Transplant. Proc. [JOURNAL]
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200 papers
Cytokine Storm Following Lung Transplant in the Setting of Alistipes finegoldii Bacteremia: A Case Report.
Ishaq F, Gomez PAA, Nguyen NA
Transplant Proc · 2026 Mar · PMID 41622104 · Publisher ↗
Cytokine storm is an uncommon but devastating complication following lung transplantation, characterized by systemic hyperinflammation, multiorgan dysfunction, and hemodynamic collapse. We report the case of a 36-year-ol...
Cytokine storm is an uncommon but devastating complication following lung transplantation, characterized by systemic hyperinflammation, multiorgan dysfunction, and hemodynamic collapse. We report the case of a 36-year-old woman with systemic sclerosis-associated interstitial lung disease and pulmonary arterial hypertension who underwent bilateral lung transplantation and developed severe primary graft dysfunction requiring extracorporeal membrane oxygenation. Her course was complicated by clinical and biochemical features consistent with a cytokine storm, including elevated ferritin, IL-6, creatine phosphokinase, and transaminases, as well as persistent fever, rash, myocarditis, and vasoplegic shock. Despite aggressive immunomodulatory therapy-including corticosteroids, intravenous immunoglobulin, plasmapheresis, and anakinra-her recovery was protracted and complex. This case highlights the need for early recognition of cytokine storm in the lung transplant population and supports incorporating cytokine-targeted strategies into the management of severe posttransplant inflammation.
Pediatric Full and In-situ Split Domino Living Donor Liver Transplants Experience.
Polat KY, Kargı A, Yazar Ş … +5 more , Aslan S, Gürbulak B, Kamit F, Gökçe S, Astarcıoğlu I
Transplant Proc · 2026 · PMID 41535152 · Publisher ↗
BACKGROUND: Domino liver transplantation (DLT) is a method in which an explanted liver from a patient with metabolic disease is transplanted to another recipient. In cases where the liver is split and used for two recipi...
BACKGROUND: Domino liver transplantation (DLT) is a method in which an explanted liver from a patient with metabolic disease is transplanted to another recipient. In cases where the liver is split and used for two recipients, the technique is termed domino split liver transplantation. METHODS: This study presents our experience with three pediatric DLT cases, in which liver grafts from two donor-recipient patients with maple syrup urine disease (MSUD) were transplanted to separate recipients. First donor recipient's liver was splitted in situ, while the other was transplanted as a full-sized graft. Demographics, surgical techniques, biliary reconstruction methods, and posttransplant outcomes were analyzed. RESULTS: All recipients were discharged uneventfully following transplantation. No vascular or biliary complications were observed, and de novo MSUD did not develop in any recipient. This confirms that MSUD livers are safe for DLT, particularly in pediatric cases. CONCLUSION: DLT using MSUD donor livers is a viable option for expanding the organ pool for pediatric transplantation. Advancements in surgical techniques and perioperative care contribute to improved patient outcomes, making DLT a valuable strategy in liver transplantation programs.
Thymoglobulin Induction Therapy in Kidney Transplant Patients Receiving Organs Donated after Cardiac Death in China: A Real-World Patient-Level Pooled Analysis of the T-DCD and Start-DCD Studies.
Li Y, Xue W
Transplant Proc · 2026 · PMID 41529969 · Publisher ↗
BACKGROUND: Thymoglobulin is used in kidney transplantation as an induction therapy to prevent acute rejections; however, studies and data to support thymoglobulin induction therapy in Chinese patients undergoing kidney...
