Pub Date : 2025-11-01DOI: 10.1016/j.transproceed.2025.09.009
Hasret Ayyıldız Civan, Ferhat Sarı
Objective
The study aimed to retrospectively evaluate the demographic characteristics, presenting complaints, and etiologies of pediatric patients hospitalized with a diagnosis of severe acute hepatitis in the last 2 years in our institution.
Methods
Between July 1, 2022, and July 1, 2024, 9 patients with a diagnosis of probable severe acute hepatitis who were considered candidates for liver transplantation were included. Informed consent was obtained from the families.
Results
The mean Glasgow Coma Scale score at presentation was 11 (range: 4–15). Severe acute hepatitis is an urgent condition with rapid progression, potential for multiorgan failure, unpredictable course, and possible severe complications, often requiring liver transplantation. Patients are managed with a multidisciplinary approach including pediatric intensive care, pediatric gastroenterology, and the organ transplant unit.
{"title":"Severe Acute Hepatitis of Unknown Cause in Children: A 2-Year Single-Center Experience","authors":"Hasret Ayyıldız Civan, Ferhat Sarı","doi":"10.1016/j.transproceed.2025.09.009","DOIUrl":"10.1016/j.transproceed.2025.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to retrospectively evaluate the demographic characteristics, presenting complaints, and etiologies of pediatric patients hospitalized with a diagnosis of severe acute hepatitis in the last 2 years in our institution.</div></div><div><h3>Methods</h3><div>Between July 1, 2022, and July 1, 2024, 9 patients with a diagnosis of probable severe acute hepatitis who were considered candidates for liver transplantation were included. Informed consent was obtained from the families.</div></div><div><h3>Results</h3><div>The mean Glasgow Coma Scale score at presentation was 11 (range: 4–15). Severe acute hepatitis is an urgent condition with rapid progression, potential for multiorgan failure, unpredictable course, and possible severe complications, often requiring liver transplantation. Patients are managed with a multidisciplinary approach including pediatric intensive care, pediatric gastroenterology, and the organ transplant unit.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1802-1803"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314467","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}
Pub Date : 2025-11-01DOI: 10.1016/j.transproceed.2025.02.045
Kenan Evren Öztop , Yusuf Can , Mahmud İslam , Taner Demirci , Gözde Cakırsoy Çakar , Necattin Fırat , Musa Pınar , Zafer Ercan , Emrah Akın , Salih Salihi , Ahmed Cihad Genç , Fatih Altıntoprak , Hamad Dheir
Aim
We aimed to investigate the effects of Empagliflozin on cardiac arrhythmias and heart rate variability in kidney transplant recipients (KTRs).
Methods
Twenty-seven diabetic patients who underwent kidney transplantation between August 2020 and August 2023 were included. Patients with HbA1c >8% were received Empagliflozin treatment. A 24-hour Holter ECG monitoring was performed before and one year after beginning Empagliflozin. Holter ECGs were evaluated by a single cardiologist, comparing ventricular ectopic beats (VEB) and supraventricular ectopic beats (SEB) arrhythmias and heart rate variability parameters before and after one year of Empagliflozin treatment.
Results
Twenty-seven patients completed the study, and the mean patient age was 56.1 ± 10 years. Fifteen of the patients (55.6%) were male. The mean duration since transplant before starting Empagliflozin was 62.8 ± 46.2 months. In follow-up, HbA1c decreased from 8.2% to 7.7%(P = .075), urine protein/creatinine ratio reduced from 0.437 ± 0.428 to 0.267 ± 0.146 gr/g (P = .056), and platelet count increased significantly (P = .004). After one year of treatment, the number of VEBs and SEBs in the patients decreased compared to pretreatment. They decreased from 173.5 ± 460.8 and 514.8 ± 265 beats before treatment to 125.1 ± 231.7 and 125.1 ± 231.7 beats after treatment, respectively, but did not reach statistical significance (P > .05). No significant changes were found in heart rate variability parameters (P > .05). No significant correlation was found between VEBs and SEBs and cardiac inflammation indicators (P > .05).
Conclusion
This study, for the first time, investigated the effect of Empagliflozin on cardiac arrhythmias and heart rate variability in diabetic KTRs. Empagliflozin did not significantly affect cardiac arrhythmias and heart rate variability in KTRs.
