世界移植杂志(英文版)最新文献

{"title":"Living donor outcomes in an emerging living donor liver transplantation program: A single-center experience from Malaysia.","authors":"Yeong Sing Lee, Shi Yu Cheng, Arbaie Hannis, Sanjiv Mahadeva, Kee Seang Chew, Peng Soon Koh","doi":"10.5500/wjt.122256","DOIUrl":"10.5500/wjt.122256","url":null,"abstract":"<p><strong>Background: </strong>Living donor liver transplantation (LDLT) has become an essential strategy to address the shortage of deceased donor organs in Malaysia. Universiti Malaya Medical Centre (UMMC), the second public institution in the country to establish a liver transplantation program, initiated its adult LDLT program in 2017 and became the first center in the country to successfully perform a living-related adult right lobe LDLT. However, data on donor outcomes from emerging LDLT programs remain limited.</p><p><strong>Aim: </strong>To evaluate donor outcomes and perioperative results of an emerging LDLT program in Malaysia.</p><p><strong>Methods: </strong>This retrospective cohort study included all living donor hepatectomies performed at UMMC from January 2017 to June 2025. Data on donor selection, perioperative management, morbidity, and mortality were analyzed.</p><p><strong>Results: </strong>A total of 30 living donor hepatectomies were performed using right lobe, left lobe, and left lateral segment grafts. No donor mortality was observed. Complications included superficial wound infection (<i>n</i> = 4, 13.3%), anesthetic complications (<i>n</i> = 2, 6.7%), pulmonary atelectasis (<i>n</i> = 2, 6.7%), bile leak (<i>n</i> = 1, 3.3%), and gastrointestinal bleeding (<i>n</i> = 1, 3.3%). The median intraoperative blood loss was 500 mL (interquartile range: 400-800 mL), with a transfusion rate of 6.7%. The median length of hospital stay was 10 days. All donors achieved full functional recovery during follow-up.</p><p><strong>Conclusion: </strong>As an emerging liver transplantation program, UMMC demonstrated favorable donor safety outcomes consistent with published reports from established LDLT centers. Continued refinement of surgical techniques, multidisciplinary perioperative care, and public awareness initiatives will be essential for the sustainable expansion of liver transplantation in Malaysia.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"122256"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992681","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":"Higher model for end-stage liver disease excluding international normalized ratio scores predict worse kidney graft outcomes in simultaneous heart-kidney transplantation.","authors":"Marco E Diaz-Cordova, Matthew Rega, Ishani Sharma, Ryosuke Misawa, Abhay Dhand, Seigo Nishida, Kenji Okumura","doi":"10.5500/wjt.119505","DOIUrl":"10.5500/wjt.119505","url":null,"abstract":"<p><strong>Background: </strong>While the model for end-stage liver disease excluding international normalized ratio (MELD-XI) is known to be associated with adverse outcomes following cardiac surgery and heart transplantation, its predictive value in outcomes of simultaneous heart-kidney transplant (SHKT) remains unclear. To identify a reliable pre-transplant risk marker for graft and patient survival among SHKT recipients, we hypothesized that higher MELD-XI scores are linked to worse post-transplant outcomes.</p><p><strong>Aim: </strong>To determine the association between MELD-XI and post-transplant outcomes in SHKT recipients.</p><p><strong>Methods: </strong>We performed a retrospective cohort study in adult SHKT recipients using the United Network for Organ Sharing database from 2014 to 2023. MELD-XI was calculated and categorized into tertiles (high, medium and low). Multivariable Cox proportional hazards models and generalized additive models were used to evaluate the association between MELD-XI and patient mortality and kidney graft failure.</p><p><strong>Results: </strong>Among the cohort of 2148 SHKT recipients the MELD-XI tertile distribution was: High (11%), medium (56%), and low (36%). Statistically significant differences among recipients in the highest tertile were seen and they were younger, more frequently female, had higher rates of dialysis, and shorter waitlist times. Recipients in the higher MELD-XI tertile also had significant increase in the delayed kidney graft function and longer hospital stays after transplantation. On multivariable analysis, MELD-XI independently predicted increase in 90-day graft failure, and 1-year graft failure and mortality.</p><p><strong>Conclusion: </strong>Higher MELD-XI is associated with increased early mortality and kidney graft failure in SHKT recipients. MELD-XI can provide an objective risk-stratification tool to help identify candidates who should undergo SHKT <i>vs</i> kidney-after-heart transplantation.