Annals of Transplantation最新文献_第4页

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}

引用次数: 0

Cyclosporine A Does Not Mitigate Liver Ischemia/Reperfusion Injury in an Ex Vivo Porcine Model of Donation After Circulatory Death. 环孢素 A 不能减轻猪体外循环死亡后捐献模型中的肝脏缺血/再灌注损伤。

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2024-01-30 DOI: 10.12659/AOT.941054

Joshua Hefler, Sanaz Hatami, Aducio Thiesen, Mitchell J Wagner, Guilherme Mainardi, Sayed Himmat, Constantine J Karvellas, David L Bigam, Darren H Freed, A M James Shapiro

{"title":"Cyclosporine A Does Not Mitigate Liver Ischemia/Reperfusion Injury in an Ex Vivo Porcine Model of Donation After Circulatory Death.","authors":"Joshua Hefler, Sanaz Hatami, Aducio Thiesen, Mitchell J Wagner, Guilherme Mainardi, Sayed Himmat, Constantine J Karvellas, David L Bigam, Darren H Freed, A M James Shapiro","doi":"10.12659/AOT.941054","DOIUrl":"10.12659/AOT.941054","url":null,"abstract":"BACKGROUND Ischemia/reperfusion injury (IRI) is an inherent problem in organ transplantation, owing to the obligate period of ischemia that organs must endure. Cyclosporine A (CsA), though better know as an immunosuppressant, has been shown to mitigate warm IRI in a variety of organ types, including the liver. However, there is little evidence for CsA in preventing hepatic IRI in the transplant setting. MATERIAL AND METHODS In the present study, we tested the effect of CsA on hepatic IRI in a large-animal ex vivo model of donation after circulatory death (DCD). Porcine donors were pre-treated with either normal saline control or 20 mg/kg of CsA. Animals were subject to either 45 or 60 minutes of warm ischemia before hepatectomy, followed by 2 or 4 hours of cold storage prior to reperfusion on an ex vivo circuit. Over the course of a 12-hour perfusion, perfusion parameters were recorded and perfusate samples and biopsies were taken at regular intervals. RESULTS Peak perfusate lactate dehydrogenase was significantly decreased in the lower-ischemia group treated with CsA compared to the untreated group (4220 U/L [3515-5815] vs 11 305 [10 100-11 674]; P=0.023). However, no difference was seen between controls and CsA-treated groups on other parameters in perfusate alanine or asparagine aminotransferase (P=0.912, 0.455, respectively). Correspondingly, we found no difference on midpoint histological injury score (P=0.271). CONCLUSIONS We found minimal evidence that CsA is protective against hepatic IRI in our DCD model.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"29 ","pages":"e941054"},"PeriodicalIF":1.1,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575046","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

Effects of Preservation of Donor Liver Gastroduodenal Artery on Post-Transplant Biliary Complications in 187 Liver Transplant Recipients: A Retrospective Study. 保留供肝胃十二指肠动脉对 187 例肝移植受者移植后胆道并发症的影响：一项回顾性研究

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2023-12-26 DOI: 10.12659/AOT.941699

Qing Yan, Ying Liu, Fei-Wen Deng, Feng-Jie Wang, Huan-Wei Chen

{"title":"Effects of Preservation of Donor Liver Gastroduodenal Artery on Post-Transplant Biliary Complications in 187 Liver Transplant Recipients: A Retrospective Study.","authors":"Qing Yan, Ying Liu, Fei-Wen Deng, Feng-Jie Wang, Huan-Wei Chen","doi":"10.12659/AOT.941699","DOIUrl":"10.12659/AOT.941699","url":null,"abstract":"BACKGROUND This retrospective study aimed to evaluate the effects of preservation of the donor liver gastroduodenal artery on post-transplant biliary complications in 187 liver transplant recipients. MATERIAL AND METHODS The clinical data of 187 liver transplantation recipients were retrospectively analyzed. Recipients were divided into conventional and modified groups. The technical point of the modified group is to preserve at least 2 cm of the distal gastroduodenal artery, and pay special attention to preserve the superior pancreaticoduodenal artery to ensure the distal blood supply to the common bile duct. RESULTS The modified group had significantly shorter operative time (7.17 vs 7.98) h (P<0.001) and less intraoperative blood loss (2715.40 vs 3434.93) ml (P=0.003) than the conventional group. The incidence of postoperative biliary complications (including anastomotic biliary leakage, ischemic bile duct stenosis, and anastomotic bile duct stenosis) in the modified group (4/114, 4.1%) was significantly lower (15/73, 20.5%) (P<0.001). There was no significant difference in the intraoperative cold and warm ischemia time and postoperative hospital stay length between the 2 groups. In addition, there was no significant difference in the effect of cardiac-death and brain-death sources on perioperative biliary complications, while the peak postoperative transaminase and total bilirubin were higher in patients receiving the donor liver of cardiac death (P<0.05). CONCLUSIONS Preserving the integrity of the donor gastroduodenal artery and surrounding tissue is beneficial to protect the blood supply of the extrahepatic bile duct, and can reduce the incidence of biliary complications.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"28 ","pages":"e941699"},"PeriodicalIF":1.1,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037318","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

Preliminary Evaluation of 2 Patient-Centered Educational Animations About Kidney Transplant Complications 对两部以患者为中心的肾移植并发症教育动画片的初步评估

IF 1.1 4区医学

Annals of Transplantation Pub Date : 2023-12-21 DOI: 10.12659/aot.942611

Sydney Johnson, Anne Solbu, Renee Cadzow, T. Feeley, Maria M. Keller, L. Kayler