Annals of Transplantation最新文献

{"title":"Analysis of Factors Influencing the Psychological State of Patients After Autologous Liver Transplantation.","authors":"Ting Zhang, Songnian Fu","doi":"10.12659/AOT.953645","DOIUrl":"https://doi.org/10.12659/AOT.953645","url":null,"abstract":"<p><p>BACKGROUND The use of ex vivo liver resection and autologous liver transplantation (ELRA) for end-stage hepatic alveolar echinococcosis is gradually increasing, while postoperative psychological disorders in these patients remain underrecognized. We prespecified that longer pre-transplant waiting time, postoperative complications, and higher transfusion volume would be associated with worse anxiety, depression, and sleep disturbance at 1 month after ELRA. MATERIAL AND METHODS This single-center retrospective study enrolled 138 patients who underwent ELRA from 2020 to 2025. We collected demographic data, perioperative clinical indexes, and scores at baseline and 1 month postoperatively using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and Pittsburgh Sleep Quality Index (PSQI). Univariate analysis and multivariate linear regression were used to identify independent influencing factors. RESULTS Longer pre-transplant waiting time independently predicted worse scores across all psychological and sleep scales (all P<0.05). Prolonged anhepatic phase duration was specifically associated with higher PSQI scores (P<0.05). Intraoperative transfusion showed marginal but nonsignificant associations, and postoperative complications were significant only in univariate analysis. CONCLUSIONS Longer pre‑transplant waiting time is the core and most consistent risk factor for poor mental health after ELRA, while prolonged anhepatic phase is specifically linked to postoperative sleep disturbance. These findings support the implementation of targeted, stage-specific psychological interventions, especially during the pre-transplant waiting period, to improve mental health and quality of life in patients undergoing ELRA.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e953645"},"PeriodicalIF":1.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Psychological Resilience on Emotional Health in Kidney and Liver Transplant Recipients.","authors":"Marta Katarzyna Hreńczuk, Tomasz Dawid Piątek, Joanna Gotlib-Małkowska, Mariusz Panczyk, Piotr Małkowski","doi":"10.12659/AOT.952824","DOIUrl":"10.12659/AOT.952824","url":null,"abstract":"<p><p>BACKGROUND Psychological resilience is an increasingly recognized important protective factor for emotional health after solid organ transplantation; however, its role in the early post-transplant period is insufficiently explored. This study examined the role of psychological resilience in emotional health among kidney and liver transplant recipients, using a cross-sectional indirect-effect model. MATERIAL AND METHODS A cross-sectional, multicenter study was conducted at 4 transplant centers in Poland. Adult kidney and liver transplant recipients were assessed the day before hospital discharge after transplantation (mean hospital stay: 19.62 days). The study included 117 participants (68.4% kidney and 31.6% liver transplant recipients). Perceived social support was assessed with the Multidimensional Scale of Perceived Social Support (MSPSS), psychological resilience with the Psychological Resilience Scale (SPP-25), and overall emotional distress with the Hospital Anxiety and Depression Scale (HADS). Cross-sectional mediation analyses tested an indirect-effect model with MSPSS as the independent variable (X), SPP-25 as the mediator (M), and emotional distress measured by the HADS as the outcome variable (Y). RESULTS Participants reported moderate to high psychological resilience and high perceived social support, particularly from family and significant others, along with low to moderate emotional distress. Mediation analyses showed associations between perceived social support and emotional distress were statistically significant only as indirect effects mediated by psychological resilience. CONCLUSIONS In the early post-transplant period, psychological resilience is statistically associated with emotional health and may serve as an important mediator linking perceived social support to lower levels of emotional distress. These findings are consistent with a theoretical indirect-effect model and underscore the need for longitudinal studies to clarify temporal relationships in psychological adaptation after transplantation.