世界移植杂志最新文献

{"title":"Haemoadsorption cartridge connected to the machine perfusion for donation after circulatory death porcine liver marginal grafts.","authors":"Irene Scalera, Rossana Franzin, Alessandra Stasi, Antonino Castellaneta, Enrico Fischetti, Giulia Morelli, Margherita Raele, Emilio Panetta, Andjela Kurevija, William Pulga, Mauro Atti, Loreto Gesualdo","doi":"10.5500/wjt.v15.i2.99287","DOIUrl":"10.5500/wjt.v15.i2.99287","url":null,"abstract":"<p><strong>Background: </strong>Marginal donation after circulatory death (DCD) liver grafts are carefully used to combat the constant shortage of donors. Clinically, the worst outcomes are mainly related to severe ischemia-reperfusion-injury and the dangerous effect of various inflammatory cytokines (CK). The machine perfusion (MP) is a promising device to rescue these grafts.</p><p><strong>Aim: </strong>To analyze the role of MP connected to a sorbent cartridge (PerSorb^®) and used for very damaged DCD pig livers.</p><p><strong>Methods: </strong>Seven grafts were procured from pigs from a slaughterhouse. Grafts were made very marginal with at least 60 minutes of donor warm ischemia time and 24 hours of static-cold ischemia time: (1) 3 grafts were perfused in hypothermic MP with PerSorb (Sorb); (2) 2 other grafts in hypothermic MP (HMP) without the cartridge (NoSorb); and (3) The other 2 livers stored in the ice box (NoTreat). The CK were measured at HMP start (T0) and at the end (Tend). Biopsies were taken at T0 and Tend.</p><p><strong>Results: </strong>All 5 grafts treated with HMP had a negative lactate trend after 3 hours of treatment (8.83 at T0 <i>vs</i> 6.4 at Tend of Sorb; 15 at T0 <i>vs</i> 5.45 at Tend for NoSorb, <i>P</i> value > 0.05). At Tend, both Sorb and NoSorb groups had better hemodynamic parameters, comparable between the two groups. Enzyme-linked immunosorbent assay analysis showed a reduction of monocyte chemotactic protein-1, tumor necrosis factor-alpha and interleukin-1β for NoSorb group at Tend and a complete downregulation to physiological levels of the same CK in Sorb livers after 3 hours of treatment. Biopsies showed a reduction of the perisinusoidal edema for the Sorb grafts compared with the NoSorb livers.</p><p><strong>Conclusion: </strong>These data suggest a potential protective role of treatment of grafts with MP and sorbent cartridge in reducing the inflammatory response after a severe ischemic injury.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"99287"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327877","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":"Immunotherapy and liver transplantation for hepatocellular carcinoma: Current and future challenges.","authors":"Theodoros Pettas, Sofia Lachanoudi, Filippos F Karageorgos, Ioannis A Ziogas, Asimina Fylaktou, Vassilios Papalois, Georgios Katsanos, Nikolaos Antoniadis, Georgios Tsoulfas","doi":"10.5500/wjt.v15.i2.98509","DOIUrl":"10.5500/wjt.v15.i2.98509","url":null,"abstract":"<p><p>Despite existing curative options like surgical removal, tissue destruction techniques, and liver transplantation for early-stage hepatocellular carcinoma (HCC), the rising incidence and mortality rates of this global health burden necessitate continuous exploration of novel therapeutic strategies. This review critically assesses the dynamic treatment panorama for HCC, focusing specifically on the burgeoning role of immunotherapy in two key contexts: early-stage HCC and downstaging advanced HCC to facilitate liver transplant candidacy. It delves into the unique immunobiology of the liver and HCC, highlighting tumor-mediated immune evasion mechanisms. Analyzing the diverse immunotherapeutic approaches including checkpoint inhibitors, cytokine modulators, vaccines, oncolytic viruses, antigen-targeting antibodies, and adoptive cell therapy, this review acknowledges the limitations of current diagnostic markers alpha-fetoprotein and glypican-3 and emphasizes the need for novel biomarkers for patient selection and treatment monitoring. Exploring the rationale for neoadjuvant and adjuvant immunotherapy in early-stage HCC, current research is actively exploring the safety and effectiveness of diverse immunotherapeutic approaches through ongoing clinical trials. The review further explores the potential benefits and challenges of combining immunotherapy and liver transplant, highlighting the need for careful patient selection, meticulous monitoring, and novel strategies to mitigate post-transplant complications. Finally, this review delves into the latest findings from the clinical research landscape and future directions in HCC management, paving the way for optimizing treatment strategies and improving long-term survival rates for patients with this challenging malignancy.