首页 > 最新文献

Transplant immunology最新文献

英文 中文
mRNA vaccine for human cytomegalovirus in immunocompromised hosts: An immunoinformatics approach 免疫功能低下的人巨细胞病毒mRNA疫苗:免疫信息学方法。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-12-10 DOI: 10.1016/j.trim.2025.102342
Muhammad Zeeshan Ahmed , Sana Dilbar , Syeda Masooma Zahra Bukhari , Zareena Ali , Binyamin Wattoo , Sayra Tariq , Zeeshan Mutahir , Noreen Samad
Human cytomegalovirus (HCMV) poses a significant threat to immunocompromised individuals, including transplant recipients, neonates, and patients with immunosuppression. Despite extensive research, no effective vaccine exists—especially one leveraging mRNA technology. This study aimed to design a safe and immunogenic multi-epitope mRNA vaccine against HCMV using a comprehensive immunoinformatics approach. Glycoprotein B (gB), a highly conserved and immunodominant antigen, was selected as the vaccine target. B-cell, MHC-I, and MHC-II epitopes were predicted based on their antigenicity, immunogenicity, non-allergenicity, and non-toxicity. Of these, three B-cell binding epitopes, 3 MHC-II, and 4 MHC-I binding epitopes of T-cells, along with a toll-like receptor (TLR) agonist and an MHC I- targeting domain (MITD), were rationally assembled to design an mRNA vaccine construct (HCMVV). This construct was evaluated for physicochemical properties, population coverage, structural stability, interactions with innate receptors (TLR 2/4), and simulated immune responses. The vaccine showed high stability and favorable expression profiles, including ten conserved epitopes with broad MHC coverage, especially in South Asian populations. Docking studies indicated a stronger binding affinity for HCMVV–TLR 4 (− 19. 6 kcal/mol) compared to HCMVV–TLR 2 (− 14. 1 kcal/mol), characterized by high affinity and structural complementarity. Normal mode analysis confirmed complex stability, with average deformability per atom index for HCMVV, HCMVV–TLR 2, and HCMVV–TLR 4. Furthermore, molecular dynamics simulation (MDS) over 100 ns using GROMACS confirmed the stability of HCMVV–TLR2 and HCMVV–TLR4 complexes, with RMSD values below 2 Å (HCMVV–TLR4 more stable at <1.3 nm), low RMSF indicating rigidity (except specific flexible regions in TLR4), consistent hydrogen bonds (400–540), compact RoG (<2.7 nm for TLR4), stable SASA (370–430 nm2 with slight reduction in TLR4), and PCA revealing dominant conformational motions. Immune simulations predicted strong IgG and T-cell responses, as well as memory formation and efficient antigen clearance. This study introduces a promising mRNA vaccine candidate against HCMV with substantial immunogenic potential, especially for high-risk groups. However, experimental validation, including in vitro expression, in vivo immunogenicity, and protective efficacy studies, is essential to translate these computational findings into clinical applications.
人类巨细胞病毒(HCMV)对免疫功能低下的个体,包括移植受者、新生儿和免疫抑制患者构成重大威胁。尽管进行了广泛的研究,但目前还没有有效的疫苗,尤其是利用mRNA技术的疫苗。本研究旨在利用综合免疫信息学方法设计一种安全、免疫原性强的HCMV多表位mRNA疫苗。糖蛋白B (gB)是一种高度保守且具有免疫优势的抗原,被选择作为疫苗的靶点。b细胞、MHC-I和MHC-II表位的预测基于它们的抗原性、免疫原性、非过敏原性和无毒性。其中,3个b细胞结合表位,3个MHC- ii和4个MHC-I结合t细胞表位,以及toll样受体(TLR)激动剂和MHC I靶向结构域(MITD),被合理组装以设计mRNA疫苗构建体(HCMVV)。该构建体的理化性质、种群覆盖率、结构稳定性、与先天受体(TLR 2/4)的相互作用以及模拟免疫反应进行了评估。该疫苗表现出高稳定性和良好的表达谱,包括10个保守的表位,具有广泛的MHC覆盖范围,特别是在南亚人群中。对接研究表明其与hcmvv - tlr4(- 19)的结合亲和力更强。6 kcal/mol),与hcmvv - tlr2相比(- 14。1 kcal/mol),具有高亲和力和结构互补性。正态分析证实了复合稳定性,HCMVV、HCMVV- tlr 2和HCMVV- tlr 4的单原子变形能力指数平均。此外,使用GROMACS进行超过100 ns的分子动力学模拟(MDS)证实了HCMVV-TLR2和HCMVV-TLR4配合物的稳定性,RMSD值低于2 Å (HCMVV-TLR4在2时更稳定,TLR4略有减少),PCA显示了优势构象运动。免疫模拟预测了强烈的IgG和t细胞反应,以及记忆形成和有效的抗原清除。本研究介绍了一种有希望的mRNA候选疫苗,具有很强的免疫原性潜力,特别是对高危人群。然而,实验验证,包括体外表达、体内免疫原性和保护功效研究,对于将这些计算结果转化为临床应用至关重要。
{"title":"mRNA vaccine for human cytomegalovirus in immunocompromised hosts: An immunoinformatics approach","authors":"Muhammad Zeeshan Ahmed ,&nbsp;Sana Dilbar ,&nbsp;Syeda Masooma Zahra Bukhari ,&nbsp;Zareena Ali ,&nbsp;Binyamin Wattoo ,&nbsp;Sayra Tariq ,&nbsp;Zeeshan Mutahir ,&nbsp;Noreen Samad","doi":"10.1016/j.trim.2025.102342","DOIUrl":"10.1016/j.trim.2025.102342","url":null,"abstract":"<div><div>Human cytomegalovirus (HCMV) poses a significant threat to immunocompromised individuals, including transplant recipients, neonates, and patients with immunosuppression. Despite extensive research, no effective vaccine exists—especially one leveraging mRNA technology. This study aimed to design a safe and immunogenic multi-epitope mRNA vaccine against HCMV using a comprehensive immunoinformatics approach. Glycoprotein B (gB), a highly conserved and immunodominant antigen, was selected as the vaccine target. B-cell, MHC-I, and MHC-II epitopes were predicted based on their antigenicity, immunogenicity, non-allergenicity, and non-toxicity. Of these, three B-cell binding epitopes, 3 MHC-II, and 4 MHC-I binding epitopes of T-cells, along with a toll-like receptor (TLR) agonist and an MHC I- targeting domain (MITD), were rationally assembled to design an mRNA vaccine construct (HCMVV). This construct was evaluated for physicochemical properties, population coverage, structural stability, interactions with innate receptors (TLR 2/4), and simulated immune responses. The vaccine showed high stability and favorable expression profiles, including ten conserved epitopes with broad MHC coverage, especially in South Asian populations. Docking studies indicated a stronger binding affinity for HCMVV–TLR 4 (− 19. 6 kcal/mol) compared to HCMVV–TLR 2 (− 14. 1 kcal/mol), characterized by high affinity and structural complementarity. Normal mode analysis confirmed complex stability, with average deformability per atom index for HCMVV, HCMVV–TLR 2, and HCMVV–TLR 4. Furthermore, molecular dynamics simulation (MDS) over 100 ns using GROMACS confirmed the stability of HCMVV–TLR2 and HCMVV–TLR4 complexes, with RMSD values below 2 Å (HCMVV–TLR4 more stable at &lt;1.3 nm), low RMSF indicating rigidity (except specific flexible regions in TLR4), consistent hydrogen bonds (400–540), compact RoG (&lt;2.7 nm for TLR4), stable SASA (370–430 nm<sup>2</sup> with slight reduction in TLR4), and PCA revealing dominant conformational motions. Immune simulations predicted strong IgG and T-cell responses, as well as memory formation and efficient antigen clearance. This study introduces a promising mRNA vaccine candidate against HCMV with substantial immunogenic potential, especially for high-risk groups. However, experimental validation, including in vitro expression, in vivo immunogenicity, and protective efficacy studies, is essential to translate these computational findings into clinical applications.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102342"},"PeriodicalIF":1.4,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744822","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 induction agent selection on rejection, allograft function, and survival in kidney transplant recipients 诱导剂选择对肾移植受者排斥反应、同种异体移植功能和生存的影响。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-12-09 DOI: 10.1016/j.trim.2025.102341
Mohamad Saria Aldarwish , Wassim Toomah , Amro Idilbi , Roaa Ghanem , Mohamed Hussam Hallak , Alaa Alhalabi , Alia Alhassoun , Mohammad Mawaldi , Mohamad Amir Balloura , Emily C. Craver , Tambi Jarmi

