Transplantation proceedings最新文献

{"title":"Imbalances of Th1/Th2 and Tc1/Tc2 are Associated With Active Cytomegalovirus Infection in Infant Liver Transplant Recipients.","authors":"Dan Li, Chun Liu, Zhongyu Kang, Yan Zheng, Yuliang Wang","doi":"10.1016/j.transproceed.2024.10.036","DOIUrl":"10.1016/j.transproceed.2024.10.036","url":null,"abstract":"<p><strong>Background: </strong>Because cytomegalovirus (CMV) infection is one of the most common complications following liver transplantation (LT), it is important to analyze the impact of CMV infection on the LT-associated changes in T cells polarization. This study aimed to investigate T helper (Th) and T cytotoxic (Tc) cells polarization and their correlation in infant LT recipients with active CMV infection.</p><p><strong>Methods: </strong>Twenty infant LT recipients with active CMV infection (the CMV group) and 20 recipients without CMV infection (the stable group) were enrolled. The percentages of Th1, Th2, Tc1, and Tc2 cells were detected by flow cytometry after intracellular staining for cytokines (IFN-γ and IL-10, respectively) in peripheral blood. The correlation between Th and Tc cells was analyzed by Pearson correlation coefficient.</p><p><strong>Results: </strong>The percentages of Th1 and Tc1 cells were significantly decreased, whereas the percentages of Tc2 cells were significantly increased in CMV group compared with the stable group, along with significant reduction of Th1/Th2 and Tc1/Tc2 ratios (P < .01). The percentages of Th1 cells were positively correlated with Tc1 cells (P < .01). A higher Th1/Th2 and Tc1/Tc2 ratios were showed in the CMV group after antiviral therapy than those in the CMV group before therapy (P < .01).</p><p><strong>Conclusions: </strong>Our findings show an imbalanced Th1/Th2 and Tc1/Tc2 immunity in infant LT recipients with active CMV infection, which were involved in the pathogenesis of CMV infection.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2172-2177"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788292","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":"Discrepancy Between Pulmonary Artery Catheter and Co-Oximeter Value of Mixed Venous Oxygen Saturation After Graft Reperfusion During Living Donor Liver Transplantation.","authors":"Yeonji Noh, Jeayoun Kim, Sooyeon Lee, Jisun Choi, Gaab Soo Kim","doi":"10.1016/j.transproceed.2024.11.015","DOIUrl":"10.1016/j.transproceed.2024.11.015","url":null,"abstract":"<p><strong>Background: </strong>Monitoring tissue oxygenation is critical in liver recipients. The pulmonary artery catheter (PAC) provides continuous monitoring of mixed venous oxygen saturation (SvO₂) using fiberoptic reflectance spectrophotometry. Despite the need for in vivo calibration during liver transplantation, recalibration guidelines are absent, and we frequently observed a significant discrepancy between PAC and reference co-oximeter SvO₂ values after graft reperfusion. This study aimed to assess the incidence and risk factors of a significant discrepancy after reperfusion during living donor liver transplantation.</p><p><strong>Methods: </strong>This retrospective study included 54 recipients who underwent living donor liver transplantation at our institution between October 2021 and April 2022. A PAC was inserted, and in vivo calibration was conducted using the co-oximeter SvO₂ value. We defined a significant discrepancy as a drift was ≥ 3% at 1 hour after reperfusion. Logistic regression analysis was performed to determine the association between perioperative variables and the risk of significant discrepancy.</p><p><strong>Results: </strong>PAC SvO₂ was higher than co-oximeter SvO₂ in 51 recipients. A significant discrepancy was observed in 37 recipients (68.5%). The risk of significant discrepancy decreased with a high preoperative hemoglobin concentration (odds ratio [OR] = 0.65 [0.47-0.91], P = .011) and a high arterial oxygen partial pressure (PaO₂) at 1 hour after reperfusion (OR = 0.96 [0.94-0.99], P = .004) but increased with a high baseline co-oximeter SvO₂ value (OR = 1.29 [1.05-1.59], P = .015).</p><p><strong>Conclusions: </strong>PAC SvO₂ significantly drifted from the reference co-oximeter value in over two-thirds of recipients after reperfusion. Therefore, in vivo recalibration is required for the reliable measurement of PAC SvO₂ during living donor liver transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2191-2195"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775949","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 Outcomes in Delayed Sternal Closure in Lung Transplantation.","authors":"Arvind Bakthavatsalam, Billanna Hwang, Michael S Mulligan","doi":"10.1016/j.transproceed.2024.10.044","DOIUrl":"10.1016/j.transproceed.2024.10.044","url":null,"abstract":"<p><strong>Introduction: </strong>Lung transplantation (LTx) is a critical treatment for end-stage pulmonary diseases. Delayed sternal closure (DSC) has been noted in cardiac surgery for several decades and is a viable strategy for patients who are hemodynamically unstable, at high risk for postoperative bleeding, and/or require prolonged cardiopulmonary bypass. However, DSC use and its effects on LTx clinical outcomes are not well-defined.