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Defiance of Occam’s Razor: Recent Changes in US Kidney Allocation and Impact on Efficiency and Marginal Kidney Outcomes 奥卡姆剃刀的挑战:美国肾脏分配的最新变化及其对效率和边际肾脏预后的影响
Q2 SURGERY Pub Date : 2023-10-11 DOI: 10.1007/s40472-023-00412-6
Colleen L. Jay, Robert J. Stratta
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引用次数: 0
Exosomes as Modulators and Biomarkers of Transplant Immunity 外泌体作为移植免疫的调节剂和生物标志物
Q2 SURGERY Pub Date : 2023-10-04 DOI: 10.1007/s40472-023-00413-5
Liv Palma, Micaela Gentile, Nicholas Chun
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引用次数: 0
COVID-19 in Kidney Transplant Recipients: What Did We Understand After Three Years Since the Pandemic Outbreak in Kidney Transplant Recipients? 肾移植受者的COVID-19:在肾移植受者大流行爆发三年后,我们了解了什么?
Q2 SURGERY Pub Date : 2023-10-04 DOI: 10.1007/s40472-023-00414-4
Angelica Canossi, Alessandra Panarese, Valentina Savino, Tiziana Del Beato, Francesco Pisani
Abstract Purpose of review In this study we describe the impact of COVID-19 infection on the immunological response of kidney transplant recipients of a single transplant center. We evaluated the seroconversion after vaccination and COVID-19 disease, the management of immunosuppressive therapy, and the effects of the withdrawal of immunosuppressive therapy on renal function and clinical outcome. Recent findings A prospective and cross-sectional observational study was performed on 156 kidney transplant recipients with a positive PCR test for SARS-CoV-2 and vaccinated with mRNA vaccine from November 2021 to September 2022. After examining the anti-Spike antibody production before and after COVID-19 infection, we detected a significant increase after disease both in kidney transplant recipients with three doses ( p = 0.011, 180.9 vs. 1186 IU/mL) and with four doses of vaccine ( p = 0.002, 19.5 vs. 1557.0 IU/mL). We also observed a correlation between age and critical symptoms of COVID-19 disease ( p = 0.005, R = 0.224); the pre-COVID-19 antibody levels are found to be linearly correlated to resolution time of disease ( p = 0.05, F = 3.986). Regarding the management of immunosuppressive therapy after infection, we noticed that the kidney transplant recipients with mycophenolate mofetil withdrawal had a stable graft function, in terms of serum creatinine and proteinuria, and a significant increase of the immune response, expressed as SARS-CoV-2 seroconversion (1557.0 vs. 32.4 IU/mL, p = 0.001). Summary We learned how to manage kidney transplant recipients affected by Covid-19 with patient-tailored therapy, thus improving the disease outcome without worsening the renal function.
摘要综述目的本研究描述了COVID-19感染对单一移植中心肾移植受者免疫反应的影响。我们评估了疫苗接种和COVID-19疾病后的血清转化,免疫抑制治疗的管理,以及免疫抑制治疗退出对肾功能和临床结局的影响。在2021年11月至2022年9月期间,对156名SARS-CoV-2 PCR检测阳性并接种mRNA疫苗的肾移植受者进行了前瞻性和横断面观察性研究。在检测了COVID-19感染前后的抗spike抗体产生后,我们发现三剂疫苗(p = 0.011, 180.9 vs. 1186 IU/mL)和四剂疫苗(p = 0.002, 19.5 vs. 1557.0 IU/mL)的肾移植受者在疾病后的抗spike抗体产生显著增加。我们还观察到年龄与COVID-19疾病危重症状之间的相关性(p = 0.005, R = 0.224);抗体水平与疾病消退时间呈线性相关(p = 0.05, F = 3.986)。关于感染后免疫抑制治疗的管理,我们注意到停用霉酚酸酯的肾移植受者在血清肌酐和蛋白尿方面具有稳定的移植功能,并且免疫应答显著增加,表现为SARS-CoV-2血清转化(1557.0 vs. 32.4 IU/mL, p = 0.001)。我们学习了如何对受Covid-19影响的肾移植受者进行个体化治疗,从而在不恶化肾功能的情况下改善疾病结局。
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引用次数: 0
Mesenchymal Stem Cells as an Adjuvant Tool to Induce Regeneration and Repair in Marginal Renal Allografts 间充质干细胞作为诱导边缘异体肾移植再生和修复的辅助工具
Q2 SURGERY Pub Date : 2023-09-22 DOI: 10.1007/s40472-023-00408-2
John R. Savino, Alexandra R. Monetti, Jake B. Miller, Joshua J. Bowlby, Lori N. Byers, Arunkumar Rengaraj, Emma Peveri, Woonwoo Jeong, Ainsley J. Ruley, Benedetta Bussolati, Amish Asthana, Giuseppe Orlando
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引用次数: 0
Regenerative Surgery: Is This an Independent Field of Health Sciences or Only a Semantic Exercise? 再生外科:这是一个独立的健康科学领域还是仅仅是一个语义练习?
Q2 SURGERY Pub Date : 2023-09-22 DOI: 10.1007/s40472-023-00409-1
Alexandra R. Monetti, John R. Savino, Jake B. Miller, Joshua J. Bowlby, Lori N. Byers, Arunkumar Rengaraj, Wonwoo Jeong, Emma Peveri, Ainsley J. Ruley, Amish Asthana, Giuseppe Orlando
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引用次数: 0
Virologic Studies in COVID-Positive Donors covid - 19阳性供体的病毒学研究
Q2 SURGERY Pub Date : 2023-09-09 DOI: 10.1007/s40472-023-00411-7
Ambreen Azhar, Bekir Tanriover, Ahmet B. Gungor, Miklos Z. Molnar, Gaurav Gupta
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引用次数: 0
Pregnancy in Living Kidney Donors: An Evidence-Based Review. 活体肾脏捐献者的妊娠:一项基于证据的综述。
IF 2.4 Q2 SURGERY Pub Date : 2023-09-01 Epub Date: 2023-08-17 DOI: 10.1007/s40472-023-00402-8
Ayse Serra Artan, Vidyaratna Fleetwood, Nurane Guller, Ozgur Akin Oto, Safak Mirioglu, Halil Yazici, Aydin Turkmen, Yasar Caliskan, Krista L Lentine

