Annals of Transplantation最新文献_第2页

Impact of Recipient and Donor Body Mass Index on Survival Outcomes After Intestinal Transplantation: A United Network for Organ Sharing Database Analysis. 受体和供体体重指数对肠道移植后生存结果的影响：器官共享联合网络数据库分析。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-07-09 DOI: 10.12659/AOT.943994

Prince Addo Ameyaw, Sarpong Boateng, Eugene N Annor, Basile Njei

{"title":"Impact of Recipient and Donor Body Mass Index on Survival Outcomes After Intestinal Transplantation: A United Network for Organ Sharing Database Analysis.","authors":"Prince Addo Ameyaw, Sarpong Boateng, Eugene N Annor, Basile Njei","doi":"10.12659/AOT.943994","DOIUrl":"10.12659/AOT.943994","url":null,"abstract":"BACKGROUND Long-term patient survival after intestinal transplantation (IT) remains low compared with other organ transplants despite years of advancement in clinical experience. While patients with extremely high or low body mass index (BMI) are often considered ineligible for IT, the impact of BMI on post-transplant IT survival remains understudied. MATERIAL AND METHODS Using the United Network for Organ Sharing Standard Transplant database, we conducted a retrospective cohort study on patients who underwent IT between April 11, 1994, and September 29, 2021. We assessed the association of recipient and donor BMI at transplant with post-transplant mortality using Kaplan-Meier survival curves and univariate and multivariate Cox regression analyses. RESULTS A total of 1541 patients were included in our final sample. Of these patients, 806 were females (52.5%) and most were in the normal-weight BMI subgroup (54.2%). Obese class II (mean; 36.8±10.92 years) and underweight patients (mean; 37.6±13.37 years) were significantly younger than patients in other BMI categories. The adjusted multivariate model demonstrated an increased risk of mortality in underweight IT recipients compared to normal-weight IT recipients (aHR=1.25, 95% confidence interval [CI], 1.02-1.54; P=0.032).There was no significant association between donor BMI categories and survival in IT recipients. CONCLUSIONS Recipient BMI below normal is associated with an increased risk of mortality after intestinal transplantation and represents a potentially modifiable patient characteristic to improve survival outcomes.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e943994"},"PeriodicalIF":1.1,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557871","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

Clonal Hematopoiesis-Associated Gene Mutations Affect Acute Graft-Versus-Host Disease After Hematopoietic Stem Cell Transplantation in AML Patients. 克隆造血相关基因突变影响急性髓细胞性白血病患者造血干细胞移植后的急性移植物抗宿主疾病

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-07-02 DOI: 10.12659/AOT.943688

Xiaoxuan Wei, Sai Huang, Zhenyang Gu, Jing Liu, Meng Li, Xiangshu Jin, Jian Bo, Fei Li, Yu Jing, Xiaoning Gao, Liping Dou, Daihong Liu, Chunji Gao

{"title":"Clonal Hematopoiesis-Associated Gene Mutations Affect Acute Graft-Versus-Host Disease After Hematopoietic Stem Cell Transplantation in AML Patients.","authors":"Xiaoxuan Wei, Sai Huang, Zhenyang Gu, Jing Liu, Meng Li, Xiangshu Jin, Jian Bo, Fei Li, Yu Jing, Xiaoning Gao, Liping Dou, Daihong Liu, Chunji Gao","doi":"10.12659/AOT.943688","DOIUrl":"10.12659/AOT.943688","url":null,"abstract":"BACKGROUND The relationship between clonal hematopoiesis (CH)-associated gene mutations and allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been extensively studied since next-generation sequencing (NGS) technology became widely available. However, research has mainly focused on the relationship between donor CH mutations and transplant prognosis, and research into the relationship between CH mutations in the recipient and acute graft-versus-host disease (aGVHD) is lacking. MATERIAL AND METHODS We analyzed NGS results and their correlation with aGVHD and prognosis in 196 AML patients undergoing allo-HSCT. RESULTS A total of 93 (47.4%) patients had CH mutations. The most frequently mutated genes were DNMT3A (28 of 196; 14.3%), TET2 (22 of 196; 11.2%), IDH1 (15 of 196; 7.7%), IDH2 (14 of 196; 7.1%), and ASXL1 (13 of 196; 6.6%). The incidence of aGVHD was higher in patients older than 45 years old with DTA mutations (DNMT3A, TET2 or ASXL1). DNMT3A mutation but not with TET2 or ASXL1 mutation was an independent risk factor for aGVHD in patients receiving allo-HSCT older than 45 years old. With a median follow-up of 42.7 months, CH mutations were not associated with overall survival and leukemia-free survival. CONCLUSIONS DNMT3A mutation, but not TET2 or ASXL1 mutation, was associated with higher incidence of aGVHD.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e943688"},"PeriodicalIF":1.1,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475757","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 the Organ Donation Quality System on Donation Activity of Warsaw Hospitals. 器官捐献质量体系对华沙医院捐献活动的影响。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-06-28 DOI: 10.12659/AOT.943520

