Transplantation proceedings最新文献

{"title":"From Metro Ticket to a Cape-to-Khartoum Pass: Reimagining Liver Transplantation Criteria for HCC in Sub-Saharan Africa","authors":"Sanju Sobnach ,&nbsp;Urda Kotze ,&nbsp;Inae Kim ,&nbsp;C. Wendy Spearman ,&nbsp;Marc Bernon ,&nbsp;Tinus du Toit ,&nbsp;Mark W. Sonderup ,&nbsp;Muhammad Emmamally ,&nbsp;Luiz F. Zerbini ,&nbsp;Elie Keli ,&nbsp;Abdelmounem Abdo ,&nbsp;Christian Tzeuton ,&nbsp;Eduard Jonas","doi":"10.1016/j.transproceed.2025.10.021","DOIUrl":"10.1016/j.transproceed.2025.10.021","url":null,"abstract":"<div><h3>Background</h3><div>Current liver transplantation (LT) criteria and the Metroticket model were developed in high-income countries (HICs) and may not be appropriate for hepatocellular carcinoma (HCC) patients in sub-Saharan Africa (SSA).</div></div><div><h3>Methods</h3><div>A retrospective observational cohort study of 647 HCC patients managed at Groote Schuur Hospital, Cape Town, South Africa was performed. Our LT experience and outcomes were reviewed, and current transplant criteria (Milan, University of California San Franciso, extended Toronto) were applied to non-transplanted patients. An exploratory cohort was then generated and analysed to inform a regionally adapted LT framework for SSA.</div></div><div><h3>Results</h3><div>Six (0.9%) patients underwent LT with a median survival of 2557.5 (range:1049-3076) days. In the non-transplanted group, 31(4.8%) met at least one LT criterion, of whom 19 (61.3%) were eventually treated with resection (12) and ablation (7). The exploratory cohort (n = 140) was predominantly male (84.2%) with advanced HCC (BCLC stage C/D in 79.2%), but preserved liver function (median MELD-Na of 10 and Child-Turcotte-Pugh grade A disease in 61.4%). Only 16.2% of the exploratory cohort received curative-intended therapies. Patients who underwent LT survived significantly longer than the two other patient groups (<em>P &lt; .</em>001).</div></div><div><h3>Conclusion</h3><div>This study highlights the potential limited applicability of current LT criteria in SSA, where applying criteria, less than 5% of HCC patients qualify. We propose a novel Cape-to-Khartoum framework incorporating clinical and biological parameters, including tumour markers, tumour differentiation and multi-omic profiling. This model may broaden LT eligibility and improve outcomes for HCC in SSA and warrants further validation through multicentre studies across the region.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1930-1937"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433140","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":"Analysis of Decision-making Behavior and Influencing Factors Among Organ Donor Families in Guangxi","authors":"Xu Zhou ,&nbsp;Yuanyue Zhu ,&nbsp;Zhaoyuan Mo ,&nbsp;Yanbing Wei ,&nbsp;Yuanyuan Gan","doi":"10.1016/j.transproceed.2025.10.020","DOIUrl":"10.1016/j.transproceed.2025.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Organ donation remains a critical and sensitive issue, yet the factors influencing the decision to donate among citizens of potential donors are not well understood. This study aims to explore demographic characteristics, awareness, decision-making process, and factors influencing organ donation willingness among citizens of organ donation candidates.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in Guangxi, China, between January 2019 and December 2023. A total of 510 citizens (aged 18-70 years) were divided into an agreement group (n = 255) and a disagreement group (n = 255). Data were collected using structured questionnaires and semi-structured interviews, focusing on demographic information, awareness of organ donation, and cultural and emotional factors. Statistical analysis was performed using SPSS 24.0, with chi-square tests and logistic regression to identify key factors affecting organ donation willingness.</div></div><div><h3>Results</h3><div>The study found no significant differences between groups regarding demographic characteristics (<em>P &gt; .</em>05). Approximately 78.2% of participants had heard of organ donation, with those agreeing to donation demonstrating significantly higher levels of understanding (90.2%) compared to those disagreeing (66.3%) (<em>P &lt; .</em>001). Information from medical institutions was the primary source of knowledge for 72.2% of participants, with those who agreed to donation more likely to obtain information from healthcare providers (<em>P &lt; .</em>05). Cultural beliefs and religious views were identified as significant barriers to organ donation, with 53.3% participants feeling that donation conflicted with traditional culture, especially in the disagreeing group (<em>P &lt; .