Transplantation proceedings最新文献

{"title":"Rapid Progression of Cardiac Allograft Vasculopathy With Sudden Cardiac Death Within the First Year of Heart Transplantation: A Case Report.","authors":"Malcom Dix, Jean-Pierre Iskandar, Lefan He, Mohaned S Serdah, Aditya A Joshi, Anuradha Godishala, Abhishek Chaturvedi, Katherine Kaproth-Joslin, David A Dombroski, YeeAnn Chen, Wendy A Cheruiyot, Ronald Chong-Yik, Ronald G Schwartz, Jeffrey Alexis, Igor Gosev, Katherine L Wood, Sabu Thomas","doi":"10.1016/j.transproceed.2026.09.019","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.019","url":null,"abstract":"<p><p>Cardiac allograft vasculopathy (CAV) is a major cause of mortality and morbidity within the first 3 years of heart transplantation (HT). CAV results in progressive coronary artery stenosis and may lead to arrhythmias and sudden cardiac death. In some cases, sudden cardiac death represents the initial presentation of CAV, as cardiac denervation blunts anginal symptoms that otherwise could have preceded sudden cardiac death (SCD). Here, we describe the case of a 56-year-old man with non-ischemic cardiomyopathy. He underwent left ventricular assist device implantation followed by orthotopic HT. Five months after transplantation, he presented with atypical mid-sternal chest discomfort initially thought to be musculoskeletal in origin. Routine coronary angiography at 12 months revealed severe, diffuse 3-vessel disease consistent with International Society of Heart and Lung Transplantation (ISHLT) CAV-3, and cardiac MRI revealed full thickness delayed enhancement in the inferior wall consistent with infarction. Despite overall preserved left ventricular ejection fraction, he developed polymorphic ventricular tachycardia (VT) with an appropriate shock from a wearable cardioverter-defibrillator (WCD) and was transferred with an intra-aortic balloon pump to a larger transplant center and underwent another heart transplantation. This case highlights rapid CAV progression leading to infarction and arrhythmia despite preserved LVEF, emphasizing the need for enhanced screening with biomarkers and imaging as well as earlier consideration for device-based strategies to prevent sudden cardiac death in high-risk transplant recipients.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of CYP3A Phenoconversion in Immunosuppressed Patients Following Kidney Transplantation.","authors":"Balázs Nemes, Gyula Erdélyi, Tímea Silye-Cseh, Katalin Monostory, Ildikó Nagy","doi":"10.1016/j.transproceed.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.10.002","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus, featuring a narrow therapeutic index, is key in post-kidney transplant immunosuppression. Changes in CYP3A enzyme expression may complicate achieving therapeutic tacrolimus concentrations. This study investigated factors contributing to CYP3A phenoconversion.</p><p><strong>Methods: </strong>Data from 24 kidney transplant recipients (May 2, 2021-November 27, 2024) were analyzed. CYP3A genotypes and phenotypes were assessed postoperatively before discharge, and re-evaluated after 2 (± 6 weeks; n = 14) or 3 years (± 6 weeks; n = 10). Changes in expression magnitude and metabolizer status between time points were analyzed regarding age, sex, time elapsed, and corticosteroid therapy.</p><p><strong>Results: </strong>Metabolizer status remained unchanged in 15 patients (7 in the 2-year, 8 in the 3-year group) and altered in 9 patients (7 in the 2-year, 2 in the 3-year group; 6 increased, 3 decreased). Status showed no significant association with age, sex, time, or mean corticosteroid dose. However, phenotype change demonstrated a significant association with time elapsed since surgery (P < .05).</p><p><strong>Discussion: </strong>Contrary to previous reports - likely due to our small sample size - administered corticosteroid therapy did not contribute to CYP3A phenoconversion. Aligned with international literature, time elapsed since transplantation appears to be an important factor associated with expression changes, potentially underpinned by the complex therapeutic regimen between measurements. Future studies with larger cohorts are planned.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short and Long-Term Results of Kidney Transplantation From Extended Criteria Donors.","authors":"Eszter Mán, Zoltán Hódi, Richárd Rokszin, Ferenc Rárosi, Edit Szederkényi","doi":"10.1016/j.transproceed.2026.09.009","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.009","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of chronic kidney disease (CKD) is around 9%, and with the aging of the population, it is increasing. The growing gap between the number of patients on waiting lists and the number of donors made it necessary to transplant organs from extended criteria donors (ECD).