Pub Date : 2025-11-01DOI: 10.1016/j.transproceed.2025.08.007
Arif Aslaner, Kemal Eyvaz
Background
To evaluate the role of using isosulfan blue via a three-way catheter in performing ureteroneocystostomy in kidney transplant recipients.
Methods
A single-center, observational, descriptive study was conducted between December 2015 and July 2024 involving 112 kidney transplant recipients. A three-way catheter was used in all cases, and the bladder volume was assessed using a 1% isosulfan blue solution. Data on recipient demographics, bladder volume, and complications were analyzed.
Results
A total of 112 patients were included. The mean age of recipients was 48.04 years (range: 25-69). A three-way urinary catheter with physiological saline and isosulfan blue solution was used in all cases. Bladder volume ranged from 50 cc to 250 cc. No intraoperative or postoperative complications were observed.
Conclusion
The use of isosulfan blue through a three-way catheter significantly facilitated the identification of the bladder prior to ureteroneocystostomy, making the procedure easier and more reliable. We recommend the use of isosulfan blue for bladder exposure in kidney transplantation.
{"title":"Isosulfan Blue and Bladder Disclosure in Kidney Transplant Recipients","authors":"Arif Aslaner, Kemal Eyvaz","doi":"10.1016/j.transproceed.2025.08.007","DOIUrl":"10.1016/j.transproceed.2025.08.007","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the role of using isosulfan blue via a three-way catheter in performing ureteroneocystostomy in kidney transplant recipients.</div></div><div><h3>Methods</h3><div>A single-center, observational, descriptive study was conducted between December 2015 and July 2024 involving 112 kidney transplant recipients. A three-way catheter was used in all cases, and the bladder volume was assessed using a 1% isosulfan blue solution. Data on recipient demographics, bladder volume, and complications were analyzed.</div></div><div><h3>Results</h3><div>A total of 112 patients were included. The mean age of recipients was 48.04 years (range: 25-69). A three-way urinary catheter with physiological saline and isosulfan blue solution was used in all cases. Bladder volume ranged from 50 cc to 250 cc. No intraoperative or postoperative complications were observed.</div></div><div><h3>Conclusion</h3><div>The use of isosulfan blue through a three-way catheter significantly facilitated the identification of the bladder prior to ureteroneocystostomy, making the procedure easier and more reliable. We recommend the use of isosulfan blue for bladder exposure in kidney transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1704-1706"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056461","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}
This study aimed to present etiological insights by evaluating the histopathological findings of patients who underwent liver transplantation for cryptogenic cirrhosis (CC).
Patients and Methods
We retrospectively analyzed patients who underwent liver transplantation with a preoperative diagnosis of CC at our center between February 1997 and 2024. Clinical and pathological data were recorded, survival analyses were conducted, and statistical comparisons were performed.
Results
Among 66 patients preoperatively diagnosed with CC, a specific etiology was identified in 13 (%19.6) cases, while the remaining 53 (%80.4) were classified as CC. The median patient age was 49 years, with a mean BMI of 25.7. Type 2 diabetes was present in 22.6% of cases, and obesity in 13.2%. The mean follow-up period was 139 months, the median MELD score was 16, the incidence of hepatocellular carcinoma was 6%, and total mortality was recorded in 19 (%35.8) patients. The survival rates at 1, 3, 5, and 10 years were calculated as 87%, 81%, 79.2%, and 74.3%, respectively. While type 2 diabetes did not significantly affect survival (P = .78), obesity was found to be associated with a significantly lower survival rate (P = .001).
Conclusion
Although CC is widely considered the advanced stage of a metabolic syndrome-related liver disease, our findings do not fully support this hypothesis. Therefore, further research is needed to investigate other potential contributing factors in the etiology of CC.
