Transplantation proceedings最新文献

{"title":"Anxiety and Depression Outcomes in Liver Transplant Candidates and Recipients Using the Hospital Anxiety and Depression Scale.","authors":"Ali Emre Bardak, Asli Cifcibasi Ormeci, Zuhal Yildiz, Volkan Senkal, Ziya Imanov, Zulal Istemihan, Kanan Nuriyev, Aynura Rustamzada, Sezen Genc, Filiz Akyuz, Kadir Demir, Fatih Besisik, Sabahtattin Kaymakoglu, Bilger Cavus","doi":"10.1016/j.transproceed.2025.05.032","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.032","url":null,"abstract":"<p><strong>Objectives: </strong>Liver transplantation is a life-saving treatment for patients with end-stage liver disease, but it is associated with significant psychological burdens, including anxiety and depression. This study aimed to evaluate the anxiety and depression of this population using the Hospital Anxiety and Depression Scale (HADS) and to identify associated demographic and clinical factors.</p><p><strong>Methods: </strong>This study included 113 liver transplant candidates and recipients. Anxiety and depression were assessed using the HADS with an anonymous questionairre. Subgroup analyses were conducted based on transplant status, donor type, gender, age, body mass index, education level, and antidepressant use.</p><p><strong>Results: </strong>The mean overall HADS score was 11.16. Although female participants showed slightly higher mean anxiety, depression, and overall HADS scores, the differences were not statistically significant. Generation Z had the highest anxiety scores (significantly greater than Generation X, P = .048, and Baby Boomers, P = .034), while Baby Boomers had the highest, albeit non-significant, depression scores. Education level and BMI categories showed no significant group differences. Individuals taking antidepressants had significantly elevated anxiety (P = .044) and overall HADS (P = .026) scores. Among candidates, having a confirmed living donor was associated with significantly lower depression (P = .034) and overall HADS (P = .043). Time since transplantation showed no significant correlation with psychological outcomes.</p><p><strong>Conclusions: </strong>Psychological distress is prevalent among liver transplant candidates and recipients, and it has a substantial impact on morbidity and mortality. Raising awareness for the recognition of the psychological aspect of transplantation is critical to improve mental health and clinical outcomes in this population.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512994","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":"Islet Transplantation Provides Superior Glycemic Control and Maintenance of Better Islet Architecture Compared to Early Insulin Treatment in 50% Pancreatectomized Mice.","authors":"Byung-Joon Kim, Heekyoung Park, Jun-Seop Shin, Jin Kuk Kim, Kwang-Won Kim","doi":"10.1016/j.transproceed.2025.05.029","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.029","url":null,"abstract":"<p><p>Early insulin intervention is speculated to promote β-cell rest, potentially preserving and regenerating residual β-cells in β-cell-deficient environments, such as recent-onset type 1 diabetes. However, exogenous insulin supplementation is supposed not to be enough to fulfill these beneficial outcomes. To investigate this, we employed a 50% partial pancreatectomy (Px) in mice as a model for β-cell deficiency. Four experimental groups are included: 1. a sham group that underwent 50% Px (sham group), 2. control group that underwent 50% Px with saline injection for 7 days (Px group), 3. insulin group that administered insulin injection for 7 days post-Px (PX+INS group) and 4. islet transplantation group that islet transplantation after 50% Px. (PX+IT group). Intraperitoneal glucose tolerance tests (IPGTTs) were performed at 3- and 7-days postinsulin treatment or IT, and glycemic control was assessed by calculating the area under the curve (AUC) of blood glucose concentrations. Histomorphometric analysis was used to evaluate islet distribution, islet morphology and the composition of β- and α-cells. The results showed significantly improved glucose tolerance at 3- and 7- days in the islet-transplantation group compared to the insulin-treated group. Islet proportions in the pancreas were similar across groups; however, the insulin-treated group exhibited a significant increase in α-cell numbers, with their distribution extending both to the periphery and inner core of the islets. Our findings demonstrate that islet transplantation is superior to insulin treatment for glycemic control following 50% pancreatectomy in mice. Short-term insulin treatment was associated with α-cell expansion and worsened glycemic outcomes. These results suggest that islet transplantation is more effective in β-cell-deficient conditions, and caution is warranted when implementing early preventive insulin interventions.