Background

Kidney allograft rejection, driven by the recipient's immune response to non-self-HLA, remains a key barrier to kidney allograft survival. Induction therapy seeks to suppress early alloimmunity and reduce rejection. This study compares Basiliximab, Alemtuzumab, and Thymoglobulin in terms of acute rejection, kidney allograft function, and patients' survival.

Methods

A retrospective, single-center cohort study was conducted on 917 kidney transplant recipients between January 2019 and December 2023. Patients were stratified into Alemtuzumab (n = 337), Basiliximab (n = 300), and Thymoglobulin (n = 280) groups. The primary outcome was biopsy-proven acute rejection within the first 12 months post-transplant. Secondary outcomes included kidney allograft function. Kaplan-Meier survival analysis was performed to assess survival differences across groups.

Results

There was no statistically significant difference in acute rejection rates within the first 12 months among the three induction groups: Basiliximab (15 %), Thymoglobulin (14 %), and Alemtuzumab (9 %) (p = 0.16). Median creatinine clearance showed significant differences, with higher values in the Thymoglobulin (57.0 mL/min) and Alemtuzumab (56.0 mL/min) groups compared to the Basiliximab group (48.0 mL/min) (p = 0.003). Kaplan-Meier survival analysis demonstrated a statistically significant difference in patient survival over the 5-years follow-up period, with the highest survival observed in the Alemtuzumab group, followed by Thymoglobulin and then Basiliximab (p = 0.0067).

