Annals of Transplantation最新文献

{"title":"The Role of Cavoportal and Renoportal Hemitransposition in Liver Transplantation","authors":"Betty Maillot, G. Bouzillé, J. Mabrut, E. Girard, A. Laurent, F. Navarro, A. Chebaro, L. Chiche, F. Faitot, L. Sulpice, E. Vibert, K. Boudjema","doi":"10.12659/AOT.935892","DOIUrl":"https://doi.org/10.12659/AOT.935892","url":null,"abstract":"Background Few series of cavoportal (CPA) or renoportal (RPA) anastomosis have been published and their survival rates have never been compared. The objective of this study was to evaluate perioperative and long-term outcomes of CPA and RPA in a nationwide multicentric series and to compare hemitranspositions (HT) to paired orthotopic liver transplantations (OLT). Material/Methods HT performed in France up to April 2019 were analyzed. Endpoints were the incidence of severe (Clavien-Dindo>IIIa) 90-day perioperative complications and long-term patient and graft survival. Results Sixty-four HT (13 CPA, 51 RPA) were performed in 59 patients. The rates of perioperative CD>IIIa complications were 64% and 49% in patients with CPA and RPA, respectively (P=0.59), and the rates of portal thrombosis and ascites were 38.5% and 9.8% (p=0.023) and 53.8% and 21.6% (p=0.049) in patients with CPA and RPA, respectively. The patient and graft perioperative survival rates were 54.4% and 83.3% (HR=3.2; CI 95 [1.1–9.9]; p=0.039) and 54.4% and 77.1% (HR=2.2; CI 95 [0.77–6.4]; P=0.14) in the CPA and RPA groups, respectively. Five-year patient survival was 36.4% and 61.8% in the CPA and RPA groups, respectively (HR=2.5; CI 95 [1–6.1]; P=0.039). Compared with OLT grafts, long-term HT graft survival rates were not different (HR=1.7; CI 95 [0.96–3.1]; P=0.066), while patient survival rates were lower in the HT group (HR=4.6; CI 95 [2–11]; P<0.001). Conclusions Compared to OLT, HT significantly reduces patient survival. Given the poor survival results of CPA, the indication deserves to be limited in the context of organ shortage and RPA should be preferred when HT is needed.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"27 1","pages":"e935892-1 - e935892-14"},"PeriodicalIF":1.1,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48509271","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":"Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.","authors":"Manjunatha T A, Rebecca Chng, Wai-Ping Yau","doi":"10.12659/AOT.933588","DOIUrl":"10.12659/AOT.933588","url":null,"abstract":"<p><p>BACKGROUND Tacrolimus is an established component of immunosuppressive regimens for kidney transplant recipients (KTRs); however, data comparing long-term outcomes between formulations are lacking. We conducted a systematic literature review and network meta-analysis assessing tacrolimus (primarily Advagraf [once-daily] and Prograf [twice-daily])-based maintenance regimens. MATERIAL AND METHODS Embase, MEDLINE, and Cochrane databases and congress proceedings were searched to identify studies of adult de novo KTRs who received tacrolimus-based therapy in phase II/III randomized controlled trials. Outcomes were acute rejection, graft/patient survival, and incidence of new-onset diabetes mellitus after transplantation (NODAT) and cytomegalovirus (CMV) infection. Bayesian network meta-analysis was used to analyze treatment effects on graft/patient survival. RESULTS Sixty-eight publications (61 primary) were included. Of 21 publications reporting graft rejection following Advagraf or Prograf treatment in ≥1 study arm, 12-month biopsy-proven acute rejection (BPAR) ranged from 3.3% with Prograf to 55.0% with mycophenolic acid (MPA)+corticosteroids (CS); >24 month BPAR ranged from 0% to 58.7% (the latter with bleselumab-based therapy). Fourteen publications reported graft loss following Advagraf (0-9.6%) or Prograf (0-7.5%). Patient mortality ≤24 months after transplantation (14 publications) ranged from 0% to 8.1% with Advagraf or Prograf. Advagraf+MPA+CS and reference treatment, Prograf+MPA+CS, were associated with a similar risk of graft loss (odds ratio 1.19; 95% credible-interval 0.51, 3.06) and mortality (odds ratio 1.21; 95% credible-interval 0.1557, 9.03). Incidence of NODAT and CMV varied by treatment arm. CONCLUSIONS Graft loss and patient mortality rates were generally comparable between Advagraf- and Prograf-based regimens. Further prospective studies are needed to evaluate longer-term outcomes.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e933588"},"PeriodicalIF":1.1,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/2b/anntransplant-26-e933588.PMC8721964.