Clinical Transplantation最新文献

{"title":"Opioid Use as a Predictor of Pancreas Transplant Outcomes","authors":"Youngmin Ko,&nbsp;Eunbyeol Cho,&nbsp;Hye Eun Kwon,&nbsp;Jin-Myung Kim,&nbsp;Sung Shin,&nbsp;Young Hoon Kim,&nbsp;Edward Choi,&nbsp;Byunghyun Choi,&nbsp;Hyunwook Kwon","doi":"10.1111/ctr.70453","DOIUrl":"10.1111/ctr.70453","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Posttransplant opioid dependence has been linked to adverse outcomes in solid organ transplantation, but its impact on pancreas transplantation is underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed 193 PTA/PAK recipients from Asan Medical Center (AMC) (2010–2022) and externally validated results in 77 recipients from Pusan National University Yangsan Hospital (PNUYH) (2015–2022). Posttransplant opioid dependence was defined as ≥ 10 opioid prescriptions between 3 and 12 months posttransplant. Logistic regression and three ML algorithms (CatBoost, XGBoost, and LightGBM) were used to identify risk factors and predict 5-year graft survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Posttransplant opioid dependence (OR 2.87, <i>p</i> = 0.005) independently predicted 5-year graft failure, along with pre-transplant retinopathy, bladder drainage, and lower BMI. ML models showed favorable internal AUROC (0.695–0.719) and moderate external AUROC (0.649–0.671). Opioid dependence consistently ranked among top predictive features across models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Posttransplant opioid dependence is a significant predictor of graft failure after pancreas transplantation. Incorporating this variable into ML models may enhance risk stratification and candidate selection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965504","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":"Cardiac Allograft Vasculopathy in Heart Transplantation From Circulatory Death Donors: A Systematic Review and Meta-Analysis","authors":"Wasif Safdar,&nbsp;Marvyn Allen G. Chan,&nbsp;Lorenzo D'Angelo,&nbsp;Arjun Kumar,&nbsp;Snehal R. Patel,&nbsp;Omar Saeed,&nbsp;Daniel J. Goldstein,&nbsp;Ulrich P. Jorde,&nbsp;Shivank Madan","doi":"10.1111/ctr.70435","DOIUrl":"10.1111/ctr.70435","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiac allograft vasculopathy (CAV) remains a major cause of long-term morbidity and mortality after heart transplantation (HT). With the growing use of donation after circulatory death (DCD) donors, it is crucial to assess the incidence of CAV in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of studies published between January 2010 and December 2024. comparing 1-year CAV incidence and 1-year mortality between DCD and donation after brain death (DBD) HT recipients. Odds ratios (OR) with 95% confidence intervals (CI) were pooled using fixed and random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four studies met inclusion criteria, comprising 951 HTs (576 DBD and 375 DCD). Of these, 594 HTs contributed to the CAV analysis and 914 to the mortality analysis. Pooled analysis demonstrated no significant difference in 1-year CAV incidence between DCD and DBD recipients (OR = 0.71, 95% CI: 0.43–1.17, <i>p</i> = 0.17). Similarly, no difference was observed in 1-year mortality (OR = 0.87, 95% CI: 0.48–1.58, <i>p</i> = 0.66).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DCD and DBD-HT recipients demonstrated comparable 1-year CAV incidence and mortality. These findings support the continued and expanded use of DCD donors to address the ongoing shortage of suitable donor hearts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965496","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":"Life Satisfaction and Psychosocial Adjustment in Lung Transplant Recipients: Work, Family, and Sexual Life","authors":"Aleksandra Stańska,&nbsp;Maja Krajewska,&nbsp;Aleksandra Mikołajczyk,&nbsp;Anna Borzyszkowska,&nbsp;Sławomir Żegleń,&nbsp;Wojciech Karolak,&nbsp;Jacek Wojarski","doi":"10.1111/ctr.70434","DOIUrl":"10.1111/ctr.70434","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung transplantation (LTx) significantly improves survival in end-stage pulmonary “disease” but its impact on life satisfaction and psychosocial adjustment is still underexplored. This study aimed to assess global life satisfaction and satisfaction with work, family life, and sexual life among lung transplant recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty adults after LTx were interviewed using Polish-language instruments (validated where available), including the SWLS, Satisfaction with Job Scale, a widely used Polish Family Satisfaction Scale, and the Sexual Satisfaction Questionnaire. Pearson's correlations, Mann–Whitney U tests, and multiple linear regression were performed to examine associations and predictors of life satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean SWLS score indicated