Transplantation proceedings最新文献

{"title":"Factors Associated With Intraoperative Blood Loss in Living Donor Liver Transplantation","authors":"Kaoru Umehara ,&nbsp;Kazuhiro Shirozu ,&nbsp;Ken Yamaura","doi":"10.1016/j.transproceed.2025.11.007","DOIUrl":"10.1016/j.transproceed.2025.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Although several studies have assessed factors associated with intraoperative blood loss (IBL) during liver transplantation, most have been conducted on brain-dead donors, with few studies on living donors that have reported inconsistent findings. This study retrospectively investigated factors associated with IBL in living-donor liver transplantation (LDLT).</div></div><div><h3>Methods</h3><div>This study included 250 patients aged ≥20 years who underwent LDLT at our institution between January 2013 and September 2018. IBL, obtained from anesthetic records, was subjected to log-transformation and analyzed using a general linear regression model. The backward method was used for variable selection and the values were exponentially transformed to describe the results.</div></div><div><h3>Results</h3><div>Multivariable analysis revealed that male sex (vs female, 1.37-fold, 95% confidence interval (CI): 1.14-1.66), body mass index (BMI) (1.05-fold for every 1 kg/m² increase, 95% CI: 1.03-1.08), platelet count (0.98-fold for every 10,000/µL increase, 95% CI: 0.96-0.99), white blood cell (WBC) count (1.04-fold for every 1000/µL increase, 95% CI: 1.002-1.08), serum sodium ion (Na⁺) levels (0.96-fold for every 1 mEq/L increase, 95% CI: 0.94-0.98), serum total protein (TP) (0.88-fold for every 1 g/dL increase, 95% CI: 0.79-0.98), and use of a venous bypass (vs nonuse, 1.96-fold, 95% CI: 1.01-3.73) were significantly associated with IBL.</div></div><div><h3>Conclusions</h3><div>Male sex, high BMI, low platelet count, high WBC count, low Na⁺ levels, low TP levels, and the use of venous bypass can lead to excessive IBL during LDLT. Preoperative assessment of these factors is crucial for perioperative management.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 145-150"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919574","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":"Outcomes of Biliary Complications in Pediatric Liver Transplantation: Is There a Role of Anastomosis Type and Epstein–Barr Virus Viremia?","authors":"Cansu Altuntaş ,&nbsp;Alaaddin Aydın ,&nbsp;Ali Koçyiğit ,&nbsp;Eryiğit Eren ,&nbsp;Fatih Ensaroğlu ,&nbsp;Mehmet Tokaç ,&nbsp;Gülden Özek ,&nbsp;Taylan Şahin ,&nbsp;Ayhan Dinçkan","doi":"10.1016/j.transproceed.2025.11.004","DOIUrl":"10.1016/j.transproceed.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Biliary complications remain a common adverse event after pediatric liver transplantation, with distinct etiologies and management approaches based on timing. This study aimed to evaluate the incidence, risk factors, and outcomes of early and late biliary complications in a high-volume living donor pediatric liver transplant center.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 98 pediatric liver transplantations performed between January 2018 and February 2024. Biliary complications were categorized as early (≤90 days) or late (&gt;90 days) post-transplant. Risk factors were assessed using univariate and multivariable logistic regression models. The impact of biliary complications on overall survival was also evaluated.</div></div><div><h3>Results</h3><div>Biliary complications occurred in 34.6% (n = 34) of cases. Early complications (19.4%, n = 19) were predominantly bile leaks, with duct-to-duct anastomosis identified as an independent risk factor (OR: 5.179, 95% CI: 1.511-17.756). Late complications (15.3%, n = 15) were primarily biliary strictures. Older recipient age and EBV viremia emerged as significant independent risk factors for late biliary complications (OR: 1.140 and OR: 60.793, respectively). No significant difference in overall survival was observed between patients with and without biliary complications (<em>P</em> = .158).</div></div><div><h3>Conclusion</h3><div>Duct-to-duct anastomosis remains a safe and reliable option in anatomically suitable pediatric cases when performed by experienced teams, despite a higher risk of early complications. EBV viremia and increased recipient age are significant predictors of late biliary strictures. These findings emphasize the need for vigilant surveillance, individualized transplant timing, and standardized EBV management strategies to reduce long-term biliary morbidity.