Annals of Transplantation最新文献_第3页

Abnormal Liver Biopsies of Donor Grafts in Pediatric Liver Transplantation: How Do They Fare? 小儿肝移植中供体移植物的异常肝活检：他们的表现如何？

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-08-06 DOI: 10.12659/AOT.944245

Jason Guo, Jorge A Sanchez-Vivaldi, Madhukar S Patel, Benjamin K Wang, Andrew D Shubin, Yash Kadakia, Jigesh A Shah, Malcolm MacConmara, Steven Hanish, Parsia A Vagefi, Christine S Hwang

{"title":"Abnormal Liver Biopsies of Donor Grafts in Pediatric Liver Transplantation: How Do They Fare?","authors":"Jason Guo, Jorge A Sanchez-Vivaldi, Madhukar S Patel, Benjamin K Wang, Andrew D Shubin, Yash Kadakia, Jigesh A Shah, Malcolm MacConmara, Steven Hanish, Parsia A Vagefi, Christine S Hwang","doi":"10.12659/AOT.944245","DOIUrl":"10.12659/AOT.944245","url":null,"abstract":"BACKGROUND Little is known about outcomes of pediatric patients transplanted using donor liver grafts with abnormal biopsy results. We assessed donor liver biopsy data to report characteristics and outcomes of abnormal livers transplanted in pediatric patients. MATERIAL AND METHODS We identified pediatric patients who received a liver transplant from a biopsied deceased donor between 2015 and 2022 using the national database UNOS Standard Transplant Analysis and Research files. Recipients were excluded if they received multi-organ transplants or were lost to follow-up. Livers with ≤5% macrosteatosis, no fibrosis, and no inflammation were classified as normal livers (NL). Allografts with >5% macrosteatosis, any fibrosis, or any inflammation were considered abnormal livers (AL). Donor and recipient demographic data and outcomes were examined. RESULTS Of the 3808 total pediatric liver transplants in the study period, there were 213 biopsied donor liver allografts transplanted into pediatric recipients. Of those, 114 were NL and 99 were AL. 35.4% (35/99) of the AL had >5% macrosteatosis with a mean of 7.6±11.4%, 64.6% (64/99) had any inflammation, and 18.2% (18/99) had any fibrosis. AL donors were significantly older than NL donors. AL recipients had higher PELD scores. There were no significant differences in length of stay, rejection rates and causes, or allograft survival between AL and NL. Multivariable analysis revealed that inflammation was independently associated with a significantly greater risk for graft failure. CONCLUSIONS Outcomes of abnormal livers are excellent. Inflammation was an independent risk factor for poor graft prognosis. Donor biopsies in pediatric liver transplantation can be a useful adjunct to assess outcomes.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944245"},"PeriodicalIF":1.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892684","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

Comparative Study of Acute Kidney Injury in Liver Transplantation: Donation after Circulatory Death versus Brain Death. 肝移植中急性肾损伤的比较研究：循环死亡后捐献与脑死亡后捐献的比较研究

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-07-30 DOI: 10.12659/AOT.944077

Benedikt Hilger, Katja Frick, Rolf Erlebach, Philipp Dutkowski, Rea Andermatt, Sascha David, Reto A Schüpbach, Stephanie Klinzing