Conclusion

Basiliximab showed similar acute rejection rates to lymphocyte-depleting agents, suggesting it is not inferior in preventing early rejection when used for a selected group of patients. These findings support the need for further multi-center studies to better define optimal induction strategies and adapt therapy to individual patient profiles.
背景:由受体对非自身hla的免疫反应驱动的异体肾移植排斥反应仍然是异体肾移植存活的关键障碍。诱导疗法旨在抑制早期同种免疫,减少排斥反应。本研究比较了Basiliximab、Alemtuzumab和Thymoglobulin在急性排斥反应、同种异体肾移植功能和患者生存率方面的差异。方法:对2019年1月至2023年12月期间的917名肾移植受者进行回顾性、单中心队列研究。患者被分为阿仑单抗组(n = 337)、巴昔单抗组(n = 300)和胸腺球蛋白组(n = 280)。主要结果是移植后12个月内活检证实的急性排斥反应。次要结局包括肾移植功能。Kaplan-Meier生存分析评估各组间的生存差异。结果:Basiliximab(15%)、Thymoglobulin(14%)和Alemtuzumab(9%)三个诱导组在前12个月内的急性排斥率无统计学差异(p = 0.16)。中位肌酐清除率有显著差异,胸腺球蛋白组(57.0 mL/min)和阿仑单抗组(56.0 mL/min)高于巴昔昔单抗组(48.0 mL/min) (p = 0.003)。Kaplan-Meier生存分析显示,患者在5年随访期间的生存率有统计学意义,阿仑单抗组的生存率最高,其次是胸腺球蛋白,然后是巴昔昔单抗(p = 0.0067)。结论:Basiliximab显示出与淋巴细胞消耗药物相似的急性排斥率,表明它在预防早期排斥反应方面并不逊色,当用于选定的患者组时。这些发现支持了进一步多中心研究的需要,以更好地定义最佳诱导策略,并使治疗适应个体患者的情况。
{"title":"Impact of induction agent selection on rejection, allograft function, and survival in kidney transplant recipients","authors":"Mohamad Saria Aldarwish ,&nbsp;Wassim Toomah ,&nbsp;Amro Idilbi ,&nbsp;Roaa Ghanem ,&nbsp;Mohamed Hussam Hallak ,&nbsp;Alaa Alhalabi ,&nbsp;Alia Alhassoun ,&nbsp;Mohammad Mawaldi ,&nbsp;Mohamad Amir Balloura ,&nbsp;Emily C. Craver ,&nbsp;Tambi Jarmi","doi":"10.1016/j.trim.2025.102341","DOIUrl":"10.1016/j.trim.2025.102341","url":null,"abstract":"<div><h3>Background</h3><div>Kidney allograft rejection, driven by the recipient's immune response to non-self-HLA, remains a key barrier to kidney allograft survival. Induction therapy seeks to suppress early alloimmunity and reduce rejection. This study compares Basiliximab, Alemtuzumab, and Thymoglobulin in terms of acute rejection, kidney allograft function, and patients' survival.</div></div><div><h3>Methods</h3><div>A retrospective, single-center cohort study was conducted on 917 kidney transplant recipients between January 2019 and December 2023. Patients were stratified into Alemtuzumab (<em>n</em> = 337), Basiliximab (<em>n</em> = 300), and Thymoglobulin (<em>n</em> = 280) groups. The primary outcome was biopsy-proven acute rejection within the first 12 months post-transplant. Secondary outcomes included kidney allograft function. Kaplan-Meier survival analysis was performed to assess survival differences across groups.</div></div><div><h3>Results</h3><div>There was no statistically significant difference in acute rejection rates within the first 12 months among the three induction groups: Basiliximab (15 %), Thymoglobulin (14 %), and Alemtuzumab (9 %) (<em>p</em> = 0.16). Median creatinine clearance showed significant differences, with higher values in the Thymoglobulin (57.0 mL/min) and Alemtuzumab (56.0 mL/min) groups compared to the Basiliximab group (48.0 mL/min) (<em>p</em> = 0.003). Kaplan-Meier survival analysis demonstrated a statistically significant difference in patient survival over the 5-years follow-up period, with the highest survival observed in the Alemtuzumab group, followed by Thymoglobulin and then Basiliximab (<em>p</em> = 0.0067).</div></div><div><h3>Conclusion</h3><div>Basiliximab showed similar acute rejection rates to lymphocyte-depleting agents, suggesting it is not inferior in preventing early rejection when used for a selected group of patients. These findings support the need for further multi-center studies to better define optimal induction strategies and adapt therapy to individual patient profiles.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102341"},"PeriodicalIF":1.4,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744824","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
Human leukocyte antigen-C*08 increases the risk of BK virus viremia in kidney transplant recipients 人白细胞抗原c *08增加肾移植受者发生BK病毒血症的风险
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-12-04 DOI: 10.1016/j.trim.2025.102340
Marie-Pier Thivierge, Stéphanie Béland, Olivier Désy, Sacha A. De Serres
BK virus (BKV) infection can cause graft loss in kidney transplant recipients. Several factors increase the risk of infection, including high level of immunosuppression, older age, and human leukocyte antigen (HLA) mismatch. The primary function of the major histocompatibility complex (HLA in human) is the presentation of peptides that originated from foreign or self-antigens to T cells to trigger an immune response, such as during infections. Identifying HLA genotypes that can influence the course of BKV infection could allow for stratifying patients according to their risk of developing the infection, thus personalizing the use of immunosuppressants. We conducted a retrospective study in a cohort of 1302 kidney transplant recipients, of whom 243 (19 %) developed BKV viremia. Clinical data and HLA genotype were evaluated for associations with BKV viremia. Among the 51 HLA genotypes analyzed, exploratory analysis revealed that patients expressing the HLA-C*08 genotype had a high risk of developing BKV viremia (p = 0.04). Using multivariate analyses adjusted for clinical variables that differed between patients with and without BK viremia (age and number of HLA-B mismatches), we confirmed that the HLA-C*08 genotype was associated with BK viremia. HLA-C*08, expressed by a sizeable proportion of the patients (82 individuals, or 6.3 % of the cohort), increased the risk of BKV viremia by 1.61 fold (p = 0.03). The HLA genotype may be useful in managing screening strategies for BKV in transplant recipients.
BK病毒(BKV)感染可导致肾移植受者移植物丢失。几个因素增加感染的风险,包括高水平的免疫抑制,年龄较大,和人类白细胞抗原(HLA)不匹配。主要组织相容性复合体(人类HLA)的主要功能是将源自外源或自身抗原的肽呈递到T细胞,以触发免疫反应,例如在感染期间。确定可以影响BKV感染过程的HLA基因型可以根据患者发生感染的风险对患者进行分层,从而使免疫抑制剂的使用个性化。我们对1302例肾移植受者进行了回顾性研究,其中243例(19% %)发生了BKV病毒血症。评估临床资料和HLA基因型与BKV病毒血症的关系。在分析的51个HLA基因型中,探索性分析发现表达HLA- c *08基因型的患者发生BKV病毒血症的风险较高(p = 0.04)。通过多变量分析调整了BK病毒血症患者和非BK病毒血症患者之间的临床变量差异(年龄和HLA-B错配次数),我们证实HLA-C*08基因型与BK病毒血症相关。相当大比例的患者(82例,占队列的6.3% %)表达HLA-C*08,使BKV病毒血症的风险增加了1.61倍(p = 0.03)。HLA基因型可能有助于移植受者BKV筛查策略的管理。
{"title":"Human leukocyte antigen-C*08 increases the risk of BK virus viremia in kidney transplant recipients","authors":"Marie-Pier Thivierge,&nbsp;Stéphanie Béland,&nbsp;Olivier Désy,&nbsp;Sacha A. De Serres","doi":"10.1016/j.trim.2025.102340","DOIUrl":"10.1016/j.trim.2025.102340","url":null,"abstract":"<div><div>BK virus (BKV) infection can cause graft loss in kidney transplant recipients. Several factors increase the risk of infection, including high level of immunosuppression, older age, and human leukocyte antigen (HLA) mismatch. The primary function of the major histocompatibility complex (HLA in human) is the presentation of peptides that originated from foreign or self-antigens to T cells to trigger an immune response, such as during infections. Identifying HLA genotypes that can influence the course of BKV infection could allow for stratifying patients according to their risk of developing the infection, thus personalizing the use of immunosuppressants. We conducted a retrospective study in a cohort of 1302 kidney transplant recipients, of whom 243 (19 %) developed BKV viremia. Clinical data and HLA genotype were evaluated for associations with BKV viremia. Among the 51 HLA genotypes analyzed, exploratory analysis revealed that patients expressing the HLA-C*08 genotype had a high risk of developing BKV viremia (<em>p</em> = 0.04). Using multivariate analyses adjusted for clinical variables that differed between patients with and without BK viremia (age and number of HLA-B mismatches), we confirmed that the HLA-C*08 genotype was associated with BK viremia. HLA-C*08, expressed by a sizeable proportion of the patients (82 individuals, or 6.3 % of the cohort), increased the risk of BKV viremia by 1.61 fold (<em>p</em> = 0.03). The HLA genotype may be useful in managing screening strategies for BKV in transplant recipients.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102340"},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695893","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
Relation between monocyte to high-density lipoprotein cholesterol ratio and prognosis in recipients after liver transplantation 肝移植受者单核细胞与高密度脂蛋白胆固醇比值与预后的关系
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-12-01 DOI: 10.1016/j.trim.2025.102331
Serafettin Okutan , Hasan Saritas , Serdar Saritas , Semra Bulbuloglu , Hüseyin Guneş

Background

The end-stage liver diseases require liver transplantation as the life-saving solution. It is known that monocytes/macrophages and high-density lipoprotein cholesterol (HDLC) have important contributions to the development of hepatic inflammation and oxidative stress before liver transplantation. However, the effect of monocyte/HDL-C ratio (MHR) on clinical progression and outcome in the post-transplant period are not fully understood. Our hypothesis is that the MHR value may be associated with poor vs. good outcomes after liver transplantation.

Methods

In our retrospective study, we included 464 liver transplant recipients. Patients' data were extracted from electronic and other paper records in our teaching/research hospital. The MHR values and other blood parameters (creatinine, total protein, albumin, etc.) were expressed as a mean and standard deviation, which were analyzed by the Pearson correlation test. The relationship between graft dysfunction and MHR was determined by ROC curve analysis.

Results

The mean age of liver transplant recipients was 45.8 ± 13.7 years. Nineteen percent of patients had liver failure due to Alcoholic Fatty Liver Disease (AFLD) and 34.5 % had liver failure due to hepatitis B virus. At the end of 3 months after liver transplantation, 84.5 % of liver transplant recipients were alive, 5.8 % experienced graft rejection and 5.17 % had an infection. There was a statistically significant improvement in total protein, albumin, liver function tests, and serum creatinine values of the survivors (all p < 0.05). The MHR levels were significantly higher in patients who died after transplantation in comparison to those who survived before and after liver transplantation and these differences were statistically significant (p < 0.01).

