Transplantation proceedings最新文献

{"title":"COVID-19 Outcomes in Kidney Transplant Recipients Receiving Tixagevimab/Cilgavimab for Pre-exposure Prophylaxis: A Single-center Retrospective Study.","authors":"Jakob Joachim Spencker, Michael Mikhailov, Friederike Bachmann, Mira Choi, Wiebke Duettmann, Georgios Eleftheriadis, Fabian Halleck, Marcel G Naik, Eva Schrezenmeier, Bianca Zukunft, Klemens Budde, Bilgin Osmanodja","doi":"10.1016/j.transproceed.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.06.021","url":null,"abstract":"<p><strong>Background/aim: </strong>Kidney transplant recipients (KTRs) show higher morbidity and mortality from COVID-19 than the general population and have an impaired response to vaccination. For patients without serological response to COVID-19 vaccination, pre-exposure prophylaxis with tixagevimab/cilgavimab is an option to achieve alternative immunization.</p><p><strong>Methods: </strong>We retrospectively analyzed COVID-19 incidence and outcomes in a single-center cohort of 104 KTRs who received tixagevimab/cilgavimab pre-exposure prophylaxis between March 16, 2022, and January 18, 2023, comparing them with 36 unvaccinated and 224 vaccinated KTRs without pre-exposure prophylaxis infected during the Omicron era.</p><p><strong>Results: </strong>During a median follow-up time of 7.4 months (IQR, 5.9-10.1 months) after pre-exposure prophylaxis, 36 KTRs (35%) experienced breakthrough SARS-CoV-2 infections, with 5 (5%) having recurrent infections. Among those with breakthrough infection, 4 (11%) were hospitalized, and 1 (3%) died from COVID-19. No serious adverse events have followed tixagevimab/cilgavimab administration. In comparison, unvaccinated KTRs had a 51.0% hospitalization rate and an 8.6% mortality rate, and vaccinated patients without pre-exposure prophylaxis had a 17.0% hospitalization rate and a 2.2% mortality rate.</p><p><strong>Conclusion: </strong>These real-world data show that pre-exposure prophylaxis with tixagevimab/cilgavimab was a feasible alternative for patients without sufficient serological response to vaccination during a period of Omicron dominance. Novel therapeutics are necessary for variants resistant to tixagevimab/cilgavimab.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088662","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 Impact of HLA Alleles on the Severity of COVID-19 in Kidney Transplant Patientss.","authors":"Hayriye Senturk Ciftci, Erol Demir, Demet Kivanc, Huseyin Bakkaloglu, Ayse Erol Bozkurt, Cigdem Kekik Cinar, Meltem Savran Karadeniz, Tzevat Tefik, Ayse Serra Artan, Yeliz Ogret, Mediha Suleymanoglu, Nurana Garayeva, Aydın Turkmen, Ismet Nane, Ali Emin Aydin, Fatma Savran Oguz","doi":"10.1016/j.transproceed.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.06.020","url":null,"abstract":"<p><strong>Background: </strong>Human Leukocyte Antigen (HLA) genes play a crucial role in immune response against infectious disease. In this study, we aimed to investigate the frequency of HLA alleles in kidney transplant patients diagnosed with COVID-19 and explore potential associations with disease severity.</p><p><strong>Material and methods: </strong>Kidney transplant patients who were diagnosed with COVID-19 and followed up at the Istanbul Medical Faculty Hospital kidney transplant clinic between March 2020 and January 2023 were included in this study. All patients were genotyped for HLA loci (HLA-A,-B,-DRB1) at low resolution using the Luminex method. Patients were classified as mild, moderate, and severe according to COVID-19 severity.</p><p><strong>Results: </strong>In a study of 332 kidney transplant patients, 52 developed severe COVID-19, with 24 deaths. Severe cases were older and had higher rates of hospitalization, Intensive Care Unit (ICU) admissions, acute kidney injury, and mortality (all P < .001). The HLA-B*38 and HLA-DRB1*11 alleles were more common in severe cases (P = .045 and P = .005). Among those who died, cardiovascular disease, longer hospital stays, and ICU admissions were more frequent (all P < .001). The HLA-B*35 allele was higher in the deceased (P = .021), while the HLA-DRB1*03 allele was absent in those who died but present in 8.3% of survivors (P = .042).</p><p><strong>Conclusion: </strong>The association with HLA was examined for susceptibility with COVID-19 infection in patients who underwent kidney transplantation: HLA-B*38 and HLA-DRB1*11 were found to be more common in patients with SARS-CoV-2 infections.