Transplantation proceedings最新文献_第6页

Outcomes of Living Related Kidney Donors Following Donor Nephrectomy in Pakistan 巴基斯坦活体亲属肾供者肾切除术后的预后。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.09.011

Maria Ijaz , Tehreem Afroz , Hafiz Ijaz Ahmad , Adil Manzoor , Dua Ali , Saad Ahmed Waqas , Muhammad Awais , Raheel Ahmed , Syed Rizwan Bokhari

Background

Kidney transplantation is the preferred treatment for end-stage renal disease. In Pakistan, living related kidney donors constitute the primary source of kidney transplantation. However, data on postdonation outcomes in this population remain limited.

Objective

This study aims to evaluate the short- and intermediate-term effects of unilateral nephrectomy on donor kidney function, physical parameters, and glycemic status among living related kidney donors in Pakistan.

Methods

This retrospective observational cohort study was conducted at the Pakistan Kidney and Liver Institute from March 2018 to February 2021. Predonation data were obtained from hospital records, and postdonation follow-up assessments were conducted at intervals ranging from 6 months to 3 years.

Results

A total of 132 donors donated a kidney, and 100 participated in follow-up assessments. The mean postdonation serum creatinine increased significantly by 0.27 mg/dL (P < .05), while estimated glomerular filtration rate decreased by 30 mL/min (P < .05). Systolic blood pressure increased slightly (by 1.35 mm Hg), while diastolic blood pressure decreased, although neither change was statistically significant (P > .05). Body mass index showed a minor increase of 0.5 kg/m², and HbA1c levels remained stable with no significant postdonation changes (P > .05).

Conclusions

The study findings suggest that while kidney donation results in a significant decline in renal function in the short term, compensatory mechanisms contribute to gradual improvement over time. These results highlight the importance of continued postdonation monitoring to ensure donor health and identify potential long-term risks.

背景：肾移植是终末期肾脏疾病的首选治疗方法。在巴基斯坦，活着的亲属肾供体是肾移植的主要来源。然而，关于这一人群捐献后结果的数据仍然有限。目的：本研究旨在评估巴基斯坦单侧肾切除术对供者肾功能、身体参数和血糖状态的短期和中期影响。方法：这项回顾性观察性队列研究于2018年3月至2021年2月在巴基斯坦肾脏和肝脏研究所进行。捐赠前的数据从医院记录中获得，捐赠后的随访评估间隔为6个月至3年。结果：132名献血者捐献肾脏，100名参与随访评估。捐献后血清肌酐平均升高0.27 mg/dL (P < 0.05)，肾小球滤过率降低30 mL/min （P < 0.05）。收缩压略有升高（1.35 mm Hg），舒张压下降，但变化均无统计学意义（P < 0.05）。身体质量指数小幅上升0.5 kg/m²，HbA1c水平保持稳定，捐献后无明显变化（P < 0.05）。结论：研究结果表明，虽然肾脏捐献在短期内导致肾功能显著下降，但代偿机制有助于随着时间的推移逐渐改善肾功能。这些结果强调了继续进行捐赠后监测以确保捐赠者健康和识别潜在长期风险的重要性。

{"title":"Outcomes of Living Related Kidney Donors Following Donor Nephrectomy in Pakistan","authors":"Maria Ijaz , Tehreem Afroz , Hafiz Ijaz Ahmad , Adil Manzoor , Dua Ali , Saad Ahmed Waqas , Muhammad Awais , Raheel Ahmed , Syed Rizwan Bokhari","doi":"10.1016/j.transproceed.2025.09.011","DOIUrl":"10.1016/j.transproceed.2025.09.011","url":null,"abstract":"<div><h3>Background</h3><div>Kidney transplantation is the preferred treatment for end-stage renal disease. In Pakistan, living related kidney donors constitute the primary source of kidney transplantation. However, data on postdonation outcomes in this population remain limited.</div></div><div><h3>Objective</h3><div>This study aims to evaluate the short- and intermediate-term effects of unilateral nephrectomy on donor kidney function, physical parameters, and glycemic status among living related kidney donors in Pakistan.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study was conducted at the Pakistan Kidney and Liver Institute from March 2018 to February 2021. Predonation data were obtained from hospital records, and postdonation follow-up assessments were conducted at intervals ranging from 6 months to 3 years.</div></div><div><h3>Results</h3><div>A total of 132 donors donated a kidney, and 100 participated in follow-up assessments. The mean postdonation serum creatinine increased significantly by 0.27 mg/dL (<em>P</em> < .05), while estimated glomerular filtration rate decreased by 30 mL/min (<em>P</em> < .05). Systolic blood pressure increased slightly (by 1.35 mm Hg), while diastolic blood pressure decreased, although neither change was statistically significant (<em>P</em> > .05). Body mass index showed a minor increase of 0.5 kg/m², and HbA1c levels remained stable with no significant postdonation changes (<em>P</em> > .05).</div></div><div><h3>Conclusions</h3><div>The study findings suggest that while kidney donation results in a significant decline in renal function in the short term, compensatory mechanisms contribute to gradual improvement over time. These results highlight the importance of continued postdonation monitoring to ensure donor health and identify potential long-term risks.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1925-1929"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477218","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}

引用次数: 0

Current Methodological Procedures in Rat Models After Circulatory Death 循环性死亡大鼠模型的现行方法学程序

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.028

Mayara Munhoz de Assis Ramos , Fernanda Yamamoto Ricardo-da-Silva , Larissa dos Santos Pedroso , Henri G.D. Leuvenink , Ana Cristina Breithaupt-Faloppa , Luiz Felipe Pinho Moreira