Purpose of review: To review the current studies and guidelines on the risk of adverse pregnancy outcomes in female kidney donors.

Recent findings: Living kidney donors include a significant amount of young women of child-bearing age. Safety and possible risks of pregnancy after donation are a concern for female kidney donor candidates. Many current studies indicate a higher risk of preeclampsia in women after kidney donation. Considering the increasing number of living kidney donors, the maternal outcomes of living kidney donation is an active area of research.

Summary: Guidelines and consensus statements on the risk of pregnancy in living kidney donors recommend close monitoring of blood pressure, weight gain, and proteinuria during pregnancy. Current studies indicate an increased risk of hypertensive disorders of pregnancy in living kidney donors. Counseling and informing donor candidates about the possible risks is important.

综述目的:综述目前关于女性肾脏捐献者不良妊娠结局风险的研究和指南。最近的发现:活体肾脏捐献者包括大量育龄年轻女性。捐献肾脏后的安全性和可能的妊娠风险是女性肾脏捐献者候选人关注的问题。目前的许多研究表明,肾脏捐献后女性患先兆子痫的风险更高。考虑到活体肾脏捐献者的数量不断增加,活体肾脏捐献的母体结果是一个活跃的研究领域。摘要:关于活体肾脏捐献者妊娠风险的指南和共识声明建议在妊娠期间密切监测血压、体重增加和蛋白尿。目前的研究表明,活体肾脏捐献者患妊娠期高血压疾病的风险增加。就可能存在的风险向捐助者候选人提供咨询和告知是很重要的。
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引用次数: 0
Novel Imaging Technologies for Accurate Assessment of Cardiac Allograft Performance. 用于精确评估心脏移植物性能的新型成像技术
IF 2.4 Q2 SURGERY Pub Date : 2023-09-01 Epub Date: 2023-07-17 DOI: 10.1007/s40472-023-00400-w
Manuela Lopera Higuita, Rohil Jain, Asishana A Osho, S Alireza Rabi, Timothy L Pruett, Richard N Pierson, Paul A Iaizzo, Shannon N Tessier

Purpose of the review: The current lack of objective and quantitative assessment techniques to determine cardiac graft relative viability results in risk-averse decision-making, which negatively impact the utilization of cardiac grafts. The purpose of this review is to highlight the current deficiencies in cardiac allograft assessment before focusing on novel cardiac assessment techniques that exploit conventional and emerging imaging modalities, including ultrasound, magnetic resonance, and spectroscopy.

