首页 > 最新文献

Transplantation最新文献

英文 中文
Protein Expression Profiling: At the Crossroads Between AMR and ACR?
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-31 DOI: 10.1097/TP.0000000000005346
Stephan Ensminger
{"title":"Protein Expression Profiling: At the Crossroads Between AMR and ACR?","authors":"Stephan Ensminger","doi":"10.1097/TP.0000000000005346","DOIUrl":"https://doi.org/10.1097/TP.0000000000005346","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Commentary on "Validation of a Pretransplant Risk Prediction Model for Early Allograft Dysfunction After Living-donor Liver Transplantation".
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-28 DOI: 10.1097/TP.0000000000005319
Akihiko Soyama, Susumu Eguchi
{"title":"Commentary on \"Validation of a Pretransplant Risk Prediction Model for Early Allograft Dysfunction After Living-donor Liver Transplantation\".","authors":"Akihiko Soyama, Susumu Eguchi","doi":"10.1097/TP.0000000000005319","DOIUrl":"https://doi.org/10.1097/TP.0000000000005319","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Should We Transplant Candidates With a Positive SARS-CoV-2 RT-PCR Test?
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-28 DOI: 10.1097/TP.0000000000005333
Ilies Benotmane, Nathan Kasriel, Christophe Masset, Baptiste Michard, Paolo Malvezzi, Baptiste Giguet, Claire Tinel, Filomena Conti, Florent Von Tokarski, José Ursic-Bedoya, Marie Matignon, Adrien Flahault, Inna Mohamadou, Fanny Lebossé, Nassim Kamar, Mehdi Maanaoui, Ilias Kounis, Coralie Poulain, Marie-Noëlle Hilleret, Dany Anglicheau, Florence Lacaille, Nicolas Bouvier, Léonard Golbin, Agnès Duveau, Sophie Caillard, Lionel Couzi, Hannah Kaminski, Jérôme Dumortier

Background: It remains unclear whether physicians should accept transplantation offers for candidates with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test due to the potential risk of severe infection after initiating immunosuppressive therapy.

Methods: A multicenter observational study was conducted in 19 French solid organ transplantation units. Patients on the waiting list for liver or kidney transplants who had a positive SARS-CoV-2 reverse transcription polymerase chain reaction nasopharyngeal swab at the time of transplantation were recorded.

Results: Sixty-five patients were included. The recipients were predominantly men (n = 40; 62%) with a mean age of 55.4 y (SD = 16.5). On the day of transplantation, 2 patients exhibited symptoms compatible with COVID-19. The majority of patients (n = 55; 85%) underwent thoracic imaging, with only 3 patients showing imaging results compatible with COVID-19. Ten patients (28%) had a cycle threshold value <30. Anti-SARS-CoV-2 spike protein serology within 3 mo before transplantation was available for 36 patients; only 2 patients were seronegative. Due to COVID-19, physicians adapted the immunosuppressive therapy for 16 patients (25%). Specific antiviral therapy was used for 15 patients (23%), primarily remdesivir (n = 12). Overall, the majority of patients did not receive any adjustment of immunosuppressive therapy or antiviral treatment (n = 36; 55%). The outcomes were generally favorable even for patients with the lowest cycle threshold values, indicating a high viral load. Four patients died during follow-up, although none of these deaths were attributable to COVID-19.

Conclusions: Transplantation appears to be safe for patients who are asymptomatic or have mild symptoms, reassuring thoracic imaging, and a history of anti-SARS-CoV-2 infection and/or immunization.