high overall life satisfaction (<i>M</i> = 26.90, <i>SD</i> = 5.38). Sexual satisfaction correlated significantly with global life satisfaction (<i>r</i> = 0.413, <i>p</i> = 0.007). Family and work satisfaction showed positive but non-significant trends. Gender comparisons revealed no significant differences in life satisfaction or its domains. Multiple regression showed that family-related satisfaction (<i>β</i> = 0.361, <i>p</i> = 0.013) and sexual satisfaction (<i>β</i> = 0.365, <i>p</i> = 0.013) were significant predictors of life satisfaction, explaining 33% of its variance. Time since LTx and gender were not significant predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings highlight the central role of interpersonal well-being in life satisfaction after lung transplantation. Satisfaction with family and intimate relationships emerged as key factors supporting psychosocial adjustment. This underscores the need for comprehensive post-transplant care addressing relational and sexual well-being, beyond physical recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965430","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":"Changing Landscape of Procurement of Deceased Donor Organs: An Analysis of National Trends","authors":"Elizabeth J. Bashian,&nbsp;Eric W. Etchill,&nbsp;Thomas F. O'Shea,&nbsp;Ashtyn Philipsheck,&nbsp;Nicholas R. Teman,&nbsp;Michael T. Cain,&nbsp;Jordan R. H. Hoffman","doi":"10.1111/ctr.70442","DOIUrl":"10.1111/ctr.70442","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Donation after circulatory death (DCD) has historically been underutilized compared with donation after brain death (DBD). Advances in preservation strategies and policy reforms have accelerated DCD adoption, raising the potential for meaningful shifts in the US donor pool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed national donor trends using Scientific Registry of Transplant Recipients (SRTR) Explorer data from 2015 to 2025. Donor type (DCD vs. DBD) was evaluated across organ types and organ procurement organizations (OPOs). Temporal trends were assessed and crossover intervals were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified an interval in which the 30-day rolling donor count for DCD exceeded that of DBD for the first time (May 18 and June 18, 2025). During this period, DCD accounted for 52% of kidney, 44% of liver, and 26% of heart and lung recoveries. In 2025, DCD increased by 2.7 donors per day while DBD declined by 0.6 per day (<i>p</i> &lt; 0.001). Over the past decade, DCD growth outpaced DBD nearly threefold, with kidney and lung showing the steepest increases. Both high- and low-volume OPOs demonstrated upward trends. Since reporting began in 2023, use of normothermic regional perfusion has expanded steadily.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This analysis identifies an interval in which the 30-day rolling donor count for DCD exceeded that of DBD, reflecting a notable shift in donor-availability trends. These findings underscore the need for standardized practices to ensure equitable allocation and minimize organ discard as reliance on DCD continues to grow.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965476","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":"Prolonged Invasive Mechanical Ventilation is Associated With Decreased Survival After Lung Transplantation Among Recipients With Primary Graft Dysfunction: A Lung Transplant Outcomes Group Study","authors":"Meghan Aversa,&nbsp;Shaf Keshavjee,&nbsp;Tereza Martinu,&nbsp;Marcelo Cypel,&nbsp;Andrew T. Sage,&nbsp;Joshua M. Diamond,&nbsp;Jonathan P. Singer,&nbsp;Scott M. Palmer,&nbsp;Krishna Pandya,&nbsp;Edward Cantu,&nbsp;Jason D. Christie,&nbsp;Michaela R. Anderson","doi":"10.1111/ctr.70447","DOIUrl":"10.1111/ctr.70447","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Prolonged invasive mechanical ventilation (IMV) after lung transplantation is an appealing early prognostic outcome as it can be reproducibly assessed both prospectively and retrospectively. Whether use of IMV at 72 h after lung transplantation is associated with post-transplant graft survival is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study of 1511 participants in the multi-center Lung Transplant Outcomes Group cohort (2011–2018). Using Cox proportional hazards models and restricted mean survival time, we investigated whether IMV at 72 h was associated with post-transplant graft survival. We secondarily evaluated whether IMV at 72 h was concordant with severe primary graft dysfunction (PGD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants requiring IMV at 72 h after transplant were sicker at transplantation (higher lung allocation score [LAS], increased extracorporeal membrane oxygenation, or IMV bridge) and more likely to have severe PGD. Use of IMV at 72 h was associated with 55% (95% CI 26%–92%) increased hazards of death or re-transplantation after adjustment for age, ECMO, diagnosis, LAS, and intra-operative transfusion. The association between IMV and graft survival was modified by severe PGD (<i>p</i>-for interaction 0.002) but not by pre-transplant ECMO (<i>p</i>-for interaction 0.88) or pre-transplant IMV (<i>p</i>-for interaction 0.92). IMV was associated with increased risk of death or re-transplantation among those with PGD (HR 2.35, 95% CI 1.43–3.85) but not among those without PGD (HR 1.04, 95% CI 0.77-1.41).