Transplant. Proc. [JOURNAL]
Sun
200 papers
Neopterin Levels in Pediatric Allogeneic Hematopoietic Stem Cell Transplantation: A Potential Biomarker for Acute Graft-Versus-Host Disease?
Kirkiz Kayalı S, Deveci TS, Gülbahar Ö … +3 more , Kaya Z, Yenicesu İ, Koçak Ü
Transplant Proc · 2026 Jun · PMID 42303546 · Publisher ↗
INTRODUCTION: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for hematologic disorders. Acute graft-versus-host disease (aGVHD) remains a major cause of nonrelapse mortality. Disti...
INTRODUCTION: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for hematologic disorders. Acute graft-versus-host disease (aGVHD) remains a major cause of nonrelapse mortality. Distinguishing aGVHD from early post-transplant complications is challenging. This study evaluated serum neopterin (Np) as a potential early biomarker in pediatric patients. METHODS: Forty-five pediatric allo-HSCT patients with available serum samples were included. Clinical, laboratory, and transplant-related parameters were retrospectively assessed. Patients were categorized by aGVHD status. Blood samples for Np measurement were collected on days 0, 7, and 28 post-transplant and stored at -80°C. Normal Np was defined as <10 nmol/L. RESULTS: Patients (18 female, 27 male; mean age 8.97 ± 4.82 years) underwent HSCT for acute lymphoblastic leukemia (ALL) (n: 12), acute myeloblastic leukemia (AML) (n: 9), thalassemia major (TM) (n: 10), severe aplastic anemia (sAA) (n: 9), hemophagocytic lymphohistiocytosis (HLH) (n: 2), biphenotypic leukemia (BL) (n: 1) and inborn errors of metabolism (IEM) (n: 2). Twenty-three developed aGVHD. No significant differences were observed between patients with and without aGVHD regarding age, sex, diagnosis, ABO incompatibility, HLA matching, stem cell source, infused CD34+ and CD3+ cells, myeloid and platelet engraftment, or Np levels on days 0, 7, and 28. In all patients, levels were higher on day 28 than on day 7. CONCLUSIONS: Early detection and treatment of aGVHD after HSCT is crucial for reducing morbidity and mortality. Although no significant correlation between Np and aGVHD was observed, larger studies are warranted.
Assessment of the Psychosocial Status and Quality of Life of Liver Transplant Recipients.
Darilmaz C, Unal A, Yilmaz S
Transplant Proc · 2026 Jun · PMID 42303545 · Publisher ↗
BACKGROUND: To determine the prevalence and types of psychiatric disorders in liver transplant patients, identify sociodemographic and clinical risk factors, and assess their impact on quality of life compared with healt...
BACKGROUND: To determine the prevalence and types of psychiatric disorders in liver transplant patients, identify sociodemographic and clinical risk factors, and assess their impact on quality of life compared with healthy individuals. METHODS: Sixty liver transplant patients (≥1 year post-transplant) and 60 healthy volunteers were included in this cross-sectional study. Psychiatric disorders were assessed using the Structured Clinical Interview for DSM-5 (SCID-5/CV). Quality of life was measured with the Short Form-36 Health Survey (SF-36), depressive symptoms with Hamilton Depression Rating Scale (HAM-D), and anxiety with Beck Anxiety Inventory (BAI). Sociodemographic and clinical data were collected using a structured form. Nonparametric tests were applied. RESULTS: At least 1 psychiatric disorder was present in 36.7% of patients. Anxiety related to another health condition (40.9%) and depression (27.3%) were most common. Psychiatric disorders were significantly associated with female gender and unmarried status, but not with clinical variables such as pre-transplant disease duration, waiting time, or post-transplant hospitalizations. Patients with psychiatric disorders had lower SF-36 scores in all subscales except physical functioning. Even patients without psychiatric disorders showed lower scores than healthy controls in some domains. CONCLUSION: Psychiatric disorders are common in liver transplant patients and negatively affect emotional, social, and mental aspects of quality of life. Post-transplant follow-up should include psychiatric assessment and psychosocial support, in addition to biomedical care.
Treacherous Pitfalls in Liver Transplantation for Budd-Chiari Syndrome: When the Devil Hides in the Shadows-A Case Report.
Mendonça IC, Waisberg DR, Silva MS … +10 more , Pinheiro RS, Rocha-Santos V, Arantes RM, Ducatti L, Haddad LB, Galvão FH, Lee AD, Song AT, Martino RB, Andraus W
Transplant Proc · 2026 Jun · PMID 42303544 · Publisher ↗
INTRODUCTION: Budd-Chiari syndrome (BCS) is a rare vascular liver disorder characterized by obstruction of the hepatic venous outflow, involving the hepatic veins and/or the inferior vena cava (IVC). Etiology varies geog...