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"119505"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992674","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":"Post-transplant atrial tachyarrhythmias: Epidemiology, mechanisms, outcomes, and management across solid organs.","authors":"Alexandra Régia Dantas Brigido, Hugo Cardoso de Souza Falcon, Vanessa Simioni Faria, Helena Garcia Betinardi Bernardi, Júlio César Vieira de Sousa, Deborah de Sá Pereira Belfort, Guilherme Dagostin de Carvalho, Paulo Ricardo Gessolo Lins","doi":"10.5500/wjt.122203","DOIUrl":"10.5500/wjt.122203","url":null,"abstract":"<p><p>Post-transplant atrial tachyarrhythmias - including atrial fibrillation (AF), atrial flutter, and organized atrial tachycardias - occur after solid-organ transplantation and follow distinct time- and organ-dependent patterns. Early arrhythmias are mainly postoperative, resulting from inflammatory and autonomic stress, hemodynamic and metabolic shifts, and atrial injury. Thoracic transplantation bears the highest burden: Early postoperative AF is frequent, while late arrhythmias typically present as macroreentrant tachycardias at anastomotic or incisional sites. These late arrhythmias can signal graft pathology or atrial remodeling. In heart transplantation, late atrial tachyarrhythmias depend on surgical technique and often coincide with rejection or cardiac allograft vasculopathy. In abdominal transplantation, AF is less common but remains relevant. In liver transplantation, AF links closely to advanced disease and perioperative instability, with poorer outcomes. Across organs, post-transplant AF leads to longer hospitalization and higher risks of thromboembolism, mortality, and graft loss, emphasizing its significance beyond a brief postoperative event. Management is complex and multidisciplinary, requiring careful evaluation for reversible causes, patient-specific rate-control or rhythm-control, and attention to interactions among antiarrhythmics, anticoagulants, and immunosuppressive agents. Rhythm control is increasingly mechanism-driven. Catheter ablation, at experienced centers, is effective for late organized tachyarrhythmias, achieving high acute and durable success in recent single-center series. Stroke prevention remains difficult due to changing bleeding risk, organ function, and limited relevant trial evidence. Anticoagulation requires ongoing reassessment. Left atrial appendage occlusion is an emerging alternative for patients ineligible for long-term anticoagulation. Evidence, mainly from registry data and small series, suggests potentially higher vascular complication rates. This review summarizes current knowledge, clarifies knowns and unknowns, and describes future goals, including standardized definitions, phenotyping, surveillance windows, transplant-specific risk stratification, and comparative studies of anticoagulation, ablation, and appendage-closure strategies to improve outcomes.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"122203"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992778","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":"Reply: Chronic kidney disease after liver transplantation: Accurate measurement, early acute kidney injury, and renal-protective strategies.","authors":"Pranjal Kashiv, Khushboo Saxena, Manish Ramesh Balwani, Vivek B Kute","doi":"10.5500/wjt.124182","DOIUrl":"10.5500/wjt.124182","url":null,"abstract":"<p><p>In this article, we comment on the article by Sessa <i>et al</i> published in the recent issue of the <i>World Journal of Transplantation</i>, who revisit the three-decade single centre cohort of Muñoz-Serrano <i>et al</i> and conclude that chronic kidney disease (CKD) after liver transplantation (LT) is a modifiable determinant of long-term survival rather than an unavoidable consequence of calcineurin inhibitor exposure. We share their central position and welcome the weight they give to perioperative acute kidney injury (AKI), to calcineurin inhibitor minimisation through basiliximab induction and mycophenolate, and to the disciplined control of hypertension and metabolic disease. Our intention is to carry the argument one step further, because three problems lie beneath the literature they assemble and constrain what any inventory of risk factors can deliver. The first is metrological. Almost every reported association, including the signal attached to female sex, and the reported incidence itself, which varies according to the definition of CKD applied, the time point of ascertainment and whether creatinine-based or measured filtration is used, derive from creatinine-based estimates of glomerular filtration, a measure the same authors concede performs poorly in patients who are sarcopenic, oedematous and metabolically deranged. The second concerns timing, since the most powerful and most modifiable determinant of chronic injury is the passage from early AKI to fixed nephropathy, a transition that draws surveillance away from isolated tacrolimus trough concentrations, which did not predict one year disease in the index cohort, towards intrapatient variability and time within the therapeutic range. The third is therapeutic, because the prevailing synthesis omits the sodium glucose cotransporter 2 inhibitors, agents with established renal benefit in non-transplant CKD populations that deserve formal evaluation after LT. Measured accurately, protected early and evaluated pharmacologically, the kidney of the liver transplant recipient is more defensible than current practice assumes.