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e952824"},"PeriodicalIF":1.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Curve and Outcomes of Pure Laparoscopic Donor Major Hepatectomy Performed by Fellowship-Trained Surgeons: Cumulative Sum and Propensity Score Matching Analysis.","authors":"Chan Woo Cho, Namkee Oh, Jinsoo Rhu, Kyeong Sik Kim, Do Hyeon Lee, Hyoung Joo Kim, Gyu-Seong Choi","doi":"10.12659/AOT.953061","DOIUrl":"10.12659/AOT.953061","url":null,"abstract":"<p><p>BACKGROUND Pure laparoscopic donor major hepatectomy (PLDMH) offers important advantages for donors but has largely been restricted to expert surgeons. Evidence on fellowship-trained surgeons (FTSs) performing PLDMH after structured training is limited. This study evaluated donor safety and operative efficiency of FTSs using propensity score matching (PSM) and cumulative sum (CUSUM) analysis. MATERIAL AND METHODS We retrospectively reviewed 517 consecutive PLDMHs from 3 centers, including 1 expert surgeon (n = 462) and 3 FTSs (n = 55). FTSs underwent a structured, phase-task-based training program; 2 received short-term on-site proctorship for initial cases. To reduce baseline differences, we applied 1: 3 propensity score matching (PSM) between FTS and expert cases. Donor and recipient characteristics were balanced. Learning curves were assessed using risk-adjusted CUSUM for major donor complications and residual CUSUM for operative time. RESULTS After PSM, 55 FTS cases were matched to 165 expert cases. Major donor complications were comparable (5.5% vs 4.2%, P=0.714) and no case required conversion to open surgery. Donor operative time was longer in the FTS group (338±102 vs 220±44 minutes, P<0.001). Recipient biliary leakage was more frequent in the FTS group (18.2% vs 8.5%, P=0.046), whereas other outcomes were similar after matching. Risk-adjusted CUSUM demonstrated stabilization of donor safety within 8 to 10 cases per FTS, while operative efficiency stabilized after 6 to 15 cases. CONCLUSIONS FTSs demonstrated acceptable donor safety outcomes under structured training conditions, with operative performance showing a trend toward improvement after approximately 10 to 15 cases.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e953061"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Pretransplant and Posttransplant Diabetes on Long-Term Heart Transplant Outcomes.","authors":"Bingqian Yan, Zhenqiang Wei, Xiaode Feng, Shuai Huang, Yujia Luo, Yinlei Dong, Zhou Jiang","doi":"10.12659/AOT.953220","DOIUrl":"10.12659/AOT.953220","url":null,"abstract":"<p><p>BACKGROUND Diabetes mellitus (DM) is increasingly prevalent among heart transplant candidates, but its long-term prognostic significance remains undefined. The impact of posttransplant DM (PTDM) and insulin-dependent PTDM on outcomes has not been fully characterized. This study evaluated associations of pretransplant DM, PTDM, and insulin-dependent PTDM with long-term outcomes after heart transplantation. MATERIAL AND METHODS Adult heart transplant recipients in the Scientific Registry of Transplant Recipients between December 2005 and December 2020, with no prior transplant, were included. Recipients were stratified by pretransplant DM status, PTDM development, and insulin dependence among PTDM patients. Overall survival (OS) was assessed using Kaplan-Meier analysis, and independent predictors of mortality and PTDM were evaluated using multivariable Cox and logistic regression. RESULTS A total of 30 430 recipients were analyzed, including 8361 with pretransplant DM. Pretransplant DM was associated with worse 10-year OS and independently predicted mortality (HR=1.39, 95% CI: 1.32-1.46; P<0.001). Recipients with pretransplant DM also had higher rates of acute drug-treated rejection, dialysis requirement, drug-treated infection, and infection- or pulmonary-related death. Among 21 121 recipients without pretransplant DM, 3003 developed PTDM. PTDM was independently associated with worse OS (HR=1.14; 95% CI, 1.06-1.22; P=0.001), acute rejection, and infection. Among patients with PTDM, insulin-dependent PTDM conferred greater mortality risk than non-insulin-dependent PTDM (HR=1.58; 95% CI, 1.38-1.80; P<0.001) and was associated with higher rates of rejection, dialysis, infection, and cardiovascular death. CONCLUSIONS Diabetes across the transplant continuum has distinct prognostic implications after heart transplantation. Pretransplant DM and PTDM are independently associated with worse long-term OS, while insulin-dependent PTDM identifies a particularly high-risk subgroup.