{"title":"Impact of Empagliflozin on Cardiac Arrhythmias and Heart Rate Variability in Kidney Transplant Recipients","authors":"Kenan Evren Öztop , Yusuf Can , Mahmud İslam , Taner Demirci , Gözde Cakırsoy Çakar , Necattin Fırat , Musa Pınar , Zafer Ercan , Emrah Akın , Salih Salihi , Ahmed Cihad Genç , Fatih Altıntoprak , Hamad Dheir","doi":"10.1016/j.transproceed.2025.02.045","DOIUrl":"10.1016/j.transproceed.2025.02.045","url":null,"abstract":"<div><h3>Aim</h3><div>We aimed to investigate the effects of Empagliflozin<span> on cardiac arrhythmias<span> and heart rate variability in kidney transplant recipients (KTRs).</span></span></div></div><div><h3>Methods</h3><div><span><span>Twenty-seven diabetic patients who underwent kidney transplantation between August 2020 and August 2023 were included. Patients with </span>HbA1c<span> >8% were received Empagliflozin<span> treatment. A 24-hour Holter ECG monitoring was performed before and one year after beginning Empagliflozin. Holter ECGs were evaluated by a single cardiologist, comparing ventricular </span></span></span>ectopic beats (VEB) and supraventricular ectopic beats (SEB) arrhythmias and heart rate variability parameters before and after one year of Empagliflozin treatment.</div></div><div><h3>Results</h3><div><span>Twenty-seven patients completed the study, and the mean patient age was 56.1 ± 10 years. Fifteen of the patients (55.6%) were male. The mean duration since transplant before starting Empagliflozin was 62.8 ± 46.2 months. In follow-up, HbA1c decreased from 8.2% to 7.7%(</span><em>P</em> = .075), urine protein/creatinine ratio reduced from 0.437 ± 0.428 to 0.267 ± 0.146 gr/g (<em>P</em> = .056), and platelet count increased significantly (<em>P</em> = .004). After one year of treatment, the number of VEBs and SEBs in the patients decreased compared to pretreatment. They decreased from 173.5 ± 460.8 and 514.8 ± 265 beats before treatment to 125.1 ± 231.7 and 125.1 ± 231.7 beats after treatment, respectively, but did not reach statistical significance (<em>P</em> > .05). No significant changes were found in heart rate variability parameters (<em>P</em><span> > .05). No significant correlation was found between VEBs and SEBs and cardiac inflammation indicators (</span><em>P</em> > .05).</div></div><div><h3>Conclusion</h3><div>This study, for the first time, investigated the effect of Empagliflozin on cardiac arrhythmias and heart rate variability in diabetic KTRs. Empagliflozin did not significantly affect cardiac arrhythmias and heart rate variability in KTRs.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1731-1735"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675123","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}
Acute liver failure (ALF) caused by hepatic vascular injury during cholecystectomy is a rare but serious indication of liver transplantation (LT). We present a case of acute liver failure secondary to portal vein, hepatic artery, and common bile duct injury during laparoscopic cholecystectomy, requiring a same-day emergency living donor liver transplantation (LDLT).
A 57-year-old man underwent elective laparoscopic cholecystectomy at an external facility. During the operation, uncontrolled bleeding from the liver hilum led to conversion to open surgery. Despite attempts to control the bleeding with sutures, the patient developed abnormal liver enzymes postoperatively. A computed tomography scan revealed necrosis of the right liver lobe and hypoplasia of the left lobe, leading to the patient to be transferred to our center. Upon admission, the patient was found to have encephalopathy, coagulopathy, hypotension, and oliguria, with elevated transaminase levels. Based on these findings, an emergency LT was deemed necessary. Due to the unavailability of a cadaveric organ, the patient's daughter was prepared as a living donor.
Exploratory laparotomy revealed a necrotic right liver lobe, atrophic left lobe, transection of the right hepatic artery and common bile duct, and a thrombosed right portal vein. The patient successfully underwent LDLT from his daughter within 24 hours. At the seventh-month follow-up, he had no complications.
Hepatic vascular injury during laparoscopic cholecystectomy can lead to ALF, which carries a high mortality risk. In such cases, LDLT may be a life-saving strategy. Early referral of a patient with ALF to a transplant center is life-saving.
{"title":"Living Donor Liver Transplantation for Iatrogenic Vascular Injury During Laparoscopic Cholecystectomy: Case Report","authors":"Adem Tuncer , Canan Dilay Dirican , Emrah Sahin , Veysel Ersan , Bulent Unal , Abuzer Dirican","doi":"10.1016/j.transproceed.2025.02.039","DOIUrl":"10.1016/j.transproceed.2025.02.039","url":null,"abstract":"<div><div>Acute liver failure (ALF) caused by hepatic vascular injury during cholecystectomy is a rare but serious indication of liver transplantation (LT). We present a case of acute liver failure secondary to portal vein, hepatic artery, and common bile duct injury during laparoscopic cholecystectomy, requiring a same-day emergency living donor liver transplantation (LDLT).</div><div>A 57-year-old man underwent elective laparoscopic cholecystectomy at an external facility. During the operation, uncontrolled bleeding from the liver hilum led to conversion to open surgery. Despite attempts to control the bleeding with sutures, the patient developed abnormal liver enzymes postoperatively. A computed tomography scan revealed necrosis of the right liver lobe and hypoplasia of the left lobe, leading to the patient to be transferred to our center. Upon admission, the patient was found to have encephalopathy, coagulopathy, hypotension, and oliguria, with elevated transaminase levels. Based on these findings, an emergency LT was deemed necessary. Due to the unavailability of a cadaveric organ, the patient's daughter was prepared as a living donor.</div><div>Exploratory laparotomy revealed a necrotic right liver lobe, atrophic left lobe, transection of the right hepatic artery and common bile duct, and a thrombosed right portal vein. The patient successfully underwent LDLT from his daughter within 24 hours. At the seventh-month follow-up, he had no complications.</div><div>Hepatic vascular injury during laparoscopic cholecystectomy can lead to ALF, which carries a high mortality risk. In such cases, LDLT may be a life-saving strategy. Early referral of a patient with ALF to a transplant center is life-saving.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1812-1815"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694977","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}
Pub Date : 2025-11-01DOI: 10.1016/j.transproceed.2025.06.011
İbrahim Furkan Küçük , Necattin Fırat , Fatih Altıntoprak , Merve Yeşilsancak , Enes Malik Kocatürk , Hamad Dheir , Salih Salihi , Emrah Akın , Fehmi Çelebi
Objective
Living donor nephrectomy (LDN) has been described as a safe operation with low morbidity and mortality rates. The aim of the study was to evaluate the differences between preoperative and postoperative renal functions in LDN and to identify risk factors predicting possible long-term persistent renal dysfunction.
