Transplantation proceedings最新文献

{"title":"Sequential Liver, Kidney, and Heart Transplantation in a Single Recipient: Long-Term Survival Complicated by Chronic Renal Allograft Failure, Lung Cancer, and Recurrent Infection-A Case Report.","authors":"Jia-Ni Xia, Zhi-Kun Luo, Jing-Hao Li, Hang Yu","doi":"10.1016/j.transproceed.2026.09.015","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.015","url":null,"abstract":"<p><strong>Background: </strong>Multi-organ transplant recipients face a substantial long-term risk of infection, malignancy, and chronic rejection secondary to prolonged immunosuppression. Sequential liver, kidney, and heart transplantations remain rare, resulting in limited evidence to guide perioperative management and long-term follow-up.</p><p><strong>Case summary: </strong>A 61-year-old man underwent sequential liver, kidney, and heart transplantations in 2012, 2018, and 2022, respectively. Initial graft function was favorable under an immunosuppressive regimen comprising tacrolimus, mycophenolate mofetil, and corticosteroids. From 2023 onwards, he developed recurrent SARS-CoV-2 infections, lung cancer requiring a segmentectomy, recurrent lower-extremity arteriosclerosis obliterans, and progressive renal allograft failure. He ultimately died from cardiopulmonary arrest precipitated by severe metabolic acidosis and electrolyte derangements complicating renal allograft failure.</p><p><strong>Discussion: </strong>This case suggests that patients undergoing sequential multi-organ transplantations can achieve meaningful long-term survival with multidisciplinary care and individualized immunosuppression. Nevertheless, complications related to cumulative immunosuppression remain a major challenge, necessitating dynamic follow-up and tailored post-transplant management.</p><p><strong>Conclusion: </strong>Sequential liver, kidney, and heart transplantations are feasible in carefully selected patients. However, the delayed adverse effects of chronic immunosuppression pose a major threat to long-term outcomes, underscoring the absolute necessity for vigilant monitoring and highly individualized pharmacological management.</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":"149187440","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":"Mycophenolate Mofetil-Induced Hypofibrinogenemia: A Case Report.","authors":"Shuangping Cai, Leping Ning, Fangyan Gan, Jingshu Fang, Shuang Deng","doi":"10.1016/j.transproceed.2026.09.012","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.012","url":null,"abstract":"<p><p>Mycophenolate mofetil (MMF) is an immunosuppressive agent used extensively in post-transplant management and the treatment of autoimmune diseases. Its hematological adverse effects manifest primarily as anemia, leukopenia, and thrombocytopenia induced by bone marrow suppression. Adverse reactions associated with coagulation dysfunction are rarely reported. This report describes a case of hypofibrinogenemia attributed to MMF in a renal transplant recipient. The patient developed fibrinogen levels below 0.6 g/L, accompanied by cutaneous ecchymosis, after initiating MMF therapy. Fibrinogen levels normalized within 10 days following discontinuation of MMF. During MMF treatment, regular monitoring of fibrinogen levels is recommended, particularly in patients with hemorrhagic manifestations.</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":"149187371","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":"Profound Tacrolimus-Induced Catatonic Encephalopathy in a Kidney Transplant Recipient With Mitochondrial Myopathy: A Cautionary Case of Reversible Neurotoxicity.","authors":"Valeria Ripa, Stuart R Geffner, Matthew G Rosenzweig, Matthew Hanlon, Harry Sun","doi":"10.1016/j.transproceed.2026.09.022","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.022","url":null,"abstract":"<p><strong>Introduction: </strong>Maternally inherited diabetes and deafness (MIDD) is a multisystem mitochondrial disorder most commonly caused by the m.3243A>G pathogenic variant in the MT-TL1 gene. Kidney transplantation in affected individuals presents unique perioperative and immunosuppressive management challenges due to underlying metabolic, neurologic, cardiac, and neuromuscular vulnerability.</p><p><strong>Case report: </strong>We report a 64-year-old woman with end-stage renal disease secondary to insulin-dependent diabetes and MIDD (m.3243A>G) who underwent unrelated living donor kidney transplantation. The immediate postoperative period was complicated by diabetic ketoacidosis with lactic acidosis, transient slow graft function, and profound encephalopathy with catatonic features. Neuroimaging showed no acute abnormalities, and electroencephalography demonstrated severe diffuse encephalopathy without epileptiform activity. Tacrolimus levels were supratherapeutic in the early postoperative period. Given concern for calcineurin inhibitor neurotoxicity superimposed on mitochondrial dysfunction, tacrolimus was discontinued, and immunosuppression was switched to cyclosporine. Neurologic status gradually improved, and kidney allograft function fully normalized.