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882684","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":"Comparison of Coronary Artery Calcium Scoring with Dobutamine Stress Echo for Detection of Coronary Artery Disease Before Liver Transplantation.","authors":"Cerise Kleb, Vardhmaan Jain, Chirag Sheth, Kathy Wolski, Samir Kapadia, Richard Grimm, Milind Desai, Amar Krishnaswamy, Nicholas Kassis, Calvin Sheng, Huili Zheng, Jacek Cywinski, K V Narayanan Menon, Bijan Eghtesad, Teresa Diago Uso, Cristiano Quintini, Paul Schoenhagen, Serge C Harb, Vikram Sharma, Maan Fares","doi":"10.12659/AOT.934163","DOIUrl":"10.12659/AOT.934163","url":null,"abstract":"<p><p>BACKGROUND Dobutamine stress echocardiography (DSE) is commonly used for cardiovascular assessment before orthotopic liver transplantation (OLT). The coronary artery calcium score (CACS) is a useful screening tool for coronary artery disease (CAD). We aimed to compare the sensitivity and specificity of DSE and CACS for CAD in OLT candidates. MATERIAL AND METHODS A total of 265 of the 1589 patients who underwent OLT at our center between 2008 and 2019 had preoperative coronary angiography (CAG). Of these, 173 had DSE and 133 had a CT scan suitable for CACS calculation within 1 year of OLT. Patients with a nondiagnostic DSE were excluded (n=100). Two reviewers evaluated CACS on CT scans. The sensitivity/specificity of DSE and CACS for detection of angiographically significant CAD were calculated for patients with both tests (n=36). A separate analysis compared the sensitivity/specificity of a diagnostic DSE (n=73) and CACS (n=133) against CAG for all patients with either test. RESULTS Sensitivity and specificity were 57.1% and 89.7%, respectively, for DSE, compared with 71.4% and 62.1% for CACS at ≥100 Agatston score. For the analysis of all patients with either test, the sensitivity/specificity of DSE for detection of CAD and CACS were 30.8% and 85.0% and 80.0% and 62.8%, respectively. On ROC analysis, CACS was a satisfactory predictor of obstructive CAD (AUC, 0.76±0.06, 95% CI, 0.66-0.87; P<0.001). CONCLUSIONS CACS may be an important tool for cardiovascular assessment in patients undergoing OLT. DSE was nondiagnostic in a large percentage of OLT candidates, limiting its use in this population.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e934163"},"PeriodicalIF":1.1,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/97/anntransplant-26-e934163.PMC8711211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39745117","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":"Rex Shunt for Portal Vein Thrombosis After Pediatric Living Donor Liver Transplantation.","authors":"Yuji Soejima, Tomoaki Taguchi, Toshiharu Matsuura, Makoto Hayashida, Toru Ikegami, Tomoharu Yoshizumi, Yoshihiko Maehara","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND Portal vein thrombosis (PVT) after pediatric liver transplantation (LT) is a common but grave complication which could eventually result in life-threatening portal hypertension. A \"Rex\" shunt between the superior mesenteric vein and the Rex recess of the liver has been reported to be a treatment option for extrahepatic portal vein obstruction; however, its application to living donor liver transplantation (LDLT) is limited due to the availability of appropriate vein grafts. In this study, we retrospectively evaluated the effectiveness of Rex shunt as an option for the treatment of PVT after pediatric LDLT. CASE REPORT Three children underwent the Rex shunt for early (n=2) and late (n=1) PVT after LDLT using the greater saphenous vein (n=2) and the external iliac vein (n=1) from the parents who previously donated their livers. Two of the 3 children are free from symptoms with patent shunt grafts at 14 years after the procedures. One child died at 30 days after LDLT due to repeated episodes of PVT, which finally led to hepatic infarction. CONCLUSIONS The Rex shunt is feasible to treat PVT after LDLT. However, additional surgical insults to the living donor need further discussion.