Clinical Transplantation最新文献

{"title":"Stepwise Intravenous Immunoglobulin Therapy for Resistant BK Virus Nephropathy in Kidney Transplant Recipients: A Case Series With 1-Year Follow-Up","authors":"Engin Onan, Tuba Canpolat, Sedat Yıldırım, Kenan Çalışkan, Mehmet Haberal","doi":"10.1111/ctr.70102","DOIUrl":"https://doi.org/10.1111/ctr.70102","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Extracorporeal Life Support Application in Lung Transplantation","authors":"Barbara Jeanne Wilkey,&nbsp;Tyler Elliott,&nbsp;Todd Everett Jones,&nbsp;Terrie Vasilopoulos,&nbsp;Theresa Gelzinis,&nbsp;Melissa Bellomy,&nbsp;Jessica Louise Brodt,&nbsp;Joshua Knight,&nbsp;Mariya Atanassova Geube,&nbsp;John Michael Fox,&nbsp;Christopher Lee Racine,&nbsp;Justin Nadeem Tawil,&nbsp;Katharine Kozarek,&nbsp;Sudhakar Subramani,&nbsp;Kara Kimberly Siegrist,&nbsp;Pratik Kothary,&nbsp;Yong Gang Peng,&nbsp;Andrea Nicole Miltiades,&nbsp;Sharon Lorraine McCartney,&nbsp;Brandi Anne Bottiger,&nbsp;Archer Kilbourne Martin","doi":"10.1111/ctr.70094","DOIUrl":"https://doi.org/10.1111/ctr.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Lung transplantation has been evolving since its inception in 1963. Over recent years, literature has suggested a shift in the perioperative strategy of mechanical support toward extracorporeal membrane oxygenation (ECMO) as the preferred modality of extracorporeal life support (ECLS) in lung transplantation. The Survey of ECLS Application in Lung transplantation (SEAL) was designed to elucidate the current practice patterns of perioperative ECLS within the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, a physician from 62 adult lung transplantation centers across the United States of America (USA) was surveyed on their institutional practices regarding the perioperative management of lung transplantation patients, with a focus on mechanical support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The survey completion rate was 74% (46/62 eligible institutions). Most transplant centers utilize venoarterial (VA) ECMO (78%, 36/46) and/or venovenous (VV) ECMO (93%, 29/43) as a bridge to lung transplantation. When ECLS is used intraoperatively, 61% of (28/46) responding programs use VA ECMO as their preferred support. All programs use transesophageal echocardiography (TEE) intraoperatively, 85% (33/39) cannulate for ECMO centrally, and 74% (29/39) use a combination of inhaled and intravenous anesthesia while using ECMO intraoperatively. Most programs do not use antifibrinolytic during VA ECMO (62%, 28/45). Anticoagulation management and VA ECMO flows throughout the procedure showed considerable variation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Data from SEAL illustrates that though there are some practice commonalities within the United States, there is also quite a bit of variability in practice. Multiple dominant practices within the USA are consistent with a recently published International Society of Heart and Lung Transplantation consensus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Tolerability of SGLT-2 Inhibitors Following Lung Transplantation","authors":"Peter Wilcox,&nbsp;Krysta Walter,&nbsp;Jonathan Troost,&nbsp;Elizabeth Belloli","doi":"10.1111/ctr.70104","DOIUrl":"https://doi.org/10.1111/ctr.70104","url":null,"abstract":"<p>Sodium-glucose cotransporter-2 inhibitors (SGLT2i's) are frequently prescribed for T2DM control, with additional efficacy in congestive heart failure therapy and preserving renal function in CKD. Despite their potential to mitigate comorbidities, prescribing of SGLT2i's following solid organ transplantation has been limited due to safety concerns regarding infection, renal function, and diabetic ketoacidosis. SGLT2i prescription following transplantation of other solid organs has been evaluated, but only one study included a limited number of lung transplant recipients. We performed a retrospective case control study of all patients in Michigan Medicine clinics with a prior lung transplant who were prescribed an SGLT2i between January, 2010 and March, 2023. We collected demographic information, medical history pertaining to transplant, SGLT2i prescription history, and abstracted safety, tolerability, and efficacy outcomes for comparison between the SGLT2i cohort and a control population. Among 20 patients who met inclusion criteria, median SGLT2i prescription duration was 372 days. There were no UTI's or GU infections, and severe AKI occurred in five patients. There was a median reduction of 0.6% in hemoglobin A1c within the SGLT2i group not observed in controls (<i>p</i> = 0.09). Our findings demonstrate safety and tolerability of SGLT2i's following lung transplantation and suggest efficacy in controlling T2DM or PTDM.