</p><p><strong>Methods: </strong>A retrospective analysis was performed on patients who had undergone LTx between January 1, 2010, and October 1, 2018, at the University of Washington. Patients under the age of 18, undergoing repeat LTx, other solid organ transplantation, and/or had prior major cardiothoracic surgery were excluded. Patients were classified into 2 categories: DSC and primary sternal closure (PSC) groups. We examined hospital length of stay (LOS), intensive care unit (ICU) LOS, duration on the ventilator, and overall survival.</p><p><strong>Results: </strong>A total of 370 patients were identified, with 350 patients in the PSC group and 20 patients in the DSC group. The median hospital LOS, ICU LOS and duration on the ventilator in the DSC group were 23.0 ± 3.8, 16.0 ± 3.6, and 9.0 ± 3.5 compared with 15.0 ± 0.8, 5.0 ± 0.5, and 1.0 ± 0.3 in the PSC group, respectively (All P < .01). Kaplan-Meier analysis revealed that, at 1, 3, and 5 years, the DSC group had a survival of 75.0%, 60.0%, and 55.0%, and the PSC group had a survival of 91.4%, 82.6% and 75.1% respectively (P = .019).</p><p><strong>Conclusion: </strong>DSC is not uncommon in LTx and patients who do require DSC had a longer duration on the ventilator, ICU LOS, and hospital LOS. Additionally, the DSC group had a worse survival compared with the PSC group. DSC is unlikely to be the sole factor influencing worse survival, but may be a marker of underlying patient factors that negatively affect survival.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2231-2236"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793085","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 Status and Development of Rat DCD Renal Transplantation Model.","authors":"Shang Xu, Zhilong Liu, Xinning Wang","doi":"10.1016/j.transproceed.2024.11.004","DOIUrl":"10.1016/j.transproceed.2024.11.004","url":null,"abstract":"<p><p>Donation after Cardiac Death (DCD) is an important source of kidneys for kidney transplantation, but DCD kidney transplantation is associated with more complications, impacting the function of the transplanted kidney. Establishing a stable DCD kidney transplantation model in rats can help study the mechanisms of injury and complications prevention in DCD kidney transplantation. This review summarizes the current research status and progress in rat DCD kidney transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2280-2283"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741818","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":"Impact of Preprocurement Cardiac Arrest in Brain-Dead Donors on the Outcome of Pancreas Transplantation.","authors":"Minyan Zheng, Yue Wu, Jie Xiang, Li Wang, Zhiwei Li, Feng Gao","doi":"10.1016/j.transproceed.2024.11.011","DOIUrl":"10.1016/j.transproceed.2024.11.011","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the risk factors and whether cardiac arrest (CA) in brain-death donors (DBD) could affect pancreas transplantation outcomes.</p><p><strong>Methods: </strong>We analyzed data from the Scientific Registry of Transplant Recipients (2000-2020). The study included 21,499 pancreas transplantations, divided into CA-DBD and noCA-DBD groups based on whether the DBD had a history of CA.</p><p><strong>Results: </strong>There were 1129 CA-DBD (5.3%) transplantations. The principal donor death cause for both groups was head trauma. Graft and patient survival rates were similar in both groups. CA time (CAT) was a risk factor for pancreatic graft survival in the univariate analysis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03-1.08; P = .010) and multivariate Cox regression model (HR, 1.03; 95% CI, 1.02-1.04; P =.015). Pancreas graft survival in those with CAT ≥30 minutes was significantly lower than in those with CAT <30 minutes and the noCA-DBD group (log-rank P = .018 and P = .014, respectively), which were comparable (log-rank P = .711). No relationships were found among the various transplantation types.</p><p><strong>Conclusions: </strong>CA in donors did not affect the pancreatic graft prognosis. However, pancreatic donors with CAT ≥30 minutes should be meticulously evaluated.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2255-2262"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751947","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":"Comparison of 2 Different Types of Arterial and Biliary Anastomoses While Preserving the Gastroduodenal Artery: A Retrospective Study.","authors":"Yafei Guo, Zebin Zhu, Wei Wu, Hao Zheng, Xiaodong Yuan, Can Qi, Zhijun Xu, Xuefeng Li, Ning Wang, Jiwei Qin, Ruipeng Song, Jizhou Wang, Dalong Yin, Lianxin Liu, Shugeng Zhang, Björn Nashan","doi":"10.1016/j.transproceed.2024.10.040","DOIUrl":"10.1016/j.transproceed.2024.10.040","url":null,"abstract":"<p><strong>Objective: </strong>Here we investigated 2 different arterial reconstruction procedures with preservation of the gastroduodenal artery (GDA) in orthotopic liver transplantation (OLT).