Lung transplantation continues to face significant hurdles, mainly regarding graft preservation and minimizing ischemia-reperfusion injury (IRI). Conventional preservation techniques like static cold storage often lead to complications, stimulating the development of ex vivo lung perfusion (EVLP) as a more effective alternative. EVLP offers the advantage of evaluating and treating the graft prior to transplantation, thereby improving the use of extended-criteria donors and donation after circulatory death (DCD). Recent findings demonstrate the potential of normothermic EVLP in reducing IRI damage. Additionally, the application of various temperature settings for EVLP—hypothermic, subnormothermic, and normothermic—shows promise in better preserving lung function. Ventilation strategies also influence graft viability, with negative-pressure ventilation emerging as a potential method to decrease inflammation and damage relative to traditional positive-pressure methods. Furthermore, gas treatments during perfusion, such as hydrogen sulfide, carbon monoxide, and nitric oxide, offer promising avenues to enhance lung graft preservation. Despite the advantages, widespread adoption of EVLP faces challenges, especially related to highlighting the need for cost-effective preservation techniques. Future investigations should focus on deepening our understanding of graft injury mechanisms, especially in DCD models, and refining preservation protocols. Developing more reliable small animal models and aligning studies with the Maastricht classification will help bridge the gap between preclinical research and clinical application, ultimately expanding the donor pool and improving transplantation outcomes.

肺移植仍然面临着重大的障碍，主要是关于移植物保存和最小化缺血再灌注损伤（IRI）。传统的保存技术如静态冷藏往往会导致并发症，刺激体外肺灌注（EVLP）的发展是一种更有效的替代方法。EVLP提供了在移植前评估和处理移植物的优势，从而改善了延长标准供体的使用和循环性死亡（DCD）后的捐赠。最近的研究结果表明，常温EVLP在减少IRI损伤方面具有潜力。此外，在evlp中应用不同的温度设置——低温、亚常温和常温——有望更好地保护肺功能。通气策略也会影响移植物的生存能力，与传统的正压通气相比，负压通气成为减少炎症和损伤的潜在方法。此外，灌注过程中的气体处理，如硫化氢、一氧化碳和一氧化氮，为增强肺移植物保存提供了有希望的途径。尽管EVLP具有优势，但它的广泛采用面临着挑战，特别是在强调成本效益的保存技术方面。未来的研究应侧重于加深我们对移植物损伤机制的理解，特别是在DCD模型中，并完善保存方案。开发更可靠的小动物模型并使研究与马斯特里赫特分类相一致，将有助于弥合临床前研究和临床应用之间的差距，最终扩大供体库并改善移植结果。

{"title":"Current Methodological Procedures in Rat Models After Circulatory Death","authors":"Mayara Munhoz de Assis Ramos , Fernanda Yamamoto Ricardo-da-Silva , Larissa dos Santos Pedroso , Henri G.D. Leuvenink , Ana Cristina Breithaupt-Faloppa , Luiz Felipe Pinho Moreira","doi":"10.1016/j.transproceed.2025.10.028","DOIUrl":"10.1016/j.transproceed.2025.10.028","url":null,"abstract":"<div><div>Lung transplantation continues to face significant hurdles, mainly regarding graft preservation and minimizing ischemia-reperfusion injury (IRI). Conventional preservation techniques like static cold storage often lead to complications, stimulating the development of <em>ex vivo</em> lung perfusion (EVLP) as a more effective alternative. EVLP offers the advantage of evaluating and treating the graft prior to transplantation, thereby improving the use of extended-criteria donors and donation after circulatory death (DCD). Recent findings demonstrate the potential of normothermic EVLP in reducing IRI damage. Additionally, the application of various temperature settings for EVLP—hypothermic, subnormothermic, and normothermic—shows promise in better preserving lung function. Ventilation strategies also influence graft viability, with negative-pressure ventilation emerging as a potential method to decrease inflammation and damage relative to traditional positive-pressure methods. Furthermore, gas treatments during perfusion, such as hydrogen sulfide, carbon monoxide, and nitric oxide, offer promising avenues to enhance lung graft preservation. Despite the advantages, widespread adoption of EVLP faces challenges, especially related to highlighting the need for cost-effective preservation techniques. Future investigations should focus on deepening our understanding of graft injury mechanisms, especially in DCD models, and refining preservation protocols. Developing more reliable small animal models and aligning studies with the Maastricht classification will help bridge the gap between preclinical research and clinical application, ultimately expanding the donor pool and improving transplantation outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 2028-2037"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524772","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}

引用次数: 0

Impact of Delayed Graft Function Duration on Long-Term Graft Survival After Kidney Transplantation 肾移植后移植物功能持续时间延迟对移植物长期存活的影响。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.014

Ki Yoon Moon, Eun Ju Jang, Sang Seob Yun, JangYong Kim, Sun Cheol Park

Introduction

In patients with end-stage renal disease, kidney transplantation is the most recommended option for renal replacement therapy. However, due to the shortage of donor kidneys, the use of marginal kidneys has increased, leading to a higher incidence of delayed graft function (DGF). This study aimed to evaluate the effects of DGF and its duration on kidney transplantation outcomes.

Methods

A total of 1903 patients who underwent kidney transplantation between 2005 and 2020 were analyzed. DGF was defined as the need for dialysis within the first week after transplantation. Propensity score matching was used to ensure a balanced comparison between patients with DGF and those without DGF. Patients were further categorized based on the duration of DGF (group A’: postoperative day 0-13, group B’: postoperative day 14-). Graft survival was compared between these groups.