Edyta Karpeta, Izabella Godlewska, Piotr Małkowski, Maciej Kosieradzki

{"title":"Effect of the Organ Donation Quality System on Donation Activity of Warsaw Hospitals.","authors":"Edyta Karpeta, Izabella Godlewska, Piotr Małkowski, Maciej Kosieradzki","doi":"10.12659/AOT.943520","DOIUrl":"10.12659/AOT.943520","url":null,"abstract":"BACKGROUND Like many other countries, Poland faces a shortage of transplantable organs despite implementing strategies to develop donation programs. Increasing the effectiveness of deceased organ donation programs requires the implementation of protocols and quality standards for the entire process. The aim of this study was to assess the organ donation potential in Warsaw hospitals (with and without implemented donation procedures) in the years 2017-2018, before the COVID-19 pandemic affected donation activity. The obtained results were compared with quality indicators established in the ODEQUS project and the European Commission project \"Improving Knowledge and Practices in Organ Donation\" (DOPKI). MATERIAL AND METHODS Retrospective analysis was performed of hospitalization and death causes (including deaths in the brain death mechanism) in the hospitals and intensive care units in 2017-2018. We divided 15 Warsaw hospitals into 2 groups: those with implemented quality programs for organ donation (n=4) and those without such programs (n=11). RESULTS Hospitals with procedures obtained significantly higher values than hospitals without procedures, but were lower than the values in DOPKI and ODEQUS. The success rate of the organ donation process after brain death recognition was comparable in all groups. The conversion rate to actual donors was 73% in hospitals with procedures compared to 68% in hospitals without procedures, significantly higher than in the 42% reported in the DOPKI project. CONCLUSIONS Low numbers of brain death declarations in Warsaw hospitals result from low recognition of deaths in the brain death mechanism. Implementing procedures at each hospital level will enable identification of critical points and comparison of solution outcomes.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e943520"},"PeriodicalIF":1.1,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465712","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

Post-Donation Regret and Anxiety Among Family Living Liver Donors: The Mediating Roles of Family Relationships and Sense of Mastery. 家庭活体肝脏捐献者捐献后的遗憾和焦虑：家庭关系和主人翁意识的中介作用。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-06-25 DOI: 10.12659/AOT.944176

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

{"title":"Post-Donation Regret and Anxiety Among Family Living Liver Donors: The Mediating Roles of Family Relationships and Sense of Mastery.","authors":"Ye Sol Lee, Chin Kang Koh, Nam-Joon Yi","doi":"10.12659/AOT.944176","DOIUrl":"10.12659/AOT.944176","url":null,"abstract":"BACKGROUND Post-donation regret in family living liver donors can impact their mental well-being. This study examined whether the relationship between post-donation regret and anxiety is mediated by family relationships and a sense of mastery. MATERIAL AND METHODS We conducted a secondary analysis of de-identified cross-sectional data from a prior study that included 124 living liver donors. These donors underwent partial hepatectomy between January 2011 and March 2021 at a tertiary hospital in Seoul, South Korea. The data included demographic and clinical characteristics, along with the results from administering the following measures: the Post-Donation Regret Scale, Family Relationships Index, Pearlin Mastery Scale, and the Generalized Anxiety Disorder-2 scale. RESULTS Among family living liver donors, 5.6% had anxiety after donation. The total effect of post-donation regret on anxiety was significant (B=0.41, p<0.05). However, the direct effect of regret on anxiety was not significant (B=-0.05, p=0.733). Post-donation regret had indirect effects on anxiety, solely through family relationships (B=0.329, 95% CI=0.130, 0.563) and sequentially through family relationships and mastery (B=0.088, 95% CI=0.008, 0.232), even after controlling for sex, age, postoperative complications, years since donation, and recipient's death. In addition, postoperative complication was a predictor of anxiety (B=0.64, p<0.05). CONCLUSIONS Providing family-centered and mastery-enhancing interventions may help alleviate the anxiety of family living liver donors.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944176"},"PeriodicalIF":1.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445301","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

