Transplantation Reviews最新文献

{"title":"Use of aspirin for prevention of hepatic artery thrombosis after liver transplantation: A systematic review and meta-analysis","authors":"Raul Valério Ponte ,&nbsp;Amanda Freitas Pompeu dos Santos ,&nbsp;Maria Fernanda Moura de Lima ,&nbsp;Priscila Ferreira de Lima Souza ,&nbsp;João Bernardo Sancio ,&nbsp;Lucas Ernani ,&nbsp;Daiki Soma ,&nbsp;Werviston De Faria ,&nbsp;Thiago Beduschi ,&nbsp;Estrella Bianca de Mello","doi":"10.1016/j.trre.2026.101002","DOIUrl":"10.1016/j.trre.2026.101002","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatic artery thrombosis (HAT) is a leading cause of graft loss after liver transplantation. While aspirin is used for prophylaxis, its benefit is debated due to potential bleeding risks. We performed a systematic review and meta-analysis to assess the efficacy and safety of aspirin prophylaxis in liver transplant recipients.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane Library for studies comparing aspirin prophylaxis to no aspirin. We computed risk ratios (RR) for binary outcomes, with 95% confidence intervals (CIs), and assessed heterogeneity using I² statistics.</div></div><div><h3>Results</h3><div>We included five studies with 4983 patients (2299 on aspirin). Aspirin significantly reduced HAT risk (RR 0.47; 95% CI: 0.24–0.94; <em>p</em> = 0.03) without increasing major bleeding risk (RR 0.81; 95% CI: 0.54–1.22; <em>p</em> = 0.31). Graft survival was higher in the aspirin group at 1 year (RR 1.06; <em>p</em> = 0.003) and 5 years (RR 1.06; <em>p</em> &lt; 0.0001). Aspirin also reduced the incidence of acute cellular rejection at 1 year (RR 0.71; <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Our meta-analysis suggests that aspirin prophylaxis after liver transplantation may reduce the incidence of hepatic artery thrombosis, particularly among high-risk patients, without a significant increase in major bleeding events.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 2","pages":"Article 101002"},"PeriodicalIF":3.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise on the efficacy and adverse effects of immunosuppressants: a systematic review and meta-analysis","authors":"Paula Etayo-Urtasun ,&nbsp;Mikel L. Sáez de Asteasu ,&nbsp;Mikel Izquierdo","doi":"10.1016/j.trre.2026.101001","DOIUrl":"10.1016/j.trre.2026.101001","url":null,"abstract":"<div><h3>Background</h3><div>Lifelong immunosuppression is the standard care after solid organ transplantation; however, it is associated with a wide range of adverse effects. Emerging evidence indicates that structured exercise may help reduce these complications. Therefore, this review aimed to assess the effects of exercise interventions on the side effects of immunosuppressive treatment.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Web of Science, and Scopus following the PRISMA 2020 guidelines (PROSPERO CRD420251078616). Randomised controlled trials (RCTs) examining post-transplant exercise interventions were included. Two reviewers independently screened studies published since 2000 using the PICOS framework and assessed their quality with the PEDro scale. Pooled analyses employed random effects models.</div></div><div><h3>Results</h3><div>Twenty-five RCTs involving 560 participants were included. Exercise significantly increased peak oxygen uptake (VO₂peak; standardised mean difference [SMD] = 0.749, 95% confidence interval [CI]: 0.225 to 1.274, <em>p</em> = 0.010) and decreased body fat percentage (SMD = −0.509, 95% CI: −0.899 to −0.118, <em>p</em> = 0.022). No significant effects were observed on blood pressure, muscle strength, or metabolism. Evidence on bone health and immunomodulatory efficacy remains limited.</div></div><div><h3>Conclusion</h3><div>Exercise may partially mitigate adverse effects of immunosuppressants by improving cardiorespiratory fitness and body composition. However, gaps still exist regarding its impact on metabolic, skeletal, and immunological effects.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 2","pages":"Article 101001"},"PeriodicalIF":3.