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American Journal of Transplantation: Volume 22, Number 12, December 2022
doi : 10.1111/ajt.16686
American Journal of Transplantation: Volume 22, Number 12, December 2022
On the cover: This final issue of 2022 centers on cellular therapeutics in transplantation. Hirai and colleagues (page 3061) engineer a strategy to neutralize the negative impact of calcineurin inhibitors on regulatory T cell (Treg) number and function. In a mouse model, administration of mutant IL-2 after transfer of Tregs bearing a mutant IL-2 receptor selectively stimulated transduced Tregs and resulted in heart allograft tolerance.
AJT Digest for Patients: Their Own Window into Key Research
Lara C. Pullen PHD
doi : 10.1111/ajt.16683
In this month's installment of “The AJT Report,� we announce the launch of The AJT Digest for Patients, our new source of research information curated and designed specifically for transplant recipients. We also report on positive news concerning the use of living unrelated donor kidneys for pediatric kidney transplants.
RASA2 a new gatekeeper for TCR signaling
A. Connor MD, Xian C. Li MD, PHD
doi : 10.1111/ajt.16684
RASA2 is a new checkpoint inhibitor suppressing T cell activation and promoting T cell exhaustion.
Pure laparoscopic or robotic liver transplantation: Feel the movement?
Suk Kyun Hong, Kyung-Suk Suh
doi : 10.1111/ajt.17185
This editorial examines minimally invasive liver transplantation and discusses its future. See Dokmak et al (page 3069).
Humans versus machines: Who learns faster? Editorial regarding: “Machine learning-supported interpretation of kidney graft elementary lesions in combination with clinical data�
Michael Mengel
doi : 10.1111/ajt.17211
Strictly following rules is difficult, especially for independently thinking humans, because sometimes the rules just do not make sense! I conducted a survey as part of the 2007 Banff meeting (unpublished data) in preparation to start the discussion for including the total i and i-IFTA score (total and inflammation in areas of interstitial fibrosis and tubular atrophy) into the Banff classification.
Tracheal replacement: A never–ending search
Erino A. Rendina, G. Alexander Patterson
doi : 10.1111/ajt.17179
Based on their more than 25-year experience in tissue regeneration with preclinical and first-in-human trials, Martinod and colleagues report the results of the prospective, single-institution study of airway replacement to reconstruct long-segment defects of the trachea and central bronchi by stented cryopreserved aortic matrices.1
The current status of stem cell-based therapies during ex vivo graft perfusion: An integrated review of four organs
Stefan H. Luijmes, Monique M. A. Verstegen, Martin J. Hoogduijn, Leonard Seghers, Robert C. Minnee, Edris A. F. Mahtab, Yannick J. H. J. Taverne, Marlies E. J. Reinders, Luc J. W. van der Laan, Jeroen de Jonge
doi : 10.1111/ajt.17161
The use of extended criteria donor grafts is a promising strategy to increase the number of organ transplantations and reduce waitlist mortality.
Management of cardiac diseases in liver transplant recipients: Comprehensive review and multidisciplinary practice-based recommendations
Manhal Izzy, Brett E. Fortune, Marina Serper, Nicole Bhave, Andrew deLemos, Juan F. Gallegos-Orozco, Cesar Guerrero-Miranda, Shelley Hall, Matthew E. Harinstein, Maria G. Karas, Michael Kriss, Nicholas Lim, Maryse Palardy, Deirdre Sawinski, Emily Schonfeld, Anil Seetharam, Pratima Sharma, Jose Tallaj, Darshana M. Dadhania, Lisa B. VanWagner
doi : 10.1111/ajt.17049
Cardiac diseases are one of the most common causes of morbidity and mortality following liver transplantation (LT). Prior studies have shown that cardiac diseases affect close to one-third of liver transplant recipients (LTRs) long term and that their incidence has been on the rise. This rise is expected to continue as more patients with advanced age and/or non-alcoholic steatohepatitis undergo LT.
Practice and challenges for organ donation after medical assistance in dying: A scoping review including the results of the first international roundtable in 2021
Johannes Mulder, Hans Sonneveld, Dirk Van Raemdonck, James Downar, Kim Wiebe, Beatriz DomÃnguez-Gil, Andrew Healey, Bruno Desschans, Arne Neyrinck, Alicia Pérez Blanco, Ingeborg van Dusseldorp, Gert Olthuis
doi : 10.1111/ajt.17198
The procedure combining medical assistance in dying (MAiD) with donations after circulatory determination of death (DCDD) is known as organ donation after euthanasia (ODE). The first international roundtable on ODE was held during the 2021 WONCA family medicine conference as part of a scoping review.