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted. The clinicopathological data of 40 pairs of donors and recipients who underwent OLT from May 2018 to August 2023 were analyzed. The GDA of all recipients was preserved during the hepatic arteries reconstruction, which were divided into 2 groups according to different anastomosis locations, namely the end-to-side group (E-S group, n = 17, Branch-patch between the common hepatic and the gastroduodenal artery) and end-to-end group (E-E group, n = 23, between common hepatic and proper hepatic).</p><p><strong>Results: </strong>Demographics did not differ between both groups (P > .05). The warm ischemia time (WIT) was numerically longer in the E-S group (403.3 ± 103.3 vs 195.2 ± 35.8 s; P < .001), but the cold ischemia time (CIT) was numerically shorter in the E-S group (279.2 ± 74.7 vs 325.2 ± 15.1 min; P = .023). The time of artery reconstruction and duration of surgery was numerically shorter in the E-S group (21.0 ± 3.6 vs 51.0 ± 9.1 min, P < .001; 326.0 ± 103.4 vs 422.7 ± 24.6 min, P = .001). The E-S group had a lower resistance index (RI) (0.5 ± 0.3 vs 0.6 ± 0.1; P = .049).</p><p><strong>Conclusion: </strong>Both groups showed no differences in artery and biliary complications. GDA preservation meets the anatomical and physiological requirements. E-S is superior to E-E by the time of hepatic artery reconstruction and RI.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2183-2190"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781842","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":"Effect of Parathyroidectomy After Renal Transplantation on Grafted Kidney Function Within One Year: A Meta-Analysis.","authors":"Fu Yan, Zhou Sun, Guofu Liang, Chao Liu, Yulin Niu","doi":"10.1016/j.transproceed.2024.11.019","DOIUrl":"10.1016/j.transproceed.2024.11.019","url":null,"abstract":"<p><strong>Objective: </strong>Secondary hyperparathyroidism (sHPT) is a common symptom of chronic kidney disease (CKD), and at the time of transplantation, more than two-thirds of patients with end-stage renal disease have secondary hyperparathyroidism. After kidney transplantation, parathyroid function is normalized in some kidney transplant recipients, but up to 50% of kidney transplant recipients develop tertiary hyperparathyroidism (tHPT) 1 year after kidney transplantation. The effect of parathyroidectomy on the grafts is currently unclear; thus, we conducted a meta-analysis of relevant studies to evaluate changes in graft function 1 year after parathyroidectomy, aiming to assess the procedure's safety in renal transplant recipients.</p><p><strong>Methods: </strong>A thorough exploration was conducted across Embase, PubMed, Web of Science, and the Cochrane Library databases to gather pertinent literature spanning from January 1, 2000, to December 31, 2023. The search criteria encompassed terms such as \"kidney transplantation,\" \"parathyroidectomy,\" and \"hyperparathyroidism.\"</p><p><strong>Results: </strong>Twelve studies were scrutinized to assess alterations in graft functionality at 1, 3, 6, and 12 months postparathyroidectomy. The meta-analysis unveiled a notable decline in overall glomerular filtration rate and a concurrent elevation in serum creatinine 1 year postparathyroidectomy, signifying an impairment in graft function compared to the preoperative phase. Significant heterogeneity was observed among the studies.</p><p><strong>Conclusion: </strong>Following parathyroidectomy in renal transplant recipients 1 year postsurgery, calcium and parathyroid hormone levels normalized. Nonetheless, there was evident impairment in graft function and an elevated risk of graft loss. Hence, the safety of parathyroidectomy in patients with secondary hyperparathyroidism postrenal transplantation necessitates meticulous consideration.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2134-2143"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755988","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 and Risk Factors for Clinically Significant Oropharyngeal Dysphagia After Lung Transplantation.","authors":"Jacques Neelankavil, Reed Harvey, Jure Marijic, Michael Tan, Lorraine Lubin, Ali Salehi, Theodora Wingert, Tristan Grogan, David Sayah, Abbas Ardehali","doi":"10.1016/j.transproceed.2024.11.003","DOIUrl":"10.1016/j.transproceed.2024.11.003","url":null,"abstract":"<p><p>Aspiration is one of many risk factors for chronic lung allograft dysfunction, which continues to limit survival in lung transplant recipients. Oropharyngeal dysphagia (OPD) occurring after lung transplant surgery increases the risk of antegrade aspiration. While the incidence and risk factors for OPD have been well described in cardiac surgery, there is less known in the lung transplant population. The aim of this retrospective, single-center study was