</p><p><strong>Material and methods: </strong>Results of 211 kidney transplantations between 2013 and 2018 were analyzed retrospectively. Short- and long-term results were investigated, such as delayed graft function (DGF), post-transplantation e-GFR levels, rejection, graft and patient survival. The initial vasculopathy in \"0\" biopsy samples and the effect of the level of vasculopathy on the survival of the graft were also analyzed. The statistical analysis was made by SPSS 2.0 program. The level of significance was P < .05.</p><p><strong>Results: </strong>Between 2013 and 2018, 30 transplantations (16.57%) were carried out from ECD and 181 (83.43%) from standard donors (SD). A significant difference was found in DGF (ECD n = 10 vs SD n = 27, P = .016), and in the e-GFR levels at the control in the 1, 3, and 6. Furthermore, there was no significant difference in the incidence of rejection (ECD group n = 6, SD group n = 38, P = .572) or in the 10-year death-censored graft survival (ECD 93% vs SD 85%, P = .267). According to the vasculopathy in \"0\" biopsy sample results, atherosclerosis was significantly higher in the ECD group (P = .02), but it did not affect graft survival significantly.</p><p><strong>Conclusion: </strong>Transplantation from ECDs can be used safely, and it increases transplantation activity in clinical practice without serious long-term harmful effects.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematopoietic Stem Cell Transplantation for the Management of Histiocytic Sarcoma: A Case Report and Systematic Review.","authors":"Muhammad Kashif Amin, Aaron Higginbotham, Abat Khan, Umar Akram, Muhammad Uzair Ishaq, Nooria Saif, Fatima Akram, Javeria Shahani, Anurag Singh, Al-Ola Abdallah, Moazzam Shahzad, Joseph P McGuirk, Muhammad Umair Mushtaq","doi":"10.1016/j.transproceed.2026.09.021","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.021","url":null,"abstract":"<p><strong>Introduction: </strong>Histiocytic sarcoma (HS) is a rare, aggressive hematolymphoid malignancy, accounting for <1% of cases, and no standard treatment exists. Management typically includes surgery, chemotherapy, radiotherapy, and immunotherapy. This systematic review and case report describe the clinical features, treatments, and outcomes of adult HS, with emphasis on stem cell transplantation in refractory disease.</p><p><strong>Methods: </strong>Following PRISMA guidelines, PubMed, Embase, and Cochrane databases were searched from inception to September 2025. Original studies involving adults (≥18 years) with confirmed HS were included. The extracted data included demographics, presentation, disease characteristics, diagnostic criteria, immunohistochemistry, treatments, follow-up, and outcomes.</p><p><strong>Results: </strong>Ninety-nine studies involving 185 patients were included. The median age was 55 years (range, 18-82 years). CHOP was the most frequently used chemotherapy regimen, followed by ICE; other regimens included HIPEC, DHAP, and AEVD. The median follow-up was 12 months (range, 0.5-144). Immunotherapy (eg, nivolumab and pembrolizumab) has demonstrated potential benefit in PD-L1-positive cases. Surgery (± radiotherapy) was performed in 64 patients with primarily unifocal disease, and favorable outcomes were achieved in approximately half of them. Ten patients underwent stem cell transplantation (5 allogeneic and 5 autologous), and 60% achieved remission in each group. We report a case of a 33-year-old man with refractory systemic HS who achieved durable remission (>1 year) following allogeneic haploidentical peripheral blood stem cell transplantation after failure of multiple chemotherapy regimens.</p><p><strong>Conclusion: </strong>HS exhibits heterogeneous and aggressive behaviors that require individualized management. Allogeneic hematopoietic stem cell transplantation may be a viable option for treating refractory diseases.