Results

Diabetes mellitus, predialysis duration, kidney weight, and the duration of DGF were identified as significant risk factors for graft failure. The 10-year graft survival rate among all patients with DGF was 58.8%. When stratified by DGF duration, the 10-year graft survival rate was 85.4% in the no DGF group, 68.5% in group A’, and 31.3% in group B’.

Conclusion

This study confirms that both the presence and prolonged duration of DGF adversely affect graft outcomes, particularly when dialysis is required for more than 14 days after transplantation.

在终末期肾病患者中，肾移植是最推荐的肾脏替代治疗选择。然而，由于供体肾脏的短缺，边缘肾脏的使用增加，导致移植功能延迟（DGF）的发生率更高。本研究旨在评估DGF及其持续时间对肾移植预后的影响。方法：对2005 ~ 2020年接受肾移植的1903例患者进行分析。DGF定义为移植后第一周内需要透析。倾向评分匹配用于确保DGF患者和未DGF患者之间的平衡比较。根据DGF持续时间对患者进行进一步分类（A组：术后0 ~ 13天，B组：术后14 ~ 14天）。比较两组间移植物存活率。结果：糖尿病、透析前持续时间、肾脏重量和DGF持续时间被确定为移植物衰竭的重要危险因素。所有DGF患者的10年移植存活率为58.8%。按DGF持续时间分层，无DGF组10年移植物存活率为85.4%，A组为68.5%，B组为31.3%。结论：本研究证实，DGF的存在和持续时间的延长都会对移植结果产生不利影响，特别是当移植后需要透析超过14天时。

{"title":"Impact of Delayed Graft Function Duration on Long-Term Graft Survival After Kidney Transplantation","authors":"Ki Yoon Moon, Eun Ju Jang, Sang Seob Yun, JangYong Kim, Sun Cheol Park","doi":"10.1016/j.transproceed.2025.10.014","DOIUrl":"10.1016/j.transproceed.2025.10.014","url":null,"abstract":"<div><h3>Introduction</h3><div>In patients with end-stage renal disease, kidney transplantation is the most recommended option for renal replacement therapy. However, due to the shortage of donor kidneys, the use of marginal kidneys has increased, leading to a higher incidence of delayed graft function (DGF). This study aimed to evaluate the effects of DGF and its duration on kidney transplantation outcomes.</div></div><div><h3>Methods</h3><div>A total of 1903 patients who underwent kidney transplantation between 2005 and 2020 were analyzed. DGF was defined as the need for dialysis within the first week after transplantation. Propensity score matching was used to ensure a balanced comparison between patients with DGF and those without DGF. Patients were further categorized based on the duration of DGF (group A’: postoperative day 0-13, group B’: postoperative day 14-). Graft survival was compared between these groups.</div></div><div><h3>Results</h3><div>Diabetes mellitus, predialysis duration, kidney weight, and the duration of DGF were identified as significant risk factors for graft failure. The 10-year graft survival rate among all patients with DGF was 58.8%. When stratified by DGF duration, the 10-year graft survival rate was 85.4% in the no DGF group, 68.5% in group A’, and 31.3% in group B’.</div></div><div><h3>Conclusion</h3><div>This study confirms that both the presence and prolonged duration of DGF adversely affect graft outcomes, particularly when dialysis is required for more than 14 days after transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1907-1913"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427256","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}

引用次数: 0

The Correlation of Hemodynamic Changes and Early Allograft Function Following Liver Transplantation 肝移植术后血流动力学变化与早期同种异体移植物功能的相关性。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.011

Ssu-Min Cheng , Li-Chueh Weng , Wei-Chen Lee , Li-Tzu Chen , Chen-Fang Lee

Background

The systemic circulation in patients with cirrhosis is hyperdynamic, marked by elevated cardiac output (CO) and heart rate (HR), coupled with significantly reduced systemic vascular resistance. This retrospective study aimed to evaluate the correlation between hemodynamic alterations and liver function through non-invasive hemodynamic monitoring during the early postoperative period in liver transplant recipients.

Materials and Methods

The medical records of patients who underwent living donor liver transplantation between February and December 2024 were reviewed. Liver function indices, including total bilirubin, prothrombin time-international normalized ratio (PT-INR), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and ammonia, were collected from the operative day to postoperative day 28. Hemodynamic indices, including CO, cardiac index (CI), HR, stroke volume (SV), SV index (SVI), SV variation (SVV), and thoracic fluid content (TFC), were collected during the initial six days post-transplantation.

Results

Nineteen recipients were enrolled in the study. Levels of total bilirubin, PT-INR, AST, ALT, ammonia and LDH significantly decreased from postoperative day 1 to day 7 (p for trend: .049, < .001, < .001, < .001, < .001, and < .001, respectively). During the initial 132 hours post-transplantation, significant decreases were observed in CO, CI, HR, SV, and SVI (all p for trend < .001). In contrast, SVV and TFC levels increased during the same period (all p for trend < .001). Reductions in CO, CI, HR, SV, and SVI were significantly correlated with decreases in liver function indices (all p < .05). In contrast, the rise in SVV demonstrated a substantial correlation with diminished liver function indices (all p < .05).

Conclusion

These findings suggested that the recovery of hemodynamic stability may serve as a reliable indicator of a well-functioning liver graft.