INTRODUCTION: Budd-Chiari syndrome (BCS) is a rare vascular liver disorder characterized by obstruction of the hepatic venous outflow, involving the hepatic veins and/or the inferior vena cava (IVC). Etiology varies geographically, with thrombophilic conditions and myeloproliferative disorders predominating in Western countries, and membranous IVC obstruction being more frequent in Eastern countries. Liver transplantation (LT) remains the definitive treatment for patients with acute liver failure or advanced disease refractory to medical and interventional therapies, but it presents unique surgical challenges due to hepatomegaly, retroperitoneal fibrosis, and potential IVC stenosis or thrombosis. CASE REPORT: We report a 33-year-old male with BCS who underwent deceased-donor LT using the piggyback technique. Intraoperatively, the retrohepatic IVC was fibrotic and narrowed; a diamond-shaped side-to-side cavocaval anastomosis was performed to optimize venous outflow. Despite an initially well-perfused graft, the patient developed primary graft nonfunction on the first postoperative day. Urgent retransplantation revealed severe venous outflow obstruction caused by an unrecognized stenosis of the native suprahepatic IVC near the right atrium. The first graft exhibited extensive congestion and coagulative necrosis. Retransplantation was successfully performed using conventional technique without veno-venous bypass, completely removing the recipient's IVC. CONCLUSION: This case illustrates the potential for subtle anatomical anomalies, such as suprahepatic IVC stenosis, to cause acute post-transplant hepatic venous outflow obstruction in BCS. Awareness of these "Budd-Chiari pitfalls" is critical for surgical planning and intraoperative decision-making. LT remains a safe and effective therapy for carefully selected BCS patients, provided that meticulous attention is paid to venous anatomy and possible intraoperative challenges.
Efficacy and Safety of Colistin Sulfate in Treating Carbapenem-Resistant Gram-Negative Bacterial Infections in Liver Transplant Recipients.
Chen Y, Fang Z, Liu X … +6 more , Pan Y, Zheng W, Hong H, Xu T, Wu Y, Tang L
Transplant Proc · 2026 Jun · PMID 42303543 · Publisher ↗
OBJECTIVE: Carbapenem-resistant Gram-negative bacteria (CR-GNB), including carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and carbapenem-resistant Acinetobacter baumannii...
OBJECTIVE: Carbapenem-resistant Gram-negative bacteria (CR-GNB), including carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and carbapenem-resistant Acinetobacter baumannii (CRAB), are critical postoperative complications in liver transplant recipients. This study aimed to evaluate the clinical efficacy and safety of intravenous colistin sulfate (CS) in treating CR-GNB infections in liver transplant patients and identify independent predictive factors influencing therapeutic outcomes. METHODS: A retrospective cohort of 20 liver transplant recipients with CR-GNB infections admitted to the intensive care unit (ICU) was included. Patients received intravenous colistin sulfate and were stratified into an effective treatment group (n = 10) and an ineffective group (n = 10) based on clinical response. Baseline clinical data and laboratory parameters were collected. Chi-square tests and t-tests compared differences between groups. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors of CS efficacy. RESULTS: Significant differences in serum procalcitonin (PCT) and tumor necrosis factor-alpha (TNF-α) levels were observed between the effective and ineffective groups (P < .05). Multivariate analysis identified TNF-α (OR = 1.009, 95% CI: 0.955-1.066; P = .049) and PCT (OR = 0.590, 95% CI: 0.350-0.997; P = .049) as independent predictors of treatment efficacy. ROC curve analysis demonstrated that TNF-α alone predicted efficacy with an area under the curve (AUC) of 0.900 (specificity=100%, sensitivity=70%), while PCT showed an AUC of 0.885 (specificity = 100%, sensitivity = 80%). Combined TNF-α and PCT improved predictive accuracy (AUC = 0.970, specificity = 100%, sensitivity = 90%). CONCLUSION: TNF-α and PCT serve as reliable biomarkers for optimizing colistin sulfate therapy in liver transplant recipients with CR-GNB infections. Dynamic monitoring of these inflammatory markers during treatment may enhance therapeutic outcomes.
Racial and Ethnic Disparities in Cytomegalovirus Disease Progression Among Kidney Transplant Recipients: A Single-Center Exploratory Study.
Cabanilla MG, Dauenhauer A, St John B
Transplant Proc · 2026 Jun · PMID 42303542 · Publisher ↗
BACKGROUND: Cytomegalovirus (CMV) is a major cause of morbidity in kidney transplant recipients. However, little is known about racial and ethnic disparities in CMV outcomes. This study explored the potential differences...
BACKGROUND: Cytomegalovirus (CMV) is a major cause of morbidity in kidney transplant recipients. However, little is known about racial and ethnic disparities in CMV outcomes. This study explored the potential differences in CMV disease progression among different racial and ethnic groups. METHODS: This single-center retrospective cohort study included adult kidney transplant recipients who developed CMV viremia (≥200 copies/mL) between January 2012 and July 2022. The primary outcome was the progression to CMV syndrome or invasive disease. Secondary outcomes included disease severity, 12-month mortality, and graft failure. Patients were categorized as non-Hispanic white or racial/ethnic minorities. RESULTS: Of 31 patients with CMV viremia, 28 (90.3%) were racial/ethnic minorities (15 Hispanic, 11 Native American, 2 other), despite minorities representing 52% of the overall transplant population. Progression to CMV syndrome or invasive disease occurred in 13 (41.9%) patients. Among the 13 patients who progressed, 12 (92.3%) were minorities. All 5 patients who developed tissue-invasive disease were minorities. Twelve-month all-cause mortality was 32.3% (n = 10), with 90% of deaths occurring in minorities. Patients who progressed had higher median initial viral loads than those who did not (4,680 vs. 1,565 copies/mL; p = .12). CONCLUSION: Racial and ethnic minorities comprised 90.3% of patients who developed CMV viremia and experienced nearly all disease progression, despite representing half of the transplant population. These preliminary findings warrant validation through larger multicenter studies that incorporate socioeconomic, geographic, and immunogenetic variables to identify modifiable factors contributing to disparities and to guide equitable interventions.