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic agents for the prevention of primary graft dysfunction after lung transplantation: A comprehensive narrative review","authors":"Andréa M. Poupard ,&nbsp;Georgie Mullin","doi":"10.1016/j.trre.2026.101000","DOIUrl":"10.1016/j.trre.2026.101000","url":null,"abstract":"<div><div>Primary graft dysfunction (PGD) remains the leading cause of morbidity and mortality following lung transplantation. This narrative review explores current evidence regarding pharmacological strategies for the prevention and management of PGD. A comprehensive literature search identified randomized controlled trials and clinical studies evaluating therapeutic agents targeting ischemia–reperfusion injury and inflammatory pathways. Interventions assessed include inhaled nitric oxide, surfactants, complement inhibitors, platelet-activating factor antagonists, and novel anti-inflammatory agents. Despite promising preclinical data, most trials failed to demonstrate statistically significant improvements in clinical outcomes, primarily due to small sample sizes and methodological heterogeneity. Current PGD management remains supportive and modeled on acute respiratory distress syndrome (ARDS) principles. Future research should focus on multicenter, adequately powered studies testing multimodal strategies combining pharmacologic and procedural interventions. Preventing PGD will be essential to improving early survival and long-term graft function in lung transplant recipients.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 2","pages":"Article 101000"},"PeriodicalIF":3.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiovascular evaluation of candidates for living kidney donation","authors":"Keshvi Chauhan ,&nbsp;Neetika Garg ,&nbsp;Matthew R. Wolff ,&nbsp;Didier A. Mandelbrot ,&nbsp;Ravi Dhingra","doi":"10.1016/j.trre.2025.100990","DOIUrl":"10.1016/j.trre.2025.100990","url":null,"abstract":"<div><div>Most studies concluding that living kidney donation does not increase cardiovascular risk have been conducted in low-risk cohorts. As transplant programs increasingly encounter medically complex donors, careful consideration of long-term cardiovascular risks is essential. There is significant variation among institutions in the practices regarding the selection of living donors. This comprehensive review examines the existing evidence on post-donation cardiovascular outcomes, and prevalent risk factors in the donor candidate population including older age, hypertension, prediabetes, diabetes, obesity, dyslipidemias and metabolic syndrome. The use of atherosclerotic cardiovascular risk calculators for coronary artery disease screening and medical optimization is discussed. Data on outcomes with commonly encountered electrocardiographic and echocardiographic abnormalities identified on screening tests in the donor population are essentially non-existent. To address this gap, we review the literature on their prevalence, natural history and outcomes in the general population. Extrapolating from these data, we make recommendations on risk stratification, decision-making regarding donor selection and follow up. Uncertainties in the context of living kidney donation are highlighted. This review underscores the importance of informed consent, and the need for ongoing research regarding long-term cardiovascular effects of kidney donation in higher-risk individuals.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 2","pages":"Article 100990"},"PeriodicalIF":3.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting leukocytes, neutrophil extracellular traps and cytokines: A conceptual review to prevent primary graft dysfunction after lung transplantation","authors":"Hiroshi Kagawa ,&nbsp;Nicolas Contreras ,&nbsp;Matthew Goodwin ,&nbsp;Laura Frye ,&nbsp;Sanjeev Raman ,&nbsp;Barbara Cahill ,&nbsp;Ramsey Hachem ,&nbsp;Matthew Morrell ,&nbsp;Craig H. Selzman","doi":"10.1016/j.trre.2025.100989","DOIUrl":"10.1016/j.trre.2025.100989","url":null,"abstract":"<div><div>Even with the advances of perioperative management and surgical techniques, the outcomes of lung transplantation remain inferior to other solid organ transplantations, in part due to the high occurrence of primary