{"title":"Comparative Study of Acute Kidney Injury in Liver Transplantation: Donation after Circulatory Death versus Brain Death.","authors":"Benedikt Hilger, Katja Frick, Rolf Erlebach, Philipp Dutkowski, Rea Andermatt, Sascha David, Reto A Schüpbach, Stephanie Klinzing","doi":"10.12659/AOT.944077","DOIUrl":"10.12659/AOT.944077","url":null,"abstract":"BACKGROUND Acute kidney injury (AKI) after orthotopic liver transplantation (OLT) contributes to morbidity and mortality. Donation after circulatory death (DCD) has been established to increase the pool of organs. While surgical complications are reported to be comparable in DCD and donation after brain death (DBD) OLT, there is a knowledge gap concerning adverse kidney events in these 2 groups. MATERIAL AND METHODS In this retrospective cohort study, 154 patients received a DBD and 68 received a DCD organ (2016-2020). The primary outcome was a major adverse kidney event within 30 days (MAKE-30). The secondary outcome was dynamics of AKI and kidney replacement therapy (KRT) during the first postoperative week and on postoperative day 30. Incidence and resolution from AKI and KRT and patient survival (PS) 30 days after OLT were compared between the DCD and DBD recipients. RESULTS MAKE-30 incidence after OLT was comparable in DCD (n=27, 40%) vs DBD (n=41, 27%) recipients (risk ratio 1.49 [95% CI 1.01, 2.21], p=0.073). AKI incidence was comparable in DCD (n=58, 94%) vs DBD (n=95, 82%) recipients (risk ratio 1.14 [95% CI: 1.03, 1.27], P=0.057). Overall, 40% (n=88) of patients required KRT, with no difference between DCD (n=27, 40%) vs DBD (n=61, 40%) recipients (risk ratio 1.00 [95% CI 0.71, 1.43], P>0.999). Resolution of AKI by day 30 was lower in DCD (n=29, 50%) than in DBD (n=66, 69%) recipients (risk ratio 0.71 [95% CI: 0.53, 0.95], P=0.032). Survival after 30 days (DCD: n=64, 94% vs DBD: n=146, 95%, risk ratio 0.99 [95% CI 0.93, 1.06], P>0.999) was also comparable. CONCLUSIONS MAKE-30, short-term renal outcome, and survival did not significantly differ between DBD and DCD-OLT. Resolution of AKI by day 30 was lower in DCD than in DBD recipients.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944077"},"PeriodicalIF":1.1,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791745","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

Ginkgetin Pretreatment Reduces Inflammatory Response in DCD Donor Liver via JAK2/STAT3 Signaling Pathway. 银杏黄酮预处理通过 JAK2/STAT3 信号通路降低 DCD 供体肝脏的炎症反应

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-07-16 DOI: 10.12659/AOT.944153

Jia Liu, Jiansheng Xiao, Qin Deng, ZhiHui Fu, Qi Xiao

{"title":"Ginkgetin Pretreatment Reduces Inflammatory Response in DCD Donor Liver via JAK2/STAT3 Signaling Pathway.","authors":"Jia Liu, Jiansheng Xiao, Qin Deng, ZhiHui Fu, Qi Xiao","doi":"10.12659/AOT.944153","DOIUrl":"10.12659/AOT.944153","url":null,"abstract":"BACKGROUND Ginkgetin inhibits growth of tumor cells, reducing blood lipids, and improving atherosclerosis, but the protective effect of ginkgetin in donation after cardiac death (DCD) livers is still unknown. The aim of this study was to determine whether pretreatment of DCD donor livers with ginkgetin can reduce inflammatory response through the JAK2/STAT3 signaling pathway. MATERIAL AND METHODS Twenty male Sprague-Dawley rats (200-250 g) were randomly divided into 4 groups: Sham, DCD, Ginkgetin (0.6 mg/kg) pretreatment 1 h before surgery, and Ginkgetin (0.6 mg/kg) plus broussonin E (0.3 mg/kg) (JAK2/STAT3 signaling agonist) pretreatment 1 h before surgery. Rat livers were subjected to 30 min warm ischemia and 24 h cold storage to simulate the preservation process of DCD donor livers, followed by normothermic machine perfusion for 1 h to simulate liver reperfusion in vivo. Liver tissues and perfusate samples were collected for further studies. RESULTS Ginkgetin pretreatment significantly decreased the values of ALT and AST (P<0.05), and improved histological alterations according to improved Suzuki's Score (P<0.05). Ginkgetin also inhibited the protein expression levels of p-JAK2/JAK2 and p-STAT3/STAT3 (P<0.05). Furthermore, ginkgetin pretreatment inhibited levels of interleukin-1β, interleukin-6 and tumor necrosis factor a (P<0.05) to suppress inflammatory response. In addition, broussonin E reversed the improvement of ginkgetin on DCD donor livers. CONCLUSIONS Ginkgetin can inhibit the inflammatory response through the JAK2/STAT3 signaling pathway to improve the quality of DCD donor livers.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e944153"},"PeriodicalIF":1.1,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625788","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

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