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e953220"},"PeriodicalIF":1.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errate: The Anatomical Landscape of Living Donor Livers: A 101-Case Retrospective Single-Center Study in Indonesia From 2010 to 2025.","authors":"Arnetta Naomi Louise Lalisang, Toar Jean Maurice Lalisang, Yarman Mazni, Ridho Ardhi Syaiful, Lam Sihardo, Vania Myralda Giamour Marbun, Anisa Ayu Maharani, Nathaniel Jason Zacharia, Afid Brilliana Putra, Taufik Agung Wibowo","doi":"10.12659/AOT.955533","DOIUrl":"10.12659/AOT.955533","url":null,"abstract":"<p><p>The ethical approval number was incorrectly stated as: \"Approval No. KET-/76/UNZ.F1/ETIK/PPM.00.02/2024.\" It should read: \"Approval No. KET-/176/UN2.F1/ETIK/PPM.00.02/2024.\" Reference: Arnetta Naomi Louise Lalisang, Toar Jean Maurice Lalisang, Yarman Mazni, Ridho Ardhi Syaiful, Lam Sihardo, Vania Myralda Giamour Marbun, Anisa Ayu Maharani, Nathaniel Jason Zacharia, Afid Brilliana Putra, Taufik Agung Wibowo. The Anatomical Landscape of Living Donor Livers: A 101-Case Retrospective Single-Center Study in Indonesia From 2010 to 2025.  Ann Transplant. 2026;31:e952031. DOI: 10.12659/AOT.952031.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e955533"},"PeriodicalIF":1.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Lack of Consent for Deceased Organ Donation Among Nurses and Physicians: A Cross-Sectional Study.","authors":"Paulina Kurleto, Lucyna Tomaszek, Irena Milaniak","doi":"10.12659/AOT.953598","DOIUrl":"10.12659/AOT.953598","url":null,"abstract":"<p><p>BACKGROUND Deceased organ donation is the principal source of transplantable organs; however, organ shortages remain a major public health challenge. Healthcare professionals play a pivotal role in shaping societal attitudes toward transplantation. This study aimed to identify sociodemographic, psychological, and attitudinal factors independently associated with lack of willingness to consent to deceased organ donation among nurses and physicians working in dialysis units. MATERIAL AND METHODS A nationwide cross-sectional survey was conducted in Poland between February 2023 and June 2024 among 850 nurses and 243 physicians. Data were collected using paper-based and online questionnaires, incorporating sociodemographic variables, donation-related attitudes, and validated psychometric scales assessing life satisfaction, self-esteem, self-efficacy, and empathy. The primary outcome was lack of willingness to consent to deceased organ donation. Group comparisons were performed using Mann-Whitney U and chi-square tests. Multivariable logistic regression identified independent determinants. RESULTS Overall, 35.2% of participants either declined or did not clearly express willingness to consent to deceased organ donation. Higher levels of personal distress were associated with increased odds of lack of willingness to consent (B = 0.05; OR = 1.05; 95% CI, 1.00-1.10; P = 0.04), whereas higher empathic concern was associated with decreased odds (B = -0.06; OR = 0.94; 95% CI, 0.89-0.98; P = 0.01). Belief in the safety of blood donation was linked to lower odds of lack of willingness to consent (B = -0.28; OR = 0.76; 95% CI, 0.63-0.91; P < 0.001). The strongest association was observed for acceptance of organ donation from a deceased close family member (B = -2.36; OR = 0.09; 95% CI, 0.07-0.13; P < 0.001). Donation-related beliefs demonstrated stronger associations with consent attitudes than sociodemographic characteristics. CONCLUSIONS Unwillingness to consent to deceased organ donation among dialysis staff was associated with empathy dimensions and donation-related beliefs.