Pub Date : 2024-09-06DOI: 10.1016/j.ajt.2024.09.002
Jesse D Schold, Timothy L Pruett, Elizabeth A Pomfret, Ty Dunn
The American Transplant Congress (ATC) is the largest national transplant meeting in the United States jointly sponsored by the American Society of Transplantation and the American Society of Transplant Surgeons. The 2024 ATC was held in Philadelphia, Pennsylvania during which a number of peer-reviewed scientific abstracts were censored from the program by the Health Resources and Services Administration (HRSA). These abstract presentations were redacted from the program for perceived conflict with current government policy effectively restricting dissemination of highly rated findings and discussion in a scientific forum. In this viewpoint we describe the content of the abstracts that were withdrawn from the annual ATC meeting and the implications of this censorship by HRSA. We further consider the ramifications of this action for prospective evaluation of government policy and the relationship of the contract agency with the transplant community in the context of ongoing discussions of modernizing the transplant system which has previously been critiqued for lack of transparency.
{"title":"The Dangerous Precedent of Censoring Scientific Dissemination.","authors":"Jesse D Schold, Timothy L Pruett, Elizabeth A Pomfret, Ty Dunn","doi":"10.1016/j.ajt.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.09.002","url":null,"abstract":"<p><p>The American Transplant Congress (ATC) is the largest national transplant meeting in the United States jointly sponsored by the American Society of Transplantation and the American Society of Transplant Surgeons. The 2024 ATC was held in Philadelphia, Pennsylvania during which a number of peer-reviewed scientific abstracts were censored from the program by the Health Resources and Services Administration (HRSA). These abstract presentations were redacted from the program for perceived conflict with current government policy effectively restricting dissemination of highly rated findings and discussion in a scientific forum. In this viewpoint we describe the content of the abstracts that were withdrawn from the annual ATC meeting and the implications of this censorship by HRSA. We further consider the ramifications of this action for prospective evaluation of government policy and the relationship of the contract agency with the transplant community in the context of ongoing discussions of modernizing the transplant system which has previously been critiqued for lack of transparency.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1016/j.ajt.2024.09.001
{"title":"Updated Seasonal Influenza and RSV Vaccine Recommendations of the Advisory Committee on Immunization Practices - 2024.","authors":"","doi":"10.1016/j.ajt.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.09.001","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.07.032
{"title":"Impact of short-term vegan versus ketogenic diets on human immunity and microbiome","authors":"","doi":"10.1016/j.ajt.2024.07.032","DOIUrl":"10.1016/j.ajt.2024.07.032","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613524004593/pdfft?md5=55bf313fbb30c2d6c892e607cef477ed&pid=1-s2.0-S1600613524004593-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.04.013
Obesity is a risk factor for kidney, liver, heart, and pulmonary diseases, as well as failure. Solid organ transplantation remains the definitive treatment for the end-stage presentation of these diseases. Among many criteria for organ transplant, efficient management of obesity is required for patients to acquire transplant eligibility. End-stage organ failure and obesity are 2 complex pathologies that are often entwined. Metabolic and bariatric surgery before, during, or after organ transplant has been studied to determine the long-term effect of bariatric surgery on transplant outcomes. In this review, a multidisciplinary group of surgeons from the Society of American Gastrointestinal and Endoscopic Surgeons and the American Society for Transplant Surgery presents the current published literature on metabolic and bariatric surgery as a therapeutic option for patients with obesity awaiting solid organ transplantation. This manuscript details the most recent recommendations, pharmacologic considerations, and psychological considerations for this specific cohort of patients. Since level one evidence is not available on many of the topics covered by this review, expert opinion was implemented in several instances. Additional high-quality research in this area will allow for better recommendations and, therefore, treatment strategies for these complex patients.