Liver Transplantation from Brain-Dead Donors with Hepatitis B or C in South Korea: A 2014-2020 Korean Organ Transplantation Registry Data Analysis. 韩国乙型或丙型肝炎脑死亡捐献者的肝移植：2014-2020年韩国器官移植登记数据分析》。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-05-21 DOI: 10.12659/AOT.943588

Hoonsung Park, Hanyoung Lee, Seungmin Baik, Myoung Soo Kim, Jaeseok Yang, Jong Cheol Jeong, Tai Yeon Koo, Deok-Gie Kim, Jae-Myeong Lee

{"title":"Liver Transplantation from Brain-Dead Donors with Hepatitis B or C in South Korea: A 2014-2020 Korean Organ Transplantation Registry Data Analysis.","authors":"Hoonsung Park, Hanyoung Lee, Seungmin Baik, Myoung Soo Kim, Jaeseok Yang, Jong Cheol Jeong, Tai Yeon Koo, Deok-Gie Kim, Jae-Myeong Lee","doi":"10.12659/AOT.943588","DOIUrl":"10.12659/AOT.943588","url":null,"abstract":"BACKGROUND According to the current guidelines for liver transplantation (LT) of brain-dead donors with hepatitis B or C virus (HBV or HCV) in Korea, grafts from hepatitis B surface antigen (HBsAg)(+) or HCV antibody (anti-HCV)(+) donors must be transplanted only to HBsAg(+) or anti-HCV(+) recipients, respectively. We aimed to determine the current status and outcomes of brain-dead donor LT with HBV or HCV in Korea. MATERIAL AND METHODS This retrospective observational study included all LTs from brain-dead donors in the Korean Organ Transplantation Registry between April 2014 and December 2020. According to donor hepatitis status, 24 HBV(+), 1 HCV(+), and 1010 HBV(-)/HCV(-) donors were included. RESULTS Baseline/final model for end-stage liver disease score (MELD) for HBV(+), HCV(+), and HBV(-)/HCV(-) were 22.4±9.3/27.8±7.8, 16/11, and 33.0±15.4/35.5±7.1, respectively. MELD score of HBV (+) were lower than those of HBV(-)/HCV(-) (P<0.01). Five-year graft and patient survival rates of HBV(+) and HBV(-)/HCV(-) recipients were 81.7%/85.6%, and 76.6%/76.7%, respectively (P=0.73 and P=0.038). One-year graft and patient survival rates of HCV (+) graft recipients were both 100%. CONCLUSIONS No differences in graft and patient survival rates between HBV(+) and HBV(-)/HCV(-) groups were observed. Although accumulating the results of transplants from HBV (+) or HCV(+) grafts to HBV(-) or HCV(-) recipients is not possible owing to domestic regulations, Korea should conditionally permit transplantations from HBV(+) or HCV(+) grafts to HBV(-) or HCV(-) recipients by considering the risks and benefits based on foreign studies. Thereafter, we can accumulate the data from Korea and analyze the outcomes.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e943588"},"PeriodicalIF":1.1,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11127609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070131","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

Association Between FEV₁ Decline Rate and Mortality in Long-Term Follow-Up of a 21-Patient Pilot Clinical Trial of Inhaled Liposomal Cyclosporine Plus Standard-of-Care Versus Standard-of-Care Alone for Bronchiolitis Obliterans Syndrome After Lung Transplantation. 肺移植术后支气管炎闭塞综合征吸入脂质体环孢素加标准护理与单用标准护理的 21 例患者试点临床试验的长期随访中，FEV₁ 下降率与死亡率之间的关系。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-05-14 DOI: 10.12659/AOT.942823