Portomesenteric Jump Graft for Liver Transplantation. Single Center Experience in Latin America.
Reyes N, Riveros S, Irarrazaval MJ … +6 more , Ochoa G, Jarufe N, Viñuela E, Martínez J, Dib M, Briceño E
Transplant Proc · 2026 Jun · PMID 42297711 · Publisher ↗
INTRODUCTION: Chronic portal vein thrombosis and cavernomatosis are a complex challenge for liver transplantation. This study aims to analyze the results of portomesenteric reconstruction with a jump graft using the cada...
INTRODUCTION: Chronic portal vein thrombosis and cavernomatosis are a complex challenge for liver transplantation. This study aims to analyze the results of portomesenteric reconstruction with a jump graft using the cadaveric iliac vein in liver transplantation. MATERIAL AND METHODS: Non-concurrent cohort study from 2001 to 2023. All patients who underwent portal vein reconstruction with a mesenteric jump graft for liver transplantation were included. RESULTS: Nineteen patients were included. Pretransplant diagnosis of portal vein thrombosis was in 13 patients (68,4%), with 7 of them (36.8%) receiving anticoagulation. A preoperative decision to perform the venous jump graft was made in 8 patients (42.1%). Intraoperatively, 11 patients were classified as grade III according to the Yerdel classification, and eight were found to have cavernomatosis. Eleven patients (57.9%) experienced major complications, with 7 patients requiring reoperation. None of the complications were related to the portomesenteric jump graft. Two patients (10,5%) died in the first 30 days. The 5-year overall and graft survival rates were identical at 63.2%, as no retransplantations occurred. The median follow-up for venous bridge patency was 18 months, identifying only 2 thrombosed bridges (13.3%). CONCLUSIONS: Portomesenteric reconstruction with a jump graft using a cadaveric iliac vein yields favorable outcomes in this cohort of liver transplantations. This technique represents a vital surgical strategy, enabling transplantation for patients who would otherwise not be considered transplant candidates.
Invasive Candidiasis in Liver Transplant Recipients Undergoing Antifungal Prophylaxis.
de Abreu Guimarães LF, Pereira LO, Curcio TM … +5 more , de Sousa CCT, Basto ST, Szrajbman D, Fernandes ESM, Santoro-Lopes G
Transplant Proc · 2026 Jun · PMID 42288427 · Publisher ↗
INTRODUCTION: Invasive candidiasis (IC) is the most frequent invasive fungal infection (IFI) affecting liver transplant (LT) recipients. Antifungal prophylaxis (AP) effectively reduces the incidence IFI after LT. However...
INTRODUCTION: Invasive candidiasis (IC) is the most frequent invasive fungal infection (IFI) affecting liver transplant (LT) recipients. Antifungal prophylaxis (AP) effectively reduces the incidence IFI after LT. However, a considerable proportion of LT recipients undergoing AP are still affected by IC. OBJECTIVES: To assess the incidence and factors associated with IC in high-risk LT recipients undergoing AP. PATIENTS AND METHODS: Retrospective single-center study including high-risk LT recipients undergoing AP between 2015 and 2020. The primary outcome was the occurrence of IC within the first 90 days after LT. Secondary outcomes included mortality within 30 days of diagnosis of IC and the occurrence of other IFI within 90 days after LT. The basic prophylactic regimen was fluconazole 200 mg/d, with micafungin being an alternative option. RESULTS: There were 10 cases (5.8%) of IC among 171 high-risk recipients who started AP. Most cases were caused by non-albicans Candida spp. The 30-day mortality rate was 40%. Only 1 case (0.6%) of another IFI (disseminated cryptococcosis) was diagnosed during the study period. IC was more frequent among Black patients (p=0.02), after reoperation (p = .036), and in recipients with a higher count of risk factors for IFI (p = .061). Oppositely, IC was less frequent in patients with a pre-transplant diagnosis of hepatocellular carcinoma (p = .065). CONCLUSION: IC occurred in 5.8% of LT recipients undergoing AP and was associated with high mortality. The predictive factors for IC identified in this study may inform the decision to start empirical antifungal therapy in high-risk LT recipients undergoing AP.
A Study to Determine If Donor Kidney Volume Influences Kidney Function After Renal Transplantation.
Konnur A, Gang S, Hegde U … +5 more , Patel H, Pandya A, Shukla H, Rathi Y, Shete N
Transplant Proc · 2026 Jun · PMID 42285821 · Publisher ↗
INTRODUCTION: Kidney transplantation is the preferred treatment for end-stage renal disease. Donor kidney volume (DKV) and its adjustment to recipient body surface area (BSA), termed nephron dose (DKV/BSA), may influence...
