Pub Date : 2024-12-01DOI: 10.1016/j.tpr.2024.100165
Mahdi Awwad , Nasim Afif AbuKaresh , Hamza A. Abdul-Hafez , Ma'moun Qawasmeh , Mohanad Jaber , Ahmad Thiab Albaw , Mohammad Alnees
Introduction and importance
Primary hyperoxaluria (PH) is a metabolic condition that leads to oxalate production, resulting in kidney failure and oxalate nephropathy. Posttransplant mobilization of oxalate poses a risk of recurrence. This case emphasizes the importance of measures in cases of end-stage kidney disease (ESKD) with unknown origins.
Case presentation
A 53-year-old man with a history of hypothyroidism, recurring kidney stones, and a family background of renal disease and stomach cancer presented with high blood pressure and elevated creatinine levels (2 mg/dL). A subsequent renal biopsy confirmed PH1. Despite initiating hemodialysis, his kidney function deteriorated, necessitating a liver and kidney transplant. Following the transplant, the patient developed lymph node enlargement. Experienced humoral rejection, leading to the resumption of hemodialysis.
Clinical discussion
The case discussion highlights the treatment complexities associated with PH1, emphasizing the importance of detection and vigilant monitoring post transplantation and multidisciplinary care for managing complications effectively.
Conclusion
Early detection, thorough diagnostics, and customized posttransplant care play roles in managing hyperoxaluria. Future research should focus on enhancing methods, refining transplantation techniques, and developing strategies to prevent and manage complications effectively.
{"title":"Management challenges in primary hyperoxaluria type 1 with end-stage kidney disease: A case report","authors":"Mahdi Awwad , Nasim Afif AbuKaresh , Hamza A. Abdul-Hafez , Ma'moun Qawasmeh , Mohanad Jaber , Ahmad Thiab Albaw , Mohammad Alnees","doi":"10.1016/j.tpr.2024.100165","DOIUrl":"10.1016/j.tpr.2024.100165","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Primary hyperoxaluria (PH) is a metabolic condition that leads to oxalate production, resulting in kidney failure and oxalate nephropathy. Posttransplant mobilization of oxalate poses a risk of recurrence. This case emphasizes the importance of measures in cases of end-stage kidney disease (ESKD) with unknown origins.</div></div><div><h3>Case presentation</h3><div>A 53-year-old man with a history of hypothyroidism, recurring kidney stones, and a family background of renal disease and stomach cancer presented with high blood pressure and elevated creatinine levels (2 mg/dL). A subsequent renal biopsy confirmed PH1. Despite initiating hemodialysis, his kidney function deteriorated, necessitating a liver and kidney transplant. Following the transplant, the patient developed lymph node enlargement. Experienced humoral rejection, leading to the resumption of hemodialysis.</div></div><div><h3>Clinical discussion</h3><div>The case discussion highlights the treatment complexities associated with PH1, emphasizing the importance of detection and vigilant monitoring post transplantation and multidisciplinary care for managing complications effectively.</div></div><div><h3>Conclusion</h3><div>Early detection, thorough diagnostics, and customized posttransplant care play roles in managing hyperoxaluria. Future research should focus on enhancing methods, refining transplantation techniques, and developing strategies to prevent and manage complications effectively.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Donor hepatectomy is considered as a major surgical procedure and can lead to severe complications. Since 2012, 64 deceased donor liver transplantation (DDLT) and 420 living donor liver transplantation were performed in Kazakhstan. Efforts to increase deceased liver donation have shown no success. In this study, we analyzed major and minor complications among living liver donor after left and right liver lobe donation, performed in our center. Patients and methods This retrospective study was conducted in compliance with the principles of the Declaration of Helsinki. The Local Ethics Committee of NROC approved this study. All data regarding living liver donors, who underwent donor hepatectomy between 2016 and 2023 were retrieved from electronic records. Results The mean age of living donors was 32 years (range 18–61).Male/female ratio was 51(70.8 %)/21(29.2). 4 left liver grafts;2 left lateral grafts and 66 right liver grafts. Bile leak occurred in 9 cases (12.5 %), 2 cases of bile leakage in living donors required surgery (Clavien grade III). Bleeding totally occurred in 3 living donors (4.2 %), in 2 cases it required surgery. PHLF occurred in 15(20.8 %) cases after right liver lobe donation. No living liver donor death was encountered in our study. Conclusions Our experience in living donor hepatectomy was not fully safe procedure. However, complication occurrence was comparable with other reports from transplant centers.