Conclusion

The increased MHR values of recipients after liver transplantation correlated with their risk of survival. Furthermore, the MHR value increased with increased MELD score and the number of days of hospitalization and was not affected by gender and age. MHR was higher in patients with chronic diseases. Patients with high MHR before and after transplantation should be monitored more closely in the perioperative period.
背景:终末期肝病需要肝移植作为挽救生命的解决方案。已知单核/巨噬细胞和高密度脂蛋白胆固醇(HDLC)在肝移植前肝脏炎症和氧化应激的发展中起重要作用。然而,单核细胞/HDL-C比值(MHR)对移植后临床进展和预后的影响尚不完全清楚。我们的假设是,MHR值可能与肝移植后预后好坏有关。方法回顾性研究纳入464例肝移植受者。患者资料摘自我们教学/研究型医院的电子和其他纸质记录。MHR值及其他血液参数(肌酐、总蛋白、白蛋白等)以均值和标准差表示,采用Pearson相关检验进行分析。通过ROC曲线分析确定移植物功能障碍与MHR的关系。结果肝移植受者平均年龄为45.8±13.7岁。19%的患者因酒精性脂肪性肝病(AFLD)而肝功能衰竭,34.5%的患者因乙型肝炎病毒而肝功能衰竭。在肝移植后3个月结束时,84.5%的肝移植受者存活,5.8%发生移植排斥反应,5.17%发生感染。幸存者的总蛋白、白蛋白、肝功能检查和血清肌酐值均有统计学意义的改善(p < 0.05)。肝移植后死亡患者的MHR水平明显高于肝移植前后存活患者,差异有统计学意义(p < 0.01)。结论肝移植后受者MHR值的升高与其生存风险相关。MHR值随MELD评分和住院天数的增加而增加,不受性别和年龄的影响。慢性疾病患者的MHR较高。移植前后MHR高的患者围手术期应密切监测。
{"title":"Relation between monocyte to high-density lipoprotein cholesterol ratio and prognosis in recipients after liver transplantation","authors":"Serafettin Okutan ,&nbsp;Hasan Saritas ,&nbsp;Serdar Saritas ,&nbsp;Semra Bulbuloglu ,&nbsp;Hüseyin Guneş","doi":"10.1016/j.trim.2025.102331","DOIUrl":"10.1016/j.trim.2025.102331","url":null,"abstract":"<div><h3>Background</h3><div>The end-stage liver diseases require liver transplantation as the life-saving solution. It is known that monocytes/macrophages and high-density lipoprotein cholesterol (HDL<img>C) have important contributions to the development of hepatic inflammation and oxidative stress before liver transplantation. However, the effect of monocyte/HDL-C ratio (MHR) on clinical progression and outcome in the post-transplant period are not fully understood. Our hypothesis is that the MHR value may be associated with poor vs. good outcomes after liver transplantation.</div></div><div><h3>Methods</h3><div>In our retrospective study, we included 464 liver transplant recipients. Patients' data were extracted from electronic and other paper records in our teaching/research hospital. The MHR values and other blood parameters (creatinine, total protein, albumin, etc.) were expressed as a mean and standard deviation, which were analyzed by the Pearson correlation test. The relationship between graft dysfunction and MHR was determined by ROC curve analysis.</div></div><div><h3>Results</h3><div>The mean age of liver transplant recipients was 45.8 ± 13.7 years. Nineteen percent of patients had liver failure due to Alcoholic Fatty Liver Disease (AFLD) and 34.5 % had liver failure due to hepatitis B virus. At the end of 3 months after liver transplantation, 84.5 % of liver transplant recipients were alive, 5.8 % experienced graft rejection and 5.17 % had an infection. There was a statistically significant improvement in total protein, albumin, liver function tests, and serum creatinine values of the survivors (all <em>p</em> &lt; 0.05). The MHR levels were significantly higher in patients who died after transplantation in comparison to those who survived before and after liver transplantation and these differences were statistically significant (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The increased MHR values of recipients after liver transplantation correlated with their risk of survival. Furthermore, the MHR value increased with increased MELD score and the number of days of hospitalization and was not affected by gender and age. MHR was higher in patients with chronic diseases. Patients with high MHR before and after transplantation should be monitored more closely in the perioperative period.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102331"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614841","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
Temporal dynamics of cPRA levels and their categorical impact on waitlist longevity in Ecuadorian kidney transplant candidates: A 2011–2022 Nationwide cohort analysis cPRA水平的时间动态及其对厄瓜多尔肾移植候选者等待名单寿命的分类影响:2011-2022年全国队列分析
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-11-29 DOI: 10.1016/j.trim.2025.102329
David Garrido , Verónica Jeréz , Jorge Huertas
Background: Chronic kidney disease is a major public health concern for which kidney transplantation offers the best survival benefit. Patients with high calculated panel-reactive antibody (cPRA) levels often face extended waiting times owing to donor compatibility challenges.
Methods: We conducted a descriptive, cross-sectional analysis of all 724 kidney transplant candidates on Ecuador's national waiting list between 2011 and 2022, using anonymized INDOT data. cPRA values were obtained with solid-phase, bead-based luminometric assays. We applied descriptive statistics, Joinpoint regression to assess temporal trends, Spearman correlation for cPRA versus waiting time, chi-square tests for categorical comparisons, and logistic regression to estimate odds ratios (ORs) for prolonged waiting time (>5 years).
Results: Overall, 166 candidates (22.9 %) had cPRA ≥20 %. Of these, 86 (51.8 %) exhibited cPRA ≥75 %. The number of sensitized patients with cPRA ≥75 % rose from one in 2011 to nineteen in 2022 (annual percent change 10.4 %). Median waiting time was 54.5 months for candidates with cPRA ≥75 % versus 51.5 months for those with cPRA 20–74 %; there was no linear correlation between cPRA and waiting time (ρ = 0.11, p = 0.18). However, candidates with cPRA ≥75 % were more likely to wait >5 years than those below this threshold (44.2 % vs. 25.0 %; OR 2.38; p = 0.01), and a similar pattern was observed for candidates with cPRA ≥70 % (OR 2.98; p = 0.003).
Conclusion: The proportion of highly sensitized candidates has increased substantially between 2011 and 2022. Patients with cPRA levels ≥75 % were associated with prolonged waitlist time to obtain a kidney transplant. Prospective studies are warranted to explore underlying mechanisms and inform allocation strategies.
背景:慢性肾脏疾病是一个主要的公共卫生问题,肾移植提供了最佳的生存效益。由于供体相容性的挑战,计算出的高反应性抗体(cPRA)水平的患者往往面临延长的等待时间。方法:我们使用匿名INDOT数据,对2011年至2022年厄瓜多尔全国等待名单上的所有724名肾移植候选人进行了描述性横断面分析。cPRA值采用固相、珠状荧光法测定。我们应用描述性统计、连接点回归来评估时间趋势、cPRA与等待时间的Spearman相关性、卡方检验来进行分类比较、逻辑回归来估计等待时间延长(>;5年)的优势比(ORs)。结果:总体而言,166名候选人(22.9%)的cPRA≥20%。其中,86例(51.8%)cPRA≥75%。cPRA≥75%致敏患者的数量从2011年的1例增加到2022年的19例(年变化10.4%)。cPRA≥75%的候选者中位等待时间为54.5个月,而cPRA 20 - 74%的候选者中位等待时间为51.5个月;cPRA与等待时间无线性相关(ρ = 0.11, p = 0.18)。然而,cPRA≥75%的患者比低于该阈值的患者更有可能等待5年(44.2% vs. 25.0%; OR 2.38; p = 0.01), cPRA≥70%的患者也有类似的情况(OR 2.98; p = 0.003)。结论:2011年至2022年间,高敏感候选人比例大幅增加。cPRA水平≥75%的患者与获得肾移植的等待时间延长相关。有必要进行前瞻性研究,以探索潜在的机制并为分配策略提供信息。
{"title":"Temporal dynamics of cPRA levels and their categorical impact on waitlist longevity in Ecuadorian kidney transplant candidates: A 2011–2022 Nationwide cohort analysis","authors":"David Garrido ,&nbsp;Verónica Jeréz ,&nbsp;Jorge Huertas","doi":"10.1016/j.trim.2025.102329","DOIUrl":"10.1016/j.trim.2025.102329","url":null,"abstract":"<div><div>Background: Chronic kidney disease is a major public health concern for which kidney transplantation offers the best survival benefit. Patients with high calculated panel-reactive antibody (cPRA) levels often face extended waiting times owing to donor compatibility challenges.</div><div>Methods: We conducted a descriptive, cross-sectional analysis of all 724 kidney transplant candidates on Ecuador's national waiting list between 2011 and 2022, using anonymized INDOT data. cPRA values were obtained with solid-phase, bead-based luminometric assays. We applied descriptive statistics, Joinpoint regression to assess temporal trends, Spearman correlation for cPRA versus waiting time, chi-square tests for categorical comparisons, and logistic regression to estimate odds ratios (ORs) for prolonged waiting time (&gt;5 years).</div><div>Results: Overall, 166 candidates (22.9 %) had cPRA ≥20 %. Of these, 86 (51.8 %) exhibited cPRA ≥75 %. The number of sensitized patients with cPRA ≥75 % rose from one in 2011 to nineteen in 2022 (annual percent change 10.4 %). Median waiting time was 54.5 months for candidates with cPRA ≥75 % versus 51.5 months for those with cPRA 20–74 %; there was no linear correlation between cPRA and waiting time (ρ = 0.11, <em>p</em> = 0.18). However, candidates with cPRA ≥75 % were more likely to wait &gt;5 years than those below this threshold (44.2 % vs. 25.0 %; OR 2.38; <em>p</em> = 0.01), and a similar pattern was observed for candidates with cPRA ≥70 % (OR 2.98; <em>p</em> = 0.003).</div><div>Conclusion: The proportion of highly sensitized candidates has increased substantially between 2011 and 2022. Patients with cPRA levels ≥75 % were associated with prolonged waitlist time to obtain a kidney transplant. Prospective studies are warranted to explore underlying mechanisms and inform allocation strategies.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102329"},"PeriodicalIF":1.4,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651724","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
Novel, short-course, low-dose total lymphoid irradiation (TLI) post heart transplant for recalcitrant rejection – A single centre experience 新型、短疗程、低剂量全淋巴细胞照射(TLI)治疗心脏移植后顽固性排斥反应-单中心经验。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-11-29 DOI: 10.1016/j.trim.2025.102333
Felicity Lee , B.N. Clare Fazackerley , Tee S. Lim , Lloyd D'Orsogna , Jon Downing , Linh Truong , Amit Shah , Jay Baumwol , Kaitlyn Lam , James Lambert , Peter Dias , Faith Njue , Lawrence Dembo

