Redox-active nanocrystals of cerium dioxide (CeO2) are of interest as antioxidants; therefore, it is relevant to study the potential ability of these nanocrystals to correct prooxidative markers in irradiated cell culture in vitro. The purpose of the study was to evaluate the effect of redox-active spherical nanocrystals of cerium dioxide on markers of oxidative stress induced by γ-irradiation in a two-dimensional culture of rat lung fibroblasts. Materials and methods. The study was performed on a monolayer of lung fibroblasts of Wistar rats. Nanocrystals were added to the nutrient medium one hour before irradiation until their final concentration in the medium of 2.5 μg/L. The cells were incubated with nanocrystals for one hour and then irradiated. The radiation dose was 0.75 Gy. The concentration of 8-isoprostane was determined by spectrophotometry. The concentration of free oxygen species and the degree of lipid peroxidation in living cells were determined by fluorimetry. Visualization and measurement of fluorescence intensity were performed by confocal laser scanning microscopy. Results. 3 hours after irradiation under the conditions of pre-incubation with CeO2 nanocrystals, the content of reactive oxygen species, the level of lipid peroxidation, and the content of 8-isoprostane were significantly decreased in rat lung fibroblast culture. At the same time, incubation with cerium dioxide nanocrystals much more effectively reduced the content of reactive oxygen species in the cytoplasm of cells than in their nuclei and nucleoli in particular. Conclusion. Preincubation of rat lung fibroblasts in vitro with СeО2 nanocrystals can significantly reduce the oxidizing effects of ionizing radiation.
{"title":"The effect of cerium dioxide nanocrystals on the prooxidant status of rat lung fibroblasts in vitro under γ-irradiation conditions","authors":"Y. Kot, K. Kot, N. Kavok, V. Klochkov","doi":"10.22494/cot.v10i2.142","DOIUrl":"https://doi.org/10.22494/cot.v10i2.142","url":null,"abstract":"Redox-active nanocrystals of cerium dioxide (CeO2) are of interest as antioxidants; therefore, it is relevant to study the potential ability of these nanocrystals to correct prooxidative markers in irradiated cell culture in vitro. The purpose of the study was to evaluate the effect of redox-active spherical nanocrystals of cerium dioxide on markers of oxidative stress induced by γ-irradiation in a two-dimensional culture of rat lung fibroblasts. Materials and methods. The study was performed on a monolayer of lung fibroblasts of Wistar rats. Nanocrystals were added to the nutrient medium one hour before irradiation until their final concentration in the medium of 2.5 μg/L. The cells were incubated with nanocrystals for one hour and then irradiated. The radiation dose was 0.75 Gy. The concentration of 8-isoprostane was determined by spectrophotometry. The concentration of free oxygen species and the degree of lipid peroxidation in living cells were determined by fluorimetry. Visualization and measurement of fluorescence intensity were performed by confocal laser scanning microscopy. Results. 3 hours after irradiation under the conditions of pre-incubation with CeO2 nanocrystals, the content of reactive oxygen species, the level of lipid peroxidation, and the content of 8-isoprostane were significantly decreased in rat lung fibroblast culture. At the same time, incubation with cerium dioxide nanocrystals much more effectively reduced the content of reactive oxygen species in the cytoplasm of cells than in their nuclei and nucleoli in particular. Conclusion. Preincubation of rat lung fibroblasts in vitro with СeО2 nanocrystals can significantly reduce the oxidizing effects of ionizing radiation.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42610994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The literature review is devoted to the analysis of modern data on the effectiveness of stem cell transplantation in patients with non-coronary heart diseases: myocarditis, dilated cardiomyopathy, and systemic amyloidosis with heart damage. The results of experimental studies on laboratory animals and clinical trials concerning the use of various types of stem cells, their mechanisms of action and prospects for application in non-coronary heart diseases are presented. Emphasis is placed on the need for further randomized multicenter clinical trials, especially in patients with inflammatory myocardial injury, involving a large number of patients.
