: </strong>The cohort included 579905 recipients (kidney: 386878; liver: 108390; heart: 45046; lung: 37643; pancreas: 1948) with a mean follow-up of 7.3 years and a median age of 50.6 ± 13.2 years. RGF was associated with a reduction in PTM risk across all time points [hazard ratio (HR) = 0.07-0.20, <i>P</i> < 0.001], even after excluding mortality cases. Kidney transplant recipients exhibited the most pronounced reduction (HR = 0.22, <i>P</i> < 0.001). Conversely, among recipients with PTM, RGF risk decreased across all time points up to 15 years after excluding mortality cases (HR = 0.49-0.80, <i>P</i> < 0.001). This risk reduction was observed in kidney, liver, heart, and lung transplants (HRs = 0.90, 0.21, 0.21, and 0.18, respectively; <i>P</i> < 0.001) but not in pancreas transplants.</p><p><strong>Conclusion: </strong>RGF reduces PTM risk, particularly in kidney transplants, while PTM decreases RGF risk in kidney, liver, heart, and lung transplants.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"102384"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327881","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":"Ten years of a pediatric living donor liver transplantation program in Brazil.","authors":"Marco Aurélio Farina Junior, Melina Utz-Melere, Carolina Soares da Silva, Luiza Salgado Nader, Cristine Suzana Trein, Angelica Maria Lucchese, Mayara Machry, Rodrigo Mariano, Cristina Targa Ferreira, Antônio Nocchi Kalil, Flávia Heinz Feier","doi":"10.5500/wjt.v15.i2.98616","DOIUrl":"10.5500/wjt.v15.i2.98616","url":null,"abstract":"<p><strong>Background: </strong>Pediatric living-donor liver transplantation is considered a safe alternative for the treatment of children with end-stage liver disease. Experienced tertiary centers and specialized medical staff are necessary to ensure compatible long-term survival rates and quality-of-life for these children.</p><p><strong>Aim: </strong>To report the results and the 10-year learning curve of a pediatric living-donor liver transplantation program.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of pediatric recipients from 2013 to 2023. Post-transplant outcomes and patient survival rates were compared between two 5-year periods of the program.</p><p><strong>Results: </strong>A total of 25 and 48 patients underwent transplantation in the first (2013-2017) and second period (2018-2023), respectively. Portal vein and hepatic artery thrombosis occurred in 11 (15.1%) and seven (9.6%) patients, respectively. Biliary complications were observed in 39 of 73 patients (53.4%). A lower warm ischemia time was observed in the second period compared to the first (32.6 ± 8.6 minutes <i>vs</i> 38.4 ± 9.8 minutes, <i>P</i> = 0.018, respectively). Patient survival rates at 1 and 5 years were 84% in the first period and 91.7% in the second period, with no significant difference (<i>P</i> = 0.32).</p><p><strong>Conclusion: </strong>The reported indications and outcomes align with the current literature. Our findings provide crucial evidence regarding the feasibility of establishing a living donor program with consistent results over time.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"98616"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327922","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}
世界移植杂志Pub Date : 2025-06-18DOI: 10.5500/wjt.v15.i2.99554
Biagio Pinchera, Rosa Carrano, Elisa Schettino, Alessia D'Agostino, Emilia Trucillo, Federica Cuccurullo, Fabrizio Salemi, Amerigo Piccione, Ivan Gentile
{"title":"Urinary tract infections in kidney transplant patients admitted to hospital: A real-life experience.","authors":"Biagio Pinchera, Rosa Carrano, Elisa Schettino, Alessia D'Agostino, Emilia Trucillo, Federica Cuccurullo, Fabrizio Salemi, Amerigo Piccione, Ivan Gentile","doi":"10.5500/wjt.v15.i2.99554","DOIUrl":"10.5500/wjt.v15.i2.99554","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) in kidney transplant patients are a challenge.</p><p><strong>Aim: </strong>To evaluate epidemiology, clinical status, therapeutic management, and clinical outcome of kidney transplant patients in a university hospital for UTI.</p><p><strong>Methods: </strong>We conducted a retrospective observational study, enrolling all kidney transplant patients hospitalized for UTI, with the objective to evaluate the epidemiology, clinical status, therapeutic management, and clinical outcome of kidney transplant patients.</p><p><strong>Results: </strong>From our real-life experience, infection with multidrug-resistant germs was confirmed as a risk factor for the severe evolution of the infection. At the same time, the re-evaluation of immunosuppressive therapy could be an important therapeutic strategy in the course of infection.</p><p><strong>Conclusion: </strong>Prompt initiation of empiric antibiotic therapy upon initiation of microbiological investigations may reduce the risk of severe infection progression.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"99554"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327924","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}