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083035","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":"Clinical and Anemia-Related Predictors of Short-Term Mortality in Renal Transplantation Recipients After Graft Rejection: A Retrospective Study.","authors":"Alper Tuna Güven, Kübra Yıldız Cömert, Elvar Mirzaevi, Cihat Burak Sayın","doi":"10.1016/j.transproceed.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.06.023","url":null,"abstract":"<p><strong>Introduction: </strong>Renal transplantation is the treatment of choice for end-stage chronic kidney disease (CKD). Rejection is a relatively common complication and mortality is increased compared to the general population. There are several established predictors of mortality in patients with renal transplantation. We aimed to investigate whether these factors are also applicable after graft rejection and whether anemia and related factors have an impact on short-term mortality after graft rejection.</p><p><strong>Methodology: </strong>We conducted a retrospective chart study in a high-volume tertiary care renal transplantation referral center. We obtained clinical, demographic, and mortality data, as well as anemia- and transplantation-related variables, via electronic medical records. We analyzed short-term (6 months) mortality and hematological characteristics based on baseline variables and mortality predictors. Two 3-variable models were constructed using multivariate logistic regression (MLR) to identify factors associated with short-term mortality.</p><p><strong>Results: </strong>The analysis included 67 patients who had received renal transplantation, experienced graft rejection and mortality. Months to graft rejection after transplantation were 24 (117), and months to death after rejection were 10 (77). Months to death after rejection showed positive correlation with months to graft rejection after transplantation and lowest hemoglobin (Hb_min), and negative correlation with age at transplantation and ferritin levels. MLR demonstrated in 2 different models that either erythropoietin use, months to graft rejection after transplantation, and Hb_min, or erythropoietin use, months to graft rejection after transplantation, and Log_Ferritin are independently associated with short-term mortality.</p><p><strong>Discussion: </strong>Anemia and high ferritin levels-markers of inflammation-are associated with increased short-term mortality, and erythropoietin use is associated with improved survival among patients with renal graft rejection, similar to patients with non-dialysis or dialysis CKD, as well as renal transplantation patients.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082854","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":"Intramuscular Tacrolimus Pharmacokinetics in a Pediatric Porcine Model for Partial Heart Transplantation.","authors":"Louis Steen, Herra Javed, Eli Contorno, David Irby, John Lowery, Mary Bradley, Kimberly Paige O'Brien, Brian Reemsten, T Konrad Rajab","doi":"10.1016/j.transproceed.2025.07.030","DOIUrl":"10.1016/j.transproceed.2025.07.030","url":null,"abstract":"<p><strong>Objective: </strong>The cornerstone of immunosuppression for transplantation is tacrolimus. One of the most reliable routes for administering tacrolimus in porcine models is intramuscular injection. However, the pharmacokinetics of intramuscular tacrolimus in piglets remain unexplored. Here, we close this gap in knowledge to guide intramuscular tacrolimus dosing in pediatric porcine transplant models.</p><p><strong>Method: </strong>In the dosing trial, piglets (n = 7) underwent partial heart transplantation. Post-operatively, the piglets received immunosuppression with tacrolimus at daily doses between 0.07-0.4mg/kg. In the pharmacokinetic study, piglets (n = 6) underwent external jugular line placement. After a baseline blood draw, 0.25mg/kg of intramuscular tacrolimus was administered, and serial blood draws were performed to determine tacrolimus blood levels. The data was statistically analyzed to determine the pharmacokinetic parameters.</p><p><strong>Results: </strong>The dosing trial showed that intramuscular tacrolimus daily doses between 0.217-0.421mg/kg most consistently achieved tacrolimus blood levels within the therapeutic window. Therefore, 0.25mg/kg was used for the pharmacokinetic study. This revealed a half-life of 7.7 ± 0.9 hours, an average elimination constant of 0.09 ± 0.01, and an average volume of distribution of 30.9 ± 5.3 liters.