Transplantation proceedings最新文献

{"title":"Impact of Ultrasonographically Measured Elastography Scores on Renal Prognosis in Kidney Transplant Recipients.","authors":"Serap Yadigar, Pınar Özdemir, Erman Özdemir, Ömer Aydıner, Ayşegül Karadayı, Elif Arı Bakır","doi":"10.1016/j.transproceed.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.01.009","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the relationship between ultrasonographic elastography score and long-term renal prognosis in renal transplant patients.</p><p><strong>Methods: </strong>A retrospective cohort study of 100 patients who underwent renal transplantation in our hospital between 2005 and 2022 was performed. Patients were divided into two groups as those with elastography scores higher than 8.45 kPa (n = 50) and those with elastography scores equal to or lower than 8.45 kPa (n = 50). Elastography measurements were performed with Siemens Acuson S2000 ultrasound system and the scores were compared with renal function parameters and other clinical characteristics.</p><p><strong>Results: </strong>Patients with high elastography scores had smaller kidney size (P = .010), lower eGFR (P = .002), and higher proteinuria and albuminuria levels (P < .05) than patients with low elastography scores. There was a significant association between elastography score and the risk of renal dysfunction (OR = 1.039, P = .006).</p><p><strong>Conclusions: </strong>A large elastography score may act as a significant biomarker for prognosing the risk of renal dysfunction in subjects undergoing kidney transplantation. These findings suggest that elastography may become an invaluable noninvasive tool during the long-term follow-up of patients with renal transplants.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639957","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":"Current Applications and Developments of Natural Language Processing in Kidney Transplantation: A Scoping Review.","authors":"René Gatsinga, Rachel Shu-En Lau, Benjamin Jia Han Lim, Khi Yung Fong, Marc Zhen Guo Yeong, Amber Hwa Hwa Chung, Lay Guat Ng, Edwin Jonathan Aslim, Valerie Huei Li Gan, Ee Jean Lim","doi":"10.1016/j.transproceed.2025.02.027","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.027","url":null,"abstract":"<p><strong>Background and objective: </strong>Natural language processing (NLP) is a subfield of artificial intelligence that enables computers to process human language. As most human interactions today involve the internet and electronic devices, NLP tools quickly become indispensable to modern life. The use of NLP tools in medical practice and research is growing fast. This scoping review evaluates the current and potential future applications of NLP in kidney transplantation medicine.</p><p><strong>Design: </strong>We conducted an electronic literature search on NLP in the setting of kidney transplantation on PubMed, EMBASE, and Scopus from inception to August 26, 2024. Two independent investigators conducted the search strategy and reviewed abstracts and full texts; conflicts were resolved after discussion with a third and fourth author. A total of ten studies were included in the study.</p><p><strong>Results: </strong>The most commonly studied clinical applications of NLP in kidney transplantation are its use as an adjunct tool to facilitate early diagnosis of renal disease and as an effective predictor of graft loss and complications among kidney transplant recipients. Some researchers were able to predict organs at risk of delayed implant or discard by analyzing donors' EHR; this has the potential to improve organ utilization significantly. In clinical research, NLP tools can be tailored to perform specific tasks of interest on unstructured text. By studying n comments from social media and news websites, 1 group was able to gauge public perception of transplant policies and identify potential actions to improve access to transplant care.</p><p><strong>Conclusions: </strong>NLP tools have only recently been introduced into medical research, but they are already significantly impacting kidney transplantation medicine. The literature demonstrates the potential to improve early diagnosis of renal failure, predict renal transplantation outcomes, improve organ utilization, and support advocacy and policymaking. With more widespread use of EHR globally and the continued development of NLP technology, these tools are poised to revolutionize the practice of renal transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639956","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":"Preoperative Calcimimetic Treatment may Prevent Serum Creatinine Elevation after Parathyroidectomy in Kidney Transplant Recipients: A Retrospective Cohort Study.","authors":"Manabu Okada, Shunji Narumi, Tetsuhiko Sato, Tomoki Himeno, Yuki Hasegawa, Kenta Futamura, Takahisa Hiramitsu, Yuki Shimamoto, Yoshihiko Watarai, Toshihiro Ichimori","doi":"10.1016/j.transproceed.