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 137-144"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919587","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":"Single Center Retrospective Comparison of Post-Transplant Cyclophosphamide and Standard Graft-Versus-Host Disease Prophylaxis in Matched Donor Allogeneic Transplantation","authors":"Haein Kim ,&nbsp;Akil Merchant ,&nbsp;Justin Darrah ,&nbsp;Joshua Sasine ,&nbsp;Hannah Lee ,&nbsp;Robert Vescio ,&nbsp;David Oveisi ,&nbsp;Brittany McGalliard ,&nbsp;Yuliya Linhares ,&nbsp;Ali Rejali ,&nbsp;Patricia Van Strein ,&nbsp;Ellen Klapper ,&nbsp;Behrooz Hekimian ,&nbsp;John Chute ,&nbsp;Ron Paquette ,&nbsp;Noah Merin","doi":"10.1016/j.transproceed.2025.12.008","DOIUrl":"10.1016/j.transproceed.2025.12.008","url":null,"abstract":"<div><h3>Background</h3><div>Post-transplant cyclophosphamide (PTCy) was developed to allow the use of haploidentical donors for allogeneic stem cell transplantation (alloHSCT), then tested with matched donors. Cedars-Sinai Medical Center Blood and Marrow Transplant was an early adopter of PTCy for matched alloHSCT in 2016.</div></div><div><h3>Purpose of the Research</h3><div>We retrospectively analyzed 15-year outcomes of patients who underwent alloHSCT with matched donor stem cells prior to 2016 (n = 252), with the outcomes of patients who were transplanted in the PTCy era, post-2016 (n = 99), to assess the impact of the switch to PTCy, while controlling for other differences between the cohorts.</div></div><div><h3>Principle Results</h3><div>Overall Survival (OS) was better in the PTCy group (at 1 year, 90% vs 62%, <em>P</em> &lt; .0001), and the difference persisted in OS at 2 years and 3 years. There was no difference in relapse (26% non-PTCy vs 19% PTCy; <em>P</em> = .3560). Non-relapse mortality was lower with PTCy, 7% vs 22% without, <em>P</em> = .0002. Acute GVHD was lower in the PTCy group (16% PTCy vs 33% non-PTCy, <em>P</em> = .0013). Chronic GVHD was similar between the two groups, 35% in the PTCy group and 42% in the non-PTCy group (<em>P</em> = .1235), but the rate of extensive cGVHD was lower, 15% with PTCy vs 29% without; <em>P</em> = .0078. Post-transplant hospital stay was shorter, 23 ± 13.1 days in the non-PTCy group and 18 ± 7.0 days with PTCy, <em>P</em> &lt; .0001.</div></div><div><h3>Conclusions</h3><div>Long-term follow up of patients transplanted using PTCy with matched donors has demonstrated superiority of PTCy compared to tacrolimus methotrexate.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 207-218"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947017","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":"Thymoglobulin Induction Therapy in Kidney Transplant Patients Receiving Organs Donated after Cardiac Death in China: A Real-World Patient-Level Pooled Analysis of the T-DCD and Start-DCD Studies","authors":"Yang Li,&nbsp;Wujun Xue","doi":"10.1016/j.transproceed.2025.11.002","DOIUrl":"10.1016/j.transproceed.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Thymoglobulin is used in kidney transplantation as an induction therapy to prevent acute rejections; however, studies and data to support thymoglobulin induction therapy in Chinese patients undergoing kidney transplant with donation after cardiac death (DCD) kidneys remain unclear. Therefore, we investigated the clinical outcomes of thymoglobulin induction therapy in recipients of DCD kidney transplant in real-world clinical practice.</div></div><div><h3>Methods</h3><div>This pooled analysis from the T-DCD and START-DCD studies was conducted to investigate acute rejection (AR), biopsy-proven AR (BPAR), delayed graft function (DGF), and graft and patient survival at 6 months in patients undergoing DCD kidney transplantation in the pooled population, in subgroups receiving thymoglobulin doses of &lt;4 mg/kg and ≥4 mg/kg, and in subgroups receiving thymoglobulin doses of &lt;1.5 mg/kg, 1.5 mg/kg to 4 mg/kg, and ≥4 mg/kg. Possible risk factors for AR, BPAR, DGF, graft survival, and patient survival were investigated as well.</div></div><div><h3>Results</h3><div>A total of 458 patients were included in this study. The incidence of AR within 6 months was 8% (n = 10) in patients receiving &lt;4 mg/kg of thymoglobulin and 10.5% (n = 35) in those receiving ≥4 mg/kg. The dose-dependent incidence of BPAR was 3.1% in patients receiving a thymoglobulin dose &lt;1.5 mg/kg, 2.3% in those receiving 1.5 to 4 mg/kg, and 1.6% in those receiving ≥4 mg/kg. In these 3 subgroups, a statistically significant reduction in DGF incidence (<em>P</em> = .023) was observed in 21.9%, 15.9%, and 7.2% of patients, respectively. The overall graft survival and patient survival rates at 6 months were 98% and 99.56%, respectively. The possible risk factors for AR were donor or recipient age, those for DGF were baseline creatinine and dosage, and those for graft survival were donor body mass index, warm ischemia time, thymoglobulin dosage, and donor history of cardiopulmonary resuscitation.