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Requirement of IMV at 72 h is an important early post-transplant outcome associated with post-transplant survival. This appears driven by those with severe PGD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965510","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":"Efficacy of a Single Dose of Intravesical Aminoglycoside for the Prevention of Urinary Tract Infections in Kidney Transplant Recipients","authors":"Sarah Dean,&nbsp;Andrew Santeusanio,&nbsp;Gopi Patel,&nbsp;Vikram Wadhera,&nbsp;Ron Shapiro","doi":"10.1111/ctr.70449","DOIUrl":"10.1111/ctr.70449","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Urinary tract infections (UTIs) occur commonly following kidney transplant and are associated with significant morbidity. Some providers perform intra-operative antibiotic bladder irrigation at the time of ureteroneocystostomy, although practice varies widely among surgeons. As a result, this study was performed to assess outcomes following a single intravesical gentamicin injection for the prevention of UTIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective cohort study of adult patients who underwent a first isolated kidney transplant between January 2018 and January 2023. Outcomes were compared between patients who received bladder irrigation with a single dose of gentamicin and controls who did not receive antibiotic irrigation. The primary end point was the incidence of culture-confirmed UTI within 3-months of transplant. Key secondary endpoints included delayed allograft function and serum creatinine at 3-months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 764 patients were included in the study analysis (gentamicin = 406 vs. control = 358). At 3 months, the incidence of UTIs was 18.2% in the gentamicin group compared to 13.1% in the control group (<i>p</i> = 0.05). A higher incidence of BK viremia &gt;10,000 copies/mL was also observed in the gentamicin group compared with control patients (5.9% vs. 2.5%; <i>p</i> = 0.02). After multivariable regression analysis older age, female sex, early rejection, longer dialysis vintage, and urinary catheter duration were all found to be positively correlated with the incidence of UTIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among kidney transplant recipients, bladder irrigation with gentamicin was not found to reduce the incidence of UTIs at 3 months. Additional studies should explore a possible association between antibiotic bladder irrigation and subsequent BK viremia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965491","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":"Induction Regimens and Kidney Re-Transplant Outcomes after BK Nephropathy–Related Graft Loss: A U.S. Cohort Study","authors":"Rasha El-Rifai,&nbsp;Lauren Fontana,&nbsp;Scott Jackson,&nbsp;Byron H. Smith,&nbsp;Amir Hossein Shams,&nbsp;Artur Quintiliano,&nbsp;Andrew J. Bentall,&nbsp;Raymund R. Razonable,&nbsp;Raja Kandaswamy,&nbsp;Samy M. Riad","doi":"10.1111/ctr.70446","DOIUrl":"10.1111/ctr.70446","url":null,"abstract":"<div>\u0000 \u0000 <p>This study investigated the association between induction type and long-term outcomes in kidney retransplant recipients who experienced graft loss due to BK virus–associated nephropathy (BKVAN). Using Scientific Registry of Transplant Recipients data (2003–2021), we identified 277 adult kidney-alone retransplant recipients with BKVAN-related graft loss and categorized them by induction regimen: depletional (<i>n</i> = 217) and nondepletional (<i>n</i> = 60). The groups were similar overall, except the nondepletional cohort had lower panel-reactive antibodies, a shorter time between transplants, and more live donor kidneys. Kaplan–Meier curves assessed 10-year recipient and graft survival, and Cox proportional hazards models, adjusted for key donor and recipient factors, evaluated associations between induction type and outcomes. Rates of delayed graft function, one-year rejection, and estimated glomerular filtration rate were comparable between groups. Ten-year recipient and death-censored graft survival did not differ by induction type (recipient survival: HR 1.09; 95% CI 0.43–2.77; <i>p</i> = 0.85; graft survival: HR 0.85; 95% CI 0.24–2.97; <i>p</i> = 0.79). Recurrent BKVAN-related graft failure occurred only in the depletional group (5 of 217; 2.3%), while rejection-related graft failure was more common in the nondepletional group (5 of 60; 8.3% vs. 6 of 217; 2.8%). Although these differences did not translate into long-term graft survival disparities, they highlight the competing risks of viral recurrence and rejection. Thus, clinicians should interpret these results with caution and weigh the risks and benefits of induction choice in retransplant recipients with prior BKVAN, recognizing that this observational study cannot establish causality.