{"title":"Evaluation of Etiology Based on Post-Transplant Pathological Diagnosis in Cases of Cryptogenic Cirrhosis","authors":"Tufan Egeli , Tarkan Unek , Mucahit Ozbilgin , Cihan Agalar , Anıl Aysal Agalar , Ozgul Sagol , Nilay Danis , Erhan Tukel , Berkay Sakaoglu , Emre Karadeniz , Aylın Bacakoglu , Ali Durubey Cevlik , Ibrahim Astarcioglu","doi":"10.1016/j.transproceed.2025.08.012","DOIUrl":"10.1016/j.transproceed.2025.08.012","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to present etiological insights by evaluating the histopathological findings of patients who underwent liver transplantation for cryptogenic cirrhosis (CC).</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed patients who underwent liver transplantation with a preoperative diagnosis of CC at our center between February 1997 and 2024. Clinical and pathological data were recorded, survival analyses were conducted, and statistical comparisons were performed.</div></div><div><h3>Results</h3><div>Among 66 patients preoperatively diagnosed with CC, a specific etiology was identified in 13 (%19.6) cases, while the remaining 53 (%80.4) were classified as CC. The median patient age was 49 years, with a mean BMI of 25.7. Type 2 diabetes was present in 22.6% of cases, and obesity in 13.2%. The mean follow-up period was 139 months, the median MELD score was 16, the incidence of hepatocellular carcinoma was 6%, and total mortality was recorded in 19 (%35.8) patients. The survival rates at 1, 3, 5, and 10 years were calculated as 87%, 81%, 79.2%, and 74.3%, respectively. While type 2 diabetes did not significantly affect survival (<em>P = .</em>78), obesity was found to be associated with a significantly lower survival rate (<em>P = .</em>001).</div></div><div><h3>Conclusion</h3><div>Although CC is widely considered the advanced stage of a metabolic syndrome-related liver disease, our findings do not fully support this hypothesis. Therefore, further research is needed to investigate other potential contributing factors in the etiology of CC.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1788-1792"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077000","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.2025.01.008
Nihal Celikturk Doruker , Tugba Nur Oden , Fatma Demir Korkmaz
Background
Nonadherence to immunosuppressive therapy after heart transplantation, driven by factors such as patient, caregiver, institutional, policy-related issues, and health literacy, leads to rejection and increased mortality. This study aimed to investigate the relationship between health literacy and adherence to immunosuppressive therapy in heart transplant patients.
Methods
The sample of this cross-sectional study consisted of 57 patients who underwent heart transplantation in a university hospital in Izmir, Turkey. “Sociodemographic and Descriptive Characteristics Form”, “Data on Immunosuppressive Drug Therapy Form”, “Rapid Estimate of Adult Health Literacy in Medicine (REALM) Scale”, and “Immunosuppressive Therapy Adherence Scale (ITAS)” were used to collect the data..
Results
The median score on the REALM scale was 64.00 (IQR = 3.00, min = 18.00, max = 66.00) and 80.7% of the patients scored adequately. The median score of the immunosuppressive therapy adherence scale was 11.00 (IQR= 1.00, min= 5.00, max= 12.00) and 42.1% of the patients scored full score. There was no statistically significant relationship between the median total scores of the REALM and ITAS scales in heart transplant patients (r = 0.181, P = .178).
Conclusions