{"title":"Should We Transplant Candidates With a Positive SARS-CoV-2 RT-PCR Test?","authors":"Ilies Benotmane, Nathan Kasriel, Christophe Masset, Baptiste Michard, Paolo Malvezzi, Baptiste Giguet, Claire Tinel, Filomena Conti, Florent Von Tokarski, José Ursic-Bedoya, Marie Matignon, Adrien Flahault, Inna Mohamadou, Fanny Lebossé, Nassim Kamar, Mehdi Maanaoui, Ilias Kounis, Coralie Poulain, Marie-Noëlle Hilleret, Dany Anglicheau, Florence Lacaille, Nicolas Bouvier, Léonard Golbin, Agnès Duveau, Sophie Caillard, Lionel Couzi, Hannah Kaminski, Jérôme Dumortier","doi":"10.1097/TP.0000000000005333","DOIUrl":"https://doi.org/10.1097/TP.0000000000005333","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether physicians should accept transplantation offers for candidates with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test due to the potential risk of severe infection after initiating immunosuppressive therapy.</p><p><strong>Methods: </strong>A multicenter observational study was conducted in 19 French solid organ transplantation units. Patients on the waiting list for liver or kidney transplants who had a positive SARS-CoV-2 reverse transcription polymerase chain reaction nasopharyngeal swab at the time of transplantation were recorded.</p><p><strong>Results: </strong>Sixty-five patients were included. The recipients were predominantly men (n = 40; 62%) with a mean age of 55.4 y (SD = 16.5). On the day of transplantation, 2 patients exhibited symptoms compatible with COVID-19. The majority of patients (n = 55; 85%) underwent thoracic imaging, with only 3 patients showing imaging results compatible with COVID-19. Ten patients (28%) had a cycle threshold value <30. Anti-SARS-CoV-2 spike protein serology within 3 mo before transplantation was available for 36 patients; only 2 patients were seronegative. Due to COVID-19, physicians adapted the immunosuppressive therapy for 16 patients (25%). Specific antiviral therapy was used for 15 patients (23%), primarily remdesivir (n = 12). Overall, the majority of patients did not receive any adjustment of immunosuppressive therapy or antiviral treatment (n = 36; 55%). The outcomes were generally favorable even for patients with the lowest cycle threshold values, indicating a high viral load. Four patients died during follow-up, although none of these deaths were attributable to COVID-19.</p><p><strong>Conclusions: </strong>Transplantation appears to be safe for patients who are asymptomatic or have mild symptoms, reassuring thoracic imaging, and a history of anti-SARS-CoV-2 infection and/or immunization.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Addressing Social Determinants of Health to Achieve Equity in Liver Transplantation: Moving From Identification to Implementation.
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-28 DOI: 10.1097/TP.0000000000005352
Elizabeth S Aby, Alyson Kaplan
{"title":"Addressing Social Determinants of Health to Achieve Equity in Liver Transplantation: Moving From Identification to Implementation.","authors":"Elizabeth S Aby, Alyson Kaplan","doi":"10.1097/TP.0000000000005352","DOIUrl":"https://doi.org/10.1097/TP.0000000000005352","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Toward Activity and Chronicity Indices for the Evaluation of Kidney Transplant Rejection: A Viewpoint by the Banff Working Group.
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-28 DOI: 10.1097/TP.0000000000005336
Maarten Naesens, Lynn D Cornell, Surya V Seshan, Mark Haas
{"title":"Toward Activity and Chronicity Indices for the Evaluation of Kidney Transplant Rejection: A Viewpoint by the Banff Working Group.","authors":"Maarten Naesens, Lynn D Cornell, Surya V Seshan, Mark Haas","doi":"10.1097/TP.0000000000005336","DOIUrl":"https://doi.org/10.1097/TP.0000000000005336","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Donor-derived Cell-free DNA: A Step Forward in the Quest for Transplant Truth.
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-28 DOI: 10.1097/TP.0000000000005332
Philip F Halloran, Katelynn S Madill-Thomsen
{"title":"Donor-derived Cell-free DNA: A Step Forward in the Quest for Transplant Truth.","authors":"Philip F Halloran, Katelynn S Madill-Thomsen","doi":"10.1097/TP.0000000000005332","DOIUrl":"https://doi.org/10.1097/TP.0000000000005332","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Beyond the Test: Moving Forward With Transplant Candidates Testing Positive for COVID-19.
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-28 DOI: 10.1097/TP.0000000000005316
Nicolas Barros, Camille N Kotton
{"title":"Beyond the Test: Moving Forward With Transplant Candidates Testing Positive for COVID-19.","authors":"Nicolas Barros, Camille N Kotton","doi":"10.1097/TP.0000000000005316","DOIUrl":"https://doi.org/10.1097/TP.0000000000005316","url":null,"abstract":"","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Validation of a Pretransplant Risk Prediction Model for Early Allograft Dysfunction After Living-donor Liver Transplantation.
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-28 DOI: 10.1097/TP.0000000000005331
Zhihao Li, Dimitri Raptis, Ashwin Rammohan, Vasanthakumar Gunasekaran, Suyoung Hong, Itsuko Chih-Yi Chen, Jongman Kim, Kris Ann Hervera Marquez, Shih-Chao Hsu, Elvan Onur Kirimker, Nobuhisa Akamatsu, Oren Shaked, Michele Finotti, Marcus Yeow, Lara Genedy, Julia Braun, Henock Yebyo, Philipp Dutkowski, Silvio Nadalin, Markus U Boehnert, Wojciech G Polak, Glenn K Bonney, Abhishek Mathur, Benjamin Samstein, Jean C Emond, Giuliano Testa, Kim M Olthoff, Charles B Rosen, Julie K Heimbach, Timucin Taner, Tiffany Cl Wong, Chung-Mau Lo, Kiyoshi Hasegawa, Deniz Balci, Mark Cattral, Gonzalo Sapisochin, Nazia Selzner, Long-Bin Jeng, Jae-Won Joh, Chao-Long Chen, Kyung-Suk Suh, Mohamed Rela, Dieter Broering, Pierre-Alain Clavien