BACKGROUND: Thymoglobulin is used in kidney transplantation as an induction therapy to prevent acute rejections; however, studies and data to support thymoglobulin induction therapy in Chinese patients undergoing kidney transplant with donation after cardiac death (DCD) kidneys remain unclear. Therefore, we investigated the clinical outcomes of thymoglobulin induction therapy in recipients of DCD kidney transplant in real-world clinical practice. METHODS: This pooled analysis from the T-DCD and START-DCD studies was conducted to investigate acute rejection (AR), biopsy-proven AR (BPAR), delayed graft function (DGF), and graft and patient survival at 6 months in patients undergoing DCD kidney transplantation in the pooled population, in subgroups receiving thymoglobulin doses of <4 mg/kg and ≥4 mg/kg, and in subgroups receiving thymoglobulin doses of <1.5 mg/kg, 1.5 mg/kg to 4 mg/kg, and ≥4 mg/kg. Possible risk factors for AR, BPAR, DGF, graft survival, and patient survival were investigated as well. RESULTS: A total of 458 patients were included in this study. The incidence of AR within 6 months was 8% (n = 10) in patients receiving <4 mg/kg of thymoglobulin and 10.5% (n = 35) in those receiving ≥4 mg/kg. The dose-dependent incidence of BPAR was 3.1% in patients receiving a thymoglobulin dose <1.5 mg/kg, 2.3% in those receiving 1.5 to 4 mg/kg, and 1.6% in those receiving ≥4 mg/kg. In these 3 subgroups, a statistically significant reduction in DGF incidence (P = .023) was observed in 21.9%, 15.9%, and 7.2% of patients, respectively. The overall graft survival and patient survival rates at 6 months were 98% and 99.56%, respectively. The possible risk factors for AR were donor or recipient age, those for DGF were baseline creatinine and dosage, and those for graft survival were donor body mass index, warm ischemia time, thymoglobulin dosage, and donor history of cardiopulmonary resuscitation. CONCLUSION: Based on a pooled analysis of the T-DCD and START-DCD data in Chinese patients, treatment with thymoglobulin as an induction therapy has shown greater dose-dependent protection against DGF within 6 months after kidney transplantation. The higher thymoglobulin dose did not prolong the duration or reduce the incidence of AR and BPAR and showed no significant effect on graft survival or patient survival within 6 months of transplantation.
Bacteroides in Bile Detected by Metagenomic Next-Generation Sequencing: Potential Novel Indicator for Early Allograft Dysfunction After Liver Transplantation.
Zhu NQ, Zhang QB, Wang ZX … +1 more , Li RD
Transplant Proc · 2026 · PMID 41521100 · Publisher ↗
OBJECTIVE: Metagenomic next-generation sequencing (mNGS) is an effective method for the detection of microorganisms. Early allograft dysfunction (EAD) is a common complication after liver transplantation. The association...
OBJECTIVE: Metagenomic next-generation sequencing (mNGS) is an effective method for the detection of microorganisms. Early allograft dysfunction (EAD) is a common complication after liver transplantation. The association between early postoperative microorganisms in bile and EAD is unclear, so we evaluated the association of microorganisms and other potential risk factors with EAD. METHODS: A total of 100 patients who underwent orthotopic liver transplantation with biliary T tube placement in Huashan Hospital Fudan University from March 2021 to July 2022 were studied. Clinical data, the occurrence of EAD, and bile microorganisms' information detected by mNGS were collected. RESULTS: EAD occurred in 22 recipients (22%). Patients with EAD had a longer length of postoperative hospital stay. Bacteroides spp. detected by mNGS in bile was identified as an independent risk factor for EAD. Also, operation time, the MELD score of the recipient, and donor AST level were also independent risk factors for EAD. CONCLUSION: Bacteroides spp. detected by mNGS in bile after liver transplantation was identified as an independent risk factor for EAD, which may reflect the translocation of intestinal flora into the biliary tract and may serve as a potential early warning indicator of poor quality of the donor liver. Recipients with EAD had longer LOS, which may indicate a poor short-term prognosis.
Corrigendum to 'Donor-derived bacterial infections in deceased donor liver transplantation: reassessment of risk in the era of marginal grafts' [Transplantation Proceedings 57(5) (2025) 823-832].
Accardo C, Vella I, LiPetri S … +7 more , Pagano D, di Francesco F, Mularoni A, Barbàra M, Canzonieri M, Grossi P, Gruttadauria S
Transplant Proc · 2026 · PMID 41521099 · Publisher ↗
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Bibliometric Analysis of Research on Chinese Heart Transplantation Technology under the Background of Innovative Development in Organ Donation and Transplantation.
Long Y, Zhao Z, Xie X … +1 more , Wu Q
Transplant Proc · 2026 · PMID 41521098 · Publisher ↗
OBJECTIVES: This study examined and systematically summarized the current research status and characteristics of trends in heart transplantation, emphasizing innovative developments in organ donation and transplantation...
OBJECTIVES: This study examined and systematically summarized the current research status and characteristics of trends in heart transplantation, emphasizing innovative developments in organ donation and transplantation in China. METHODS: A bibliometric analysis and information visualization were conducted utilizing the literature from the China National Knowledge Infrastructure database from 2015 to 2024. This analysis examines the research status of heart transplantation, concentrating on the number of published documents, ratio of funded papers, authorship of publications, scientific research institutions of the published papers, and relevant keywords. RESULTS: The annual average number of papers published on heart transplantation was consistently at 169.30. The publications mainly originated from Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, as well as Union Hospital of Tongji Medical College of Huazhong University. The majority of papers were published in Organ Transplantation. The primary research hotspots focused on pre-operative evaluation and prognosis of heart transplantation, experimental studies involving rats and mice, immune tolerance related to heart transplantation, and cardiac xenotransplantation. CONCLUSION: In the past decade, research on heart transplantation has shown consistency. Research predominantly occurs within universities and their affiliated medical institutions, with minimal collaboration among research institutions; research hotspots span multiple fields, incorporating both clinical and basic research.