</p><p><strong>Discussion: </strong>This case highlights the substantial perioperative metabolic and neurologic risks associated with kidney transplantation in patients with MIDD. Patients with compensated cardiac dysfunction and manageable neuromuscular impairment should not be excluded from transplantation solely on the basis of mitochondrial cytopathy.</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":"149187336","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":"The Role of Varying Cardiac Troponin Levels in Long-Term Mortality in Liver Transplant Patients.","authors":"Carlos Romero, Nicolas Celso, José Méndez, Jorge Muniagurria, Ramiro Barolo, Diego Toscana, Glenda Ernst, Fernando Gilsanz Rodriguez","doi":"10.1016/j.transproceed.2026.09.013","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.013","url":null,"abstract":"<p><strong>Background: </strong>Increased serum concentrations of (High-sensitivity) ultrasensitive Troponin (hsTn) could predict short-term mortality in patients undergoing liver transplant (LT). This study aimed to determine whether there is an association between changes in intraoperative hsTn values during LT and long-term mortality.</p><p><strong>Methods: </strong>A retrospective study was conducted on adult LT recipients who underwent orthotopic LT from deceased donors. HsTn levels were obtained during surgery at baseline and 60 minutes after graft reperfusion. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. The association between troponin delta and mortality was assessed using Cox proportional hazards regression, and discriminatory performance was evaluated by ROC analysis.</p><p><strong>Results: </strong>A total of 101 LT recipients were included and followed for 3 years; 17 patients (16.8%) died during follow-up. No significant differences were observed in baseline hsTn concentrations between survivors and non-survivors. HsTn levels measured 60 minutes after graft reperfusion were significantly higher in patients who died (median 45.2 ng/L [IQR: 30-105] vs 35 ng/L [IQR: 23-54]; p < .05). The difference between baseline and 60-minute hsTn values (delta-hsTn) was analyzed. ROC analysis identified an optimal cut-off of 26.45 ng/L (AUC, 0.65). Patients with delta-hsTn ≥26 ng/L had increased 3-year mortality (sensitivity 62.5%, specificity 71.7%). In Cox proportional hazards analysis, delta-hsTn ≥26 ng/L was independently associated with mortality (HR, 3.31, 95% CI: 1.3-8.4).</p><p><strong>Conclusion: </strong>Intraoperative hsTn changes, reflected by delta-hsTn, were associated with long-term mortality after LT and may represent a clinically accessible marker of perioperative myocardial stress and risk stratification.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171290","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":"Inadvertent Coronary Sinus Cannulation During Central Venous Catheter Placement in a Liver Transplant Recipient with Persistent Left Superior Vena Cava: A Case Report.","authors":"Samuelu M Atoa, Alexander Dennis Berry-Rieser, Alexander A Vitin, Charles E Galaviz, Jacob E Pollard, Henry Cameron Norris, Evelyn C Loose, Jacob B Brandenburg, Bianca E Rich, Alastair E Moody","doi":"10.1016/j.transproceed.2026.09.020","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.020","url":null,"abstract":"<p><p>Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly and is usually asymptomatic. Central venous catheterization through a PLSVC can be challenging, and inadvertent advancement of catheters into the coronary sinus may result in arrhythmias, perforation, thrombosis, or inaccurate hemodynamic measurements. We report a case of coronary sinus cannulation by a left internal jugular dialysis catheter in a liver transplant recipient with previously unrecognized PLSVC. Initial chest radiography suggested catheter termination within a duplicated left superior vena cava; however, intraoperative transesophageal echocardiography (TEE) demonstrated the catheter tip within the coronary sinus. The catheter was withdrawn under direct echocardiographic guidance, avoiding potential complications. This case highlights the utility of intraoperative TEE for definitive localization of central venous catheters in patients with anomalous thoracic venous anatomy.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168010","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":"Risk Factors and Clinical Predictors of Urinary Tract Infections in Kidney Transplant Recipients: A Retrospective Single-Center Study.","authors":"Arjun Iyer, Lóránt Illésy, Richard Budaházi, Balázs Nemes","doi":"10.1016/j.transproceed.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.010","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) remain a significant complication following kidney transplantation (KT), contributing to morbidity and potential graft-related complications. This study investigates the incidence, risk factors, recurrence patterns, and multidrug-resistant (MDR) characteristics of UTIs in KT recipients.</p><p><strong>Methods: </strong>A retrospective cohort study was performed, including 236 KT recipients transplanted between 2016 and 2023 at the University of Debrecen. Patients were classified according to UTI occurrence: 131 patients remained UTI-free, while 105 patients developed at least one microbiologically confirmed UTI. A total of 234 UTI episodes were analyzed, including 177 non-MDR and 57 MDR episodes. Clinical, donor-related, operative, viral, and immunosuppressive variables were evaluated. Univariate and multivariate logistic regression analyses were performed to identify independent predictors.