</div></div><div><h3>Conclusion</h3><div>Based on a pooled analysis of the T-DCD and START-DCD data in Chinese patients, treatment with thymoglobulin as an induction therapy has shown greater dose-dependent protection against DGF within 6 months after kidney transplantation. The higher thymoglobulin dose did not prolong the duration or reduce the incidence of AR and BPAR and showed no significant effect on graft survival or patient survival within 6 months of transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 28-36"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968174","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":"Mortality Estimation in Renal Disease (MERD Score): A Model Predicting Waitlist Mortality in Kidney Transplant Candidates","authors":"Aisha Albu Mustaf ,&nbsp;Jose Ramirez ,&nbsp;Ashley Montgomery ,&nbsp;Gwendolyn Henry ,&nbsp;Abbas Rana","doi":"10.1016/j.transproceed.2025.11.010","DOIUrl":"10.1016/j.transproceed.2025.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Predicting waitlist mortality is important for prioritizing organ allocation and selecting candidates for extended criteria donors. Currently, there is no widely adopted and reliable index for predicting early mortality among kidney transplant candidates. In this study, we aim to develop an index score utilizing variables from the OPTN database to predict mortality among adult kidney transplant candidates within 3 years of being on the waitlist.</div></div><div><h3>Methods</h3><div>This study utilized data from 147,307 adult kidney transplant candidates listed in the OPTN database from 2018 to 2023. The cohort was randomly divided into training and validation groups. Sixteen variables were analyzed using univariate logistic regression, with significant factors incorporated into a multivariable analysis to develop the MERD (Mortality Estimation in Renal Disease) score. Predictive performance was assessed through ROC analysis in both cohorts.</div></div><div><h3>Results</h3><div><u>T</u>en variables, age, ABO blood type, ethnicity, dialysis duration, presence of peripheral vascular disease, albumin level, functional status, Previous kidney malignancy, primary etiologies of kidney disease, and insurance type were identified as significant predictors and used to formulate the MERD score. The AUC was 0.6657 in the training cohort and 0.6580 in the validation cohort.</div></div><div><h3>Conclusion</h3><div>The MERD score provides proof of concept for short-term mortality prediction for kidney transplant waitlist candidates. Further prospective validation and model refinement are warranted.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 83-93"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947043","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":"Changes in Patient Symptoms After Kidney Transplantation","authors":"Catherine P. King ,&nbsp;Amelia R. Cossart ,&nbsp;Nicole M. Isbel ,&nbsp;Scott B. Campbell ,&nbsp;Meng-Wong Taing ,&nbsp;Diana Leary ,&nbsp;Vincent Houlihan ,&nbsp;Christine E. Staatz","doi":"10.1016/j.transproceed.2025.11.005","DOIUrl":"10.1016/j.transproceed.2025.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Immunosuppressant usage in kidney transplant recipients is commonly associated with toxicity which can manifest in a variety of adverse effects. This study aimed to compare the nature and frequency of patient-reported symptoms before and after kidney transplantation.</div></div><div><h3>Methods</h3><div>A single-center study was conducted involving adult kidney transplant recipients at 3 to 11 weeks post-transplantation. Patients completed a questionnaire pertaining to the prevalence of symptoms experienced a few months before and since transplantation. A paired Student’s t-test and Wilcoxon signed-rank tests were used to identify changes in the number and frequency of symptoms, respectively, with a <em>p</em>-value &lt;.05 considered statistically significant.</div></div><div><h3>Results</h3><div>Eighty patients completed this non-interventional study. While a similar number of symptoms (mean ± standard deviation) were experienced before and after transplantation (9.9 ± 4.8 and 9.0 ± 4.7, respectively; <em>p</em> = .098) there was a shift in the frequency of symptoms. Since transplantation, there was an improvement (reduced frequency) in itch (<em>p</em> ≤ .001), tiredness/fatigue (<em>p</em> = .045), nausea (<em>p</em> ≤ .001), headache/migraine (<em>p</em> ≤ .001), fidgetiness/restlessness (<em>p</em> = .018) and mind going blank (<em>p</em> = .022). However, hand tremor (<em>p</em> ≤.001), tremor elsewhere (<em>p</em> ≤.001), waking at night (<em>p</em> ≤.001), and dysesthesia (thermodysregulation and paresthesia) (<em>p</em> = .008) worsened (increased frequency), as reported by 75%, 26%, 45%, and 38% of patients, respectively.