背景：肝硬化患者的体循环是高动力的，其特征是心输出量（CO）和心率（HR）升高，同时全身血管阻力显著降低。本回顾性研究旨在通过无创血流动力学监测评估肝移植术后早期血流动力学改变与肝功能的相关性。材料与方法：回顾2024年2月至12月接受活体肝移植患者的病历。从手术第1天至术后第28天收集肝功能指标，包括总胆红素、凝血酶原时间-国际标准化比值（PT-INR）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、乳酸脱氢酶（LDH）、氨氮。在移植后最初6天内收集血液动力学指标，包括CO、心脏指数（CI）、HR、卒中量（SV）、SV指数（SVI）、SV变化（SVV）和胸腔液体含量（TFC）。结果：19名接受者被纳入研究。术后第1天至第7天，总胆红素、PT-INR、AST、ALT、氨和LDH水平显著降低（p为趋势）。049, < .001, < .001, < .001, < .001, < .001)。在移植后132小时内，CO、CI、HR、SV和SVI显著下降（趋势均p < 0.001）。相比之下，SVV和TFC水平在同一时期增加（趋势均p < 0.001）。CO、CI、HR、SV和SVI的降低与肝功能指数的降低显著相关（均p < 0.05）。相反，SVV升高与肝功能指数下降有显著相关性（均p < 0.05）。结论：这些结果提示血流动力学稳定性的恢复可作为肝移植功能良好的可靠指标。

{"title":"The Correlation of Hemodynamic Changes and Early Allograft Function Following Liver Transplantation","authors":"Ssu-Min Cheng , Li-Chueh Weng , Wei-Chen Lee , Li-Tzu Chen , Chen-Fang Lee","doi":"10.1016/j.transproceed.2025.10.011","DOIUrl":"10.1016/j.transproceed.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>The systemic circulation in patients with cirrhosis is hyperdynamic, marked by elevated cardiac output (CO) and heart rate (HR), coupled with significantly reduced systemic vascular resistance. This retrospective study aimed to evaluate the correlation between hemodynamic alterations and liver function through non-invasive hemodynamic monitoring during the early postoperative period in liver transplant recipients.</div></div><div><h3>Materials and Methods</h3><div>The medical records of patients who underwent living donor liver transplantation between February and December 2024 were reviewed. Liver function indices, including total bilirubin, prothrombin time-international normalized ratio (PT-INR), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and ammonia, were collected from the operative day to postoperative day 28. Hemodynamic indices, including CO, cardiac index (CI), HR, stroke volume (SV), SV index (SVI), SV variation (SVV), and thoracic fluid content (TFC), were collected during the initial six days post-transplantation.</div></div><div><h3>Results</h3><div>Nineteen recipients were enrolled in the study. Levels of total bilirubin, PT-INR, AST, ALT, ammonia and LDH significantly decreased from postoperative day 1 to day 7 (<em>p</em> for trend: .049, < .001, < .001, < .001, < .001, and < .001, respectively). During the initial 132 hours post-transplantation, significant decreases were observed in CO, CI, HR, SV, and SVI (all <em>p</em> for trend < .001). In contrast, SVV and TFC levels increased during the same period (all <em>p</em> for trend < .001). Reductions in CO, CI, HR, SV, and SVI were significantly correlated with decreases in liver function indices (all <em>p</em> < .05). In contrast, the rise in SVV demonstrated a substantial correlation with diminished liver function indices (all <em>p</em> < .05).</div></div><div><h3>Conclusion</h3><div>These findings suggested that the recovery of hemodynamic stability may serve as a reliable indicator of a well-functioning liver graft.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1956-1963"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427279","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}

引用次数: 0

Patient Satisfaction With Belatacept Therapy: A Single-Center, Cross-Sectional Study 患者对belataccept治疗的满意度：一项单中心、横断面研究。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.006

Abhinaya Sridhar , Andrew Santeusanio , Emily Rademacher , Jonathan Armenti , Samira S. Farouk

Background

The efficacy of belatacept for maintenance immunosuppression after kidney transplantation is well-established in the literature. Although this medication is being increasingly used as a strategy to avoid calcineurin inhibitors, which are associated with numerous adverse effects, patient satisfaction with monthly belatacept infusions is not well understood.

Methods

We administered a validated treatment satisfaction tool (SATMED-Q) to kidney transplant recipients aged 17 to 85 years, who were receiving monthly belatacept infusions at a single health system-affiliated infusion center.

Results

A total of 74 patients were approached for the study, and 70 completed the survey. The overall satisfaction score was 86.6/100. Scores for satisfaction with medical follow-up and impact on everyday life were 96.9 and 76.7, respectively. Patients also reported high scores in relation to side effects (94.2), general opinion (94.1), and convenience (81.8).

Conclusions

Patients with kidney transplants reported very high satisfaction scores with belatacept use, with almost 100% patients intending to continue belatacept therapy.

背景：文献已经证实了贝拉他普对肾移植术后维持免疫抑制的疗效。尽管这种药物越来越多地被用作一种避免钙调磷酸酶抑制剂的策略，但患者对每月输注迟发肽的满意度尚不清楚。方法：我们对17岁至85岁的肾移植受者实施了一个经过验证的治疗满意度工具（SATMED-Q），这些受者每月在一个卫生系统附属的输注中心接受belatacept输注。结果：共接触74例患者，其中70例完成调查。总体满意度得分为86.6/100。对医疗随访的满意度和对日常生活的影响得分分别为96.9和76.7。患者在副作用（94.2）、一般意见（94.1）和便利性（81.8）方面也报告了高分。结论：肾移植患者报告了非常高的满意度评分，几乎100%的患者打算继续使用belatacept治疗。

