Annals of Transplantation最新文献

{"title":"Changes in Physical Activity Due to Fear of COVID-19 and Its Impact on Depression Among Post-Liver Transplant Patients in Japan: A Longitudinal Survey Study.","authors":"Satomi Tanaka,&nbsp;Kimie Fujita,&nbsp;Kanako Yakushiji,&nbsp;Noboru Harada,&nbsp;Tomoharu Yoshizumi","doi":"10.12659/AOT.938239","DOIUrl":"https://doi.org/10.12659/AOT.938239","url":null,"abstract":"<p><p>BACKGROUND Regular physical activity (PA) is important for maintaining mental and physical health after liver transplantation (LT); however, the fluctuations in routine PA during COVID-19 and its putative impacts are currently unknown. This study examined the changes in PA during the COVID-19 pandemic and explored its association with fear and depression during the pandemic. MATERIAL AND METHODS This longitudinal study included 83 LT patients whose PA was measured using the short form of the International Physical Activity Questionnaire before and during COVID-19. Fear of COVID-19 was estimated based on previous studies, and depression was assessed using the Patient Health Questionnaire-9. Participants were also asked about important sources of information on COVID-19. PA was classified as inactive or active depending on the changes in PA, and logistic regression analyses with PA as a dependent variable were conducted to explore the associations among PA, depression, and fear of COVID-19. RESULTS Moderate and high PA exhibited decreasing trends before and during the COVID-19 pandemic, especially in males. Fear of being infected with SARS-CoV-2, the virus that causes COVID-19, while shopping was significantly higher in females and was significantly independent of inactivity during the COVID-19 pandemic. Only 1 patient reported that their transplant center was their main source of information about COVID-19. Only 4.9% of the LT participants were depressed. CONCLUSIONS Our study results indicate the need to support the provision of accurate information about COVID-19 by health care professionals in transplant centers, especially for patients with low PA, to prevent PA decline in LT patients.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/f6/anntransplant-27-e938239.PMC9737614.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10390459","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":"Pure Laparoscopic Versus Open Right Hepatectomy in Living Liver Donors: Graft Weight Discrepancy.","authors":"Jiwon Seo,&nbsp;Suk Kyun Hong,&nbsp;Sola Lee,&nbsp;Su Young Hong,&nbsp;YoungRok Choi,&nbsp;Nam-Joon Yi,&nbsp;Kwang-Woong Lee,&nbsp;Kyung-Suk Suh","doi":"10.12659/AOT.938274","DOIUrl":"https://doi.org/10.12659/AOT.938274","url":null,"abstract":"<p><p>BACKGROUND Accurate volumetric evaluation of donors' livers before surgery is crucial for successful living-donor liver transplantation. However, there are few studies on the volumetric evaluation in the recently popularized pure laparoscopic donor hepatectomy method, in contrast to the number of studies for conventional donor hepatectomy. We aimed to analyze the difference between estimated graft weight and actual graft weight in pure laparoscopic donor right hepatectomy (PLDRH) and conventional donor right hepatectomy (CDRH) procedures. MATERIAL AND METHODS The medical records of 612 donors who underwent right hepatectomy in living-donor liver transplantation between January 2014 and December 2020 were retrospectively reviewed. The CDRH group targeted patients from January 2014 to October 2015, and the PLDRH group targeted patients from March 2016 to December 2020. RESULTS There were 119 and 376 donors who underwent CDRH and PLDRH, respectively. Although there was no significant difference in the estimated graft weights (P=0.994) and actual graft weights (P=0.489) between the groups, the estimated graft weights were significantly higher than the actual graft weights in both groups. However, the estimated graft weight and actual graft weight showed linear correlations in both the CDRH (r=0.81, P<0.001) and PLDRH (r=0.76, P<0.001) groups, with the CDRH group having greater linearity. CONCLUSIONS The estimates of graft weight were similar between the 2 groups. However, since the actual graft weight tended to be smaller in the PLDRH group, this should be considered before surgery.