Transplantation proceedings最新文献

{"title":"Isosulfan Blue and Bladder Disclosure in Kidney Transplant Recipients.","authors":"Arif Aslaner, Kemal Eyvaz","doi":"10.1016/j.transproceed.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.007","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the role of using isosulfan blue via a three-way catheter in performing ureteroneocystostomy in kidney transplant recipients.</p><p><strong>Methods: </strong>A single-center, observational, descriptive study was conducted between December 2015 and July 2024 involving 112 kidney transplant recipients. A three-way catheter was used in all cases, and the bladder volume was assessed using a 1% isosulfan blue solution. Data on recipient demographics, bladder volume, and complications were analyzed.</p><p><strong>Results: </strong>A total of 112 patients were included. The mean age of recipients was 48.04 years (range: 25-69). A three-way urinary catheter with physiological saline and isosulfan blue solution was used in all cases. Bladder volume ranged from 50 cc to 250 cc. No intraoperative or postoperative complications were observed.</p><p><strong>Conclusion: </strong>The use of isosulfan blue through a three-way catheter significantly facilitated the identification of the bladder prior to ureteroneocystostomy, making the procedure easier and more reliable. We recommend the use of isosulfan blue for bladder exposure in kidney transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056461","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":"Experiences of Potential Living Donors Who Withdrew From Liver Donor Evaluation: A Qualitative Study.","authors":"Tugba Nur Oden, Tufan Gumus, Sirin Vatansever Durmus, Alper Uguz","doi":"10.1016/j.transproceed.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.006","url":null,"abstract":"<p><strong>Background: </strong>Understanding the psychological, emotional, and managerial challenges faced by potential donors is essential for the proper management of the living donor evaluation process, and appropriate solutions need to be developed for these challenges. This study aimed to explore the experiences of potential liver donors who voluntarily withdrew from the living donor evaluation process.</p><p><strong>Methods: </strong>A phenomenological qualitative design was employed. Ten participants who had voluntarily withdrawn from the living donor evaluation process were interviewed. Three main themes were identified: (1) Experiences Related to the Evaluation Process, (2) Reasons for the Withdrawal Decision, and (3) Recommendations regarding the potential donor evaluation process.</p><p><strong>Results: </strong>Positive experiences included adequate information sharing, emotional support, psychiatric consultations, and support from hospital staff. Negative experiences focused on prolonged waiting times, psychological and emotional barriers, systemic and organizational issues. Key reasons for withdrawal included concerns about health and surgical risks, family responsibilities, psychological unpreparedness, and organizational difficulties experienced throughout the evaluation process. Participants suggested accelerating hospital procedures, improving communication with specialists, offering accommodation during the evaluation process, and increasing public awareness about organ donation.</p><p><strong>Conclusions: </strong>The findings emphasize the need to improve the living donor evaluation process. Prioritizing donor candidates, expediting procedures, and developing donor support programs that address physical, emotional, financial, and systemic needs may enhance the effectiveness of living donor transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007025","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":"HALP Score Predicts Early Post-Transplant Outcomes: A 25-Year Retrospective Study on Hepatocellular Carcinoma and Liver Transplantation Outcomes.","authors":"Cihan Agalar, Tufan Egeli, Anil Aysal, Mucahit Ozbilgin, Berkay Sakaoglu, Nilay Danis, Emre Karadeniz, Erhan Tükel, Ibrahim Astarcioglu, Ozgul Sagol, Tarkan Unek","doi":"10.1016/j.transproceed.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.001","url":null,"abstract":"<p><strong>Aim: </strong>The Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score is an immune nutritional marker associated with prognosis in various malignancies. However, its prognostic significance in liver transplantation (LT) for hepatocellular carcinoma (HCC) remains unexplored. This study investigates the prognostic impact of the HALP score on post-transplant survival and recurrence in HCC patients.