Background: Early allograft dysfunction (EAD) affects outcomes in liver transplantation (LT). Existing risk models developed for deceased-donor LT depend on posttransplant factors and fall short in living-donor LT (LDLT), where pretransplant evaluations are crucial for preventing EAD and justifying the donor's risks.

Methods: This retrospective study analyzed data from 2944 adult patients who underwent LDLT at 17 centers between 2016 and 2020. We developed a logistic regression model to predict EAD based on this development cohort. We used data from 1020 patients at the King Faisal Transplant Center for external validation.

Results: In the development cohort, 321 patients (10.9%) experienced EAD. These patients had poorer health status, more liver decompensation, and higher requirements of hospitalization than those without EAD. Multivariable logistic regression identified independent pretransplant predictors of EAD: laboratory Model for End-Stage Liver Disease score (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.06-1.09), the necessity for hospitalization at the time of transplant (OR, 2.58; 95% CI, 2.00-3.30), and graft weight in kilogram (OR, 0.27; 95% CI, 0.17-0.45). Using these predictors, we developed the model for EAD after LDLT, which demonstrated strong discriminative ability in the development cohort with an area under the curve (AUC) of 0.71 (95% CI, 0.68-0.74). The model maintained high discrimination during internal validation (AUC, 0.70; 95% CI, 0.67-0.73) and showed a modest reduction in discriminative power in external validation (AUC, 0.65; 95% CI, 0.61-0.68).

Conclusions: EAD post-LDLT is influenced by the recipient's pretransplant health condition and the graft weight. Integrating the model for EAD after LDLT into the pretransplant process of pairing donors and recipients can enhance the safety and efficacy of LDLT.