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"98509"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327878","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":"Burden, stress and depression in caregivers of cirrhosis patients before and after liver transplantation.","authors":"Adriano Virches, Mariana B Claudino, Maria C Miyazaki, Eliane T Miyazaki, Renato F Silva, Rita C Silva, Heitor B Farias, Neide A Domingos, Randolfo Santos, Patricia S Fucuta","doi":"10.5500/wjt.v15.i2.102003","DOIUrl":"10.5500/wjt.v15.i2.102003","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers of cirrhosis patients (CPs) often experience burden, stress, and depression. Investigating whether these conditions improve following the patient undergoing liver transplantation (LT) is crucial, as it would elucidate the comprehensive benefits of the procedure and demonstrate the positive impacts not only on the patients but also on their caregivers and society.</p><p><strong>Aim: </strong>To compare the levels of burden, stress and depression among family caregivers of cirrhotic and liver transplant patients.</p><p><strong>Methods: </strong>This cross-sectional observational study evaluated caregivers of CPs and LT recipients at a quaternary Brazilian hospital. Instruments included identification cards, interview scripts, the caregiver burden scale Inventory, Lipp's Stress Symptom Inventory, and the Beck Depression Inventory-Second Edition. Psychometric analyses involved confirmatory factor analysis and calculation of McDonald's omega and composite reliability. Factor scores were compared with the Mann-Whitney <i>U</i> test, with effect size as the rank-biserial correlation coefficient (<i>r</i>). Statistical analysis was performed with R software (<i>P</i> < 0.05).</p><p><strong>Results: </strong>Seventy-seven CP caregivers and 65 LT recipient caregivers were included. Most were female (CP: 85.7% <i>vs</i> LT: 84.6%) and the patients' spouses (76.6% <i>vs</i> 63.1%). The median age and caregiving duration were 55.4 (23.3-76.3) <i>vs</i> 54.6 (25.7-82.1) and 3.9 (1-20) <i>vs</i> 8 (1.5-24) years, respectively (<i>P</i> = 0.001). LT caregivers were less likely to be at risk of overload (21.5% <i>vs</i> 49.4%), to be under stress (33.8% <i>vs</i> 36.4%) and to show symptoms of depression (15.4% <i>vs</i> 35.1%). Compared with LT caregivers, CP caregivers had greater median factor scores for burden (general tension, <i>P</i> = 0.012; isolation, <i>P</i> = 0.014; disappointment, <i>P</i> = 0.004), depression (<i>P</i> = 0.008), and stress (<i>P</i> = 0.047), with small to moderate effect sizes. The disappointment (<i>r</i> = 0.240) and depression (<i>r</i> = 0.225) dimensions had the largest effect sizes.</p><p><strong>Conclusion: </strong>Family caregivers of LT recipients are less likely to exhibit symptoms of burden, stress, and depression, suggesting that the benefits of LT extend to the patients' family members.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"102003"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327815","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":"Changes in the liver transplant evaluation process during the early COVID-19 era and the role of telehealth.","authors":"Ashley H Jowell, Allison J Kwong, Reshma Reguram, Tami J Daugherty, Paul Yien Kwo","doi":"10.5500/wjt.v15.i2.99401","DOIUrl":"10.5500/wjt.v15.i2.99401","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) disrupted healthcare and led to increased telehealth use. We explored the impact of COVID-19 on liver transplant evaluation (LTE).</p><p><strong>Aim: </strong>To understand the impact of telehealth on LTE during COVID-19 and to identify disparities in outcomes disaggregated by sociodemographic factors.</p><p><strong>Methods: </strong>This was a retrospective study of patients who initiated LTE at our center from 3/16/20-3/16/21 (\"COVID-19 era\") and the year prior (3/16/19-3/15/20, \"pre-COVID-19 era\"). We compared LTE duration times between eras and explored the effects of telehealth and inpatient evaluations on LTE duration, listing, and pre-transplant mortality.</p><p><strong>Results: </strong>One hundred and seventy-eight patients were included in the pre-COVID-19 era cohort and one hundred and ninety-nine in the COVID-19 era cohort. Twenty-nine percent (58/199) of COVID-19 era initial LTE were telehealth, compared to 0% (0/178) pre-COVID-19. There were more inpatient evaluations during COVID-19 era (40% <i>vs</i> 28%, <i>P</i> < 0.01). Among outpatient encounters, telehealth use for initial LTE during COVID-19 era did not impact likelihood of listing, pre-transplant mortality, or time to LTE and listing. Median times to LTE and listing during COVID-19 were shorter than pre-COVID-19, driven by increased inpatient evaluations. Sociodemographic factors were not predictive of telehealth.