Methods
Donors who underwent LDN operations in our center between April 2019 and January 2023 were evaluated retrospectively. Demographic characteristics, renal function tests, routine blood and urine tests, post-transplant complications, ultrasonographic kidney size measurement, and control parameters 1 year after the operation were compared. Factors affecting renal function at 1-year postdonation were analyzed.
Results
A total of 110 who met the inclusion criteria were included. Fifty-eight donors (52.7%) were male, and the mean age was 46.54 ± 12.18 years. During follow-up, kidney size of donors increased significantly 1 year after nephrectomy (109.38 ± 9.70 vs 115.65 ± 11.58 mm, P = .001), and estimated glomerular filtration ratio (e-GFR) values were decreased significantly (107.83 ± 13.72 vs 75.68 ± 17.14 mL/min/1.73 m², P < .001). The urine protein creatinine ratio (PCR) was found to be significantly increased (157.6 ± 89.6 vs 206.6 ± 147.2 g/g, P = .001). Although within normal values, there was a significant increase in serum creatinine levels (P < .001), thyroid stimulating hormone (TSH) (P = .050), and serum potassium (P < .001) levels in one year after donation. The increase rates in serum creatinine after 1 year of follow-up were more significant in male gender and in individuals over 50 years of age (P = .016 and P = .006, respectively).
Conclusion
Although renal dysfunction may occur when well-selected donors remain with a single kidney after LDN, long-term outcomes are safe and may carry tolerable minor risks.
目的：活体供肾切除术（LDN）被认为是一种安全、低发病率和死亡率的手术。本研究的目的是评估LDN术前和术后肾功能的差异，并确定预测可能长期持续肾功能障碍的危险因素。方法：回顾性分析2019年4月至2023年1月在我中心行LDN手术的供体。比较两组患者术后1年的人口学特征、肾功能检查、血常规、尿常规、移植后并发症、超声测量肾脏大小及对照参数。分析肾脏捐献后1年影响肾功能的因素。结果：共纳入符合纳入标准的患者110例。男性58例（52.7%），平均年龄46.54±12.18岁。随访中，肾切除术后1年供者肾脏体积显著增大（109.38±9.70 vs 115.65±11.58 mm, P = 0.001），肾小球滤过率（e-GFR）估计值显著降低（107.83±13.72 vs 75.68±17.14 mL/min/1.73 m²，P < 0.001）。尿蛋白肌酐比值（PCR）显著升高（157.6±89.6 vs 206.6±147.2 g/g, P = 0.001）。捐献后1年内血清肌酐水平（P < 0.001）、促甲状腺激素（P = 0.050）、血清钾水平（P < 0.001）均在正常值范围内显著升高。随访1年后血清肌酐升高率在男性和50岁以上人群中更为显著（P = 0.016和P = 0.006）。结论：虽然在LDN后选择好的供者保留单肾可能会发生肾功能障碍，但长期结果是安全的，并且可能存在可容忍的轻微风险。
{"title":"Mid-Term Results of Renal Function in Living Kidney Donors in a Single Center","authors":"İbrahim Furkan Küçük , Necattin Fırat , Fatih Altıntoprak , Merve Yeşilsancak , Enes Malik Kocatürk , Hamad Dheir , Salih Salihi , Emrah Akın , Fehmi Çelebi","doi":"10.1016/j.transproceed.2025.06.011","DOIUrl":"10.1016/j.transproceed.2025.06.011","url":null,"abstract":"<div><h3>Objective</h3><div>Living donor nephrectomy (LDN) has been described as a safe operation with low morbidity and mortality rates. The aim of the study was to evaluate the differences between preoperative and postoperative renal functions in LDN and to identify risk factors predicting possible long-term persistent renal dysfunction.</div></div><div><h3>Methods</h3><div>Donors who underwent LDN operations in our center between April 2019 and January 2023 were evaluated retrospectively. Demographic characteristics, renal function tests<span>, routine blood and urine tests, post-transplant complications, ultrasonographic kidney size measurement, and control parameters 1 year after the operation were compared. Factors affecting renal function at 1-year postdonation were analyzed.</span></div></div><div><h3>Results</h3><div>A total of 110 who met the inclusion criteria were included. Fifty-eight donors (52.7%) were male, and the mean age was 46.54 ± 12.18 years. During follow-up, kidney size of donors increased significantly 1 year after nephrectomy (109.38 ± 9.70 vs 115.65 ± 11.58 mm, <em>P</em><span> = .001), and estimated glomerular filtration ratio (e-GFR) values were decreased significantly (107.83 ± 13.72 vs 75.68 ± 17.14 mL/min/1.73 m², </span><em>P</em> < .001). The urine protein creatinine ratio (PCR) was found to be significantly increased (157.6 ± 89.6 vs 206.6 ± 147.2 g/g, <em>P</em> = .001). Although within normal values, there was a significant increase in serum creatinine levels (<em>P</em><span> < .001), thyroid stimulating hormone (TSH) (</span><em>P</em> = .050), and serum potassium (<em>P</em> < .001) levels in one year after donation. The increase rates in serum creatinine after 1 year of follow-up were more significant in male gender and in individuals over 50 years of age (<em>P</em> = .016 and <em>P</em> = .006, respectively).</div></div><div><h3>Conclusion</h3><div>Although renal dysfunction may occur when well-selected donors remain with a single kidney after LDN, long-term outcomes are safe and may carry tolerable minor risks.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1751-1755"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621602","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}