Single-Center Experience With Complications and Clinical Outcomes of 464 Living Kidney Donors.
Mehren N, Schönfelder K, Kribben A … +3 more , Eisenberger U, Jürgens C, Friebus-Kardash J
Transplant Proc · 2026 · PMID 41521097 · Publisher ↗
BACKGROUND: This retrospective single-center cohort study reports the complications and outcomes experienced by living kidney donors. METHODS: Our study involved 464 donors who donated a kidney between January 2004 and M...
BACKGROUND: This retrospective single-center cohort study reports the complications and outcomes experienced by living kidney donors. METHODS: Our study involved 464 donors who donated a kidney between January 2004 and March 2023 at the University Hospital Essen. RESULTS: Of the 452 available donors having clinical assessment for arterial hypertension, 101 (22%) exhibited arterial hypertension at the time of donation, whereas 112 of the 351 (32%) donors without preexisting arterial hypertension experienced new-onset arterial hypertension at follow-up after donation. The development of arterial hypertension after donation was related to male sex, older age, elevated body mass index (BMI), and elevated cholesterol levels at donation but did not relevantly affect renal function after donation. Preexisting arterial hypertension was associated with a reduction in the estimated glomerular filtration rate (eGFR) and an increase in creatinine levels at donation and over the entire follow-up period. Follow-up at 1 year after donation found that eGFR levels were significantly lower than predonation levels (P < .0001). No significant changes in the incidence of proteinuria (P = .20) or albuminuria (P = .17) were found at 1-year follow-up. At 1 year after donation, 98 of 270 (36%) available donors had retained 70% or more of their baseline renal function related to eGFR determined at donation. CONCLUSIONS: Our results suggest an increased risk of new-onset arterial hypertension after living kidney donation. The deterioration of renal function was higher after living kidney donation among donors with preexisting arterial hypertension. Among our cohort of 464 donors, living donation was associated with a reduction in renal function.
Effects of Acupuncture-Combined General Anesthesia on Hemodynamic Stability, Renal Function, and Inflammatory Response in Patients Undergoing Renal Transplantation: A Retrospective Pilot Study.
Li Y, Li Y, Li Y … +1 more , Zhu H
Transplant Proc · 2026 · PMID 41519623 · Publisher ↗
OBJECTIVE: General anesthesia (GA) is standard for kidney transplantation but can induce significant stress responses. The integration of acupuncture with GA remains unexplored in this context. This study evaluates the e...
OBJECTIVE: General anesthesia (GA) is standard for kidney transplantation but can induce significant stress responses. The integration of acupuncture with GA remains unexplored in this context. This study evaluates the effects of acupuncture-combined GA on anesthetic efficacy and organ protection in kidney transplantation. METHODS: A retrospective study was conducted on 90 patients undergoing elective kidney transplantation between March 2022 and October 2024. Patients were classified into three groups: Group 1 (GA only), Group 2 (Acupuncture + GA), and Group 3 (Sham acupuncture + GA). Hemodynamics, renal function, inflammatory markers, and postoperative adverse reactions were compared among the groups at different intraoperative time points. RESULTS: Mean arterial pressure (MAP) and heart rate (HR) varied significantly over time (P < .05). At T4, MAP was higher, and HR was lower in Group 2 than in the other groups (P < .05). Renal function markers (Cr, BUN, eGFR, urine volume) increased over time (P < .05) but showed no significant intergroup differences. Inflammatory markers (IL-6, TNF-α) were lower in Group 2 (P < .05). Adverse reactions were fewer in the acupuncture groups but not significantly different. CONCLUSION: Acupuncture-combined GA stabilizes intraoperative hemodynamics, exhibits renal protective and anti-inflammatory effects, and demonstrates high safety, suggesting its potential as an effective anesthetic approach in kidney transplantation.
Inefficacy of Intraoperative Renal Replacement Therapy in Mitigating Early Allograft Dysfunction Among Liver Transplant Recipients: A Propensity Score Matched Study.
Rezaoui S, Bignon A, Vogel J … +9 more , Devauchelle P, Lebuffe G, Chebaro A, Lebossé F, Gazon M, Aubrun F, Rossignol G, Mohkam K, Guichon C
Transplant Proc · 2026 · PMID 41519622 · Publisher ↗
BACKGROUND: Intraoperative continuous renal replacement therapy (IoCRRT) represents a viable approach for managing the hemodynamic and metabolic challenges encountered during liver transplantation (LT), particularly in h...
