世界移植杂志最新文献

{"title":"Optimizing liver utilization for transplantation with partial grafts undergoing normothermic machine perfusion: Two case reports.","authors":"Maria Baimas-George, William H Archie, Kyle Soltys, Jose R Soto, David Levi, Lon Eskind, Vincent Casingal, Roger Denny, Magdy Attia, George V Mazariegos, Dionisios Vrochides","doi":"10.5500/wjt.v15.i3.104109","DOIUrl":"10.5500/wjt.v15.i3.104109","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation (LT) is the only curative, life-saving option for children and adults with end-stage liver disease. Due to the well-known shortage and heterogeneity of grafts, split LT (SLT) is an attractive strategy to expand the donor pool and reduce waitlist times. Given increased risk of cold ischemia time with SLT, machine perfusion represents a promising option to reduce it and optimize transplant logistics and outcomes. The present communication describes various possible combinations of procurement steps to perform SLT facilitated by placing one or both grafts on a normothermic machine perfusion (NMP) closed circuit device.</p><p><strong>Case summary: </strong>A 19-month-old female with biliary atresia after failed Kasai portoenterostomy and a 42-year-old woman with unresectable intrahepatic cholangiocarcinoma were selected as recipients for a SLT from a 17-year-old male donor. The SLT generated a left lateral segment and a right trisectional graft of appropriate volume for both recipients. After a mixed in-situ and ex-situ split, in order to improve logistics, the right trisectional graft was placed on a closed circuit NMP device, following an appropriate vascular reconstruction. Both grafts were implanted with excellent short-term outcomes.</p><p><strong>Conclusion: </strong>Use of NMP with SLT for preservation prior to implantation allows not only for graft optimization but also for significant improvement of transplant logistics. We propose various models and standardization of logistic options for combining SLT with NMP to optimize graft availability and outcomes.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"104109"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980383","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":"Disparities in liver transplantation for metabolic dysfunction-associated steatohepatitis-associated hepatocellular carcinoma.","authors":"David W Victor, Sudha Kodali, Mazen Noureddin, Elizabeth W Brombosz, Analisa Lopez, Tamneet Basra, Edward A Graviss, Duc T Nguyen, Ashish Saharia, Ashton A Connor, Maen Abdelrahim, Yee Lee Cheah, Caroline J Simon, Mark J Hobeika, Constance M Mobley, R Mark Ghobrial","doi":"10.5500/wjt.v15.i3.101997","DOIUrl":"10.5500/wjt.v15.i3.101997","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatohepatitis (MASH) is increasingly common, as is hepatocellular carcinoma (HCC) in the background of MASH. Liver transplantation (LT) provides superior long-term survival for patients with unresectable MASH-HCC, but not all patients have equal access to transplant. MASH-HCC disproportionately affects Hispanic patients, but minorities are less likely to undergo LT for HCC. Additionally, females also undergo LT at lower rates than males.</p><p><strong>Aim: </strong>To investigate whether race/ethnicity and sex affect LT waitlist outcomes.</p><p><strong>Methods: </strong>Records of adults with MASH-HCC in the United States Organ Procurement and Transplantation Network database listed for LT between 1/2015 and 12/2021 were analyzed.</p><p><strong>Results: </strong>Most of the 3810 patients waitlisted for LT for MASH-HCC were non-Hispanic (NH) white (71.2%) or Hispanic (23.4%), with only 49 (1.1%) NH Black candidates. Hispanics underwent LT at lower rates than NH whites (71.6% <i>vs</i> 78.4%, <i>P</i> < 0.001), but race/ethnicity did not affect waitlist mortality (<i>P</i> = 0.06). Patients with Hispanic [hazard ratio (HR) = 0.85, 95%CI: 0.77-0.95, <i>P</i> = 0.002] or Asian (HR = 0.79, 95%CI: 0.63-0.98, <i>P</i> = 0.04) race/ethnicity were less likely to undergo LT. Women were also less likely to receive LT (male: HR = 1.16, 95%CI: 1.04-1.29, <i>P</i> = 0.01). Patients in regions 1 and 9 were less likely to be transplanted as well (<i>P</i> = 0.07).</p><p><strong>Conclusion: </strong>Hispanic patients are less likely to undergo LT for MASH-HCC, concerning given their susceptibility to MASH and HCC. There were very few NH Black candidates. Disparities were also unequal across regions, which is particularly concerning in states where at-risk populations have rising cancer incidence. Additional research is needed to identify strategies for mitigating these differences in access to LT for MASH-HCC.