{"title":"Patient Satisfaction With Belatacept Therapy: A Single-Center, Cross-Sectional Study","authors":"Abhinaya Sridhar , Andrew Santeusanio , Emily Rademacher , Jonathan Armenti , Samira S. Farouk","doi":"10.1016/j.transproceed.2025.10.006","DOIUrl":"10.1016/j.transproceed.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of belatacept for maintenance immunosuppression after kidney transplantation is well-established in the literature. Although this medication is being increasingly used as a strategy to avoid calcineurin inhibitors, which are associated with numerous adverse effects, patient satisfaction with monthly belatacept infusions is not well understood.</div></div><div><h3>Methods</h3><div>We administered a validated treatment satisfaction tool (SATMED-Q) to kidney transplant recipients aged 17 to 85 years, who were receiving monthly belatacept infusions at a single health system-affiliated infusion center.</div></div><div><h3>Results</h3><div>A total of 74 patients were approached for the study, and 70 completed the survey. The overall satisfaction score was 86.6/100. Scores for satisfaction with medical follow-up and impact on everyday life were 96.9 and 76.7, respectively. Patients also reported high scores in relation to side effects (94.2), general opinion (94.1), and convenience (81.8).</div></div><div><h3>Conclusions</h3><div>Patients with kidney transplants reported very high satisfaction scores with belatacept use, with almost 100% patients intending to continue belatacept therapy.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1902-1906"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433308","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}

引用次数: 0

Effects of Multimodal Perioperative Temperature Management on Hypothermia in Orthotopic Liver Transplantation 多模式围手术期温度管理对原位肝移植低体温的影响。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.013

Hao Zhang , Xueqing Hu , Guimei Zhang , Xiaorui Yang , Weilong Gu , Qijun Chen , Wanling Xiao , Lulu Sun

Objective

This study aimed to investigate the impact of multimodal perioperative temperature management on the incidence of perioperative hypothermia in individuals undergoing orthotopic liver transplantation (OLT).

Methods

A retrospective analysis was conducted on 226 patients who underwent elective OLT at our hospital between January 2022 and August 2024. Patients were divided into two groups based on the intraoperative body temperature management approach: a conventional temperature maintenance group (n = 112) and a multimodal temperature management group (n = 87). Propensity score matching (PSM), using caliper values, resulted in the matching of 156 patients, with 78 in each group. Baseline and perioperative data were compared between the two groups before and after matching.

Results

The lowest body temperature in both groups was recorded at time point T5. From T1 to T7, the multimodal temperature management group consistently demonstrated higher body temperatures compared to the conventional group (P < .05). Additionally, the conventional group exhibited significantly higher rates of postoperative shivering and agitation (P < .05), longer stays in the postoperative anesthesia recovery room (P < .05), and lower quality of recovery-15 (QoR-15) scores (P < .05). These differences were statistically significant (P < .05).

Conclusion

Patients undergoing OLT experienced a notable decline in body temperature throughout the perioperative period, with the lowest temperature recorded at the onset of the neohepatic phase. Multimodal temperature management was effective in maintaining more stable body temperatures, contributing to improved recovery outcomes.

目的：本研究旨在探讨多模式围手术期温度管理对原位肝移植（OLT）患者围手术期低温发生率的影响。方法：对2022年1月至2024年8月在我院行选择性OLT的226例患者进行回顾性分析。根据术中体温管理方法将患者分为两组：常规体温维持组（n = 112）和多模式体温管理组（n = 87）。使用卡尺值进行倾向评分匹配（PSM），结果匹配156例患者，每组78例。比较两组配对前后的基线及围手术期资料。结果：两组患者均在T5时间点记录最低体温。从T1到T7，与常规组相比，多模式温度管理组始终表现出较高的体温（P < 0.05）。此外，常规组术后颤抖和躁动率明显高于常规组（P < 0.05），术后麻醉恢复室停留时间更长（P < 0.05），恢复-15 （QoR-15）评分质量较低（P < 0.05）。差异有统计学意义（P < 0.05）。结论：OLT患者围手术期体温明显下降，新肝期开始时体温最低。多模式温度管理可以有效地维持更稳定的体温，有助于改善恢复结果。

{"title":"Effects of Multimodal Perioperative Temperature Management on Hypothermia in Orthotopic Liver Transplantation","authors":"Hao Zhang , Xueqing Hu , Guimei Zhang , Xiaorui Yang , Weilong Gu , Qijun Chen , Wanling Xiao , Lulu Sun","doi":"10.1016/j.transproceed.2025.10.013","DOIUrl":"10.1016/j.transproceed.2025.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the impact of multimodal perioperative temperature management on the incidence of perioperative hypothermia in individuals undergoing orthotopic liver transplantation (OLT).</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 226 patients who underwent elective OLT at our hospital between January 2022 and August 2024. Patients were divided into two groups based on the intraoperative body temperature management approach: a conventional temperature maintenance group (n = 112) and a multimodal temperature management group (n = 87). Propensity score matching (PSM), using caliper values, resulted in the matching of 156 patients, with 78 in each group. Baseline and perioperative data were compared between the two groups before and after matching.</div></div><div><h3>Results</h3><div>The lowest body temperature in both groups was recorded at time point T5. From T1 to T7, the multimodal temperature management group consistently demonstrated higher body temperatures compared to the conventional group (<em>P < .</em>05). Additionally, the conventional group exhibited significantly higher rates of postoperative shivering and agitation (<em>P < .</em>05), longer stays in the postoperative anesthesia recovery room (<em>P < .</em>05), and lower quality of recovery-15 (QoR-15) scores (<em>P < .</em>05). These differences were statistically significant (<em>P < .</em>05).</div></div><div><h3>Conclusion</h3><div>Patients undergoing OLT experienced a notable decline in body temperature throughout the perioperative period, with the lowest temperature recorded at the onset of the neohepatic phase. Multimodal temperature management was effective in maintaining more stable body temperatures, contributing to improved recovery outcomes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1950-1955"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433669","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}

引用次数: 0

Association of Serum Uric Acid–Lowering Therapy and Resistance Index After Renal Transplantation 肾移植后血清降尿酸治疗与抵抗指数的关系。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.007

Sebastian Bertram , Maximilian Seidel , Nikolaos Pagonas , Panagiota Zgoura , Thomas Klein , Richard Viebahn , Nina Babel , Felix S. Seibert , Timm H. Westhoff

Introduction

Hyperuricemia is a frequent problem after renal transplantation. It is associated with an increased risk of cardiovascular events and graft loss. In the present study, we evaluated whether treatment of hyperuricemia is associated with intrarenal hemodynamic changes as measured by the resistance index (RI).