{"title":"Obesity, organ failure, and transplantation: A review of the role of metabolic and bariatric surgery in transplant candidates and recipients","authors":"","doi":"10.1016/j.ajt.2024.04.013","DOIUrl":"10.1016/j.ajt.2024.04.013","url":null,"abstract":"<div><p>Obesity is a risk factor for kidney, liver, heart, and pulmonary diseases, as well as failure. Solid organ transplantation remains the definitive treatment for the end-stage presentation of these diseases. Among many criteria for organ transplant, efficient management of obesity is required for patients to acquire transplant eligibility. End-stage organ failure and obesity are 2 complex pathologies that are often entwined. Metabolic and bariatric surgery before, during, or after organ transplant has been studied to determine the long-term effect of bariatric surgery on transplant outcomes. In this review, a multidisciplinary group of surgeons from the Society of American Gastrointestinal and Endoscopic Surgeons and the American Society for Transplant Surgery presents the current published literature on metabolic and bariatric surgery as a therapeutic option for patients with obesity awaiting solid organ transplantation. This manuscript details the most recent recommendations, pharmacologic considerations, and psychological considerations for this specific cohort of patients. Since level one evidence is not available on many of the topics covered by this review, expert opinion was implemented in several instances. Additional high-quality research in this area will allow for better recommendations and, therefore, treatment strategies for these complex patients.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613524002843/pdfft?md5=b8a42874148d5539868a4eb2dcc71441&pid=1-s2.0-S1600613524002843-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.03.034
Biopsy-based transcript diagnostics may identify molecular antibody-mediated rejection (AMR) when microvascular inflammation (MVI) is absent. In this single-center cohort, biopsy-based transcript diagnostics were validated in 326 kidney allograft biopsies. A total of 71 histological AMR and 35 T cell–mediated rejection (TCMR) cases were identified as molecular AMR and TCMR in 55% and 63%, respectively. Among 121 cases without MVI (glomerulitis + peritubular capillaritis = 0), 45 (37%) donor-specific antibody (DSA)-positive and 76 (63%) DSA-negative cases were analyzed. Twenty-one out of the 121 (17%) cases showed borderline changes, or TCMR, while BK nephropathy was excluded. None of the 45 DSA-positive patients showed molecular AMR. Among 76 DSA-negative patients, 2 had mixed molecular AMR/TCMR. All-AMR phenotype scores (sum of R4-R6) exhibited median values of 0.13 and 0.12 for DSA-positive and DSA-negative patients, respectively (P = .84). A total of 13% (6/45) DSA-positive and 11% (8/76) DSA-negative patients showed an all-AMR phenotype score > 0.30 (P = .77). Patients with a higher all-AMR phenotype score showed 33% more histologic TCMR (P = .005). The median all-AMR phenotype scores of glomerular basement membrane double contours = 0 and glomerular basement membrane double contours > 0 biopsies were 0.12 and 0.10, respectively (P = .35). Biopsy-based transcript diagnostics did not identify molecular AMR in cases without MVI. Follow-up biopsies and outcome data should evaluate the clinical relevance of subthreshold molecular alterations.