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.03.001","url":null,"abstract":"<p><strong>Background: </strong>Hyperparathyroidism (HPT) often persists after successful kidney transplantation (KTx). Although parathyroidectomy (PTx) is an effective treatment option for post-KTx HPT, it is associated with postoperative elevation of serum creatinine levels. We hypothesized that pre-PTx calcimimetic treatment could alleviate the post-PTx increase in serum creatinine levels.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled KTx patients who underwent initial PTx between 2004 and 2023. Patients' background characteristics and laboratory data were investigated. The primary outcome was a change in the estimated glomerular filtration rate (eGFR). The cohort was divided into 2 groups based on the presence of pre-PTx calcimimetic treatment. Multivariate linear regression analysis assessed the association between calcimimetic treatment and percent eGFR 1 week after PTx.</p><p><strong>Results: </strong>Of the 77 KTx patients who underwent PTx, 28 were treated with pre-PTx calcimimetics (calcimimetic group), and the others were not (noncalcimimetic group). Compared with the noncalcimimetic group, the calcimimetic group had lower serum calcium levels before PTx (10.3 vs 11.2 mg/dL, P < .001) and a significantly higher percentage of eGFR 1 week after PTx (95.1% vs 81.5%, P < .001). According to the multivariate analysis, pre-PTx calcimimetic treatment was positively associated with percent eGFR (regression coefficient estimate, 13.76; 95% confidence interval, 7.02-20.50; P < .001) 1 week after PTx.</p><p><strong>Conclusion: </strong>Pre-PTx calcimimetic treatment may prevent post-PTx elevation of serum creatinine levels in KTx patients.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639958","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":"Development and Validation of a Nomogram for Predicting Subtherapeutic Tacrolimus Blood Levels in Renal Transplant Recipients: A Multivariate Logistic Regression Analysis.","authors":"Bowen Duan, Jinxian Gao, Bin Ge, Shujin Wu, Jing Yu","doi":"10.1016/j.transproceed.2025.02.025","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.025","url":null,"abstract":"<p><p>This study constructs a nomogram risk prediction model to identify factors affecting subtherapeutic tacrolimus (FK506) blood concentrations in postrenal transplant patients, enhancing clinical management. Data from renal transplant patients treated with tacrolimus from January to December 2023 were analyzed using multivariate logistic regression to identify risk factors. A nomogram model was constructed and validated through cross-validation and bootstrapping. Predictive performance was assessed via receiver operating characteristic curve and Hosmer- Lemeshow test. Among 340 patients, 224 achieved target FK506 concentrations (5-15 ng/mL). Independent risk factors for subtherapeutic levels included white blood cell count ≤4 × 10^9/L, total bilirubin >20 μmol/L, creatinine >73 μmol/L, and blood urea nitrogen ≤7.1 mmol/L. The model's receiver operating characteristic area under the curve was 0.84, with a Hosmer- Lemeshow test P-value of .386, indicating high predictive accuracy and good calibration. The nomogram effectively predicts subtherapeutic FK506 levels, providing a valuable tool for personalized patient management. Future research should refine and externally validate the model.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627296","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":"Pretransplant Midodrine Use-A Risk Factor for Graft Loss at 1 Year in Kidney Transplant Recipients?","authors":"Jayanthan Subramanian, April Logan, Farjad Siddiqui, Sai Rithin Punjala, Lauren Von Stein, Priyamvada Singh, Pranit Chotai, Ashley Limkemann, Musab Al-Ebrahim, Austin D Schenk, William K Washburn, Amer Rajab, Navdeep Singh","doi":"10.1016/j.transproceed.2025.02.024","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.024","url":null,"abstract":"<p><strong>Introduction: </strong>Hypotension is a frequent complication of patients who are on chronic maintenance hemodialysis. Midodrine is an alpha-1 adrenergic agonist used to treat patients on hemodialysis who have chronic hypotensiom. The aim of our study was to evaluate if patients who required midodrine for hypotension had inferior outcomes compared to those who did not require midodrine.</p><p><strong>Methods: </strong>All kidney transplants performed at The Ohio State University Wexner Medical Center between January 2015 and January 2021 were analyzed. Patients that had a dual solid organ transplant that included a kidney transplant were excluded from our study. Patients were divided into two groups based on midodrine use. The main outcomes of interest were graft and patient survival at 1-year.