graft dysfunction (PGD) which occurs in up to 30–50 % of lung transplant recipients. Ischemia-reperfusion injury (IRI) is one of the main causes of PGD. Neutrophils play an important role in the mechanism of IRI. Recent studies showed that neutrophil extracellular traps (NETs) also play an important role in development of PGD. There are also some studies about the innovative devices which can remove NETs and pathogenic cytokines. In this review, we discuss the effects of a leukocyte-depleting filter, NETs disruption with Deoxyribonuclease, NETs removal with filter (NucleoCapture), cytokine adsorption filter (CytoSorb), and neutrophil elastase inhibitor for the prevention of PGD. All of these techniques have been studied mainly in animal lung transplant models or ex vivo lung perfusion models, and have shown to have a potential to prevent PGD after clinical lung transplantation. However, clinical trials are needed to critically assess these novel therapies.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 2","pages":"Article 100989"},"PeriodicalIF":3.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative unfractionated heparin (UFH) for kidney transplantation: A systematic review and meta-analysis","authors":"Animesh Singla ,&nbsp;Shirley Cai ,&nbsp;Ahmer Hameed ,&nbsp;Henry Pleass ,&nbsp;Tess Cooper ,&nbsp;Melanie Wyld ,&nbsp;Angela C. Webster","doi":"10.1016/j.trre.2025.100985","DOIUrl":"10.1016/j.trre.2025.100985","url":null,"abstract":"<div><h3>Introduction</h3><div>Balancing bleeding risk with graft thrombosis is a challenge in transplantation surgery. This systematic review assessed the efficacy and safety of intraoperative administration of intravenous (IV) unfractionated heparin (UFH) bolus during adult kidney transplantation.</div></div><div><h3>Methodology</h3><div>We searched MEDLINE, Embase, and CENTRAL (from inception to May 2025) for comparative studies of any design recruiting adults undergoing living or deceased donor kidney transplantation (PROSPERO CRD42023391473), that examined intraoperative IV UFH as a perioperative intervention. Study quality was assessed using the Newcastle Ottawa Scale. Outcomes: Graft thrombosis (including subgroup analysis of arterial thromboses), bleeding complications, delayed graft function, and transplant nephrectomy. Relative and absolute effects were synthesised using a random-effects model as risk ratio (RR) with 95 % confidence intervals (CI). Certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.</div></div><div><h3>Results</h3><div>Three retrospective cohort studies (1989 participants) met inclusion criteria. Study quality was rated as ‘fair’ in two studies and ‘good’ in one study. There was no difference for graft thrombosis with intraoperative IV UFH (3 studies, 1989 participants, RR 1.02, 95 % CI 0.49–2.12, I² = 0 %, very low certainty evidence). Sub-group analysis also did not identify any difference for arterial thrombosis risk. Nearly all graft thromboses (17/23) resulted in transplant nephrectomy. IV UFH did not increase bleeding complications (3 studies, 1989 participants, RR 1.29, 95 % CI 0.78–2.13, I² 68 %, very low certainty evidence). There was no difference in delayed graft function (2 studies, 461 participants, RR = 0.95, 95 % CI 0.57 to 1.58, I² = 40 %, very low certainty evidence).</div></div><div><h3>Conclusion</h3><div>Despite its common use in clinical practice, evidence supporting intraoperative IV UFH during kidney transplant surgery is sparce and of very low certainty. Current evidence does not demonstrate a reduction in graft thrombosis or delayed graft function demonstrated with intraoperative IV UFH, nor a clear increase in bleeding complications. High-quality prospective studies are needed to clarify the net clinical benefit of intraoperative UFH in kidney transplant surgery.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 1","pages":"Article 100985"},"PeriodicalIF":3.