To retrospectively investigate the correlation between anti-HLA antibody PRA identification and single antigen bead (SAB) results and the relationship between mean fluorescence intensity (MFI) values determined using Luminex-based techniques and complement-dependent cytotoxicity (CDC-XM) and flow cytometry (FC-XM) results.
Material and method
Between 2017 and 2020, 256 patients with end-stage renal disease who were admitted to the Tissue Typing Laboratory of Istanbul Faculty of Medicine and tested for anti-HLA antibodies were included in the study. The correlation between antigen-specific antibody identification, SAB, CDC-XM, and FC-XM tests was analyzed retrospectively.
Results
PRA identification was positive in 78.5% of the patients. Of these patients, 15.2% were class I positive and 31.6% were class II positive. In the SAB test, 171 patients (66.8%) were positive. Of the SAB-positive patients, 16.8% were SAB-I positive and 24.2% were SAB-II positive. Fifty-two percent of patients were FC-XM positive and 10.5% were CDC-XM positive. SAB-I MFI>5141 and SAB-II MFI>7649 values were significantly correlated with positive CDC-XM (p < .001 and p = .048, respectively). SAB-I MFI>2721 and SAB-II MFI>2719 values were correlated with positive FC-XM-B (p = .003 and p = .038, respectively). The highest MFI values for identification were HLA-A:20896, HLA-B:18100, HLA-DRB1:21054, HLA-DQ:24034, and HLA-A:15715, HLA-B:11002, HLA-DR:22400, HLA-DQB1:22700, and DQA1:14782 for SAB.
Conclusion
In our study, it was found that some low-titer antibodies that could not be identified using PRA could be detected using SAB. We think it is important to evaluate SAB tests in these patients and to include this region in HLA typing reports because antibodies frequently develop in the HLA-DQA1 region.
背景：回顾性研究hla抗体PRA鉴定与单抗原珠（SAB）结果的相关性，以及利用luminex技术测定的平均荧光强度（MFI）值与补体依赖性细胞毒性（CDC-XM）和流式细胞术（FC-XM）结果之间的关系。材料和方法：2017年至2020年，伊斯坦布尔医学院组织分型实验室收治的256例终末期肾病患者进行hla抗体检测，纳入研究。回顾性分析抗原特异性抗体鉴定、SAB、CDC-XM和FC-XM检测的相关性。结果：78.5%的患者PRA鉴定阳性。其中15.2%为I类阳性，31.6%为II类阳性。SAB检测阳性171例（66.8%）。在sabb阳性患者中，16.8%为sabb - 1阳性，24.2%为sabb - ii阳性。52%的患者FC-XM阳性，10.5%的患者CDC-XM阳性。sabb - i MFI bbb5141和sabb - ii MFI>7649值与CDC-XM阳性呈显著相关（p < 0.001和p = 0.048）。ab - i MFI bbb2721和ab - ii MFI bbb2719值与FC-XM-B阳性相关（p = 0.003和p = 0.038）。SAB的最高MFI值为HLA-A:20896、HLA-B:18100、HLA-DRB1:21054、HLA-DQ:24034、HLA-A:15715、HLA-B:11002、HLA-DR:22400、HLA-DQB1:22700、DQA1:14782。结论：在我们的研究中，我们发现一些用PRA不能识别的低效价抗体可以用SAB检测到。我们认为在这些患者中评估SAB测试并将该区域包括在HLA分型报告中是很重要的，因为抗体经常在HLA- dqa1区域产生。
{"title":"Determination of Anti-HLA Antibody Positivity in Kidney Transplant Candidates in a Tissue Typing Laboratory and Results Analysis","authors":"Hayriye Senturk Ciftci, Demet Kivanc, Cigdem Kekik Cinar, Fatma Savran Oguz","doi":"10.1016/j.transproceed.2025.09.010","DOIUrl":"10.1016/j.transproceed.2025.09.010","url":null,"abstract":"<div><h3>Background</h3><div>To retrospectively investigate the correlation between anti-HLA antibody PRA identification and single antigen bead (SAB) results and the relationship between mean fluorescence intensity (MFI) values determined using Luminex-based techniques and complement-dependent cytotoxicity (CDC-XM) and flow cytometry (FC-XM) results.</div></div><div><h3>Material and method</h3><div>Between 2017 and 2020, 256 patients with end-stage renal disease who were admitted to the Tissue Typing Laboratory of Istanbul Faculty of Medicine and tested for anti-HLA antibodies were included in the study. The correlation between antigen-specific antibody identification, SAB, CDC-XM, and FC-XM tests was analyzed retrospectively.</div></div><div><h3>Results</h3><div>PRA identification was positive in 78.5% of the patients. Of these patients, 15.2% were class I positive and 31.6% were class II positive. In the SAB test, 171 patients (66.8%) were positive. Of the SAB-positive patients, 16.8% were SAB-I positive and 24.2% were SAB-II positive. Fifty-two percent of patients were FC-XM positive and 10.5% were CDC-XM positive. SAB-I MFI>5141 and SAB-II MFI>7649 values were significantly correlated with positive CDC-XM (<em>p</em> < .001 and <em>p</em> = .048, respectively). SAB-I MFI>2721 and SAB-II MFI>2719 values were correlated with positive FC-XM-B (<em>p</em> = .003 and <em>p</em> = .038, respectively). The highest MFI values for identification were HLA-A:20896, HLA-B:18100, HLA-DRB1:21054, HLA-DQ:24034, and HLA-A:15715, HLA-B:11002, HLA-DR:22400, HLA-DQB1:22700, and DQA1:14782 for SAB.</div></div><div><h3>Conclusion</h3><div>In our study, it was found that some low-titer antibodies that could not be identified using PRA could be detected using SAB. We think it is important to evaluate SAB tests in these patients and to include this region in HLA typing reports because antibodies frequently develop in the HLA-DQA1 region.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1736-1743"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228722","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}