INTRODUCTION: Kidney transplantation is the preferred treatment for end-stage renal disease. Donor kidney volume (DKV) and its adjustment to recipient body surface area (BSA), termed nephron dose (DKV/BSA), may influence graft function based on the nephron dosing hypothesis. This study evaluated the impact of nephron dose on recipient estimated glomerular filtration rate (eGFR) at 1 year. MATERIALS AND METHODS: A prospective observational study was conducted on 130 living donor kidney transplants at a tertiary care center (August 2022 to July 2023). Donor kidney volume was measured via computed tomography angiography and 3-dimensional volumetric analysis. Nephron dose (mL/m²) was calculated and correlated with recipient eGFR (Chronic Kidney Disease Epidemiology Collaboration 2021) at baseline, 3, 6, and 12 months. A ≥30% eGFR decline from peak was defined as significant deterioration. RESULTS: The mean DKV was 103.2 ± 20.9 mL, with a mean nephron dose of 64.5 ± 14.7 mL/m². A significant positive correlation was observed between nephron dose and eGFR, strongest at baseline (r = 0.436) and persisting at 1 year (r = 0.184). Receiver operating characteristic curve analysis identified a nephron dose cutoff of 61.88 mL/m², predicting >30% eGFR decline with 79.3% sensitivity and 54.1% specificity (area under the curve = 0.634, P = .028). CONCLUSION: Donor kidney volume relative to recipient size significantly predicts graft function at 1 year. Incorporating nephron dose into preoperative planning may optimize donor-recipient matching and improve long-term outcomes.
Development and Validation of a Prognostic Nomogram for Predicting 3-Month Mortality After Liver Transplantation.
Zhang G, Zhang J, Wang Y … +4 more , Cui B, Wang J, Sun Y, Li G
Transplant Proc · 2026 Jun · PMID 42285820 · Publisher ↗
BACKGROUND AND AIMS: Identifying patients at high risk of mortality following liver transplantation and implementing timely interventions are essential to reducing fatality rates. This study aimed to develop a prognostic...
BACKGROUND AND AIMS: Identifying patients at high risk of mortality following liver transplantation and implementing timely interventions are essential to reducing fatality rates. This study aimed to develop a prognostic model to predict mortality after liver transplantation, using a nomogram based on specific risk factors. METHODS: The study included 1951 liver transplant recipients, divided into a training group (n = 1366) and a validation group (n=585) through stratified cluster sampling. Nine key factors were considered for the prognostic model: Child-Pugh score, MELD score, extended Intensive Care Unit stays over seven days, catheter-related bloodstream infections, delayed graft function, intraperitoneal hemorrhages, pulmonary infections, renal failure, and vascular complications. Lasso regression and Boruta feature selection were applied to identify the most important predictors. The model's effectiveness was evaluated using ROC curves, calibration plots, decision curve analysis, and internal validation. RESULTS: The model achieved an area under the curve of 0.824 in the training group and 0.774 in the validation group. Calibration plots showed good alignment with the ideal diagonal line, indicating robust predictive accuracy. Decision curve analysis demonstrated various levels of clinical benefit across a range of risk thresholds (3%-81%). CONCLUSIONS: This nomogram, despite its limitations from the retrospective cohort, proves to be a valuable tool for predicting mortality outcomes in liver transplant recipients. It helps healthcare professionals identify high-risk patients who require urgent interventions following transplantation.
Lactate Dynamic Changes as a Predictive Tool for Early Primary Graft Dysfunction After Lung Transplantation: A Retrospective Study.
Lin T, Liu S, Zhao Y … +5 more , Tan S, Wu Q, Li S, Wang H, Zhang G
Transplant Proc · 2026 Jun · PMID 42276939 · Publisher ↗
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common and severe complications after lung transplantation. However, beyond the ratio of partial pressure of oxygen to fraction of inspired oxygen, there is...
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common and severe complications after lung transplantation. However, beyond the ratio of partial pressure of oxygen to fraction of inspired oxygen, there is a lack of objective clinical or laboratory indicators to guide real-time decision-making during the first 24 hours after surgery. METHODS: We retrospectively examined 74 patients who underwent lung transplantation at our center between September 2022 and December 2024. The patients were classified into 2 groups based on the presence or absence of PGD. We analyzed their clinical data and lactate dynamic changes within 24 hours. RESULTS: The PGD group showed significantly higher lactate values at 0 hours (L0, P = .011), 3 hours (L3, P = .001), and 6 hours (L6, P = .001) after intensive care unit admission than the group without PGD. The largest difference occurred at 6 hours. There was no statistically significant difference in lactate levels at 24 hours (L24, P = .139) between the 2 groups. Delta lactate values between 0 and 24 hours (L0-L24) showed no statistically significant difference (P = .096), while the values of L3-L24 and L6-L24 showed statistically significant differences between the 2 groups (P = .015 and P = .002, respectively). Multivariate Cox regression analysis showed that L6-L24 was independently a protective factor for PGD (Wald = 4.227, P = .04). CONCLUSIONS: After lung transplantation, a significant increase in 6-hour lactate levels and untimely clearance from 6 to 24 hours are powerful warning signs for the development of PGD.
