Annals of Transplantation最新文献

Family-Related Motivation and Regret Intensity Among Family Liver Donors by Type of Family Relationship.

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-03-25 DOI: 10.12659/AOT.947414

Ye Sol Lee, Chin Kang Koh, Nam-Joon Yi

{"title":"Family-Related Motivation and Regret Intensity Among Family Liver Donors by Type of Family Relationship.","authors":"Ye Sol Lee, Chin Kang Koh, Nam-Joon Yi","doi":"10.12659/AOT.947414","DOIUrl":"10.12659/AOT.947414","url":null,"abstract":"BACKGROUND Living donor liver transplantation (LDLT) from a family member, particularly adult children, is common in South Korea. Although LDLT is restricted to donors with altruistic motivations, some still experience post-donation regret. However, the role of family-related motivation in post-donation regret remains underexplored. This study examined whether family-related motivations were associated with regret intensity and whether these associations varied by the type of family relationship (child vs spouse, sibling, or parent donors). MATERIAL AND METHODS This study was a cross-sectional secondary analysis. The sample comprised 124 postoperative living liver donors. They completed a family-related motivation subscale of the Donor Motivation Questionnaire and a single-item measure of regret intensity. For moderation analysis, Model 1 of the PROCESS macro was used. RESULTS The mean score of post-donation regret was 1.3 out of 4. Non-child donors reported higher levels of regret than child donors. Particularly in non-child donors, family-related motivation was inversely associated with regret intensity, after adjusting for age, sex, caregiver role, postoperative complications, and months since donation. CONCLUSIONS These findings suggest that child and non-child donors have distinct motivations, which are linked to differing levels of regret. Accordingly, transplant teams should provide tailored information and support services based on the donor's family relationship type.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e947414"},"PeriodicalIF":1.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699370","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}

引用次数: 0

Effect of a Nursing Program on Anxiety, Depression, and Insomnia in Patients After Liver Transplantation: A Randomized Controlled Trial.

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-03-18 DOI: 10.12659/AOT.947351

Shuang-Mei Xi, Yan-Mei Gu, Hui-Min Guo, Xin Liu, Yu-Lin Zheng, Guang-Ming Li, Li-Li Zhang

{"title":"Effect of a Nursing Program on Anxiety, Depression, and Insomnia in Patients After Liver Transplantation: A Randomized Controlled Trial.","authors":"Shuang-Mei Xi, Yan-Mei Gu, Hui-Min Guo, Xin Liu, Yu-Lin Zheng, Guang-Ming Li, Li-Li Zhang","doi":"10.12659/AOT.947351","DOIUrl":"10.12659/AOT.947351","url":null,"abstract":"BACKGROUND The incidence of anxiety, depression, and sleep disturbances is high among patients after liver transplantation, significantly impacting their quality of life. However, existing nursing programs often lack a comprehensive focus on psychological and physical health outcomes. This study aimed to evaluate the effectiveness of a targeted nursing program in reducing anxiety, depression, and sleep disturbances among liver transplantation patients through psychological care, lifestyle guidance, pain management, and rehabilitation training. MATERIAL AND METHODS A randomized controlled trial was conducted with 80 liver transplantation patients at Beijing Youan Hospital (2021-2023). Patients were randomly assigned to the control group (traditional nursing, n=40) or the intervention group (targeted nursing, n=40). The intervention included psychological care, lifestyle guidance, pain management, and rehabilitation training. Anxiety, depression, and sleep quality were assessed using the SDS, HAMA, and PSQI at 4 time points: 0-60, 61-120, 121-180, and 181-360 days after surgery. RESULTS The incidence of anxiety, depression, and insomnia at 0-60, 61-120, 121-180, and 181-360 days after liver transplantation was 42.50%, 37.50%, 35.00%, and 30.00%; 14.50%, 9.40%, 3.20%, and 1.20%; and 15.80%, 12.10%, 7.30%, and 6.50%, respectively. After the care program, the depression, anxiety, and sleep scores were lower in the intervention group than in the control group and gradually decreased over time (p<0.05). CONCLUSIONS The nursing program after liver transplantation includes postoperative psychology, pain care, life strategies, and rehabilitation training, which can effectively reduce the depression, anxiety, and sleep scores of patients and is recommended for wide use.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e947351"},"PeriodicalIF":1.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647181","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}

引用次数: 0

Herbal Medicine Use Among Transplant Recipients in Saudi Arabia: Prevalence and Risk Awareness.