BACKGROUND: Intraoperative continuous renal replacement therapy (IoCRRT) represents a viable approach for managing the hemodynamic and metabolic challenges encountered during liver transplantation (LT), particularly in high-acuity patients. Our objective was to evaluate the impact of IoCRRT in comparison with conservative treatment on liver graft function during the immediate post-transplant period. METHODS: This retrospective, bicentric cohort study included patients who underwent LT between January 2014 and December 2019. Propensity score matching was conducted to mitigate disparities between the IoCRRT and control groups. Comparative analysis of post-transplant outcomes encompassed early allograft dysfunction (EAD), as defined by Olthoff, along with quantitative evaluation using the Model for Early Allograft Function (MEAF) scoring. RESULTS: The analysis included 73 patients in both groups, demonstrating comparability, with a mean MELD score of 31.5 ± 9.4 in the IoCRRT group compared to 30.6 ± 9.6 (SMD, Standardized mean difference = 0.088) in the control group. The overall frequency of EAD was 32.9% in the IoCRRT group and 43.8% in the control group (P = .243), with quantitative assessment using the MEAF score yielding 6.81 versus 6.89 (P = .843), respectively. No significant differences were observed in the length of stay in the intensive care unit or 90-day mortality. CONCLUSIONS: Implementation of IoCRRT during LT did not correlate with a reduction in the occurrence or severity of early allograft dysfunction.
Mapping the Geographic Distribution of Lung Transplant Centers and Smoking-Associated Diseases Across the United States.
Tomasovic LM, Ellis JR, Ruck JM … +3 more , Warman A, Rizaldi AA, Bush EL
Transplant Proc · 2026 · PMID 41519621 · Full text
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are progressive lung diseases strongly associated with cigarette smoking, together accounting for nearly 50% of lung transp...
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are progressive lung diseases strongly associated with cigarette smoking, together accounting for nearly 50% of lung transplants annually. Given this widespread disease burden, we aimed to assess whether the uneven distribution of transplant centers contributes to regional disparities in lung transplant access for patients with COPD and IPF. METHODS: We conducted a cross-sectional analysis using data from multiple, publicly available databases. We analyzed state-level data on cigarette users, COPD or IPF deaths, lung transplant centers, and recipients of lung transplants for COPD or IPF. To identify regions where transplant services may be inadequate relative to the burden of smoking-associated diseases, we also created 2 novel metrics: the cigarette users-to-transplant recipients (CUT) ratio and the smoking-associated disease deaths-to-transplant recipients (SADT) ratio. RESULTS: Across states, there were significant negative correlations between transplant center density and both the CUT and SADT ratios. Moreover, states without a transplant center had significantly higher CUT and SADT ratios and fewer lung transplant recipients per capita than states with more than 3 centers per 100,000 square miles. Choropleth maps further illustrated that CUT and SADT ratios are higher in regions with a lower density of transplant centers. CONCLUSIONS: These findings reveal geographic disparities in access to lung transplants for COPD or IPF, highlighting the need to provide additional support to candidates in states without lung transplant centers. Future studies should focus on identifying specific patient populations who encounter social or geographic barriers to transplant care.
Intraoperative Mean Arterial Pressure in Relation to Delayed Graft Function in Living-Donor Kidney Transplantation.
Pongpruksa C, Khampitak N, Bunnapradist S … +1 more , Xia VW
Transplant Proc · 2026 · PMID 41513528 · Publisher ↗
BACKGROUND: Maintaining optimal kidney graft perfusion is a primary goal of intraoperative kidney transplant care, which is often monitored by mean arterial blood pressure (MAP). Delayed graft function (DGF) is a signifi...
BACKGROUND: Maintaining optimal kidney graft perfusion is a primary goal of intraoperative kidney transplant care, which is often monitored by mean arterial blood pressure (MAP). Delayed graft function (DGF) is a significant complication that is associated with long-term outcomes. The goal of this study is to study the association of various MAP thresholds and the risk of DGF in adult patients undergoing living-donor kidney transplant. METHODS: We collected data from the UCLA data warehouse between 2013 and 2024. We analyzed MAP at various thresholds and associated cumulative minutes during the pre- and postreperfusion periods. DGF, defined by dialysis within 7 days of KT, was the primary outcome. RESULTS: This study comprised 1314 patients. The DGF rate was 5.0%. Forty-two percent experienced at least 1 minute of MAP threshold at ≤60 mm Hg. Those with DGF had longer minutes spent on the MAP thresholds of ≤60 to 85. Adjusted durations of postreperfusion MAP ≤60, 65, 70, 75, 80, and 85 mm Hg associated with the DGF started from 3, 15, 20, 10, 25, and 25 minutes, in that order. CONCLUSION: We found an association between intraoperative MAP ≤85 mm Hg and DGF. The minimal duration for postreperfusion ≤60 and ≤85 mm Hg associated with DGF was 3 and 25 minutes, respectively.