</p><p><strong>Results: </strong>UTIs occurred in 44.5% of recipients. Among 234 UTI episodes, 149 (63.7%) were recurrent and 57 (24.4%) were MDR. Patient-level risk factors associated with UTI occurrence included older age (P = .036), female sex (P < .001), higher Charlson Comorbidity Index (P = .040), and increased Kidney Donor Profile Index (P = .030). Prolonged hospitalization was independently associated with UTI occurrence and recurrence (P = .004 and P = .001, respectively). After multivariate adjustment, Extended-release calcineurin inhibitor formulations were independantly associated with reduced UTI occurrence and recurrence. Mycophenolic acid exposure was associated with increased UTI occurrence and MDR episodes in univariate analyses (P = .001 and P < .001, respectively), but no independent predictors of MDR infection were identified on multivariate analysis (P = .082).</p><p><strong>Conclusions: </strong>UTIs remain a frequent complication following KT, with recurrent and MDR episodes representing a substantial proportion of infections. Recipient characteristics, donor factors, prolonged hospitalization, and immunosuppressive regimen characteristics contribute to infection risk. Optimization of perioperative management and immunosuppressive strategies may help reduce infectious morbidity, although prospective studies are required for validation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169405","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 Scoring Systems in Kidney Transplantation: A Single Center Experience.","authors":"Ildikó Nagy, Fanni Fodor, Júlia Kiss, Balázs Nemes","doi":"10.1016/j.transproceed.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.09.006","url":null,"abstract":"<p><strong>Purpose: </strong>The global shortage of donor organs has led to increasing efforts to optimize the allocation process of renal allografts.</p><p><strong>Method: </strong>We conducted our study at the University of Debrecen, utilizing data pertaining to kidney transplants that were performed between January 1, 2018, and December 31, 2022. We used expanded criteria donor (ECD), kidney donor profile index (KDPI), and kidney donor risk index (KDRI) criteria systems to evaluate donor kidneys. We wanted to measure graft function and 3- to 5-year graft survival of kidneys offered to our center.</p><p><strong>Results: </strong>During this time frame, 830 kidneys were offered to our center, and 160 were successfully transplanted. Looking at them, it can be observed that, based on the ECD/standard criteria donor (SCD) criteria systems, 5-year graft survival significantly differs in the 2 groups, which confirms the use of the criteria systems in clinical practice. Moreover, it can also be stated that using KDPI classification for the ECD group, there are donor kidneys (KDPI <85) which have the same characteristics as SCD donor kidneys. Thus, the KDPI criteria system is better suited to project expected graft survival of donor kidneys. This is also confirmed by the 3-year graft survival of the kidneys, discarded by us but transplanted elsewhere, which also shows that lower graft survival is only observable in the group with a KDPI of more than 85.</p><p><strong>Conclusion: </strong>Taking the weaknesses of KDPI into account, it is really important to use tools that were developed to assess kidneys that can contribute to maximizing organ utilization, as quality of life of end-stage kidney disease patients can only be improved by transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166875","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":"Regional Expansion of Transplant Oncology: The First Case of Liver Transplantation for Unresectable Colorectal Liver Metastasis in the Gulf Region.","authors":"Fatima AlKhyeli, Juan S Barajas-Gamboa, Chase J Wehrle, Essa Aleassa, Mahmoud Nalawi, Omar Abu Sham, Sandra El Hajj, Ahmad Raza, Fadi Younes, Carla Hajj, Shiva Kumar, Luis Campos, Teresa D Uso, Cristiano Quintini, Giuseppe Iuppa","doi":"10.1016/j.transproceed.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.08.006","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Liver transplantation for colorectal liver metastases (CRLM) has emerged as a potential curative option for highly selected patients with unresectable liver-only disease, with recent trials demonstrating 5-year overall survival rates of 55% to 83%. Surgical resection remains the only curative treatment for colorectal liver metastases (CRLM), but its applicability is limited, with only 25% of patients eligible. However, this approach remains investigational with limited global experience and has never been implemented in the Middle East region. Recently, liver transplantation (LT) has emerged as a potential curative option for select patients with unresectable liver-only metastases. This report highlights the potential for liver transplantation to serve as a curative modality in highly selected patients with CRLM and demonstrates its feasibility in a new geographic region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case report: &lt;/strong&gt;We report the first case in the Gulf Cooperation Council (GCC) region of a 41-year-old male with unresectable CRLM who underwent LT following an aggressive multimodal pretransplant protocol. The patient was initially treated at an outside facility for synchronous left-sided colorectal cancer with liver metastases, achieving complete remission after FOLFOX chemotherapy. He subsequently developed 2 liver recurrences: the first in July 2023, with 17 metastases managed at the outside facility by surgical resection and chemotherapy; and the second in October 2023, with 40 metastases, treated with systemic chemotherapy and trans arterial radioembolization (TARE-Y90). He received additional treatment with ablative liver-directed therapies consistent with the \"Cleveland Protocol.