{"title":"Stem cell therapy of myocarditis and cardiomyopathies: a promising strategy","authors":"V. Kovalenko, E. Nesukay, S. Cherniuk, A. Kozliuk","doi":"10.22494/cot.v10i2.140","DOIUrl":"https://doi.org/10.22494/cot.v10i2.140","url":null,"abstract":"The literature review is devoted to the analysis of modern data on the effectiveness of stem cell transplantation in patients with non-coronary heart diseases: myocarditis, dilated cardiomyopathy, and systemic amyloidosis with heart damage. The results of experimental studies on laboratory animals and clinical trials concerning the use of various types of stem cells, their mechanisms of action and prospects for application in non-coronary heart diseases are presented. Emphasis is placed on the need for further randomized multicenter clinical trials, especially in patients with inflammatory myocardial injury, involving a large number of patients.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45405856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vitalii Kyryk, A. Ustymenko, T. Lutsenko, P. Klymenko, O. Tsupykov
Critical limb ischemia of the is a serious disease that threatens a significant decrease in working ability and disability of patients. Cell therapy may be useful in correcting the endothelial dysfunction that accompanies this disorder. The aim of study was to evaluate the effectiveness of local transplantation of mouse aortic endothelial cells (MAECs) in a model of critical limb ischemia in mice. Materials and methods. Critical limb ischemia in FVB mice was modeled by femoral artery ligation. The primary culture of endothelial cells was obtained from the murine aortic intima. The endothelial phenotype of cells for the expression of CD31, CD38 and CD309 markers was confirmed by flow cytometry and 1•106 MAECs were transplanted intramuscularly into ischemic limb. Tissue perfusion was assessed by laser Doppler flowmetry as well as descriptive histology was used to analyze changes in ischemic muscle after cell transplantation compared to the control group. Results. After MAECs transplantation in animals with modeled critical limb ischemia, the skin of the foot kept pink color and the corresponding temperature of the healthy limb without signs of necrosis of the distal phalanges in contrast to animals of the control group. According to laser Doppler flowmetry data, a significant difference (p ≤ 0.05) in perfusion of ischemic and sham-operated limbs in animals of the control group remained at the level of Δ = 45.7 ± 13.1 %. In animals after MAECs transplantation, the difference of these indicators between limbs was only Δ = 14.0 ± 8.23 % and was not statistically significant. A histological examination of muscle tissue after MAECs transplantation demonstrated the signs of compensatory processes characterized by hyperplasia and hypertrophy of myocyte’s nuclei and lightening of the nucleoplasm with well-defined nucleoli in some myofibrils. In the cytoplasm of myocytes, intermediate Z-discs were clearly visualized, and the number of myofibrils in muscle fibers increased. Conclusion. In animals with model of critical limb ischemia, the transplantation of aorta-derived endothelial cells recover the perfusion of ischemic limbs and improve the histological indicators of muscle tissue.
{"title":"Regenerative effects of mouse aortic endothelial cells in a murine model of critical limb ischemia","authors":"Vitalii Kyryk, A. Ustymenko, T. Lutsenko, P. Klymenko, O. Tsupykov","doi":"10.22494/cot.v10i2.143","DOIUrl":"https://doi.org/10.22494/cot.v10i2.143","url":null,"abstract":"Critical limb ischemia of the is a serious disease that threatens a significant decrease in working ability and disability of patients. Cell therapy may be useful in correcting the endothelial dysfunction that accompanies this disorder. The aim of study was to evaluate the effectiveness of local transplantation of mouse aortic endothelial cells (MAECs) in a model of critical limb ischemia in mice. Materials and methods. Critical limb ischemia in FVB mice was modeled by femoral artery ligation. The primary culture of endothelial cells was obtained from the murine aortic intima. The endothelial phenotype of cells for the expression of CD31, CD38 and CD309 markers was confirmed by flow cytometry and 1•106 MAECs were transplanted intramuscularly into ischemic limb. Tissue perfusion was assessed by laser Doppler flowmetry as well as descriptive histology was used to analyze changes in ischemic muscle after cell transplantation compared to the control group. Results. After MAECs transplantation in animals with modeled critical limb ischemia, the skin of the foot kept pink color and the corresponding temperature of the healthy limb without signs of necrosis of the distal phalanges in contrast to animals of the control group. According to laser Doppler flowmetry data, a significant difference (p ≤ 0.05) in perfusion of ischemic and sham-operated limbs in animals of the control group remained at the level of Δ = 45.7 ± 13.1 %. In animals after MAECs transplantation, the difference of these indicators between limbs was only Δ = 14.0 ± 8.23 % and was not statistically significant. A histological examination of muscle tissue after MAECs transplantation demonstrated the signs of compensatory processes characterized by hyperplasia and hypertrophy of myocyte’s nuclei and lightening of the nucleoplasm with well-defined nucleoli in some myofibrils. In the cytoplasm of myocytes, intermediate Z-discs were clearly visualized, and the number of myofibrils in muscle fibers increased. Conclusion. In animals with model of critical limb ischemia, the transplantation of aorta-derived endothelial cells recover the perfusion of ischemic limbs and improve the histological indicators of muscle tissue.