{"title":"Report on living liver donor risk and outcomes: Single center experience","authors":"Jamilya Saparbay , Abylaikhan Sharmenov , Chokhan Aytbayev , Assylmurat Zhumukov , Bekkhozha Yeskendirov , Zhanat Spatayev , Asan Zhexembayev","doi":"10.1016/j.tpr.2024.100166","DOIUrl":"10.1016/j.tpr.2024.100166","url":null,"abstract":"<div><div>Introduction Donor hepatectomy is considered as a major surgical procedure and can lead to severe complications. Since 2012, 64 deceased donor liver transplantation (DDLT) and 420 living donor liver transplantation were performed in Kazakhstan. Efforts to increase deceased liver donation have shown no success. In this study, we analyzed major and minor complications among living liver donor after left and right liver lobe donation, performed in our center. Patients and methods This retrospective study was conducted in compliance with the principles of the Declaration of Helsinki. The Local Ethics Committee of NROC approved this study. All data regarding living liver donors, who underwent donor hepatectomy between 2016 and 2023 were retrieved from electronic records. Results The mean age of living donors was 32 years (range 18–61).Male/female ratio was 51(70.8 %)/21(29.2). 4 left liver grafts;2 left lateral grafts and 66 right liver grafts. Bile leak occurred in 9 cases (12.5 %), 2 cases of bile leakage in living donors required surgery (Clavien grade III). Bleeding totally occurred in 3 living donors (4.2 %), in 2 cases it required surgery. PHLF occurred in 15(20.8 %) cases after right liver lobe donation. No living liver donor death was encountered in our study. Conclusions Our experience in living donor hepatectomy was not fully safe procedure. However, complication occurrence was comparable with other reports from transplant centers.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1016/j.tpr.2024.100164
Jade M Kozuch , Alicia Lichvar , Dana Abraham , Eugene Golts , Christine M Lin , Aarya Kafi , Gordon Yung , Kamyar Afshar
The proportion of elderly lung transplant recipients has increased substantially in recent years. The immunosuppressants required significantly increase the risk for infection and malignancy in the elderly population. However, there is a paucity of data on immunosuppression management practices in this group. Herein, we report results of the first national aggregation of immunosuppressant strategies in elderly lung transplant recipients within the US.
{"title":"A national survey of immunosuppression adjustment in elderly lung transplant recipients","authors":"Jade M Kozuch , Alicia Lichvar , Dana Abraham , Eugene Golts , Christine M Lin , Aarya Kafi , Gordon Yung , Kamyar Afshar","doi":"10.1016/j.tpr.2024.100164","DOIUrl":"10.1016/j.tpr.2024.100164","url":null,"abstract":"<div><div>The proportion of elderly lung transplant recipients has increased substantially in recent years. The immunosuppressants required significantly increase the risk for infection and malignancy in the elderly population. However, there is a paucity of data on immunosuppression management practices in this group. Herein, we report results of the first national aggregation of immunosuppressant strategies in elderly lung transplant recipients within the US.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1016/j.tpr.2024.100163
Lorenzo Olivero , Hong Liang , Ian A. Makey , Si M. Pham , Jorge Sinclair , Stephen Aniskevich III , Sadia Z. Shah , Dana K. Perry , Wesley L. Allen , Nathan H. Waldron , Liu Yang , Pramod K. Guru , Candido E. Rivera , Pablo Moreno Franco , Tathagat Narula
Combined lung and liver transplantation (CLLT) is a rare intervention for end-stage lung and liver diseases. It poses a challenge for patients with increased bleeding risk due to Hemophilia A and liver coagulopathy. We present the first documented case of CLLT in an elderly male with Hemophilia A, HCV-associated cirrhosis, and Idiopathic Pulmonary Fibrosis (IPF). Despite the patient exhibiting stable liver function and hemophilia, his lung condition rapidly deteriorated, prompting the listing for transplant. The patient underwent a successful CLLT with perioperative management coordinated by the multidisciplinary team to address the unique challenges of Hemophilia A, resulting in intra-operative correction of coagulopathy. The patient exhibited a favorable recovery, with no requirement for Factor FVIII replacement therapy postoperatively. This case demonstrates that CLLT can address three diseases with distinct pathophysiologies: end-stage lung and liver disease, and correct the hemophilia A phenotype. Our report contributes to the limited literature on the suitability of CLLT in patients with hemophilia A.