Single Center Retrospective Comparison of Post-Transplant Cyclophosphamide and Standard Graft-Versus-Host Disease Prophylaxis in Matched Donor Allogeneic Transplantation.
Kim H, Merchant A, Darrah J … +13 more , Sasine J, Lee H, Vescio R, Oveisi D, McGalliard B, Linhares Y, Rejali A, Van Strein P, Klapper E, Hekimian B, Chute J, Paquette R, Merin N
Transplant Proc · 2026 · PMID 41513527 · Publisher ↗
BACKGROUND: Post-transplant cyclophosphamide (PTCy) was developed to allow the use of haploidentical donors for allogeneic stem cell transplantation (alloHSCT), then tested with matched donors. Cedars-Sinai Medical Cente...
BACKGROUND: Post-transplant cyclophosphamide (PTCy) was developed to allow the use of haploidentical donors for allogeneic stem cell transplantation (alloHSCT), then tested with matched donors. Cedars-Sinai Medical Center Blood and Marrow Transplant was an early adopter of PTCy for matched alloHSCT in 2016. PURPOSE OF THE RESEARCH: We retrospectively analyzed 15-year outcomes of patients who underwent alloHSCT with matched donor stem cells prior to 2016 (n = 252), with the outcomes of patients who were transplanted in the PTCy era, post-2016 (n = 99), to assess the impact of the switch to PTCy, while controlling for other differences between the cohorts. PRINCIPLE RESULTS: Overall Survival (OS) was better in the PTCy group (at 1 year, 90% vs 62%, P < .0001), and the difference persisted in OS at 2 years and 3 years. There was no difference in relapse (26% non-PTCy vs 19% PTCy; P = .3560). Non-relapse mortality was lower with PTCy, 7% vs 22% without, P = .0002. Acute GVHD was lower in the PTCy group (16% PTCy vs 33% non-PTCy, P = .0013). Chronic GVHD was similar between the two groups, 35% in the PTCy group and 42% in the non-PTCy group (P = .1235), but the rate of extensive cGVHD was lower, 15% with PTCy vs 29% without; P = .0078. Post-transplant hospital stay was shorter, 23 ± 13.1 days in the non-PTCy group and 18 ± 7.0 days with PTCy, P < .0001. CONCLUSIONS: Long-term follow up of patients transplanted using PTCy with matched donors has demonstrated superiority of PTCy compared to tacrolimus methotrexate.
Fospropofol Disodium for Anesthesia Induction in Liver Transplant Recipients - A Case Series.
Wang R, Jiang X, Zhang W
Transplant Proc · 2026 · PMID 41513526 · Publisher ↗
BACKGROUND: Fospropofol disodium for injection (Fospropofol) is a novel water-soluble propofol prodrug metabolized by alkaline phosphatase (ALP). In contrast to propofol, it demonstrates superior hemodynamic stability an...
BACKGROUND: Fospropofol disodium for injection (Fospropofol) is a novel water-soluble propofol prodrug metabolized by alkaline phosphatase (ALP). In contrast to propofol, it demonstrates superior hemodynamic stability and reduced lipid metabolism-related adverse effects in patients with normal hepatic function. These characteristics hold particular significance for liver transplant recipients with decompensated cirrhosis, who frequently exhibit hemodynamic instability and impaired lipid homeostasis. However, clinical evidence supporting the use of Fospropofol in this high-risk population remains lacking. This case series aims to evaluate the potential advantages of Fospropofol for anesthesia induction in liver transplant recipients with Child-Pugh B/C cirrhosis. METHODS: In this prospective observational study, three cirrhotic patients (Model for End-stage Liver Disease scores: 22-38) were administered Fospropofol-based induction (10 mg/kg) during liver transplantation. Hemodynamics, bispectral index (BIS), and perioperative organ function were monitored. RESULTS: All patients achieved rapid induction (≤1 minute) with stable hemodynamics (mean arterial pressure ≥60 mm Hg) and BIS <60. No intraoperative hypoxemia or delayed awakening occurred. Postoperative hepatic/renal function remained stable, with extubation completed ≤10 minutes. Diverging from reports in non-cirrhotic cohorts, we found that ALP levels did not correlate with BIS trends, suggesting multifactorial influences on pharmacokinetics in end-stage liver disease. CONCLUSION: Although these findings highlight Fospropofol's potential as a lipid-free alternative to propofol in high-risk liver transplant settings, the observational design and small sample size (n = 3) warrant further validation through randomized controlled trials to establish dosing protocols and confirm safety and efficacy.