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-03-04 DOI: 10.12659/AOT.947275

Bassem A Almalki, Fawaz M Alotaibi, Mohammed Aldholmi, Yousef S Alqarni, Sawsan M Kurdi, Mohammed M Alsultan, Wafa A Alzlaiq, Mansour M Alotaibi, Noor M Alashi, Fatimah S Alzahrani, Nouf E Alotaibi, Mohamed A Albekery, Sarah A Albilal, Khawla M Kahtani, Mohammed Abdelgawad Gafar, Sahar M Al-Mowaina, Ahmed K Alalawi, Abdullah A Alshehab, Ahmed J Aljasem, Abdulkareem M Albekairy

{"title":"Herbal Medicine Use Among Transplant Recipients in Saudi Arabia: Prevalence and Risk Awareness.","authors":"Bassem A Almalki, Fawaz M Alotaibi, Mohammed Aldholmi, Yousef S Alqarni, Sawsan M Kurdi, Mohammed M Alsultan, Wafa A Alzlaiq, Mansour M Alotaibi, Noor M Alashi, Fatimah S Alzahrani, Nouf E Alotaibi, Mohamed A Albekery, Sarah A Albilal, Khawla M Kahtani, Mohammed Abdelgawad Gafar, Sahar M Al-Mowaina, Ahmed K Alalawi, Abdullah A Alshehab, Ahmed J Aljasem, Abdulkareem M Albekairy","doi":"10.12659/AOT.947275","DOIUrl":"10.12659/AOT.947275","url":null,"abstract":"BACKGROUND Herbal medicine is commonly used in Saudi Arabia, and is widely viewed as natural and safe. However, its use among transplant recipients poses risks due to interactions with immunosuppressive therapies. This study explores herbal medicine use, knowledge, and attitudes among Saudi transplant recipients. MATERIAL AND METHODS A cross-sectional study of 203 transplant recipients from multiple clinics in Saudi Arabia was conducted using a structured questionnaire to assess demographics, herbal supplement use, awareness of risks, and attitudes. Statistical analyses compared users and non-users of herbal supplements. RESULTS Post-transplant herbal supplement use decreased significantly (44.3% to 19.2%, p=0.0001). Many relied on unreliable sources like friends or the internet, and 54.24% of reported supplements posed interaction risks with immunosuppressive drugs. Participants aware of these risks were significantly less likely to use herbal supplements (15% vs 88%, p=0.0007). Alarmingly, 81.1% received no pre-transplant education, and 70.4% received no post-transplant care, despite 81% desiring guidance from healthcare providers. CONCLUSIONS Herbal supplement use among transplant recipients in Saudi Arabia is prevalent and risky due to potential drug interactions. Most patients lack education about these risks, underscoring the need for improved healthcare education.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e947275"},"PeriodicalIF":1.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539983","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}

引用次数: 0

Pulmonary Embolism Following Living Donor Hepatectomy: A Report of 4 Cases and Literature Review.

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-02-18 DOI: 10.12659/AOT.946752