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e909493"},"PeriodicalIF":1.1,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8690054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39725930","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":"Rex Shunt for Portal Vein Thrombosis After Pediatric Living Donor Liver Transplantation","authors":"Y. Soejima, T. Taguchi, T. Matsuura, M. Hayashida, T. Ikegami, T. Yoshizumi, Y. Maehara","doi":"10.12659/AOT.909493","DOIUrl":"https://doi.org/10.12659/AOT.909493","url":null,"abstract":"Background Portal vein thrombosis (PVT) after pediatric liver transplantation (LT) is a common but grave complication which could eventually result in life-threatening portal hypertension. A “Rex” shunt between the superior mesenteric vein and the Rex recess of the liver has been reported to be a treatment option for extrahepatic portal vein obstruction; however, its application to living donor liver transplantation (LDLT) is limited due to the availability of appropriate vein grafts. In this study, we retrospectively evaluated the effectiveness of Rex shunt as an option for the treatment of PVT after pediatric LDLT. Case Report Three children underwent the Rex shunt for early (n=2) and late (n=1) PVT after LDLT using the greater saphenous vein (n=2) and the external iliac vein (n=1) from the parents who previously donated their livers. Two of the 3 children are free from symptoms with patent shunt grafts at 14 years after the procedures. One child died at 30 days after LDLT due to repeated episodes of PVT, which finally led to hepatic infarction. Conclusions The Rex shunt is feasible to treat PVT after LDLT. However, additional surgical insults to the living donor need further discussion.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 1","pages":"e909493-1 - e909493-6"},"PeriodicalIF":1.1,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45826577","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":"Solid-Phase C1q/C3d Fixing Readouts Correlate with High Median Fluorescence Intensity (MFI) De Novo Donor-Specific HLA Antibodies and C4d⁺ Antibody-Mediated Rejection in Kidney Transplant Recipients.","authors":"Vasishta S Tatapudi,&nbsp;Dessislava Kopchaliiska,&nbsp;Gilberto J da Gente,&nbsp;Owen F Buenaventura,&nbsp;Manpreet Singh,&nbsp;Zoltan Laszik,&nbsp;Deborah B Adey,&nbsp;Raja Rajalingam","doi":"10.12659/AOT.934175","DOIUrl":"https://doi.org/10.12659/AOT.934175","url":null,"abstract":"<p><p>BACKGROUND Solid-phase assays to investigate the complement-activating capacity of HLA antibodies have been utilized to optimize organ allocation and improve transplant outcomes. The clinical utility of C1q/C3d-binding characteristics of de novo donor-specific anti-HLA antibodies (dnDSA) associated with C4d-positive antibody-mediated rejection (C4d⁺ AMR) in kidney transplants (KTx) has not been defined. MATERIAL AND METHODS Sera from 120 KTx recipients that had dnDSA concurrent with protocol/cause biopsy (median 3.8 years after transplantation) were screened for C1q and C3d-binding dnDSA. The difference in the incidence of C4d⁺ AMR between recipients with and without C1q/C3d-binding dnDSA was assessed. RESULTS Over 86% of dnDSAs were class II antibodies. The immunodominant dnDSAs characterized by the highest median fluorescence intensity (MFI) in most recipients were HLA-DQ antibodies (67%). Most recipients (62%, n=74) had either C1q⁺ (56%), C3d⁺ (48%), or both C1q⁺C3d⁺ (41.2%) dnDSA, while the remaining 38% were negative for both C1q and C3d. Of those with C1q⁺/C3d⁺ dnDSA, 87% had high-MFI IgG (MFI=14144±5363 and 13932±5278, respectively), while 65% of C1q⁻C3d⁻ dnDSA had low-MFI IgG (MFI=5970±3347). The incidence of C4d+ AMR was significantly higher in recipients with C1q⁺ (66%), C3d+ (74%), and C1q⁺C3d⁺ (72%) dnDSA than in those with C1q⁻C3d⁻ dnDSA (30%) recipients. Recipients with C3d⁺/C1q⁺ dnDSA had higher C4d⁺ scores on biopsy. CONCLUSIONS C1q⁺/C3d⁺ dnDSA were associated with C4d⁺ AMR and high-IgG MFI. Our data call into question the predictive utility of C1q/C3d-binding assays in identifying KTx recipients at risk of allograft failure. In conclusion, IgG MFI is sufficient for clinical management, and the C1q/C3d-assays with added cost do not provide any additional information.