In this study, the majority of heart transplant patients had adequate health literacy. It was found that less than half of these patients adhered to immunosuppressive therapy. Less than half of these patients were found to comply with immunosuppressive therapy. In this study, no relationship was found between health literacy and adherence to immunosuppressive therapy.
背景：心脏移植后不坚持免疫抑制治疗，由患者、护理人员、机构、政策相关问题和健康素养等因素驱动，导致排斥反应和死亡率增加。本研究旨在探讨心脏移植患者健康素养与免疫抑制治疗依从性之间的关系。方法：本横断面研究的样本包括在土耳其伊兹密尔一所大学医院接受心脏移植的57例患者。采用《社会人口统计学及描述性特征表》、《免疫抑制药物治疗资料表》、《成人医学健康素养快速评估量表（REALM）》和《免疫抑制药物治疗依从性量表（ITAS）》收集资料。结果：REALM量表中位数为64.00分（IQR = 3.00, min = 18.00, max = 66.00）， 80.7%的患者得分充分。免疫抑制治疗依从性量表中位得分为11.00 (IQR= 1.00, min= 5.00, max= 12.00)， 42.1%的患者获得满分。心脏移植患者REALM总分和ITAS总分中位数之间无统计学意义（r = 0.181, P = 0.178）。结论：在本研究中，大多数心脏移植患者具有足够的健康素养。发现这些患者中只有不到一半坚持免疫抑制治疗。这些患者中只有不到一半的人接受了免疫抑制治疗。在这项研究中，没有发现健康素养和免疫抑制治疗依从性之间的关系。
{"title":"Investigation of the Relationship Between Health Literacy and Adherence to Immunosuppressive Therapy in Heart Transplant Patients: A Cross-Sectional Study","authors":"Nihal Celikturk Doruker , Tugba Nur Oden , Fatma Demir Korkmaz","doi":"10.1016/j.transproceed.2025.01.008","DOIUrl":"10.1016/j.transproceed.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Nonadherence to immunosuppressive therapy after heart transplantation, driven by factors such as patient, caregiver, institutional, policy-related issues, and health literacy, leads to rejection and increased mortality. This study aimed to investigate the relationship between health literacy and adherence to immunosuppressive therapy in heart transplant patients.</div></div><div><h3>Methods</h3><div>The sample of this cross-sectional study consisted of 57 patients who underwent heart transplantation in a university hospital in Izmir, Turkey. “Sociodemographic and Descriptive Characteristics Form”, “Data on Immunosuppressive Drug Therapy Form”, “Rapid Estimate of Adult Health Literacy in Medicine (REALM) Scale”, and “Immunosuppressive Therapy Adherence Scale (ITAS)” were used to collect the data..</div></div><div><h3>Results</h3><div>The median score on the REALM scale was 64.00 (IQR = 3.00, min = 18.00, max = 66.00) and 80.7% of the patients scored adequately. The median score of the immunosuppressive therapy adherence scale was 11.00 (IQR= 1.00, min= 5.00, max= 12.00) and 42.1% of the patients scored full score. There was no statistically significant relationship between the median total scores of the REALM and ITAS scales in heart transplant patients (<em>r</em> = 0.181, <em>P</em> = .178).</div></div><div><h3>Conclusions</h3><div>In this study, the majority of heart transplant patients had adequate health literacy. It was found that less than half of these patients adhered to immunosuppressive therapy. Less than half of these patients were found to comply with immunosuppressive therapy. In this study, no relationship was found between health literacy and adherence to immunosuppressive therapy.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1816-1821"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660244","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}
Liver transplantation is currently the most treatment for fulminant hepatitis, end-stage liver failure, hepatocellular carcinoma, and liver-originated metabolic diseases in children. With technological advances, improvements in surgical techniques and immunosuppressive therapy protocols have increased 1-year survival rates to 80%-90%. Our center successfully performs both living donor and cadaveric liver transplants in children. This study retrospectively analyzed the preoperative and postoperative data of 72 pediatric patients who underwent liver transplantation between July 2022 and July 2024.