Ling-Li Cui, Xu-Ming Liu, Liang Zhang, Shen Liu, Bo Wu, Yun Wang, Zhi-Jun Zhu

{"title":"Pulmonary Embolism Following Living Donor Hepatectomy: A Report of 4 Cases and Literature Review.","authors":"Ling-Li Cui, Xu-Ming Liu, Liang Zhang, Shen Liu, Bo Wu, Yun Wang, Zhi-Jun Zhu","doi":"10.12659/AOT.946752","DOIUrl":"10.12659/AOT.946752","url":null,"abstract":"BACKGROUND Living donor liver transplantation (LDLT) is an established treatment for end-stage liver disease, where donor safety remains a top priority. Pulmonary embolism (PE) is an unpredictable but serious complication following liver donor hepatectomy (LDH), contributing significantly to postoperative morbidity and mortality. CASE REPORT This article reports 4 cases of PE in living donors following LDH, discussing their clinical presentations, diagnosis, and treatment, and reviewing the relevant literature. Patient 1 was a 46-year-old man who underwent laparotomy right hepatectomy and developed PE on postoperative day (POD) 2. Patient 2 was a 42-year-old woman who donated the left half liver for her son. On POD 8, she was diagnosed with PE by enhanced computed tomography (CT) scan. Patient 3 was a 65-year-old man with 2 years history of hypertension. He underwent a laparotomy right hepatectomy and developed PE on POD 2. Patient 4 was a 57-year-old woman who underwent laparotomy left hepatectomy with the middle hepatic vein. On POD 3, the patient suddenly developed dyspnea after ambulation, and the enhanced CT of pulmonary arteries showed extensive PE in both lungs. All donors developed symptoms such as dyspnea and hypoxemia postoperatively, and were diagnosed with PE through imaging studies. Prompt anticoagulation therapy led to favorable outcomes in all cases. CONCLUSIONS Although PE is a rare and serious complication after LDH, early recognition and timely intervention are crucial to prevent catastrophic outcomes for the donor. Improving perioperative management is key to enhancing donor safety.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946752"},"PeriodicalIF":1.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439681","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}

引用次数: 0

Retrospective Study to Compare Outcomes in 159 Patients Undergoing First Autologous Stem Cell Transplantation for Myeloma Treated with Melphalan 140 mg/m² or 200 mg/m².

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-02-11 DOI: 10.12659/AOT.947186

Umut Yılmaz, Şükran Erdem Nurcan, Deniz Özmen, Ayşe Salihoğlu, Ahmet Emre Eşkazan, Şeniz Öngören, Zafer Başlar, Teoman Soysal, Muhlis Cem Ar, Tuğrul Elverdi

{"title":"Retrospective Study to Compare Outcomes in 159 Patients Undergoing First Autologous Stem Cell Transplantation for Myeloma Treated with Melphalan 140 mg/m² or 200 mg/m².","authors":"Umut Yılmaz, Şükran Erdem Nurcan, Deniz Özmen, Ayşe Salihoğlu, Ahmet Emre Eşkazan, Şeniz Öngören, Zafer Başlar, Teoman Soysal, Muhlis Cem Ar, Tuğrul Elverdi","doi":"10.12659/AOT.947186","DOIUrl":"10.12659/AOT.947186","url":null,"abstract":"BACKGROUND The standard conditioning regimen for autologous stem cell transplantation (ASCT) in multiple myeloma (MM) is 200 mg/m² of melphalan (Mel200). Dosing is reduced by 30% (Mel140) in frail patients. Studies comparing the performance of these regimens report inconsistent findings, mainly confounded by non-consecutive patient inclusion, missing data, and heterogenous practices. The largest study reported an increased risk of death with Mel200 among patients with very good partial remission, or better, before ASCT. This retrospective study from a single center compared outcomes of patients with a first ASCT for myeloma treated with melphalan 140 mg/m² or 200 mg/m². MATERIAL AND METHODS This was a retrospective real-world analysis from a single center. Data from 159 consecutive, first, single ASCTs for MM between 2012 and 2021 were included. Mel200 and Mel140 were administered to 131 and 28 patients, respectively. Primary and secondary objectives were overall survival (OS) and progression-free survival (PFS), respectively. RESULTS Median follow-up was 5.8 years. Over 90% received bortezomib-based induction, and over 76% achieved at least very good partial remission (VGPR) before ASCT in either group. PFS estimates were similar between groups (P=0.49). OS was longer with Mel200 (HR=0.42, P=0.002). Mel200 maintained OS superiority in all relevant subgroups. CONCLUSIONS In a homogenous population of patients with MM, Mel200 was associated with longer OS, likely reflecting the physiological state of patients and tolerance to subsequent treatments. Concerns reported from EBMT data regarding the association of Mel200 with mortality among patients with VGPR or better before ASCT are not supported by this study's findings.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e947186"},"PeriodicalIF":1.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389775","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}

引用次数: 0

Medication Adherence Among Pediatric Post-Heart Transplant Patients in a Tertiary Care Hospital.