{"title":"Molecular diagnosis of antibody-mediated rejection: Evaluating biopsy-based transcript diagnostics in the presence of donor-specific antibodies but without microvascular inflammation, a single-center descriptive analysis","authors":"","doi":"10.1016/j.ajt.2024.03.034","DOIUrl":"10.1016/j.ajt.2024.03.034","url":null,"abstract":"<div><p><span><span><span>Biopsy-based transcript diagnostics may identify molecular antibody-mediated rejection (AMR) when microvascular inflammation (MVI) is absent. In this single-center cohort, biopsy-based transcript diagnostics were validated in 326 kidney allograft biopsies. A total of 71 histological AMR and 35 T cell–mediated rejection (TCMR) cases were identified as molecular AMR and TCMR in 55% and 63%, respectively. Among 121 cases without MVI (glomerulitis + peritubular </span>capillaritis = 0), 45 (37%) donor-specific antibody (DSA)-positive and 76 (63%) DSA-negative cases were analyzed. Twenty-one out of the 121 (17%) cases showed borderline changes, or TCMR, while BK </span>nephropathy was excluded. None of the 45 DSA-positive patients showed molecular AMR. Among 76 DSA-negative patients, 2 had mixed molecular AMR/TCMR. All-AMR phenotype scores (sum of R4-R6) exhibited median values of 0.13 and 0.12 for DSA-positive and DSA-negative patients, respectively (</span><em>P</em> = .84). A total of 13% (6/45) DSA-positive and 11% (8/76) DSA-negative patients showed an all-AMR phenotype score > 0.30 (<em>P</em> = .77). Patients with a higher all-AMR phenotype score showed 33% more histologic TCMR (<em>P</em><span> = .005). The median all-AMR phenotype scores of glomerular basement membrane double contours = 0 and glomerular basement membrane double contours > 0 biopsies were 0.12 and 0.10, respectively (</span><em>P</em> = .35). Biopsy-based transcript diagnostics did not identify molecular AMR in cases without MVI. Follow-up biopsies and outcome data should evaluate the clinical relevance of subthreshold molecular alterations.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.03.013
The imbalance between organ supply and demand continues to limit the broader benefits of organ transplantation. Machine perfusion (MP) may increase the supply of donor livers by expanding the use of extended-criteria donors. Using the United Network for Organ Sharing/Organ Procurement and Transplantation Network and the Standard Transplant Analysis and Research dataset, we reviewed the effect of MP implementation on the behavior of transplant centers. We identified 15 high-utilizing MP centers that were matched to suitable controls based on volume and geographical proximity. We conducted a differences-in-differences analysis using linear regression to estimate the impact of MP adoption on the transplant centers’ donor utilization. We found a significant increase in cold ischemia time and organs with donor warm ischemia time over 30 minutes (P < .05). After removing one outlier center, the analysis showed that these centers through MP accepted overall more donation after circulatory death donors, donation after circulatory death donors over 50 years old, donors with macrovesicular steatosis greater than 30% on liver biopsy, and donor warm ischemia time over 30 minutes (P < .05). MP has allowed centers to expand their use of extended-criteria donors beyond traditional cutoffs and to increase patient access to liver transplantation.
{"title":"Liver machine perfusion technology: Expanding the donor pool to improve access to liver transplantation","authors":"","doi":"10.1016/j.ajt.2024.03.013","DOIUrl":"10.1016/j.ajt.2024.03.013","url":null,"abstract":"<div><p>The imbalance between organ supply and demand continues to limit the broader benefits of organ transplantation. Machine perfusion (MP) may increase the supply of donor livers by expanding the use of extended-criteria donors. Using the United Network for Organ Sharing/Organ Procurement and Transplantation Network and the Standard Transplant Analysis and Research dataset, we reviewed the effect of MP implementation on the behavior of transplant centers. We identified 15 high-utilizing MP centers that were matched to suitable controls based on volume and geographical proximity. We conducted a differences-in-differences analysis using linear regression to estimate the impact of MP adoption on the transplant centers’ donor utilization. We found a significant increase in cold ischemia time and organs with donor warm ischemia time over 30 minutes (<em>P</em> < .05). After removing one outlier center, the analysis showed that these centers through MP accepted overall more donation after circulatory death donors, donation after circulatory death donors over 50 years old, donors with macrovesicular steatosis greater than 30% on liver biopsy, and donor warm ischemia time over 30 minutes (<em>P</em> < .05). MP has allowed centers to expand their use of extended-criteria donors beyond traditional cutoffs and to increase patient access to liver transplantation.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613524002090/pdfft?md5=2cca62eb503bc1f1ac3e1c2dbf908995&pid=1-s2.0-S1600613524002090-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140173422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.05.003
The strategy for progressive multifocal leukoencephalopathy (PML) in solid organ transplant recipients primarily focuses on reducing immunosuppressive therapy. However, this approach offers limited efficacy and carries a high risk of graft loss. Here, we present the case of a 64-year-old male kidney transplant recipient with a high degree of immunosuppression who developed PML in October 2022. Despite the standard reduction of immunosuppressive therapy, the patient’s condition continued to deteriorate, as evidenced by worsening neurological symptoms and increasing JC virus (JCV) DNA levels in cerebrospinal fluid. This prompted the innovative use of BKPyV-virus–specific T cell (BKPyV-VST) therapy, given the genetic similarities between BK and JCVs. Infusion of third-party donor BKPyV-VST resulted in clinical stabilization, a significant reduction in JCV-DNA levels, and the emergence of a JCV-specific T cell response, as observed in enzyme-linked immunospot assays and TCRβ sequencing. This represents the first case report of successful third-party BKPyV-VST therapy in a kidney recipient presenting PML, without graft-versus-host disease or graft dysfunction.
