{"title":"CD146⁺ Endothelial Cells Facilitate Renal Interstitial Fibrosis Through Endothelial-to-Mesenchymal Transition.","authors":"Huixian Zhang, Liling Zhang, Dongli Tian, Yu Bai, Yiduo Feng, Wenhu Liu, Zongli Diao","doi":"10.12659/AOT.945917","DOIUrl":"10.12659/AOT.945917","url":null,"abstract":"<p><p>BACKGROUND Endothelial cells play a crucial role in the pathogenesis of renal interstitial fibrosis (RIF), with CD146 being upregulated on injured endothelial cells. However, the precise contribution of CD146⁺ endothelial cells to RIF remains unclear. This study aimed to observe and detect the relationship between CD146 expression and endothelial cells and to explore the role and possible mechanism of CD146 promoting endothelial-mesenchymal transition in RIF. MATERIAL AND METHODS In this study, we investigated the association between CD146⁺ endothelial cells and RIF. Double-label immunofluorescence was used in patients with chronic kidney disease, whereas multiplex immunofluorescence staining was used for the analysis in unilateral ureteral obstruction (UUO) mice. Hematoxylin and eosin and Masson trichrome staining were performed to evaluate RIF. RESULTS Our results revealed an elevation of CD146⁺ endothelial cells, which positively correlated with the degree of RIF in chronic kidney disease patients and UUO mice. Notably, CD146⁺ endothelial cells undergoing endothelial-mesenchymal transition (CD146⁺ EndMT) were significantly higher in subjects with severe renal interstitial fibrosis, as observed in chronic kidney disease patients and UUO mice. Additionally, with the progression of renal interstitial fibrosis, the expression of PDGFRb, the receptor of PDGF-B signaling pathway, increased and co-localized with CD146⁺ CD31⁺ a-SMA⁺ cells. The proportion of CD146⁺ CD31⁺ alpha-SMA⁺ PDGFRß⁺ cells in CD31⁺ cells increased. CONCLUSIONS In the process of renal interstitial fibrosis, CD146 is mainly expressed in renal interstitial vascular endothelial cells and participates in endothelial-to-mesenchymal transition, which may be related to the PDGF-B/PDGFR-ß signaling pathway.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945917"},"PeriodicalIF":1.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799141","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":"Hepatopulmonary Syndrome and Liver Transplantation: Impact on Survival and Postoperative Complications.","authors":"Yin Lai, Hao-Chien Hung, Jin-Chiao Lee, Yu-Chao Wang, Chih-Hsien Cheng, Tsung-Han Wu, Ting-Jung Wu, Hong-Shiue Chou, Kun-Ming Chan, Wei-Chen Lee, Chen-Fang Lee","doi":"10.12659/AOT.945297","DOIUrl":"10.12659/AOT.945297","url":null,"abstract":"<p><p>BACKGROUND Liver transplantation (LT) is the preferred treatment for patients with cirrhosis who have hepatopulmonary syndrome (HPS). However, the effect of HPS on LT remains controversial. We assessed the correlation between HPS severity and LT survival and compared the incidence of postoperative complications between patients with and without HPS undergoing LT. MATERIAL AND METHODS We retrospectively reviewed the recipients who received living-donor LT in our institute between January 2016 and July 2019. Patients with HPS (HPS group) and patients without HPS (non-HPS group) were included in our study. HPS is defined as a defect in arterial oxygenation caused by the presence of intrapulmonary vascular dilatations, which is found by transthoracic echocardiography with pre-existing liver cirrhosis. HPS severity was graded according to the value of partial pressure of arterial oxygen. The demographic characteristics and clinical outcomes between the HPS and non-HPS groups were compared. RESULTS A total of 181 patients were enrolled. Among them, 104 patients (57.5%) had HPS. The mean overall survival of HPS and non-HPS groups was 69.82±3.1 vs 63.36±3.8 months, with no significant difference (P=0.332). The overall survival between different degrees of HPS was also compared, and showed no significant difference (P=0.466). The HPS group had a higher incidence of delayed extubation (22.1% vs 10.4%, P=0.028) and chest pigtail catheter insertion (16.3% vs 10.4%, P=0.012). Nevertheless, it did not lead to a longer Intensive Care Unit/hospital stay or higher risk of short-term mortality. CONCLUSIONS Patients with HPS tend to have more post-LT pulmonary complications, but the overall survival is not adversely influenced, regardless of the severity of HPS.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945297"},"PeriodicalIF":1.