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47695474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The responsible stage of choosing the source of bone allografts is the process of examination and selection of the donor, which includes moral and ethical, legal and medical aspects. The selection of potential donors should be carried out with the participation of a qualified doctor, with a thorough collection of anamnesis, social conditions and a general medical examination. Up to 48 % of all potential donors are rejected to collect bone in the pre-operative period; up to 22 % of the received tissues are not suitable for transplantation according to the results of further examinations. Purpose – to develop a protocol for the examination of potential living donors of bone tissue based on anamnestic, clinical, laboratory and instrumental examinations to ensure the selection of high-quality bone material for the production of bone grafts. Materials and methods. From 01.01.2016 to 01.12.2021, 640 patients for hip replacement were involved in the selection of bone tissue donors. The following selection steps were applied: obtaining informed consent, filling in a questionnaire about the possibility of donation, express-tests for infections and X-ray morphometric examination based on the results of radiography of the hip joints in direct projection. Results. Based on the results of the examination of potential donors, it was established that the number of patients who were excluded from further research due to refusal to donate was 3 %, due to contraindications according to the results of filling out the questionnaire – 15 %, according to X-ray morphometric criteria – 51 %, according to the results of laboratory examination – 2 %. Conclusions. A protocol of examination of bone tissue donors for the production of scaffolds has been developed. It was established that about 30 % of all examined potential donors are suitable for donation.
{"title":"Protocol for the examination and selection of potential living donors of bone tissue for the production of allografts","authors":"S. Strafun, Y. Holiuk, T. Pschenychny","doi":"10.22494/cot.v10i2.145","DOIUrl":"https://doi.org/10.22494/cot.v10i2.145","url":null,"abstract":"The responsible stage of choosing the source of bone allografts is the process of examination and selection of the donor, which includes moral and ethical, legal and medical aspects. The selection of potential donors should be carried out with the participation of a qualified doctor, with a thorough collection of anamnesis, social conditions and a general medical examination. Up to 48 % of all potential donors are rejected to collect bone in the pre-operative period; up to 22 % of the received tissues are not suitable for transplantation according to the results of further examinations. Purpose – to develop a protocol for the examination of potential living donors of bone tissue based on anamnestic, clinical, laboratory and instrumental examinations to ensure the selection of high-quality bone material for the production of bone grafts. Materials and methods. From 01.01.2016 to 01.12.2021, 640 patients for hip replacement were involved in the selection of bone tissue donors. The following selection steps were applied: obtaining informed consent, filling in a questionnaire about the possibility of donation, express-tests for infections and X-ray morphometric examination based on the results of radiography of the hip joints in direct projection. Results. Based on the results of the examination of potential donors, it was established that the number of patients who were excluded from further research due to refusal to donate was 3 %, due to contraindications according to the results of filling out the questionnaire – 15 %, according to X-ray morphometric criteria – 51 %, according to the results of laboratory examination – 2 %. Conclusions. A protocol of examination of bone tissue donors for the production of scaffolds has been developed. It was established that about 30 % of all examined potential donors are suitable for donation.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45254658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-02DOI: 10.3390/transplantology3040030
M. Salvadori
I should highlight that this manuscript is not a formal review on the topic, but a report from an ESOT meeting held on 22 June 2022. The assumption of immunosuppressants exposes kidney transplant recipients to the risk of infections, including COVID-19 infection. A transplant patient having COVID-19 infection raises several questions, including whether the immunosuppressive therapy should be reduced with the consequent risk of favoring acute rejections. Patient vaccination before transplantation is probably the gold standard to avoid the risk of COVID-19 infection after transplantation. In the case of transplant patients, three measures may be undertaken: vaccination, use of monoclonal antibodies and use of therapeutic antiviral small molecules. Concerning vaccination, it is still debated which one is the best and how many doses should be administered, particularly considering the new variants of the virus. The onset of virus variants has stimulated researchers to find new active vaccines. In addition, not all transplant patients develop antibodies. An alternative prophylactic measure to be principally used for patients that do not develop antibodies after vaccination is the use of monoclonal antibodies. These drugs may be administered as prophylaxis or in the early stage of the disease. Finally, the small antiviral molecules may be used again as prophylaxis or treatment. Their major drawbacks are their interference with immunosuppressive drugs and the fact that some of them cannot be administered to patients with low eGFR.