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512995","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":"Cryopreserved Skin Transplantation in a Nonhuman Primate Model.","authors":"Meghan Hu, Rafaela Belloni, Joseph Ladowski, Davide Schiliro, Alessandro Martinino, Allison Schwalb, Zishen Li, Mingqing Song, Kyha Williams, Alton B Farris, Stuart Knechtle, Jean Kwun","doi":"10.1016/j.transproceed.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Skin transplantation is often used in nonhuman primate (NHP) transplant research for sensitization and to assess tolerance. However, the availability of donor animals for skin can be constrained after organ donation. In this study, we evaluated the feasibility of cryopreserving skin patches to address this issue.</p><p><strong>Methods: </strong>A full-thickness dorsal skin section with a diameter of ∼3 cm was excised. Following defatting process, the skin graft was immersed in a skin-cryopreservation media and preserved in liquid nitrogen. Prior to transplantation, the frozen skin was rapidly thawed using a 37°C water bath and thoroughly washed with normal saline. Cryopreserved syngeneic skin transplantations were performed, monitored, and assessed histologically.</p><p><strong>Results: </strong>Autologous skin grafts preserved in liquid nitrogen with prolonged storage time (>1 month) demonstrated successful engraftment in NHP recipients. The cryopreserved skin exhibited well-preserved epidermis and dermis, with minimal distinction compared to non-cryopreserved samples. In fully engrafted cryopreserved skin grafts, dermal fibrosis appeared slightly less distinct at 28 days after transplantation. These differences could be attributable to anatomical location of the samples.</p><p><strong>Conclusion: </strong>The cryopreserved skin showed well-preserved normal skin histology before and after skin transplantation. Here, we show that cryopreserved NHP skin can be stored for a prolonged time and grafted in a delayed manner. Cryopreserved skin could serve as a source when a living donor NHP is unavailable, including for testing donor-specific tolerance in the absence of the organ donor.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510204","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":"Exploring the Protective Effect and Regulatory Mechanism of Plumbagin on Renal Ischemia-Reperfusion Injury Based on the Nrf-2/HO-1 Signaling Pathway.","authors":"Qixun Luo, Zunwei Zhu, Lisong Wan","doi":"10.1016/j.transproceed.2025.05.028","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.028","url":null,"abstract":"<p><strong>Objective: </strong>To investigate and validate the protective role of plumbagin (PL) in renal ischemia-reperfusion injury (IRI) by mediating the Nrf2/HO-1 pathway and reducing renal function damage, thereby providing a theoretical basis for the application of PL in the prevention of renal IRI.</p><p><strong>Methods: </strong>Twenty-four healthy adult male BALB/c mice were randomly divided into four groups: the sham group, the IR model group (IRI group), the IRI + PL 10 mg/kg group, and the IRI + PL 10 mg/kg + ML385 (30 mg/kg) group. Four groups of mice were given drugs 2 weeks before modeling, for 2 consecutive weeks (once a day), and the modeling was started 1 hour after the administration on the 14th day. In the sham operation group, only the renal vessels were isolated without clamping ischemia, and in the other groups, minimally invasive artery clamps were used to establish the mouse RIRI injury model. Serum creatinine (Scr), blood urea nitrogen (BUN), interleukin-6 (IL-6), myeloperoxidase (MPO), serum superoxide dismutase (SOD), GSH-Px, malondialdehyde (MDA), and inflammatory levels of mice in each group were detected and analyzed; pathological examination of renal tissue injury; and the expressions of Nrf-2 and HO-1 were detected by Western blotting.</p><p><strong>Results: </strong>Compared with the sham group, the IRI group showed elevated Scr, BUN, IL-6, MDA, and MPO levels, reduced SOD and GSH-Px activities, severe renal injury, and decreased Nrf-2/HO-1 expression. PL administration reduced renal injury, decreased Scr, BUN, IL-6, MDA, and MPO levels, increased SOD and GSH-Px levels, and increased Nrf-2/HO-1 expression, as confirmed by pathology and Western blotting.</p><p><strong>Conclusions: </strong>PL can reduce the level of oxidative stress and the release of inflammatory factors by regulating the Nrf-2/HO-1 signaling pathway, improve renal injury induced by ischemia/reperfusion in mice, and play a renoprotective role.