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/a6/anntransplant-27-e938274.PMC9724455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10403313","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":"Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipients with Hepatocellular Carcinoma.","authors":"Gonzalo Sapisochin,&nbsp;Wei Chen Lee,&nbsp;Dong Jin Joo,&nbsp;Jae-Won Joh,&nbsp;Koichiro Hata,&nbsp;Arvinder Singh Soin,&nbsp;Uday Kiran Veldandi,&nbsp;Shuhei Kaneko,&nbsp;Matthias Meier,&nbsp;Denise Leclair,&nbsp;Gangadhar Sunkara,&nbsp;Long Bin Jeng","doi":"10.12659/AOT.937988","DOIUrl":"https://doi.org/10.12659/AOT.937988","url":null,"abstract":"<p><p>BACKGROUND The study objective was to evaluate the effect of everolimus (EVR) in combination with reduced tacrolimus (rTAC) compared with a standard TAC (sTAC) regimen on hepatocellular carcinoma (HCC) recurrence in de novo living-donor liver transplantation recipients (LDLTRs) with primary HCC at liver transplantation through 5 years after transplantation. MATERIAL AND METHODS In this multicenter, non-interventional study, LDLTRs with primary HCC, who were previously randomized to either everolimus plus reduced tacrolimus (EVR+rTAC) or standard tacrolimus (sTAC), and who completed the 2-year core H2307 study, were followed up. Data were collected retrospectively (end of core to the start of follow-up study), and prospectively (during the 3-year follow-up study). RESULTS Of 117 LDLTRs with HCC at LT in the core H2307 study (EVR+rTAC, N=56; sTAC, N=61), 86 patients (EVR+rTAC, N=41; sTAC, N=45) entered the follow-up study. Overall HCC recurrence was lower but statistically non-significant in the EVR+rTAC group (3.6% vs 11.5% in sTAC; P=0.136) at 5 years after LT. There was no graft loss or chronic rejection. Acute rejection and death were comparable between treatment groups. Higher mean estimated glomerular filtration rate in the EVR+rTAC group (76.8 vs 65.8 mL/min/1.73 m² in sTAC) was maintained up to 5 years. Reported adverse events were numerically lower in the EVR+rTAC group (41.0% vs 53.5% sTAC) but not statistically significant. CONCLUSIONS Although statistically not significant, early EVR initiation reduced HCC recurrence, with comparable efficacy and safety, and better long-term renal function, than that of sTAC treatment.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/ed/anntransplant-27-e937988.PMC9700399.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10747582","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":"Altered Serum Bile Acid Profile Associated with Chronic Allograft Dysfunction in Kidney Transplant Recipients.","authors":"Yamei Li,&nbsp;Hua Zhang,&nbsp;Xinhua Dai,&nbsp;Yunfei An,&nbsp;Yi Li,&nbsp;Lin Yan,&nbsp;Yunying Shi,&nbsp;Jiwen Fan,&nbsp;Xingxin Gong,&nbsp;Lei Zhang,&nbsp;Yuangao Zou,&nbsp;Lanlan Wang,&nbsp;Yangjuan Bai","doi":"10.12659/AOT.937974","DOIUrl":"https://doi.org/10.12659/AOT.937974","url":null,"abstract":"<p><p>BACKGROUND Chronic allograft dysfunction (CAD) is the leading cause of graft loss among kidney transplant recipients (KTRs). Bile acids (BAs) play an important role in regulating inflammatory process, which is the major contributor to the development of CAD. The aim of this study was to evaluate the association between BAs metabolic dysregulation and CAD in KTRs. MATERIAL AND METHODS Fifteen serum BA species were determined in 43 healthy controls (HCs) and 131 KTRs by UPLC-MS/MS. KTRs were grouped into stable renal function (STA) and CAD1 and CAD2 groups based on eGFR levels. Circulating CYP7A1, CYP7B1, CYP27A1, and SLCO2B1 mRNA levels were determined by RT-PCR. RESULTS Total BA concentrations were comparable among the 4 groups. However, KTRs showed significantly different BAs profiling compared to HCs. KTRs with severe CAD (CAD2) had significantly lower unconjugated BAs and secondary BAs (SBAs) compared to the other 3 groups. KTRs had significantly lower SBAs/primary BAs (PBAs) ratios than HCs, which were comparable among the 3 KTR groups. Conjugated/unconjugated BAs ratios increased significantly with the deterioration of allograft function, which was further confirmed by correlation analysis. Differential correlation network analysis revealed that perturbations in intraclass and interclass BA coregulation existed during CAD progression. Moreover, relative gene expressions of CYP7B1 and CYP27A1 were positively correlated with eGFR. CONCLUSIONS BA species profiling, but not total BA concentrations, was significantly altered in KTRs with CAD. The shifts from unconjugated BAs toward conjugated BAs, SBAs toward PBAs, and distinct pairwise BAs coregulation patterns were the main characteristics of KTRs with CAD.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/a6/anntransplant-27-e937974.PMC9680208.