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History and challenges of multi-organ allocation in the United States: A systematic review","authors":"Maggie Cheng ,&nbsp;Steven Cao Tri Huynh ,&nbsp;Reid Dale ,&nbsp;Maria Elizabeth Currie","doi":"10.1016/j.trre.2025.100988","DOIUrl":"10.1016/j.trre.2025.100988","url":null,"abstract":"<div><div>Current multi-organ candidates are prioritized primarily based on single-organ risk scores. Once the primary organ is allocated, the secondary organ follows to the same recipient, resulting in waitlisted single-organ candidates being skipped in allocation.</div><div>Our previous work examined the ethical and statistical alignment of single-organ risk scores. Here, we aim to extend our analysis to multi-organ transplantation policies in the United States, surveying the current state of multi-organ candidate prioritization and the challenges of conducting high-quality research in multi-organ transplantation.</div><div>We systematically searched PubMed for published literature on the allocation of all multi-organ pairs involving the liver, kidney, lungs, and heart. After screening based on our inclusion and exclusion criteria, we identified 126 articles to include in this review. These include 31 articles for Heart-Lung, 24 for Heart-Kidney, 52 for Liver-Kidney, and 19 for Liver-Heart transplantation. We did not discuss the remaining organ pairs due to insufficient literature to provide a balanced analysis.</div><div>Provider-, center-, and region-dependent variations exist in multi-organ practices due to evolving national guidelines and a lack of standardized institutional protocols for candidate evaluation and listing. The use of single-organ risk scores in multi-organ allocation has not been statistically validated, therefore raising concerns about applicability.</div><div>Multi-organ transplant research relies heavily on single-center reports, case studies, and registry-based analyses. The frequent re-use of national registry data limits the novelty and reliability of multi-organ research. We encourage future efforts to consider exploratory, prospective, and perhaps randomized-controlled trials to advance understanding and strengthen the evidence base in multi-organ transplantation.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 1","pages":"Article 100988"},"PeriodicalIF":3.6,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the timing of organ procurement from donors after brainstem death: Impact on outcomes in abdominal organ transplantation – A systematic review","authors":"Nikolaos Koliakos ,&nbsp;Phong A. Tran ,&nbsp;Dimitrios Papakonstantinou ,&nbsp;Nikolaos Machairas ,&nbsp;Hung N. Dang ,&nbsp;Georgios C. Sotiropoulos ,&nbsp;Dimitrios Schizas ,&nbsp;Valerio Lucidi","doi":"10.1016/j.trre.2025.100987","DOIUrl":"10.1016/j.trre.2025.100987","url":null,"abstract":"<div><div>Organ transplantation remains the gold-standard treatment for end-stage organ failure, with brain-dead donors being the primary source of transplantable organs. The timing of organ procurement—particularly the interval between brain death declaration and cold perfusion—has emerged as a critical factor influencing graft outcomes. This systematic review synthesizes evidence on the impact of procurement timing on liver, pancreas, and kidney transplantation outcomes. A comprehensive literature search identified six studies (196,389 patients) meeting inclusion criteria. For patients undergoing liver transplantation, longer procurement intervals (median 34.6 vs. 10.5 h) were associated with improved graft survival and reduced acute rejection. In patients undergoing pancreas transplantation, each 10-h delay correlated with a 5.6 % reduction in graft loss and a 6.3 % lower rejection risk. Studies looking into outcomes after kidney transplantation demonstrated that extended intervals (&gt;20 h) reduced delayed graft function (DGF) in younger donors and improved long-term graft survival, without increasing rejection rates. Contrary to traditional beliefs, prolonged procurement intervals did not harm abdominal organ viability and, in some cases, enhanced outcomes, likely due to improved donor stabilization and reduced inflammatory injury. These findings suggest that transplant teams can adopt more flexible procurement timelines while maintaining graft quality. However, study heterogeneity and limited data warrant further research to refine optimal timing strategies. This review supports a paradigm shift toward individualized, organ-specific procurement protocols to maximize transplantation success.