</p><p><strong>Conclusion: </strong>COVID-19 demonstrates a shift to telehealth and inpatient LTE. Telehealth does not impact LTE or listing duration, likelihood of listing, or mortality, suggesting telehealth may facilitate LTE without negative outcomes.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"99401"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327858","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":"Liver transplant practices in the era of normothermic machine perfusion in the United States.","authors":"Kenji Okumura, Abhay Dhand, Bima J Hasjim, Ryosuke Misawa, Hiroshi Sogawa, Gregory Veillette, Seigo Nishida","doi":"10.5500/wjt.v15.i2.100427","DOIUrl":"10.5500/wjt.v15.i2.100427","url":null,"abstract":"<p><strong>Background: </strong>Normothermic liver machine perfusion (NMP) is a novel technology used to preserve and evaluate the function of liver allografts.</p><p><strong>Aim: </strong>To assess NMP utilization in liver transplant (LT) practices.</p><p><strong>Methods: </strong>All adult deceased-donor LT recipients between January 2021 and September 2023 in the United States were analyzed. Outcomes including discard rates, survival, preservation time and timing of surgery were compared between two groups: NMP <i>vs</i> non-NMP.</p><p><strong>Results: </strong>Between 2021 and 2023, NMP was utilized in 1493 (6.3%) of all LTs in the United States. Compared to non-NMP group, NMP group had lower allograft discard rate (6.5% <i>vs</i> 10%, <i>P</i> < 0.001), older recipients' age (median: 47 <i>vs</i> 42 years, <i>P</i> < 0.001), and higher utilization of donors from donation after circulatory death (DCD) (55% <i>vs</i> 11%, <i>P</i> < 0.001). NMP group also had longer distances between recipient and donor hospitals (median: 156 <i>vs</i> 138 miles, <i>P</i> < 0.001), longer preservation time (median: 12.2 <i>vs</i> 5.8 hours, <i>P</i> < 0.001), and more daytime reperfusion (74% <i>vs</i> 55%, <i>P</i> < 0.001). Post-transplant survival outcomes were comparable between the two groups. In a subgroup analysis of NMP, recipients in the long preservation time (≥ 8 hours) group had higher daytime reperfusion (78% <i>vs</i> 55%, <i>P</i> < 0.001) and similar post-transplant survival when compared to the short preservation time (< 8 hours) group.</p><p><strong>Conclusion: </strong>The utilization of NMP is associated with lower discard rates and increased DCD organs for LT. NMP allows for prolonging the preservation time and increased occurrence of daytime LT, without any impact on the survival outcomes.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"100427"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327880","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":"Significance of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio as prognostic predictors after liver transplantation.","authors":"Marco Maria Pascale, Francesco Frongillo, Pierangelo Vasta, Giuseppe Massimiani, Erida Nure, Salvatore Agnes","doi":"10.5500/wjt.v15.i2.100157","DOIUrl":"10.5500/wjt.v15.i2.100157","url":null,"abstract":"<p><strong>Background: </strong>The use of biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and the neutrophil-to-platelet ratio (NPR), has shown promise in evaluating early outcomes after medical, interventional, and surgical treatments. NLR has emerged as an indicator of systemic inflammation and physiological stress. NPR has emerged as a potential indicator of inflammation and thrombotic risk in the context of surgical and radiological procedures.</p><p><strong>Aim: </strong>To analyze the correlation of NLR and NPR with the development of post-liver transplantation (LT) early complications after stratification for hepatocellular carcinoma diagnosis.</p><p><strong>Methods: </strong>Consecutive patients undergone LT between January 2019 and December 2023 were enrolled. Data regarding the concentration of hemoglobin and the differential leukocyte count on postoperative days (POD) 0, 1, 3, and 5 were collected.</p><p><strong>Results: </strong>The dataset included 161 consecutive patients undergone LT. Clavien-Dindo IV-V complications had a good correlation with NLR POD 1 (<i>P</i> = 0.05), NLR POD 3 (<i>P</i> < 0.001), NLR POD 7 (<i>P</i> < 0.001), NPR POD 3 (<i>P</i> < 0.001). In addition, the NPR ratio on POD 3 correlated with the onset of 30-day hemorrhage (<i>P</i> = 0.009). Finally, 30-day mortality had a significant association with the NLR POD 1 (<i>P</i> = 0.03) and with NLR POD 7 (<i>P</i> = 0.004), while NPR had a significant correlation with 30-day mortality in NPR POD 7 (<i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>The analysis of NLR and NPR are strictly correlated with Clavien-Dindo IV-V complications and 30-day post-LT death.