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e953598"},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four Years of Clinical Experience With COVID-19 Outcomes in Heart Transplant Recipients.","authors":"Agnieszka Kuczaj, Szymon Warwas, Mikołaj Tyrka, Błażej Skotnicki, Daniel Szymecki, Oliwia Jewuła, Joanna Śliwka, Szymon Pawlak, Piotr Przybyłowski, Tomasz Hrapkowicz","doi":"10.12659/AOT.952888","DOIUrl":"10.12659/AOT.952888","url":null,"abstract":"<p><p>BACKGROUND COVID-19 significantly impacted the outcomes of patients, particularly those with comorbidities, including solid organ transplant recipients. The aim of this study was to investigate the incidence and mortality of COVID-19, as well as to identify independent risk factors associated with COVID-19-related death in patients undergoing orthotopic heart transplantation (OHT). MATERIAL AND METHODS The study followed 556 heart transplant recipients at a high-volume transplant center in Poland from March 2020 to March 2024. Patients were classified as infected based on a positive result from reverse transcription-polymerase chain reaction (RT-PCR) tests or SARS-CoV-2 antigen rapid tests performed on nasopharyngeal swab samples. RESULTS In the analyzed cohort, 189 of 556 patients (33.99%; 40 women, 21.16%) were diagnosed with COVID-19 following OHT. In total, 15 patients (7.94%) experienced recurrent SARS-CoV-2 infections, with 1 patient being diagnosed 3 times. A total of 33 patients (5.94%) required hospitalization due to COVID-19. Among the entire study cohort, 75 patients (13.49%) died, with 18 of these deaths (24%) directly attributable to COVID-19. In the multivariable analysis, vaccination against COVID-19 was identified as a protective factor against death due to the virus (OR, 0.22; 95% CI, 0.07-0.68; P=0.009) while increasing age was associated with a higher risk of mortality (OR, 1.08; 95% CI, 1.02-1.14; P=0.008). CONCLUSIONS The lack of COVID-19 vaccination and advanced age significantly influenced the COVID-19-related mortality risk.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e952888"},"PeriodicalIF":1.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Prognostic Performance of Pretransplant AARC, CLIF-C ACLF, and MELD-Na Scores for 90-Day Mortality After Liver Transplantation in Patients With EASL-CLIF Acute-on-Chronic Liver Failure.","authors":"Nguyen Thai Cuong, Le Xuan Duong, Nguyen Chi Tam, Nam Van Do, Ngo Dinh Trung","doi":"10.12659/AOT.954888","DOIUrl":"10.12659/AOT.954888","url":null,"abstract":"<p><p>BACKGROUND Acute-on-chronic liver failure (ACLF) is associated with multiorgan failure and high short-term mortality. Liver transplantation (LT) can be lifesaving, but commonly used pretransplant severity scores were not developed to predict post-transplant mortality. This study compared AARC, CLIF-C ACLF, and MELD-Na for 90-day mortality after LT. MATERIAL AND METHODS This single-center observational cohort study included 78 consecutive patients aged 16 years or older with EASL-CLIF ACLF who underwent LT at the 108 Military Central Hospital between January 2022 and June 2025. All 3 scores were independently recalculated from a common pretransplant assessment. The primary outcome was 90-day all-cause mortality, and the primary score comparison was non-directional. Discrimination was assessed using AUROCs with stratified percentile-bootstrap confidence intervals and paired DeLong comparisons with Holm adjustment. Separate Firth logistic and Cox models evaluated associations per 1-standard-deviation increase. RESULTS HBV-related liver disease accounted for 62.8% of the cohort, and 89.7% underwent living-donor LT. Fourteen patients (17.9%) died within 90 days. CLIF-C ACLF had the highest numerical AUROC (0.755; 95% CI, 0.562-0.917), followed by MELD-Na (0.714; 0.550-0.854) and AARC (0.654; 0.491-0.799); no pairwise difference remained significant after Holm adjustment. A 1-standard-deviation increase in CLIF-C ACLF (11.05 points) and MELD-Na (6.17 points) was associated with higher 90-day mortality, whereas AARC was not. Sensitivity analyses produced similar findings. CONCLUSIONS CLIF-C ACLF showed the strongest numerical prognostic performance, but statistically significant superiority was not established. These scores should complement multidisciplinary transplant assessment.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e954888"},"PeriodicalIF":1.