{"title":"What Is New in Prophylaxis and Treatment of COVID-19 in Renal Transplant Patients? A Report from an ESOT Meeting on the Topic","authors":"M. Salvadori","doi":"10.3390/transplantology3040030","DOIUrl":"https://doi.org/10.3390/transplantology3040030","url":null,"abstract":"I should highlight that this manuscript is not a formal review on the topic, but a report from an ESOT meeting held on 22 June 2022. The assumption of immunosuppressants exposes kidney transplant recipients to the risk of infections, including COVID-19 infection. A transplant patient having COVID-19 infection raises several questions, including whether the immunosuppressive therapy should be reduced with the consequent risk of favoring acute rejections. Patient vaccination before transplantation is probably the gold standard to avoid the risk of COVID-19 infection after transplantation. In the case of transplant patients, three measures may be undertaken: vaccination, use of monoclonal antibodies and use of therapeutic antiviral small molecules. Concerning vaccination, it is still debated which one is the best and how many doses should be administered, particularly considering the new variants of the virus. The onset of virus variants has stimulated researchers to find new active vaccines. In addition, not all transplant patients develop antibodies. An alternative prophylactic measure to be principally used for patients that do not develop antibodies after vaccination is the use of monoclonal antibodies. These drugs may be administered as prophylaxis or in the early stage of the disease. Finally, the small antiviral molecules may be used again as prophylaxis or treatment. Their major drawbacks are their interference with immunosuppressive drugs and the fact that some of them cannot be administered to patients with low eGFR.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"52 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90080916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-09DOI: 10.3390/transplantology3040029
F. Zennaro, N. Giurici, N. Maximova
Pneumocysis jirovecii pneumonia (PJP) is a type of pneumonia originating from the fungus Pneumocystis jiroveci and is a major cause of serious pneumonia in immunocompromised conditions. PJP typically appears as bilateral diffuse pulmonary infiltrates. Granulomatous PJP is an uncommon form of pneumocystis infection, occurring in only 3% to 5% of patients. Calcification is exceptional. We present a 9-month-old boy affected by Severe Combined Immunodeficiency (SCID) that has been diagnosed at the age of 7 months following a lung Pneumocystis jirovecii infection. He underwent a routine total-body magnetic resonance imaging (MRI) prior to an allogeneic hematopoietic stem cell transplantation (HSCT). The MRI showed significant alterations of the pulmonary parenchyma; hence, a computer tomography of the lung was performed showing the presence of 11 calcified granulomatous nodules. We report a unique case of calcified granulomatous PJP in a toddler affected by SCID. Awareness of this rare yet possible presentation in patients with SCID is important given the potential clinical implications when managing a patient undergoing HSCT and it further enhances the importance of advanced radiologic imaging prior to HSCT.