实体器官移植受者进行性多灶性白质脑病(PML)的治疗策略主要是减少免疫抑制治疗。然而,这种方法的疗效有限,且存在移植物丢失的高风险。在此,我们介绍了一例 64 岁的男性肾移植受者,他患有高度免疫抑制,于 2022 年 10 月患上了 PML。尽管按照标准减少了免疫抑制治疗,但患者的病情持续恶化,表现为神经系统症状恶化和脑脊液中JC病毒DNA水平升高。鉴于 BK 病毒和 JC 病毒在基因上的相似性,这促使我们创新性地使用了 BKPyV 特异性 T 细胞(BKPyV -VST)疗法。输注第三方供体 BKPyV -VST 后,患者的临床症状趋于稳定,JCV DNA 水平显著降低,并出现了 JC 病毒特异性 T 细胞应答,这一点在 ELISpot 检测和 TCRβ 测序中均有观察到。这是首例成功治疗出现 PML 的肾脏受者的第三方 BKPyV -VST 特异性疗法的病例报告,患者没有出现移植物抗宿主疾病或移植物功能障碍。
{"title":"Successful BK virus–specific T cell therapy in a kidney transplant recipient with progressive multifocal leukoencephalopathy","authors":"","doi":"10.1016/j.ajt.2024.05.003","DOIUrl":"10.1016/j.ajt.2024.05.003","url":null,"abstract":"<div><p><span><span>The strategy for progressive multifocal leukoencephalopathy<span> (PML) in solid organ transplant recipients primarily focuses on reducing </span></span>immunosuppressive therapy<span><span>. However, this approach offers limited efficacy and carries a high risk of graft loss. Here, we present the case of a 64-year-old male </span>kidney transplant<span> recipient with a high degree of immunosuppression<span> who developed PML in October 2022. Despite the standard reduction of immunosuppressive therapy, the patient’s condition continued to deteriorate, as evidenced by worsening </span></span></span></span>neurological symptoms<span> and increasing JC virus<span> (JCV) DNA levels in cerebrospinal fluid. This prompted the innovative use of BKPyV-virus–specific T cell<span> (BKPyV-VST) therapy, given the genetic similarities between BK and JCVs. Infusion of third-party donor BKPyV-VST resulted in clinical stabilization, a significant reduction in JCV-DNA levels, and the emergence of a JCV-specific T cell response<span>, as observed in enzyme-linked immunospot assays and TCRβ sequencing. This represents the first case report of successful third-party BKPyV-VST therapy in a kidney recipient presenting PML, without graft-versus-host disease or graft dysfunction.</span></span></span></span></p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.02.014
In kidney transplant recipients, delayed graft function increases the risk of graft failure and mortality. In a phase 3, randomized, double-blind, placebo-controlled trial, we investigated the hepatocyte growth factor mimetic, ANG-3777 (once daily for 3 consecutive days, starting ≤30 hours posttransplant), in 248 patients receiving a first kidney transplant from a deceased donor. At day 360, estimated glomerular filtration rate (primary endpoint) was not significantly different between the ANG-3777 and placebo groups. There were no significant between-group differences in the duration of dialysis through day 30 or in the percentage of patients with an estimated glomerular filtration rate of >30 mL/min/1.73 m2 at day 360. The incidence of both delayed graft function and acute rejection was similar between ANG-3777 and placebo groups (68.5% vs 69.4% and 8.1% vs 6.5%, respectively). ANG-3777 was well tolerated, and there was a numerically lower incidence of graft failure versus placebo (3.2% vs 8.1%). Although there is insufficient evidence to support an indication of ANG-3777 for patients at risk of renal dysfunction after deceased-donor kidney transplantation, these findings indicate potential biological activity that may warrant further investigation.