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"101997"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980392","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":"Optimizing patient outcomes in interstitial lung disease through pre- and post-transplant management strategies.","authors":"Vasiliki E Georgakopoulou","doi":"10.5500/wjt.v15.i3.101866","DOIUrl":"10.5500/wjt.v15.i3.101866","url":null,"abstract":"<p><p>Interstitial lung diseases (ILD) encompass a diverse group of over 200 chronic pulmonary disorders characterized by varying degrees of inflammation and fibrosis, which can lead to severe respiratory impairment. Lung transplantation offers a crucial therapeutic option for patients with advanced ILD, extending survival and improving quality of life. This review explores optimal management strategies in both the pre- and post-transplant phases to enhance patient outcomes. Comprehensive pre-transplant evaluation, including pulmonary function testing, imaging, and comorbidity assessment, is critical for determining transplant eligibility and timing. Post-transplant care must focus on preventing complications such as primary graft dysfunction and chronic lung allograft dysfunction, managed through tailored immunosuppression and proactive monitoring. Recent advancements in diagnostic techniques and therapeutic approaches, including emerging technologies like <i>ex vivo</i> lung perfusion and precision medicine, promise to further improve outcomes. The ultimate goal is to establish an evidence-based, multidisciplinary framework for optimizing ILD management and lung transplantation.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"101866"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980407","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":"Advantages and future outlooks in the use of telemedicine in liver transplantation.","authors":"Marco Zeppieri","doi":"10.5500/wjt.v15.i3.104825","DOIUrl":"10.5500/wjt.v15.i3.104825","url":null,"abstract":"<p><p>To maintain care during the coronavirus disease 2019 outbreak, telemedicine was implemented quickly. Jowell <i>et al</i>'s pandemic study on telehealth integration and liver transplant evaluation is examined in this editorial. The study showed that telehealth did not affect clinical outcomes including time to evaluation, listing rates, or pre-transplant death. The study found that telehealth did not increase sociodemographic inequalities, suggesting a fair care framework. The editorial discusses how telemedicine in hepatology might help patients receive expert treatment while reducing logistical and financial burdens. Telehealth can democratize liver transplantation by delivering equivalent clinical results as in-person examinations. However, the editorial highlights technological barriers, difficulties in remotely assessing mental and physical health, and the need for specialized outreach to underserved communities. After the pandemic, telemedicine is essential to a more flexible, patient-centered healthcare system. The editorial encourages creativity and research to overcome challenges, improve hybrid care models, and ensure telehealth's egalitarian and successful potential. Pandemic insights can improve liver transplantation treatment and outcomes for diverse patient populations.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"104825"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980350","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":"Advances in fertility preservation and pregnancy care for transplant patients.","authors":"Velik Lazarov, Emilia Naseva, Dimitrina Georgieva Miteva, Latchezar P Tomov, Russka Shumnalieva, Milena Peruhova, Tsvetelina Velikova","doi":"10.5500/wjt.v15.i3.103958","DOIUrl":"10.5500/wjt.v15.i3.103958","url":null,"abstract":"<p><p>Fertility preservation and pregnancymanagement are critical considerations for patients undergoing organtransplantation. Innovations in assisted reproductive technologies, hormonalmodulation, and personalized medicine have expanded options for these patients, who face unique challenges due to immunosuppressive therapy and organ functionconcerns. This mini-review explores advancements in cryopreservationtechniques, pre-conception counseling, and multidisciplinary strategies forsafe pregnancies post-transplantation. Emphasis is placed on balancing maternalhealth, graft function, and fetal outcomes. The integration of reproductive andtransplant medicine is paving the way for improved quality of life andreproductive autonomy for this patient population.