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e934175"},"PeriodicalIF":1.1,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/7f/anntransplant-26-e934175.PMC8647455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39680299","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":"Validation of Accuracy of Non-Invasive Imaging Methods (Magnetic Resonance Imaging (MRI) Fat Fraction Calculation and Computed Tomography (CT) Liver Attenuation Index) for Hepatic Graft Fat Quantification in Living Liver Transplant Donors.","authors":"Abhideep Chaudhary,&nbsp;Gaurav Sood,&nbsp;Niteen Kumar,&nbsp;Chandraprakash Chauhan,&nbsp;Dhirendra Pratap Singh Yadav,&nbsp;Vivek Kasana,&nbsp;Raman Arora,&nbsp;Gaurav Gangwani","doi":"10.12659/AOT.933801","DOIUrl":"https://doi.org/10.12659/AOT.933801","url":null,"abstract":"<p><p>BACKGROUND Diagnosis of significant hepatic graft steatosis remains vital for success of any transplant program as it has an impact on donor morbidity and recipient survival. Even histopathological quantification faces limitations. The present study compared the diagnostic accuracy of CT-LAI and MRI fat fraction imaging with histopathological analysis for donor graft parenchymal fat quantification. MATERIAL AND METHODS CT-LAI and MR-FF values and histopathological fat quantification results of 273 patients were identified from electronic records of the author's institutes from September 2015 to April 2020. Data analysis was done using SPSS version 21.0. RESULTS Most participants were young with nearly equal sex distribution and significant number of overweight and obese patients. Moderate agreement and significant positive correlation were found between MR fat fraction (%) and biopsy-macrosteatosis (%). Diagnostic accuracy and negative predictive value of MRI for fat fraction calculation was high (95.24% and 98.07% for fat fraction of 10% threshold, respectively), and it further improved for fat fraction threshold of 15%. CONCLUSIONS MRI-based fat quantification calculation displayed near-perfect negative predictive values and very high diagnostic accuracy, suggesting that it can obviate the need for biopsy in patients with graft fat percentage <10% on MRI.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e933801"},"PeriodicalIF":1.1,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/60/anntransplant-26-e933801.PMC8630986.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39748661","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":"The Future Direction of the Organ Donation System After Legislation of the Life-Sustaining Treatment Decision Act.","authors":"Seung Min Baik,&nbsp;Jin Park,&nbsp;Tae Yoon Kim,&nbsp;Jung Hwa Lee,&nbsp;Kyung Sook Hong","doi":"10.12659/AOT.934345","DOIUrl":"https://doi.org/10.12659/AOT.934345","url":null,"abstract":"Background The transplant community is seeking ways to encourage organ donation after cardiac arrest to solve the problem of the insufficiency of organs available for the increasing number of people awaiting transplantation. This study aimed to determine whether the life-sustaining treatment (LST) decision system, implemented in Korea on February 4, 2018, can address the shortage of organ donations. Material/Methods We retrospectively analyzed the medical records of the 442 patients who had filled out forms for the LST decision at Ewha Womans University Mokdong Hospital from April 2018 to December 2019, and classified the eligibility of organ and tissue donation according to the Korean Organ Donation Agency criteria. Results We included 442 patients in this study. Among them, 238 (53.8%) were men, and 204 (46.2%) were women. The average age of the patients was 71.8 years (the youngest and oldest were aged 23 years and 103 years, respectively). Of these, 110 patients (24.9%) decided on their own to discontinue LST, whereas 332 (75.1%) decided to discontinue with their family’s consent. This study demonstrated that 50% of patients who were not brain-dead and discontinued LST were eligible for organ donation. However, the patients and caregivers were not aware of this option because the current law does not allow the discussion of such donations. Conclusions A discussion regarding donation after circulatory death is recommended to solve the problem of insufficient organ donation.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e934345"},"PeriodicalIF":1.1,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/dd/anntransplant-26-e934345.PMC8626983.