The 21st Century Cures Act and psychosocial electronic documentation in solid organ transplantation: Potential harms and practical strategies
Gerald Scott Winder, Erin G. Clifton
doi : 10.1111/ajt.17153
Recent health system initiatives and government legislation have enhanced electronic health information (EHI) sharing in the healthcare technology environment. These measures are favorably viewed by most patients and clinicians.
Emerging technologies and ethics�exogenic chimeric humanized organs
Mary G. Garry, Arthur L. Caplan, Daniel J. Garry
doi : 10.1111/ajt.17188
Organ transplantation is limited due to the scarcity of donor organs. In order to expand the supply of organs for transplantation, interspecies chimeras have been examined as a potential future source of humanized organs. Recent studies using gene editing technologies in combination with somatic cell nuclear transfer technology and hiPSCs successfully engineered humanized skeletal muscle in the porcine embryo. As these technologies progress, there are ethical issues that warrant consideration and dialogue.
De novo SIX2 activation in human kidneys treated with neonatal kidney stem/progenitor cells
Fanny Oliveira Arcolino, Sarah Hosgood, Sara Akalay, Nina Jordan, Jean Herman, Tegwen Elliott, Koenraad Veys, Kurt Vermeire, Ben Sprangers, Michael Nicholson, Lambertus van den Heuvel, Elena Levtchenko
doi : 10.1111/ajt.17164
During development, nephron structures are derived from a SIX2+ stem cell population. After 36 weeks of gestation, these cells are exhausted, and no new nephrons are formed. We have previously described a non-invasive strategy to isolate and expand the native SIX2+ kidney stem cells from the urine of preterm neonates, named neonatal kidney stem/progenitor cells (nKSPC).
Humanized anti-IL-26 monoclonal antibody as a novel targeted therapy for chronic graft-versus-host disease
Ryo Hatano, Takumi Itoh, Haruna Otsuka, Harumi Saeki, Ayako Yamamoto, Dan Song, Yuki Shirakawa, Satoshi Iyama, Tsutomu Sato, Noriaki Iwao, Norihiro Harada, Thomas M. Aune, Nam H. Dang, Yutaro Kaneko, Taketo Yamada, Chikao Morimoto, Kei Ohnuma
doi : 10.1111/ajt.17178
IL-26 is a Th17 cytokine, with its gene being absent in rodents. To characterize the in vivo immunological effects of IL-26 in chronic systemic inflammation, we used human IL26 transgenic (hIL-26Tg) mice and human umbilical cord blood mononuclear cells (hCBMC) in mouse allogeneic-graft-versus-host disease (GVHD) and chronic xenogeneic-GVHD model, respectively.
Machine learning-supported interpretation of kidney graft elementary lesions in combination with clinical data
Marc Labriffe, Jean-Baptiste Woillard, Wilfried Gwinner, Jan-Hinrich Braesen, Dany Anglicheau, Marion Rabant, Priyanka Koshy, Maarten Naesens, Pierre Marquet
doi : 10.1111/ajt.17192
Interpretation of kidney graft biopsies using the Banff classification is still heterogeneous. In this study, extreme gradient boosting classifiers learned from two large training datasets (n = 631 and 304 cases) where the “reference diagnosesâ€� were not strictly defined following the Banff rules but from central reading by expert pathologists and further interpreted consensually by experienced transplant nephrologists, in light of the clinical context.
Maximizing the use of potential donors through increased rates of family approach for authorization
Macey L. Levan, Allan B. Massie, Chad Trahan, Jonathan Hewlett, Tyler Strout, Samantha B. Klitenic, Karen B. Vanterpool, Dorry L. Segev, Bradley L. Adams, Patricia Niles
doi : 10.1111/ajt.17194
In the United States, a small proportion of potential deceased organ donor referrals lead to donation and recovery. Understanding variation in the processes involved between organ procurement organizations (OPOs) may help increase deceased donation and reduce the organ shortage.
Influence of organ quality on the observed association between deceased donor kidney procurement biopsy findings and graft survival
S. Ali Husain, Kristen L. King, David C. Cron, Krista L. Lentine, Joel T. Adler, Sumit Mohan
doi : 10.1111/ajt.17167
Deceased donor kidney procurement biopsies findings are the most common reason for kidney discard. Retrospective studies have found inconsistent associations with post-transplant outcomes but may have been limited by selection bias because kidneys with advanced nephrosclerosis from high-risk donors are typically discarded.