肺肝联合移植（CLLT）是一种罕见的治疗终末期肺病和肝病的干预措施。对于因血友病 A 和肝凝血功能障碍而导致出血风险增加的患者来说，这是一项挑战。我们介绍了首例有记录的 CLLT 病例，患者是一名患有血友病 A、丙型肝炎病毒相关性肝硬化和特发性肺纤维化（IPF）的老年男性。尽管患者的肝功能和血友病病情稳定，但他的肺部状况却迅速恶化，因此被列入移植名单。患者成功接受了 CLLT，多学科团队协调了围手术期管理，以应对血友病 A 的独特挑战，从而在术中纠正了凝血病。患者术后恢复良好，无需进行因子 FVIII 替代治疗。本病例表明，CLLT 可以治疗三种病理生理不同的疾病：终末期肺病和肝病，并纠正 A 型血友病表型。我们的报告为有关 CLLT 是否适用于 A 型血友病患者的有限文献做出了贡献。
{"title":"Combined lung and liver transplant for cirrhosis, idiopathic pulmonary fibrosis, and hemophilia A: Case report","authors":"Lorenzo Olivero , Hong Liang , Ian A. Makey , Si M. Pham , Jorge Sinclair , Stephen Aniskevich III , Sadia Z. Shah , Dana K. Perry , Wesley L. Allen , Nathan H. Waldron , Liu Yang , Pramod K. Guru , Candido E. Rivera , Pablo Moreno Franco , Tathagat Narula","doi":"10.1016/j.tpr.2024.100163","DOIUrl":"10.1016/j.tpr.2024.100163","url":null,"abstract":"<div><div>Combined lung and liver transplantation (CLLT) is a rare intervention for end-stage lung and liver diseases. It poses a challenge for patients with increased bleeding risk due to Hemophilia A and liver coagulopathy. We present the first documented case of CLLT in an elderly male with Hemophilia A, HCV-associated cirrhosis, and Idiopathic Pulmonary Fibrosis (IPF). Despite the patient exhibiting stable liver function and hemophilia, his lung condition rapidly deteriorated, prompting the listing for transplant. The patient underwent a successful CLLT with perioperative management coordinated by the multidisciplinary team to address the unique challenges of Hemophilia A, resulting in intra-operative correction of coagulopathy. The patient exhibited a favorable recovery, with no requirement for Factor FVIII replacement therapy postoperatively. This case demonstrates that CLLT can address three diseases with distinct pathophysiologies: end-stage lung and liver disease, and correct the hemophilia A phenotype. Our report contributes to the limited literature on the suitability of CLLT in patients with hemophilia A.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.tpr.2024.100162
Jordan Leal, William Wesson, Liza Rodriguez, Jason Gray, Kelly Bosak, Joseph McGuirk, Kristin Grdinovac
Background
Steroid-induced hyperglycemia (SIH) worsens overall outcomes in the allo-SCT population. Currently, there is no standardized workflow for monitoring SIH. To address this need, a quality improvement (QI) initiative was implemented, as part of a Doctor of Nursing Practice project for the University of Kansas School of Nursing, to standardize glucose monitoring after the initiation of glucocorticoids (CGs) for the treatment of acute or chronic graft-versus-host-disease (GVHD).
Objective
This QI initiative aimed to decrease the median time to identification of SIH and the initiation of treatment in allo-SCT recipients on GCs for GVHD.
Study Design
The study took place at a large Midwestern blood and marrow transplant program. Patients diagnosed with acute or chronic GVHD and prescribed ≥0.5 mg kg-1/day prednisone equivalent (PE) steroids were requested to monitor postprandial blood glucose values for 14 days. A control group (retrospective chart review) was used for comparison. Time to the identification of SIH was compared between the two groups, as well as the time to treatment of hyperglycemia.