Methods

We performed a retrospective analysis of 402 patients who underwent renal transplants over a follow-up period of 120 months. The population was stratified into three groups based on examinations at month 12 after transplantation. Group 1 (normouricemia) had a serum uric acid (SUA) concentration <7 mg/dL and never received SUA-lowering therapy during follow-up. Group 2 (hyperuricemia, untreated) had a SUA≥7 mg/dL and never received SUA-lowering therapy. Group 3 (hyperuricemia, treated) received SUA-lowering therapy within the follow-up period.

Results

At 12 and 60 months, linear regression analysis was performed between RI and SUA concentrations showing a significant correlation for this group at month 12. The development of RI within the 10-year follow-up period differed among groups: At month 120, RI was significantly higher in subjects with hyperuricemia that was untreated (0.76 ± 0.06) than in the other groups (P < 0.05), although it started at a level even lower than the group of subjects with hyperuricemia that were treated at 12 months (0.70 ± 0.08 vs. 0.73 ± 0.08, P < 0.05). In cox regression analysis adjusted for age, eGFR, body mass index, and postmortal versus living donation, there was a trend to better survival in Group 3.

Conclusion

SUA-lowering therapy is associated with a lower increase of RI over time and a trend to better survival of recipients of renal transplants in this retrospective analysis.

高尿酸血症是肾移植术后常见的问题。它与心血管事件和移植物损失的风险增加有关。在本研究中，我们评估了高尿酸血症的治疗是否与通过抵抗指数（RI）测量的肾内血流动力学变化有关。方法：我们对402例接受肾移植的患者进行了回顾性分析，随访时间为120个月。根据移植后12个月的检查将患者分为三组。结果：在12个月和60个月时，对RI和SUA浓度进行线性回归分析，显示该组在12个月时的血清尿酸（SUA）浓度显著相关。在10年随访期间，不同组间的RI发展情况不同：在第120个月，未治疗的高尿酸血症组的RI显著高于其他组（0.76±0.06）（P < 0.05），尽管其开始水平甚至低于12个月治疗的高尿酸血症组（0.70±0.08比0.73±0.08,P < 0.05）。经年龄、eGFR、体重指数、死后与活体捐献校正后的cox回归分析显示，第3组有更好的生存趋势。结论：在本回顾性分析中，降低sua治疗与较低的随时间增加的RI以及肾移植受者更好的生存趋势相关。

{"title":"Association of Serum Uric Acid–Lowering Therapy and Resistance Index After Renal Transplantation","authors":"Sebastian Bertram , Maximilian Seidel , Nikolaos Pagonas , Panagiota Zgoura , Thomas Klein , Richard Viebahn , Nina Babel , Felix S. Seibert , Timm H. Westhoff","doi":"10.1016/j.transproceed.2025.10.007","DOIUrl":"10.1016/j.transproceed.2025.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Hyperuricemia is a frequent problem after renal transplantation. It is associated with an increased risk of cardiovascular events and graft loss. In the present study, we evaluated whether treatment of hyperuricemia is associated with intrarenal hemodynamic changes as measured by the resistance index (RI).</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of 402 patients who underwent renal transplants over a follow-up period of 120 months. The population was stratified into three groups based on examinations at month 12 after transplantation. Group 1 (normouricemia) had a serum uric acid (SUA) concentration <7 mg/dL and never received SUA-lowering therapy during follow-up. Group 2 (hyperuricemia, untreated) had a SUA≥7 mg/dL and never received SUA-lowering therapy. Group 3 (hyperuricemia, treated) received SUA-lowering therapy within the follow-up period.</div></div><div><h3>Results</h3><div>At 12 and 60 months, linear regression analysis was performed between RI and SUA concentrations showing a significant correlation for this group at month 12. The development of RI within the 10-year follow-up period differed among groups: At month 120, RI was significantly higher in subjects with hyperuricemia that was untreated (0.76 ± 0.06) than in the other groups (<em>P</em> < 0.05), although it started at a level even lower than the group of subjects with hyperuricemia that were treated at 12 months (0.70 ± 0.08 vs. 0.73 ± 0.08, <em>P</em> < 0.05). In cox regression analysis adjusted for age, eGFR, body mass index, and postmortal versus living donation, there was a trend to better survival in Group 3.</div></div><div><h3>Conclusion</h3><div>SUA-lowering therapy is associated with a lower increase of RI over time and a trend to better survival of recipients of renal transplants in this retrospective analysis.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1873-1879"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461044","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}

引用次数: 0

Corrigendum to “Cytochrome b5 Interacts With Cytochrome C and Inhibits Hepatocyte Apoptosis in Brain-dead Rabbit Donors” [Transplantation Proceedings, 51/6 2019: 2108-2115] “细胞色素b5与细胞色素C相互作用抑制脑死亡兔供体肝细胞凋亡”[中国移植杂志，2019,51/6:2108-2115]。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.05.005

Yan Xiong , Lin Fan , Qiang Tu , Guizhu Peng , Yanfeng Wang , Qifa Ye

引用次数: 0

Differential Effect of Two Transplantation Methods of Adipose-derived Mesenchymal Stem Cells on Hearing Improvement in Simulated Aging Rats 脂肪源性间充质干细胞两种移植方法对模拟衰老大鼠听力改善的差异影响。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.003

Jia Liu , Xiuying Wang , Na Li , Danna Chen , Dawei Yang

Background

Presbycusis is an age-related condition characterized by symmetrical bilateral hearing loss that progresses to total deafness in severe cases. Mesenchymal stem cells demonstrate strong therapeutic and regenerative potential, making it worthwhile to explore optimal transplantation pathways for improving age-related hearing loss.