Aldo Iacono, Marniker Wijesinha, Andreas Völp, Maksim Korotun, Michael Terrin

{"title":"Association Between FEV₁ Decline Rate and Mortality in Long-Term Follow-Up of a 21-Patient Pilot Clinical Trial of Inhaled Liposomal Cyclosporine Plus Standard-of-Care Versus Standard-of-Care Alone for Bronchiolitis Obliterans Syndrome After Lung Transplantation.","authors":"Aldo Iacono, Marniker Wijesinha, Andreas Völp, Maksim Korotun, Michael Terrin","doi":"10.12659/AOT.942823","DOIUrl":"10.12659/AOT.942823","url":null,"abstract":"BACKGROUND The association between forced expiratory volume in 1 second (FEV1) trajectory and mortality in bronchiolitis obliterans syndrome (BOS) is not well defined. Using long-term data from a prior clinical trial of inhaled liposomal cyclosporine A (L-CsA-I) for lung transplant patients with BOS, this study examined the association between longitudinal FEV₁ change and mortality. MATERIAL AND METHODS We analyzed long-term data from a clinical trial which randomized 21 patients with BOS (³20% decrease in FEV1 from personal maximum) to receive L-CsA-I plus standard-of-care (n=11) or standard-of-care (SOC) alone (n=10) for 24 weeks. A joint statistical model, combining a linear mixed model for FEV₁ change and Cox regression for mortality, was utilized to examine the overall association between FEV₁ trajectory and mortality during follow-up. RESULTS The 21 trial participants (10 single, 11 double lung recipients) had a mean FEV₁ of 1.7±0.6 Liters at randomization. Median follow-up post-randomization was 35 months. In joint model analysis, 1 percent FEV₁ decline predicted 1.076-fold increased mortality risk (95% confidence interval: -0.998 to 1.160, p=0.058). FEV₁ decline was reduced by 2.6% per year in L-CsA-I patients compared to SOC (p=0.210), and overall survival at 1/3/5 years was 91%/64%/27% vs 90%/20%/0% for L-CsA-I versus SOC, respectively (p=0.164). CONCLUSIONS In BOS patients, greater longitudinal FEV₁ decline predicts increased mortality. Trends towards prolonged stabilization of FEV₁ and improved survival were observed with L-CsA-I receipt. Further analyses will aid in evaluating the utility of FEV₁ change as a survival predictor, having implications in BOS management and future trial design.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e942823"},"PeriodicalIF":1.1,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915683","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}

引用次数: 0

Long-Term Outcomes with Prolonged-Release Tacrolimus in Kidney Transplantation: A Retrospective Real-World Data Analysis. 肾移植中使用长效缓释他克莫司的长期疗效：回顾性真实世界数据分析。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-03-19 DOI: 10.12659/AOT.942167

Wilfried Gwinner, Swapneel Anaokar, Martin Blogg, Birgit Hermann, Carola Del Pilar Repetur, Mario Schiffer

{"title":"Long-Term Outcomes with Prolonged-Release Tacrolimus in Kidney Transplantation: A Retrospective Real-World Data Analysis.","authors":"Wilfried Gwinner, Swapneel Anaokar, Martin Blogg, Birgit Hermann, Carola Del Pilar Repetur, Mario Schiffer","doi":"10.12659/AOT.942167","DOIUrl":"10.12659/AOT.942167","url":null,"abstract":"BACKGROUND Long-term real-world outcomes data for kidney transplant recipients (KTRs) converting from immediate-release tacrolimus (IRT) to prolonged-release tacrolimus (PRT) are limited. MATERIAL AND METHODS A retrospective, non-interventional review of adult KTRs treated with PRT for ≥1 month was conducted in Germany. Data were extracted from time of transplant (2008-2014) to 2018. Primary composite endpoints (graft loss, biopsy-confirmed acute rejection, graft dysfunction) and secondary endpoints (all-cause mortality, kidney function course, and tacrolimus dose/trough levels) were analyzed for sub-cohorts: de novo PRT, early conversion from IRT (within 6 months post-transplant), and late conversion (7 months to 3 years). RESULTS Analysis included 163 patients (101 de novo, 12 early converters, and 50 late converters). The overall Kaplan-Meier estimate of freedom from efficacy failure through 5 years was 0.537, (95% confidence interval (CI) 0.455-0.612) (de novo: 0.512 [0.407-0.608]; early converters: 0.500 [0.208-0.736]; late converters: 0.594 [0.443-0.717]). The overall survival rate was 0.925 (95% CI 0.872-0.957) (de novo: 0.900 [0.823-0.945]; early converters: 0.917 [0.539-0.988]; late converters: 0.977 [0.846-0.997]). During follow-up, there was a gradual reduction in tacrolimus dose and trough levels; kidney function remained stable in all cohorts. Multivariable analysis found re-transplantation, organ donor quality, best estimated glomerular filtration rate 8-12 weeks after transplant, and treatment center (between-center differences in age, sex, donor status/quality) were significantly associated with efficacy failure. CONCLUSIONS There was no difference in long-term survival profiles between KTRs who received PRT de novo vs those who converted from IRT, with 5-year survival remaining high in both groups.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e942167"},"PeriodicalIF":1.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140157387","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

Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians. 在肾移植中使用 LCP-Tacrolimus (LCPT)：临床专家德尔菲共识调查。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-03-12 DOI: 10.12659/AOT.943498

Alexander Wiseman, Tarek Alhamad, Rita R Alloway, Beatrice P Concepcion, Matthew Cooper, Richard Formica, Christina L Klein, Vineeta Kumar, Nicolae Leca, Fuad Shihab, David J Taber, Sarah Mulnick, Donald M Bushnell, Monica Hadi, Suphamai Bunnapradist

{"title":"Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians.","authors":"Alexander Wiseman, Tarek Alhamad, Rita R Alloway, Beatrice P Concepcion, Matthew Cooper, Richard Formica, Christina L Klein, Vineeta Kumar, Nicolae Leca, Fuad Shihab, David J Taber, Sarah Mulnick, Donald M Bushnell, Monica Hadi, Suphamai Bunnapradist","doi":"10.12659/AOT.943498","DOIUrl":"10.12659/AOT.943498","url":null,"abstract":"BACKGROUND LCPT (Envarsus XR®) is a common once-daily, extended-release oral tacrolimus formulation used in kidney transplantation. However, there are minimal evidence-based recommendations regarding optimal dosing and treatment in the de novo and conversion settings. MATERIAL AND METHODS Using Delphi methodology, 12 kidney transplantation experts with LCPT experience reviewed available data to determine potential consensus topics. Key statements regarding LCPT use were generated and disseminated to the panel in an online Delphi survey. Statements were either accepted, revised, or rejected based on the level of consensus, perceived strength of evidence, and alignment with clinical practice. Consensus was defined a priori as ≥75% agreement. RESULTS Twenty-three statements were generated: 14 focused on de novo LCPT use and 9 on general administration or LCPT conversion use. After 2 rounds, consensus was achieved for 11/14 of the former and 7/9 of the latter statements. In a de novo setting, LCPT was recognized as a first-line option based on its safety and efficacy compared to immediate-release tacrolimus. In particular, African Americans and rapid metabolizer populations were identified as preferred for first-line LCPT therapy. In a conversion setting, full consensus was achieved for converting to LCPT to address neurological adverse effects related to immediate-release tacrolimus and for the time required (approximately 7 days) for steady-state LCPT trough levels to be reached. CONCLUSIONS When randomized clinical trials do not replicate current utilization patterns, the Delphi process can successfully generate consensus statements by expert clinicians to inform clinical decision-making for the use of LCPT in kidney transplant recipients.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e943498"},"PeriodicalIF":1.1,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206212","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 Retrospective Study of Long-Term Outcomes in 16 ABO-Incompatible Deceased Donor Pediatric Liver Transplants from a National Transplant Center at Helsinki University Hospital, Finland, 1987-2022. 1987-2022年芬兰赫尔辛基大学医院国家移植中心对16例ABO血型不相容死亡供体小儿肝脏移植手术长期结果的回顾性研究。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-02-13 DOI: 10.12659/AOT.941929

Timo Jahnukainen, Inna Sareneva, Jouni Lauronen, Elisa Ylinen, Juuso Tainio, Arno Nordin, Maria Hukkinen, Mikko P Pakarinen, Hannu Jalanko