背景:早期移植物功能障碍(EAD)会影响肝移植(LT)的预后。活体肝移植(LDLT)的移植前评估对于预防 EAD 和证明供体风险的合理性至关重要:这项回顾性研究分析了2016年至2020年间在17个中心接受LDLT的2944名成年患者的数据。我们根据这一发展队列建立了一个逻辑回归模型来预测 EAD。我们使用费萨尔国王移植中心 1020 名患者的数据进行了外部验证:在发展队列中,321 名患者(10.9%)经历了 EAD。与未发生 EAD 的患者相比,这些患者的健康状况更差、肝功能失代偿更严重、住院要求更高。多变量逻辑回归确定了独立的移植前 EAD 预测因素:终末期肝病实验室模型评分(几率比 [OR],1.08;95% 置信区间 [CI],1.06-1.09)、移植时住院必要性(OR,2.58;95% CI,2.00-3.30)和移植体重(公斤)(OR,0.27;95% CI,0.17-0.45)。利用这些预测因子,我们建立了 LDLT 后 EAD 模型,该模型在开发队列中表现出很强的判别能力,曲线下面积 (AUC) 为 0.71 (95% CI, 0.68-0.74)。该模型在内部验证中保持了较高的判别能力(AUC,0.70;95% CI,0.67-0.73),在外部验证中的判别能力略有下降(AUC,0.65;95% CI,0.61-0.68):结论:LDLT术后EAD受受者移植前健康状况和移植物重量的影响。将 LDLT 术后 EAD 模型整合到移植前供体和受体配对过程中可提高 LDLT 的安全性和有效性。
{"title":"Validation of a Pretransplant Risk Prediction Model for Early Allograft Dysfunction After Living-donor Liver Transplantation.","authors":"Zhihao Li, Dimitri Raptis, Ashwin Rammohan, Vasanthakumar Gunasekaran, Suyoung Hong, Itsuko Chih-Yi Chen, Jongman Kim, Kris Ann Hervera Marquez, Shih-Chao Hsu, Elvan Onur Kirimker, Nobuhisa Akamatsu, Oren Shaked, Michele Finotti, Marcus Yeow, Lara Genedy, Julia Braun, Henock Yebyo, Philipp Dutkowski, Silvio Nadalin, Markus U Boehnert, Wojciech G Polak, Glenn K Bonney, Abhishek Mathur, Benjamin Samstein, Jean C Emond, Giuliano Testa, Kim M Olthoff, Charles B Rosen, Julie K Heimbach, Timucin Taner, Tiffany Cl Wong, Chung-Mau Lo, Kiyoshi Hasegawa, Deniz Balci, Mark Cattral, Gonzalo Sapisochin, Nazia Selzner, Long-Bin Jeng, Jae-Won Joh, Chao-Long Chen, Kyung-Suk Suh, Mohamed Rela, Dieter Broering, Pierre-Alain Clavien","doi":"10.1097/TP.0000000000005331","DOIUrl":"https://doi.org/10.1097/TP.0000000000005331","url":null,"abstract":"<p><strong>Background: </strong>Early allograft dysfunction (EAD) affects outcomes in liver transplantation (LT). Existing risk models developed for deceased-donor LT depend on posttransplant factors and fall short in living-donor LT (LDLT), where pretransplant evaluations are crucial for preventing EAD and justifying the donor's risks.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 2944 adult patients who underwent LDLT at 17 centers between 2016 and 2020. We developed a logistic regression model to predict EAD based on this development cohort. We used data from 1020 patients at the King Faisal Transplant Center for external validation.</p><p><strong>Results: </strong>In the development cohort, 321 patients (10.9%) experienced EAD. These patients had poorer health status, more liver decompensation, and higher requirements of hospitalization than those without EAD. Multivariable logistic regression identified independent pretransplant predictors of EAD: laboratory Model for End-Stage Liver Disease score (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.06-1.09), the necessity for hospitalization at the time of transplant (OR, 2.58; 95% CI, 2.00-3.30), and graft weight in kilogram (OR, 0.27; 95% CI, 0.17-0.45). Using these predictors, we developed the model for EAD after LDLT, which demonstrated strong discriminative ability in the development cohort with an area under the curve (AUC) of 0.71 (95% CI, 0.68-0.74). The model maintained high discrimination during internal validation (AUC, 0.70; 95% CI, 0.67-0.73) and showed a modest reduction in discriminative power in external validation (AUC, 0.65; 95% CI, 0.61-0.68).</p><p><strong>Conclusions: </strong>EAD post-LDLT is influenced by the recipient's pretransplant health condition and the graft weight. Integrating the model for EAD after LDLT into the pretransplant process of pairing donors and recipients can enhance the safety and efficacy of LDLT.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Regulatory Immune Cell-derived Exosomes: Modes of Action and Therapeutic Potential in Transplantation.
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-27 DOI: 10.1097/TP.0000000000005309
Cindy G Avalos-de Leon, Angus W Thomson