{"title":"Calcified Granulomatous Pneumocystis Jirovecii Pneumonia in a Toddler with Severe Combined Immunodeficiency—A Case Report","authors":"F. Zennaro, N. Giurici, N. Maximova","doi":"10.3390/transplantology3040029","DOIUrl":"https://doi.org/10.3390/transplantology3040029","url":null,"abstract":"Pneumocysis jirovecii pneumonia (PJP) is a type of pneumonia originating from the fungus Pneumocystis jiroveci and is a major cause of serious pneumonia in immunocompromised conditions. PJP typically appears as bilateral diffuse pulmonary infiltrates. Granulomatous PJP is an uncommon form of pneumocystis infection, occurring in only 3% to 5% of patients. Calcification is exceptional. We present a 9-month-old boy affected by Severe Combined Immunodeficiency (SCID) that has been diagnosed at the age of 7 months following a lung Pneumocystis jirovecii infection. He underwent a routine total-body magnetic resonance imaging (MRI) prior to an allogeneic hematopoietic stem cell transplantation (HSCT). The MRI showed significant alterations of the pulmonary parenchyma; hence, a computer tomography of the lung was performed showing the presence of 11 calcified granulomatous nodules. We report a unique case of calcified granulomatous PJP in a toddler affected by SCID. Awareness of this rare yet possible presentation in patients with SCID is important given the potential clinical implications when managing a patient undergoing HSCT and it further enhances the importance of advanced radiologic imaging prior to HSCT.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89960730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23DOI: 10.3390/transplantology3040028
R. Hage, M. Schuurmans
Introduction: We report on characteristics and lung function outcomes among lung transplant recipients (LTRs) after COVID-19 with infections occurring in the first year of the coronavirus pandemic prior to introduction of the vaccines. Methods: This was a retrospective study of 18 LTRs who tested positive for SARS-CoV-2 between 1 February 2020 and 1 March 2021. The mean age was 49.9 (22–68) years; 12 patients (67%) were male. Two patients died due to severe COVID-19. Results: During the study period, there were 18 lung transplant recipients with a community-acquired SARS-CoV-2 infection. In this cohort, seven had mild, nine had moderate, and two had severe COVID-19. All patients with mild and moderate COVID-19 survived, but the two patients with severe COVID-19 died in the intensive care unit while intubated and on mechanical ventilation. Most patients with moderate COVID-19 showed a permanent lung function decrease that did not improve after 12 months. Conclusion: A majority of LTRs in the current cohort did not experience an alteration in the trajectory of FEV1 evolution after developing SARS-CoV-2 infection. However, in the patients with moderate COVID-19, most patients had a decline in the FEV1 that was present after 1 month after recovery and did not improve or even deteriorated further after 12 months. In LTRs, COVID-19 can have long-lasting effects on pulmonary function. Treatment strategies that influence this trajectory are needed.
{"title":"COVID-Related Chronic Allograft Dysfunction in Lung Transplant Recipients: Long-Term Follow-up Results from Infections Occurring in the Pre-vaccination Era","authors":"R. Hage, M. Schuurmans","doi":"10.3390/transplantology3040028","DOIUrl":"https://doi.org/10.3390/transplantology3040028","url":null,"abstract":"Introduction: We report on characteristics and lung function outcomes among lung transplant recipients (LTRs) after COVID-19 with infections occurring in the first year of the coronavirus pandemic prior to introduction of the vaccines. Methods: This was a retrospective study of 18 LTRs who tested positive for SARS-CoV-2 between 1 February 2020 and 1 March 2021. The mean age was 49.9 (22–68) years; 12 patients (67%) were male. Two patients died due to severe COVID-19. Results: During the study period, there were 18 lung transplant recipients with a community-acquired SARS-CoV-2 infection. In this cohort, seven had mild, nine had moderate, and two had severe COVID-19. All patients with mild and moderate COVID-19 survived, but the two patients with severe COVID-19 died in the intensive care unit while intubated and on mechanical ventilation. Most patients with moderate COVID-19 showed a permanent lung function decrease that did not improve after 12 months. Conclusion: A majority of LTRs in the current cohort did not experience an alteration in the trajectory of FEV1 evolution after developing SARS-CoV-2 infection. However, in the patients with moderate COVID-19, most patients had a decline in the FEV1 that was present after 1 month after recovery and did not improve or even deteriorated further after 12 months. In LTRs, COVID-19 can have long-lasting effects on pulmonary function. Treatment strategies that influence this trajectory are needed.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77621346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-17DOI: 10.3390/transplantology3030027
Bruno Mendes, C. Figueiredo, M. Cabral, A. Borba, A. Mineiro, J. Cardoso, P. Calvinho, L. Semedo, J. Fragata
Basiliximab (BAS) is an interleukin-2 monoclonal antibody initially used as induction therapy after liver and kidney transplantation. BAS use after lung transplantation (LTx) has supplanted antithymocyte globulin (ATG) as the main induction immunosuppression over the years, but few studies have compared them. In this study, we aimed to compare the efficacy and safety between BAS and ATG in LTx. We performed a retrospective analysis of all LTx done in Portugal between January 2016 and December 2019. Three groups were made according to the initial induction status: BAS, ATG or no induction (NI). The occurrences of cytomegalovirus (CMV) infection, pneumonia, side effects, primary graft dysfunction (PGD), acute rejection, chronic allograft disfunction (CLAD) and death episodes were assessed during two years after LTx. A total of 124 patients were divided in 3 groups: 61 (49.2%) BAS; 43 (34.7%) ATG; 20 (16.1%) NI. The incidences of pneumonia and CMV were similar between induction groups. Additionally, there was no difference between the induction groups in PGD, acute rejection, CLAD, deaths and two-year survival. Side effects were reported only in ATG group (n = 20; 46.5%). In our study, BAS had a better safety profile than ATG in LTx with a similar efficacy.