Evaluation of Transplant Renal Artery Stenosis by Contrast-Enhanced Ultrasonography: Comparison with Digital Subtraction Angiography.
Yang W, Lai Z, Cui X … +3 more , Zhong C, Jiang L, Li H
Transplant Proc · 2026 · PMID 41513525 · Publisher ↗
OBJECTIVE: Contrast-enhanced ultrasonography (CEUS) is a potential and safe imaging method to evaluate the transplant renal artery. To evaluate the degree and location of transplant renal artery stenosis (TRAS) by CEUS c...
OBJECTIVE: Contrast-enhanced ultrasonography (CEUS) is a potential and safe imaging method to evaluate the transplant renal artery. To evaluate the degree and location of transplant renal artery stenosis (TRAS) by CEUS compared with digital subtraction angiography (DSA) as the reference standard. METHODS: This retrospective study included a cohort of 47 patients with TRAS who underwent ultrasound followed by DSA as the gold standard from March 2018 to January 2025. The degree and location of TRAS were evaluated using CEUS and were compared to that of DSA. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS for evaluating stenosis ≥50% and stenosis ≥70% were calculated. RESULTS: The diagnostic accuracy of CEUS in grading TRAS and diagnosing the location of TRAS was 83.8% and 97.3%, respectively. No significant differences were observed in assessing stenosis ≥50%, stenosis ≥70%, and the location of TRAS between CEUS and DSA (P = .250; P = .063; P = 1.000). There was a significant difference in grading TRAS between CEUS and DSA (P = .031). CEUS had a good performance in distinguishing stenosis ≥50% with a sensitivity of 91.4%, specificity of 100%, accuracy of 91.9%, PPV of 100%, and NPV of 40%. The sensitivity, specificity, accuracy, PPV, and NPV for the identification of stenosis ≥70% by CEUS were 87.1%, 100%, 89.2%, 100%, and 60%, respectively. CONCLUSION: CEUS demonstrates a great depiction of the degree and location in the TRAS compared with DSA. CEUS has the potential to be a noninvasive method to support the diagnosis and follow-up of TRAS.
Changes in Patient Symptoms After Kidney Transplantation.
King CP, Cossart AR, Isbel NM … +5 more , Campbell SB, Taing MW, Leary D, Houlihan V, Staatz CE
Transplant Proc · 2026 · PMID 41513524 · Publisher ↗
BACKGROUND: Immunosuppressant usage in kidney transplant recipients is commonly associated with toxicity which can manifest in a variety of adverse effects. This study aimed to compare the nature and frequency of patient...
BACKGROUND: Immunosuppressant usage in kidney transplant recipients is commonly associated with toxicity which can manifest in a variety of adverse effects. This study aimed to compare the nature and frequency of patient-reported symptoms before and after kidney transplantation. METHODS: A single-center study was conducted involving adult kidney transplant recipients at 3 to 11 weeks post-transplantation. Patients completed a questionnaire pertaining to the prevalence of symptoms experienced a few months before and since transplantation. A paired Student's t-test and Wilcoxon signed-rank tests were used to identify changes in the number and frequency of symptoms, respectively, with a p-value <.05 considered statistically significant. RESULTS: Eighty patients completed this non-interventional study. While a similar number of symptoms (mean ± standard deviation) were experienced before and after transplantation (9.9 ± 4.8 and 9.0 ± 4.7, respectively; p = .098) there was a shift in the frequency of symptoms. Since transplantation, there was an improvement (reduced frequency) in itch (p ≤ .001), tiredness/fatigue (p = .045), nausea (p ≤ .001), headache/migraine (p ≤ .001), fidgetiness/restlessness (p = .018) and mind going blank (p = .022). However, hand tremor (p ≤.001), tremor elsewhere (p ≤.001), waking at night (p ≤.001), and dysesthesia (thermodysregulation and paresthesia) (p = .008) worsened (increased frequency), as reported by 75%, 26%, 45%, and 38% of patients, respectively. CONCLUSION: Many patients experience tremor and dysesthesia as new symptoms or report them more frequently early after transplantation. Further research into understanding and managing these toxicities over this period is warranted.
Low Preoperative Exercise Tolerance Predicts Impaired Skeletal Muscle Recovery After Kidney Transplantation.
Yanishi M, Kimura Y, Koito Y … +5 more , Matsushita J, Yoshida R, Tsukaguchi H, Taniyama Y, Kinoshita H
Transplant Proc · 2026 · PMID 41513523 · Publisher ↗
BACKGROUND: Sarcopenia remains a significant concern among kidney transplant recipients even after renal function improves. However, the predictors of impaired muscle recovery are not well established. METHODS: We retros...