</div></div><div><h3>Conclusion</h3><div>Many patients experience tremor and dysesthesia as new symptoms or report them more frequently early after transplantation. Further research into understanding and managing these toxicities over this period is warranted.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 58-65"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947052","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":"Fospropofol Disodium for Anesthesia Induction in Liver Transplant Recipients - A Case Series","authors":"Rong Wang ,&nbsp;Xiaojuan Jiang ,&nbsp;Weiyi Zhang","doi":"10.1016/j.transproceed.2025.11.011","DOIUrl":"10.1016/j.transproceed.2025.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Fospropofol disodium for injection (Fospropofol_FD) is a novel water-soluble propofol prodrug metabolized by alkaline phosphatase (ALP). In contrast to propofol, it demonstrates superior hemodynamic stability and reduced lipid metabolism-related adverse effects in patients with normal hepatic function. These characteristics hold particular significance for liver transplant recipients with decompensated cirrhosis, who frequently exhibit hemodynamic instability and impaired lipid homeostasis. However, clinical evidence supporting the use of Fospropofol_FD in this high-risk population remains lacking. This case series aims to evaluate the potential advantages of Fospropofol_FD for anesthesia induction in liver transplant recipients with Child-Pugh B/C cirrhosis.</div></div><div><h3>Methods</h3><div>In this prospective observational study, three cirrhotic patients (Model for End-stage Liver Disease scores: 22-38) were administered Fospropofol_FD-based induction (10 mg/kg) during liver transplantation. Hemodynamics, bispectral index (BIS), and perioperative organ function were monitored.</div></div><div><h3>Results</h3><div>All patients achieved rapid induction (≤1 minute) with stable hemodynamics (mean arterial pressure ≥60 mm Hg) and BIS &lt;60. No intraoperative hypoxemia or delayed awakening occurred. Postoperative hepatic/renal function remained stable, with extubation completed ≤10 minutes. Diverging from reports in non-cirrhotic cohorts, we found that ALP levels did not correlate with BIS trends, suggesting multifactorial influences on pharmacokinetics in end-stage liver disease.</div></div><div><h3>Conclusion</h3><div>Although these findings highlight Fospropofol_FD’s potential as a lipid-free alternative to propofol in high-risk liver transplant settings, the observational design and small sample size (n = 3) warrant further validation through randomized controlled trials to establish dosing protocols and confirm safety and efficacy.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 114-118"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947058","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":"Evaluating the Use of Hepatitis B Immunoglobulin After Liver Transplant","authors":"Ella Shanahan,&nbsp;Trana Hussaini,&nbsp;Eric M. Yoshida","doi":"10.1016/j.transproceed.2025.12.001","DOIUrl":"10.1016/j.transproceed.2025.12.001","url":null,"abstract":"<div><div>Current guidelines differ on the duration that hepatitis B immunoglobulin (HBIG) therapy should be offered after liver transplant for hepatitis B. Most guidelines state that selected patients who are considered at low risk of recurrence could discontinue HBIG therapy 6 to 12 months posttransplant. At Vancouver General Hospital, a cohort of patients remains on HBIG therapy long term. The aim of this audit was to evaluate whether we are following the proposed guidelines established by several organizations (American Association for the Study of Liver Diseases, European Association for the Study of the Liver, Canadian Association for the Study of the Liver). Our unit maintains a database of all patients currently on HBIG therapy since the inception of the program. This database was accessed, and all patients currently receiving HBIG therapy were included in the audit. The cases were manually reviewed, and data were collected for date of transplant, indication for transplant, presence of hepatocellular carcinoma in explant, hepatitis B virus DNA level at the time of transplant, presence of HIV or hepatitis D virus coinfection, hepatitis B serology, any episodes of relapse, and which antiviral the patient was taking. Twenty-two patients were included in the audit. Eight patients (36%) have been identified who are currently receiving HBIG therapy that could be ceased. Three patients developed a recurrence of hepatitis B surface antigen on lamivudine. These patients could be changed to tenofovir and have their HBIG ceased with monitoring as per protocol. This project demonstrates that patients receiving HBIG therapy should be more regularly reviewed for consideration of cessation, in line with the guidelines.