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510205","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":"Survival of Highly Sensitized Patients on the Waiting List for Kidney Transplantation at Modena Transplant Center.","authors":"Giacomo Mori, Jessica Plessi, Niccolò Morisi, Laura Tonelli, Laura Melara, Giuseppe Oliviero, Alice Parmigiani, Marco Ferrarini, Stefano Di Sandro, Gabriele Donati","doi":"10.1016/j.transproceed.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.04.010","url":null,"abstract":"<p><strong>Background: </strong>HLA sensitization plays a pivotal role in kidney transplantation. The presence of anti HLA antibodies strongly limits access to transplantation to subjects on the waiting list, particularly for highly sensitized patients. The aim of this study is to evaluate the waiting time of highly sensitized candidates, when compared with patients with a lower level of sensitization, and the respective survival rates on the waiting list.</p><p><strong>Methods: </strong>We conducted a single center retrospective observational study stratified according to calculated panel reactive antibodies (cPRAs) in highly sensitized patients (cPRA ≥ 80%) and patients with a lower level of sensitization (NH; cPRA < 80%). A total of 911 patients on the waiting list were considered. Survival analysis was performed according to Kaplan Meier, and multivariate analysis was performed with Cox regression. Mortality data were collected only for 222 patients who were residents in the Province of Modena, Italy.</p><p><strong>Results: </strong>Highly sensitized subjects have a significantly longer waiting time from enrollment to kidney transplantation when compared to patients with a lower level of sensitization, but in our highly sensitized patients the mortality rate resulted slightly lower because of the protective effect of a younger age at enrollment.</p><p><strong>Conclusions: </strong>Highly sensitized patients wait longer to achieve kidney transplantation, but they do not show worse survival rates, likely because of a younger age at enrollment. These results highlight the importance of innovative strategies to allow access to transplantation to highly sensitive subjects to limit the personal and social cost of a prolonged stay on dialysis.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500005","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":"Transplant Ureteral Stenosis Caused by Polyomavirus Ureteritis in Allograft Kidney Transplantation: Two Cases Report and a Literature Review.","authors":"Tianlu Zhang, Qinyun Wu, Rongfang Shen, Wenhan Peng, Zhenpeng Jin, Sulin Luo, Luying Guo, Meifang Wang, Jianyong Wu, Jianghua Chen, Rending Wang","doi":"10.1016/j.transproceed.2025.05.026","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.026","url":null,"abstract":"<p><strong>Background: </strong>Polyomavirus ureteritis is a rare but increasingly recognized complication in kidney transplantation, with the potential to cause ureteral stenosis and graft loss. We report two pathologically confirmed cases of polyomavirus ureteritis presenting as ureteral stenosis, successfully treated with ureterovesical reimplantation surgery and adjustments in immunosuppressive therapy.</p><p><strong>Case presentation: </strong>The first case describes a 41-year-old male renal transplant recipient, who presented with progressive hydronephrosis and an elevated serum creatinine (Scr) level of 308 μmol/L 5 months post-transplant. The second case involves a 25-year-old female recipient who developed hydronephrosis and dilatation of the upper ureter in the transplanted kidney 2 months post-transplant, with a subsequent rise in Scr level to 167 μmol/L. Urine tests revealed high polyomavirus loads, while blood viremia tests remained negative. Ureteral biopsy confirmed polyomavirus ureteritis through simian virus 40 immunohistochemical staining. Following successful ureterovesical reimplantation surgery and tailored reduction in immunosuppressive regimens, both patients cleared the virus in urine and their Scr levels returned to baseline.</p><p><strong>Conclusion: </strong>This report highlights ureteral polyomavirus infection as a critical differential diagnosis in cases of ureteral stenosis among kidney transplant recipients. Accurate diagnosis requires thorough pathological evaluation, including simian virus 40 staining of ureteral tissue. Early recognition and individualized therapeutic strategies are essential to preserve graft function and improve patient outcomes.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500006","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":"Construction and Evaluation of a Nomogram for Unplanned Readmission Within 1 Year After Kidney Transplantation: Based on Lasso-Logistic Regression Model.","authors":"Weiwei Cao, Bei Ding, Kejing Zhu, Li Ma, Minghuan Zhong, Yulin Niu","doi":"10.1016/j.transproceed.