BACKGROUND: Sarcopenia remains a significant concern among kidney transplant recipients even after renal function improves. However, the predictors of impaired muscle recovery are not well established. METHODS: We retrospectively analyzed 40 adults who underwent living-donor kidney transplantation at Kansai Medical University Hospital between January 2018 and December 2020. Preoperative cardiopulmonary exercise testing (CPX) was used to stratify patients into low-tolerance (anaerobic threshold VO₂ < 11 mL/kg/min and peak VO₂ < 20 mL/kg/min) and normal groups. The skeletal muscle index (SMI) was measured using dual-energy x-ray absorptiometry from baseline to 3 years post-transplantation. Multivariable linear regression and correlation analyses were performed to identify predictors of long-term SMI improvement. RESULTS: Forty recipients were analyzed, including 12 (30%) in the low-tolerance group. Following transplantation, the median SMI in both groups decreased at 6 months and improved thereafter. However, from 1 year after transplantation onwards, the normal group demonstrated a significant increase in SMI compared with the low-tolerance group. Three years after transplantation, the median SMI in the normal group exceeded pretransplant levels and steadily increased, whereas in the low-tolerance group, there was little improvement and no return to baseline (P ≤ .05). Multivariable analysis identified low preoperative exercise tolerance as an independent predictor of reduced SMI recovery (P ≤ .05). Correlation analysis revealed that preoperative anaerobic threshold VO₂ and peak VO₂ were moderately and significantly associated with 3-year SMI improvement (r = 0.427 and r = 0.607, respectively). CONCLUSIONS: Low exercise tolerance before kidney transplantation strongly predicts impaired long-term skeletal muscle recovery. Cardiopulmonary exercise testing-based risk assessment may help identify candidates who could benefit from tailored perioperative rehabilitation strategies to enhance functional outcomes.
Mortality Estimation in Renal Disease (MERD Score): A Model Predicting Waitlist Mortality in Kidney Transplant Candidates.
Albu Mustaf A, Ramirez J, Montgomery A … +2 more , Henry G, Rana A
Transplant Proc · 2026 · PMID 41513522 · Publisher ↗
BACKGROUND: Predicting waitlist mortality is important for prioritizing organ allocation and selecting candidates for extended criteria donors. Currently, there is no widely adopted and reliable index for predicting earl...
BACKGROUND: Predicting waitlist mortality is important for prioritizing organ allocation and selecting candidates for extended criteria donors. Currently, there is no widely adopted and reliable index for predicting early mortality among kidney transplant candidates. In this study, we aim to develop an index score utilizing variables from the OPTN database to predict mortality among adult kidney transplant candidates within 3 years of being on the waitlist. METHODS: This study utilized data from 147,307 adult kidney transplant candidates listed in the OPTN database from 2018 to 2023. The cohort was randomly divided into training and validation groups. Sixteen variables were analyzed using univariate logistic regression, with significant factors incorporated into a multivariable analysis to develop the MERD (Mortality Estimation in Renal Disease) score. Predictive performance was assessed through ROC analysis in both cohorts. RESULTS: Ten variables, age, ABO blood type, ethnicity, dialysis duration, presence of peripheral vascular disease, albumin level, functional status, Previous kidney malignancy, primary etiologies of kidney disease, and insurance type were identified as significant predictors and used to formulate the MERD score. The AUC was 0.6657 in the training cohort and 0.6580 in the validation cohort. CONCLUSION: The MERD score provides proof of concept for short-term mortality prediction for kidney transplant waitlist candidates. Further prospective validation and model refinement are warranted.
Effectiveness Study of Bundle Maintenance Strategies in Donor Lung Quality Improvement.
Wang C, Bai X, Lu J … +9 more , Qie G, Liu G, Tai Z, Ding R, Guo Q, Wang Q, Liu C, Sun X, Zhang J
Transplant Proc · 2026 · PMID 41507004 · Publisher ↗
To assess the efficacy of a bundle donor lung maintenance strategy in enhancing donor lung quality for transplantation. This retrospective study analyzed 155 potential lung donors admitted to Shandong Provincial Hospital...