</p><p><strong>Patients and methods: </strong>A retrospective cohort study included 131 patients who underwent Liver Transplantation for HCC between 1998 and 2023. Patients were stratified into high and low HALP groups based on a threshold value of 55.689 determined via receiver operating characteristic (ROC) analysis. Overall survival (OS), disease-free survival (DFS), and perioperative mortality were analyzed using Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>The low HALP group exhibited significantly higher perioperative mortality (18.3% vs. 5.6%, P = .003), first-year mortality (30.0% vs. 9.9%, P = .001), and three-year mortality (48.3% vs. 22.5%, P = .001). Overall survival was significantly shorter in the low HALP group (P = .003). Multivariate analysis identified low HALP as an independent risk factor for perioperative (OR: 12.76, P = .019; HR: 11.68, P = .021), first-year (OR: 5.19, P = .005; HR: 4.22, P = .007) and third-year mortality (OR: 3.67, P = .01; HR: 2.88, P = .012).</p><p><strong>Conclusion: </strong>The HALP score is a promising prognostic biomarker for predicting early risk in LT candidates with HCC. Integrating HALP into pre-transplant assessment may optimize patient selection and perioperative management, improving post-transplant outcomes.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984283","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":"Pathologic Complete Response as a Prognostic Indicator in Bridging Therapy: A 25-Year Retrospective Study on Hepatocellular Carcinoma and Liver Transplantation Outcomes.","authors":"Cihan Agalar, Tufan Egeli, Mucahit Ozbilgin, Berkay Sakaoglu, Anil Aysal, Ibrahim Astarcioglu, Aytac Gulcu, Nilay Danis, Erkan Derebek, Ozgul Sagol, Tarkan Unek","doi":"10.1016/j.transproceed.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.08.004","url":null,"abstract":"<p><strong>Aim: </strong>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, and liver transplantation (LT) remains the most effective curative option for eligible patients. Bridging therapies are often employed during the waiting period to control tumor progression and improve transplant eligibility. However, their prognostic impact remains controversial. We aimed to evaluate the effect of bridging therapy and pathological complete response (CR) on post-transplant outcomes in patients who underwent LT for HCC.</p><p><strong>Patients and methods: </strong>In this retrospective study, 120 patients with HCC who underwent LT between 1998 and 2023 were analyzed. Bridging therapies included transarterial chemoembolization (TACE), transarterial radioembolization (TARE), radiofrequency ablation (RFA), and microwave ablation (MWA). Overall survival (OS), disease-free survival (DFS), and recurrence were compared between patients with and without bridging therapy. The prognostic significance of pathological CR was also assessed.</p><p><strong>Results: </strong>Bridging therapy was administered to 24.2% of patients. There was no statistically significant difference in OS or DFS between patients who received bridging therapy and those who did not. However, a pathological CR was achieved in 27.6% of bridged patients and was significantly associated with improved OS (P = .018) and DFS (P = .05). No recurrence or mortality occurred in patients who achieved CR.</p><p><strong>Conclusion: </strong>While bridging therapy did not independently affect post-transplant survival, achieving a pathological complete response emerged as a strong prognostic indicator. These findings highlight the clinical importance of treatment response and support the role of CR as a potential predictor of favorable long-term outcomes following LT in HCC patients.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Real-World Disproportionality Analysis of FDA Adverse Event Reporting System(FAERS) Event for Belatacept.","authors":"Chengze Liang, Turun Song, Tao Lin","doi":"10.1016/j.transproceed.2025.07.024","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.07.024","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to comprehensively evaluate the safety profile of belatacept administration in real-world clinical settings.</p><p><strong>Methods: </strong>Disproportionality analysis methodologies, including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS) algorithms, were utilized to quantify real-world adverse event (AE) signals associated with belatacept.