To investigate the incidence, causes, and treatment methods of biliary complications (BC) following liver transplantation (LT).
Patients and Methods
Patients who underwent LT between February 1997 and 2024 were identified. Cases with BC were determined. Patients aged 18 years and older were classified as adults. Patients who experienced mortality within the first postoperative week or had spontaneous regression of bile drainage were excluded. The study aimed to evaluate the incidence and types of BC, complications associations between recipient/donor characteristics, graft type, steatosis, cold ischemia time (CIT), number of bile ducts, donor hepatectomy technique, and type of biliary reconstruction. Additionally, treatment methods, morbidity, and mortality rates were analyzed.
Results
A total of 590 patients were included in the study. BC occurred in 49 patients (8.2%). In the multivariate analysis including all patients, living donor LT and prolonged CIT were identified as risk factors for the development of BC (P ≤ .001 and P ≤ .001, respectively). In the multivariate analysis conducted exclusively on cases who underwent LT due to cirrhosis, the factors associated with the development of BC were identified as living donor transplantation (P = .001), prolonged CIT (P ≤ .001), and viral etiology (P = .046). Complications were managed using endoscopic and interventional radiologic techniques. Mortality due to BC occurred in 19 (38.7%) of the cases.
Conclusion
BC are still a significant challenge in LT. Identifying and avoiding causative factors and strict selection criteria may substantially reduce the incidence of BC. Effective treatment can be achieved through a multidisciplinary approach in most cases.
{"title":"Biliary Complications and Management After Liver Transplantation","authors":"Tufan Egeli , Ibrahim Kemal Astarcioglu , Tarkan Unek , Mucahit Ozbilgin , Cihan Agalar , Aytac Gulcu , Mesut Akarsu , Nilay Danis , Aylin Bacakoglu , Berkay Sakaoglu , Emre Karadeniz , Huseyin Astarcioglu , Sedat Karademir","doi":"10.1016/j.transproceed.2025.07.002","DOIUrl":"10.1016/j.transproceed.2025.07.002","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the incidence, causes, and treatment methods of biliary complications (BC) following liver transplantation (LT).</div></div><div><h3>Patients and Methods</h3><div>Patients who underwent LT between February 1997 and 2024 were identified. Cases with BC were determined. Patients aged 18 years and older were classified as adults. Patients who experienced mortality within the first postoperative week or had spontaneous regression of bile drainage were excluded. The study aimed to evaluate the incidence and types of BC, complications associations between recipient/donor characteristics, graft type, steatosis, cold ischemia time (CIT), number of bile ducts, donor hepatectomy technique, and type of biliary reconstruction. Additionally, treatment methods, morbidity, and mortality rates were analyzed.</div></div><div><h3>Results</h3><div>A total of 590 patients were included in the study. BC occurred in 49 patients (8.2%). In the multivariate analysis including all patients, living donor LT and prolonged CIT were identified as risk factors for the development of BC (<em>P</em> ≤ .001 and <em>P</em> ≤ .001, respectively). In the multivariate analysis conducted exclusively on cases who underwent LT due to cirrhosis, the factors associated with the development of BC were identified as living donor transplantation (<em>P</em> = .001), prolonged CIT (<em>P</em> ≤ .001), and viral etiology (<em>P</em> = .046). Complications were managed using endoscopic and interventional radiologic techniques. Mortality due to BC occurred in 19 (38.7%) of the cases.</div></div><div><h3>Conclusion</h3><div>BC are still a significant challenge in LT. Identifying and avoiding causative factors and strict selection criteria may substantially reduce the incidence of BC. Effective treatment can be achieved through a multidisciplinary approach in most cases.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1781-1787"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762925","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}
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, and liver transplantation (LT) remains the most effective curative option for eligible patients. Bridging therapies are often employed during the waiting period to control tumor progression and improve transplant eligibility. However, their prognostic impact remains controversial. We aimed to evaluate the effect of bridging therapy and pathological complete response (CR) on post-transplant outcomes in patients who underwent LT for HCC.