世界移植杂志Pub Date : 2025-06-18DOI: 10.5500/wjt.v15.i2.101005
Thirugnanasambandan Sunder, Paul Ramesh, Madhan Kumar
{"title":"Atrial arrhythmias following lung transplantation: A state of the art review.","authors":"Thirugnanasambandan Sunder, Paul Ramesh, Madhan Kumar","doi":"10.5500/wjt.v15.i2.101005","DOIUrl":"10.5500/wjt.v15.i2.101005","url":null,"abstract":"<p><p>Lung transplantation (LT) is now an accepted therapy for end stage lung disease in appropriate patients. Atrial arrhythmias (AA) can occur after LT. Early AA after LT are most often atrial fibrillation, whereas late arrhythmias which occur many months or years after LT are often atrial tachycardia. The causes of AA are multifactorial. The review begins with a brief history of LT and AA. This review further describes the pathophysiology of the AA. The risk factors, incidence, recipient characteristics including intra-operative factors are elaborated on. Since there are no clear and specific guidelines on the management of atrial arrhythmia following LT, the recommended guidelines on the management of AA in general are often extrapolated and used in the setting of post LT arrhythmia. The strategy of rate control <i>vs</i> rhythm control is discussed. The pros and cons of various drug regimen, need for direct current cardioversion and catheter ablation therapies are considered. Possible methods to prevent or reduce the incidence of AA after LT are considered. The impact of AA on the short-term and long-term outcomes following LT is discussed.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"101005"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327814","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}
世界移植杂志Pub Date : 2025-06-18DOI: 10.5500/wjt.v15.i2.99992
Nisreen Yaghmour, Dina Alramini, Mohammad Alsarayrah, Mohammad Abuassi, Awn Al-Rameni, Mohammad Aladaileh, Haneen Al-Abdallat, Badi Rawashdeh
{"title":"COVID-19's impact on heart and lung transplantation: Citation-based analysis of research output.","authors":"Nisreen Yaghmour, Dina Alramini, Mohammad Alsarayrah, Mohammad Abuassi, Awn Al-Rameni, Mohammad Aladaileh, Haneen Al-Abdallat, Badi Rawashdeh","doi":"10.5500/wjt.v15.i2.99992","DOIUrl":"10.5500/wjt.v15.i2.99992","url":null,"abstract":"<p><strong>Background: </strong>Since being declared as a pandemic on March 11, 2020, coronavirus disease 2019 (COVID-19) has profoundly influenced heart and lung transplant programs, impacting donor availability, patient management, and healthcare resources. This study offers a citation-based review of the research output on this subject, seeking to understand how the transplant community has responded to these challenges. Through a review of literature from the beginning of the pandemic to early 2023, we evaluate the shifts in academic emphasis and the emerging trends in heart and lung transplantation during the COVID-19 period.</p><p><strong>Aim: </strong>To assess the impact of COVID-19 on heart and lung transplantation research, highlighting key themes, contributions, and trends in the literature during the pandemic.</p><p><strong>Methods: </strong>We conducted an extensive search of the Web of Science database on February 9, 2023. We employed the terms \"transplant\" and \"transplantation\", as well as organ-specific terms like \"heart\", \"cardiac\", and \"lung\", combined with COVID-19-related terms such as \"COVID-19\", \"coronavirus\", and \"SARS-CoV-2\". The search encompassed publications from March 11, 2020 to February 9, 2023. Data on authors, journals, countries, institutions, and publication types (articles, reviews, conference papers, letters, notes, editorials, brief surveys, book chapters, and errata) were analyzed. The data was visualized and processed with VOSviewer 1.6.18 and Excel.