Recent findings: Extensive work is ongoing by the scientific community to identify improved objective metrics and tools for cardiac graft assessment, with the goal to safely increasing the number and proportion of hearts accepted for transplantation.

Summary: This review briefly discusses the in situ and ex vivo tools currently available for clinical organ assessment, before focusing on the individual capabilities of ultrasound, magnetic resonance, and spectroscopy to provide insightful, non-invasive information regarding cardiac graft functional and metabolic status that may be used to predict outcome after transplantation.

综述的目的:目前缺乏客观、定量的评估技术来确定心脏移植物的相对存活率,这导致了规避风险的决策,对心脏移植物的利用产生了负面影响。本综述旨在强调目前在心脏同种异体移植评估方面存在的不足,然后重点介绍利用传统和新兴成像模式(包括超声、磁共振和光谱学)的新型心脏评估技术:摘要:本综述简要讨论了目前可用于临床器官评估的原位和体外工具,然后重点介绍了超声波、磁共振和光谱学在提供有关心脏移植物功能和代谢状态的深入、非侵入性信息方面的各自能力,这些信息可用于预测移植后的预后。
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引用次数: 0
Kidney paired donation in developing countries: A global perspective. 发展中国家肾脏配对捐赠:全球视角。
IF 2.4 Q2 SURGERY Pub Date : 2023-09-01 Epub Date: 2023-08-28 DOI: 10.1007/s40472-023-00401-9
Vivek B Kute, Vidya A Fleetwood, Sanshriti Chauhan, Hari Shankar Meshram, Yasar Caliskan, Chintalapati Varma, Halil Yazıcı, Özgür Akın Oto, Krista L Lentine

Purpose of review: We review the key principles of kidney paired donation (KPD) and discuss the status and unique considerations for KPD in developing countries.

Recent findings: Despite the advantages of KPD programs, they remain rare among developing nations, and the programs that exist have many differences with those of in developed countries. There is a paucity of literature and lack of published data on KPD from most of the developing nations. Expanding KPD programs may require the adoption of features and innovations of successful KPD programs. Cooperation with national and international societies should be encouraged to ensure endorsement and sharing of best practices.

Summary: KPD is in the initial stages or has not yet started in the majority of the emerging nations. But the logistics and strategies required to implement KPD in developing nations differ from other parts of the world. By learning from the KPD experience in developing countries and adapting to their unique needs, it should be possible to expand access to KPD to allow more transplants to happen for patients in need world-wide.

综述目的:我们回顾了肾脏配对捐赠(KPD)的关键原则,并讨论了KPD在发展中国家的地位和独特考虑。最近的研究结果:尽管KPD项目具有优势,但在发展中国家中仍然很少见,而且现有的项目与发达国家的项目有很多不同。大多数发展中国家关于KPD的文献很少,也缺乏公布的数据。扩展KPD项目可能需要采用成功的KPD项目的特点和创新。应鼓励与国家和国际社会合作,以确保认可和分享最佳做法。概要:KPD在大多数新兴国家处于初级阶段或尚未开始。但在发展中国家实施KPD所需的后勤和战略与世界其他地区不同。通过学习发展中国家的KPD经验并适应其独特需求,应该有可能扩大KPD的使用范围,以便为世界各地有需要的患者进行更多的移植。
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引用次数: 0
Improving the Odds—COVID-Omics and Predicting Patient Outcomes 提高几率——新冠病毒奥密克戎和预测患者预后
IF 2.1 Q2 SURGERY Pub Date : 2023-08-25 DOI: 10.1007/s40472-023-00403-7
Audrey A Shi, Sherry G. Mansour
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Current Transplantation Reports
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