Results
Over 9 weeks, 19 patients enrolled in the QI initiative. The control group consisted of 21 patients. The median PE steroid dose was 1 mg kg-1/day in both groups (p = 0.8100). Eighteen of the 19 patients (95 %) had at least 1 blood glucose (BG) > 180 mg/dL and only 6 of 21 patients (29 %) had at least 1 BG > 180 mg/dL (p < 0.0001). The median time to a BG > 180 mg/dL was 1.5 days in the QI group and 7 days in the control group (p = 0.0232). The median time to insulin was 2 days in the QI group and 10 days in the control group (p = 0.0355).
Conclusion
This project demonstrated that daily postprandial blood glucose monitoring is superior for the earlier identification and treatment of SIH when compared to monitoring at routine clinic visits alone.
{"title":"Implementing a standardized workflow for early detection of steroid-induced hyperglycemia in allogeneic stem cell transplant recipients: A quality improvement project","authors":"Jordan Leal, William Wesson, Liza Rodriguez, Jason Gray, Kelly Bosak, Joseph McGuirk, Kristin Grdinovac","doi":"10.1016/j.tpr.2024.100162","DOIUrl":"10.1016/j.tpr.2024.100162","url":null,"abstract":"<div><h3>Background</h3><div>Steroid-induced hyperglycemia (SIH) worsens overall outcomes in the allo-SCT population. Currently, there is no standardized workflow for monitoring SIH. To address this need, a quality improvement (QI) initiative was implemented, as part of a Doctor of Nursing Practice project for the University of Kansas School of Nursing, to standardize glucose monitoring after the initiation of glucocorticoids (CGs) for the treatment of acute or chronic graft-versus-host-disease (GVHD).</div></div><div><h3>Objective</h3><div>This QI initiative aimed to decrease the median time to identification of SIH and the initiation of treatment in allo-SCT recipients on GCs for GVHD.</div></div><div><h3>Study Design</h3><div>The study took place at a large Midwestern blood and marrow transplant program. Patients diagnosed with acute or chronic GVHD and prescribed ≥0.5 mg kg<sup>-1</sup>/day prednisone equivalent (PE) steroids were requested to monitor postprandial blood glucose values for 14 days. A control group (retrospective chart review) was used for comparison. Time to the identification of SIH was compared between the two groups, as well as the time to treatment of hyperglycemia.</div></div><div><h3>Results</h3><div>Over 9 weeks, 19 patients enrolled in the QI initiative. The control group consisted of 21 patients. The median PE steroid dose was 1 mg kg<sup>-1</sup>/day in both groups (<em>p</em> = 0.8100). Eighteen of the 19 patients (95 %) had at least 1 blood glucose (BG) > 180 mg/dL and only 6 of 21 patients (29 %) had at least 1 BG > 180 mg/dL (<em>p</em> < 0.0001). The median time to a BG > 180 mg/dL was 1.5 days in the QI group and 7 days in the control group (<em>p</em> = 0.0232). The median time to insulin was 2 days in the QI group and 10 days in the control group (<em>p</em> = 0.0355).</div></div><div><h3>Conclusion</h3><div>This project demonstrated that daily postprandial blood glucose monitoring is superior for the earlier identification and treatment of SIH when compared to monitoring at routine clinic visits alone.</div></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 4","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-05DOI: 10.1016/j.tpr.2024.100160
Stephanie Almeida , William Snyder , Mita Shah , Jonathan Fisher , Christopher Marsh , Alana Hawkes , Diana Gorial , Sean DeWolf , Dianne B. McKay
Solid organ transplantation is lifesaving for persons with end-stage organ disease. Thanks to advancements in organ preservation, surgeons are now able to successfully transplant organs that were previously considered high risk for poor graft function. Innovations in perfusion machine types, preservation solutions and additives to preservation solutions have significantly improved the ability to utilize organs previously thought unusable.
Newer organ preservation techniques are offering a promising outlook for extending graft longevity and improving transplant outcomes. This review explores the impact of deceased donor type on graft quality and highlights emerging strategies designed to improve the function and viability of deceased donor organs.