Methods

Rats were injected with D-galactose to establish an animal model simulating aging. Adipose-derived stem cells were injected intravenously and into the auditory cortex. The hearing of rats was assessed indirectly through the establishment of an acoustic fear conditioned reflex and directly evaluated by the auditory brainstem response. Gabaergic neurons in the auditory cortex were detected using indirect immunofluorescence, and apoptosis was detected using the terminal uridine nick-end labeling method.

Results

In comparison with the control group, rats in the model B group exhibited a poor association between sound and electrical stimulation. Similar results were observed in the group injected intravenously with adipose-derived stem cells (group C). However, acoustical fear conditioning was more effectively established in the auditory cortex injection group (group D). Auditory brainstem response analysis revealed a significantly lower hearing threshold in group D compared with group B, indicating a more pronounced hearing recovery in rats receiving auditory cortex injections, whereas intravenous stem cell injection had no discernible effect. In group D, there was a substantial increase in the number of GABAergic neurons, a slight decrease in apoptotic cells, and a significant decrease in apoptotic GABAergic neurons.

Conclusions

The injection of adipose-derived stem cells into the auditory cortex is able to ameliorate deafness in rats with simulated aging, which may be effected mainly by increasing the number of GABAergic neurons.

背景：老年性耳聋是一种与年龄相关的疾病，其特征是对称性双侧听力丧失，严重者可发展为全聋。间充质干细胞显示出强大的治疗和再生潜力，因此值得探索改善年龄相关性听力损失的最佳移植途径。方法：给大鼠注射d -半乳糖，建立模拟衰老动物模型。将脂肪来源的干细胞静脉注射到听觉皮层。通过建立声恐惧条件反射间接评价大鼠的听力，通过听觉脑干反应直接评价大鼠的听力。用间接免疫荧光法检测听觉皮层gabaergy神经元，用末端尿苷镍端标记法检测细胞凋亡。结果：与对照组相比，B模型组大鼠声电刺激相关性较差。在静脉注射脂肪来源干细胞组（C组）中观察到类似的结果。然而，听觉皮层注射组（D组）更有效地建立了听觉恐惧条件反射。听觉脑干反应分析显示，与B组相比，D组的听力阈值明显降低，这表明接受听觉皮层注射的大鼠听力恢复更为明显，而静脉注射干细胞则没有明显的效果。D组gabaergy神经元数量显著增加，凋亡细胞略有减少，凋亡gabaergy神经元数量明显减少。结论：将脂肪来源的干细胞注入听觉皮层能够改善模拟衰老大鼠的耳聋，其主要作用可能是增加gaba能神经元的数量。

{"title":"Differential Effect of Two Transplantation Methods of Adipose-derived Mesenchymal Stem Cells on Hearing Improvement in Simulated Aging Rats","authors":"Jia Liu , Xiuying Wang , Na Li , Danna Chen , Dawei Yang","doi":"10.1016/j.transproceed.2025.10.003","DOIUrl":"10.1016/j.transproceed.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Presbycusis is an age-related condition characterized by symmetrical bilateral hearing loss that progresses to total deafness in severe cases. Mesenchymal stem cells demonstrate strong therapeutic and regenerative potential, making it worthwhile to explore optimal transplantation pathways for improving age-related hearing loss.</div></div><div><h3>Methods</h3><div>Rats were injected with D-galactose to establish an animal model simulating aging. Adipose-derived stem cells were injected intravenously and into the auditory cortex. The hearing of rats was assessed indirectly through the establishment of an acoustic fear conditioned reflex and directly evaluated by the auditory brainstem response. Gabaergic neurons in the auditory cortex were detected using indirect immunofluorescence, and apoptosis was detected using the terminal uridine nick-end labeling method.</div></div><div><h3>Results</h3><div>In comparison with the control group, rats in the model B group exhibited a poor association between sound and electrical stimulation. Similar results were observed in the group injected intravenously with adipose-derived stem cells (group C). However, acoustical fear conditioning was more effectively established in the auditory cortex injection group (group D). Auditory brainstem response analysis revealed a significantly lower hearing threshold in group D compared with group B, indicating a more pronounced hearing recovery in rats receiving auditory cortex injections, whereas intravenous stem cell injection had no discernible effect. In group D, there was a substantial increase in the number of GABAergic neurons, a slight decrease in apoptotic cells, and a significant decrease in apoptotic GABAergic neurons.</div></div><div><h3>Conclusions</h3><div>The injection of adipose-derived stem cells into the auditory cortex is able to ameliorate deafness in rats with simulated aging, which may be effected mainly by increasing the number of GABAergic neurons.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 2038-2044"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454469","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}

引用次数: 0

Challenges in Management of BK Virus Infections in HIV-Infected Renal Transplant Recipients hiv感染肾移植受者BK病毒感染管理的挑战

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings

Pub Date : 2025-12-01 DOI: 10.1016/j.transproceed.2025.10.017

Dante A. Puntiel, Jayalakshmi N. Alagar, Julienne Jeong, Dianly C. Centeno, Ryan A. Quan, Brooke Stanicki, Ibrahim Y. Khalil, Konstantinos A. Zorbas, Sunil S. Karhadkar

Background

BK virus (BKV) poses a significant threat to kidney transplantation as it can lead to severe complications, including BK virus nephropathy (BKVN). Many transplant recipients harbor latent BKV, which can reactivate under immunosuppression, leading to viruria, viremia, and potential graft loss. The management of BKVN in human immunodeficiency virus (HIV)-positive patients is especially complex owing to the dual challenge of balancing immunosuppressive therapy and antiretroviral treatment, compounded by potential drug interactions. This study aimed to investigate the incidence, risk factors, and outcomes of BKVN in HIV-positive kidney transplant recipients, comparing these findings to findings in HIV-negative recipients.