</em>05). Psychological factors, such as emotional reactions to the perceived loss of a loved one, also significantly affected decision-making, with those agreeing to donation more likely to show emotional openness (<em>P &lt; .</em>05). Logistic regression analysis revealed that urban residency (<em>P = .</em>01), fewer extended citizens (<em>P = .</em>03), greater awareness of organ donation (<em>P &lt; .</em>001), and a willingness to forgo life-saving treatment (<em>P = .</em>04) were positive predictors of donation willingness. In contrast, perceived cultural or religious conflicts, emotional aversion to loss, and lack of knowledge were significant predictors of refusal (<em>P &lt; .</em>05).</div></div><div><h3>Conclusions</h3><div>The decision to donate organs is influenced by a complex interplay of demographic, cultural, psychological, and informational factors. Efforts to increase awareness, address cultural and emotional concerns, and provide clear, culturally sensitive information are essential in enhancing organ donation willingness.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1856-1862"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446906","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":"Predictive Value of Preoperative Serum Substance P Levels for Post-Transplant Recurrence in Patients With Hepatocellular Carcinoma","authors":"Cong Li ,&nbsp;Yibo Sun ,&nbsp;Jing Din,&nbsp;Pengfei Cheng,&nbsp;Feng Wu,&nbsp;Yuanming Qiang,&nbsp;Guangming Li","doi":"10.1016/j.transproceed.2025.10.010","DOIUrl":"10.1016/j.transproceed.2025.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Recurrence contributes a lot to hepatocellular carcinoma (HCC) death. This study aims to evaluate the predictive value of preoperative serum Substance P (SP) levels for post-transplant recurrence in patients with HCC.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 359 patients who underwent primary allogeneic orthotopic liver transplantation for HCC at Beijing You’an Hospital Affiliated to Capital Medical University between February 2019 and January 2022. Based on inclusion and exclusion criteria, 307 patients were ultimately enrolled. Patients were divided into recurrence and nonrecurrence groups according to disease recurrence within 3 years post-transplantation. Baseline clinical data and 3-year follow-up records were collected. Serum SP levels were measured by enzyme-linked immunosorbent assay. Spearman correlation was used to assess the relationship between serum SP levels and alpha-fetoprotein (AFP) levels, as well as Model for End-Stage Liver Disease (MELD) scores. Cox regression models were constructed to identify independent risk factors for recurrence, and Kaplan–Meier survival curves were plotted to evaluate the impact of SP expression on recurrence.</div></div><div><h3>Results</h3><div>Significant differences were observed between the recurrence and nonrecurrence groups in gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, AFP, microvascular invasion, capsule integrity, tumor-node-metastasis staging, MELD scores, total tumor diameter, and Milan criteria compliance. Preoperative serum SP levels were significantly higher in the recurrence group and positively correlated with AFP and MELD scores. Higher tumor-node-metastasis stage, larger tumor burden, noncompliance with Milan criteria, and elevated serum SP and AFP levels were independent risk factors for 3-year post-transplant recurrence.</div></div><div><h3>Conclusion</h3><div>Serum SP levels can assist in predicting post-transplant recurrence in HCC.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1964-1970"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558798","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":"Reviewer Acknowledgement","authors":"","doi":"10.1016/S0041-1345(25)00558-5","DOIUrl":"10.1016/S0041-1345(25)00558-5","url":null,"abstract":"","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Page 1843"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665552","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":"Incidence of Post-Transplantation Major Adverse Cardiovascular Events in Lung Transplant Recipients With No Prior Cardiovascular Disease","authors":"Yael Shostak ,&nbsp;Mordechai R. Kramer ,&nbsp;Neta Sternbach ,&nbsp;Barak Pertzov ,&nbsp;Dorit Shitenberg ,&nbsp;Shay M. Amor ,&nbsp;Moshe Heching ,&nbsp;Dror Rosengarten ,&nbsp;Ilana Bakal ,&nbsp;Keren Skalsky ,&nbsp;Alon Eisen ,&nbsp;Yuri Peysakhovich ,&nbsp;Yaron D. Barac ,&nbsp;Amir Shlomai ,&nbsp;Osnat Shtraichman","doi":"10.1016/j.transproceed.2025.09.012","DOIUrl":"10.1016/j.transproceed.2025.09.012","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Cardiovascular disease (CVD) is a significant concern after solid organ transplantation, partly due to the adverse effects of immunosuppressive therapy. However, the incidence of major adverse cardiovascular events (MACE) in patients without prior CVD among this population is not well understood. This study aimed to evaluate the occurrence of MACE in lung transplant recipients (LTRs) without pre-existing CVD.