Background

A previous small study (2007) of patients who received short-course, low-dose total lymphoid irradiation (sTLI) as treatment for recalcitrant cardiac rejection post-heart transplantation (HTx) reported good treatment compliance without significant toxicities and improvement in rejection frequency. We conducted a retrospective analysis, evaluating longer-term outcomes in this patient cohort.

Methods and results

We reviewed the medical records of 21 HTx recipients (mean age ± std. 43.7 ± 12.8 years; 47.6 % female) who received sTLI between 2001 and 2023. Five patients were highly sensitized pre-HTx (calculated panel-reactive antibody >80 %) and 8 patients received induction immunosuppression at time of HTx. Patients received 4.5Gy in four fractions over 4 consecutive days administered (n = 13 as an outpatient), at a median of 442 (IQR 47–966) days post-HTx. STLI was well-tolerated symptomatically with no persistent lymphopenias. Eleven patients had no further rejection. Ten patients had immediate rejection resolution with later rejection detected (median 401 [IQR 301–1569] days post-sTLI). Thirteen patients, mostly transplanted pre-2010, have deceased (median graft survival 7.6 years, mean follow-up 9.4 years). One patient died of metastatic colon cancer. There were no haematological malignancies. Two patients received a second sTLI course and subsequent re-HTx.

Conclusions

We report the largest case series of patients who received sTLI post-HTx. STLI is well-tolerated, with resolution of immediate recalcitrant rejection in all patients and resolution of rejection in the longer term in 52 %. STLI is a possible alternative option for patients with cardiac rejection refractory to routine, augmented immunotherapy. Further larger studies are required to assess the longer-term efficacy and safety of this treatment.
背景:之前的一项小型研究(2007年)对接受短疗程、低剂量全淋巴细胞照射(sTLI)治疗心脏移植后顽固性心脏排斥反应(HTx)的患者进行了研究,报告了良好的治疗依从性,没有明显的毒性和排斥反应频率的改善。我们进行了回顾性分析,评估该患者队列的长期结果。方法与结果:我们回顾了21例HTx受者(平均年龄 ± )的病历。 43.7±12.8  年;47.6 %女性),在2001年至2023年间接受sTLI治疗。5例患者在HTx前高度致敏(计算出面板反应抗体>80 %),8例患者在HTx时接受诱导免疫抑制。患者在连续4天内分四部分接受4.5Gy (n = 13,作为门诊患者),htx后中位数为442 (IQR 47-966)天。STLI在症状上耐受良好,无持续性淋巴细胞减少。11名患者没有出现进一步的排斥反应。10例患者即刻排异反应消退,随后发现排异反应(stli后中位401 [IQR 301-1569]天)。13例患者,大多数在2010年前移植,已经死亡(中位移植生存7.6 年,平均随访9.4 年)。一名患者死于转移性结肠癌。无血液学恶性肿瘤。两名患者接受了第二次sTLI治疗,随后再次接受htx治疗。结论:我们报道了htx术后接受sTLI的最大病例系列。STLI耐受性良好,所有患者立即出现顽固性排斥反应,52% %的患者长期出现排斥反应。STLI是对常规增强免疫治疗难治性心脏排斥患者的一种可能的替代选择。需要更大规模的研究来评估这种治疗的长期疗效和安全性。
{"title":"Novel, short-course, low-dose total lymphoid irradiation (TLI) post heart transplant for recalcitrant rejection – A single centre experience","authors":"Felicity Lee ,&nbsp;B.N. Clare Fazackerley ,&nbsp;Tee S. Lim ,&nbsp;Lloyd D'Orsogna ,&nbsp;Jon Downing ,&nbsp;Linh Truong ,&nbsp;Amit Shah ,&nbsp;Jay Baumwol ,&nbsp;Kaitlyn Lam ,&nbsp;James Lambert ,&nbsp;Peter Dias ,&nbsp;Faith Njue ,&nbsp;Lawrence Dembo","doi":"10.1016/j.trim.2025.102333","DOIUrl":"10.1016/j.trim.2025.102333","url":null,"abstract":"<div><h3>Background</h3><div>A previous small study (2007) of patients who received short-course, low-dose total lymphoid irradiation (sTLI) as treatment for recalcitrant cardiac rejection post-heart transplantation (HTx) reported good treatment compliance without significant toxicities and improvement in rejection frequency. We conducted a retrospective analysis, evaluating longer-term outcomes in this patient cohort.</div></div><div><h3>Methods and results</h3><div>We reviewed the medical records of 21 HTx recipients (mean age ± std. 43.7 ± 12.8 years; 47.6 % female) who received sTLI between 2001 and 2023. Five patients were highly sensitized pre-HTx (calculated panel-reactive antibody &gt;80 %) and 8 patients received induction immunosuppression at time of HTx. Patients received 4.5Gy in four fractions over 4 consecutive days administered (<em>n</em> = 13 as an outpatient), at a median of 442 (IQR 47–966) days post-HTx. STLI was well-tolerated symptomatically with no persistent lymphopenias. Eleven patients had no further rejection. Ten patients had immediate rejection resolution with later rejection detected (median 401 [IQR 301–1569] days post-sTLI). Thirteen patients, mostly transplanted pre-2010, have deceased (median graft survival 7.6 years, mean follow-up 9.4 years). One patient died of metastatic colon cancer. There were no haematological malignancies. Two patients received a second sTLI course and subsequent re-HTx.</div></div><div><h3>Conclusions</h3><div>We report the largest case series of patients who received sTLI post-HTx. STLI is well-tolerated, with resolution of immediate recalcitrant rejection in all patients and resolution of rejection in the longer term in 52 %. STLI is a possible alternative option for patients with cardiac rejection refractory to routine, augmented immunotherapy. Further larger studies are required to assess the longer-term efficacy and safety of this treatment.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102333"},"PeriodicalIF":1.4,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655374","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
Conversion to belatacept-based immunosuppression as a calcineurin sparing regimen in lung transplant: A multi-institutional retrospective study 在肺移植中转换为基于belataccept的免疫抑制作为钙调磷酸酶保留方案:一项多机构回顾性研究。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-11-29 DOI: 10.1016/j.trim.2025.102330
Moustafa Younis , Cecelia M. Miller , Christopher I. Mederos , Ariana Ishaq , Pooja Kumar , Biplab Saha , Cynthia Gries , Victoria Reams , Vaidehi Kaza , Srinivas Bollineni , Fernando Torres , Mohammad A. Aladaileh , Mindaugas Rackauskas , Irina Timofte , Amir Emtiazjoo