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10369371","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":"Organ Procurement, Donation, and Transplant Awareness in an Urban Eastern European Region: A General Population Survey.","authors":"Alberto Emanuel Bacușcă,&nbsp;Alexandru Burlacu,&nbsp;Grigore Tinică,&nbsp;Mihail Enache,&nbsp;Andrei Ţărus,&nbsp;Cristina Gavriluţă,&nbsp;Crischentian Brinza,&nbsp;Bianca Hanganu,&nbsp;Beatrice Gabriela Ioan","doi":"10.12659/AOT.938016","DOIUrl":"https://doi.org/10.12659/AOT.938016","url":null,"abstract":"<p><p>BACKGROUND Despite significant improvements in Romania's transplantation system, actual donor numbers have paradoxically fallen, contrary to the European trend. With a donation rate of 3.44 donors per million inhabitants, Romania ranks near the bottom of European countries. This study aimed to identify several predictors of a positive attitude toward organ donation in the Romanian population that could aid in reshaping public policies to improve donation and transplantation rates. MATERIAL AND METHODS The study included a representative Iasi population. Data were collected by means of a questionnaire focused on revealing attitudes toward organ donation, importance of consent, willingness to donate a family member's organs, and role of medical staff in the donation decision. A perception score was calculated as a methodological approach to validate attitudes toward organ donation. RESULTS Of all respondents, 55% agreed to donate their organs if declared brain-dead, while 20% opposed this idea; 72.7% considered consent necessary; 70% believed that consent must belong to the family when it comes to brain-dead organ donors; and 44.5% supported the idea of financial compensation. Higher monthly income was correlated with a positive attitude toward organ donation. CONCLUSIONS Even though the study population had a positive attitude toward organ donation, the willingness to donate was lower than in other European countries and did not translate into actual donations. The necessity of informed consent, lack of knowledge on the topic, bureaucratic aspects, and openness to financial compensation could explain the current situation of the Romanian transplantation system.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/fd/anntransplant-27-e938016.PMC9653012.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670651","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":"Revisiting the \"Weekend Effect\" on Adult and Pediatric Liver and Kidney Offer Acceptance.","authors":"Takayuki Yamamoto,&nbsp;Anushi Shah,&nbsp;Mike Fruscione,&nbsp;Shoko Kimura,&nbsp;Nahel Elias,&nbsp;Heidi Yeh,&nbsp;Tatsuo Kawai,&nbsp;James F Markmann","doi":"10.12659/AOT.937825","DOIUrl":"https://doi.org/10.12659/AOT.937825","url":null,"abstract":"<p><p>BACKGROUND Weekends can impose resource and manpower constraints on hospitals. Studies using data from prior allocation schemas showed increased adult organ discards on weekends. We examined the impact of day of the week on adult and pediatric organ acceptance using contemporary data. MATERIAL AND METHODS Retrospective analysis of UNOS-PTR match-run data of all offers for potential kidney and liver transplant from 1/1/2016 to 7/1/2021 were examined to study the rate at which initial offers were declined depending on day of the week. Risk factors for decline were also evaluated. RESULTS Of the total initial adult/pediatric liver and kidney offers, the fewest offers occurred on Mondays and Sundays. The decline rate for adult/pediatric kidneys was highest on Saturdays and lowest on Tuesdays. The decline rate for adult livers was highest on Saturday and lowest on Wednesday. In contrast, the decline rate for pediatric livers was highest on Tuesdays and lowest on Wednesdays. Independent risk factors from multivariate analysis of the adult/pediatric kidney and liver decline rate were analyzed. The weekend offer remains an independent risk factor for adult kidney and liver offer declines, but for pediatric offers, these were not significant independent risk factors. CONCLUSIONS Although allocation systems have changed, and the availability of kidneys and livers have increased in the USA over the past 5 years, the weekend effect remains significant for adult liver and kidney offers for declines. Interestingly, the weekend effect was not seen for pediatric liver and kidney offers.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/58/anntransplant-27-e937825.PMC9641986.