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"103958"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980433","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":"Living donor transplant: Right <i>vs</i> left kidney.","authors":"Evaldo Favi, Marika Morabito","doi":"10.5500/wjt.v15.i3.104873","DOIUrl":"10.5500/wjt.v15.i3.104873","url":null,"abstract":"<p><p>Khan <i>et al</i>' single-centre, retrospective study on the use of right or left kidneys in living-donor renal transplantation, offers the opportunity to further discuss a complex and debated topic in clinical transplantation. In brief, the authors confirm that, despite the historical preference for left kidneys, attributed to their anatomical advantages during donor nephrectomy and recipient transplantation, right kidneys can provide excellent outcomes when donors and recipients are carefully selected, and a meticulous surgical technique is applied in every step of the process. Usefully, the article includes some practical tips to help less experienced surgeons address the technical challenges of right kidney transplantation, such as extended renal vein dissection or full mobilization of the iliac vein of the recipient to minimize tension during anastomosis. Although limited by the selective use of minimally invasive (MI) nephrectomy for left kidneys, this work underscores the importance of expanding the living-donor pool, challenging the traditional taboos, and facilitating access to transplantation for a wider population of patients around the globe. Properly designed studies with larger sample size, comparable MI surgical techniques, prospective data collection, and long-term donor and recipient outcomes are warranted.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"104873"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980439","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":"Acupuncture-assisted embryo transfer techniques: Research frontiers and future directions.","authors":"Rui-Yue Mao, Ai-Ling Wang, Yue Zhao, Shuai-Yan Wang, Zhen-Yu Yang, You-Bing Xia, Tian-Cheng Xu","doi":"10.5500/wjt.v15.i3.102536","DOIUrl":"10.5500/wjt.v15.i3.102536","url":null,"abstract":"<p><strong>Background: </strong>Acupuncture, an ancient practice, is gaining recognition as a complementary and alternative medicine, especially in assisted reproductive technology. It plays a crucial role in enhancing embryo transfer success rates. Research indicates that acupuncture can improve blood flow, increase endometrial receptivity regulate pressure, and affect neuroendocrine activities in the ovaries and uterus during embryo implantation, therefore improving pregnancy outcomes.</p><p><strong>Aim: </strong>To highlight recent developments related to acupuncture's influence on embryo transfer and elucidating the precise mechanisms by which acupuncture influences embryo transfer.</p><p><strong>Methods: </strong>We searched database including PubMed, Cochrane Library up to September 2024 for relevant studies and patents to evaluate the effects of acupuncture on women undergoing <i>in vitro</i> fertilization (IVF). The experimental design included an intervention group using needling, and a control group consisting of no needling or sham needling. The main outcome is clinical pregnancy rate (CPR), while secondary includes live birth rate (LBR) and biochemical pregnancy rate (BPR). We examined the influence of adjunctive needling on pregnancy outcomes by analyzing variations in the main outcomes.</p><p><strong>Results: </strong>A total of 145 randomized controlled trials involving 27748 participants were analyzed. Data revealed that the overall CPR was significantly elevated in all acupuncture cohorts compared to the control group [relative risk (RR): 1.21, 95%CI: 1.07-1.38, <i>P</i> = 0.01]. In contrast, the aggregated LBR did not exhibit a corresponding increase, and notable statistical heterogeneity was observed among the studies. Acupuncture-assisted frozen-thawed embryo transfer enhanced the BPR (RR: 1.51, 95%CI: 1.21-1.89, <i>P</i> = 0.03) and improved endometrial morphology (RR: 1.41, 95%CI: 1.13-1.75, <i>P</i> = 0.01). Furthermore, IVF outcomes were significantly superior in the acupuncture group when acupuncture was administered during controlled ovarian hyperstimulation (RR: 1.71, 95%CI: 1.08-2.13, 95%CI: 1.08-4.21, <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>We find that acupuncture positively influences pregnancy rates in women receiving IVF treatment. Nonetheless, there are no established guidelines for optimal acupuncture protocols. Considering the methodological limitations identified in current research, there is a need for larger, methodologically rigorous studies.