{"title":"Revolutionizing deceased donor transplantation: How new approaches to machine perfusion broadens the horizon for organ donation","authors":"Stephanie Almeida , William Snyder , Mita Shah , Jonathan Fisher , Christopher Marsh , Alana Hawkes , Diana Gorial , Sean DeWolf , Dianne B. McKay","doi":"10.1016/j.tpr.2024.100160","DOIUrl":"10.1016/j.tpr.2024.100160","url":null,"abstract":"<div><p>Solid organ transplantation is lifesaving for persons with end-stage organ disease. Thanks to advancements in organ preservation, surgeons are now able to successfully transplant organs that were previously considered high risk for poor graft function. Innovations in perfusion machine types, preservation solutions and additives to preservation solutions have significantly improved the ability to utilize organs previously thought unusable.</p><p>Newer organ preservation techniques are offering a promising outlook for extending graft longevity and improving transplant outcomes. This review explores the impact of deceased donor type on graft quality and highlights emerging strategies designed to improve the function and viability of deceased donor organs.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000118/pdfft?md5=ed685e553841b4cf78318976de9115ff&pid=1-s2.0-S2451959624000118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141985268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1016/j.tpr.2024.100159
Omaya Al Salkini , Mohammad Alsultan , Kassem Basha , Qussai Hassan
Introduction
proteinuria is associated with poor allograft and patient survival in kidney transplant recipients (KTRs). This study aims to investigate the prevalence and risk factors of proteinuria in KTRs and its impact on kidney function during the first two years after kidney transplantation (KT).
Materials and methods
200 KTRs were included in this retrospective cohort study from living donors, performed in two University hospitals in Syria, from January 2018 to March 2021. Demographic and immunological characteristics were analyzed depending on the 24 h urine protein (Up) excretion that was classified into three groups: Up I (150–500 mg/day), Up II between (0.5–1 g/day), and Up III (>1 g/day).
Results
Up was increased subsequently as the transplant progressed, where the greatest excretion of the Up was reported 2 years after KT. At 6 months after KT; the cold ischemic time (CIT), serum creatinine (Cr), using angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin II receptor blockers (ARBs), and GFR showed strong significant differences between Up groups (P = 0.00003, 0.0001, 0.00001, and 0.026; respectively). The CIT and Cr were higher in the Up III group compared to Up I and UP II groups. At 12 months after KT; Cr, using ACEIs/ARBs, and GFR showed strong significant differences between Up groups (P = 0.00009, <0.0001, and <0.0001; respectively). The mean Cr was higher in Up II and Up III groups (1.7 mg/dL; for each) compared to the Up I group (1.0 mg/dL). At 24 months after KT; CIT, using ACEIs/ARBs, Cr, and GFR showed strong significant differences between Up groups (P = 0.02, <0.0001, 0.00008, and <0.0001; respectively).
Conclusion
This is the first study from Syria that conducted in KT patients. The prevalence and amount of proteinuria showed subsequently increased as the transplant progressed. Serum Cr, GFR, CIT, and using ACEIs/ARBs showed differences between Up groups at 6 months, 1 year, and 2 years after KT. Our data suggest that the use of ACEIs/ARBs is not a contraindication in early posttransplant period. Due to several known cardiovascular and renal benefits of ACEIs/ARBs future studied in KT population should investigated to determine if these drugs could give beneficial effects on grafts and patients survival.