Patients and Methods
In this retrospective study, 120 patients with HCC who underwent LT between 1998 and 2023 were analyzed. Bridging therapies included transarterial chemoembolization (TACE), transarterial radioembolization (TARE), radiofrequency ablation (RFA), and microwave ablation (MWA). Overall survival (OS), disease-free survival (DFS), and recurrence were compared between patients with and without bridging therapy. The prognostic significance of pathological CR was also assessed.
Results
Bridging therapy was administered to 24.2% of patients. There was no statistically significant difference in OS or DFS between patients who received bridging therapy and those who did not. However, a pathological CR was achieved in 27.6% of bridged patients and was significantly associated with improved OS (P = .018) and DFS (P = .05). No recurrence or mortality occurred in patients who achieved CR.
Conclusion
While bridging therapy did not independently affect post-transplant survival, achieving a pathological complete response emerged as a strong prognostic indicator. These findings highlight the clinical importance of treatment response and support the role of CR as a potential predictor of favorable long-term outcomes following LT in HCC patients.
{"title":"Pathologic Complete Response as a Prognostic Indicator in Bridging Therapy: A 25-Year Retrospective Study on Hepatocellular Carcinoma and Liver Transplantation Outcomes","authors":"Cihan Agalar , Tufan Egeli , Mucahit Ozbilgin , Berkay Sakaoglu , Anil Aysal , Ibrahim Astarcioglu , Aytac Gulcu , Nilay Danis , Erkan Derebek , Ozgul Sagol , Tarkan Unek","doi":"10.1016/j.transproceed.2025.08.004","DOIUrl":"10.1016/j.transproceed.2025.08.004","url":null,"abstract":"<div><h3>Aim</h3><div>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, and liver transplantation (LT) remains the most effective curative option for eligible patients. Bridging therapies are often employed during the waiting period to control tumor progression and improve transplant eligibility. However, their prognostic impact remains controversial. We aimed to evaluate the effect of bridging therapy and pathological complete response (CR) on post-transplant outcomes in patients who underwent LT for HCC.</div></div><div><h3>Patients and Methods</h3><div>In this retrospective study, 120 patients with HCC who underwent LT between 1998 and 2023 were analyzed. Bridging therapies included transarterial chemoembolization (TACE), transarterial radioembolization (TARE), radiofrequency ablation (RFA), and microwave ablation (MWA). Overall survival (OS), disease-free survival (DFS), and recurrence were compared between patients with and without bridging therapy. The prognostic significance of pathological CR was also assessed.</div></div><div><h3>Results</h3><div>Bridging therapy was administered to 24.2% of patients. There was no statistically significant difference in OS or DFS between patients who received bridging therapy and those who did not. However, a pathological CR was achieved in 27.6% of bridged patients and was significantly associated with improved OS (<em>P = .</em>018) and DFS (<em>P = .</em>05). No recurrence or mortality occurred in patients who achieved CR.</div></div><div><h3>Conclusion</h3><div>While bridging therapy did not independently affect post-transplant survival, achieving a pathological complete response emerged as a strong prognostic indicator. These findings highlight the clinical importance of treatment response and support the role of CR as a potential predictor of favorable long-term outcomes following LT in HCC patients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1768-1772"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984608","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}
The aim of this study was to investigate the relationship between ultrasonographic elastography score and long-term renal prognosis in renal transplant patients.
Methods
A retrospective cohort study of 100 patients who underwent renal transplantation in our hospital between 2005 and 2022 was performed. Patients were divided into two groups as those with elastography scores higher than 8.45 kPa (n = 50) and those with elastography scores equal to or lower than 8.45 kPa (n = 50). Elastography measurements were performed with Siemens Acuson S2000 ultrasound system and the scores were compared with renal function parameters and other clinical characteristics.