Reduced dependence on antirejection agents, improved long-term allograft survival, and induction of operational tolerance remain major unmet needs in organ transplantation due to the limitations of current immunosuppressive therapies. To address this challenge, investigators are exploring the therapeutic potential of adoptively transferred host- or donor-derived regulatory immune cells. Extracellular vesicles of endosomal origin (exosomes) secreted by these cells seem to be important contributors to their immunoregulatory properties. Twenty years ago, it was first reported that donor-derived exosomes could extend the survival of transplanted organs in rodents. Recent studies have revealed that regulatory immune cells, such as regulatory myeloid cells (dendritic cells, macrophages, or myeloid-derived suppressor cells), regulatory T cells, or mesenchymal stem/stromal cells can suppress graft rejection via exosomes that express a cargo of immunosuppressive molecules. These include cell surface molecules that interact with adaptive immune cell receptors, immunoregulatory enzymes, and micro- and long noncoding RNAs that can regulate inflammatory gene expression via posttranscriptional changes and promote tolerance through promotion of regulatory T cells. This overview analyzes the diverse molecules and mechanisms that enable regulatory immune cell-derived exosomes to modulate alloimmunity and promote experimental transplant tolerance. We also discuss the potential benefits and limitations of their application as therapeutic entities in organ transplantation.

{"title":"Regulatory Immune Cell-derived Exosomes: Modes of Action and Therapeutic Potential in Transplantation.","authors":"Cindy G Avalos-de Leon, Angus W Thomson","doi":"10.1097/TP.0000000000005309","DOIUrl":"10.1097/TP.0000000000005309","url":null,"abstract":"<p><p>Reduced dependence on antirejection agents, improved long-term allograft survival, and induction of operational tolerance remain major unmet needs in organ transplantation due to the limitations of current immunosuppressive therapies. To address this challenge, investigators are exploring the therapeutic potential of adoptively transferred host- or donor-derived regulatory immune cells. Extracellular vesicles of endosomal origin (exosomes) secreted by these cells seem to be important contributors to their immunoregulatory properties. Twenty years ago, it was first reported that donor-derived exosomes could extend the survival of transplanted organs in rodents. Recent studies have revealed that regulatory immune cells, such as regulatory myeloid cells (dendritic cells, macrophages, or myeloid-derived suppressor cells), regulatory T cells, or mesenchymal stem/stromal cells can suppress graft rejection via exosomes that express a cargo of immunosuppressive molecules. These include cell surface molecules that interact with adaptive immune cell receptors, immunoregulatory enzymes, and micro- and long noncoding RNAs that can regulate inflammatory gene expression via posttranscriptional changes and promote tolerance through promotion of regulatory T cells. This overview analyzes the diverse molecules and mechanisms that enable regulatory immune cell-derived exosomes to modulate alloimmunity and promote experimental transplant tolerance. We also discuss the potential benefits and limitations of their application as therapeutic entities in organ transplantation.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Long-term Metabolic Outcomes Post-Simultaneous Pancreas-Kidney Transplantation in Recipients With Type 1 Diabetes.
IF 5.3 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-01-23 DOI: 10.1097/TP.0000000000005334
Harsham Choksi, Henry Pleass, Paul Robertson, Eric Au, Natasha Rogers

Background: Simultaneous pancreas-kidney (SPK) transplantation is an effective treatment option for type 1 diabetes mellitus and concurrent end-stage kidney disease. However, the diabetogenic effects of immunosuppression can counteract the beneficial effects of sustained normoglycemia. Long-term metabolic trends that reflect cardiovascular risk are reported poorly in the literature.