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Transplant Lymphoproliferative Disorder After Successful Treatment of Graft-Versus Host Disease Following Liver Transplantation.","authors":"Tonguç Utku Yılmaz, Can Boynukara, Ant Uzay, Özgür Özkayar, Cuyan Demirkesen, Hamdi Karakayalı","doi":"10.1016/j.transproceed.2026.09.018","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.018","url":null,"abstract":"<p><p>Graft-versus-host disease (GVHD) is a rare complication after liver transplantation. Post-transplantation lymphoproliferative disorders (PTLD) are lymphomas that develop after transplantation due to the immunosuppression. Both disorders have high mortality risks. A 65-year-old male patient underwent LDLT from his son due to cryptogenic liver cirrhosis. In the third month, the patient diagnosed as GVHD with the initial symptom being skin changes. The patient was treated with high-dose steroids and extracorporeal photopheresis. There was gastrointestinal and bone marrow involvement. On the 11th month, the patient suffered from lymphadenopathy and was diagnosed as PTLD. The patient was treated with Rituxima, ruxolitinib. The patient is still alive with good performance. This is the first case of PTLD occurring after GVHD. Treatments such as extracorporeal photopheresis and ruxolitinib used in this case resulted in successful survival.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful First-Line Haploidentical Hematopoietic Stem Cell Transplantation in an Elderly Patient With Severe Aplastic Anemia and Complex Comorbidities: A Case Report.","authors":"Yingxin Sun, Tianzhi Wang, Xinfeng Wang, Yaping Zhang, Xi Yang, Yifeng Cai","doi":"10.1016/j.transproceed.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.011","url":null,"abstract":"<p><p>Standard management guidelines generally recommend immunosuppressive therapy (IST) as first-line treatment for older patients with severe aplastic anemia (SAA), whereas the role of upfront haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in this population remains uncertain, particularly in patients with complex comorbidities. We report a 62-year-old woman with SAA, a history of surgically resected stage IA lung adenocarcinoma, and previous left lower extremity deep vein thrombosis treated with venous stent implantation and long-term aspirin therapy. Because no matched sibling or unrelated donor was available, and following individualized counseling regarding IST and transplantation, the patient underwent upfront haplo-HSCT combined with umbilical cord-derived mesenchymal stem cells after a conditioning regimen including fludarabine, busulfan, cyclophosphamide, antithymocyte globulin, and thiotepa. Neutrophil engraftment occurred on post-transplant day +12, and platelet independence was achieved on day +13. Donor chimerism reached 99.6% by day +14 and remained within the complete-chimerism range through the latest available assessment in January 2026. In late December 2025 and January 2026, the patient developed cytomegalovirus infection accompanied by transient trilineage cytopenia; after anti-CMV treatment with maribavir, the infection was controlled and peripheral blood counts subsequently recovered. At the most recent clinical follow-up on August 6, 2026, approximately 17 months after transplantation, no chronic graft-versus-host disease had developed, the previous lung adenocarcinoma remained in remission, and the thrombotic condition remained clinically stable. This case suggests that upfront haplo-HSCT combined with UC-MSCs may represent a feasible individualized treatment option for carefully selected older patients with SAA who lack matched donors, although broader conclusions require larger studies and longer follow-up.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience and Rearrangement of Deceased Organ Donation Activity in 27 European Union Countries After COVID-19 Pandemic.","authors":"Márk Karsai, Sándor Mihály","doi":"10.1016/j.transproceed.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.008","url":null,"abstract":"","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It Is Possible to Save the Kidney With Renal Artery Occlusion Without Autotransplantation: A Case Report.","authors":"Adem Şafak, Emre Karakaya, İlgin Demir, Esra Baskın, Sedat Yıldırım, Atilla Sezgin, Mehmet Haberal","doi":"10.1016/j.transproceed.2026.10.001","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.10.001","url":null,"abstract":"<p><p>Renal artery stenosis is a rare but important cause of renovascular hypertension in children that may lead to malignant hypertension and renal failure. A 13-year-old girl presented with malignant hypertension and acute kidney injury, and imaging demonstrated occlusion of both renal arteries. Endovascular recanalization was unsuccessful because of complete, heavily fibrotic occlusions involving a long segment of the right renal artery extending to the hilum, leaving no suitable distal artery for reconstruction, and a 7.3-mm segment of the left renal artery at its aortic origin. To preserve renal function, surgical revascularization was performed by in situ reimplantation of the left renal artery into the aorta, without autotransplantation. Postoperatively, renal function recovered, the proteinuria present at admission regressed, and the patient became normotensive without antihypertensive medication.