</p><p><strong>Results: </strong>We included 847 research items. There were 392 articles (46.3%) and 88 reviews (10.3%). The studies included were referenced 7757 times, with an average of 9.17 citations per article. The majority of the publications (<i>n</i> = 317) were conducted by institutes from the United States with highest citations (<i>n</i> = 4948) on this subject, followed by Germany, Italy, and France. The majority of papers (<i>n</i> = 101) were published in the <i>Journal of Heart and Lung Transplantation</i>.</p><p><strong>Conclusion: </strong>To the fullest extent of our knowledge, this is the first bibliometric study of COVID-19's impact on heart and lung transplantation to offer a visual analysis of the literature in order to predict future frontiers and provide an overview of current research hotspots.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"99992"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327861","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":"Predictive value of tacrolimus concentration/dose ratio in first post-transplant week for <i>CYP3A5</i>-polymorphism in kidney-transplant recipients.","authors":"Pham-Thai Dung, Hoang-Xuan Su, Nguyen-Chi Tue, Nguyen-Huu Ben, Nguyen-Minh Phuong, Tuan-Ngoc Tran, Phan-Ba Nghia, Diem-Thi Van, Nguyen Thi-Thuy Dung, Hoang-Trung Vinh, Lionel Rostaing, Pham-Quoc Toan","doi":"10.5500/wjt.v15.i2.103247","DOIUrl":"10.5500/wjt.v15.i2.103247","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus (TAC) is metabolized primarily by the <i>CYP3A</i>-encoded enzyme family (<i>CYP3A4</i>, <i>CYP3A5</i>, and <i>CYP3A7</i>). Individuals expressing the <i>CYP3A51</i> allele are considered fast metabolizers and generally require higher TAC doses to reach therapeutic levels.</p><p><strong>Aim: </strong>To evaluate the predictive value of the TAC concentration-to-dose (C0/D) ratio for identifying <i>CYP3A5</i> polymorphisms in renal transplant recipients.</p><p><strong>Methods: </strong>Eighty-six <i>de novo</i> kidney transplant recipients with TAC-based immunosuppression from the Department of Nephrology and Dialysis at Military Hospital 103 (Hanoi, Vietnam) were included in this retrospective study. Blood samples were collected within the first week post-transplantation to monitor TAC levels and to perform genotyping for <i>CYP3A5</i> genetic polymorphisms.</p><p><strong>Results: </strong>The <i>CYP3A53/3</i> genotype was identified in 37 patients (43%), <i>CYP3A51/3</i> in 40 patients (46.5%), and <i>CYP3A51/1</i> in 9 patients (10.5%). Patients carrying the <i>CYP3A51/3</i> or <i>CYP3A51/1</i> genotype, classified as fast metabolizers (<i>CYP3A5</i> expressers), had significantly lower TAC C0 concentrations and C0/D ratios compared to slow metabolizers (<i>CYP3A53/3</i> genotype) at multiple time points during follow-up (all <i>P</i> < 0.001). Notably, the TAC C0/D ratio obtained on day 1 (0.91) was shown to predict <i>CYP3A5</i> polymorphism with a sensitivity of 84.6% and a specificity of 84.6%.</p><p><strong>Conclusion: </strong>This study demonstrates that the TAC C0/D ratio provides a reliable predictive value for <i>CYP3A5</i> polymorphisms, which can be used to individualize TAC dosing in renal transplant recipients in Vietnam and other low-income countries.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"103247"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327918","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":"Cardiac transplantation: A review of current status and emerging innovations.","authors":"Umashri Sundararaju, Srinivas Rachoori, Abdulkader Mohammad, Hamrish Kumar Rajakumar","doi":"10.5500/wjt.v15.i2.100460","DOIUrl":"10.5500/wjt.v15.i2.100460","url":null,"abstract":"<p><p>Heart transplantation (HTx) is a life-saving procedure for patients with end-stage heart failure and has undergone remarkable advancements since the first successful transplant in 1967. The introduction of cyclosporine in the 1970s significantly improved patient outcomes, leading to a global increase in transplants, including in India, where the practice has grown despite initial challenges. This review provides an extensive overview of HTx, focusing on current practices, technological advancements, and the ongoing challenges the field faces today. It explores the evolution of surgical techniques, such as minimally invasive and robotic-assisted procedures, and the management of posttransplant rejection through tailored immunosuppressive strategies, including new monoclonal antibodies and personalized therapies. The review also highlights emerging innovations such as mechanical circulatory support devices and xenotransplantation as potential solutions to donor shortages while acknowledging the ethical and logistical challenges these approaches entail. Furthermore, the analysis delves into the implications of using extended-criteria donors and the role of multidisciplinary teams in evaluating absolute and relative contraindications. Despite the progress made, the persistent issues of organ scarcity and ethical concerns underscore the need for ongoing research and innovation to further enhance the efficacy, safety, and accessibility of HTx.