Background

Calcineurin inhibitor (CNI) related kidney dysfunction is common and associated with worse outcomes after lung transplantation (LTx). To mitigate that risk, belatacept use in a CNI-sparing regimen is an alternative in LTx. We aim to describe our experience using belatacept as a CNI-sparing regimen in LTx.

Methods

A multi-institutional retrospective review of LTx patients who received belatacept (1/2018–8/2023) was performed. The primary outcome is the change in estimated glomerular filtration rate (eGFR) after initiation of belatacept. Secondary outcomes were compared with a control group of patients transplanted during 1/2018–8/2023 that did not receive belatacept. Secondary outcomes include acute cellular rejection (ACR), denovo donor specific antibodies (DSA), antibody mediated rejection (AMR), infections, malignancy, chronic lung allograft dysfunction (CLAD) and mortality.

Results

A total of 170 LTx patients who received belatacept were included for the primary outcome. To investigate the secondary outcomes an additional 288 LTx controls were used. The median (IQR) eGFR at the time of belatacept initiation, six months, and one year post belatacept initiation was 43 (34–52), 46 (37–53) and 43 (36–53) mL/min/1.73 m2, respectively (p = 0.21). There was no significant difference in ACR, DSA, AMR, infections, malignancy, CLAD or mortality between both groups.