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recipient Outcomes After Utilization of Kidneys From Deceased Donors With Diagnosed Glioblastoma Multiforme","authors":"Venkata Kanaka Naga Karthik Nasika,&nbsp;Vanjinathan Subramani,&nbsp;Ashish Sharma,&nbsp;Sarbpreet Singh,&nbsp;Jasmine Sethi,&nbsp;SreeVani Paladugu,&nbsp;Kajal Jain,&nbsp;Navdeep Bansal","doi":"10.1111/ctr.70090","DOIUrl":"https://doi.org/10.1111/ctr.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The exact incidence of donor tumor transmission in patients with glioblastoma multiforme (GBM) is still unknown. These transplants are usually considered as a high-risk endeavor due to fear of potential spread especially with medical intervention leading to breach in blood–brain barrier. This report describes successful outcomes after renal transplantation from two donors with World Health Organization (WHO) Grade IV primary GBM who had undergone surgical excision with ventriculoperitoneal shunt (VPS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between January 2019 and June 2024, case records of organ donors where the primary cause of death was GBM were screened from the departmental database. Renal transplant patients from donors with a histopathological diagnosis GBM WHO Grade IV were included in the study. The follow-up of these recipients was recorded for tumor transmission, delayed graft function, patient and graft survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only kidneys were retrieved from these donors. The donor's kidneys were transplanted to four consented recipients after taking informed consent explaining the risks. During the mean follow-up of 3 years, all four patients were alive with good graft function. Nuclear scan at 3, 6 months, and yearly thereafter showed no abnormal uptake or no evidence of donor-transmitted tumor transmission in any of these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High-grade GBM donors with no evidence of systemic spread may be considered for renal transplantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Transplant in Patients With Human Immunodeficiency Virus: A Case Series","authors":"Paulamy Ganguly,&nbsp;Ramya Varadarajan,&nbsp;Max W. Adelman,&nbsp;Priya Arunachalam,&nbsp;Simon Yau,&nbsp;Jihad G. Youssef,&nbsp;Ahmad Goodarzi","doi":"10.1111/ctr.70097","DOIUrl":"https://doi.org/10.1111/ctr.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Historically, patients with human immunodeficiency virus (PWH) were at higher risk for pulmonary morbidities than patients without HIV. Lung transplantation in PWH has been limited by uncertain outcomes and a lack of guidelines for transplantation and immunosuppression. However, several case reports in the United States and Europe have demonstrated that lung transplantation in PWH is feasible. Although there remain concerns regarding these patients as higher-risk recipients, lung transplantation is feasible with careful modification of immunosuppression and close monitoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed lung transplantation on three PWHs and analyzed their post-transplant outcomes to determine the feasibility of lung transplant in PWH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that all three patients (mean age 59, SD 10.98) with HIV underwent lung transplantation. Two of the three patients experienced acute cellular rejection that resolved with intravenous corticosteroids. None had long-term complications including chronic rejection, antibody-mediated rejection, or infections. All three patients maintained baseline HIV therapy following transplantation with adequate HIV disease control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although PWH has an increased risk of pulmonary comorbidities compared to the general population, lung transplantation appears to be a feasible treatment option supported by the growing body of literature and the three cases described here.