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765690","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":"Factors Influencing Stress Disorders in Intensive Care Unit (ICU) Patients After Liver Transplantation: A Cross-Sectional Study.","authors":"Xiao-Qing Sun, Ying Xu, Xiu-Lian Wu, Jing-Jing Zhi, Yan-Mei Gu","doi":"10.12659/AOT.944320","DOIUrl":"10.12659/AOT.944320","url":null,"abstract":"<p><p>BACKGROUND Evidence on psychological factors associated with post-transplant post-traumatic stress disorder (PTSD) in liver transplantation (LT) patients is limited. Identifying the psychological factors associated with post-transplant PTSD would help to understand the symptoms of PTSD and take preventive measures. The aim of this study was to investigate factors influencing stress disorders in Intensive Care Unit (ICU) patients 1 year after LT. MATERIAL AND METHODS We assessed data from 184 LT patients at our hospital between January 2020 and December 2022. According to the PCL-C score, the patients were divided into the PTSD group (score ≤37) and the non-PTSD group (score >37). The demographic data, clinical data, the pain visual analogue scale (VAS), the anxiety and depression scale (HADS), and the psychological resilience scale (CD-RISC score) were compared between the 2 groups. Pearson correlation analysis was used to analyze the correlation between PCL-C and VAS, HADS, and CD-RISC, and logistic regression was used to analyze the factors influencing PTSD. SPSS 23.0 software was used for statistical analysis. RESULTS The average age of the 184 participants was 53.17 years (±3.47) and 66.85% of the subjects were male. The prevalence rate of post-transplant PTSD was 22.83% and the total score on the PCL-C scale was 32.47±7.81. Pearson correlation analysis showed that PCL-C score was positively correlated with VAS (r=0.312, P=0.012) and HADS (r=0.412, P<0.001), and negatively correlated with CD-RISC (r=-0.468, P<0.001). Logistic regression analysis showed that the symptom of post-transplant PTSD was significantly associated with higher VAS (OR=1.058, P=0.007) and HADS (OR=1.885, P<0.001) scores and lower CD-RISC (OR=2.213, P<0.001) score, which indicated that higher VAS and HAD scores were risk factors that contributed to PTSD and lower CD-RISC was a protective factor against PTSD. CONCLUSIONS We found that pain, anxiety, depression, and resilience were associated with symptoms of PTSD in LT patients in the ICU. Nursing staff should seek to relieve their patients' pain and assure provision of targeted health education and personalized psychological counseling to reduce the risk of PTSD after LT.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944320"},"PeriodicalIF":1.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715305","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}
Jerzy Strużyna, Piotr Tomaka, Agnieszka Surowiecka, Tomasz Korzeniowski, Grzegorz Wilhelm, Maciej Łączyk, Ryszard Mądry, Magdalena Bugaj-Tobiasz, Sergey Antonov, Łukasz Drozd, Aldona S Stachura
{"title":"Ten-Year Retrospective Analysis of Continuous Renal Replacement Therapy in Burn Patients: Impact on Survival and Timing of Initiation.","authors":"Jerzy Strużyna, Piotr Tomaka, Agnieszka Surowiecka, Tomasz Korzeniowski, Grzegorz Wilhelm, Maciej Łączyk, Ryszard Mądry, Magdalena Bugaj-Tobiasz, Sergey Antonov, Łukasz Drozd, Aldona S Stachura","doi":"10.12659/AOT.945815","DOIUrl":"10.12659/AOT.945815","url":null,"abstract":"<p><p>BACKGROUND Acute kidney injury (AKI) is a common issue in intensive care units and is a potentially lethal consequence of severe burns. In severely burned patients with non-renal indications, renal replacement treatment is frequently used. This study's aim was to compile a 10-year summary of continuous renal replacement therapy (CRRT) experience at a single burn center, including patient outcomes, effectiveness, and potential complications in the context of severe burns. MATERIAL AND METHODS This retrospective analysis included the clinical data from 723 burned patients. The data analysis of 300 patients with CRRT therapy included clinical data, laboratory tests, and CRRT parameters. The study group was split into 2 subgroups regarding onset of CRRT: early (up to 7 days after the trauma) and late. RESULTS Age, burn extent, length of stay, and inhalation injury all had an impact on survival. Early CRRT was linked to a greater probability of death (P<0.005). Upon admission to the burn center, patients with early CRRT exhibited a bigger burn area, higher Baux and SOFA scores, and were younger (P<0.05). Sepsis was diagnosed more frequently in the late CRRT group. CONCLUSIONS Our findings show that patients who require CRRT within the first 7 days following a burn injury have a poorer prognosis; however, this is not due to CRRT's effect, but rather to the trauma's severity. Future studies should explore long-term patient outcomes of CRRT among burn patients.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945815"},"PeriodicalIF":1.