</p><p><strong>Results: </strong>A total of 1538 kidneys were transplanted during the study period. A total of 1070 were recipients of deceased donor kidney transplants, 468 were recipients of living donor kidney transplants. In the deceased donor group the estimated glomerular filtration rate was higher in the non-midodrine patients compared to the midodrine group and this difference was statistically significant. Graft survival at 1 year was higher in the non-midodrine group (96% vs 79% P, .0001 OR 6.6). Patient survival at 1-year was also higher in the non-midodrine group (97% vs 86%, P = .0002, OR 6.3). Time to graft failure and patient death was faster in the midodrine group (P < .0001 for both).</p><p><strong>Conclusion: </strong>The need for Midodrine to maintain blood pressure before kidney transplantation can serve as a marker for inferior graft and patient outcomes at 1-year. Additional studies with more data are needed to further support this theory and adjust for confounding effects.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631162","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 Liver Transplantation After Achieving Complete Clinical Remission of Hepatocellular Carcinoma With Combination Therapy of Immune Checkpoint Inhibitors and Targeted Agents: A Case Report.","authors":"Shaobo Zhang, Shugeng Zhang","doi":"10.1016/j.transproceed.2025.02.041","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.041","url":null,"abstract":"<p><p>Immunotherapy, primarily with immune checkpoint inhibitors, has become pivotal in the treatment of advanced hepatocellular carcinoma (HCC), leading to significant tumor burden reduction. However, its applicability in liver transplantation remains controversial. Due to the potential risks of rejection limiting large-scale clinical trials and the incomplete understanding of underlying mechanisms, whether transplant recipients can benefit from immunotherapy remains uncertain. This report describes the application of immunotherapy in liver transplantation, wherein two patients achieved complete tumor remission after receiving immunotherapy combined with other treatments before transplantation, enabling successful liver transplantation surgeries. Additionally, one patient received combination therapy with tislelizumab and lenvatinib before transplantation (Case 2), representing the first reported case utilizing this combination therapy as a bridging treatment before LT.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631164","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":"Hypothermic Myocardial Preservation: The Freezing Debate.","authors":"Mohammed Quader, Zachary Kiernan, Gina Labate, Qun Chen","doi":"10.1016/j.transproceed.2025.02.035","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.035","url":null,"abstract":"<p><strong>Background: </strong>Storage of hearts in ice for transportation is thought to cause post-transplantation graft dysfunction secondary to freeze injury. We studied the myocardial damage and resulting function in hearts stored at 0 °C, 4 °C and 8 °C for 4 hours.</p><p><strong>Methods: </strong>Rat hearts were procured under general anesthesia and immediately stored in University of Wisconsin solution at 0 °C, 4 °C and 8 °C for 4 hours (n = 6-8/group). Hearts were then re-perfused on a Langendorff apparatus for 90 minutes using oxygenated Kreb-Henseleit buffer (37 °C). Functional parameters were recorded via a balloon tip catheter in the left ventricle. Following reperfusion hearts were collected for infarct size quantification using triphenyltetrazolium chloride staining. A separate group of hearts (n = 2-3) were similarly stored then studied for ultrastructural and biochemical changes.</p><p><strong>Results: </strong>There were no signs of freeze injury in hearts stored at 0 °C by histologic or biochemical analysis. There was no significant difference in infarct size between hearts stored at 0 °C and 4 °C. Cardiac troponin I level, and left ventricle developed pressure in hearts stored at 0 °C, 4 °C, and 8 °C were comparable (all P > .05).</p><p><strong>Conclusion: </strong>Hearts stored at 0 °C for 4 hours showed no signs of freeze injury and had similar functional parameters compared to hearts stored at 4 °C or 8 °C.