To assess the efficacy of a bundle donor lung maintenance strategy in enhancing donor lung quality for transplantation. This retrospective study analyzed 155 potential lung donors admitted to Shandong Provincial Hospital (2022-2024). After excluding 76 cases meeting absolute exclusion criteria, 79 donors received a bundle maintenance protocol, including fluid management, targeted anti-infection therapy, airway care, lung-protective ventilation, and VAP prevention. Outcomes were evaluated by comparing pre- and post-maintenance oxygenation index (PaO₂/FiO₂), lactate levels, infection markers (WBC, PCT, IL-6), and transplantable lung rates. Subgroup analysis compared outcomes between prone and nonprone positioning during maintenance. Post-intervention, oxygenation index increased by 77.25% (P < .01), with lactate reduced by 33.33% (P < .01). Infection markers improved significantly: WBC (-16.42%), PCT (-50%), and IL-6 (-61.30%) (P < .01). Transplantable lung rates rose from 49.37% to 87.34% (χ² = 28.03, P < .01), converting 75% of initially nontransplantable lungs. Prone positioning further amplified benefits: ΔOI improvement (median 214 vs 148, P < .01) and 83.33% oxygenation enhancement (P < .01). The bundle strategy effectively optimizes donor lung quality, increasing transplantable grafts by 37.97% and demonstrating the added value of prone positioning. These findings advocate for standardized protocols to address donor shortages while ensuring transplant success.
Cultural and Religious Influences on Organ Donation Attitudes Among Indian American Physicians and Medical Students.
Vivek N, Vivek N, Kankaria RA … +3 more , Xiao D, Gordon EJ, Forbes R
Transplant Proc · 2026 · PMID 41507003 · Publisher ↗
PURPOSE: While 54% of the United States (US) population is registered as organ donors, only 0.01% of India's population is willing to donate. Indian American physicians' attitudes might reflect those of the general India...
PURPOSE: While 54% of the United States (US) population is registered as organ donors, only 0.01% of India's population is willing to donate. Indian American physicians' attitudes might reflect those of the general Indian-identifying US population, potentially inadvertently dissuading patients from organ donation. This study assessed whether attitudes toward organ donation differ between Indian American physicians/medical students and their non-Indian counterparts. METHODS: We administered an online survey to Indian American and non-Indian physicians and medical students at the American Association of Physicians of Indian Origin (AAPI) 2023 medical conference, Vanderbilt University School of Medicine, and St. Mary's County MedStar Shah Medical Group network. RESULTS: A total of 172 individuals participated. Compared to their non-Indian counterparts, Indian American participants expressed less support for deceased (p = .002) and living (p = .006) organ donation. Hindus, constituting approximately 85% of our Indian American participants, were less supportive of deceased (p = .001) and living (p = .019) organ donation than non-Hindus. Additionally, Hindus expressed less agreement with the safety and efficacy of deceased organ donation than non-Hindus (p = .047). Participants who expressed concern over illegal organ trade also expressed less support for living organ donation (p < .05). CONCLUSIONS: Our study suggests different attitudes towards organ donation between physicians and medical students of Indian vs. non-Indian origin. Indian-origin individuals and Hindus demonstrated weaker support towards organ donation. Identifying these differences can help when developing targeted quality improvement initiatives in organ donation advocacy and education.
T Lymphocyte Reconstitution in Acute Leukemia Patients After Allogeneic Stem Cell Transplantation: A Single Center Experience (2016-2023).
Nguyen KB, Nguyen NTH, Vo BTT … +1 more , Nguyen TH
Transplant Proc · 2026 · PMID 41507002 · Publisher ↗
INTRODUCTION: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective treatment for patients with acute myeloid leukemia. However, the success of allo-SCT is influenced by the patients' immunocompr...
INTRODUCTION: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective treatment for patients with acute myeloid leukemia. However, the success of allo-SCT is influenced by the patients' immunocompromised condition post-transplantation, particularly complications arising from infections due to prolonged immunodeficiency. This study aims to analyze the recovery of CD4+ and CD8+ T lymphocytes of patients with AML after allogeneic stem cell transplantation. METHODS: A retrospective study of 66 AML patients who underwent allogeneic stem cell transplantation at the National Institute of Hematology and Blood Transfusion from 2016 to 2023. The patients were monitored for immune indexes, including CD4+ and CD8+ lymphocytes, on a monthly basis for 12 months after transplantation. RESULTS: The median recovery time for CD4+ lymphocytes to reach 200 cells/μl was 84.5 ± 11.2 days, and the median time for them to reach 500 cells/μL was 8.6 months. CD8+ cells recovered faster than CD4+ cells, with a median time to reach 400 cells/μL of 64 days. CONCLUSION: Careful monitoring of immune indicators after allo-HSCT, as demonstrated in this study, can significantly enhance prognosis and inform strategies to prevent infectious complications, particularly in patients experiencing prolonged cellular immunodeficiency. When applied, this approach could improve transplant success and reduce mortality rates, offering a deeper insight into care within hematology and transplantation.
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