导言蛋白尿与肾移植受者（KTR）的异体移植和患者存活率低下有关。本研究旨在调查肾移植（KT）后头两年中蛋白尿在肾移植受者中的发生率、风险因素及其对肾功能的影响。材料与方法 2018年1月至2021年3月，叙利亚两所大学医院对200名活体供体肾移植受者进行了回顾性队列研究。根据 24 小时尿蛋白（Up）排泄量分析了人口统计学和免疫学特征，并将其分为三组：结果随着移植的进展，尿蛋白随之增加，KT 2 年后尿蛋白排泄量最大。KT 6 个月后，Up 组之间的冷缺血时间（CIT）、血清肌酐（Cr）、血管紧张素转换酶抑制剂（ACEIs）/血管紧张素 II 受体阻滞剂（ARBs）和肾小球滤过率显示出显著差异（P = 0.00003、0.0001、0.00001 和 0.026；分别为 0.00003、0.0001、0.00001 和 0.026）。与 Up I 组和 Up II 组相比，Up III 组的 CIT 和 Cr 更高。KT 12 个月后，Up 组之间在 Cr、使用 ACEIs/ARBs 和 GFR 方面存在显著差异（分别为 P = 0.00009、<0.0001 和 <0.0001）。与 Up I 组（1.0 mg/dL）相比，Up II 组和 Up III 组的平均 Cr 值更高（均为 1.7 mg/dL）。KT 24 个月后，使用 ACEIs/ARBs 的 CIT、Cr 和 GFR 在 Up 组之间显示出显著差异（分别为 P = 0.02、<0.0001、0.00008 和 <0.0001）。随着移植的进展，蛋白尿的发生率和数量随之增加。在 KT 术后 6 个月、1 年和 2 年，血清 Cr、GFR、CIT 和使用 ACEIs/ARBs 的情况在 Up 组之间存在差异。我们的数据表明，在移植后早期使用 ACEIs/ARBs 并非禁忌。由于已知 ACEIs/ARBs 对心血管和肾脏有多种益处，因此今后应对 KT 患者进行研究，以确定这些药物是否会对移植物和患者存活产生有益影响。
{"title":"Prevalence of proteinuria after living donor kidney transplantation and related risk factors: A retrospective cohort study from Syria","authors":"Omaya Al Salkini , Mohammad Alsultan , Kassem Basha , Qussai Hassan","doi":"10.1016/j.tpr.2024.100159","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100159","url":null,"abstract":"<div><h3>Introduction</h3><p>proteinuria is associated with poor allograft and patient survival in kidney transplant recipients (KTRs). This study aims to investigate the prevalence and risk factors of proteinuria in KTRs and its impact on kidney function during the first two years after kidney transplantation (KT).</p></div><div><h3>Materials and methods</h3><p>200 KTRs were included in this retrospective cohort study from living donors, performed in two University hospitals in Syria, from January 2018 to March 2021. Demographic and immunological characteristics were analyzed depending on the 24 h urine protein (Up) excretion that was classified into three groups: Up I (150–500 mg/day), Up II between (0.5–1 g/day), and Up III (>1 g/day).</p></div><div><h3>Results</h3><p>Up was increased subsequently as the transplant progressed, where the greatest excretion of the Up was reported 2 years after KT. At 6 months after KT; the cold ischemic time (CIT), serum creatinine (Cr), using angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin II receptor blockers (ARBs), and GFR showed strong significant differences between Up groups (<em>P</em> = 0.00003, 0.0001, 0.00001, and 0.026; respectively). The CIT and Cr were higher in the Up III group compared to Up I and UP II groups. At 12 months after KT; Cr, using ACEIs/ARBs, and GFR showed strong significant differences between Up groups (<em>P</em> = 0.00009, <0.0001, and <0.0001; respectively). The mean Cr was higher in Up II and Up III groups (1.7 mg/dL; for each) compared to the Up I group (1.0 mg/dL). At 24 months after KT; CIT, using ACEIs/ARBs, Cr, and GFR showed strong significant differences between Up groups (<em>P</em> = 0.02, <0.0001, 0.00008, and <0.0001; respectively).</p></div><div><h3>Conclusion</h3><p>This is the first study from Syria that conducted in KT patients. The prevalence and amount of proteinuria showed subsequently increased as the transplant progressed. Serum Cr, GFR, CIT, and using ACEIs/ARBs showed differences between Up groups at 6 months, 1 year, and 2 years after KT. Our data suggest that the use of ACEIs/ARBs is not a contraindication in early posttransplant period. Due to several known cardiovascular and renal benefits of ACEIs/ARBs future studied in KT population should investigated to determine if these drugs could give beneficial effects on grafts and patients survival.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000106/pdfft?md5=62db12851e39bc8664786b007e90254f&pid=1-s2.0-S2451959624000106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.1016/j.tpr.2024.100156
Estella Y Huang , Kamyar Afshar , Eugene Golts , Ryan C Broderick , Graham J Spurzem , Daniel Chung , Josefin Holmgren , Bryan J Sandler , Garth R Jacobsen , David C Kunkel , Santiago Horgan
Background
Early laparoscopic fundoplication (LF) has been shown to slow lung function decline in chronic lung disease (CLD) patients and lung transplant (LTx) recipients. Magnetic sphincter augmentation (MSA) has emerged as an effective minimally invasive alternative to LF for the treatment of GERD. We evaluate the safety and efficacy of MSA compared to LF for GERD in CLD and LTx.