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"100157"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327921","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":"Prevalence and risk of progression of pancreatic cystic lesions in immunosuppressed patients: A systematic review and meta-analysis.","authors":"Maximilian Kießler, Helmut Friess, Volker Assfalg","doi":"10.5500/wjt.v15.i2.98055","DOIUrl":"10.5500/wjt.v15.i2.98055","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cystic lesions are common in patients eligible for solid organ transplantation. It has been shown that the need for immunosuppression after organ transplantation increases the rate of malignancies in organ recipients. However, the impact of immunosuppression on pancreatic cystic lesions is yet unknown.</p><p><strong>Aim: </strong>To evaluate the prevalence of pancreatic cystic lesions and the risk of cyst progression in immunosuppressed patients.</p><p><strong>Methods: </strong>A systematic literature search was performed in relevant databases. Studies reporting either on the prevalence and/or the incidence of pancreatic cyst progression compared to a control group were implemented in the first systematic review and meta-analysis on this topic.</p><p><strong>Results: </strong>The prevalence of pancreatic cystic lesions was comparable with 7% (95%CI: 5%-11%) in the immunosuppressed cohort and 9% (95%CI: 5%-16%) in the control cohort. The mean cyst size increase in the immunosuppression group was 3.2 mm (range 1.0-5.2mm) compared to 3.5 mm (1.0-6.9) in the control group (standardized mean difference 0.0 mm, 95%CI: -0.3-0.2 mm, <i>P</i> = 0.72). There was also no significant increase in the development of resection criteria or worrisome features under immunosuppression either [relative risk 1.1 (fixed effect model), 1.2 (random effects model), <i>P</i> = 0.61].</p><p><strong>Conclusion: </strong>Immunosuppression does not increase the prevalence of pancreatic cystic lesions, nor does it increase the risk of cyst progression in terms of cyst size and development of resection criteria. Therefore, pancreatic cystic lesions in transplant candidates should not be a contraindication for solid organ transplantation.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"98055"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327919","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":"Upper limit of normothermic machine preservation of liver grafts from donation after circulatory death yet to be defined.","authors":"William H Archie, Maria Baimas-George, Nathanael Haynes, Souma Kundu, Katheryn Peterson, Chase J Wehrle, Damien Huckleberry, Lon Eskind, David Levi, Jose R Soto, Roger Denny, Vincent Casingal, Allyson Cochran, Erin H Rein, Dionisios Vrochides","doi":"10.5500/wjt.v15.i2.99170","DOIUrl":"10.5500/wjt.v15.i2.99170","url":null,"abstract":"<p><strong>Background: </strong>The normothermic machine perfusion pump (NMPP) could shape the future of transplantation. Providing <i>ex-vivo</i> optimization, NMPP attenuates ischemic insult while replenishing energy. An understanding of machine perfusion time (MPT) impact and potential clinical benefits is paramount and necessitates exploration.</p><p><strong>Aim: </strong>To investigate the relationship between MPT and post-transplant graft function.</p><p><strong>Methods: </strong>Retrospective review of the first 50 donation after circulatory death (DCD) grafts preserved using NMPP in a tertiary institution was performed. Essential preservation time points, graft parameters, recipient information, and postoperative outcomes were prospectively recorded. Early allograft dysfunction (EAD), L-Graft₇ score and 90-day outcomes were collected for all grafts. The first 20 recipients were allocated into the early group, considered the learning curve population for the center. The subsequent 30 were allocated into the late group. Recipients were also stratified into cohorts depending on MPT, <i>i.e.</i>, short (< 8 hours), medium (8-16 hours) and long (> 16 hours).</p><p><strong>Results: </strong>NMPP operational parameters were not predictive of EAD, L-GrAFT₇ or 90-day outcomes. The early group had significantly less MPT and cold ischemia time than the late group (553 minutes <i>vs</i> 850 minutes, <i>P</i> < 0.001) and (127.5 minutes <i>vs</i> 154 minutes, <i>P</i> = 0.025), respectively. MPT had no impact in either group.