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 126-129"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902063","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":"Mapping the Geographic Distribution of Lung Transplant Centers and Smoking-Associated Diseases Across the United States","authors":"Luke M. Tomasovic ,&nbsp;Jeremy R. Ellis ,&nbsp;Jessica M. Ruck ,&nbsp;Anmol Warman ,&nbsp;Alexandra A. Rizaldi ,&nbsp;Errol L. Bush","doi":"10.1016/j.transproceed.2025.12.009","DOIUrl":"10.1016/j.transproceed.2025.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are progressive lung diseases strongly associated with cigarette smoking, together accounting for nearly 50% of lung transplants annually. Given this widespread disease burden, we aimed to assess whether the uneven distribution of transplant centers contributes to regional disparities in lung transplant access for patients with COPD and IPF.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis using data from multiple, publicly available databases. We analyzed state-level data on cigarette users, COPD or IPF deaths, lung transplant centers, and recipients of lung transplants for COPD or IPF. To identify regions where transplant services may be inadequate relative to the burden of smoking-associated diseases, we also created 2 novel metrics: the cigarette users-to-transplant recipients (CUT) ratio and the smoking-associated disease deaths-to-transplant recipients (SADT) ratio.</div></div><div><h3>Results</h3><div>Across states, there were significant negative correlations between transplant center density and both the CUT and SADT ratios. Moreover, states without a transplant center had significantly higher CUT and SADT ratios and fewer lung transplant recipients per capita than states with more than 3 centers per 100,000 square miles. Choropleth maps further illustrated that CUT and SADT ratios are higher in regions with a lower density of transplant centers.</div></div><div><h3>Conclusions</h3><div>These findings reveal geographic disparities in access to lung transplants for COPD or IPF, highlighting the need to provide additional support to candidates in states without lung transplant centers. Future studies should focus on identifying specific patient populations who encounter social or geographic barriers to transplant care.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 193-201"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949512","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":"Evaluation of Donor Exclusions for Living Donor Liver Transplantation in a Tertiary Center","authors":"Tufan Gumus ,&nbsp;Veysel Umman ,&nbsp;Berk Sertoz ,&nbsp;Ezgi Guler ,&nbsp;Alper Uguz ,&nbsp;Ozen Onen Sertoz ,&nbsp;Elvan Isik ,&nbsp;Fulya Gunsar ,&nbsp;Murat Zeytunlu ,&nbsp;Sukru Emre","doi":"10.1016/j.transproceed.2025.11.006","DOIUrl":"10.1016/j.transproceed.2025.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The success of living donor liver transplantation is closely related to donor selection. Living donor liver transplantation (LDLT) plays a crucial role in saving lives, especially where cadaveric donations are limited. Donor selection is pivotal for the success of LDLT, emphasizing donor rights, minimizing complications, and ensuring donor survival. The main purpose for donor evaluation is to provide a suitable graft for the recipient while assuring a safe operation for the donor. This study aims to identify our center's donor exclusion reasons, assess limitations in donor pool utilization, and enhance its effectiveness.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from 680 healthy individuals who applied as liver donor candidates to our center between November 2016 and November 2021. Of these, 170 underwent donor hepatectomy, while 510 candidates deemed unsuitable were investigated.</div></div><div><h3>Results</h3><div>A total of 170 (25%) candidates became liver donors (group A), and 510 (75%) candidates were found unsuitable (group B). Recipient-related reasons (179, 35.09%) made up the leading exclusion cause. Psychiatric problems (105, 20%) ranked second among the reasons for rejection of donor candidates, and hepatosteatosis was the third most common reason.</div></div><div><h3>Conclusion</h3><div>The critical factor determining the success of living donor liver transplantation is the precise selection of the donor. Achieving optimal donor selection is feasible through a comprehensive multidisciplinary liver transplant team and clearly defined criteria. By employing appropriate selection standards and a skilled transplant team, it is feasible to enhance the pool of liver donors and conduct more living donor liver transplants with reduced morbidity and mortality rates.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"58 1","pages":"Pages 130-136"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936938","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}