Validating the PRETREAT Score: Risk Stratification Following Liver Transplantation for Perihilar Cholangiocarcinoma.
O'Connell RM, Nasto RA, Hammond J … +3 more , Hand F, Gallagher TK, Hoti E
Transplant Proc · 2026 Jun · PMID 42276938 · Publisher ↗
INTRODUCTION: Liver transplantation (LT) for early-stage unresectable perihilar cholangiocarcinoma (pCCA) following neoadjuvant therapy is potentially curative, with excellent long-term survival. Disease recurrence remai...
INTRODUCTION: Liver transplantation (LT) for early-stage unresectable perihilar cholangiocarcinoma (pCCA) following neoadjuvant therapy is potentially curative, with excellent long-term survival. Disease recurrence remains problematic, however, which negatively impacts survival. Recently the Mayo Clinic group proposed the Perihilar Cholangiocarcinoma Risk Estimation of Tumor REcurrence After Transplant (PRETREAT) score to attempt to risk-stratify patients following LT. AIMS: The aim of this study was to evaluate the performance of the PRETREAT score in our patient cohort. METHODS: All patients with unresectable perihilar cholangiocarcinoma who underwent neoadjuvant chemoradiotherapy followed by LT in our institution were identified retrospectively, and outcome data were collected. The PRETREAT score was applied, and patients were grouped into low-, medium-, and high-risk groups. Survival analysis was then performed. RESULTS: A total of 32 patients were identified with a median follow-up of 55 months. The 5-year recurrence-free survival (RFS) and overall survival (OS) were 57.1% and 45.6%, respectively. The 5-year RFS was as follows: low-risk (87.5%), medium-risk (17%), and high-risk (0%) groups (P < .001). A significant difference was seen in the 5-year OS among the low- (70.8%), medium- (14%), and high-risk (0%) groups (P = .011). CONCLUSION: The PRETREAT score effectively stratified low-risk patients in our cohort who experienced superior long-term RFS and OS. It did not, however, discriminate significantly between those patients in the medium-risk and high-risk groups.
Impact of Oxygenated Hypothermic Machine Perfusion for Pig Small Intestine.
Takashima M, Muto S, Ishii D … +7 more , Okazawa Y, Mori T, Toriumi A, Okada Y, Sakamoto S, Obara H, Matsuno N
Transplant Proc · 2026 Jun · PMID 42276937 · Publisher ↗
BACKGROUND: Intestinal transplantation (IT) is an important treatment for end-stage intestinal failure. However, the survival rate is lower than that of other organs. Machine perfusion (MP) is used in other organs and pr...
BACKGROUND: Intestinal transplantation (IT) is an important treatment for end-stage intestinal failure. However, the survival rate is lower than that of other organs. Machine perfusion (MP) is used in other organs and provides better preservation than simple cold storage (SCS). This study compared SCS and hypothermic machine perfusion (HMP) in the small intestine of a pig. We aim to compare the effectiveness of organ preservation and evaluate the motor function by measuring peristalsis. METHOD: Pig small intestines were extracted and preserved in the SCS group (SCS 6 hours) or HMP group (SCS 4 hours + HMP 2 hours), and then reperfusion was performed for 2 hours as an isolated reperfusion model (IRM). Pathological evaluation was based on the Swerdlow Classification. During reperfusion, peristalsis was measured using the digital image correlation method. RESULT: At 120 minutes during IRM, vascular resistance was 1.02±0.57 vs 0.31±0.05 mm Hg/mL/min (SCS vs HMP, p < .05). Oxygen consumption was 1.2±0.8 vs 2.3±0.3 mg/min (SCS vs HMP, p < .05). The peristalsis was 0.22±0.15 vs 0.47±0.15 mm/s (SCS vs HMP, p < .05) at 90 minutes of IRM. The mucosal tissue after preservation was Grade 1 in both SCS group cases and Grade 0 and Grade 2 in each HMP group case. After reperfusion, mucosal necrosis was confirmed in 2 SCS cases and 1 HMP case, while the mucosa was preserved in one HMP case. CONCLUSION: HMP provides better preservation of vascular resistance, oxygen consumption, and peristalsis in the small intestine after ex vivo reperfusion than SCS.
Preventive Dental Strategies to Minimize Oral Health Complications After Renal Transplantation: A Systematic Review.
El Hennawy HM, El Hennawy MH, Safar O … +6 more , Jaber TM, Aboalsamh GA, Awais M, Tawahri I, Balla ME, Almalki AH
Transplant Proc · 2026 Jun · PMID 42276936 · Publisher ↗
BACKGROUND: Kidney transplantation dramatically improves survival and life quality in patients with end-stage renal disease, yet it imposes a substantial and often overlooked oral health burden. Immunosuppressive therapy...