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666937","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":"Biopsychosocial Effects of Donor Traits on Heart Transplant Recipients.","authors":"Chia-Chin Hou, Yu-Ning Hu, Lan-Pin Kuo, Chun-Hao Chang, Tzu-Faye Tsai, Yu-Ching Huang, Meng-Ta Tsai, Yu-Yun Hsu, Jun-Neng Roan","doi":"10.12659/AOT.945828","DOIUrl":"10.12659/AOT.945828","url":null,"abstract":"<p><p>BACKGROUND Psychological function after transplantation has garnered increased attention, and the relationship between recipients and corresponding donors has been investigated in medical research. Here, we investigated potential qualitative and quantitative psychological and lifestyle changes among recipients after heart transplantation and their correlation with donors. MATERIAL AND METHODS Transplant recipients, their families, and the donor's families were interviewed. The interview was semi-structured, featuring open-ended questions related to 5 domains: preference, emotions and temperament, memory, self-identity, and social identity. Qualitative data were analyzed by triangulation and deductive content analysis. Quantitative data were collected using the Big Five Inventory-19 (BFI-19) questionnaire, to complement the domain of emotions and temperament. RESULTS Overall, 20 recipients, 15 recipients' families, and 13 corresponding donors' families were interviewed (5 recipients' families and 7 donors' families refused to participate) between October 2020 and July 2021. The data were matched to 13 groups, each including at least 1 recipient and the corresponding donor. Finally, 13 recipients, 9 corresponding recipients' families, and 13 corresponding donors' families were identified. Similarities between recipients' psychological and lifestyle changes and the corresponding donors' traits were primarily identified in the aspects of diet, emotions and temperament, and special experiences other than dreams. The BFI-19 data showed no significant correlations between recipients and the corresponding donors' families. CONCLUSIONS Our findings indicate significant psychological and lifestyle changes in recipients before and after heart transplantation, with 38% exhibiting characteristics partly similar to those of their donors. Further investigation is needed to explore the psychobiological correlation between recipients and donors.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945828"},"PeriodicalIF":1.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612279","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}
Mark D Minden, Cindy Audiger, Geneviève Chabot-Roy, Sylvie Lesage, Jean-Sébastien Delisle, Barbara Biemans, Violetta Dimitriadou
{"title":"The Long-Acting Glucagon-Like Peptide-2 Analog Apraglutide Enhances Intestinal Protection and Survival After Chemotherapy and Allogeneic Transplantation in Mice.","authors":"Mark D Minden, Cindy Audiger, Geneviève Chabot-Roy, Sylvie Lesage, Jean-Sébastien Delisle, Barbara Biemans, Violetta Dimitriadou","doi":"10.12659/AOT.945249","DOIUrl":"10.12659/AOT.945249","url":null,"abstract":"<p><p>BACKGROUND The gastrointestinal (GI) barrier can be damaged by chemotherapy or radiation therapy, causing fatigue, malnutrition, sepsis, dose-limiting toxicity, and, occasionally, death. Glucagon-like peptide-2 (GLP-2) promotes mucosal epithelium growth and repair in the GI tract. Here, we examined the GI-protective effects of apraglutide, a long-acting peptide GLP-2 analog, in murine models of chemotherapy, and total body irradiation followed by allogeneic transplantation. MATERIAL AND METHODS The impact of apraglutide on cytarabine or melphalan chemotherapy-induced intestinal damage was assessed in BALB/c mice, and the effect on allogeneic transplantation in BALB/cJ and C57BL/6J mice. Outcomes included survival, and changes in body weight, intestinal function and morphology, including colon length and bacterial composition of the intestinal microbiota. RESULTS Adding apraglutide to chemotherapy significantly improved survival rates and reduced weight loss, with no impact on leukocyte counts (and, therefore, no effect on chemotherapy-induced immunosuppression), compared with chemotherapy alone in mice. These benefits were associated with preservation of the morphological integrity of the GI mucosa, attenuation of the negative impact of cytarabine on the intestinal microbiota, and significant improvement in plasma levels of citrulline. In addition, in a model of irradiation followed by allogeneic transplantation, mice in groups receiving apraglutide had improved survival, reduced weight loss, and increased colon length compared with those that did not. CONCLUSIONS Apraglutide protects intestinal function and improves survival in mice following allogeneic transplantation or chemotherapy with cytarabine or melphalan. The potential effect of apraglutide on chemotherapy efficacy and on engraftment following allogeneic transplantation has been investigated in a parallel manuscript.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945249"},"PeriodicalIF":1.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574787","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}