</p><p><strong>Results: </strong>A total of 4631 adverse event reports were extracted from the FDA Adverse Event Reporting System (FAERS) database, of which 2337 adverse events were identified as \"primary suspect\" (PS) attributed to belatacept. Belatacept-related adverse events involved 27 system organ classes (SOCs). Common adverse reaction preferred terms (PTs) consistent with the FDA label for belatacept identified in FAERS analysis included anemia (PT: 10019281), diarrhea (PT: 10012736), and urinary tract infection (PT: 10046577). Notably, several potential novel or off-label adverse event signals were detected in the analysis, including multiple organ transplant rejection (ROR = 976.42), tertiary syphilis (ROR = 901.31), removal of renal transplant (ROR = 857.72), perinephric fluid collection (ROR = 563.03), graft loss (ROR = 549.26), polyomavirus positive (ROR = 548), subcapsular renal hematoma (ROR = 475.53), renal transplant rejection (ROR = 293.73), renal transplant failure (ROR = 204.27), polyomavirus viremia (ROR = 203.62), renal vein thrombosis (ROR = 171), renal transplant infection (ROR = 168.26), injection (ROR = 154.2), and graft hemorrhage (ROR = 152.17). The distribution of adverse event reports varied across populations. Most reports were submitted by consumers (P = .0099), and females were predominantly represented. There was a significant age difference between female and male patients (P = .035).</p><p><strong>Conclusion: </strong>This study identifies potential novel adverse event signals for belatacept within the FAERS database, and highlights age, sex differences, and comorbidity complexity in adverse event distribution, providing essential references for clinical drug safety and subsequent mechanistic research.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984811","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 Childhood: A 2-Year Single Center Experience.","authors":"Hasret Ayyıldız Civan, Ferhat Sarı, Feyza Sönmez Topçu, Aysel Taktak, Hüseyin İlksen, Adem Tunçer, Emrah Şahin, Halil Şahin, Veysel Esan, Bülent Ünal, Abuzer Dirican","doi":"10.1016/j.transproceed.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.07.008","url":null,"abstract":"<p><strong>Objective: </strong>Liver transplantation is currently the most treatment for fulminant hepatitis, end-stage liver failure, hepatocellular carcinoma, and liver-originated metabolic diseases in children. With technological advances, improvements in surgical techniques and immunosuppressive therapy protocols have increased 1-year survival rates to 80%-90%. Our center successfully performs both living donor and cadaveric liver transplants in children. This study retrospectively analyzed the preoperative and postoperative data of 72 pediatric patients who underwent liver transplantation between July 2022 and July 2024.</p><p><strong>Methods: </strong>We included 72 patients who underwent liver transplantation between July 1, 2022, and July 1, 2024. Cases were evaluated based on demographic data, liver failure etiology, and postoperative complications.</p><p><strong>Results: </strong>Of the cases, 37 were female (58%) and 35 male (42%), with a mean age of 6.6 years (ranging from 5 months to 17 years and 11 months). Indications included biliary atresia (25), autoimmune hepatitis (9), cryptogenic cirrhosis (7), PFIC (7), congenital hepatic fibrosis (1), Caroli disease (2), Wilson's disease (4), Alagille syndrome (3), hepatocellular carcinoma (2), primary hyperoxaluria type 1 (2), Crigler Najjar syndrome type 1 (3), Budd-Chiari syndrome (1), glycogen storage disease type 3 (1), portal vein thrombosis (1), and acute fulminant hepatitis (4). Mean PELD score for patients under 12 years was 18 (range 0-37), and MELD score for patients over 12 years was 19.3 (range 11-40). A total of 69 patients received orthotopic liver transplantation from living donors. Two patients received combined liver and kidney transplants, and 1 received a cadaveric liver transplant. Donors included 40 females and 32 males. Left lobe transplants were performed in 58 patients, and right lobe in 14. Immunosuppression included Tacrolimus + MMF in 70 patients and Cyclosporine in 2. Postoperative complications included biliary anastomosis stenosis (3), bile leakage (2), hepatic vein thrombosis (1), portal vein thrombosis (4), intestinal perforation secondary to Bogota syndrome (5), PRES syndrome due to Tacrolimus toxicity (1), primary graft dysfunction (1), and postoperative bleeding (2). Within the first month, 12 patients (16.6%) died, and 3 (4%) died between 1 month and 1 year postoperatively. The most common early cause of death was sepsis and multiorgan failure. One patient developed chronic rejection but recovered with steroid immunosuppression without the need for re-transplantation.