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidentally Diagnosed Pulmonary Embolism Two Months After Living Liver Donation in a Donor With Homozygous MTHFR A1298C Mutation: A Case Report.","authors":"Umit Ozcelik, Mesut Pekmez","doi":"10.1016/j.transproceed.2026.09.014","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.014","url":null,"abstract":"<p><p>Living donor liver transplantation (LDLT) is widely performed in countries with limited cadaveric organ donation. Although donor hepatectomy is generally safe, venous thromboembolic events such as pulmonary embolism (PE) remain rare but potentially life-threatening complications. Genetic thrombophilia, including methylenetetrahydrofolate reductase (MTHFR) mutations, may contribute to thrombotic risk. A 39-year-old female living liver donor underwent right donor hepatectomy for LDLT. The donor had no preoperative risk factors for venous thromboembolism, and a routine thrombophilia panel, including protein C, protein S, antithrombin III, factor V Leiden, and prothrombin gene mutations, was normal. Two months after surgery, an abdominal computed tomography (CT) scan performed due to fluid collection adjacent to the remnant liver in ultrasound (USG) during routine follow-up incidentally revealed partial PE. Pulmonary CT angiography confirmed the finding, while lower extremity Doppler USG showed no evidence of deep vein thrombosis. Laboratory tests revealed elevated D-dimer and homocysteine levels. Further genetic evaluation demonstrated a homozygous MTHFR A1298C mutation. The patient was treated with low molecular weight heparin followed by oral anticoagulant therapy for 6 months, resulting in complete radiological resolution of the embolism. PE after donor hepatectomy is rare but potentially fatal. This case suggests that MTHFR A1298C mutation may represent a previously underrecognized risk factor for venous thromboembolism in living liver donors. In populations with a high prevalence of MTHFR mutations, extended thrombophilia screening and appropriate thromboprophylaxis may help reduce the risk of postoperative thromboembolic complications.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiography-Detected Elevated Pulmonary Artery Systolic Pressure and Outcomes After Living Donor Liver Transplantation.","authors":"Muhammad Ahmed Bajwa, Sajawal Hussain, Syed Murtaza Hassan Kazmi, Abu Bakr Hafeez Bhatti, Maliha Aziz, Muhammad Yaqoob Akhtar, Abdul Ahad, Muslim Atiq","doi":"10.1016/j.transproceed.2026.09.016","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.016","url":null,"abstract":"<p><strong>Introduction: </strong>The clinical significance of mild to moderate elevation in pulmonary artery systolic pressure (PASP) detected by transthoracic echocardiography during liver transplant evaluation remains uncertain, particularly in living donor liver transplantation (LDLT).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted of adult living donor liver transplant recipients between 2018 and 2023. Preoperative PASP was estimated using transthoracic echocardiography, and patients were stratified into PASP ≤35 mm Hg and elevated PASP (>35 mm Hg) groups. The primary outcome was 5-year overall survival, and the secondary outcome was intensive care unit (ICU) stay.</p><p><strong>Results: </strong>Among 230 recipients, 141 had PASP ≤35 mm Hg and 89 had PASP >35 mm Hg. Five-year overall survival was similar between groups (70%vs 72%; log-rank p = 0.905). Elevated PASP was not associated with mortality on univariate Cox regression analysis. The proportion of patients with prolonged ICU stay (>5 days) did not differ significantly between groups. Higher body mass index was identified as a significant predictor of increased mortality risk.</p><p><strong>Conclusion: </strong>Mild to moderate PASP elevation detected by echocardiography was not associated with inferior long-term survival or increased ICU utilization following LDLT. Modest PASP elevation on preoperative echocardiography alone should not preclude transplantation in carefully selected candidates.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}