{"title":"Basiliximab vs. Antithymocyte Globulin as Initial Induction Therapy for Lung Transplantation: A National Two Years Review","authors":"Bruno Mendes, C. Figueiredo, M. Cabral, A. Borba, A. Mineiro, J. Cardoso, P. Calvinho, L. Semedo, J. Fragata","doi":"10.3390/transplantology3030027","DOIUrl":"https://doi.org/10.3390/transplantology3030027","url":null,"abstract":"Basiliximab (BAS) is an interleukin-2 monoclonal antibody initially used as induction therapy after liver and kidney transplantation. BAS use after lung transplantation (LTx) has supplanted antithymocyte globulin (ATG) as the main induction immunosuppression over the years, but few studies have compared them. In this study, we aimed to compare the efficacy and safety between BAS and ATG in LTx. We performed a retrospective analysis of all LTx done in Portugal between January 2016 and December 2019. Three groups were made according to the initial induction status: BAS, ATG or no induction (NI). The occurrences of cytomegalovirus (CMV) infection, pneumonia, side effects, primary graft dysfunction (PGD), acute rejection, chronic allograft disfunction (CLAD) and death episodes were assessed during two years after LTx. A total of 124 patients were divided in 3 groups: 61 (49.2%) BAS; 43 (34.7%) ATG; 20 (16.1%) NI. The incidences of pneumonia and CMV were similar between induction groups. Additionally, there was no difference between the induction groups in PGD, acute rejection, CLAD, deaths and two-year survival. Side effects were reported only in ATG group (n = 20; 46.5%). In our study, BAS had a better safety profile than ATG in LTx with a similar efficacy.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78207554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-22DOI: 10.3390/transplantology3030026
D. Franco-Palacios, Mei Lu, M. Fitzmaurice, G. Alangaden
Background: Early reports of COVID-19 in lung transplant recipients (LTRs) showed high hospitalization and mortality rates. However, the outcomes of COVID-19 in LTRs since the advent of newer therapies and vaccines have been poorly defined. Methods: We evaluated the risks for SARS-CoV-2-related hospitalization and mortality in a cohort of LTRs at the Henry Ford Lung Transplant Program in Detroit, Michigan during the study period March 2020–March 2022. Univariate logistic regression, followed by multivariable modeling were performed to estimate the odds ratio (OR) with 95% confident intervals (CI). Results: Sixty-four laboratory-confirmed SARS-CoV-2 infections were identified in 59 patients. For the primary analysis of the hospitalization and mortality risks, we included these 59 patients with symptomatic COVID-19. SARS-CoV-2 infections were confirmed with real-time polymerase chain reaction (RT-PCR) from a nasopharynx swab. The mean age (±STD) was 61 (±12), 63% were males, 27% were African Americans, and the time from lung transplant to COVID-19 was 5.5 (±4.8) years. Thirty-four (57.6%) patients were hospitalized, and the inpatient mortality rate was 24% (8/34). A multivariable analysis showed that patients with a higher baseline forced expiratory volume (FEV1) were less likely to be hospitalized (OR = 0.91 and 95% CI 0.87–0.98, p = 0.02). Seventy-five percent (75%; 6/8) of patients on invasive mechanical ventilation died, compared with only 8% mortality rate in those without mechanical ventilation (OR = 36.0 and 95% CI 4.2–310.4, p < 0.01). Although a trend toward a higher risk of death was observed in those infected during the Alpha (p = 0.17) and Delta (p = 0.22) waves, no significant risk was detected after adjusting for other covariates. Five LTRs were diagnosed with COVID-19 twice. Thirty of the sixty-four COVID-19 cases (46.8%) occurred in LTRs that had received at least two doses of any of the available mRNA vaccines at a median of 123 days (IQR 98–164 days) after vaccination. Twelve of the thirty (40%) were hospitalized, and four patients (33%) died during their hospitalizations. Conclusions: In our LTR population, the hospitalization and mortality rates associated with COVID-19 were high despite the increased use of new therapies. Vaccine-breakthrough infections were common and were associated with poor outcomes. Studies are needed to determine optimal prevention and therapeutic strategies to improve COVID-19 outcomes in LTRs.