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"102536"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980389","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":"Innovative strategies to increase cardiac donor availability.","authors":"Benjamin Alexander, Herra Javed, Anshaal Furrukh, Krittika Joshi, Louis Steen, Taufiek Konrad Rajab","doi":"10.5500/wjt.v15.i3.102768","DOIUrl":"10.5500/wjt.v15.i3.102768","url":null,"abstract":"<p><p>Heart transplantation is a life-saving procedure for many people throughout the world. Data shows that in 2024, there was an increase in the volume of adult heart transplantation in the United States even as there was a decrease in the volume of pediatric heart transplantation to the lowest volume in a decade. Organ availability remains a major limiting factor affecting transplant volume. This mandates that innovation must take place to increase the supply of donor organs. While some strategies such as donation after cardiac death, hepatitis C virus + transplantation, and ABO-incompatible transplantation have increased the pool for donation, it still falls short of meeting the demand. Other proposed strategies include splitting the donor heart to provide multiple partial heart transplants, domino partial heart transplantation, changes in legislation including opt-out legislation, and xenotransplantation. Further evolution and refinement of these strategies will make a meaningful impact on patients awaiting life-saving heart transplants.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"102768"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980395","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":"Implementation of an opioid-sparing protocol utilizing liposomal bupivacaine and intravenous ketorolac for pain management after living kidney donation.","authors":"Kevin Ly, Antonio Di Carlo, Sunil S Karhadkar, Kenneth Chavin, Francesca Graziano, Kelley Maberry, Nicole Sifontis, Daohai Yu, Xiaoning Lu, Adam Diamond","doi":"10.5500/wjt.v15.i3.101518","DOIUrl":"10.5500/wjt.v15.i3.101518","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Opioids are commonly used for management of post-operative pain in living kidney donors. Reducing exposure to opioids is desirable to minimize risk of dependence and potential side effects such as nausea, vomiting, and constipation which may delay discharge. Liposomal bupivacaine, ketorolac, and scheduled acetaminophen have all demonstrated efficacy for management of post-operative pain in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To assess the efficacy and safety of an opioid-sparing protocol utilizing a multimodal pain management approach in living kidney donors post-nephrectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Single-center, retrospective chart review study examining 52 living kidney donors (26 pre-protocol implementation, 26 post-protocol implementation) from May 24&lt;sup&gt;th&lt;/sup&gt;, 2019 to September 27&lt;sup&gt;th&lt;/sup&gt;, 2023. Patients in the post-protocol group received intraoperative liposomal bupivacaine, hydromorphone PCA (until able to tolerate oral medications), 15 mg of intravenous ketorolac every 6 hours for 3 doses, and scheduled oral acetaminophen, in addition to oxycodone as needed for moderate to severe pain. The primary endpoint was oral morphine equivalent (OME) use within 48 hours post-surgery. Secondary endpoints include average daily pain scale within 48 hours post-surgery, length of stay (LOS) (days), and incidence of new acute kidney injury (AKI) or gastrointestinal (GI) bleed during admission per provider. Differences between the pre- and post-protocol implementation groups were compared utilizing the exact Wilcoxon test for continuous variables and either the Fisher's Exact or &lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; test for categorical variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients in the pre-protocol implementation group received more OME (mg) within 48 hours post-surgery when compared to the post-protocol group (median: 84.5 &lt;i&gt;vs&lt;/i&gt; 69.0). The median of total OME over the course of admission was numerically greater the pre-protocol group (105.0 &lt;i&gt;vs&lt;/i&gt; 69.0), and was significantly more per LOS (41.3 &lt;i&gt;vs&lt;/i&gt; 25.7, &lt;i&gt;P&lt;/i&gt; = 0.02). Average daily pain score was not statistically significantly different between the two groups on post-operative day 1 (median: 5.3 &lt;i&gt;vs&lt;/i&gt; 4.4; &lt;i&gt;P&lt;/i&gt; = 0.43) and post-operative day 2 (median: 4.7 &lt;i&gt;vs&lt;/i&gt; 5.2; &lt;i&gt;P&lt;/i&gt; = 0.96). No significant differences were found in provider-identified incidences of AKI or GI bleeding during admission. There was no difference in serum creatinine at the time of discharge between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A multimodal, opioid-sparing pain management protocol was as effective for pain control and resulted in significantly less opioid daily exposure over LOS. No adverse events were found related to use of ketorolac in patients undergoing donor nephrectomy. Our findings suggest that an opioid-sparing protocol is both safe and effective at minimizing opioid exposure and managing post-operative pain within the fi","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"101518"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980359","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":"Major adverse cardiovascular events and hyperuricemia as an effect-modifying factor in kidney transplant recipients.","authors":"Elizabete Junk, Lilian Tzivian, Inese Folkmane, Kristofs Folkmanis, Janis Jushinskis, Gunta Strazda, Valdis Folkmanis, Viktorija Kuzema, Aivars Petersons","doi":"10.5500/wjt.v15.i3.102287","DOIUrl":"10.5500/wjt.v15.i3.102287","url":null,"abstract":"<p><strong>Background: </strong>Major adverse cardiovascular (CV) events (MACEs) are the primary cause of morbidity and mortality in kidney transplantation (KT) recipients. The risk for MACEs is impacted by an array of traditional and transplant-related non-traditional CV risk factors.</p><p><strong>Aim: </strong>To investigate the association between potential CV risk factors related to KT and MACEs, and their potential modification by hyperuricemia (HU).</p><p><strong>Methods: </strong>The relationship between CV risk factors related to KT and MACEs was examined in a cohort of 545 patients who underwent transplantation between 2008 and 2019. The mean age of patients at KT was 55.0 years ± 14.2 years (range 15.0-89.0 years). Univariate and multivariate logistic regression models were constructed to identify risk factors influencing MACEs. To explore the potential effect modification by uric acid (UA), patients were categorized into groups based on UA levels: (1) Low (< 356 μmol/L); (2) Normal (356-416 μmol/L); (3) High (416-475 μmol/L); and (4) Very high (> 475 μmol/L).</p><p><strong>Results: </strong>MACEs occurred in 145 of 545 (26.6%) KT recipients. The most prevalent comorbidities were hypertension (87%), dyslipidemia (78%), secondary hyperparathyroidism (68%), HU (63%) and anemia (33%). In the multivariate logistic regression model, the most significant factors associated with MACEs were previous CV events [odds ratio (OR) = 70.6, 95%CI: 24.9-200.1], left ventricular hypertrophy (LVH) (OR = 12.6, 95%CI: 2.7- 58.3), HU treatment (OR = 4.3, 95%CI: 2.4-7.6), and anemia (OR = 5.3, 95%CI: 2.9-9.8). Effect modification by the presence of HU revealed that independent factors associated with MACEs were age (OR = 1.03, 95%CI: 1.0-1.1), previous CV events (OR = 41.7, 95%CI: 13.6-127.6), LVH (OR = 15.3, 95%CI: 2.0-116.6), HU treatment (OR = 2.5, 95%CI: 1.3-4.6) and anemia (OR = 5.4, 95%CI: 2.8-10.5). Effect modification by UA levels dichotomized at 475 μmol/L (very high level of UA) revealed that HU treatment was not associated with MACEs in groups with or without very high UA levels.</p><p><strong>Conclusion: </strong>A very high level of UA was observed to act as an effect-modifying factor for MACEs, especially when combined with other risk factors such as age, previous CV events, LVH, and anemia.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 3","pages":"102287"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980429","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}