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Checkpoint Inhibitor Use in Kidney Transplant Patients: A National Case Series From Ireland","authors":"Bláthnaid O'Connell,&nbsp;Cliona Cowhig,&nbsp;Susan McAnallen,&nbsp;Jennifer B. Hanko,&nbsp;Jarushka Naidoo,&nbsp;Michael R. Clarkson,&nbsp;Peter J. Conlon","doi":"10.1111/ctr.70101","DOIUrl":"https://doi.org/10.1111/ctr.70101","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Nighttime Procurement and Transplantation on Outcomes Following Heart Transplantation","authors":"Yeahwa Hong,&nbsp;Nicholas R. Hess,&nbsp;Ander Dorken-Gallastegi,&nbsp;Mohamed Abdullah,&nbsp;Nidhi Iyanna,&nbsp;Umar Nasim,&nbsp;Ibrahim Sultan,&nbsp;Gavin W. Hickey,&nbsp;Mary E. Keebler,&nbsp;David J. Kaczorowski","doi":"10.1111/ctr.70093","DOIUrl":"10.1111/ctr.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study evaluates the effects of nighttime procurement and transplantation on outcomes following heart transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The UNOS registry was queried to analyze adult recipients who underwent isolated orthotopic heart transplantation between January 1, 2010, and September 30, 2022. The cohort was stratified into daytime (4 am–8 pm) and nighttime (8 pm–4 am) transplant groups. The primary outcome was 1-year survival. Propensity score-matching was performed. Risk adjustment was performed using multivariable Cox regression. Restricted cubic spline was used to model the association between the time of transplantation and the likelihood of 1-year mortality. Sub-analysis was performed to evaluate the impact of nighttime procurement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 30 426 recipients were analyzed, where 10 807 recipients (35.5%) underwent nighttime transplantation. The nighttime recipients had reduced 1-year post-transplant survival compared to the daytime recipients (90.6% vs. 91.5%, <i>p</i> = 0.019), and this lower survival persisted in the propensity score-matched comparison. After adjusting for established predictors for post-transplant mortality, nighttime transplantation continued to have a significantly increased risk of 1-year mortality (hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.03–1.21, <i>p</i> = 0.005). The spline model demonstrated increased odds of 1-year mortality between 5 pm and 4 am, with the highest odds at 11 pm (odds ratio [OR] 1.25, 95% CI 1.07–1.47), compared to the reference transplantation time of 7 am. When assessing the impact of procurement timing, nighttime procurement negatively impacted 1-year post-transplant survival among the daytime recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates the adverse impact of nighttime heart procurement and transplantation on early post-transplant survival. With emerging organ perfusion and thermal protection systems, additional studies are warranted to assess the safety of extending the heart preservation period to optimize the timing of transplantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Quality of Life in Adult Lung Transplant Recipients Quality of Life Post-Lung Transplant","authors":"Bashayer M. Al-Shweeman,&nbsp;Gamal Mohamed,&nbsp;Atheer Alawwad","doi":"10.1111/ctr.70098","DOIUrl":"10.1111/ctr.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Significant limitations in daily life characterize end-stage lung diseases (ESLD) due to symptoms such as dyspnea, recurrent infections, side effects of immunosuppressive medication, and frequent need for hospitalizations. In addition to physical symptoms, ESLD is associated with emotional and social sources of distress such as depression, anxiety, fear of dying, financial concerns, and regular need for relocation. A transplant can significantly affect the recipients’ life domains, from physical and emotional well-being to social relationships and roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to assess the quality of life of adult lung transplant recipients in Saudi Arabia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A cross-sectional quantitative design was employed using the self-administered World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, a sociodemographic and clinical questionnaire, and a medical chart review. The study was conducted in a tertiary care center in Saudi Arabia. Data were collected from November 2023 to April 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred fifty-seven individuals with a mean age of 45 years had completed the questionnaire, and there was no participant refusal (Response rate = 100%). Males accounted for 61.1%, and most participants were married (63.7%). About half (44.6%) had at least one comorbidity outside ESLD. Only 26.7% were working post-transplant. Overall, the