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39738324","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":"Diagnostic Utility of Presepsin in Infections After Liver Transplantation: A Preliminary Study.","authors":"Takahiro Yokose,&nbsp;Masashi Takeuchi,&nbsp;Hideaki Obara,&nbsp;Masahiro Shinoda,&nbsp;Hirofumi Kawakubo,&nbsp;Minoru Kitago,&nbsp;Hiroshi Yagi,&nbsp;Yuta Abe,&nbsp;Yohei Yamada,&nbsp;Kentaro Matsubara,&nbsp;Go Oshima,&nbsp;Shutaro Hori,&nbsp;Takumi Fujimura,&nbsp;Ryo Takemura,&nbsp;Ryota Ishii,&nbsp;Tatsuo Kuroda,&nbsp;Yuko Kitagawa","doi":"10.12659/AOT.933774","DOIUrl":"https://doi.org/10.12659/AOT.933774","url":null,"abstract":"<p><p>BACKGROUND Infectious complications after solid organ transplantation can be fatal, and early diagnosis and intervention are important. To the best of our knowledge, no study has examined the diagnostic utility of presepsin, a known accurate biomarker, for infectious complications after liver transplantation. This study aimed to evaluate the utility of presepsin for detecting infection and perioperative kinetics of presepsin after liver transplantation. MATERIAL AND METHODS This single-institutional prospective, observational study included 13 patients who underwent living-donor or deceased-donor liver transplantation. Perioperative serum presepsin level was measured 6 times within a week to evaluate its association with infectious complications and compare it with procalcitonin and C-reactive protein levels and leukocyte count. Postoperatively, patients were followed up for 15 days for infectious complications. RESULTS Five of the 13 patients developed infectious complications after liver transplantation. The median time for infection diagnosis was 9 postoperative days (25th-75th percentile, 7-10). Presepsin levels on 5 and 7 postoperative days were significantly higher in patients with infection than in those without (P=0.019 and P=0.011, respectively). In receiver operating characteristic analysis, area under the curve values of presepsin on 5 and 7 postoperative days (0.881 and 0.905, respectively) were higher than those of other biomarkers. The optimal cut-off value of presepsin was 1361 pg/mL on postoperative day 5 and 1375 pg/mL on postoperative day 7. CONCLUSIONS Although this study included a small number of patients, presepsin levels on postoperative days 5 and 7 may be useful indicators for infectious complications after liver transplantation.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e933774"},"PeriodicalIF":1.1,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/0f/anntransplant-26-e933774.PMC8609769.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39890223","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":"Coronavirus Disease 2019 (COVID-19) in Solid Organ Transplant Recipients: A Case-Control Study.","authors":"Alejandro Muñoz Serrano,&nbsp;Ana Arias,&nbsp;Víctor Moreno-Torres,&nbsp;Jorge Calderón,&nbsp;Natalia Vicente,&nbsp;Valentín Cuervas-Mons","doi":"10.12659/AOT.933152","DOIUrl":"https://doi.org/10.12659/AOT.933152","url":null,"abstract":"<p><p>BACKGROUND It is unclear whether solid organ transplant (SOT) patients have more severe coronavirus disease 2019 (COVID-19) and worse outcome than the general population. MATERIAL AND METHODS We conducted a case-control study on 32 SOT recipients and 84 non-SOT controls matched for age and sex admitted for confirmed COVID-19. The primary endpoint was in-hospital all-cause mortality rate. Secondary endpoints included severe acute respiratory distress syndrome (ARDS), use of high-flow oxygen therapy, and length of hospital stay. RESULTS The median (IQR) Charlson comorbidity index (CCI) at admission was significantly higher in SOT recipients (6 (3-8) vs 3 (2-4); P<0.01). Fever was less frequent in SOT recipients (78% vs 94%, P=0.01). SOT recipients had a higher median SaO2/FiO2 at admission (452 [443-462] vs 443 [419-452], P<0.01) and reached the worst SaO2/FiO2 value later during hospitalization 15 (10-21) vs 11 (9-14) days, P=0.01). Both groups had a similar severe ARDS rate during hospitalization (33% vs 28%) (p=0.59). There were no significant differences during hospitalization in terms of highest level of respiratory support needed, or length of hospital stay: 8.5 (5.5-21) vs 11.5 (6.5-16.5) days; P=0.34) in SOT recipients when compared to controls. In-hospital all-cause mortality rates were significantly higher in SOT recipients (21.9% vs 4.7%, P<0.01; OR 1.08; 95% CI 0.10-10.98), but among patients who died, median CCI was similar between groups (8 [6-8] vs 7 [6-8]). CONCLUSIONS In our experience, hospitalized SOT recipients for COVID-19 had higher in-hospital mortality compared to non-SOT patients, probably due to the greater number of underlying comorbidities, and not directly related to chronic immunosuppression.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"26 ","pages":"e933152"},"PeriodicalIF":1.1,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/ff/anntransplant-26-e933152.PMC8594113.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39612599","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}