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-02-04 DOI: 10.12659/AOT.946905

Khawla Kahtani, Maha Al Ammari, Meshary Almeshary, Seena Thomas

{"title":"Medication Adherence Among Pediatric Post-Heart Transplant Patients in a Tertiary Care Hospital.","authors":"Khawla Kahtani, Maha Al Ammari, Meshary Almeshary, Seena Thomas","doi":"10.12659/AOT.946905","DOIUrl":"10.12659/AOT.946905","url":null,"abstract":"BACKGROUND The present study assessed medication adherence to immunosuppressive therapy in pediatric patients following heart transplantation at a tertiary care center. MATERIAL AND METHODS A cross-sectional interview-based study combined with immunosuppressant level monitoring was conducted to encompass all pediatric patients who underwent heart transplants at King Abdulaziz Medical City-Central Region over a period of 5 months from January to May 2024. RESULTS More than 95% of patients' parents completed the questionnaire and were included in the final analysis. Among the pediatric post-heart transplant patients, 12 (60%) were males, aged from 6 to 18 years. Most patients (85%) were on tacrolimus, while 15% were on tacrolimus and sirolimus. Using the average blood serum drug levels and the ITAS, the prevalence of non-adherence was found to be 10% and 5%, respectively. Almost 95% of parents reported that they \"Never forget about taking immunosuppressive medication\". However, a small percentage reported occasional carelessness and missing administration of immunosuppressive medication to their children (5%). One reason given for stopping or missing medication were due to the child feeling worse in overall health (5%). CONCLUSIONS The results of this study indicate generally good adherence among pediatric post-heart transplant patients. Most participants demonstrated acceptable adherence behaviors. Continuous monitoring, support, and education are still necessary to maintain optimal adherence.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946905"},"PeriodicalIF":1.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121992","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}

引用次数: 0

Survival Analysis of Liver Transplants in Patients with Acute Liver Failure from Acetaminophen and Mushroom Toxicity.

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-01-28 DOI: 10.12659/AOT.946485

Emilia Kruk, Maciej Krasnodębski, Paweł Rykowski, Wojciech Figiel, Wacław Hołówko, Joanna Raszeja-Wyszomirska, Michał Grąt

{"title":"Survival Analysis of Liver Transplants in Patients with Acute Liver Failure from Acetaminophen and Mushroom Toxicity.","authors":"Emilia Kruk, Maciej Krasnodębski, Paweł Rykowski, Wojciech Figiel, Wacław Hołówko, Joanna Raszeja-Wyszomirska, Michał Grąt","doi":"10.12659/AOT.946485","DOIUrl":"10.12659/AOT.946485","url":null,"abstract":"BACKGROUND Acute liver failure (ALF) remains a critical concern, accounting for about 8% of all liver transplants, with acetaminophen overdose contributing to nearly half of these cases. Besides synthetic toxins, natural toxins such as phallotoxin from Amanita phalloides mushrooms also lead to severe hepatocyte damage. This study investigates the outcomes of liver transplantation (LT) as a life-saving intervention in patients suffering from ALF due to acetaminophen and Amanita phalloides poisoning. MATERIAL AND METHODS We conducted a retrospective analysis of 39 patients who underwent LT for ALF induced by acetaminophen (n=18) or A. phalloides (n=21) poisoning at the Medical University of Warsaw. Various statistical analyses, including logistic regression, Mann-Whitney-U, and chi-squared tests, were employed. Survival rates were determined using Kaplan-Meier analysis. RESULTS The cohort included 24 females and 15 males, with a median age of 41. The 90-day mortality rate was 22.2% for acetaminophen poisoning and 38.1% for A. phalloides poisoning (P=0.284), with an estimated 5-year survival rate of 59.6%. Key factors associated with increased 90-day mortality included the number of red blood cells transfused (OR 1.574 per unit; P=0.011), fresh frozen plasma units (OR 1.346 per unit; P=0.003), acute kidney failure requiring hemodialysis (OR 13.50; P=0.021), and days from listing to LT (OR 2.289 per day; P=0.013). CONCLUSIONS Liver transplantation for ALF, though inherently high-risk, offers substantial survival benefits. Outcomes are largely influenced by the patient's condition at the time of transplant, organ availability, and intraoperative management. Despite significant mortality risks, LT remains a crucial intervention for ALF due to acetaminophen and Amanita phalloides toxicity.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946485"},"PeriodicalIF":1.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051396","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}