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40679352","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":"Risk Factors for Polyomavirus, Cytomegalovirus, and Viruria Co-Infection for Follow-Up of Renal Transplant Patients.","authors":"Ho Trung Hieu,&nbsp;Bui Tien Sy","doi":"10.12659/AOT.937771","DOIUrl":"https://doi.org/10.12659/AOT.937771","url":null,"abstract":"<p><p>BACKGROUND The interaction of viral infection may be associated with increased morbidity after renal transplantation. This study aimed to identify the incidence and risk factors of viruria infections in renal transplant recipients. MATERIAL AND METHODS In this longitudinal study, 502 episodes recorded in 81 kidney transplant patients from 1/2019 to 12/2021 in a hospital in Vietnam were included. BK, JC polyomaviruses, CMV, EBV, and HSV were detected. Multivariable Cox regression analysis was performed to evaluate risk factors for the viruria infection. RESULTS Fifty-six patients (69.1%) had viruria co-infection. The incidence of JC, CMV, and BK infection was the most common viruria, with 67.9%, 61.7%, and 56.8%, respectively. Cox regression revealed that the risk factors for JC were single infection, dose of MMF (HR 1.002), corticoid (HR 1.02), hypertension (HR 1.65), and hematuria (HR 2.03); risk factors for CMV infection were male sex (HR 1.92) and eGFR (HR 0.98); risk factors for BK single infection were hypertension (HR 1.67), proteinuria (HR 3.80), higher tacrolimus trough level (HR 1.17), and dose of MMF (HR 1.002). Hypertension (HR 1.68), fasting plasma glucose (HR 1.13), proteinuria (HR 6.01), tacrolimus trough level (HR 1.12), and dose of MMF (HR 1.004) were independent risk factors for the viruria co-infection. CONCLUSIONS Kidney function was associated with the incidence of viruria. Higher tacrolimus trough level and dose of MMF were associated with higher risk of BK, JC, and co-infection.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/30/97/anntransplant-27-e937771.PMC9617508.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40568908","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":"Cardiovascular Risk Factors in Patients Before and After Successful Liver Transplantation.","authors":"Damian Gojowy,&nbsp;Joanna Urbaniec-Stompór,&nbsp;Joanna Adamusik,&nbsp;Gabriela Wójcik,&nbsp;Henryk Karkoszka,&nbsp;Andrzej Więcek,&nbsp;Marcin Adamczak","doi":"10.12659/AOT.935656","DOIUrl":"https://doi.org/10.12659/AOT.935656","url":null,"abstract":"<p><p>BACKGROUND Liver transplantation (LTx) is useful in the treatment of end-stage liver disease. Outcomes of transplantation are dependent upon graft survival and can also be affected by superimposed cardiovascular morbidities. The present retrospective study was performed to assess the prevalence of cardiovascular risk factors before and after LTx. MATERIAL AND METHODS A retrospective review of 130 patients undergoing liver transplantation between October 2005 and April 2014 was completed. The mean age of the patients was 49.3±11.9 years. The prevalence of cardiovascular risk factors was assessed before and 2 years after transplantation. The prevalence of cardiovascular risk factors was assessed using a comparison based upon the etiologies of liver disease resulting in transplantation including alcohol, viral, and autoimmune processes using a chi-square analysis. RESULTS The prevalence of diabetes mellitus before and 2 years after liver transplantation (LTx) were 18% and 48% (P<0.001). Hypertension was documented in 24% of patients at baseline and 70% after 2 years of follow-up (P<0.001). The prevalence rates of diabetes mellitus before and 2 years after LTx were 18% and 48% (P<0.001). The prevalence of hypertriglyceridemia before and after LTx was 15% and 38%, respectively (P<0.001). Hypercholesterolemia was noted in 16% and 46%, respectively (P<0.001). Thirteen percent of patients before LTx and 18% after were obese (body mass index higher than 30 kg/m²). The annual incidence of diabetes mellitus, hypertension, hypertriglyceridemia, hypercholesterolemia, and obesity during the first 2 years after LTx was 15%, 23.5%, 15%, 18.5%, and 6%, respectively. Twenty-four percent of patients before and 10% after LTx admitted to tobacco use (P<0.001). The prevalence of diabetes (38% vs 67%, P=0.02), hypertriglyceridemia (19% vs 63%, P<0.001), hypercholesterolemia (28% vs 67%, P=0.002), and obesity (9% vs 33%, P=0.02) was lower in patients with an autoimmune cause of liver cirrhosis in comparison to patients with alcoholic disease. CONCLUSIONS The prevalence of hypertension and glucose and lipid metabolism abnormalities may increase in patients after liver transplantation. The prevalence of cardiovascular risk factors in patients after LTx may be related to the cause of liver injury before LTx.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/df/anntransplant-27-e935656.PMC9587686.