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.012","url":null,"abstract":"<p><strong>Objective: </strong>To develop and evaluate a risk prediction model for unplanned readmission within 1 year following kidney transplantation using Lasso-logistic regression.</p><p><strong>Methods: </strong>Clinical data of kidney transplant recipients from the Department of Organ Transplantation at the Affiliated Hospital of Guizhou Medical University, spanning April 2017 to June 2023, were retrospectively analyzed. Initially, Lasso regression analysis was used to select predictive variables. Subsequently, logistic regression analysis was employed to construct a risk prediction model, which was presented as a nomogram. Bootstrap repeated sampling was conducted 1000 times for internal model validation. The comprehensive efficacy of the prediction model was assessed from four dimensions: discrimination, fit, calibration, and clinical benefit.</p><p><strong>Results: </strong>The incidence of unplanned readmission within 1-year post-transplant was 36.48%. Serum creatinine, cystatin C, albumin, serum potassium, serum magnesium, drinking history, rejection, and length of stay were the predictors of unplanned readmission within 1 year after renal transplantation. The comprehensive ability of the risk prediction model for unplanned readmission within 1 year after renal transplantation was as follows: The area under the receiver operating characteristic curve of the nomogram model was 0.715 (95% CI: 0.673-0.757). The internal validation results showed that the corrected C-index was 0.700. The positive predictive value of the model was 0.533 and the negative predictive value was 0.785. The Hosmer-Lemeshow goodness of fit test result was χ² = 4.941, P = 0.764, indicating a satisfactory fit of the model. In the calibration curve, the actual fitting curve was well-fitted to the standard curve, and the model calibration ability was acceptable. The clinical decision curve confirmed the clinical value of the model and its positive impact on actual decision-making.</p><p><strong>Conclusions: </strong>The constructed model demonstrates considerable predictive value for unplanned readmission within 1 year after kidney transplantation. It serves as a valuable tool for early clinical warning, enabling healthcare professionals to formulate personalized preventive strategies based on identified risk factors.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500003","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":"Grafting Islets to a Prevascularized Subcutaneous Site to Improve Transplant Survival and Function: A Mouse Model.","authors":"Tsuyoshi Okada, Takashi Kuise, Kenjiro Kumano, Hiroshi Tazawa, Toshiyoshi Fujiwara","doi":"10.1016/j.transproceed.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.019","url":null,"abstract":"<p><strong>Background: </strong>The subcutaneous space is regarded as a potential site for islet transplantation; however, hypoxic conditions are a major drawback. We hypothesized that islet transplantation into a prevascularized subcutaneous space created using in-body tissue architecture technology would improve islet engraftment and contribute to maintaining the function of transplanted islets.</p><p><strong>Methods: </strong>Five hundred syngeneic islets were transplanted into the prevascularized subcutaneous space (PSS) constructed by the implantation of a silicone rod for 2 weeks in C57BL/6J diabetic mice. Diabetic mice transplanted with islets into the unmodified subcutaneous space (USS) were used as the controls. After transplantation, nonfasting blood glucose levels were monitored for 8 weeks, and an intraperitoneal glucose tolerance test and histological evaluation were performed.</p><p><strong>Results: </strong>Five of the 10 recipients in the PSS group and two of the nine recipients in the USS group returned to normoglycemia. Engraftment of the transplanted islets was detected in nine of the 10 recipients in the PSS group, and the engraftment rate in the PSS group was significantly higher than that in the USS group (P = .005). Intraperitoneal glucose tolerance test results showed that the glucose tolerance of recipient mice in the PSS group was significantly better than that of the diabetic mice. Histological analysis revealed that the density of capillary vessels in the connective tissue surrounding the engrafted islets in the PSS group was significantly higher than that in the USS group (41.7/mm² vs 7.2/mm², P < .01).</p><p><strong>Conclusion: </strong>Islet transplantation into the PSS using in-body tissue architecture technology has the potential to improve graft survival.