</p><p><strong>Conclusion: </strong>Liver transplantation is a high-risk procedure requiring lifelong medication and follow-up. It is, however, the most effective treatment method for several severe pediatric liver conditions.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984447","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":"Predictive Value of Pretransplant Cytomegalovirus-Specific Cellular Immunity for Posttransplant CMV Infection in Liver Transplant Recipients Under Antiviral Prophylaxis.","authors":"Elif Seren Tanriverdi, Yusuf Yakupogullari, Yasar Bayindir, Sami Akbulut, Sibel Altunisik Toplu, Harika Gozde Gozukara Bag, Burak Isik, Baris Otlu, Sezai Yilmaz","doi":"10.1016/j.transproceed.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.07.006","url":null,"abstract":"<p><strong>Background: </strong>Existing data suggest that cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) in solid organ recipients may predict post-transplant CMV infection, but the available information is still limited, and needs to be validated for larger patient populations under certain circumstances. This study aimed to determine whether CMV-CMI could predict post-transplant CMV infection in liver transplant recipients (LTRs) receiving antiviral prophylaxis (AVP).</p><p><strong>Methods: </strong>A total of 1769 LTRs at the Inonu University Liver Transplantation Institute were retrospectively analyzed. CMV-CMI in a total of 334 patients (> 91% were CMV donor [D] positive/recipient [R] positive) who received AVP were analyzed using the CMV-Interferon (CMV-QF; QuantiFERON-CMV, Qiagen, Germany) assay within the week before transplantation. Patients were divided into two groups: group 1 (positive; n = 171, 51.2%) and group 2 (negative; n = 163, 48.8%). Patient variables were analyzed statistically.</p><p><strong>Results: </strong>A total of 124 LTRs developed CMV infection. Patients' pre-transplant characteristics did not differ significantly by their CMV-CMI result. A significantly lower percentage of LTRs with CMV-CMI positive developed infection than those with negatives (7.6% vs 68.1%, P < .001). All CMV-CMI positive patients fully recovered with antiviral treatment but only 76.6% of LTRs with negative CMV-CMI (P = .032). Logistic regression analysis showed that a negative CMV-CMI was associated with a 26 times increased risk of CMV infection compared to those with positive CMV-CMI (odds ratio [OR] = 25.9, P < .001). Female recipients developed CMV infection earlier after cessation of AVP than male recipients (median = 128 vs 144 days, P = .038).</p><p><strong>Conclusions: </strong>The pre-transplant status of CMV-CMI may be a strong indicator of post-transplant CMV infection for LTRs receiving AVP. Therefore, further consideration should be made for the LTRs with negative CMV-CMI.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850247","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":"Activity-Dependent Effects of ERK1/2 on Hepatic Ischemia-Reperfusion Injury.","authors":"Joohyun Kim, Seung-Keun Hong, Alice Lee, Suresh N Kumar, Mariko Suchi, Jong-In Park","doi":"10.1016/j.transproceed.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.07.005","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation remains the only cure for end-stage liver disease, but ischemia-reperfusion injury (IRI) limits graft availability. Although extracellular signal-regulated kinase (ERK1/2) signaling is involved in cellular responses to IRI, its precise role in hepatic IRI remains unclear. We investigated the role of ERK1/2 in hepatic IRI by modulating its activity using small-molecule chemical inhibitors.</p><p><strong>Methods: </strong>ERK1/2 activation was monitored at different phases of hepatic IRI using a rat model in which liver ischemia was induced with varying reperfusion times. ERK1/2 activity was modulated in this model by administering different doses of trametinib (MEK1/2 inhibitor) and BCI (DUSP1/6 inhibitor). Liver injury was evaluated through histological assessment, serum markers, and molecular analysis of cell death pathways.</p><p><strong>Results: </strong>ERK1/2 activity increased early in the reperfusion phase and gradually decreased over 6 hours thereafter. Inhibiting the ERK1/2 activity increase using trametinib (0.3 mg/kg) as well as inhibiting its decreases using BCI (7.5 mg/kg) worsened the liver injury. However, the injury was reduced upon titrating ERK1/2 activity to a moderately increased level by BCI and trametinib coadministration. The reduced liver injury was accompanied by decreased expression of ferroptosis markers.