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"124182"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992783","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":"Impact of obesity and income on the likelihood of kidney transplantation: A retrospective cohort study.","authors":"Tatenda G Mupfudze, Dzhuliyana G Handarova, Samantha M G Noreen, Jesse D Schold, Anil Paramesh, Rajesh Mohandas","doi":"10.5500/wjt.120639","DOIUrl":"10.5500/wjt.120639","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the joint and modifying effects of obesity and income on access to kidney transplantation, stratified by race/ethnicity.</p><p><strong>Aim: </strong>To investigate whether income modifies the association between body mass index (BMI) and the likelihood of deceased donor kidney transplantation (DDKT) and living donor kidney transplantation (LDKT).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 54891 adult kidney-only candidates added to the United States waiting list in 2020 and 2022, using data from the Organ Procurement and Transplantation Network and LexisNexis.</p><p><strong>Results: </strong>Overall, 47% of candidates were obese (BMI ≥ 30 kg/m²). In multivariable models, BMI 30- < 35 was associated with a lower likelihood of DDKT for non-Hispanic White and non-Hispanic Black candidates [sub-distribution hazard ratio (sHR): 0.93 for both]. BMI ≥ 35 was associated with an 18% lower likelihood to DDKT for non-Hispanic White candidates only. Low income was associated with higher likelihood of DDKT among non-Hispanic White (sHR: 1.34) and Hispanic/Latino (sHR: 1.20) candidates but was not associated with DDKT among non-Hispanic Black candidates. In interaction models, income-related differences in DDKT were most consistently observed among nonobese nonHispanic White and Hispanic/Latino candidates. For LDKT, both BMI ≥ 35 and low income were associated with lower likelihood of transplantation across all racial and ethnic groups; low income was also associated with reduced likelihood of LDKT among non-obese candidates in interaction models.</p><p><strong>Conclusion: </strong>Obesity and income are differentially associated with access to transplantation by racial/ethnicity and transplant modality, highlighting the importance of jointly considering clinical and social risk factors in transplantation.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"120639"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992759","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 biomarkers of early allograft dysfunction after liver transplantation: A prospective pilot study.","authors":"Elizabeth A Wilson, Ammar Rashied, Jamie R Privratsky, Mara Serbanescu, Andrew S Barbas, Kirsten M Williams, Craig M Coopersmith","doi":"10.5500/wjt.121567","DOIUrl":"10.5500/wjt.121567","url":null,"abstract":"<p><strong>Background: </strong>Early allograft dysfunction (EAD) contributes to significant morbidity and mortality. Although EAD can occur after any preservation method, the risk is higher with static cold storage (SCS) - still the predominant modality worldwide - given its longer ischemia time. We hypothesize specific peri-implantation alterations in serum cytokine and transcription factor levels are associated with EAD in recipients of allografts preserved using SCS.</p><p><strong>Aim: </strong>To identify peri-implantation predictive biomarkers of EAD in SCS recipients.</p><p><strong>Methods: </strong>We conducted a prospective single-center pilot study of adult deceased donor SCS-preserved liver transplant recipients from August 2023 to July 2024. EAD was defined by the Olthoff criteria. Arterial serum was obtained pre-implantation (timepoint, T1) and 2 (T2) and 48 hours (T3) post-implantation to measure biomarker levels by multiplex immunoassay. Biomarker levels between non-EAD and EAD groups, and their associations with clinical outcomes, were compared using Mann-Whitney <i>U</i>, <i>χ</i> ² or Fisher's exact, Friedman, Wilcoxon <i>Z</i>, and Spearman correlation tests.</p><p><strong>Results: </strong>EAD occurred in 8 of 24 SCS recipients (33.3%). Compared with non-EAD recipients, those with EAD had lower interleukin-6 (IL-6) levels at T1 [6.3 pg/mL interquartile ranges (IQR): 3.7, 12.9 <i>vs</i> 15.4 pg/mL IQR: 8.7, 24.9, <i>P</i> = 0.0433], greater peri-implantation increases in induced protein 10 (IP-10) (T2-T1) [386.7 pg/mL (IQR: -26.7, 1280.7) <i>vs</i> -181.5 pg/mL (IQR: -452.4, 145.9), <i>P</i> = 0.02], and higher 48-hour post-implantation hypoxia inducible factor-1 alpha (HIF-1α) levels at T3 [611.2 pg/mL (IQR: 384.7, 869.9) <i>vs</i> 157.9 pg/mL (IQR: 110, 273), <i>P</i> = 0.0095]. Discriminatory performance was moderate-to-strong for pre-implantation IL-6 [area under the curve (AUC) = 0.7578], peri-implantation IP-10 (AUC = 0.7969), and 48-hour post-implantation HIF-1α (AUC = 0.8889).</p><p><strong>Conclusion: </strong>When integrated with established risk factors and pending external validation, these biomarkers may predict EAD and enhance early risk stratification in SCS recipients.