</p><p><strong>Conclusions: </strong>Intramuscular tacrolimus achieves reliable blood levels with a predictable half-life. Despite high peak blood concentrations, a daily dose of 0.25 mg/kg did not result in clinical or laboratory evidence of toxicity.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Artificial Intelligence in Lung Transplantation: Current State, Challenges, and Future Directions.","authors":"Robert P Duncheskie, Omar Al Omari, Fatima Anjum","doi":"10.1016/j.transproceed.2025.08.016","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.016","url":null,"abstract":"<p><p>Lung transplantation remains a critical treatment for end-stage lung diseases, yet it continues to have 1 of the lowest survival rates among solid organ transplants. Despite its life-saving potential, the field faces several challenges, including organ shortages, suboptimal donor matching, and post-transplant complications. The rapidly advancing field of artificial intelligence (AI) offers significant promise in addressing these challenges. Traditional statistical models, such as linear and logistic regression, have been used to predict post-transplant outcomes but struggle to adapt to new trends and evolving data. In contrast, machine learning algorithms can evolve with new data, offering dynamic and updated predictions. AI holds the potential to enhance lung transplantation at multiple stages. In the pre-transplant phase, AI can optimize waitlist management, refine donor selection, and improve donor-recipient matching, and enhance diagnostic imaging by harnessing vast datasets. Post-transplant, AI can help predict allograft rejection, improve immunosuppressive management, and better forecast long-term patient outcomes, including quality of life. However, the integration of AI in lung transplantation also presents challenges, including data privacy concerns, algorithmic bias, and the need for external clinical validation. This review explores the current state of AI in lung transplantation, summarizes key findings from recent studies, and discusses the potential benefits, challenges, and ethical considerations in this rapidly evolving field, highlighting future research directions.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076975","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":"Psychosocial Impact of Being Denied as a Living Kidney Donor.","authors":"Fern Calkins, Abraham J Matar, Michael G Megaly, Jennifer Wiseman, Dawn Larson, Arthur J Matas, Vanessa Humphreville","doi":"10.1016/j.transproceed.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.09.007","url":null,"abstract":"<p><p>Nationally, nearly 50% of living kidney donor (LKD) candidates are denied the opportunity to donate. We studied the psychosocial impact of denial on LKD candidates and explored potential improvements in the evaluation process. A 21-question survey was developed covering topics related to donation denial including emotional responses, communication experiences, and suggestions for process improvement. Of 193 denied candidates contacted, 64 (33.2%) completed the survey. Respondents reported they were denied due to pre-existing conditions (30%), poor kidney function (25%), anatomic abnormalities (19%), malignancy (8%), and other factors (18%). The most commonly reported emotions were feeling disappointed (50%), sad (34%), content (11%), and frustrated (9%). Seventeen respondents (27%) were significantly impacted by the evaluation outcome, of which 9 (14%) reported a significant positive impact; 8 (13%) reported a significant negative impact. Of the 64 candidates, 46 (72%) felt pride they considered donating and none regretted initiating the process. Notably, 26 (41%) offered suggestions for improving the evaluation process, including enhanced communication and follow-up, with 23% desiring a post-denial follow-up call. This study highlights the significant emotional impact of denial on LKD candidates. We recommend setting clear expectations about approval rates, standardizing communication protocols and offering follow-up support through independent living donor advocates and/or support groups.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082891","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":"Trends and Barriers in Liver Transplantation for Patients With Decompensated Cirrhosis: A 15-Year Single-Center Cohort at a Japanese Center.","authors":"Yasushi Hasegawa, Hideaki Obara, Keisuke Ojiro, Minoru Kitago, Yuta Abe, Shingo Usui, Nobuhito Taniki, Nobuhiro Nakamoto, Yuko Kitagawa","doi":"10.1016/j.transproceed.