Results
Patients with high elastography scores had smaller kidney size (P = .010), lower eGFR (P = .002), and higher proteinuria and albuminuria levels (P < .05) than patients with low elastography scores. There was a significant association between elastography score and the risk of renal dysfunction (OR = 1.039, P = .006).
Conclusions
A large elastography score may act as a significant biomarker for prognosing the risk of renal dysfunction in subjects undergoing kidney transplantation. These findings suggest that elastography may become an invaluable noninvasive tool during the long-term follow-up of patients with renal transplants.
{"title":"Impact of Ultrasonographically Measured Elastography Scores on Renal Prognosis in Kidney Transplant Recipients","authors":"Serap Yadigar , Pınar Özdemir , Erman Özdemir , Ömer Aydıner , Ayşegül Karadayı , Elif Arı Bakır","doi":"10.1016/j.transproceed.2025.01.009","DOIUrl":"10.1016/j.transproceed.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to investigate the relationship between ultrasonographic elastography score and long-term renal prognosis in renal transplant patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of 100 patients who underwent renal transplantation in our hospital between 2005 and 2022 was performed. Patients were divided into two groups as those with elastography scores higher than 8.45 kPa (<em>n</em> = 50) and those with elastography scores equal to or lower than 8.45 kPa (<em>n</em> = 50). Elastography measurements were performed with Siemens Acuson S2000 ultrasound system and the scores were compared with renal function parameters and other clinical characteristics.</div></div><div><h3>Results</h3><div>Patients with high elastography scores had smaller kidney size (<em>P</em> = .010), lower eGFR (<em>P</em> = .002), and higher proteinuria and albuminuria levels (<em>P</em> < .05) than patients with low elastography scores. There was a significant association between elastography score and the risk of renal dysfunction (OR = 1.039, <em>P</em> = .006).</div></div><div><h3>Conclusions</h3><div>A large elastography score may act as a significant biomarker for prognosing the risk of renal dysfunction in subjects undergoing kidney transplantation. These findings suggest that elastography may become an invaluable noninvasive tool during the long-term follow-up of patients with renal transplants.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1697-1703"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639957","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}
Pub Date : 2025-11-01DOI: 10.1016/j.transproceed.2025.02.038
Serap Yadigar , Pınar Özdemir , Erman Özdemir
Background
Determining effective ways to make prognostic predictions after kidney transplantation of patients is essential for the management of patients. This study examines how the PNI score affects renal outcomes after kidney transplantation. The potential impact of PNI on renal function beyond the overall nutritional status was also examined.
Methods
In this retrospective study, 100 kidney transplant patients were divided into three groups according to PNI scores: low (<40), intermediate (40-45) and high (>45). Demographic characteristics, clinical parameters, serum creatinine levels, estimated glomerular filtration rate (eGFR) and parenchymal thickness were evaluated. Logistic regression analysis was applied for the risk of graft rejection. Patients who were followed up for at least 6 months after kidney transplantation and had complete clinical data were included in the study. The mean follow-up period was 36 months (range: 6-60 months).
Results
There was no statistically significant correlation between PNI scores and renal function (P > .05). The mean creatinine level was 1.73 ± 1.11 mg/dL in the low PNI group and 1.37 ± 0.52 mg/dL in the high PNI group. Although this difference was close to the limit of statistical significance, it was not significant (P = .083). In logistic regression analysis, no significant effect of PNI score on graft rejection was observed (OR: 1.0015, 95% CI: 0.7975-1.2576, P = .9899). However, age (OR: 0.9247, P = .0347) and serum creatinine levels (OR: 2.8396, P = .0151) significantly affected the risk of graft rejection. No significant effect of PNI score on complication rates was observed.
Conclusions
This study demonstrated that PNI score alone is not a sufficient predictor of renal prognosis and graft rejection risk after kidney transplantation. Factors such as age and serum creatinine levels were found to be more predictive of the risk of graft rejection.