</p><p><strong>Conclusions: </strong>Our data demonstrate that ERK1/2 activity is required for hepatic cells to tolerate IRI. Our results suggest that modulation of ERK1/2 activity using existing drugs may be a potential therapeutic strategy for mitigating hepatic IRI.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839578","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":"Kidney Transplantation and Donor Artery Grafts.","authors":"Arif Aslaner, Kemal Eyvaz","doi":"10.1016/j.transproceed.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.07.009","url":null,"abstract":"<p><strong>Background: </strong>We aim to present the mid- and long-term results of single and multiple artery grafts of donor kidneys in kidney transplantation surgeries and their effects on graft survival according to our experience.</p><p><strong>Methods: </strong>This is a single-center, observational, and descriptive study. Between December 2015 and July 2024, 112 patients with end-stage renal disease will undergo kidney transplantation with living or deceased donor kidney grafts. The transplanted patients were divided into 2 groups: Group 1, recipients of a single renal artery kidney graft (N = 95), and Group 2, recipients of multiple renal artery kidney grafts (N = 17). The groups were compared in terms of estimated glomerular filtration rates (months 1-3 and 12), delayed graft function, and graft survival. The data were statistically analyzed.</p><p><strong>Results: </strong>One hundred and eleven recipients were analyzed with all documented data. Graft function was compared between the 2 groups at 1, 3, and 12 months, and both were found to have similar results. Multiple donor artery graft anastomoses were found to have no effect on delayed graft dysfunction, higher risk of vascular injury, and biopsy-proven acute tubular necrosis.</p><p><strong>Conclusion: </strong>Our study demonstrates that, in our experience, transplants with multiple donor artery grafts, like single donor renal artery grafts, are safe in the first years after transplantation.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839581","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":"Demographic and Histopathological Features of Graft Dysfunction in Renal Transplant Biopsies: A Retrospective Study.","authors":"Şenay Yıldırım, Arif Aslaner, Kemal Eyvaz, Ayça İnci","doi":"10.1016/j.transproceed.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.transproceed.2025.07.007","url":null,"abstract":"<p><strong>Objective: </strong>Renal allograft biopsy plays a crucial role in identifying the causes of graft dysfunction and determining treatment strategies accordingly. In addition to rejection, viral infections, drug toxicity, systemic diseases such as hypertension and diabetes, as well as recurrent or de novo glomerulonephritis, can also be diagnosed through biopsy. This study aims to evaluate the diagnoses of renal allograft biopsies in conjunction with the Banff criteria.</p><p><strong>Methods: </strong>In our study, 44 renal transplant biopsies received at our pathology clinic between 2017 and 2024 were evaluated in terms of demographic, clinical, histopathological, and immunohistochemical features. Histopathological characteristics were scored according to the Banff 2019 criteria.</p><p><strong>Results: </strong>Among the cases, 70.5% (n = 31) were male, with a mean age of 45.16 years. The first transplantation had been performed in 97.7% of patients. A total of 77.3% of transplantations were from living donors, while 22.7% were from deceased donors. At the time of biopsy, the mean serum creatinine level was 4.03 ± 2.14 mg/dL (range: 0.70-8.50 mg/dL). Diagnoses included chronic active antibody-mediated rejection (ca-ABMR) (31.8%), active ABMR (18.2%), borderline changes (9.1%), polyomavirus nephropathy (9.1%), acute tubular necrosis (9.1%), recurrent/de novo glomerulonephritis (6.8%), acute T-cell-mediated rejection (TCMR) (4.5%), and chronic TCMR (4.5%). A statistically significant difference was observed in the Banff lesion scores of glomerulitis (P = .005), peritubular capillaritis (P = .002), and C4d staining (P = .001) between ABMR and TCMR. Three patients (6.8%) were deceased, while 41 patients (93.2%) survived.</p><p><strong>Conclusion: </strong>The most common causes of graft dysfunction were ca-ABMR, active ABMR, borderline changes, and polyomavirus nephropathy. Kidney biopsy remains the gold standard for prompt initiation of appropriate treatment when graft dysfunction occurs.</p>","PeriodicalId":94258,"journal":{"name":"Transplantation proceedings","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839579","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}