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500004","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":"Bibliometric Analysis and Visualization of Research Trends and Hotspots in the Body Donation Field.","authors":"Yunfeng Wang, Luqing Zhang","doi":"10.1016/j.transproceed.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.015","url":null,"abstract":"<p><strong>Introduction: </strong>The development of body donation (BD) programs has varied significantly worldwide, with recent increases in donations. This study performed a visual analysis of BD research over the past 2 decades to explore trends and key areas of interest within the field.</p><p><strong>Methods: </strong>This study used scientometric data from the Web of Science database and 2 bibliometric analysis tools: VOSviewer and CiteSpace.</p><p><strong>Results: </strong>Between 2004 and 2024, 1384 BD articles were published in 568 journals. Publication and citation numbers increased consistently. Leading contributions come from institutions in Europe and the United States. The countries, institutions, journals, and authors with the highest publication counts included the United States (342), Medical University of Innsbruck (55), Anatomical Sciences Education (117), and Raffaele De Caro (26). The most frequently used keywords were BD, anatomy, dissection, attitude, medical education, transplantation, and organ donation. Keywords that showed significant bursts included outcomes, whole BD, educators, gross anatomy education, disease, in vitro studies, governing BD, adipose tissue, respect, and legal considerations.</p><p><strong>Conclusions: </strong>The findings suggest that future research topics and hotspots in the BD field should focus on evaluating teaching effectiveness, enhancing medical ethics, improving legal frameworks, fostering public education and awareness, and advancing tissue engineering transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487590","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":"Graft-Versus-Host Disease as a Risk Factor for Heart Failure After Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study.","authors":"Tong Wang, Qian Zhu, Hongfei Zhao, Huan Liu","doi":"10.1016/j.transproceed.2025.05.030","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.05.030","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a critical therapeutic option for hematologic malignancies. However, it is associated with severe complications, including graft-versus-host disease (GVHD). While GVHD is widely recognized for its impact on various organs, its role in the development of heart failure (HF) remains insufficiently understood. This study investigates the association between GVHD and HF following allo-HSCT, focusing on identifying key risk factors contributing to HF development.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 220 patients who underwent allo-HSCT between 2005 and 2024. HF was defined by clinical criteria and left ventricular ejection fraction. The association of GVHD severity (acute and chronic), inflammatory markers (tumor necrosis factor-alpha, interleukin-6), and cardiac biomarkers (B-type natriuretic peptide) with HF was analyzed. Multivariate logistic regression was performed to identify independent predictors of HF.</p><p><strong>Results: </strong>Patients with HF demonstrated significantly lower left ventricular ejection fraction (33.92% ± 6.73% vs 61.51% ± 6.18%, P = .021) and higher levels of B-type natriuretic peptide (393.29 ± 71.29 ng/L vs 307.92 ± 76.28 ng/L, P = .042), tumor necrosis factor-alpha (80.3 ± 20.4 pg/mL vs 40.2 ± 10.1 pg/mL, P < .001), and interleukin-6 (65.1 ± 15.7 pg/mL vs 25.4 ± 8.6 pg/mL, P < .001) compared to controls. Severe acute GVHD (Grade ≥III) significantly increased the risk of HF (odds ratio = 3.5, P < .001). Patients with multiple GVHD-related complications had a 3.6-fold higher likelihood of HF development (P < .01). Echocardiographic findings revealed significant cardiac remodeling in HF patients, with increased left ventricular end-diastolic diameter (68.76 ± 7.23 mm vs 44.18 ± 7.16 mm, P = .004) and left ventricular posterior wall thickness (12.18 ± 4.32 mm vs 4.46 ± 2.19 mm, P = .002). Additionally, HF patients experienced more severe transplant-related complications, including infections (29.0% vs 10.6%, P = .041) and hemorrhagic cystitis (23.4% vs 7.1%, P = .027). Mortality was significantly higher in the HF group (86.0% vs 41.6%, P < .001), with infection (71.0%) and HF (21.5%) being the leading causes of death. GVHD significantly heightens the risk of HF after allo-HSCT.</p><p><strong>Conclusions: </strong>These findings underscore the necessity for proactive cardiovascular monitoring and targeted therapeutic interventions in GVHD patients to prevent the development of HF.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487604","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}