BACKGROUND: Kidney transplantation dramatically improves survival and life quality in patients with end-stage renal disease, yet it imposes a substantial and often overlooked oral health burden. Immunosuppressive therapy, comorbidities, and residual renal dysfunction increase susceptibility to periodontal disease, oral candidiasis, mucosal lesions, and drug-induced gingival overgrowth, which may contribute to systemic complications and negatively affect patient well-being. This review synthesizes evidence on oral complications and evaluates preventive strategies. METHODS: A comprehensive systematic review with qualitative evidence synthesis was conducted using PubMed, Scopus, Google Scholar, and the Cochrane Library, encompassing studies published over the last 20 years. Observational studies and randomized trials were analyzed, with risk-of-bias assessment using ROBINS-I and Cochrane RoB tools. Due to heterogeneity in study design, outcome definitions, and reporting methods, a quantitative meta-analysis was not feasible. RESULTS: Oral complications arise from the interplay of immunosuppression, comorbidities, and insufficient oral care. Periodontal disease affects up to 87% of recipients, with xerostomia, candidiasis, and gingival overgrowth commonly reported. Preventive measures, including pretransplant dental clearance, individualized hygiene programs, antifungal prophylaxis, fluoride use, and structured post-transplant monitoring, are associated with reductions in oral infections and inflammatory complications reported across multiple studies. Evidence gaps persist, particularly in low-resource settings, standardized protocols, and patient-reported outcomes such as oral health-related quality of life (OHRQoL). CONCLUSION: Oral health is an important component of kidney transplant care. Integrating structured, patient-centered dental protocols within transplant programs may help reduce oral morbidity and support overall patient health, although direct causal effects on graft outcomes remain incompletely established in current literature. Future research should focus on longitudinal outcomes and OHRQoL metrics to guide precision, holistic transplant care.
Kidney Transplantation: A Review of 45 Years of a Southern Brazilian Hospital.
Giaretta DS, Maestri HDP, Catto PHZ … +6 more , Santini ADR, Traesel MA, Barreiro FF, Raffin LL, Poli-de-Figueiredo CE, Kroth LV
Transplant Proc · 2026 Jun · PMID 42276935 · Publisher ↗
Kidney transplantation is the best therapeutic option for patients with end-stage kidney disease, providing longer survival and quality of life. This retrospective single-center study analyzed all kidney transplants perf...
Kidney transplantation is the best therapeutic option for patients with end-stage kidney disease, providing longer survival and quality of life. This retrospective single-center study analyzed all kidney transplants performed at Hospital São Lucas da PUCRS between 1978 and 2023, categorizing patients into different eras according to the evolution of immunosuppressive protocols. A total of 1,920 transplants were performed, and patient survival at 1, 3, and 5 years was evaluated, which was estimated at 89.6%, 86%, and 82.8%, respectively, for living donors and 85%, 80.3%, and 76.2%, respectively, for deceased donors. The acute rejection rate decreased from 39.2% in the years 1987 to 1997 to 18.8% in the most recent era. The impact of the COVID-19 pandemic was significant, increasing mortality and temporarily reducing the transplant rate. The findings demonstrate improvements in patient and graft survival over the years, in line with advances in surgical and immunosuppressive techniques. However, challenges such as infections and chronic complications remain relevant. Future studies should focus on optimizing clinical management and mitigating the impacts of health crises on the transplant population.
The Role of Machine Perfusion in Liver Transplant Surgeon Training.
Matucci-Cerinic P, Martin N, Zanchi G … +8 more , Zambon M, Bonello L, Pravisani R, Cherchi V, Lorenzin D, Bresadola V, Terrosu G, Baccarani U
Transplant Proc · 2026 Jun · PMID 42270481 · Publisher ↗
BACKGROUND: Liver transplantation (LT) is a complex surgical procedure, with a well-recognized learning curve. Machine perfusion (MP) has been shown to mitigate ischemia-reperfusion injury and extend graft preservation t...
BACKGROUND: Liver transplantation (LT) is a complex surgical procedure, with a well-recognized learning curve. Machine perfusion (MP) has been shown to mitigate ischemia-reperfusion injury and extend graft preservation time. METHODS: We conducted a retrospective single-center study including adult patients who underwent LT between January 1, 2021, and October 16, 2025. Patients were stratified into 3 groups according to transplant surgeon experience and graft storage: group Y-MP, young surgeons (<44 years) using MP; group S-SCS, senior surgeons (>52 years) using static cold storage (SCS); and group S-MP, senior surgeons using MP (gold standard). Recipient and donor characteristics, perioperative variables, early graft function scores (primary nonfunction, early allograft dysfunction, model for early allograft function, early allograft failure simplified estimation), and postoperative laboratory parameters were analyzed and compared among groups. RESULTS: A total of 136 patients were included in the analysis (37 in Y-MP, 68 in S-SCS, and 29 in S-MP). Baseline recipient characteristics and MELD scores were comparable across groups. Operative time and blood loss were significantly higher in Y-MP; however, no significant differences were observed in primary graft outcomes (primary nonfunction, early allograft dysfunction, early allograft failure simplified estimation scores) except for MEAF. Early postoperative transaminase levels were significantly lower in Y-MP compared with S-SCS, particularly on postoperative days 1 and 3. CONCLUSIONS: MP clearly ameliorates organ storage and LT logistics, but it could also be considered for young surgeons' training in performing LT. MP may represent a valuable tool in the learning curve of LT, enabling progression without compromising early graft outcomes.
Mitochondrial Transplantation-Mediated Restoration of Mitochondrial Function Alleviates Hepatic Ischemia-Reperfusion Injury in Mice.