Conclusions

Belatacept CNI-sparing therapy was well tolerated and feasible in LTx recipients, with renal function appearing to stabilize over time and no apparent safety signal for acute rejection, infection, malignancy, CLAD, or mortality.
背景:钙调磷酸酶抑制剂(CNI)相关的肾功能障碍是常见的,并且与肺移植(LTx)后较差的预后相关。为了减轻这种风险,在LTx中,在cni保留方案中使用belataccept是一种替代方案。我们的目的是描述我们在LTx中使用belataccept作为cni保护方案的经验。方法:对接受belataccept治疗的LTx患者(2018年1月- 2023年8月)进行多机构回顾性分析。主要结局是开始服用后估计肾小球滤过率(eGFR)的变化。次要结果与2018年1月至2023年8月期间未接受belataccept的移植患者的对照组进行比较。次要结局包括急性细胞排斥反应(ACR)、首发供体特异性抗体(DSA)、抗体介导的排斥反应(AMR)、感染、恶性肿瘤、慢性同种异体肺功能障碍(CLAD)和死亡率。结果:共有170例LTx患者接受了belataccept纳入主要结局。为了调查次要结果,另外使用了288例LTx对照。belatacept起始时、起始后6个月和1年的中位(IQR) eGFR分别为43(34-52)、46(37-53)和43 (36-53)mL/min/1.73 m2 (p = 0.21)。两组间ACR、DSA、AMR、感染、恶性、覆层及死亡率无显著差异。结论:在LTx受者中,Belatacept保留cni治疗耐受性良好且可行,肾功能随着时间的推移趋于稳定,并且没有明显的排斥反应、感染、恶性肿瘤、CLAD或死亡率的安全信号。
{"title":"Conversion to belatacept-based immunosuppression as a calcineurin sparing regimen in lung transplant: A multi-institutional retrospective study","authors":"Moustafa Younis ,&nbsp;Cecelia M. Miller ,&nbsp;Christopher I. Mederos ,&nbsp;Ariana Ishaq ,&nbsp;Pooja Kumar ,&nbsp;Biplab Saha ,&nbsp;Cynthia Gries ,&nbsp;Victoria Reams ,&nbsp;Vaidehi Kaza ,&nbsp;Srinivas Bollineni ,&nbsp;Fernando Torres ,&nbsp;Mohammad A. Aladaileh ,&nbsp;Mindaugas Rackauskas ,&nbsp;Irina Timofte ,&nbsp;Amir Emtiazjoo","doi":"10.1016/j.trim.2025.102330","DOIUrl":"10.1016/j.trim.2025.102330","url":null,"abstract":"<div><h3>Background</h3><div>Calcineurin inhibitor (CNI) related kidney dysfunction is common and associated with worse outcomes after lung transplantation (LTx). To mitigate that risk, belatacept use in a CNI-sparing regimen is an alternative in LTx. We aim to describe our experience using belatacept as a CNI-sparing regimen in LTx.</div></div><div><h3>Methods</h3><div>A multi-institutional retrospective review of LTx patients who received belatacept (1/2018–8/2023) was performed. The primary outcome is the change in estimated glomerular filtration rate (eGFR) after initiation of belatacept. Secondary outcomes were compared with a control group of patients transplanted during 1/2018–8/2023 that did not receive belatacept. Secondary outcomes include acute cellular rejection (ACR), denovo donor specific antibodies (DSA), antibody mediated rejection (AMR), infections, malignancy, chronic lung allograft dysfunction (CLAD) and mortality.</div></div><div><h3>Results</h3><div>A total of 170 LTx patients who received belatacept were included for the primary outcome. To investigate the secondary outcomes an additional 288 LTx controls were used. The median (IQR) eGFR at the time of belatacept initiation, six months, and one year post belatacept initiation was 43 (34–52), 46 (37–53) and 43 (36–53) mL/min/1.73 m2, respectively (<em>p</em> = 0.21). There was no significant difference in ACR, DSA, AMR, infections, malignancy, CLAD or mortality between both groups.</div></div><div><h3>Conclusions</h3><div>Belatacept CNI-sparing therapy was well tolerated and feasible in LTx recipients, with renal function appearing to stabilize over time and no apparent safety signal for acute rejection, infection, malignancy, CLAD, or mortality.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102330"},"PeriodicalIF":1.4,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655446","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
Smart transplant+: A HyCARE hybrid AI–cloud framework for intelligent donor–recipient matching, workflow automation, and post-transplant optimization 智能移植+:HyCARE混合人工智能云框架,用于智能供体-受体匹配、工作流程自动化和移植后优化。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-11-27 DOI: 10.1016/j.trim.2025.102332
Winner Pulakhandam , Archana Chaluvadi , Visrutatma Rao Vallu , R. Padmavathy
Organ transplantation is a life-saving medical intervention to reverse end-stage organ failure. Despite its life-saving potential, organ transplantation faces inefficiencies like organ shortages, long wait times, and rejection risks due to manual, clinically limited donor-recipient matching. The rapid growth of AI and cloud computing offers new opportunities to enhance organ transplantation. This study proposes Smart Transplant+, a HyCARE system enabling intelligent matching, decision-making, and process automation. The architecture leverages a huge Organ Transplant Dataset and the most advanced methods such as Feedforward Neural Networks and Genetic Algorithms to maximize donor-recipient matching. Gated Recurrent Units are utilized in pre-transplant risk prediction, and post-transplant care is augmented with real-time tracking by IoT-based wearable sensors. The system has been programmed using Python, along with software tools like TensorFlow for machine learning and AES encryption for secure data storage and transmission. The Smart Transplant+ system provides 95–98 % accuracy which is higher than existing methods in identifying suitable donors and recipients and the potential for successful transplantation, and greatly enhances organ transplant efficiency and success rate. This book illustrates the revolutionary potential of synergizing IoT, cloud technology, and AI to optimize transplant care and improve outcomes.
器官移植是一种挽救生命的医疗干预措施,以逆转终末期器官衰竭。尽管器官移植具有挽救生命的潜力,但由于人工、临床有限的供体-受体匹配,器官移植面临着器官短缺、等待时间长和排斥风险等低效率问题。人工智能和云计算的快速发展为加强器官移植提供了新的机遇。本研究提出了智能移植+,一个HyCARE系统,实现智能匹配,决策和过程自动化。该架构利用巨大的器官移植数据集和最先进的方法,如前馈神经网络和遗传算法,以最大限度地实现供体-受体匹配。门控复发单元用于移植前风险预测,移植后护理通过基于物联网的可穿戴传感器进行实时跟踪。该系统使用Python编程,以及用于机器学习的TensorFlow和用于安全数据存储和传输的AES加密等软件工具。智能移植+系统在识别合适的供体和受体以及移植成功的可能性方面提供95-98 %的准确率,大大提高了器官移植的效率和成功率。这本书说明了协同物联网、云技术和人工智能优化移植护理和改善结果的革命性潜力。
{"title":"Smart transplant+: A HyCARE hybrid AI–cloud framework for intelligent donor–recipient matching, workflow automation, and post-transplant optimization","authors":"Winner Pulakhandam ,&nbsp;Archana Chaluvadi ,&nbsp;Visrutatma Rao Vallu ,&nbsp;R. Padmavathy","doi":"10.1016/j.trim.2025.102332","DOIUrl":"10.1016/j.trim.2025.102332","url":null,"abstract":"<div><div>Organ transplantation is a life-saving medical intervention to reverse end-stage organ failure. Despite its life-saving potential, organ transplantation faces inefficiencies like organ shortages, long wait times, and rejection risks due to manual, clinically limited donor-recipient matching. The rapid growth of AI and cloud computing offers new opportunities to enhance organ transplantation. This study proposes Smart Transplant+, a HyCARE system enabling intelligent matching, decision-making, and process automation. The architecture leverages a huge Organ Transplant Dataset and the most advanced methods such as Feedforward Neural Networks and Genetic Algorithms to maximize donor-recipient matching. Gated Recurrent Units are utilized in pre-transplant risk prediction, and post-transplant care is augmented with real-time tracking by IoT-based wearable sensors. The system has been programmed using Python, along with software tools like TensorFlow for machine learning and AES encryption for secure data storage and transmission. The Smart Transplant+ system provides 95–98 % accuracy which is higher than existing methods in identifying suitable donors and recipients and the potential for successful transplantation, and greatly enhances organ transplant efficiency and success rate. This book illustrates the revolutionary potential of synergizing IoT, cloud technology, and AI to optimize transplant care and improve outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"94 ","pages":"Article 102332"},"PeriodicalIF":1.4,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640344","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
Characteristics linking ischemia-reperfusion to chronic lung allograft dysfunction in lung transplantation: A single-cell bioinformatics analysis 肺移植中缺血-再灌注与慢性同种异体肺移植物功能障碍相关的特征:单细胞生物信息学分析。
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-11-12 DOI: 10.1016/j.trim.2025.102326
Peng Zhang , Zhendong Qiao , Song Zhao , Kai Wu

Background

Lung transplantation offers a life-saving procedure to patients with end-stage lung diseases with 85–89 % one year and 60 % five-year survival rates. Lung transplants are complicated by early ischemia/reperfusion injury (IRI) and late chronic lung allograft dysfunction (CLAD). However, the cellular and molecular links between IRI and CLAD remain unclear.

Materials and methods

We integrated single-cell RNA-seq results from GSE220797 and GSE224210 data sets. After quality filtering, we performed Louvain clustering and UMAP visualization. We applied Augur method to prioritize cell populations by transcriptional responsiveness to IRI and CLAD. We also performed dynamic trajectory analyses to map pseudotemporal transitions. Pathway activity was characterized by differential expression analysis and module scoring. Intercellular communication was assessed using CellChat and MEBOCOST analyses. Regulon inference was performed with pySCENIC analysis.

Results

Overall, epithelial cells showed progressive metabolic suppression and activation of cuproptosis, a programmed cell death (PCD) triggered by excessive copper accumulation within cells. Club cells, found in the small airways of the lungs, exhibited developmental plasticity and predictive potential across IRI and CLAD conditions. Among myeloid populations, M1 proinflammatory (AM_M1TM) macrophages underwent macrophage-to-myofibroblast transition (MMT) and produced excessive extracellular matrix (ECM) supporting a network of proteins surrounding cells. Metabolite and cell–cell communication analyses revealed declining macrophage/epithelial metabolic crosstalk and differential signaling flux from normal through IRI to CLAD transition.