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631161","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":"Promising Long-Term Outcomes of Lung Transplantation With Hepatitis C Positive Donors: Insights From the UNOS Registry.","authors":"Elizabeth J Bashian, Eleanor E Bashian, Ye In Christopher Kwon, Matthew Ambrosio, Zachary Fitch, Lauren J Taylor, Vipul Patel, Walker Julliard, Vigneshwar Kasirajan, Zubair A Hashmi","doi":"10.1016/j.transproceed.2025.02.044","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.044","url":null,"abstract":"<p><strong>Background: </strong>The development of effective direct-acting antiviral treatment (DAAT) for hepatitis C virus (HCV) has opened the possibility of using HCV+ donors. We aimed to assess the long-term feasibility of lung transplantation using organs from HCV+ donors.</p><p><strong>Methods: </strong>We used the UNOS database to evaluate adult lung transplant recipients between 2000 and 2023. HCV+ organs were further divided into those positive for both antibody and nucleic acid testing (NAT) or antibody testing alone. Baseline recipient and donor characteristics were compared. The Kaplan-Meier method was used to assess 30-day, 1-year, and 5-year survival. We performed risk analyses using multivariate Cox regression analyses.</p><p><strong>Results: </strong>41,797 lung transplants were performed, among which 945 used HCV+ donors. Recipients of HCV+ lungs had higher FEV1 (P < .001), older (P < .001), and had higher BMI (P < .001). While 5-year survival did not differ between recipients of HCV+ and HCV- donor lungs (P = .093), graft survival was superior among recipients of HCV+ lungs (P = .038). Acute rejection rates were also lower for recipients of HCV+ lungs (P = .018). However, recipients of HCV+ lungs required significantly higher time on the ventilator post-transplant (P = .033). Donor HCV+ status, regardless of whether they were NAT- (HR 1.03, P = .766) or NAT+ (HR 0.89, P = .24), was not associated with adverse outcomes.</p><p><strong>Conclusions: </strong>Lung transplantation with HCV+ donor lungs demonstrates promising outcomes up to 5 years post-transplant. With careful preoperative screening, DAAT treatments, and postoperative management, recipients of HCV+ lungs may expect minimal additional complications.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631163","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 Eradication of Hepatitis C Virus after Liver Transplantation Improved Liver Function and Maintained the Health-related Quality of Life.","authors":"Atsushi Takai, Yoshihide Ueda, Etsuro Hatano, Hiroshi Seno","doi":"10.1016/j.transproceed.2025.02.040","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.040","url":null,"abstract":"<p><strong>Background: </strong>The outcomes of hepatitis C virus eradication and health-related quality of life in the patients treated with direct-acting antivirals (DAAs) after liver transplantation were examined.</p><p><strong>Methods: </strong>Thirty-five patients with HCV infection treated with sofosbuvir/ledipasvir after liver transplantation were enrolled in the study. The achievement rate of sustained viral response (SVR), liver function and health-related quality of life based on Short-Form-36 version 2 were evaluated.</p><p><strong>Results: </strong>All 35 patients achieved SVR and liver function was improved to a level comparable to that of non-transplanted cases by the DAA treatment. As to health-related quality of life, the scores of general health, vitality and mental health were comparable to Japanese national standard scores among 8 subscales of Short-Form-36 version 2.</p><p><strong>Conclusion: </strong>HCV eradication after liver transplantation is useful for not only improving liver function but maintaining health-related quality of life.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627299","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 Oral Isavuconazole Monotherapy for Invasive Pulmonary Mucormycosis in Kidney Transplant Recipients: Case Reports and Literature Review.","authors":"Zeng-Jie Wang, Jue Zhang, Yun-Ying Shi","doi":"10.1016/j.transproceed.2025.02.047","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.02.047","url":null,"abstract":"<p><p>This study represents 2 cases of kidney transplant recipients (KTRs) with invasive pulmonary Rhizopus infection, successfully treated with oral isavuconazole monotherapy without lobectomy. The rapid detection via mNGS of bronchoalveolar lavage fluid enabled early diagnosis and timely intervention, resulting in complete recovery and stable graft function. The literature review revealed a 16.7% mortality rate among 13 cases, with a higher mortality rate of 66.7% among patients receiving antifungal treatment without surgical intervention. Our findings underscore the efficacy of isavuconazole as a first-line monotherapy, characterized by lower nephrotoxicity and fewer interactions with immunosuppressants, and emphasize the crucial role of metagenome next-generation sequencing (mNGS) in early diagnosis of invasive mucormycosis in high-risk population.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627297","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}