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"121567"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992848","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 transplant outcomes in patients with complement dysregulation.","authors":"Manish Balwani, Amit Pasari, Pranjal Kashiv, Vishal Ramteke, Priyanka Tolani, Nishtha Manuja, Mohit Kurundwadkar, Shubham Dubey, Twinkle Pawar, Sunny Malde, Sushrut Gupta, Kapil Sejpal, Vijay Jeyachandran, Vivek B Kute","doi":"10.5500/wjt.120969","DOIUrl":"10.5500/wjt.120969","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Complement dysregulation is a key mechanism underlying atypical hemolytic uremic syndrome and complement-mediated thrombotic microangiopathy in kidney transplantation, and is associated with post-transplant recurrence, graft dysfunction, and graft loss. Although Western cohort data are well established, integrated transplant outcome data combining genetic analysis, anti-factor H (AFH) antibody profiling, and individualized therapy from Indian and other South Asian populations remain limited, despite a distinct biologic profile in this region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate clinical characteristics, complement biologic profile, post-transplant recurrence, and graft outcomes in kidney transplant recipients with complement dysregulation managed at a tertiary transplant center in Central India, with particular emphasis on genotype-phenotype correlation and outcomes in a resource-constrained setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective cohort study included kidney transplant recipients with evidence of complement dysregulation identified from January 2018 to March 2025 at a tertiary transplant center in Central India. Complement dysregulation was defined as the presence of a pathogenic or likely pathogenic complement gene variant, AFH antibody positivity, or both. Genetic testing was performed using multiplex ligation-dependent probe amplification and/or clinical exome sequencing covering the alternative complement pathway gene panel, and AFH antibodies were measured using enzyme-linked immunosorbent assay. All patients underwent comprehensive evaluation including hematological, biochemical, and complement (C3, C4) profiling, with kidney biopsy when clinically feasible. The primary outcome was post-transplant recurrence of thrombotic microangiopathy; secondary outcomes included graft loss, patient survival, renal function, and treatment response. Median post-transplant follow-up was approximately 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 335 patients evaluated for complement abnormalities, 136 had complement dysregulation, of whom 38 underwent kidney transplantation and constituted the study cohort. Mean age was 36.3 ± 9.3 years, 84.2% were male, and 97.4% had hypertension; 73.7% were on maintenance hemodialysis at diagnosis. Complement genetic abnormalities were identified in 34/38 recipients (89.5%), with CFHR1-CFHR3 structural variants predominating (78.9%) and complement factor H abnormalities in 18.4%; no pathogenic variants were detected in &lt;i&gt;CFI&lt;/i&gt;, &lt;i&gt;C3&lt;/i&gt;, &lt;i&gt;CD46&lt;/i&gt;, &lt;i&gt;THBD&lt;/i&gt;, or &lt;i&gt;DGKE&lt;/i&gt;. AFH antibodies were detected in 15 patients (39.5%), with 11 having concomitant genetic abnormalities. Pre-transplant immunomodulation with plasma exchange and rituximab reduced mean AFH antibody levels from 179.9 AU/mL to 59.7 AU/mL (approximately 67% reduction). Post-transplant recurrence occurred in 7/38 recipients (18.4%), all biopsy-confirmed, donor-specific antib","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"120969"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992687","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":"Integrating robotic donor nephrectomy into contemporary living donor programmes: Evidence and practical considerations.","authors":"Pranjal Kashiv, Manish Ramesh Balwani, Amit Pasari, Khushboo Saxena, Sanjay P Kolte, Vivek B Kute","doi":"10.5500/wjt.117482","DOIUrl":"10.5500/wjt.117482","url":null,"abstract":"<p><p>In this editorial, we comment on the study by Christou <i>et al</i> recently published in <i>World Journal of Transplantation</i>, which presents a matched comparative analysis evaluating robot-assisted <i>vs</i> hand-assisted laparoscopic donor nephrectomy within a contemporary United Kingdom living-donor programme. Their work directly addresses a central question in the current evolution of minimally invasive donor surgery - the robotic platforms offer incremental advantages in precision, operative consistency, or ergonomic sustainability without compromising donor safety or graft function. The authors demonstrate that both techniques achieve comparable perioperative recovery, complication profiles, and early allograft outcomes. Although modest variations were observed in warm ischaemia time, postoperative stay, and workflow dynamics, these differences lacked clinical significance and did not influence donor or graft results. Importantly, the progressive reduction in console