to determine the incidence of clinically significant OPD in lung transplant recipients and to identify patient and procedural risk factors for OPD in this population. A total of 158 lung transplant recipients who underwent postoperative fiberoptic endoscopic evaluation of swallowing (FEES) were included in the study. The incidence of OPD was 67.1% (106/158) with 29.8% (47) having a complete absence of swallowing function. Female sex, cardiopulmonary bypass, duration of intubation, and an increased number of transesophageal echocardiography (TEE) clips were associated with OPD. The incidence of OPD in this study is consistent with the limited data available in lung transplant literature, and higher than that of general cardiac surgery. An increased number of acquired TEE clips is a novel OPD risk factor in this population and a modifiable target for future intervention.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2226-2230"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781848","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":"Motivational Factors Affecting Body and Organ Donation in China Identified Based on Grounded Theory.","authors":"Yunfeng Wang, Ping Dong, Yukun Zhou, Shanshan Gao, Luqing Zhang","doi":"10.1016/j.transproceed.2024.11.005","DOIUrl":"10.1016/j.transproceed.2024.11.005","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, China has experienced a shortage of donated bodies and organs for dissection during medical education and clinical transplantation. This study investigated and analyzed motivational factors affecting body and organ donation in China.</p><p><strong>Methodology: </strong>Thirty-three body and organ donation volunteers were interviewed in-depth, and their donation motivations were investigated. The data were decomposed, detected, compared, conceptualized, and categorized using open, correlation, and selective coding based on grounded theory.</p><p><strong>Results: </strong>The results were used to construct a model that elucidates the foundation of body and organ donation based on \"humanistic medical care\" and \"death in existentialism\" as driving forces for body and organ donors.</p><p><strong>Conclusions: </strong>This study provides new theoretical perspectives that contribute to interpreting behavior related to body and organ donation and offers a theoretical basis for related policymaking and promotional work.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2115-2123"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741823","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":"Liver Transplantation in the Philippines: Light at the End of the Tunnel.","authors":"Siegfredo R Paloyo, Ferri P David-Paloyo, Rose Marie R Liquete, Enrique T Ona","doi":"10.1016/j.transproceed.2024.11.009","DOIUrl":"10.1016/j.transproceed.2024.11.009","url":null,"abstract":"<p><p>End-stage liver disease is arguably one of the leading burdensome diseases among developing countries such as the Philippines. Although liver transplantation is considered the treatment of choice for decompensated cirrhosis, the establishment of a robust transplant program locally has been protracted as numerous obstacles continue to plague our transplant landscape. Issues on cost, options of having the transplant done overseas, and low rates of deceased donation are some of the difficulties that hamper our program's progress and development. In this study, we aim to present our experience and discuss hurdles, describing the current status of liver transplantation in the country. Herein we report our initial 68 liver transplants covering 35 years. A retrospective review was performed including all transplants done in 4 active transplant centers from August 1988 to December 2023. Recipients were mostly male patients (69%) with hepatitis B as the most common (32%) primary liver disease. Deceased donor liver transplant was more common (65%) with recipients having a median Model for End-Stage Liver Disease (MELD) score of 22. Among living donor liver transplants, 58% of the grafts were from the left lateral segment. Outcomes can be divided into two eras, with the first era (1988-2010) having a 1-year graft survival of only 25%. The second era (2011-present) was marked with surgical refinements and advancing knowledge, improving 1-year graft survival to 64% and 67% for adult and pediatric transplants, respectively. Indeed, the establishment of a liver transplant program requires a team approach and most fundamentally, full training in liver transplantation and the management of its complications. Optimal patient selection remains essential in achieving excellent survival outcomes. Last, Filipinos with liver cirrhosis now have an opportunity for a significant improvement in their quality of life by undergoing transplantation in their native country.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":"2178-2182"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735465","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}