Hua Y, Wang Z, Wang M … +2 more , Li Y, Li L
Transplant Proc · 2026 Jun · PMID 42270480 · Publisher ↗
BACKGROUND: Hepatic ischemia-reperfusion injury (HIRI) is a major complication in liver surgery and transplantation, with mitochondrial dysfunction playing a central role. Mitochondrial transplantation has shown promise...
BACKGROUND: Hepatic ischemia-reperfusion injury (HIRI) is a major complication in liver surgery and transplantation, with mitochondrial dysfunction playing a central role. Mitochondrial transplantation has shown promise in other organ systems, but its effects and mechanisms in HIRI remain incompletely understood. OBJECTIVE: This study aimed to investigate the protective effects of mitochondrial transplantation on HIRI and explore the underlying molecular mechanisms. METHODS: HIRI was induced in male C57BL/6 mice by 60 minutes of partial hepatic ischemia followed by 3 hours of reperfusion. Autologous liver mitochondria (0.5 mg/kg) or vehicle were administered intravenously at the onset of reperfusion. In parallel, human THLE-2 hepatocytes were subjected to oxygen-glucose deprivation/reoxygenation (OGD/R) with or without mitochondrial supplementation (50 μg/mL). Liver injury (serum ALT/AST, measured as mass concentrations by ELISA), histopathology, cytokine profiles (TNF-α, IL-6, IL-10), apoptosis (Bax, Bcl-2, Cleaved Caspase-3, Annexin V), mitochondrial function (membrane potential, ROS production), and cell viability were assessed. RESULTS: Mitochondrial transplantation was associated with significantly reduced serum ALT and AST levels and attenuated histopathological liver damage in vivo (**p < .01). These changes correlated with a shift in cytokine balance, characterized by lower TNF-α and IL-6 and higher IL-10 levels, and with reduced expression of pro-apoptotic markers. In vitro, mitochondrial supplementation was associated with improved hepatocyte viability, reduced enzyme leakage, modulated cytokine secretion, and decreased apoptosis following OGD/R. These protective effects correlated with preserved mitochondrial membrane potential and reduced mitochondrial superoxide production. CONCLUSIONS: Our findings suggest that mitochondrial transplantation is associated with mitigation of HIRI in a murine model and with improved mitochondrial parameters in stressed hepatocytes. These correlative data support the potential of this approach as a therapeutic strategy for HIRI.
Depressive Symptoms, Social Support, and Health-Related Quality of Life of Patients After Lung Transplantation.
Fan CH, Chen WH, Chou YH … +2 more , Cheng CH, Weng LC
Transplant Proc · 2026 Jun · PMID 42270479 · Publisher ↗
BACKGROUND: Lung transplant recipients often experience depressive symptoms that can negatively impact their health-related quality of life (HRQOL). This study examined the relationship between depression and HRQOL, and...
BACKGROUND: Lung transplant recipients often experience depressive symptoms that can negatively impact their health-related quality of life (HRQOL). This study examined the relationship between depression and HRQOL, and whether social support mediates this effect. MATERIAL AND METHODS: A convenient sample of 47 lung transplant recipients in Taiwan was surveyed in 2024 using a structured questionnaire. The donors were not from prisoners, or from those individuals who are coerced or paid. The mediation effect was analyzed using the PROCESS model version 4.2. RESULTS: The findings showed that participants experienced moderate to high levels of social support, mild level of depression, and moderate level of health-related quality of life. Depressive symptoms had a significant direct effect on both the physical component summary (PCS) score (B = -0.6004; 95% confidence interval [CI]: -0.9485 to -0.2523; p = .0012) and the mental component summary (MCS) score (B = -0.8034; 95% CI: -1.2473 to -0.3594, p = .0007). However, the indirect effect of depressive symptoms on PCS (B = -0.0167; 95% bootstrap CI: -0.1550 to 0.1097) and MCS (B = -0.0803; 95% bootstrap CI: -0.2543 to 0.0215), mediated by social support, was not significant. Depression emerged as a significant factor influencing HRQOL, regardless of social support. CONCLUSION: This study highlights the significant impact of depressive symptoms on HRQOL in lung transplant recipients, regardless of social support. These findings emphasize the need for routine psychological screening and early intervention for depressive symptoms.
Preoperative Predictive Modeling of Recurrent Graft Failure: Development and Validation of a 12-Month Prognostic Tool in Kidney Transplant Recipients.
Shen T, Wang X, Liu X … +1 more , Zheng W
Transplant Proc · 2026 Jun · PMID 42270478 · Publisher ↗
BACKGROUND: Kidney transplantation is among the most effective treatments for end-stage renal disease. However, kidney transplant (KT) recipients remain at a relatively high risk of mortality, with underlying causes yet...