Methods
We included 72 patients who underwent liver transplantation between July 1, 2022, and July 1, 2024. Cases were evaluated based on demographic data, liver failure etiology, and postoperative complications.
Results
Of the cases, 37 were female (58%) and 35 male (42%), with a mean age of 6.6 years (ranging from 5 months to 17 years and 11 months). Indications included biliary atresia (25), autoimmune hepatitis (9), cryptogenic cirrhosis (7), PFIC (7), congenital hepatic fibrosis (1), Caroli disease (2), Wilson’s disease (4), Alagille syndrome (3), hepatocellular carcinoma (2), primary hyperoxaluria type 1 (2), Crigler Najjar syndrome type 1 (3), Budd-Chiari syndrome (1), glycogen storage disease type 3 (1), portal vein thrombosis (1), and acute fulminant hepatitis (4). Mean PELD score for patients under 12 years was 18 (range 0-37), and MELD score for patients over 12 years was 19.3 (range 11-40). A total of 69 patients received orthotopic liver transplantation from living donors. Two patients received combined liver and kidney transplants, and 1 received a cadaveric liver transplant. Donors included 40 females and 32 males. Left lobe transplants were performed in 58 patients, and right lobe in 14. Immunosuppression included Tacrolimus + MMF in 70 patients and Cyclosporine in 2. Postoperative complications included biliary anastomosis stenosis (3), bile leakage (2), hepatic vein thrombosis (1), portal vein thrombosis (4), intestinal perforation secondary to Bogota syndrome (5), PRES syndrome due to Tacrolimus toxicity (1), primary graft dysfunction (1), and postoperative bleeding (2). Within the first month, 12 patients (16.6%) died, and 3 (4%) died between 1 month and 1 year postoperatively. The most common early cause of death was sepsis and multiorgan failure. One patient developed chronic rejection but recovered with steroid immunosuppression without the need for re-transplantation.
Conclusion
Liver transplantation is a high-risk procedure requiring lifelong medication and follow-up. It is, however, the most effective treatment method for several severe pediatric liver conditions.
{"title":"Liver Transplantation in Childhood: A 2-Year Single Center Experience","authors":"Hasret Ayyıldız Civan, Ferhat Sarı, Feyza Sönmez Topçu, Aysel Taktak, Hüseyin İlksen, Adem Tunçer, Emrah Şahin, Halil Şahin, Veysel Esan, Bülent Ünal, Abuzer Dirican","doi":"10.1016/j.transproceed.2025.07.008","DOIUrl":"10.1016/j.transproceed.2025.07.008","url":null,"abstract":"<div><h3>Objective</h3><div>Liver transplantation is currently the most treatment for fulminant hepatitis, end-stage liver failure, hepatocellular carcinoma, and liver-originated metabolic diseases in children. With technological advances, improvements in surgical techniques and immunosuppressive therapy protocols have increased 1-year survival rates to 80%-90%. Our center successfully performs both living donor and cadaveric liver transplants in children. This study retrospectively analyzed the preoperative and postoperative data of 72 pediatric patients who underwent liver transplantation between July 2022 and July 2024.</div></div><div><h3>Methods</h3><div>We included 72 patients who underwent liver transplantation between July 1, 2022, and July 1, 2024. Cases were evaluated based on demographic data, liver failure etiology, and postoperative complications.</div></div><div><h3>Results</h3><div>Of the cases, 37 were female (58%) and 35 male (42%), with a mean age of 6.6 years (ranging from 5 months to 17 years and 11 months). Indications included biliary atresia (25), autoimmune hepatitis (9), cryptogenic cirrhosis (7), PFIC (7), congenital hepatic fibrosis (1), Caroli disease (2), Wilson’s disease (4), Alagille syndrome (3), hepatocellular carcinoma (2), primary hyperoxaluria type 1 (2), Crigler Najjar syndrome type 1 (3), Budd-Chiari syndrome (1), glycogen storage disease type 3 (1), portal vein thrombosis (1), and acute fulminant hepatitis (4). Mean PELD score for patients under 12 years was 18 (range 0-37), and MELD score for patients over 12 years was 19.3 (range 11-40). A total of 69 patients received orthotopic liver transplantation from living donors. Two patients received combined liver and kidney transplants, and 1 received a cadaveric liver transplant. Donors included 40 females and 32 males. Left lobe transplants were performed in 58 patients, and right lobe in 14. Immunosuppression included Tacrolimus + MMF in 70 patients and Cyclosporine in 2. Postoperative complications included biliary anastomosis stenosis (3), bile leakage (2), hepatic vein thrombosis (1), portal vein thrombosis (4), intestinal perforation secondary to Bogota syndrome (5), PRES syndrome due to Tacrolimus toxicity (1), primary graft dysfunction (1), and postoperative bleeding (2). Within the first month, 12 patients (16.6%) died, and 3 (4%) died between 1 month and 1 year postoperatively. The most common early cause of death was sepsis and multiorgan failure. One patient developed chronic rejection but recovered with steroid immunosuppression without the need for re-transplantation.</div></div><div><h3>Conclusion</h3><div>Liver transplantation is a high-risk procedure requiring lifelong medication and follow-up. It is, however, the most effective treatment method for several severe pediatric liver conditions.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1799-1801"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984447","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.2025.07.007
Şenay Yıldırım , Arif Aslaner , Kemal Eyvaz , Ayça İnci
Objective
Renal allograft biopsy plays a crucial role in identifying the causes of graft dysfunction and determining treatment strategies accordingly. In addition to rejection, viral infections, drug toxicity, systemic diseases such as hypertension and diabetes, as well as recurrent or de novo glomerulonephritis, can also be diagnosed through biopsy. This study aims to evaluate the diagnoses of renal allograft biopsies in conjunction with the Banff criteria.
Methods
In our study, 44 renal transplant biopsies received at our pathology clinic between 2017 and 2024 were evaluated in terms of demographic, clinical, histopathological, and immunohistochemical features. Histopathological characteristics were scored according to the Banff 2019 criteria.
Results
Among the cases, 70.5% (n = 31) were male, with a mean age of 45.16 years. The first transplantation had been performed in 97.7% of patients. A total of 77.3% of transplantations were from living donors, while 22.7% were from deceased donors. At the time of biopsy, the mean serum creatinine level was 4.03 ± 2.14 mg/dL (range: 0.70-8.50 mg/dL). Diagnoses included chronic active antibody-mediated rejection (ca-ABMR) (31.8%), active ABMR (18.2%), borderline changes (9.1%), polyomavirus nephropathy (9.1%), acute tubular necrosis (9.1%), recurrent/de novo glomerulonephritis (6.8%), acute T-cell-mediated rejection (TCMR) (4.5%), and chronic TCMR (4.5%). A statistically significant difference was observed in the Banff lesion scores of glomerulitis (P = .005), peritubular capillaritis (P = .002), and C4d staining (P = .001) between ABMR and TCMR. Three patients (6.8%) were deceased, while 41 patients (93.2%) survived.
Conclusion
The most common causes of graft dysfunction were ca-ABMR, active ABMR, borderline changes, and polyomavirus nephropathy. Kidney biopsy remains the gold standard for prompt initiation of appropriate treatment when graft dysfunction occurs.