</div></div><div><h3>Materials and Methods</h3><div>We reviewed retrospectively LTRs without known CVD between 2003 and 2019. MACE outcomes included acute coronary syndrome, revascularization, cerebrovascular events, peripheral vascular disease, and cardiovascular mortality.</div></div><div><h3>Results</h3><div>Of 342 LTRs (median 55.0 (41.0, 61.0); 42.2% female), 16 (4.7%) developed MACE over a median follow-up of 54.5 months. Logistic regression analysis demonstrated a significant association between developing two or more post-transplant risk factors for CVD, such as HTN and DM, and an increased likelihood of MACE (OR 5.672, CI 1.092-29.464, <em>P = .</em>039). There was a trend toward higher mortality in the MACE group, 62.5%, compared to 39.0% in the control group (<em>P = .</em>0707). COX regression analysis showed that single lung transplantation was significantly associated with poorer survival (HR 1.762, 95% CI 1.135-2.73, <em>P = .</em>0116). Older age and CKD showed a trend toward higher mortality (HR 1.013, <em>P = .</em>1681; HR 1.369, <em>P = .</em>092, respectively).</div></div><div><h3>Conclusion</h3><div>MACE incidence was low in this large cohort of LTRs without pre-transplant CVD. Developing two or more post-transplant CVD risk factors was associated with an increased risk for MACE, highlighting the importance of rigorous post-transplant management to mitigate MACE risk.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1971-1978"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454451","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":"Feasibility, Acceptability, and Satisfaction of a Lifestyle Intervention for Post-Transplant Weight Loss","authors":"Maria P. Cote ,&nbsp;Srilakshmi Atthota ,&nbsp;Jennie Cataldo ,&nbsp;Anne MacDonald ,&nbsp;Ruby Singh ,&nbsp;Flor Flores ,&nbsp;Anushi Shah ,&nbsp;Sarah Wenyon ,&nbsp;Natalia Rodriguez-Payan ,&nbsp;Nahel Elias ,&nbsp;Leigh Anne Dageforde","doi":"10.1016/j.transproceed.2025.10.008","DOIUrl":"10.1016/j.transproceed.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal organ transplant recipients with obesity can benefit from lifestyle modification interventions for weight loss. We aimed to assess the feasibility, acceptability, and appropriateness of a lifestyle modification intervention using connected health services (Fitbit and scale), coaching phone calls, and virtual group educational sessions.</div></div><div><h3>Methods</h3><div>Twelve kidney transplant recipients and 12 liver transplant recipients received a Fitbit, weighting scale, and nutritional coaching calls for 12 months. Twelve participants were randomized to 5 educational group sessions on lifestyle modifications. Control patients who did not lose ≥2.5% of their body weight at 6 months were invited to crossover to the group sessions arm. Feasibility, acceptability, and appropriateness of the interventions were assessed at 6 months and 12 months.</div></div><div><h3>Results</h3><div>Twenty-four participants (median age, 57 years [interquartile range, 46.2-67.5 years], 75% male, a median of 24.9 months [IQR, 15.7-43.2]) months post-transplant) completed the study. The Fitbit wristband and scales were found to be 58% appropriate, 62.5% acceptable, and 67% feasible. Phone calls were found to be 50% appropriate, 54% acceptable, and 62.5% feasible. Attendance at ≥2 group sessions was achieved by 10 patients (62.5%; 7 from the intervention arm and 3 crossovers). Among these patients, 47% found the sessions acceptable, 59% appropriate, and 53% feasible.</div></div><div><h3>Conclusion</h3><div>Transplant recipients aiming for weight loss found the multicomponent lifestyle intervention feasible and acceptable. Larger studies are needed to test the effectiveness of these interventions.