BACKGROUND: Kidney transplantation is among the most effective treatments for end-stage renal disease. However, kidney transplant (KT) recipients remain at a relatively high risk of mortality, with underlying causes yet to be fully elucidated. This study aim to develop a machine learning model to predict 12-month graft survival in KT recipients and to analyze the relationship between key postoperative indicators and graft survival. METHODS: We retrospectively collected clinical data from 368 KT recipients who underwent allogeneic transplantation between April 2016 and September 2022. A novel feature selection method was employed to exclude variables with weak correlations to outcomes. Eight machine learning algorithms were compared to develop an optimal predictive model, with a primary focus on efficiency. RESULTS: Among the evaluated models, the light gradient boosting machine model demonstrated superior predictive performance, achieving an area under the receiver operating characteristic curve of 0.80 and 0.71 for internal and external validations, respectively. Notably, we redefined the threshold for assessing renal dysfunction in KT recipients, proposing an estimated glomerular filtration rate of 45 mL/min/1.73 m² as a more precise standard. CONCLUSION: The proposed machine learning model and the newly established estimated glomerular filtration rate threshold provide accurate assessments of graft dysfunction severity, offering robust support for clinical decision-making in kidney transplantation management.
The Real-World Safety and Effectiveness of Rituximab in Preventing Antibody-Mediated Rejection in ABO-Incompatible Liver Transplantation: All-Case Postmarketing Surveillance in Japan.
Kobayashi M, Sakamoto J, Ando T
Transplant Proc · 2026 Jun · PMID 42270477 · Publisher ↗
BACKGROUND: In ABO-incompatible (ABOi) liver transplantation, antibody-mediated rejection (AMR) is a challenging post-transplant complication. In Japan, rituximab was approved in 2016 to prevent AMR in ABOi kidney and li...
BACKGROUND: In ABO-incompatible (ABOi) liver transplantation, antibody-mediated rejection (AMR) is a challenging post-transplant complication. In Japan, rituximab was approved in 2016 to prevent AMR in ABOi kidney and liver transplantation and in 2023 to prevent and treat AMR in kidney, liver, heart, lung, pancreas, and intestine transplantation. METHODS: We conducted an all-case postmarketing surveillance to assess the safety and effectiveness of rituximab in ABOi liver transplant recipients, with a registration period between February 29, 2016 and May 9, 2021. The safety endpoint was the occurrence of adverse drug reactions (ADRs). The effectiveness endpoints were the AMR-free rates at weeks 4 and 24 post-transplant. Graft survival rates, rejection-free rates (excluding AMR), and survival rates at weeks 24 and 48 were also assessed. RESULTS: In the safety analysis set, 50.3% (91/181) were male, 8.8% (16/181) were aged ≥ 65 years, 12.8% (23/180) were considered at high risk for cytomegalovirus (CMV) infection, and 95.0% (171/180) received a single infusion preoperatively. ADRs and serious ADRs occurred in 65.7% (119/181) and 27.6% (50/181), respectively. ADRs associated with infection occurred in 57.5% (104/181), with CMV infection being the most frequent event. Twenty-four adverse events leading to death occurred in 16 patients, 7 of whom died from 11 ADRs. In the effectiveness analysis set of 183 patients, the AMR-free rate was 93.4% at weeks 4 and 24. At week 48, the graft survival rate was 94.8%, and the survival rate was 90.6%. CONCLUSION: Rituximab had an acceptable safety profile in real-world settings in ABOi liver transplantation.
Correlating Infrared Surface Thermometry With Core Temperature Assessments in Simulated Cooling and Rewarming of Porcine Kidneys.
Igbokwe M, Wang J, Byrne C … +5 more , Vyas KA, Richard-Mohammed M, Alfaifi A, Sener A, Luke PP
Transplant Proc · 2026 Jun · PMID 42270476 · Publisher ↗
BACKGROUND: In developing strategies to analyze the effects of controlled rewarming of donor kidneys, accurate and reproducible measurements of renal temperatures are required. While invasive probes provide accurate core...
BACKGROUND: In developing strategies to analyze the effects of controlled rewarming of donor kidneys, accurate and reproducible measurements of renal temperatures are required. While invasive probes provide accurate core temperature measurements, they risk tissue damage and may compromise the sterile field. Infrared thermometry (IRT) offers a non-contact alternative, but correlation with renal core temperature remains insufficiently validated in transplant-related scenarios. OBJECTIVE: To correlate surface IRT temperatures compared with core temperature assessments in porcine models of donor kidney cooling and rewarming. METHODS: This study was conducted in a controlled surgical setting. Porcine kidneys were procured for study. Core temperatures were measured with a calibrated thermocouple probe (Physitemp Thermalert TH-8) inserted into the renal pelvis via the ureter. Surface temperature was recorded using a non-contact infrared thermometer (CEM DT-8839) held 10 to 15 cm perpendicular to the renal capsule. Measurements were obtained by both techniques every minute from cold flush with perfusion solution and during rewarming. Agreement between modalities was assessed with Bland-Altman analysis, and correlation was determined using Pearson's coefficient. RESULTS: Across all phases, IRT measurements demonstrated strong correlation with core temperatures (r > 0.9, p < .001). Bland-Altman plots indicated minimal systematic bias, with narrower limits of agreement during steady-state cooling and wider variability during rewarming. IRT effectively tracked temperature trends, though minor deviations (±0.5-1.0°C) from core readings were observed during dynamic thermal transitions. CONCLUSIONS: Surface IRT has strong correlation with core temperature during pig kidney cooling and rewarming. IRT is well suited for trend monitoring and intraoperative workflow guidance during evaluation of controlled rewarming of donor kidneys.
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