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.019","url":null,"abstract":"<p><strong>Background and aim: </strong>Liver transplantation is the only curative treatment for end-stage liver disease; however, access remains limited, particularly in Japan, where the severe shortage of deceased donors presents a major challenge. Research comprehensively assessing the full trajectory from referral to either transplantation or death remains scarce. We aimed to analyze long-term trends and propose potential strategies to improve access to liver transplantation in Japan.</p><p><strong>Patients and methods: </strong>This study included 616 adult patients with decompensated liver cirrhosis referred for liver transplantation. Patients were divided into 3 periods to assess temporal trends: Period 1 (2009-2013), Period 2 (2014-2018), and Period 3 (2019-2023). The primary endpoint was the liver transplantation rate among referred patients. Patient demographics, liver disease etiology and severity, and donor type were analyzed.</p><p><strong>Results: </strong>The transplantation rate declined from 30.2% in Period 1 to 22.1% in Period 3, despite increases in follow-up rates and waitlist registrations. The availability of living donors significantly decreased over time, from 29.5% in Period 1 to 22.4% in Period 2 and 18.6% in Period 3. The rate of death without transplantation remained high (41.0%, 45.0%, and 40.0%, respectively). A higher MELD score at referral was an independent risk factor for both not undergoing transplantation and mortality among transplantation candidates.</p><p><strong>Conclusion: </strong>Over this 15-year period, the transplantation rate declined despite increases deceased donor registrations, resulting in persistently high waitlist mortality. Our findings suggest that expanding deceased donor pool and facilitating earlier referral of transplant candidates are essential to improving access to transplantation and patient outcomes in a Japanese transplant setting.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083002","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 Etiology Based on Post-Transplant Pathological Diagnosis in Cases of Cryptogenic Cirrhosis.","authors":"Tufan Egeli, Tarkan Unek, Mucahit Ozbilgin, Cihan Agalar, Anıl Aysal Agalar, Ozgul Sagol, Nilay Danis, Erhan Tukel, Berkay Sakaoglu, Emre Karadeniz, Aylın Bacakoglu, Ali Durubey Cevlik, Ibrahim Astarcioglu","doi":"10.1016/j.transproceed.2025.08.012","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.012","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to present etiological insights by evaluating the histopathological findings of patients who underwent liver transplantation for cryptogenic cirrhosis (CC).</p><p><strong>Patients and methods: </strong>We retrospectively analyzed patients who underwent liver transplantation with a preoperative diagnosis of CC at our center between February 1997 and 2024. Clinical and pathological data were recorded, survival analyses were conducted, and statistical comparisons were performed.</p><p><strong>Results: </strong>Among 66 patients preoperatively diagnosed with CC, a specific etiology was identified in 13 (%19.6) cases, while the remaining 53 (%80.4) were classified as CC. The median patient age was 49 years, with a mean BMI of 25.7. Type 2 diabetes was present in 22.6% of cases, and obesity in 13.2%. The mean follow-up period was 139 months, the median MELD score was 16, the incidence of hepatocellular carcinoma was 6%, and total mortality was recorded in 19 (%35.8) patients. The survival rates at 1, 3, 5, and 10 years were calculated as 87%, 81%, 79.2%, and 74.3%, respectively. While type 2 diabetes did not significantly affect survival (P = .78), obesity was found to be associated with a significantly lower survival rate (P = .001).</p><p><strong>Conclusion: </strong>Although CC is widely considered the advanced stage of a metabolic syndrome-related liver disease, our findings do not fully support this hypothesis. Therefore, further research is needed to investigate other potential contributing factors in the etiology of CC.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077000","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":"Determinants of Short-Term Survival After Heart Transplantation in Patients Bridged to Transplant With Left Ventricular Assist Device.","authors":"Suat Şenkaya, Ümit Kahraman, Ayşen Yaprak Kapkın, Özlem Balcıoğlu, Sanem Nalbantgil, Çağatay Engin, Tahir Yağdı, Mustafa Özbaran","doi":"10.1016/j.transproceed.