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 1","pages":"Article 100987"},"PeriodicalIF":3.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of natural killer cells in the immune response after liver transplantation","authors":"Zhi-Cheng Gao ,&nbsp;Hui Wan ,&nbsp;Guan-Yue Shan ,&nbsp;Yu-Xin Zhang ,&nbsp;Zi-Jun Sun ,&nbsp;Yun-Peng Shi ,&nbsp;Hai-Jun Li","doi":"10.1016/j.trre.2025.100986","DOIUrl":"10.1016/j.trre.2025.100986","url":null,"abstract":"<div><div>Natural killer (NK) cells are crucial components of the innate immune system and are abundantly present in the liver, a unique immune organ frequently subjected to clinical transplantation. NK cells regulate their functional state through a finely tuned balance between activating and inhibitory receptors, allowing them to eliminate target cells independently of major histocompatibility complex class I (MHC-I) restriction. In the context of liver transplantation, NK cells respond dynamically to ischemia-reperfusion injury, donor-recipient immune mismatch and immunosuppressive treatments, thereby influencing graft acceptance, rejection and infection control. Activated NK cells release a broad range of cytokines and chemokines, shaping both innate and adaptive immune responses. This review highlights the multifaceted roles of NK cells in transplant immunity, emphasizes their clinical and translational significance, and summarizes emerging therapeutic strategies that target NK cells. Collectively, it provides insights into NK cell biology and underscores their potential in improving long-term outcomes after liver transplantation.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 1","pages":"Article 100986"},"PeriodicalIF":3.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global epidemiology and determinants of autoimmune hepatitis recurrence post- liver transplantation: A systematic review and meta-analysis","authors":"Wellgner Fernandes Oliveira Amador ,&nbsp;Isabelle Castro Vitor ,&nbsp;Milena Ramos Tomé ,&nbsp;Igor Boechat Silveira ,&nbsp;Marina de Assis Bezerra Cavalcanti Leite ,&nbsp;Pedro Robson Costa Passos ,&nbsp;Valbert Oliveira Costa Filho ,&nbsp;Mariana Macambira Noronha ,&nbsp;Yohanna Idsabella Rossi ,&nbsp;Rodrigo Vieira Motta ,&nbsp;Guilherme Grossi Lopes Cançado","doi":"10.1016/j.trre.2025.100984","DOIUrl":"10.1016/j.trre.2025.100984","url":null,"abstract":"<div><div>Autoimmune hepatitis (AIH) recurrence after liver transplantation (LT) compromises graft function and outcomes. Evidence on risk factors is heterogeneous. We assessed recurrence rates and patient-, immunological-, clinical-, and donor-related predictors. A systematic review and meta-analysis of observational studies of LT recipients with AIH was conducted. PubMed, Embase, and CENTRAL were searched. Outcomes were recurrence incidence and associated risk factors. Random-effects models were fitted in R, with pooled proportions, odds ratios (ORs), and mean differences (MDs). Thirty-nine studies (<em>n</em> = 2600) met inclusion criteria. The pooled recurrence proportion was 21 % (95 %CI, 18 to 25 %). Recurrence was more frequent in children than adults (31 % vs 21 %; p-interaction = 0.03). Younger age was associated with recurrence (MD, −6.60 years; 95 %CI, −11.43 to −1.76). Acute rejection (OR, 1.92; 95 %CI, 1.11 to 3.31) and chronic rejection (OR, 2.64; 95 %CI, 0.99 to 6.99) were significant predictors. No significant associations were observed for sex, MELD score, AIH subtype, HLA-DR3/DR4 status, primary calcineurin inhibitor (tacrolimus vs cyclosporine), or donor type. Overall, one in five LT recipients with AIH experience recurrence, with a higher burden in pediatric and younger patients. Younger age and prior acute or chronic rejection confer the greatest risk. Targeted monitoring and tailored immunosuppression may help mitigate recurrence.</div></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"40 1","pages":"Article 100984"},"PeriodicalIF":3.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}