在肾移植受者中,移植功能延迟(DGF)会增加移植失败和死亡的风险。在一项 3 期随机、双盲、安慰剂对照试验中,我们研究了肝细胞生长因子模拟物 ANG-3777(每天一次,连续 3 天,从移植后≤30 小时开始)在 248 名接受首次肾移植的已故供体患者中的应用情况。第 360 天时,ANG-3777 组和安慰剂组的估计肾小球滤过率(eGFR;主要终点)无显著差异。在第 30 天之前的透析持续时间或第 360 天时 eGFR >30 mL/min/1.73m2 的患者比例方面,组间差异不明显。ANG-3777组和安慰剂组的DGF和急性排斥反应发生率相似(分别为68.5% vs 69.4%和8.1% vs 6.5%)。ANG-3777的耐受性良好,移植失败的发生率比安慰剂低(3.2% vs 8.1%)。虽然目前还没有足够的证据支持将 ANG-3777 用于死体供肾移植后有肾功能障碍风险的患者,但这些研究结果表明它具有潜在的生物活性,值得进一步研究。Clinicaltrials.gov 编号:NCT02474667:NCT02474667。
{"title":"The hepatocyte growth factor mimetic, ANG-3777, in kidney transplant recipients with delayed graft function: Results from a randomized phase 3 trial","authors":"","doi":"10.1016/j.ajt.2024.02.014","DOIUrl":"10.1016/j.ajt.2024.02.014","url":null,"abstract":"<div><p>In kidney transplant recipients, delayed graft function increases the risk of graft failure and mortality. In a phase 3, randomized, double-blind, placebo-controlled trial, we investigated the hepatocyte growth factor mimetic, ANG-3777 (once daily for 3 consecutive days, starting ≤30 hours posttransplant), in 248 patients receiving a first kidney transplant from a deceased donor. At day 360, estimated glomerular filtration rate (primary endpoint) was not significantly different between the ANG-3777 and placebo groups. There were no significant between-group differences in the duration of dialysis through day 30 or in the percentage of patients with an estimated glomerular filtration rate of >30 mL/min/1.73 m<sup>2</sup> at day 360. The incidence of both delayed graft function and acute rejection was similar between ANG-3777 and placebo groups (68.5% vs 69.4% and 8.1% vs 6.5%, respectively). ANG-3777 was well tolerated, and there was a numerically lower incidence of graft failure versus placebo (3.2% vs 8.1%). Although there is insufficient evidence to support an indication of ANG-3777 for patients at risk of renal dysfunction after deceased-donor kidney transplantation, these findings indicate potential biological activity that may warrant further investigation.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613524001564/pdfft?md5=41d8399a0e2834717bc77fb499a4713a&pid=1-s2.0-S1600613524001564-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139928995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.05.004
{"title":"Genetic ancestry, proportion of African ancestry, and apolipoprotein L1 risk variants in kidney recipients","authors":"","doi":"10.1016/j.ajt.2024.05.004","DOIUrl":"10.1016/j.ajt.2024.05.004","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613524002983/pdfft?md5=457bf2a131befa762b6a4d9bf6fdd858&pid=1-s2.0-S1600613524002983-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.ajt.2024.06.001
Postacute sequelae after the coronavirus disease (COVID) of 2019 (PASC) is increasingly recognized, although data on solid organ transplant (SOT) recipients (SOTRs) are limited. Using the National COVID Cohort Collaborative, we performed 1:1 propensity score matching (PSM) of all adult SOTR and nonimmunosuppressed/immunocompromised (ISC) patients with acute COVID infection (August 1, 2021 to January 13, 2023) for a subsequent PASC diagnosis using International Classification of Diseases, 10th Revision, Clinical Modification codes. Multivariable logistic regression was used to examine not only the association of SOT status with PASC, but also other patient factors after stratifying by SOT status. Prior to PSM, there were 8769 SOT and 1 576 769 non-ISC patients with acute COVID infection. After PSM, 8756 SOTR and 8756 non-ISC patients were included; 2.2% of SOTR (n = 192) and 1.4% (n = 122) of non-ISC patients developed PASC (P value < .001). In the overall matched cohort, SOT was independently associated with PASC (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.09-2.01). Among SOTR, COVID infection severity (aOR, 11.6; 95% CI, 3.93-30.0 for severe vs mild disease), older age (aOR, 1.02; 95% CI, 1.01-1.03 per year), and mycophenolate mofetil use (aOR, 2.04; 95% CI, 1.38-3.05) were each independently associated with PASC. In non-ISC patients, only depression (aOR, 1.96; 95% CI, 1.24-3.07) and COVID infection severity were. In conclusion, PASC occurs more commonly in SOTR than in non-ISC patients, with differences in risk profiles based on SOT status.