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40320606","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":"Reduced Risk of Chronic Graft-Versus-Host Disease (cGVHD) by Rabbit Anti-Thymocyte Globulin (ATG) in Patients Undergoing Matched Sibling Donor Transplantation in Hematological Malignancies.","authors":"Shu Fang,&nbsp;Nan Wang,&nbsp;Lili Wang,&nbsp;Jishan Du,&nbsp;Jingjing Yang,&nbsp;Yanan Wen,&nbsp;Yan Wei,&nbsp;Kun Qian,&nbsp;Hao Wang,&nbsp;Yifan Jiao,&nbsp;Chunji Gao,&nbsp;Liping Dou","doi":"10.12659/AOT.937356","DOIUrl":"https://doi.org/10.12659/AOT.937356","url":null,"abstract":"<p><p>BACKGROUND With the addition of anti-thymocyte globulin (ATG) to GVHD prophylaxis in patients undergoing transplantation of peripheral blood stem cells (PBSCT), the incidence of cGVHD decreases. However, the optimal dose and timing of ATG remain undetermined. MATERIAL AND METHODS In this historical controlled trial, data from 85 patients who had hematological malignancies and underwent matched sibling donor (MSD)-PBSCT were used to analyze the effectiveness of rabbit ATG (rATG) for prophylaxis of GVHD. Forty patients received 5 mg/kg rATG used for days -5 to -2, and 45 patients did not receive ATG. RESULTS All patients had successful engraftment except for 2 in the non-ATG group, who had platelet engraftment failure. The 2-year cumulative incidence of chronic GVHD (cGVHD) in the ATG group versus non-ATG group was 19.3% (95% CI, 8.4-33.6%) versus 61.4% (95% CI, 45.4-73.9%) (P<0.001), and in those with moderate to severe cGVHD it was 11.0% (95% CI, 3.4-23.6%) versus 31.8% (95% CI, 18.8-45.6%) (P=0.029), respectively. The 2-year cumulative incidence of non-relapse mortality and relapse (CIR) were 0% versus 15.5% (95% CI, 6.8-27.5%) (P=0.018), and 53.3% (95% CI, 35.6-68.1%) versus 26.7% (95% CI, 14.9-40.0%) (P=0.019), respectively. No differences were found in other survival outcomes. In the multivariate analysis, ATG was an independent protective factor for moderate to severe cGVHD (HR=0.314, 95% CI, 0.103-0.958, P=0.042), and was an independent poor risk factor for CIR (HR=2.337, 95% CI, 1.133-4.822, P=0.022). CONCLUSIONS ATG in our strategy was effective for prophylaxis of cGVHD, whereas the relapse rate was increased in patients with rATG.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/e6/anntransplant-27-e937356.PMC9569149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33499971","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":"Incidence of COVID-19 and Identification of Possible Risk Factors Associated with COVID-19 in Acute Renal Transplant Recipients in Pakistan.","authors":"Nida Saleem,&nbsp;Saima Bashir,&nbsp;Asrar Khan,&nbsp;Syed Nayer Mahmud,&nbsp;Maliha Aziz,&nbsp;Merina Khan","doi":"10.12659/AOT.937688","DOIUrl":"https://doi.org/10.12659/AOT.937688","url":null,"abstract":"<p><p>BACKGROUND Renal transplant recipients are susceptible to increased mortality with COVID-19 infection. There is insufficient data regarding risk factors for COVID-19 disease acquisition. We aimed to identify them here. MATERIAL AND METHODS We enrolled Pakistani renal transplant recipients from February 10, 2020, to March 18, 2021, and actively tracked their baseline health status, transplant characteristics, comorbidities, immunosuppressive therapies, and post-transplant follow-ups until September 2021. Furthermore, we formulated 2 questionnaires for their compliance assessment with COVID-19-preventive measures. We also identified COVID-19 disease acquisition, symptomatology, and management. RESULTS Among the 50 enrolled patients, 14 (28%) patients developed COVID-19, which is higher than the incidence observed in general Pakistani population (0.55%). Their mean age was 35.38 years ±11.69 SD years, and 82% of patients were males. The following factors were independently associated with COVID-19 disease: female gender (P value: 0.042), diabetes mellitus (P value: 0.002), anti-thymocyte globulin (ATG) induction (P value: 0.006), in-person follow-ups (P value: 0.000), prolonged immediate and late post-transplant hospital stays (P value: 0.019 and 0.000, respectively), raised post-transplant serum creatinine (P value: 0.019), and COVID-19 protective measures non-compliance (P value: 0.000). Out of 14 infected recipients, 92.85% required symptomatic management and overall mortality was 0%. CONCLUSIONS Female gender, diabetes mellitus, ATG induction, in-person follow-ups, prolonged hospital stays, raised post-transplant serum creatinine, and COVID-19-protective measures non-compliance were associated with the higher acquisition of SARS-CoV-2 infection. By taking concrete measures against these risk factors, we can continue renal transplants, as overall mortality was lower than in the general Pakistani population (2%).</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/86/anntransplant-27-e937688.PMC9547530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33487597","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}