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1999-2009"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484511","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":"Incidence and Impact of Elevated Creatine Kinase Following Living Donor Nephrectomy","authors":"Michael Dryden ,&nbsp;Abraham Matar ,&nbsp;Fern Calkins ,&nbsp;Michael G. Megaly ,&nbsp;Joseph Sushil Rao ,&nbsp;Bailey Jacoby ,&nbsp;Arthur Matas ,&nbsp;Vanessa Humphreville","doi":"10.1016/j.transproceed.2025.10.022","DOIUrl":"10.1016/j.transproceed.2025.10.022","url":null,"abstract":"<div><h3>Background</h3><div>The clinical significance of elevated creatine kinase (CK) levels following living kidney donation (LKD) remains poorly characterized.</div></div><div><h3>Methods</h3><div>In this single-center retrospective study, we analyzed 264 consecutive donors undergoing hand-assisted laparoscopic donor nephrectomy (HALDN) between March 2021 and December 2023. CK levels were monitored postoperatively on days 0 (POD0) and 1 (POD1), with POD2 testing performed only if clinically indicated. Primary outcomes included serum creatinine and estimated glomerular filtration rate (eGFR) at six months post donation.</div></div><div><h3>Results</h3><div>The cohort comprised 65.9% female and 90.2% Caucasian donors, with a median age of 42.7 years (IQR 18.8) and BMI of 26.4 (IQR 5.0). Median CK levels rose from 109 U/L (IQR 64.5) on POD0 to 406 U/L (IQR 375) on POD1, peaking at 1845 U/L (IQR 3724) on POD2. Clinically significant CK elevations (&gt;1000 U/L) occurred in 8.7% (n = 23) of donors, with 2.3% (n = 6) exceeding 5000 U/L. Presumed myoglobinuria developed in two donors (both with CK &gt;5000 U/L). Risk factors for CK &gt;1000 U/L included male sex (65% vs. 31%; <em>P = .</em>002) and higher pre-donation creatinine (0.88 vs. 0.80 mg/dL; <em>P = .</em>005). For CK &gt;5000 U/L, male sex (83% vs. 33%; <em>P = .</em>01) and longer operative time (3.9 vs. 3.3 hours; <em>P = .</em>0008) were predictive. At six months, elevated CK showed no correlation with reduced eGFR (<em>P &gt; .</em>05). All donors with CK &gt;5000 U/L recovered fully with supportive care.</div></div><div><h3>Conclusions</h3><div>While elevated CK levels are common after HLDN, progression to clinically significant rhabdomyolysis is rare when identified and treated (2.3%). Male sex, higher baseline creatinine, and prolonged operative time identify at-risk donors. Routine CK monitoring enables early detection of subclinical rhabdomyolysis, though transient elevations do not impact intermediate-term renal function.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1914-1919"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454481","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":"Optimization of Oxygen Supply Conditions for Hypothermic Oxygenated Machine Perfusion","authors":"Tomoki Abe ,&nbsp;Masafumi Furukawa ,&nbsp;Naoto Matsuno ,&nbsp;Seisuke Sakamoto ,&nbsp;Hiromichi Obara","doi":"10.1016/j.transproceed.2025.10.027","DOIUrl":"10.1016/j.transproceed.2025.10.027","url":null,"abstract":"<div><div>Hypothermic oxygenated machine perfusion (MP) contributes to the reduction of delayed graft function and ischemic reperfusion injury in donated after circulatory death donors. In this study, we focused on perfusate temperature, oxygen consumption, and oxygen supply and proposed the possibility of assessing organ function. We also calculated the oxygen supply volume for membrane, pressure, dissolved, and bubble dissolved oxygen supply methods during MP, and summarized the optimal oxygen supply methods. The consumption of adult human kidney and liver based on body surface area was converted to 5.3, 1.6, 0.6, and 0.4 mL/min for human kidney, and 86.9, 31.9, 14.3, and 9.6 mL/min for human liver (37, 22, 10, and 4°C, respectively). The results suggest that a compact oxygenation method is sufficient to supply oxygen at temperatures below 10°C, the hypothermic oxygenated MP temperature range, and that new oxygenation techniques should be investigated.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1869-1872"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477142","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":"Glomerular Complications in Primary Myelofibrosis and the Role of Renal Transplantation: Systematic Review of The Current Evidence","authors":"Laila F. Sadagah ,&nbsp;Ahmad Makeen ,&nbsp;Abdulmajeed Alamoudi ,&nbsp;Ahmad Alhouthali ,&nbsp;Belal Abdulahad Alturkistani ,&nbsp;Manal Naser Almutairy","doi":"10.1016/j.transproceed.2025.10.016","DOIUrl":"10.1016/j.transproceed.2025.10.016","url":null,"abstract":"<div><div>Despite growing evidence of the prevalence and impact of renal complications in patients with myeloproliferative neoplasms (MPNs), these complications remain underrecognized. At diagnosis, 29% of MPN patients are known to have CKD and many have a high rate of renal failure progression. A distinct