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932559","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":"Correction to “Financial Impact of Donation After Circulatory Death Heart Transplantation: A Single-Center Analysis”","authors":"","doi":"10.1111/ctr.70428","DOIUrl":"10.1111/ctr.70428","url":null,"abstract":"<p>Urban M, Ryan TR, Um JY, Siddique A, Castleberry AW, Lowes BD. Financial impact of donation after circulatory death heart transplantation: A single-center analysis. <i>Clin Transplant</i>. 2024; 38:e15296. https://doi.org/10.1111/ctr.15296.</p><p>In the article cited above, grant information is updated as follows:</p><p>Marian Urban was supported by the National Institutes of Health (P20 GM152326).</p><p>The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932564","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":"Heart Transplantation in Patients With Systemic Sclerosis","authors":"Morgan D. Smith,&nbsp;Miroslav Sekulic,&nbsp;Matthew Regan,&nbsp;Ilan Richter,&nbsp;Dor Lotan,&nbsp;Adi Hertz,&nbsp;Kyung T. Oh,&nbsp;Boaz Elad,&nbsp;Julia Baranowska,&nbsp;Irina Sobol,&nbsp;Evelyn Horn,&nbsp;Jayant Raikhelkar,&nbsp;Ersilia M. DeFilippis,&nbsp;Kevin Clerkin,&nbsp;Farhana Latif,&nbsp;Gabriel T. Sayer,&nbsp;Nir Uriel","doi":"10.1111/ctr.70424","DOIUrl":"10.1111/ctr.70424","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Systemic sclerosis (SSc) is a multisystem disease, frequently leading to heart failure (HF). Heart transplant (HT) remains the definitive therapy for advanced HF, but HT outcomes in SSc patients remain poorly characterized. This study aims to report the outcomes of HT in patients with SSc.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of all HT recipients with SSc between 2007 and 2024 at two transplant centers. Baseline characteristics, index admission, and post HT outcomes were captured from the electronic medical record. Pathology of explants and allograft biopsies was read by a dedicated pathologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven of 1153 patients who received HT had SSc. Six of these received HT alone, while one received a heart–lung transplant. Five (71%) were waitlist status 2 at the time of transplant. Median age was 52, and five patients (71%) were male. Pathologic examination of the seven patients’ explanted native hearts showed that two (29%) had active inflammation, six (86%) had fibrosis, and four (57%) had vascular remodeling. With a median follow-up of 3.2 years (range: 1.0–18.2) post-HT, six patients (86%) had a preserved ejection fraction at last assessment, while one suffered graft failure due to acute cellular (ACR) and antibody-mediated rejection (AMR). Two patients (29%) developed 2R ACR (range: 0–1 months), and two (29%) developed AMR (range: 4–5 years). Post-HT, one patient developed gastroparesis due to SSc, and one required a renal transplant due to complications of immunosuppression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HT in SSc patients demonstrates good mid-term graft function despite an increased incidence of rejection, supporting feasibility in carefully selected candidates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932578","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":"Optimizing Perioperative Outcomes in Liver Transplantation: The Role of Inpatient Rehabilitation","authors":"Laura Malmut,&nbsp;Sarah M. Eickmeyer,&nbsp;Jacqueline Neal,&nbsp;Kim Barker,&nbsp;Julie Lanphere,&nbsp;Leslie Rydberg","doi":"10.1111/ctr.70432","DOIUrl":"10.1111/ctr.70432","url":null,"abstract":"<div>\u0000 \u0000 <p>Liver transplantation is the definitive treatment for individuals with end-stage liver disease. However, a range of medical and physical complications frequently arise following transplantation, which can hinder a patient's overall recovery. Post-operative rehabilitation is often necessary to support and enhance functional outcomes. This review explores the role of early mobilization and inpatient rehabilitation, outlines the rehabilitation process, defines the role of the physiatrist and the interdisciplinary rehabilitation team, and examines the potential functional gains for liver transplant recipients who undergo inpatient rehabilitation.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917220","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}