Methods
A retrospective review identified CLD and LTx patients undergoing LF or MSA for GERD. Primary outcome was change in percent predicted FEV1. Secondary outcomes were 30d morbidity, mortality, operative time, and length of stay (LOS).
Results
77 patients met inclusion criteria, 45 (58.5 %) were LTx recipients. 35 (45.5 %) underwent Nissen, 23 (29.9 %) underwent Toupet, and 19 (24.7 %) underwent MSA. Average age was 54.2 years, 54.5 % were female, and average BMI at ARS was 24.9 kg/m2. Median FEV1 % change between pre-ARS and post-ARS was 0 % with no significant differences between groups. MSA had faster operative times at 50.5 min than Nissen (83.5 min, p = 0.002) and Toupet (72.6 min, p = 0.003) and shorter LOS at 0.8 days than Nissen (3.7 days, p = 0.002) and Toupet (2.1 days, p = 0.0008). MSA and Nissen had higher reintervention rates than Toupet, though this was not statistically significant. There were no differences in 30-day morbidities or 30-day ED visits between groups. There were no mortalities.
Conclusion
MSA is an advantageous alternative to LF in the CLD and LTx population with stabilization of percent predicted FEV1, equivalent safety profile, shorter operative times, and shorter length of hospital stay.
{"title":"Magnetic sphincter augmentation: A promising alternative to fundoplication for preserving lung function and protecting against chronic lung transplant rejection","authors":"Estella Y Huang , Kamyar Afshar , Eugene Golts , Ryan C Broderick , Graham J Spurzem , Daniel Chung , Josefin Holmgren , Bryan J Sandler , Garth R Jacobsen , David C Kunkel , Santiago Horgan","doi":"10.1016/j.tpr.2024.100156","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100156","url":null,"abstract":"<div><h3>Background</h3><p>Early laparoscopic fundoplication (LF) has been shown to slow lung function decline in chronic lung disease (CLD) patients and lung transplant (LTx) recipients. Magnetic sphincter augmentation (MSA) has emerged as an effective minimally invasive alternative to LF for the treatment of GERD. We evaluate the safety and efficacy of MSA compared to LF for GERD in CLD and LTx.</p></div><div><h3>Methods</h3><p>A retrospective review identified CLD and LTx patients undergoing LF or MSA for GERD. Primary outcome was change in percent predicted FEV<sub>1</sub>. Secondary outcomes were 30d morbidity, mortality, operative time, and length of stay (LOS).</p></div><div><h3>Results</h3><p>77 patients met inclusion criteria, 45 (58.5 %) were LTx recipients. 35 (45.5 %) underwent Nissen, 23 (29.9 %) underwent Toupet, and 19 (24.7 %) underwent MSA. Average age was 54.2 years, 54.5 % were female, and average BMI at ARS was 24.9 kg/m<sup>2</sup>. Median FEV<sub>1</sub> % change between pre-ARS and post-ARS was 0 % with no significant differences between groups. MSA had faster operative times at 50.5 min than Nissen (83.5 min, <em>p</em> = 0.002) and Toupet (72.6 min, <em>p</em> = 0.003) and shorter LOS at 0.8 days than Nissen (3.7 days, <em>p</em> = 0.002) and Toupet (2.1 days, <em>p</em> = 0.0008). MSA and Nissen had higher reintervention rates than Toupet, though this was not statistically significant. There were no differences in 30-day morbidities or 30-day ED visits between groups. There were no mortalities.</p></div><div><h3>Conclusion</h3><p>MSA is an advantageous alternative to LF in the CLD and LTx population with stabilization of percent predicted FEV<sub>1</sub>, equivalent safety profile, shorter operative times, and shorter length of hospital stay.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000076/pdfft?md5=615f7e4ce32952281c356bf54d213471&pid=1-s2.0-S2451959624000076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141482870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.1016/j.tpr.2024.100158
Maryam Rahbar , Marzieh Latifi , Elahe Pourhosein , Ebrahim Mahmoudi , Iman Seyhoun , Sanaz Dehghani
Long-term immunosuppression after transplantation can increase the risk of cancer development in recipient patients. This case report describes the treatment approach for glioblastoma in a kidney transplant recipient after transplantation. The patient, a 61-year-old woman, received a living donor kidney transplant 24 years ago due to congenital nephrotic syndrome. The patient was on various immunosuppressive medications, including cyclosporine, prednisolone, and mycophenolate mofetil.