</p><p><strong>Conclusion: </strong>Increased MPT of DCD liver grafts had no adverse recipient results for the times utilized in this population, indicating its upper limits, likely beyond 24 hours, are not demonstrated within this study. Future studies are necessary to determine whether longer MPT is beneficial or detrimental to graft function and, if the latter, what is the maximum safe duration. Further studies of the effect of normothermic machine perfusion pump duration on long-term outcomes are also needed.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 2","pages":"99170"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327923","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":"Success of intravenous immunoglobulin and steroids in managing severe COVID-19 following lung transplantation: A case report.","authors":"Yen-Shou Kuo, Kuan-Hsun Lin, Ying-Yi Chen, Yuan-Ming Tsai, Ti-Hui Wu, Hsu-Kai Huang, Tsai-Wang Huang","doi":"10.5500/wjt.v15.i1.96696","DOIUrl":"10.5500/wjt.v15.i1.96696","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) pneumonia with severe septic shock and acute respiratory distress syndrome (ARDS) are critical illnesses for patients following transplant. Intravenous immunoglobulin (IVIG) plays a role in both immune support and inflammation control, especially in immunocompromised patients. This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.</p><p><strong>Case summary: </strong>A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations. Postoperatively, he developed COVID-19 pneumonia, severe septic shock, and ARDS. He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation, in addition to IVIG and pulse steroids.</p><p><strong>Conclusion: </strong>IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection. We aim, for the first time, to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting. With further investigations, this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 1","pages":"96696"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658779","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":"Machine learning in solid organ transplantation: Charting the evolving landscape.","authors":"Badi Rawashdeh, Haneen Al-Abdallat, Emre Arpali, Beje Thomas, Ty B Dunn, Matthew Cooper","doi":"10.5500/wjt.v15.i1.99642","DOIUrl":"10.5500/wjt.v15.i1.99642","url":null,"abstract":"<p><strong>Background: </strong>Machine learning (ML), a major branch of artificial intelligence, has not only demonstrated the potential to significantly improve numerous sectors of healthcare but has also made significant contributions to the field of solid organ transplantation. ML provides revolutionary opportunities in areas such as donor-recipient matching, post-transplant monitoring, and patient care by automatically analyzing large amounts of data, identifying patterns, and forecasting outcomes.</p><p><strong>Aim: </strong>To conduct a comprehensive bibliometric analysis of publications on the use of ML in transplantation to understand current research trends and their implications.</p><p><strong>Methods: </strong>On July 18, a thorough search strategy was used with the Web of Science database. ML and transplantation-related keywords were utilized. With the aid of the VOS viewer application, the identified articles were subjected to bibliometric variable analysis in order to determine publication counts, citation counts, contributing countries, and institutions, among other factors.</p><p><strong>Results: </strong>Of the 529 articles that were first identified, 427 were deemed relevant for bibliometric analysis. A surge in publications was observed over the last four years, especially after 2018, signifying growing interest in this area. With 209 publications, the United States emerged as the top contributor. Notably, the \"<i>Journal of Heart and Lung Transplantation</i>\" and the \"<i>American Journal of Transplantation</i>\" emerged as the leading journals, publishing the highest number of relevant articles. Frequent keyword searches revealed that patient survival, mortality, outcomes, allocation, and risk assessment were significant themes of focus.</p><p><strong>Conclusion: </strong>The growing body of pertinent publications highlights ML's growing presence in the field of solid organ transplantation. This bibliometric analysis highlights the growing importance of ML in transplant research and highlights its exciting potential to change medical practices and enhance patient outcomes. Encouraging collaboration between significant contributors can potentially fast-track advancements in this interdisciplinary domain.</p>","PeriodicalId":65557,"journal":{"name":"世界移植杂志","volume":"15 1","pages":"99642"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659911","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}