背景:早期报道的肺移植受者中COVID-19的住院率和死亡率很高。然而，自新疗法和疫苗问世以来，COVID-19在ltr中的结局一直不明确。方法:在2020年3月至2022年3月的研究期间，我们评估了密歇根州底特律亨利福特肺移植项目的ltr队列中与sars - cov -2相关的住院和死亡风险。采用单变量logistic回归，然后采用多变量建模，以95%可信区间(CI)估计比值比(OR)。结果:59例患者中检测到64例实验室确诊的SARS-CoV-2感染。为了初步分析住院和死亡风险，我们纳入了这59例有症状的COVID-19患者。用鼻咽拭子实时聚合酶链反应(RT-PCR)证实了SARS-CoV-2感染。平均年龄(±STD)为61(±12)岁，63%为男性，27%为非洲裔美国人，从肺移植到COVID-19的时间为5.5(±4.8)年。34例(57.6%)患者住院，住院死亡率为24%(8/34)。多变量分析显示，基线用力呼气量(FEV1)较高的患者住院的可能性较小(OR = 0.91, 95% CI 0.87-0.98, p = 0.02)。75% (75%;有创机械通气组死亡率为8% (OR = 36.0, 95% CI 4.2 ~ 310.4, p < 0.01)。虽然在Alpha波(p = 0.17)和Delta波(p = 0.22)期间观察到感染者有较高的死亡风险趋势，但在调整其他协变量后未发现显著风险。5名ltr两次被诊断为COVID-19。64例COVID-19病例中有30例(46.8%)发生在接种疫苗后中位数123天(IQR 98-164天)接种了至少两剂任何可用mRNA疫苗的ltr。30例患者中有12例(40%)住院，4例(33%)在住院期间死亡。结论:在我们的LTR人群中，尽管新疗法的使用有所增加，但与COVID-19相关的住院率和死亡率仍然很高。疫苗突破感染很常见，并与不良预后相关。需要进行研究，以确定最佳的预防和治疗策略，以改善ltr患者的COVID-19结局。
{"title":"Outcomes of COVID-19 in a Large Cohort of Lung Transplant Recipients: A Retrospective Study","authors":"D. Franco-Palacios, Mei Lu, M. Fitzmaurice, G. Alangaden","doi":"10.3390/transplantology3030026","DOIUrl":"https://doi.org/10.3390/transplantology3030026","url":null,"abstract":"Background: Early reports of COVID-19 in lung transplant recipients (LTRs) showed high hospitalization and mortality rates. However, the outcomes of COVID-19 in LTRs since the advent of newer therapies and vaccines have been poorly defined. Methods: We evaluated the risks for SARS-CoV-2-related hospitalization and mortality in a cohort of LTRs at the Henry Ford Lung Transplant Program in Detroit, Michigan during the study period March 2020–March 2022. Univariate logistic regression, followed by multivariable modeling were performed to estimate the odds ratio (OR) with 95% confident intervals (CI). Results: Sixty-four laboratory-confirmed SARS-CoV-2 infections were identified in 59 patients. For the primary analysis of the hospitalization and mortality risks, we included these 59 patients with symptomatic COVID-19. SARS-CoV-2 infections were confirmed with real-time polymerase chain reaction (RT-PCR) from a nasopharynx swab. The mean age (±STD) was 61 (±12), 63% were males, 27% were African Americans, and the time from lung transplant to COVID-19 was 5.5 (±4.8) years. Thirty-four (57.6%) patients were hospitalized, and the inpatient mortality rate was 24% (8/34). A multivariable analysis showed that patients with a higher baseline forced expiratory volume (FEV1) were less likely to be hospitalized (OR = 0.91 and 95% CI 0.87–0.98, p = 0.02). Seventy-five percent (75%; 6/8) of patients on invasive mechanical ventilation died, compared with only 8% mortality rate in those without mechanical ventilation (OR = 36.0 and 95% CI 4.2–310.4, p < 0.01). Although a trend toward a higher risk of death was observed in those infected during the Alpha (p = 0.17) and Delta (p = 0.22) waves, no significant risk was detected after adjusting for other covariates. Five LTRs were diagnosed with COVID-19 twice. Thirty of the sixty-four COVID-19 cases (46.8%) occurred in LTRs that had received at least two doses of any of the available mRNA vaccines at a median of 123 days (IQR 98–164 days) after vaccination. Twelve of the thirty (40%) were hospitalized, and four patients (33%) died during their hospitalizations. Conclusions: In our LTR population, the hospitalization and mortality rates associated with COVID-19 were high despite the increased use of new therapies. Vaccine-breakthrough infections were common and were associated with poor outcomes. Studies are needed to determine optimal prevention and therapeutic strategies to improve COVID-19 outcomes in LTRs.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80668098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-19DOI: 10.3390/transplantology3030025