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"100460"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327857","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":"Personalized translational medicine: Investigating YKL-40 as early biomarker for clinical risk stratification in hepatocellular carcinoma recurrence post-liver transplantation.","authors":"Ileana Lulic, Dinka Lulic, Jadranka Pavicic Saric, Iva Bacak Kocman, Dunja Rogic","doi":"10.5500/wjt.v15.i2.103036","DOIUrl":"10.5500/wjt.v15.i2.103036","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) presents a significant challenge, with recurrence rates ranging from 8% to 20% globally. Current biomarkers, such as alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP), lack specificity, limiting their utility in risk stratification. YKL-40, a glycoprotein involved in extracellular matrix remodeling, hepatic stellate cell activation, and immune modulation, has emerged as a promising biomarker for post-LT surveillance. Elevated serum levels of YKL-40 are associated with advanced liver disease, tumor progression, and poorer post-LT outcomes, highlighting its potential to address gaps in early detection and personalized management of HCC recurrence. This manuscript synthesizes clinical and mechanistic evidence to evaluate YKL-40's predictive utility in post-LT care. While preliminary findings demonstrate its specificity for liver-related pathologies, challenges remain, including assay standardization, lack of prospective validation, and the need to distinguish between malignant and non-malignant causes of elevated levels. Integrating YKL-40 into multi-biomarker panels with AFP and DCP could enhance predictive accuracy and enable tailored therapeutic strategies. Future research should focus on multicenter studies to validate YKL-40's clinical utility, address confounding factors like graft rejection and systemic inflammation, and explore its role in predictive models driven by emerging technologies such as artificial intelligence. YKL-40 holds transformative potential in reshaping post-LT care through precision medicine, providing a pathway for better outcomes and improved management of high-risk LT recipients.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"103036"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327917","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}
世界移植杂志Pub Date : 2025-06-18DOI: 10.5500/wjt.v15.i2.99241
Thirugnanasambandan Sunder, Paul Ramesh Thangaraj, Madhan Kumar Kuppusamy
{"title":"Venous thromboembolism following lung transplantation.","authors":"Thirugnanasambandan Sunder, Paul Ramesh Thangaraj, Madhan Kumar Kuppusamy","doi":"10.5500/wjt.v15.i2.99241","DOIUrl":"10.5500/wjt.v15.i2.99241","url":null,"abstract":"<p><p>Lung transplantation (LT) is currently a surgical therapy option for end-stage lung disease. Venous thromboembolism (VTE), which can occur after LT, is associated with significant morbidity and mortality. Because of improved outcomes, increasing numbers of patients are receiving LT as treatment. Patients on the waitlist for LT tend to be older with weakness and frailty in addition to pulmonary symptoms. These factors contribute to a heightened risk of postoperative VTE. Furthermore, patients who clinically deteriorate while on the waitlist may require extra corporeal membrane oxygenation as a bridge to LT. Bleeding and thromboembolism are common in these patients. Pulmonary embolism (PE) in a freshly transplanted lung can have significant effects leading to morbidity and mortality. PE typically leads to impairment of gas exchange and right ventricular strain. In LT, PE can affect healing of bronchial anastomosis and may even contribute to the development of chronic allograft lung dysfunction. This article discussed the incidence, clinical features and diagnosis of VTE after LT. Furthermore, the treatment modalities, complications, and outcomes of VTE were reviewed.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"99241"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327925","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}