Juan Wang, Jianghong Chen, Yuewei Yin, Yuena Zhang, Yulin Ma
{"title":"Predictive Model for Post-Transplant Renal Fibrosis Using Ultrasound Shear Wave Elastography.","authors":"Juan Wang, Jianghong Chen, Yuewei Yin, Yuena Zhang, Yulin Ma","doi":"10.12659/AOT.945699","DOIUrl":"10.12659/AOT.945699","url":null,"abstract":"<p><p>BACKGROUND The aim of this study was to investigate the clinical utility of ultrasound shear wave elastography (SWE) for assessment of renal fibrosis in post-renal transplant patients. MATERIAL AND METHODS We selected 183 patients who underwent renal transplantation. The complete dataset was randomly partitioned into a training cohort (128 cases) and a validation cohort (55 cases). All patients were subjected to SWE and renal allograft biopsy. The baseline data was compared using t-test, Z-test, or chi-square test. Through univariate and multivariate analyses, we identified independent risk factors influencing renal fibrosis after transplantation, a predictive model for post-transplant renal fibrosis was developed, and calibration curves, decision curve analyses, and ROC curves were generated. RESULTS Age, TST, Scr, GFR, and Emean showed significant differences (P<0.05). The C-index of the nomogram was 0.85, and the calibration curve and Hosmer-Lemeshow test demonstrated accurate diagnosis of fibrosis in both the training and validation sets (P>0.05). DCA showed that the prediction model effectively improved the diagnostic accuracy of fibrosis. The highest AUC of the nomogram for combined prediction of renal fibrosis in transplant patients was 0.902 in the training group and 0.871 in the validation group. These values were significantly higher compared to the AUCs of individual predictors (P<0.05). CONCLUSIONS Ultrasound SWE allows for early evaluation of renal fibrosis following transplantation. The prediction model, constructed by amalgamating other indicators, augments the accuracy and reliability of the prediction, providing more precise and accurate diagnostic and therapeutic recommendations for clinical practitioners.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e945699"},"PeriodicalIF":1.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520774","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}
Zhiqi Zhang, Bohan Li, Lu Liu, Ruolan Xiong, Senlin Zhang, Minyuan Liu, Zihao Xia, Shuran Wang, Jie Li, Shaoyan Hu
{"title":"Early Post-Transplant Serum Ferritin Levels as Predictive Biomarkers for Severe Acute Graft-Versus-Host Disease in Pediatric Umbilical Cord Blood Transplantation for Acute Leukemia.","authors":"Zhiqi Zhang, Bohan Li, Lu Liu, Ruolan Xiong, Senlin Zhang, Minyuan Liu, Zihao Xia, Shuran Wang, Jie Li, Shaoyan Hu","doi":"10.12659/AOT.944156","DOIUrl":"10.12659/AOT.944156","url":null,"abstract":"<p><p>BACKGROUND Allogeneic hematopoietic stem cell transplantation (allo-HSCT) using umbilical cord blood is a valuable therapy option for patients with acute leukemia (AL). Acute graft-versus-host disease (aGVHD) remains the most frequently encountered complication. This study investigated risk factors for aGVHD and assessed whether post-transplant serum ferritin (SF) within 2 weeks is a potential biomarker for aGVHD in pediatric patients with AL undergoing umbilical cord blood transplantation (UCBT). MATERIAL AND METHODS We conducted a retrospective cohort study of 71 patients with AL who underwent UCBT at the Children's Hospital of Soochow University between 2017 and 2022. We evaluated several factors related to aGVHD. Univariate and multivariate analyses were performed using the proportional subdistribution hazard regression model of Fine and Gray. Analyses of overall survival (OS) were performed using the Kaplan-Meier method, and differences were compared using log-rank tests. RESULTS Of the 71 patients, 23 (32.4%) experienced grade II-IV aGVHD, of whom 18 (25.4%) developed grade III-IV aGVHD. Patients with grade II-IV and III-IV aGVHD had worse 5-year OS (69.4±10%, p=0.01; and 60.6±11.6, P=0.007, respectively). Conditioning intensity was a risk factor for grade III-IV aGVHD (HR: 0.34, 95% CI: 0.13-0.89, P=0.027). An SF level >1650 ng/mL within 2 weeks post-transplant was associated with an increased risk of severe aGVHD (HR: 3.61, 95% CI: 1.09-11.97, P=0.036). CONCLUSIONS Post-transplant SF within 2 weeks was a potential biomarker for developing severe aGVHD. Higher levels of post-transplant SF are associated with a higher incidence of grade II-IV aGVHD and grade III-IV aGVHD.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944156"},"PeriodicalIF":1.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071799","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}