{"title":"A Retrospective Study of Long-Term Outcomes in 16 ABO-Incompatible Deceased Donor Pediatric Liver Transplants from a National Transplant Center at Helsinki University Hospital, Finland, 1987-2022.","authors":"Timo Jahnukainen, Inna Sareneva, Jouni Lauronen, Elisa Ylinen, Juuso Tainio, Arno Nordin, Maria Hukkinen, Mikko P Pakarinen, Hannu Jalanko","doi":"10.12659/AOT.941929","DOIUrl":"10.12659/AOT.941929","url":null,"abstract":"BACKGROUND The use of ABO-incompatible liver transplants (ABO-ILTs) from deceased donors has become more common due to the shortage of available donor livers and increased transplant waiting times. This retrospective study from a national transplant center at Helsinki University Hospital, Finland, aimed to assess the long-term outcomes of ABO-incompatible deceased donor pediatric liver transplants between 1987 and 2022. MATERIAL AND METHODS Sixteen (9.5%) of the 169 pediatric liver transplantations were ABO-ILTs. The median age at transplantation was 5.0 (0.5-15.4) years. Reasons for ABO-ILTs were acute liver failure (18.75%), malignancy (12.5%), small body size and long waiting time (25%), and other reasons (43.75%). The median post-transplant follow-up time was 147 (0.72-353) months. Patient and graft survival and occurrence of surgical complications were compared to ABO-identical transplants, and anti-ABO antibody titers were analyzed. RESULTS The 1-, 3-, and 5-year patient survivals were comparable between the ABO-I and ABO-compatible groups, being 81.3%, 73.9%, and 73.9% (ABO-I) and 87.5%, 82.5%, 77.9% (ABO-compatible), respectively. Three patients with ABO-ILTs died of sepsis and multiorgan failure during the first 3 months after transplantation. The occurrence of biliary complications and early vascular thrombosis (<30 days after transplantation) did not differ significantly between recipients with an ABO-ILT vs ABO-compatible liver graft. CONCLUSIONS The findings from this study support findings from previous studies that outcomes after ABO-incompatible liver transplants in children were comparable to outcomes from ABO-identical liver transplants.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e941929"},"PeriodicalIF":1.1,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721312","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

Immunoprotective Effect of Liver Allograft on Patients with Combined Liver and Kidney Transplantation. 肝移植对肝肾联合移植患者的免疫保护作用

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-02-06 DOI: 10.12659/AOT.942763

Joon-Young Kim, Hye Bin Kim, Jin-Myung Kim, Hye Eun Kwon, Young Hoon Kim, Youngmin Ko, Frances S Sung, Joo Hee Jung, Chung Hee Baek, Hyosang Kim, Su-Kil Park, Sung Shin, Hyunwook Kwon

{"title":"Immunoprotective Effect of Liver Allograft on Patients with Combined Liver and Kidney Transplantation.","authors":"Joon-Young Kim, Hye Bin Kim, Jin-Myung Kim, Hye Eun Kwon, Young Hoon Kim, Youngmin Ko, Frances S Sung, Joo Hee Jung, Chung Hee Baek, Hyosang Kim, Su-Kil Park, Sung Shin, Hyunwook Kwon","doi":"10.12659/AOT.942763","DOIUrl":"10.12659/AOT.942763","url":null,"abstract":"BACKGROUND Simultaneous liver-kidney transplantation (SLKT) and kidney transplantation (KT) after liver transplantation (LT) provide potential treatment options for patients with end-stage liver and kidney disease. There is increasing attention being given to liver-kidney transplantation (LTKT), particularly regarding the immune-protective effects of the liver graft. This retrospective, single-center, observational study aimed to evaluate the clinical outcomes of KT in LTKT patients - either SLKT or KT after LT (KALT) - compared to KT alone (KTA). MATERIAL AND METHODS We included patients who underwent KT between January 2005 and December 2020, comprising a total of 4312 patients divided into KTA (n=4268) and LTKT (n=44) groups. The LTKT group included 11 SLKT and 33 KALT patients. To balance the difference in sample sizes between the 2 groups, we performed 3: 1 propensity score matching (PSM). RESULTS There was no significant difference in graft survival between the groups. However, the LTKT group exhibited significantly superior rejection-free survival compared to the KTA group (P.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e942763"},"PeriodicalIF":1.1,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691043","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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