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.005","url":null,"abstract":"<p><strong>Background: </strong>The bridge to heart transplantation has been the subject of intense debate. This study aimed to determine the factors affecting early survival after bridge to heart transplantation.</p><p><strong>Methods: </strong>Between 2011 and 2019, patients who underwent a bridge to heart transplantation in a single center were retrospectively scanned. Demographics, complications of left ventricular assist device (LVAD), cardiopulmonary bypass (CPB), and cross-clamp duration, use of blood products, length of ventricular assist device (VAD) support, post-transplant hospital stay, post-transplant complications, and in-hospital mortality rates were recorded.</p><p><strong>Results: </strong>Patients (n = 60) were divided into 2 groups; patients with 30-day mortality (group 1, n = 10) and those with survival longer than 30 days (group 2, n = 50). The patients in group 1 were found to be older (P = .009), supported for a longer duration (P = .027), have higher International Normalized Ratio (INR) levels (P = .025), and have device-specific infection more commonly (P = .003). Cardiac ischemia (P = .013) and CPB (P = .006) durations were longer in group 1. Use of blood products and nitric oxide (NO) was more frequent in group 1 (P < .05). Post-transplantation complications (stroke, sepsis, kidney failure, arrhythmia, need for intra-aortic balloon pump [IABP], and short-term mechanical circulatory support [MCS]) were significantly more common in group 1 patients (P < .05). Blood products (0.920 for red blood cells, 0.901 for fresh frozen plasma, and 0.885 for platelets), postoperative high creatinine (0.817) and lactate (0.715), and device-specific infection (0.686) had the highest area under the curve values in the receiver operating characteristic (ROC).</p><p><strong>Conclusions: </strong>Bridge to transplantation has its own challenges of being a reoperation under high INR levels. Recurrent infection attacks and an inflammatory state may be limiting the healing process. Device-specific infection may be a major reason for early mortality whereas it is also a major indication for urging heart transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082917","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":"Incidence, Risk Factors, Clinical Presentation, and Treatment Outcomes of Acute Diverticulitis Requiring Hospitalization in Kidney Transplant Recipients.","authors":"Klara Barisic, Lea Katalinic, Ivana Juric, Vesna Furic-Cunko, Bojan Jelakovic, Alan Horvat, Nikolina Basic-Jukic","doi":"10.1016/j.transproceed.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.09.004","url":null,"abstract":"<p><p>Acute diverticulitis, a complication of diverticulosis, poses significant challenges in kidney transplant recipients who are often on immunosuppressive therapy. This retrospective single-center observational cohort study analyzes the incidence, clinical presentation, and management of acute diverticulitis in kidney transplant patients at University Hospital Center Zagreb over a 14-year period. Among 1400 kidney transplant recipients, 10 patients (0.7%) developed acute diverticulitis requiring hospitalization. The average age of these patients was 60.7 years, with abdominal pain as the predominant symptom. Diagnostic imaging confirmed diverticulitis in all cases, predominantly affecting the sigmoid colon. Treatment involved intravenous antibiotics, with surgical interventions required in 4 cases due to complications, including abscess formation and perforation. The duration of hospitalization averaged 7.75 days, with a 10% mortality rate observed in this cohort. Recurrences of diverticulitis were noted, necessitating further hospitalizations in 4 patients. Notably, there were no cases of acute graft rejection within 1 year pre-diverticulitis. This study highlights the need for tailored management strategies for kidney transplant recipients with diverticulitis, as their unique clinical profiles warrant careful consideration of immunosuppressive therapy and potential complications. Further research is needed to establish comprehensive guidelines for managing diverticulitis in this vulnerable population.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082852","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}