{"title":"Demographic and Histopathological Features of Graft Dysfunction in Renal Transplant Biopsies: A Retrospective Study","authors":"Şenay Yıldırım , Arif Aslaner , Kemal Eyvaz , Ayça İnci","doi":"10.1016/j.transproceed.2025.07.007","DOIUrl":"10.1016/j.transproceed.2025.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>Renal allograft biopsy plays a crucial role in identifying the causes of graft dysfunction and determining treatment strategies accordingly. In addition to rejection, viral infections, drug toxicity, systemic diseases such as hypertension and diabetes, as well as recurrent or de novo glomerulonephritis, can also be diagnosed through biopsy. This study aims to evaluate the diagnoses of renal allograft biopsies in conjunction with the Banff criteria.</div></div><div><h3>Methods</h3><div>In our study, 44 renal transplant biopsies received at our pathology clinic between 2017 and 2024 were evaluated in terms of demographic, clinical, histopathological, and immunohistochemical features. Histopathological characteristics were scored according to the Banff 2019 criteria.</div></div><div><h3>Results</h3><div>Among the cases, 70.5% (<em>n</em> = 31) were male, with a mean age of 45.16 years. The first transplantation had been performed in 97.7% of patients. A total of 77.3% of transplantations were from living donors, while 22.7% were from deceased donors. At the time of biopsy, the mean serum creatinine level was 4.03 ± 2.14 mg/dL (range: 0.70-8.50 mg/dL). Diagnoses included chronic active antibody-mediated rejection (ca-ABMR) (31.8%), active ABMR (18.2%), borderline changes (9.1%), polyomavirus nephropathy (9.1%), acute tubular necrosis (9.1%), recurrent/de novo glomerulonephritis (6.8%), acute T-cell-mediated rejection (TCMR) (4.5%), and chronic TCMR (4.5%). A statistically significant difference was observed in the Banff lesion scores of glomerulitis (<em>P</em> = .005), peritubular capillaritis (<em>P</em> = .002), and C4d staining (<em>P</em> = .001) between ABMR and TCMR. Three patients (6.8%) were deceased, while 41 patients (93.2%) survived.</div></div><div><h3>Conclusion</h3><div>The most common causes of graft dysfunction were ca-ABMR, active ABMR, borderline changes, and polyomavirus nephropathy. Kidney biopsy remains the gold standard for prompt initiation of appropriate treatment when graft dysfunction occurs.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1726-1730"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839579","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.2025.09.002
Göksever Akpınar , Batuhan Eyduran , Safa Vatansever , Ekrem Kocatürk , Mehmet Üstün
Background
Malnutrition in patients with intestinal insufficiency negatively affects the success of intestinal transplantation. In our research, we assessed patients' nutritional status using the PNI scale and examined the impact of the PNI score on clinical outcomes during the post-transplant phase.
Results
The acute rejection rate was 38.1%, and the 30-day survival rate was 90.5%. Median PNI values were 41.5 (min-max: 33.5-65), 29.5 (min-max: 13.5-56.5), 33 (min-max: 3-51), 35.7 (min-max: 24.5-54), 33.5 (min-max: 24.5-75.5) preoperatively and on postoperative 1, 7, 15, and 30 days, respectively. No significant relationship was found between the other parameters and the PNI.
Conclusions
The PNI score alone fails to adequately represent a patient's nutritional status and has not demonstrated effectiveness in predicting early-term outcomes for those undergoing intestinal transplantation. Additional studies involving a larger number of patients and diverse nutritional markers are necessary for further insights into this matter.
{"title":"Evaluation of the Relationship Between Prognostic Nutritional Index and Early Clinical Outcomes in Intestinal Transplantation","authors":"Göksever Akpınar , Batuhan Eyduran , Safa Vatansever , Ekrem Kocatürk , Mehmet Üstün","doi":"10.1016/j.transproceed.2025.09.002","DOIUrl":"10.1016/j.transproceed.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition in patients with intestinal insufficiency negatively affects the success of intestinal transplantation. In our research, we assessed patients' nutritional status using the PNI scale and examined the impact of the PNI score on clinical outcomes during the post-transplant phase.</div></div><div><h3>Results</h3><div>The acute rejection rate was 38.1%, and the 30-day survival rate was 90.5%. Median PNI values were 41.5 (min-max: 33.5-65), 29.5 (min-max: 13.5-56.5), 33 (min-max: 3-51), 35.7 (min-max: 24.5-54), 33.5 (min-max: 24.5-75.5) preoperatively and on postoperative 1, 7, 15, and 30 days, respectively. No significant relationship was found between the other parameters and the PNI.</div></div><div><h3>Conclusions</h3><div>The PNI score alone fails to adequately represent a patient's nutritional status and has not demonstrated effectiveness in predicting early-term outcomes for those undergoing intestinal transplantation. Additional studies involving a larger number of patients and diverse nutritional markers are necessary for further insights into this matter.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1828-1831"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077007","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 bridge to heart transplantation has been the subject of intense debate. This study aimed to determine the factors affecting early survival after bridge to heart transplantation.
Methods
Between 2011 and 2019, patients who underwent a bridge to heart transplantation in a single center were retrospectively scanned. Demographics, complications of left ventricular assist device (LVAD), cardiopulmonary bypass (CPB), and cross-clamp duration, use of blood products, length of ventricular assist device (VAD) support, post-transplant hospital stay, post-transplant complications, and in-hospital mortality rates were recorded.
Results
Patients (n = 60) were divided into 2 groups; patients with 30-day mortality (group 1, n = 10) and those with survival longer than 30 days (group 2, n = 50). The patients in group 1 were found to be older (P = .009), supported for a longer duration (P = .027), have higher International Normalized Ratio (INR) levels (P = .025), and have device-specific infection more commonly (P = .003). Cardiac ischemia (P = .013) and CPB (P = .006) durations were longer in group 1. Use of blood products and nitric oxide (NO) was more frequent in group 1 (P < .05). Post-transplantation complications (stroke, sepsis, kidney failure, arrhythmia, need for intra-aortic balloon pump [IABP], and short-term mechanical circulatory support [MCS]) were significantly more common in group 1 patients (P < .05). Blood products (0.920 for red blood cells, 0.901 for fresh frozen plasma, and 0.885 for platelets), postoperative high creatinine (0.817) and lactate (0.715), and device-specific infection (0.686) had the highest area under the curve values in the receiver operating characteristic (ROC).