Methods: A total of 500 patients with type 1 diabetes mellitus receiving SPK transplants at a single center with at least 2-y follow-up were evaluated retrospectively. Metabolic parameters and allograft function were followed longitudinally, including patient and allograft survival, body mass index (BMI), lipid profile, quantitative insulin sensitivity check index, estimated glomerular filtration rate, and urinary albumin-creatinine ratio up to 10 y posttransplant.

Results: Patient survival at 1, 5, and 10 y was 97%, 92%, and 87%, and overall death-censored graft survival was 87%, 84%, and 80%, respectively. Survival remained unchanged when stratified by BMI. Compared with pretransplant measurements, BMI significantly increased at 1, 3, and 5 y posttransplant. Total cholesterol, triglycerides, and low-density lipoprotein cholesterol decreased at 10 y posttransplant, with significantly increased high-density lipoprotein cholesterol at 5 y posttransplant. Insulin sensitivity improved significantly at 10 y posttransplant but did not normalize. Urinary albumin-creatinine ratio decreased by 3 y posttransplant but increased significantly between 3 and 10 y posttransplant, although the estimated glomerular filtration rate was unchanged during this time.

Conclusions: SPK transplantation is associated with excellent patient and graft survival. Significant long-term weight gain occurs despite improving lipid profiles and insulin sensitivity posttransplant. These data potentially reflect an overall cardiovascular burden that should be addressed in this population.

{"title":"Long-term Metabolic Outcomes Post-Simultaneous Pancreas-Kidney Transplantation in Recipients With Type 1 Diabetes.","authors":"Harsham Choksi, Henry Pleass, Paul Robertson, Eric Au, Natasha Rogers","doi":"10.1097/TP.0000000000005334","DOIUrl":"https://doi.org/10.1097/TP.0000000000005334","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous pancreas-kidney (SPK) transplantation is an effective treatment option for type 1 diabetes mellitus and concurrent end-stage kidney disease. However, the diabetogenic effects of immunosuppression can counteract the beneficial effects of sustained normoglycemia. Long-term metabolic trends that reflect cardiovascular risk are reported poorly in the literature.</p><p><strong>Methods: </strong>A total of 500 patients with type 1 diabetes mellitus receiving SPK transplants at a single center with at least 2-y follow-up were evaluated retrospectively. Metabolic parameters and allograft function were followed longitudinally, including patient and allograft survival, body mass index (BMI), lipid profile, quantitative insulin sensitivity check index, estimated glomerular filtration rate, and urinary albumin-creatinine ratio up to 10 y posttransplant.</p><p><strong>Results: </strong>Patient survival at 1, 5, and 10 y was 97%, 92%, and 87%, and overall death-censored graft survival was 87%, 84%, and 80%, respectively. Survival remained unchanged when stratified by BMI. Compared with pretransplant measurements, BMI significantly increased at 1, 3, and 5 y posttransplant. Total cholesterol, triglycerides, and low-density lipoprotein cholesterol decreased at 10 y posttransplant, with significantly increased high-density lipoprotein cholesterol at 5 y posttransplant. Insulin sensitivity improved significantly at 10 y posttransplant but did not normalize. Urinary albumin-creatinine ratio decreased by 3 y posttransplant but increased significantly between 3 and 10 y posttransplant, although the estimated glomerular filtration rate was unchanged during this time.</p><p><strong>Conclusions: </strong>SPK transplantation is associated with excellent patient and graft survival. Significant long-term weight gain occurs despite improving lipid profiles and insulin sensitivity posttransplant. These data potentially reflect an overall cardiovascular burden that should be addressed in this population.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Transplantation
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:481959085
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