\" The patient subsequently underwent orthotopic liver transplantation. His postoperative course was complicated with moderate acute cellular rejection, which was successfully treated, and he was discharged on post-operative day 16.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case demonstrates the successful implementation of liver transplantation for CRLM in the Gulf region, achieving disease-free survival at 4-month follow-up despite high-risk biological features typically associated with poor prognosis. It illustrates the feasibility and potential benefit of LT for unresectable CRLM in carefully selected patients, following an aggressive pretransplant locoregional therapy protocol modeled after the Cleveland Clinic approach. Key success factors included rigorous patient selection using established criteria (Oslo score 0, low Fong score, low PET-MTV), intensive pretransplant optimization with multimodal therapy, and experienced multidisciplinary management of post-transplant complications. With careful patient selection and integration of systemic and liver-directed therapies to achieve maximal disease control, this strategy may help expand transplant eligibility, possibly offering a curative approach. This case provides valuable regional data fo","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140128","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":"Fat Embolism Syndrome as Cause of Death in a Multiorgan Donor With Successful Utilization of Thoracic and Abdominal Organs.","authors":"Anna Forslund, Åsa Norén, Emma C Hansson, Leifur Thrainsson, Sossio Perrotta, Gustav Herlenius, William Bennet, Kristjan Jonsson, Johan Nordström","doi":"10.1016/j.transproceed.2026.06.047","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.06.047","url":null,"abstract":"<p><p>Fat embolism syndrome is an under-reported consideration in organ donation and is most often associated with long-bone trauma and intramedullary fixation. We describe a deceased donor who, after a traffic accident with bilateral femoral fractures treated by bilateral intramedullary nailing, developed hypoxemia, encephalopathy out of proportion to sedation, and a petechial rash consistent with fat embolism syndrome by clinical criteria. Despite intensive care, brain death was determined according to national standards and donation after brain death proceeded. Donor optimization followed lung-protective ventilation and standard hemodynamic targets. Predonation assessments met acceptance thresholds, and procurement showed no macroscopic intravascular fat in graft vessels with only scattered fat droplets in the abdominal cavity without luminal obstruction. The heart, bilateral lungs, liver, pancreas, and both kidneys were transplanted. Early courses were uncomplicated, with immediate heart and liver function, primary graft dysfunction grade 0 at 72 hours for the lungs, early insulin independence after pancreas transplantation, and primary kidney graft function. No embolic phenomena attributable to donor fat embolism syndrome were observed, and three-month follow-up was unremarkable. These findings support physiology-based evaluation rather than categorical exclusion of donors with suspected fat embolism syndrome.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129782","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":"A Kidney Transplant Patient Suffering From Multiple Colonic Ulcers and Hepatic Abscess: A Case Report and Literature Review.","authors":"Yue Liu, Yangyan Liu, Chunsun Dai, Ming Gu, Jing Luo, Hongdi Cao","doi":"10.1016/j.transproceed.2026.08.003","DOIUrl":"https://doi.org/10.1016/j.transproceed.2026.08.003","url":null,"abstract":"<p><p>We present a rare case of colonic mucormycosis with hepatic dissemination after kidney transplantation. Early diagnosis was achieved through rapid metagenomic next-generation sequencing (mNGS) of blood and liver abscess samples, enabling timely intervention. The patient achieved complete clinical recovery with preserved allograft function. Gastrointestinal mucormycosis is extremely rare, reported cases frequently require colectomy (83.3%) and carry a mortality rate approaching 50%. This case highlights key management principles for intestinal mucormycosis in transplant recipients: rapid pathogen identification via mNGS, prompt initiation of dual antifungal therapy against Mucorales, and urgent surgical debridement of necrotic tissue.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121337","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}