背景：确定对肾移植患者进行预后预测的有效方法对患者的管理至关重要。本研究探讨了PNI评分对肾移植后肾脏预后的影响。除了总体营养状况外，PNI对肾功能的潜在影响也进行了研究。方法：在本回顾性研究中，100例肾移植患者根据PNI评分分为三组：低（45分）。评估了人口统计学特征、临床参数、血清肌酐水平、估计肾小球滤过率（eGFR）和实质厚度。采用Logistic回归分析移植排斥风险。肾移植术后随访至少6个月且临床资料完整的患者纳入研究。平均随访36个月（6 ~ 60个月）。结果：PNI评分与肾功能无统计学意义（P < 0.05）。低PNI组平均肌酐为1.73±1.11 mg/dL，高PNI组平均肌酐为1.37±0.52 mg/dL。虽然这一差异接近统计学意义的极限，但并不显著（P = .083）。在logistic回归分析中，PNI评分对移植排斥反应无显著影响（OR: 1.0015, 95% CI: 0.7975 ~ 1.2576, P = 0.9899）。然而，年龄（OR: 0.9247, P = 0.047）和血清肌酐水平（OR: 2.8396, P = 0.0151）显著影响移植排斥风险。PNI评分对并发症发生率无显著影响。结论：本研究表明，单独的PNI评分并不能充分预测肾移植后肾脏预后和移植排斥风险。年龄和血清肌酐水平等因素被发现更能预测移植排斥的风险。
{"title":"The Effect of PNI Score on Renal Prognosis and Graft Rejection After Kidney Transplantation","authors":"Serap Yadigar , Pınar Özdemir , Erman Özdemir","doi":"10.1016/j.transproceed.2025.02.038","DOIUrl":"10.1016/j.transproceed.2025.02.038","url":null,"abstract":"<div><h3>Background</h3><div>Determining effective ways to make prognostic predictions after kidney transplantation of patients is essential for the management of patients. This study examines how the PNI score affects renal outcomes after kidney transplantation. The potential impact of PNI on renal function beyond the overall nutritional status was also examined.</div></div><div><h3>Methods</h3><div>In this retrospective study, 100 kidney transplant patients were divided into three groups according to PNI scores: low (<40), intermediate (40-45) and high (>45). Demographic characteristics, clinical parameters, serum creatinine levels, estimated glomerular filtration rate (eGFR) and parenchymal thickness were evaluated. Logistic regression analysis was applied for the risk of graft rejection. Patients who were followed up for at least 6 months after kidney transplantation and had complete clinical data were included in the study. The mean follow-up period was 36 months (range: 6-60 months).</div></div><div><h3>Results</h3><div>There was no statistically significant correlation between PNI scores and renal function (<em>P</em> > .05). The mean creatinine level was 1.73 ± 1.11 mg/dL in the low PNI group and 1.37 ± 0.52 mg/dL in the high PNI group. Although this difference was close to the limit of statistical significance, it was not significant (<em>P</em> = .083). In logistic regression analysis, no significant effect of PNI score on graft rejection was observed (OR: 1.0015, 95% CI: 0.7975-1.2576, <em>P</em> = .9899). However, age (OR: 0.9247, <em>P</em> = .0347) and serum creatinine levels (OR: 2.8396, <em>P</em> = .0151) significantly affected the risk of graft rejection. No significant effect of PNI score on complication rates was observed.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that PNI score alone is not a sufficient predictor of renal prognosis and graft rejection risk after kidney transplantation. Factors such as age and serum creatinine levels were found to be more predictive of the risk of graft rejection.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1707-1714"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660246","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}
Pub Date : 2025-11-01DOI: 10.1016/j.transproceed.2025.07.009
Arif Aslaner, Kemal Eyvaz
Background
We aim to present the mid- and long-term results of single and multiple artery grafts of donor kidneys in kidney transplantation surgeries and their effects on graft survival according to our experience.
Methods
This is a single-center, observational, and descriptive study. Between December 2015 and July 2024, 112 patients with end-stage renal disease will undergo kidney transplantation with living or deceased donor kidney grafts. The transplanted patients were divided into 2 groups: Group 1, recipients of a single renal artery kidney graft (N = 95), and Group 2, recipients of multiple renal artery kidney grafts (N = 17). The groups were compared in terms of estimated glomerular filtration rates (months 1-3 and 12), delayed graft function, and graft survival. The data were statistically analyzed.
Results
One hundred and eleven recipients were analyzed with all documented data. Graft function was compared between the 2 groups at 1, 3, and 12 months, and both were found to have similar results. Multiple donor artery graft anastomoses were found to have no effect on delayed graft dysfunction, higher risk of vascular injury, and biopsy-proven acute tubular necrosis.
Conclusion
Our study demonstrates that, in our experience, transplants with multiple donor artery grafts, like single donor renal artery grafts, are safe in the first years after transplantation.
{"title":"Kidney Transplantation and Donor Artery Grafts","authors":"Arif Aslaner, Kemal Eyvaz","doi":"10.1016/j.transproceed.2025.07.009","DOIUrl":"10.1016/j.transproceed.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>We aim to present the mid- and long-term results of single and multiple artery grafts of donor kidneys in kidney transplantation surgeries and their effects on graft survival according to our experience.</div></div><div><h3>Methods</h3><div>This is a single-center, observational, and descriptive study. Between December 2015 and July 2024, 112 patients with end-stage renal disease will undergo kidney transplantation with living or deceased donor kidney grafts. The transplanted patients were divided into 2 groups: Group 1, recipients of a single renal artery kidney graft (<em>N</em> = 95), and Group 2, recipients of multiple renal artery kidney grafts (<em>N</em> = 17). The groups were compared in terms of estimated glomerular filtration rates (months 1-3 and 12), delayed graft function, and graft survival. The data were statistically analyzed.</div></div><div><h3>Results</h3><div>One hundred and eleven recipients were analyzed with all documented data. Graft function was compared between the 2 groups at 1, 3, and 12 months, and both were found to have similar results. Multiple donor artery graft anastomoses were found to have no effect on delayed graft dysfunction, higher risk of vascular injury, and biopsy-proven acute tubular necrosis.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that, in our experience, transplants with multiple donor artery grafts, like single donor renal artery grafts, are safe in the first years after transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1748-1750"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839581","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号