引用次数: 0

A New Routine Immunity Score (RIS2020) to Predict Severe Infection in Solid-Organ Transplant Recipients. 预测实体器官移植受者严重感染的新常规免疫评分（RIS2020）

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-01-21 DOI: 10.12659/AOT.946233

Elizabeth Sarmiento, Ikram Ezzahouri, Maricela Jimenez-Lopez, Kristofer M Limay Carré, Rocio Alonso, Carlos Ortiz-Bautista, Magdalena Salcedo Plaza, Maria Luisa Rodríguez-Ferrero, Pedro Martin Padilla-Machaca, Ana Cerron, Jose Carlos Chaman, Ana P Vionnet Salvo, Javier Carbone

{"title":"A New Routine Immunity Score (RIS2020) to Predict Severe Infection in Solid-Organ Transplant Recipients.","authors":"Elizabeth Sarmiento, Ikram Ezzahouri, Maricela Jimenez-Lopez, Kristofer M Limay Carré, Rocio Alonso, Carlos Ortiz-Bautista, Magdalena Salcedo Plaza, Maria Luisa Rodríguez-Ferrero, Pedro Martin Padilla-Machaca, Ana Cerron, Jose Carlos Chaman, Ana P Vionnet Salvo, Javier Carbone","doi":"10.12659/AOT.946233","DOIUrl":"10.12659/AOT.946233","url":null,"abstract":"BACKGROUND Infection is a cause of morbidity and mortality in solid-organ transplantation (SOT). We evaluated a new score that is applied during the first month after transplantation. The score comprises biomarkers of innate and acquired immunity to predict infections in SOT. MATERIAL AND METHODS Prospectively collected blood samples from 377 heart, liver, or kidney recipients were analyzed at 2 centers in Madrid (Spain) and Lima (Peru). Biomarkers were tested before transplantation and at days 7 and 30 after transplantation. During the first 6 months after transplantation, 183 (48.5%) patients developed severe infections (bacterial infections and/or CMV disease). Risk for severe infection was assessed using logistic regression analysis. We designed a score, the routine immunity score (RIS2020), which is based on the sum of the hazard ratios (HRs) of each biomarker. RESULTS The risk factors for severe infection were as follows: Moderate IgG hypogammaglobulinemia (IgG <600 mg/dL at days 7 or 30, HR 2.07, 95% CI 1.37-3.12, p=0.0005, 2 points), CD4 <400 cells/uL at day 30 (HR 1.76, 95% CI 1.03-3.04, p=0.039, 2 points), C3 <80 mg/dL at day 30 (HR 2.18, 95%CI 1.16-4.06, p=0.014, 2 points), and CRP >3 mg/dL at day 30 (HR 2.11, 95% CI 1.12-3.97, p=0.02, 2 points). In patients with ≥4 points, the HR for infection was 5.18 (95% CI 3.06-8.75; p<0.001). RIS2020 was an independent predictor of severe infection in multivariate models. CONCLUSIONS An immunological score combining moderate IgG hypogammaglobulinemia and other parameters of innate and acquired immunity could better identify the risk for severe infection in SOT.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946233"},"PeriodicalIF":1.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998752","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}

引用次数: 0

Living Donor Liver Transplantation with Small Left Lobe Grafts: Prospective Validation of Utility of Splenectomy in Selected Recipients. 活体供体肝移植与小左叶移植物：脾切除术在选定受者中的有效性的前瞻性验证。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-01-14 DOI: 10.12659/AOT.946374

Hajime Matsushima, Akihiko Soyama, Takanobu Hara, Takashi Hamada, Yuta Kawaguchi, Kazushige Migita, Ayaka Satoh, Yamashita Mampei, Hajime Imamura, Ayaka Kinoshita, Tomohiko Adachi, Susumu Eguchi