Conclusions
Bridge to transplantation has its own challenges of being a reoperation under high INR levels. Recurrent infection attacks and an inflammatory state may be limiting the healing process. Device-specific infection may be a major reason for early mortality whereas it is also a major indication for urging heart transplantation.
{"title":"Determinants of Short-Term Survival After Heart Transplantation in Patients Bridged to Transplant With Left Ventricular Assist Device","authors":"Suat Şenkaya , Ümit Kahraman , Ayşen Yaprak Kapkın , Özlem Balcıoğlu , Sanem Nalbantgil , Çağatay Engin , Tahir Yağdı , Mustafa Özbaran","doi":"10.1016/j.transproceed.2025.08.005","DOIUrl":"10.1016/j.transproceed.2025.08.005","url":null,"abstract":"<div><h3>Background</h3><div>The bridge to heart transplantation has been the subject of intense debate. This study aimed to determine the factors affecting early survival after bridge to heart transplantation.</div></div><div><h3>Methods</h3><div>Between 2011 and 2019, patients who underwent a bridge to heart transplantation in a single center were retrospectively scanned. Demographics, complications of left ventricular assist device (LVAD), cardiopulmonary bypass (CPB), and cross-clamp duration, use of blood products, length of ventricular assist device (VAD) support, post-transplant hospital stay, post-transplant complications, and in-hospital mortality rates were recorded.</div></div><div><h3>Results</h3><div>Patients (n = 60) were divided into 2 groups; patients with 30-day mortality (group 1, n = 10) and those with survival longer than 30 days (group 2, n = 50). The patients in group 1 were found to be older (<em>P</em> = .009), supported for a longer duration (<em>P</em> = .027), have higher International Normalized Ratio (INR) levels (<em>P</em> = .025), and have device-specific infection more commonly (<em>P</em> = .003). Cardiac ischemia (<em>P</em> = .013) and CPB (<em>P</em> = .006) durations were longer in group 1. Use of blood products and nitric oxide (NO) was more frequent in group 1 (<em>P</em> < .05). Post-transplantation complications (stroke, sepsis, kidney failure, arrhythmia, need for intra-aortic balloon pump [IABP], and short-term mechanical circulatory support [MCS]) were significantly more common in group 1 patients (<em>P</em> < .05). Blood products (0.920 for red blood cells, 0.901 for fresh frozen plasma, and 0.885 for platelets), postoperative high creatinine (0.817) and lactate (0.715), and device-specific infection (0.686) had the highest area under the curve values in the receiver operating characteristic (ROC).</div></div><div><h3>Conclusions</h3><div>Bridge to transplantation has its own challenges of being a reoperation under high INR levels. Recurrent infection attacks and an inflammatory state may be limiting the healing process. Device-specific infection may be a major reason for early mortality whereas it is also a major indication for urging heart transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1822-1827"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082917","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.2025.05.001
Ezgi Avanaz , Ali Avanaz
Purpose
In living donor kidney transplantation (LDKT), postoperative serum creatinine (SCr) levels in the recipients are influenced by muscle mass, which can be assessed via psoas muscle area (PMA) measurements. This study aimed to create a formula to predict the postoperative SCr levels by evaluating the difference in muscle mass between donors and recipients.
Methods
We retrospectively analyzed data from patients aged 18 years and older who underwent LDKT between January 2020 and December 2022. Recipients and donors with preoperative magnetic resonance imaging (MRI) or computed tomography (CT) scans were included in the PMA measurements. A total of 67 patients were analyzed.
Results
The recipients had a mean age of 42 ± 12.8 years and a mean postoperative SCr of 1.24 ± 0.33 mg/dl. Multivariate analysis revealed that donor age and the difference in the PMA between recipients and donors were significant predictors of postoperative SCr levels. The derived formula is as follows: Recipient postoperative SCr = 0.320 + (0.016 × recipient-donor PMA difference/100) + (0.006 × donor age).
Conclusion
This study highlights that considering the difference in muscle mass between donors and recipients can enhance the prediction of postoperative SCr levels. Further multicenter studies are needed to validate and refine this predictive model.