Methods

The United Network for Organ Sharing database was used to identify kidney transplant recipients between August 2009 and February 2022, excluding those age <18 years, with prior transplants, or with unknown HIV status. Parametric and nonparametric tests were used to assess risk factors for BKVN in HIV-positive individuals.

Results

Among 1909 HIV-positive kidney transplant recipients, 15 (0.8%) experienced graft loss due to BKVN, compared to 558 of 168,836 (0.3%) HIV-negative recipients. HIV-positive individuals had a higher risk of BKVN-related graft loss (P < .001). In the HIV-positive group, delayed graft function (DGF), greater HLA mismatch, older donor age, older recipient age, and a history of diabetes were significant risk factors for BKVN. The HIV-positive BKVN group had shorter graft survival compared to their HIV-negative counterparts (P = .044).

Conclusion

This study confirms that HIV-positive individuals are at greater risk of graft loss due to BKVN, with risk factors including DGF, greater HLA mismatch, older donor and recipient age, and a history of diabetes.

背景：BK病毒（BKV）对肾移植造成重大威胁，因为它可导致严重并发症，包括BK病毒肾病（BKVN）。许多移植受者携带潜伏的BKV，它可以在免疫抑制下重新激活，导致病毒血症、病毒血症和潜在的移植物损失。人类免疫缺陷病毒（HIV）阳性患者BKVN的管理特别复杂，因为平衡免疫抑制治疗和抗逆转录病毒治疗的双重挑战，加上潜在的药物相互作用。本研究旨在调查hiv阳性肾移植受者BKVN的发生率、危险因素和结局，并将这些结果与hiv阴性肾移植受者的结果进行比较。方法：使用联合器官共享网络数据库识别2009年8月至2022年2月期间的肾移植受者，不包括年龄。结果：在1909名hiv阳性肾移植受者中，15名（0.8%）因BKVN发生移植损失，而168,836名hiv阴性受者中有558名（0.3%）发生移植损失。hiv阳性个体发生bkvn相关移植物丢失的风险较高（P < 0.001）。在hiv阳性组中，移植功能延迟（DGF）、HLA不匹配、供体年龄较大、受体年龄较大和糖尿病史是BKVN的重要危险因素。与hiv阴性组相比，hiv阳性BKVN组的移植物存活时间较短（P = 0.044）。结论：本研究证实hiv阳性个体由于BKVN导致移植物损失的风险更大，其危险因素包括DGF、HLA错配更大、供体和受体年龄更大以及糖尿病史。

{"title":"Challenges in Management of BK Virus Infections in HIV-Infected Renal Transplant Recipients","authors":"Dante A. Puntiel, Jayalakshmi N. Alagar, Julienne Jeong, Dianly C. Centeno, Ryan A. Quan, Brooke Stanicki, Ibrahim Y. Khalil, Konstantinos A. Zorbas, Sunil S. Karhadkar","doi":"10.1016/j.transproceed.2025.10.017","DOIUrl":"10.1016/j.transproceed.2025.10.017","url":null,"abstract":"<div><h3>Background</h3><div>BK virus (BKV) poses a significant threat to kidney transplantation as it can lead to severe complications, including BK virus nephropathy (BKVN). Many transplant recipients harbor latent BKV, which can reactivate under immunosuppression, leading to viruria, viremia, and potential graft loss. The management of BKVN in human immunodeficiency virus (HIV)-positive patients is especially complex owing to the dual challenge of balancing immunosuppressive therapy and antiretroviral treatment, compounded by potential drug interactions. This study aimed to investigate the incidence, risk factors, and outcomes of BKVN in HIV-positive kidney transplant recipients, comparing these findings to findings in HIV-negative recipients.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing database was used to identify kidney transplant recipients between August 2009 and February 2022, excluding those age <18 years, with prior transplants, or with unknown HIV status. Parametric and nonparametric tests were used to assess risk factors for BKVN in HIV-positive individuals.</div></div><div><h3>Results</h3><div>Among 1909 HIV-positive kidney transplant recipients, 15 (0.8%) experienced graft loss due to BKVN, compared to 558 of 168,836 (0.3%) HIV-negative recipients. HIV-positive individuals had a higher risk of BKVN-related graft loss (<em>P</em> < .001). In the HIV-positive group, delayed graft function (DGF), greater HLA mismatch, older donor age, older recipient age, and a history of diabetes were significant risk factors for BKVN. The HIV-positive BKVN group had shorter graft survival compared to their HIV-negative counterparts (<em>P</em> = .044).</div></div><div><h3>Conclusion</h3><div>This study confirms that HIV-positive individuals are at greater risk of graft loss due to BKVN, with risk factors including DGF, greater HLA mismatch, older donor and recipient age, and a history of diabetes.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 10","pages":"Pages 1992-1998"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515282","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}

引用次数: 0