data strongly suggests that as individuals adjust and recover post-transplant, they tend to feel increasingly positive with time. Most rated their quality of life and health satisfaction as high. The lowest score was for the <i>physical domain</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study's findings showed that the quality was good overall across various domains, with moderate scores, with the lowest score on the <i>physical domain</i>. Improving rehabilitation strategies would help transplanted patients live more fulfilling lives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SherpaPak Cardiac Transport System: Experience in Pediatric Heart Transplantation","authors":"Anna Sather,&nbsp;Molly Marshall,&nbsp;Raghav Murthy,&nbsp;Jacqueline M. Lamour,&nbsp;Christyn Chase,&nbsp;Neha Bansal","doi":"10.1111/ctr.70095","DOIUrl":"10.1111/ctr.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The present study aimed to assess the clinical outcomes of pediatric heart transplant patients whose donor hearts were preserved with the SherpaPakCardiac Transport System.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All pediatric patients undergoing heart transplantation at our center between January 2020 and June 2024 were included and described. Vasoactive inotropic score (VIS) was calculated. The cohort was divided into two groups by recipient diagnoses (cardiomyopathy vs. congenital heart disease [CHD]). They were compared based on demographics, operative details, and postoperative outcomes. The <i>χ</i>2 and Fisher exact tests were used for categorical variables and the Mann–Whitney <i>U</i> test or <i>t</i>-test for continuous variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 18 patients were included. The median recipient age was 11.9 years (IQR: 2.5, 13.9). Half had cardiomyopathy, median total ischemic time was 236 min (IQR: 211.5, 283.5). Upon comparing the two groups, there were no significant differences observed in VIS or primary graft dysfunction (PGD) even though the median circulatory arrest time and bypass times were significantly longer in the CHD group (<i>p</i> &lt; 0.05). Three patients experienced early rejection (all with CHD), but there was no mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The SherpaPak Cardiac Transport System provides safe outcomes for pediatric heart transplant patients, including those with complex CHD. Further multi-institutional and registry studies are needed to evaluate this method for pediatric heart transplantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Hemodynamic Monitoring and Prediction of Early Allograft Dysfunction Following Living Donor Liver Transplantation: A Systematic Review","authors":"Audrey E. Brown,&nbsp;John Roberts","doi":"10.1111/ctr.70074","DOIUrl":"10.1111/ctr.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Multiple intraoperative hemodynamic parameters are associated with an increased risk of early allograft dysfunction (EAD) following living donor liver transplantation (LDLT); however, there is significant center-to-center variability in terms of which parameters are used. We sought to determine which intraoperative hemodynamic parameters are most predictive of EAD following LDLT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a systematic review following PRISMA guidelines (PROSPERO ID: CRD42023409711). Receiver operating characteristic (ROC) analyses were used to compare predictive parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4399 articles were identified from 3 large, international databases (PubMed, Embase, and Web of Science). Eighteen articles fit the inclusion criteria. The most commonly evaluated hemodynamic parameter was the postreperfusion portal venous pressure (PVP). A postreperfusion PVP of &lt;15–20 mmHg was consistently associated with lower rates of EAD and, in some cases, improvements in patient survival. Other hemodynamic parameters evaluated included portal venous flow, hepatic arterial flow, portal venous velocities, and the hyperperfusion index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hemodynamic measurements indicative of portal hyperperfusion, especially elevated PVP, have been consistently associated with the development of EAD. Intraoperative hemodynamics should be monitored on all LDLT recipients, with portal inflow modulation procedures indicated if portal hyperperfusion is present.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}