{"title":"Living Donor Liver Transplantation with Small Left Lobe Grafts: Prospective Validation of Utility of Splenectomy in Selected Recipients.","authors":"Hajime Matsushima, Akihiko Soyama, Takanobu Hara, Takashi Hamada, Yuta Kawaguchi, Kazushige Migita, Ayaka Satoh, Yamashita Mampei, Hajime Imamura, Ayaka Kinoshita, Tomohiko Adachi, Susumu Eguchi","doi":"10.12659/AOT.946374","DOIUrl":"10.12659/AOT.946374","url":null,"abstract":"BACKGROUND We previously reported that the Model for End-stage Liver Disease (MELD) score and donor age are risk factors for small-for-size syndrome in adult living donor liver transplantation (LDLT) involving small grafts. Since April 2021, we have performed splenectomy as a portal inflow modulation in LDLT using small grafts according to the presence of risk factors. In this study, we evaluated the validity of our splenectomy strategies for optimizing graft outcomes. MATERIAL AND METHODS We retrospectively reviewed patients who underwent primary LDLT using left lobe grafts with the middle hepatic vein from January 2005 to January 2024 at our institution. We also compared the graft outcomes between recipients who underwent LDLT beginning in April 2021 (current policy group) and those who underwent LDLT in the era when splenectomy as portal modulation was not indicated (previous policy group). RESULTS In total, 173 consecutive LDLTs (current policy group: n=15) involving left lobe grafts were analyzed. Splenectomy was performed in 9 of 15 (60.0%) patients in the current policy group. All 15 patients in the current policy group remained alive for a median follow-up of 20.5 months. The rate of early allograft dysfunction was significantly lower, and the rate of small-for-size syndrome tended to be lower in the current policy group than in the previous policy group (13.3% vs 39.2%, P=0.047 and 20.0% vs 36.1%, P=0.211, respectively). CONCLUSIONS LDLT with splenectomy for high-risk patients may expand the availability of small left lobe grafts and optimize graft outcomes.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946374"},"PeriodicalIF":1.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977226","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}

引用次数: 0

Arterial Reconstruction Using the Right Gastroepiploic Artery in Living Donor Liver Transplantation: A Single-Center Experience. 活体肝移植中使用右胃网膜动脉重建动脉：单中心经验。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2025-01-07 DOI: 10.12659/AOT.946135

Takanobu Hara, Akihiko Soyama, Hajime Matsushima, Takashi Hamada, Ayaka Kinoshita, Hajime Imamura, Mampei Yamashita, Ayaka Satoh, Kazushige Migita, Yuta Kawaguchi, Tomohiko Adachi, Mitsuhisa Takatsuki, Susumu Eguchi

{"title":"Arterial Reconstruction Using the Right Gastroepiploic Artery in Living Donor Liver Transplantation: A Single-Center Experience.","authors":"Takanobu Hara, Akihiko Soyama, Hajime Matsushima, Takashi Hamada, Ayaka Kinoshita, Hajime Imamura, Mampei Yamashita, Ayaka Satoh, Kazushige Migita, Yuta Kawaguchi, Tomohiko Adachi, Mitsuhisa Takatsuki, Susumu Eguchi","doi":"10.12659/AOT.946135","DOIUrl":"10.12659/AOT.946135","url":null,"abstract":"BACKGROUND Recipient hepatic arteries are generally used for arterial reconstructions in living donor liver transplantation. When the hepatic arteries are not feasible, the right gastroepiploic artery is one of the options for arterial reconstructions. In this study, we evaluate the feasibility of using the right gastroepiploic artery and report the analyzed retrospective patient outcomes. MATERIAL AND METHODS We included 324 patients who underwent primary living donor liver transplantation between August 1997 and December 2023. The rates of complications and surgical outcomes for different arteries used for reconstruction were compared between the groups. RESULTS For primary arterial reconstruction, the right gastroepiploic artery was used in 18 patients. The incidence of arterial complications and biliary strictures was higher than in the remaining 306 patients (P=0.01 and P=0.21, respectively). The 1-year and 5-year graft survival rates were 83.3% and 77.8% in the right gastroepiploic artery group, and 83.7% and 70.1% in the hepatic artery group, respectively (P=0.58). Eleven patients underwent arterial re-reconstruction secondary to arterial complications. The right gastroepiploic artery was used for the first time in 7 of these patients because the hepatic arteries were not reusable. Arterial complications after arterial re-reconstruction occurred in 4 patients (36.4%). CONCLUSIONS Arterial reconstruction using the right gastroepiploic artery was an effective option when the hepatic arteries were not suitable options, as it offered graft outcomes comparable to those of hepatic artery reconstruction, despite an increased risk of arterial and biliary complications.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e946135"},"PeriodicalIF":1.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963566","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}

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