{"title":"Predicting Postoperative Serum Creatinine Levels in Living Donor Kidney Transplantation: The Role of Donor–Recipient Muscle Mass Differences","authors":"Ezgi Avanaz , Ali Avanaz","doi":"10.1016/j.transproceed.2025.05.001","DOIUrl":"10.1016/j.transproceed.2025.05.001","url":null,"abstract":"<div><h3>Purpose</h3><div>In living donor kidney transplantation (LDKT), postoperative serum creatinine (SCr) levels in the recipients are influenced by muscle mass, which can be assessed via psoas muscle area (PMA) measurements. This study aimed to create a formula to predict the postoperative SCr levels by evaluating the difference in muscle mass between donors and recipients.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from patients aged 18 years and older who underwent LDKT between January 2020 and December 2022. Recipients and donors with preoperative magnetic resonance imaging (MRI) or computed tomography (CT) scans were included in the PMA measurements. A total of 67 patients were analyzed.</div></div><div><h3>Results</h3><div>The recipients had a mean age of 42 ± 12.8 years and a mean postoperative SCr of 1.24 ± 0.33 mg/dl. Multivariate analysis revealed that donor age and the difference in the PMA between recipients and donors were significant predictors of postoperative SCr levels. The derived formula is as follows: Recipient postoperative SCr = 0.320 + (0.016 × recipient-donor PMA difference/100) + (0.006 × donor age).</div></div><div><h3>Conclusion</h3><div>This study highlights that considering the difference in muscle mass between donors and recipients can enhance the prediction of postoperative SCr levels. Further multicenter studies are needed to validate and refine this predictive model.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1721-1725"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228209","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.2025.03.007
Hüseyin Yönder , Faik Tatlı , Mehmet Sait Berhuni , Hasan Elkan , Mehmet Salih Aydın , Fırat Erkmen , Felat Çiftçi , Vedat Kaplan , Abdullah Özgönül , Mehmet Yılmaz
Background
Hepatic artery thrombosis (HAT) is a severe complication following living-donor liver transplantation that can be fatal if revascularization is not achieved. This study aims to present the 8-year experience of the Organ Transplantation Clinic at Harran University Faculty of Medicine.
Methods
From 2014 to 2021, a total of 56 patients, comprising 35 men (62.5%) and 21 women (37.5%), who underwent either living-donor or cadaveric liver transplantation were included in the study. In cadaveric recipients, a continuous suture technique with 7/0 polypropylene was used, and in living-donor graft recipients, an interrupted suture technique with 7/0 polypropylene was performed in anastomosis. All patients received an intraoperative dose of 2500 to 5000 units (60 U/kg) of heparin prior to anastomosis. Doppler ultrasound was performed on all patients following the anastomosis.
Results
Three out of the 56 patients (5.35%) developed HAT on postoperative day 1. One of these patients underwent hepatic artery revision on postoperative day 1, with no subsequent rethrombosis. The second patient underwent retransplantation on postoperative day 1. However, this patient could not tolerate the reoperation and passed away on the second day after transplantation. The last patient underwent endovascular stenting on postoperative day 1. However, this patient experienced rethrombosis on the first day after the procedure and rapidly deteriorated hemodynamically, which proved fatal.
Conclusions
HAT directly affects postoperative patient morbidity and mortality. The outcomes are favorable when hepatic artery anastomosis is performed using 7/0 polypropylene, with a continuous suture technique for cadaveric cases and an interrupted suture technique for living-donor cases, and is carried out by experienced hands.
{"title":"Recommendations for Hepatic Artery Anastomosis in Liver Transplantation: A Group Experience","authors":"Hüseyin Yönder , Faik Tatlı , Mehmet Sait Berhuni , Hasan Elkan , Mehmet Salih Aydın , Fırat Erkmen , Felat Çiftçi , Vedat Kaplan , Abdullah Özgönül , Mehmet Yılmaz","doi":"10.1016/j.transproceed.2025.03.007","DOIUrl":"10.1016/j.transproceed.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Hepatic artery thrombosis (HAT) is a severe complication following living-donor liver transplantation that can be fatal if revascularization is not achieved. This study aims to present the 8-year experience of the Organ Transplantation Clinic at Harran University Faculty of Medicine.</div></div><div><h3>Methods</h3><div>From 2014 to 2021, a total of 56 patients, comprising 35 men (62.5%) and 21 women (37.5%), who underwent either living-donor or cadaveric liver transplantation were included in the study. In cadaveric recipients, a continuous suture technique with 7/0 polypropylene was used, and in living-donor graft recipients, an interrupted suture technique with 7/0 polypropylene was performed in anastomosis. All patients received an intraoperative dose of 2500 to 5000 units (60 U/kg) of heparin prior to anastomosis. Doppler ultrasound was performed on all patients following the anastomosis.</div></div><div><h3>Results</h3><div>Three out of the 56 patients (5.35%) developed HAT on postoperative day 1. One of these patients underwent hepatic artery revision on postoperative day 1, with no subsequent rethrombosis. The second patient underwent retransplantation on postoperative day 1. However, this patient could not tolerate the reoperation and passed away on the second day after transplantation. The last patient underwent endovascular stenting on postoperative day 1. However, this patient experienced rethrombosis on the first day after the procedure and rapidly deteriorated hemodynamically, which proved fatal.</div></div><div><h3>Conclusions</h3><div>HAT directly affects postoperative patient morbidity and mortality. The outcomes are favorable when hepatic artery anastomosis is performed using 7/0 polypropylene, with a continuous suture technique for cadaveric cases and an interrupted suture technique for living-donor cases, and is carried out by experienced hands.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1756-1761"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053811","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.2025.02.030
Reyhan Arslantas, Mustafa Kemal Arslantas
Purpose
Liver transplantation is a life-saving procedure for patients with end-stage liver disease. The postoperative period presents significant challenges, particularly in managing acid-base balance and lactate levels, which are crucial indicators of metabolic stability and tissue perfusion. While these parameters provide valuable insights into patient recovery, their role in predicting intensive care unit (ICU) length of stay remains unclear. This study evaluates whether early postoperative acid-base balance and lactate levels can reliably predict ICU length of stay in liver transplant recipients, aiming to enhance postoperative care strategies.