尽管实体器官移植受者(SOTR)的数据有限,但COVID-19(PASC)后急性后遗症已被越来越多的人所认识。我们使用 N3C 对所有急性 COVID(08-01-2021 至 01-13-2023)成人 SOTR 和非免疫抑制/免疫受损 (ISC) 患者进行了 1:1 倾向得分匹配 (PSM),并使用 ICD-10-CM 编码对随后的 PASC 诊断进行了匹配。采用多变量逻辑回归检验 SOT 状态与 PASC 的相关性,以及按 SOT 状态分层后的其他患者因素。在 PSM 之前,共有 8,769 名 SOT 患者和 1,576,769 名非 SOT 患者患有急性 COVID。PSM 后,纳入了 8,756 名 SOT 患者和 8,756 名非 SOT 患者;2.2% 的 SOT 患者(n=192)和 1.4%的非 SOT 患者(n=122)发展为 PASC(P-value
{"title":"The prevalence of postacute sequelae of coronavirus disease 2019 in solid organ transplant recipients: Evaluation of risk in the National COVID Cohort Collaborative","authors":"","doi":"10.1016/j.ajt.2024.06.001","DOIUrl":"10.1016/j.ajt.2024.06.001","url":null,"abstract":"<div><p><span><span><span>Postacute sequelae<span> after the coronavirus disease (COVID) of 2019 (PASC) is increasingly recognized, although data on solid organ transplant (SOT) recipients (SOTRs) are limited. Using the National COVID Cohort Collaborative, we performed 1:1 </span></span>propensity score matching (PSM) of all adult SOTR and nonimmunosuppressed/immunocompromised (ISC) patients with acute COVID infection (August 1, 2021 to January 13, 2023) for a subsequent </span>PASC<span><span> diagnosis using International Classification of Diseases, 10th Revision, Clinical Modification codes. Multivariable logistic regression was used to examine not only the association of SOT status with </span>PASC, but also other patient factors after stratifying by SOT status. Prior to PSM, there were 8769 SOT and 1 576 769 non-ISC patients with acute COVID infection. After PSM, 8756 SOTR and 8756 non-ISC patients were included; 2.2% of SOTR (n = 192) and 1.4% (n = 122) of non-ISC patients developed PASC (</span></span><em>P</em><span> value < .001). In the overall matched cohort, SOT was independently associated with PASC (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.09-2.01). Among SOTR, COVID infection severity (aOR, 11.6; 95% CI, 3.93-30.0 for severe vs mild disease), older age (aOR, 1.02; 95% CI, 1.01-1.03 per year), and mycophenolate mofetil use (aOR, 2.04; 95% CI, 1.38-3.05) were each independently associated with PASC. In non-ISC patients, only depression (aOR, 1.96; 95% CI, 1.24-3.07) and COVID infection severity were. In conclusion, PASC occurs more commonly in SOTR than in non-ISC patients, with differences in risk profiles based on SOT status.</span></p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":8.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}