B. Das, S. Deshpande, T. Hussain
The three most common modalities of graft surveillance in pediatric heart transplant (HT) recipients include echocardiography, coronary angiography, and endomyocardial biopsy (EMB). The survival outcomes after HT in children have improved considerably in recent years. However, allograft rejection and cardiac allograft vasculopathy remain the leading cause of death or re-transplantation. The routine surveillance by EMB and coronary angiography are invasive and risky. Newer noninvasive echocardiographic techniques, including tissue Doppler imaging (TDI), 2-D speckle tracking echocardiography, CT coronary angiography (CTCA), cardiovascular magnetic resonance (CMR), single-photon emission computed tomography (SPECT), and positron emission tomography (PET) and invasive techniques such as intravascular ultrasound (IVUS), functional flow reserve (CFR) of coronary arteries, optical coherence tomography (OCT), have emerged as powerful tools which may help early recognition of sub-clinical rejection, response to treatment, early detection, and progression of CAV. The multimodality imaging approach, including noninvasive and invasive tests, is the future for the transplanted heart to detect dysfunction, rejections, and early CAV. This review illustrates noninvasive and invasive imaging techniques currently used or could be considered for clinical use in detecting heart transplant rejection, dysfunction, and CAV in children.
{"title":"Multimodality Imaging to Detect Rejection, and Cardiac Allograft Vasculopathy in Pediatric Heart Transplant Recipients—An Illustrative Review","authors":"B. Das, S. Deshpande, T. Hussain","doi":"10.3390/transplantology3030025","DOIUrl":"https://doi.org/10.3390/transplantology3030025","url":null,"abstract":"The three most common modalities of graft surveillance in pediatric heart transplant (HT) recipients include echocardiography, coronary angiography, and endomyocardial biopsy (EMB). The survival outcomes after HT in children have improved considerably in recent years. However, allograft rejection and cardiac allograft vasculopathy remain the leading cause of death or re-transplantation. The routine surveillance by EMB and coronary angiography are invasive and risky. Newer noninvasive echocardiographic techniques, including tissue Doppler imaging (TDI), 2-D speckle tracking echocardiography, CT coronary angiography (CTCA), cardiovascular magnetic resonance (CMR), single-photon emission computed tomography (SPECT), and positron emission tomography (PET) and invasive techniques such as intravascular ultrasound (IVUS), functional flow reserve (CFR) of coronary arteries, optical coherence tomography (OCT), have emerged as powerful tools which may help early recognition of sub-clinical rejection, response to treatment, early detection, and progression of CAV. The multimodality imaging approach, including noninvasive and invasive tests, is the future for the transplanted heart to detect dysfunction, rejections, and early CAV. This review illustrates noninvasive and invasive imaging techniques currently used or could be considered for clinical use in detecting heart transplant rejection, dysfunction, and CAV in children.","PeriodicalId":36461,"journal":{"name":"Cell and Organ Transplantology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75441667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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