entity, MPN-related glomerulopathy, has been described, characterized by mesangial sclerosis, segmental sclerosis, and chronic thrombotic microangiopathy-like changes. Furthermore, an association between Myelofibrosis (MF), a subtype of MPN, and IgA nephropathy has been reported, though limited data exist on its clinical course and management. The present study reports a case of a 49-year-old man diagnosed with myelofibrosis and IgA nephropathy, which led to progressive renal insufficiency and ultimately end-stage renal disease (ESRD). Kidney biopsy showed IgA nephropathy with features of MPN-related glomerulopathy. Due to subsequent progressive impairment in renal function, the patient required and underwent successful renal transplantation with a favorable postoperative outcome. While treatment strategies for MPNs often include JAK2 inhibitors, their role in slowing renal disease progression remains unclear. Furthermore, renal transplantation in MPN patients with ESRD has not been thoroughly studied and should be further investigated, however, this case indicates that kidney transplant is a potential treatment option with appropriate consideration for immunosuppression. In summary, renal dysfunction in patients with MPNs should lead to careful consideration of glomerular involvement, particularly in individuals with unexplained proteinuria or progressive CKD. Kidney biopsy can provide essential diagnostic information, and renal transplantation should be considered as a treatment option in those with ESRD. Future studies are warranted to define the best management of MPN-associated renal disease and post-transplant immunosuppression in this patient population.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1893-1901"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427271","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":"Initial Clinical Outcomes of Hypothermic Machine Perfusion in Deceased Donor Kidney Transplantation: A Pilot Comparative Feasibility Study from South Korea","authors":"Won-Bae Chang ,&nbsp;Jiyoung Baik ,&nbsp;Miyeon Kim","doi":"10.1016/j.transproceed.2025.10.009","DOIUrl":"10.1016/j.transproceed.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>The shortage of donor kidneys has led to the increased use of marginal donors, including those from after circulatory death or extended criteria donors. Hypothermic machine perfusion (HMP) has shown better graft preservation than traditional static cold storage (SCS), particularly when cold ischemia time (CIT) is prolonged. This study evaluated the short-term outcomes of deceased donor kidney transplantation (DDKT) using HMP compared with SCS.</div></div><div><h3>Methods</h3><div>This pilot retrospective study included 16 DDKT patients at Jeju National University Hospital between April 2022 and July 2024. Seven grafts were preserved by SCS and nine by HMP. Donor, recipient, and perioperative characteristics were compared, as well as delayed graft function (DGF), 6-month graft and patient survival, and estimated glomerular filtration rate (eGFR). Given the limited sample size, multivariable adjustment or propensity-score analysis was not feasible, and results should be interpreted as exploratory.</div></div><div><h3>Results</h3><div>HLA mismatch was higher in the SCS group than in the HMP group (4.86 ± 1.21 vs. 2.89 ± 1.45, <em>P = .</em>012). Donor renal function was superior in SCS group, with lower serum creatinine (1.34 ± 0.68 vs. 3.22 ± 0.70, <em>P = .</em>039) and higher eGFR (65.6 ± 30.9 vs. 29.1 ± 17.6, <em>P = .</em>010). CIT was significantly longer in the HMP group (297 vs. 894 min, <em>P = .</em>001). <em>DGF occurred in 5 of 9 (55.6%) recipients in the HMP group and 1 of 7 (14.3%) in the SCS group (P = .103).</em> Six-month graft and patient survival, and short-term graft function did not differ significantly. During HMP, flow increased and renal resistance decreased at 4 hours compared with baseline. <em>Statistical power was limited, and post-hoc analysis suggested that approximately 20 patients per group would be required to detect differences in DGF with 80% power.</em></div></div><div><h3>Conclusions</h3><div>This pilot comparative study indicates that HMP is feasible for DDKT with prolonged CIT and yields comparable short-term outcomes to SCS. Dynamic perfusion parameters, including flow rate and renal resistance, may provide insights into early graft function, but validation in larger cohorts is required.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1863-1868"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461085","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}