Thi Cam Tu Hoang, Lien Han, Sandrine Hirschi, Tristan Degot, Justine Leroux, Pierre-Emmanuel Falcoz, Anne Olland, Nicola Santelmo, Marion Villard, Olivier Collange, Gauthier Appere, Romain Kessler, Benjamin Renaud-Picard
{"title":"One-Year Mortality After Lung Transplantation: Experience of a Single French Center Between 2012 and 2021.","authors":"Thi Cam Tu Hoang, Lien Han, Sandrine Hirschi, Tristan Degot, Justine Leroux, Pierre-Emmanuel Falcoz, Anne Olland, Nicola Santelmo, Marion Villard, Olivier Collange, Gauthier Appere, Romain Kessler, Benjamin Renaud-Picard","doi":"10.12659/AOT.944420","DOIUrl":"10.12659/AOT.944420","url":null,"abstract":"<p><p>BACKGROUND Lung transplantation (LTx) is a life-extending therapy for specific patients with terminal lung diseases. This study aimed to evaluate the associations and causes of 1-year mortality after lung transplantation at Strasbourg University Hospital, France, between 2012 and 2021. MATERIAL AND METHODS We carried out a retrospective analysis on 425 patients who underwent LTx at Strasbourg University Hospital between January 1, 2012, and December 31, 2021. Pre-transplant, perioperative, and postoperative data were collected from the electronic medical records. RESULTS Among all patients, 94.6% had a LTx, 4.0% a heart-lung transplantation, and 1.4% underwent pancreatic islet-lung transplantation. The median age at transplantation was 57 years, with 55.3% male patients. The main native lung disease leading to LTx was chronic obstructive pulmonary disease in 51.1% of patients; 16.2% needed super-urgent LTx. The 1-year mortality rate was 11.5%. Most deaths were either caused by multi-organ failure or septic shock. In our multivariate analysis, we identified 3 risk factors significantly related to 1-year mortality after LTx: body mass index (BMI) between 25 and 30 kg/m² vs BMI between 18.5 and 25 kg/m² (P=0.032), postoperative extracorporeal membrane oxygenation support (P=0.034), and intensive care unit length of stay after transplantation (P<0.001). Two other factors were associated with a significantly lower 1-year mortality risk: longer hospital stay after LTx (P=0.024) and tacrolimus prescription (P=0.004). CONCLUSIONS Our study reported a 1-year mortality rate of 11.5% after LTx. Although LTx candidates are carefully selected, additional data are required to improve understanding of the risk factors for post-LTx mortality.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944420"},"PeriodicalIF":1.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003443","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":"Kidney After Lung Transplants or Combined Kidney-Lung Transplantation: A Single-Center Retrospective Cohort Study.","authors":"Benoît Mesnard, Matthieu Glorion, Arwa Jalal Eddine, Antoine Roux, Julien Branchereau, Yann Neuzillet, Edouard Sage, Thierry Lebret, Alexandre Hertig, François-Xavier Madec, Yanish Soorojebally","doi":"10.12659/AOT.944049","DOIUrl":"10.12659/AOT.944049","url":null,"abstract":"<p><p>BACKGROUND End-stage renal disease is a major issue in the management of patients undergoing lung transplantation. Combined kidney-lung transplantation (CKLT) and kidney after lung transplantation (KALT) are the 2 preferred solutions to manage this situation. To evaluate these strategies, we describe kidney and lung graft outcomes and patient survival in patients managed with CKLT and KALT. MATERIAL AND METHODS We conducted a retrospective single-center cohort study. Patients who underwent a CKLT or a KALT were included in this study. Retrospective extraction of data from medical records was performed. RESULTS Seventeen patients underwent CKLT and 9 underwent KALT. Most of the patients had cystic fibrosis and presented renal failure related to anti-calcineurin toxicity. The 30-day and 1-year survival of CKLT recipients were both 75.6%. No patients with KALT died during the follow-up. Kidney graft prognosis was almost exclusively influenced by patient survival in relation to postoperative lung transplant complications. The rate of severe surgical complications was close to 60% for CKLT compared with 30% for KALT. The kidney graft function (estimated kidney graft function) did not differ according to the transplantation strategy. CONCLUSIONS KALT is a safe option, with postoperative morbidity and renal graft function identical to those of kidney transplantation in non-lung-transplanted patients. The results of CKLT depend mainly on the morbidity associated with lung transplantation but remain an attractive option for patients with respiratory failure associated with end-stage renal disease. The choice of transplant strategy must also take into account the most ethical and efficient allocation of kidney grafts.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944049"},"PeriodicalIF":1.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054635","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}