Conclusions

The integrated single-cell atlas delineates interaction of multiple cells and their signaling pathways linking IRI to CLAD processes. These findings require further verification through studies in animal models and clinical samples.
背景:肺移植为终末期肺病患者提供了一种挽救生命的手术,其一年生存率为85-89 %,五年生存率为60 %。肺移植并发早期缺血/再灌注损伤(IRI)和晚期慢性同种异体肺功能障碍(CLAD)。然而,IRI和CLAD之间的细胞和分子联系尚不清楚。材料和方法:我们整合了来自GSE220797和GSE224210数据集的单细胞RNA-seq结果。经过质量过滤后,我们进行了Louvain聚类和UMAP可视化。我们应用Augur方法通过对IRI和CLAD的转录反应来确定细胞群的优先级。我们还进行了动态轨迹分析来映射伪时间转换。通过差异表达分析和模块评分来表征通路活性。使用CellChat和MEBOCOST分析评估细胞间通信。用pySCENIC分析进行规律推理。结果:总体而言,上皮细胞表现出进行性代谢抑制和铜增生的激活,这是一种由细胞内过量铜积累引发的程序性细胞死亡(PCD)。在肺小气道中发现的俱乐部细胞在IRI和CLAD条件下表现出发育可塑性和预测潜力。在髓系人群中,M1促炎(AM_M1TM)巨噬细胞经历巨噬细胞到肌成纤维细胞的转化(MMT),并产生过多的细胞外基质(ECM),支持细胞周围的蛋白质网络。代谢物和细胞间通讯分析显示,巨噬细胞/上皮代谢串音下降,从正常到IRI到CLAD转变的差异信号通量下降。结论:整合的单细胞图谱描述了多个细胞的相互作用及其连接IRI和CLAD过程的信号通路。这些发现需要通过动物模型和临床样本的研究进一步验证。
{"title":"Characteristics linking ischemia-reperfusion to chronic lung allograft dysfunction in lung transplantation: A single-cell bioinformatics analysis","authors":"Peng Zhang ,&nbsp;Zhendong Qiao ,&nbsp;Song Zhao ,&nbsp;Kai Wu","doi":"10.1016/j.trim.2025.102326","DOIUrl":"10.1016/j.trim.2025.102326","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplantation offers a life-saving procedure to patients with end-stage lung diseases with 85–89 % one year and 60 % five-year survival rates. Lung transplants are complicated by early ischemia/reperfusion injury (IRI) and late chronic lung allograft dysfunction (CLAD). However, the cellular and molecular links between IRI and CLAD remain unclear.</div></div><div><h3>Materials and methods</h3><div>We integrated single-cell RNA-seq results from <span><span>GSE220797</span><svg><path></path></svg></span> and <span><span>GSE224210</span><svg><path></path></svg></span> data sets. After quality filtering, we performed Louvain clustering and UMAP visualization. We applied Augur method to prioritize cell populations by transcriptional responsiveness to IRI and CLAD. We also performed dynamic trajectory analyses to map pseudotemporal transitions. Pathway activity was characterized by differential expression analysis and module scoring. Intercellular communication was assessed using CellChat and MEBOCOST analyses. Regulon inference was performed with pySCENIC analysis.</div></div><div><h3>Results</h3><div>Overall, epithelial cells showed progressive metabolic suppression and activation of cuproptosis, a programmed cell death (PCD) triggered by excessive copper accumulation within cells. Club cells, found in the small airways of the lungs, exhibited developmental plasticity and predictive potential across IRI and CLAD conditions. Among myeloid populations, M1 proinflammatory (AM_M1TM) macrophages underwent macrophage-to-myofibroblast transition (MMT) and produced excessive extracellular matrix (ECM) supporting a network of proteins surrounding cells. Metabolite and cell–cell communication analyses revealed declining macrophage/epithelial metabolic crosstalk and differential signaling flux from normal through IRI to CLAD transition.</div></div><div><h3>Conclusions</h3><div>The integrated single-cell atlas delineates interaction of multiple cells and their signaling pathways linking IRI to CLAD processes. These findings require further verification through studies in animal models and clinical samples.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102326"},"PeriodicalIF":1.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514175","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
Immune mediators as therapeutic targets in GvHD; cytokines, growth factors, chemokines, and co-stimulation /co-inhibition 免疫介质作为GvHD的治疗靶点细胞因子、生长因子、趋化因子和共刺激/共抑制
IF 1.4 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-11-12 DOI: 10.1016/j.trim.2025.102328
Amir Rastegari , Fatemeh Mohebbi
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and emerging allogeneic T cell–based immunotherapies offer curative potential for hematologic malignancies, solid tumors, and selected non-malignant disorders through graft-versus-tumor (GvT) and immune reconstitution effects mediated by donor immune cells. However, their clinical success is constrained by graft-versus-host disease (GvHD) and other immune-mediated toxicities resulting from donor–host alloreactivity. Therefore, a central challenge is to develop personalized, safer allogeneic cellular therapies that preserve potent anti-tumor and immune-restorative functions while minimizing tissue injury. This review integrates the current understanding of acute and chronic GvHD immunopathogenesis, covering cytokine and chemokine networks, growth-factor signaling, and co-stimulatory/co-inhibitory pathways, and links these mechanisms to therapeutic strategies for selective immune modulation. Drawing on translational insights, we propose a framework for next-generation allogeneic cell-based therapies that are precision-tuned to donor/recipient biology, advancing individualized anticancer and immune-reconstitution outcomes with improved safety.
同种异体造血干细胞移植(allog - hsct)和新兴的基于同种异体T细胞的免疫疗法通过移植物抗肿瘤(GvT)和供体免疫细胞介导的免疫重建效应,为血液系统恶性肿瘤、实体瘤和某些非恶性疾病提供了治疗潜力。然而,它们的临床成功受到移植物抗宿主病(GvHD)和其他由供体-宿主异体反应性引起的免疫介导毒性的限制。因此,一个核心挑战是开发个性化的、更安全的同种异体细胞疗法,在最大限度地减少组织损伤的同时,保持有效的抗肿瘤和免疫恢复功能。本文综述了目前对急性和慢性GvHD免疫发病机制的理解,包括细胞因子和趋化因子网络、生长因子信号传导和共刺激/共抑制途径,并将这些机制与选择性免疫调节的治疗策略联系起来。利用翻译的见解,我们提出了下一代基于同种异体细胞的治疗框架,该框架精确调整为供体/受体生物学,在提高安全性的同时推进个体化抗癌和免疫重建结果。
{"title":"Immune mediators as therapeutic targets in GvHD; cytokines, growth factors, chemokines, and co-stimulation /co-inhibition","authors":"Amir Rastegari ,&nbsp;Fatemeh Mohebbi","doi":"10.1016/j.trim.2025.102328","DOIUrl":"10.1016/j.trim.2025.102328","url":null,"abstract":"<div><div>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and emerging allogeneic T cell–based immunotherapies offer curative potential for hematologic malignancies, solid tumors, and selected non-malignant disorders through graft-versus-tumor (GvT) and immune reconstitution effects mediated by donor immune cells. However, their clinical success is constrained by graft-versus-host disease (GvHD) and other immune-mediated toxicities resulting from donor–host alloreactivity. Therefore, a central challenge is to develop personalized, safer allogeneic cellular therapies that preserve potent anti-tumor and immune-restorative functions while minimizing tissue injury. This review integrates the current understanding of acute and chronic GvHD immunopathogenesis, covering cytokine and chemokine networks, growth-factor signaling, and co-stimulatory/co-inhibitory pathways, and links these mechanisms to therapeutic strategies for selective immune modulation. Drawing on translational insights, we propose a framework for next-generation allogeneic cell-based therapies that are precision-tuned to donor/recipient biology, advancing individualized anticancer and immune-reconstitution outcomes with improved safety.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102328"},"PeriodicalIF":1.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516906","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
期刊
Transplant immunology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1