After 16 years of follow-up, the patient presented with symptoms of brain tumor, leading to further tests. Subsequent examination revealed the presence of a tumor that had spread to frontal region within the brain.
A surgical procedure was subsequently conducted to extract the tumor cells and alleviate the resulting pressure within the brain. Based on pathology results, it was determined that the patient had glioblastoma.
Methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter was detected, indicating the potential response to chemotherapy. Chemotherapy was initiated, along with radiation therapy.
After the diagnosis and surgery, the patient's medications for the kidney transplant were modified. Rapamycin replaced the previous medications, and the dose of mycophenolate mofetil and prednisolone was decreased. After 7 years, the patient's kidney is functioning well, with a creatinine level of 1.5, and brain imaging showed no abnormalities. After kidney transplantation, there is an increased risk of various cancers.
Overall, this case report demonstrates a successful treatment approach for glioblastoma after kidney transplantation, emphasizing the need for close monitoring and individualized management in transplant recipients at risk for cancer development.
Considering the current stability of the patient's condition after a change in medication regimen, patients who have been using the drug Cyclosporine for a long time should be included in future evaluations due to its carcinogenic properties.
{"title":"Long-term graft survival in a kidney transplant recipient with glioblastoma: Case report","authors":"Maryam Rahbar , Marzieh Latifi , Elahe Pourhosein , Ebrahim Mahmoudi , Iman Seyhoun , Sanaz Dehghani","doi":"10.1016/j.tpr.2024.100158","DOIUrl":"https://doi.org/10.1016/j.tpr.2024.100158","url":null,"abstract":"<div><p>Long-term immunosuppression after transplantation can increase the risk of cancer development in recipient patients. This case report describes the treatment approach for glioblastoma in a kidney transplant recipient after transplantation. The patient, a 61-year-old woman, received a living donor kidney transplant 24 years ago due to congenital nephrotic syndrome. The patient was on various immunosuppressive medications, including cyclosporine, prednisolone, and mycophenolate mofetil.</p><p>After 16 years of follow-up, the patient presented with symptoms of brain tumor, leading to further tests. Subsequent examination revealed the presence of a tumor that had spread to frontal region within the brain.</p><p>A surgical procedure was subsequently conducted to extract the tumor cells and alleviate the resulting pressure within the brain. Based on pathology results, it was determined that the patient had glioblastoma.</p><p>Methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter was detected, indicating the potential response to chemotherapy. Chemotherapy was initiated, along with radiation therapy.</p><p>After the diagnosis and surgery, the patient's medications for the kidney transplant were modified. Rapamycin replaced the previous medications, and the dose of mycophenolate mofetil and prednisolone was decreased. After 7 years, the patient's kidney is functioning well, with a creatinine level of 1.5, and brain imaging showed no abnormalities. After kidney transplantation, there is an increased risk of various cancers.</p><p>Overall, this case report demonstrates a successful treatment approach for glioblastoma after kidney transplantation, emphasizing the need for close monitoring and individualized management in transplant recipients at risk for cancer development.</p><p>Considering the current stability of the patient's condition after a change in medication regimen, patients who have been using the drug Cyclosporine for a long time should be included in future evaluations due to its carcinogenic properties.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S245195962400009X/pdfft?md5=c85d0d1fcf492b0b46327a05eb4cce26&pid=1-s2.0-S245195962400009X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-18DOI: 10.1016/j.tpr.2024.100155
{"title":"Erratum regarding missing Declaration of Competing Interest statements and Informed consent statements in previously published articles","authors":"","doi":"10.1016/j.tpr.2024.100155","DOIUrl":"10.1016/j.tpr.2024.100155","url":null,"abstract":"","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"9 3","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959624000064/pdfft?md5=63e957c9a0101c0b343a0e73edc0b1a1&pid=1-s2.0-S2451959624000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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