Methods
A retrospective observational study was conducted on 53 adult liver transplant recipients. Acid-base and lactate parameters were measured at two-time points: early (within the first 6 hours) and late (6-24 hours) postoperatively. Paired t-tests and Wilcoxon signed-rank tests were used to compare these measurements. Multiple linear regression modeling was employed to assess the impact of these parameters on ICU length of stay.
Results
Significant changes were observed in FiO2, pH, Base Excess, HCO3, lactate, and Strong Ion Difference (SID) between early and late postoperative measurements (P < .05). However, regression analysis revealed that maximum lactate and early SID were not strong predictors of ICU length of stay (R² = 0.062). Exploratory analyses indicated that patients with elevated SID and markedly high lactate levels tended to have prolonged ICU stays.
Conclusions
While postoperative acid-base balance and lactate levels are important indicators of physiological status in liver transplant recipients, they do not serve as strong independent predictors of ICU length of stay.
目的：肝移植是终末期肝病患者的救命手段。术后出现了重大的挑战，特别是在管理酸碱平衡和乳酸水平，这是代谢稳定性和组织灌注的关键指标。虽然这些参数为患者康复提供了有价值的见解，但它们在预测重症监护病房（ICU）住院时间方面的作用尚不清楚。本研究评估术后早期酸碱平衡和乳酸水平是否能可靠地预测肝移植受者在ICU的住院时间，旨在提高术后护理策略。方法：对53例成人肝移植受者进行回顾性观察研究。在两个时间点测量酸碱和乳酸参数：术后早期（前6小时内）和晚期（6-24小时）。使用配对t检验和Wilcoxon符号秩检验来比较这些测量结果。采用多元线性回归模型评估这些参数对ICU住院时间的影响。结果：术后早期和晚期FiO2、pH、Base Excess、HCO3、乳酸、强离子差（Strong Ion Difference， SID）变化显著（P < 0.05）。然而，回归分析显示，最大乳酸浓度和早期SID不是ICU住院时间的强预测因子（R²= 0.062）。探索性分析表明，SID升高和乳酸水平明显升高的患者倾向于延长ICU的住院时间。结论：虽然术后酸碱平衡和乳酸水平是肝移植受者生理状态的重要指标，但它们不能作为ICU住院时间的强有力的独立预测指标。
{"title":"Evaluation of Postoperative Acid-Base Balance and Lactate Levels as Predictors of ICU Length of Stay in Liver Transplant Patients","authors":"Reyhan Arslantas, Mustafa Kemal Arslantas","doi":"10.1016/j.transproceed.2025.02.030","DOIUrl":"10.1016/j.transproceed.2025.02.030","url":null,"abstract":"<div><h3>Purpose</h3><div>Liver transplantation is a life-saving procedure for patients with end-stage liver disease. The postoperative period presents significant challenges, particularly in managing acid-base balance and lactate levels, which are crucial indicators of metabolic stability and tissue perfusion. While these parameters provide valuable insights into patient recovery, their role in predicting intensive care unit (ICU) length of stay remains unclear. This study evaluates whether early postoperative acid-base balance and lactate levels can reliably predict ICU length of stay in liver transplant recipients, aiming to enhance postoperative care strategies.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted on 53 adult liver transplant recipients. Acid-base and lactate parameters were measured at two-time points: early (within the first 6 hours) and late (6-24 hours) postoperatively. Paired <em>t</em>-tests and Wilcoxon signed-rank tests were used to compare these measurements. Multiple linear regression modeling was employed to assess the impact of these parameters on ICU length of stay.</div></div><div><h3>Results</h3><div>Significant changes were observed in FiO<sub>2</sub>, pH, Base Excess, HCO<sub>3</sub>, lactate, and Strong Ion Difference (SID) between early and late postoperative measurements (<em>P</em> < .05). However, regression analysis revealed that maximum lactate and early SID were not strong predictors of ICU length of stay (<em>R</em>² = 0.062). Exploratory analyses indicated that patients with elevated SID and markedly high lactate levels tended to have prolonged ICU stays.</div></div><div><h3>Conclusions</h3><div>While postoperative acid-base balance and lactate levels are important indicators of physiological status in liver transplant recipients, they do not serve as strong independent predictors of ICU length of stay.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 9","pages":"Pages 1762-1767"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660236","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}
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