time with accumulating experience reflects the characteristic learning-curve trajectory seen across early robotic adoption, underscoring how proficiency stabilises as teams internalise the platform's ergonomics and procedural choreography. Beyond the procedural metrics themselves, the study offers practical insight into how robotics may be integrated into mature donor programmes: As a complementary modality that supports technical reproducibility, preserves donor safety, and potentially enhances surgeon ergonomics. These findings therefore provide timely guidance for centres evaluating whether robotics can be incorporated alongside established laparoscopic pathways, balancing performance, training requirements, institutional resources, and long-term programme sustainability.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"117482"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992672","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":"Growth and development following paediatric kidney transplantation: Mechanisms, influencing factors, and clinical management.","authors":"Yu-Yang Wang, Gai Hang, Quan Wen, Yun-Peng Guo, Chen Long, Bo Chen","doi":"10.5500/wjt.120986","DOIUrl":"10.5500/wjt.120986","url":null,"abstract":"<p><p>Paediatric kidney transplantation substantially improves survival and quality of life in children with end-stage kidney disease. However, impaired linear growth and broader developmental challenges remain common after transplantation. This article provides an evidence-based narrative review of the mechanisms, clinical determinants, monitoring strategies, and management options for post-transplant growth and development in paediatric kidney recipients, with particular emphasis on the growth hormone (GH)-insulin-like growth factor 1 axis, graft function, immunosuppression, nutrition, GH therapy, and long-term follow-up. Current evidence indicates that post-transplant growth is influenced by age at transplantation, pretransplant growth status, graft function, cumulative corticosteroid exposure, nutritional and metabolic status, and the selective use of recombinant human GH. Younger age at transplantation and steroid-sparing strategies are consistently associated with better height outcomes, whereas chronic graft dysfunction, persistent inflammation, and metabolic complications may attenuate catch-up growth. Emerging biomarkers and precision-medicine tools are promising, but most remain insufficiently validated for routine growth-focused decision-making. Optimising growth after paediatric kidney transplantation requires early transplantation when feasible, preservation of graft function, careful balancing of rejection prevention against growth toxicity, multidisciplinary nutritional and endocrine support, and structured long-term follow-up. The evidence base is expanding, but high-quality multicentre longitudinal studies are still needed.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"120986"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992721","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":"Redefining weight management after liver transplantation with glucagon-like peptide one and gastric inhibitory polypeptide receptor agonists.","authors":"Soha Elatrebi, Rowan Abuyadek, Sohaila Mohamed Mohamed Abdelbar, Muhammad S Ahmad, Mohamed Ayyad, Muhammad AbdelAziz Quoritem, Rodaina Osama Abdel Majid, Manar Arafat, Ahmed Amgad, Amr Alnagar","doi":"10.5500/wjt.120572","DOIUrl":"10.5500/wjt.120572","url":null,"abstract":"<p><p>Obesity is a challenging complication that many liver transplant recipients face. Liver transplantation is the sole life-saving procedure in many end-stage liver diseases, but the underlying pathology, in addition to some immunosuppressive regimens, may worsen the metabolic status of many patients. A comprehensive management plan to prevent further metabolic complications, like metabolic dysfunction-associated steatotic liver disease, chronic renal dysfunction, and diabetes, is essential to obtain a favourable prognosis and a better quality of life. glucagon-like peptide-1 (GLP-1) and GLP-1/glucose-dependent insulinotropic polypeptide receptor agonists have been approved for long-term weight management by the United States Food and Drug Administration and other regulatory authorities. While this pharmacotherapeutic intervention revolutionised obesity management, it comes with many limitations. Their long-term safety profile, optimal dosing, duration of treatment and outcomes are still insufficiently studied, specifically in the transplant recipient population. This review aims to explore the pathophysiology, risk factors, clinical presentation, and burden of metabolic complications in liver transplant recipients and to review available data on the potential use of GLP-1 and GLP-1/glucose-dependent insulinotropic polypeptide receptor agonists in mitigating these complications among this vulnerable population.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"16 3","pages":"120572"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992763","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}