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective Effects of Quercetin and Sucrose on Cold Preservation Injury in Porcine Kidneys Donated After Cardiac Death.","authors":"Daisuke Ishii, Asuka Toriumi, Hiromichi Obara, Yoshiyasu Satake, Yoko Okada, Haruka Dewa, Masashi Imamura, Naoto Matsuno","doi":"10.12659/AOT.952503","DOIUrl":"10.12659/AOT.952503","url":null,"abstract":"<p><p>BACKGROUND The University of Wisconsin (UW) solution is the gold standard for kidney preservation. Quercetin (QE), a widely used flavonoid, possesses strong antioxidant, anti-inflammatory, and anti-apoptotic properties. Sucrose (Suc) has shown beneficial effects as a supplement. The aim of this study was to investigate the protective effects of QE and Suc against cold injury in porcine kidneys and to evaluate whether their use improves ischemia-reperfusion (I/R) injury after simple CS. MATERIAL AND METHODS Kidney grafts were procured after 30 min of warm ischemia, followed by preservation under 2 conditions for 22 h: Group 1, preserved with CS/UW solution (n=4), and Group 2, preserved with CS/UW solution containing QE 33.1 μM and Suc 0.1 M (n=6). All grafts were evaluated using an ex vivo isolated kidney reperfusion model with oxygenated, diluted autologous blood at room temperature. RESULTS At the end of reperfusion, creatinine phosphokinase and lactate dehydrogenase levels were significantly lower in Group 2 than in Group 1. We observed more vacuolation in the tubular epithelial cell in Group 1 than in Group 2, and the tubular epithelium showed more irregularity and exfoliation in Group 1 than in Group 2. Additionally, Group 2 had a significantly higher number of anti-ERG-positive endothelial cell nuclei than Group 1 at the end of reperfusion. CONCLUSIONS Our results suggest that the addition of QE and Suc to UW solutions can effectively prevent cold injury in DCD kidneys, with QE exerting this beneficial action, possibly by suppressing oxidative stress, and could potentially enhance kidney transplantation outcomes.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e952503"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common Versus External Iliac Arterial Anastomosis in Kidney Transplantation: A Bicentric Retrospective Analysis of Vascular Complications and Graft Outcomes.","authors":"Gaël Saint Jalmes, Matthias Buchler, Jean Picquet, Jean François Augusto, Thibaut Culty, Souhil Lebdai, Franck Bruyere, Pierre Bigot","doi":"10.12659/AOT.953269","DOIUrl":"10.12659/AOT.953269","url":null,"abstract":"<p><p>BACKGROUND Vascular complications remain a significant concern after kidney transplantation. While external iliac (EI) implantation is standard, common iliac (CI) implantation is occasionally performed in selected cases, particularly in the presence of vascular disease or anatomical constraints. We compared vascular outcomes according to the arterial anastomosis site. MATERIAL AND METHODS We conducted a bicentric retrospective study including kidney transplant recipients between 2015 and 2019. Implantation strategy differed between centers, with a preferential use of CI implantation in one center and EI implantation in the other. Patients underwent arterial anastomosis to the CI (n=157) or EI vessels (n=359). The primary endpoint was vascular complications graded according to the Clavien-Dindo classification. Secondary endpoints included ≥60% vascular stenosis, lymphocele rate, and graft failure at 2 years. RESULTS Baseline characteristics differed between groups, reflecting center-specific practices and case-mix variations. Overall vascular complication rates were similar (22.9% in CI vs 20.1% in EI; P=0.46). However, Clavien-Dindo ≥III complications were more frequent in the CI group (14.6% vs 7.5%; P=0.01). Severe vascular stenosis requiring intervention (Clavien-Dindo III) occurred more often in CI recipients (7.0% vs 0.8%; P<0.01). Lymphocele was also significantly more frequent in the CI group (27.4% vs 9.2%; P<0.01; OR 4.55, 95% CI 2.56-8.09; P<0.001). At 2 years, graft failure rates did not differ significantly (4.1% vs 5.3%; P=0.29). CONCLUSIONS In this bicentric retrospective analysis, CI implantation was associated with a higher rate of severe vascular complications, particularly stenosis, and lymphocele, without a significant impact on graft failure at 2 years. These findings should be interpreted with caution, as they likely reflect, at least in part, differences in patient selection and center-specific surgical practices.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"31 ","pages":"e953269"},"PeriodicalIF":1.3,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}