The new French kidney allocation system for donations after brain death: Rationale, implementation, and evaluation
Benoit Audry, Emilie Savoye, Myriam Pastural, Florian Bayer, Camille Legeai, Marie-Alice Macher, François Kerbaul, Christian Jacquelinet
doi : 10.1111/ajt.17180
In recent decades, the allocation policies of many countries have moved from center-based to patient-based approaches. The new French kidney allocation system (KAS) of donations after brain death for adult recipients, implemented in 2015, was principally designed to introduce a unified allocation score (UAS) to be applied locally for one kidney and nationally for the other and to replace regional borders by a new geographical model.
Scandiatransplant acceptable mismatch program�10 years with an effective strategy for transplanting highly sensitized patients
Ilse Weinreich, Mats Bengtsson, Jouni Lauronen, Christian Naper, Kaie Lokk, Ilkka Helanterä, Margrét Birna Andrésdóttir, Søren Schwartz Sørensen, Lars Wennberg, Anna Varberg Reisæter, Bjarne Møller, Pernille Koefoed-Nielsen
doi : 10.1111/ajt.17182
In March 2009, the Scandiatransplant acceptable mismatch program (STAMP) was introduced as a strategy toward improving kidney allocation to highly sensitized patients. Patients with a transplantability score ≤ 2% are potential candidates for the program.
Criteria for prediabetes and posttransplant diabetes mellitus after kidney transplantation: A 2-year diagnostic accuracy study of participants from a randomized controlled trial
Amelie Kurnikowski, Espen Nordheim, Elisabeth Schwaiger, Simon Krenn, Jürgen Harreiter, Alexandra Kautzky-Willer, Michael Leutner, Johannes Werzowa, Andrea Tura, Klemens Budde, Kathrin Eller, Julio Pascual, Michael Krebs, Trond Geir Jenssen, Manfred Hecking
doi : 10.1111/ajt.17187
Posttransplant diabetes mellitus (PTDM) and prediabetes (impaired glucose tolerance [IGT] and impaired fasting glucose [IFG]) are associated with cardiovascular events. We assessed the diagnostic performance of fasting plasma glucose (FPG) and HbA1c as alternatives to oral glucose tolerance test (OGTT)-derived 2-hour plasma glucose (2hPG) using sensitivity and specificity in 263 kidney transplant recipients (KTRs) from a clinical trial.
Delirium, changes in cognitive function, and risk of diagnosed dementia after kidney transplantation
Nadia M. Chu, Sunjae Bae, Xiaomeng Chen, Jessica Ruck, Alden L. Gross, Marilyn Albert, Karin J. Neufeld, Dorry L. Segev, Mara A. McAdams-DeMarco
doi : 10.1111/ajt.17176
Kidney transplant (KT) recipients with delirium, a preventable surgical complication, are likely to reap cognitive benefits from restored kidney function, but may be more vulnerable to longer-term neurotoxic stressors post-KT (i.e., aging, immunosuppression). In this prospective cohort study, we measured delirium (chart-based), global cognitive function (3MS), and executive function (Trail Making Test Part B minus Part A) in 894 recipients (2009–2021) at KT, 1/3/6-months, 1-year, and annually post-KT.
Comparative outcomes for over 100 deceased donor kidney transplants from SARS-CoV-2 positive donors: A single-center experience
Christine E. Koval, Mohamed Eltemamy, Emilio D. Poggio, Jesse D. Schold, Alvin C. Wee
doi : 10.1111/ajt.17203
Emerging data support the safety of transplantation of extra-pulmonary organs from donors with SARS-CoV-2-detection. Our center offered kidney transplantation (KT) from deceased donors (DD) with SARS-CoV-2 with and without COVID-19 as a cause of death (CoV + COD and CoV+) to consenting candidates. No pre-emptive antiviral therapies were given.
Awarding additional MELD points to the shortest waitlist candidates improves sex disparity in access to liver transplant in the United States
Sarah Bernards, Eric Lee, Ngai Leung, Mustafa Akan, Kyra Gan, Huan Zhao, Monika Sarkar, Sridhar Tayur, Neil Mehta
doi : 10.1111/ajt.17159
Since the introduction of the MELD-based allocation system, women are now 30% less likely than men to undergo liver transplant (LT) and have 20% higher waitlist mortality. These disparities are in large part due to height differences in men and women though no national policies have been implemented to reduce sex disparities.
Assessment of donor quality and risk of graft failure after liver transplantation: The ID2EAL score
Sumeet K. Asrani, Giovanna Saracino, Anji Wall, James F. Trotter, Giuliano Testa, Ruben Hernaez, Pratima Sharma, Allison Kwong, Srikanta Banerjee, Gregory McKenna
doi : 10.1111/ajt.17191
Accurate assessment of donor quality at the time of organ offer for liver transplantation candidates may be inadequately captured by the donor risk index (DRI). We sought to develop and validate a novel objective and simple model to assess donor risk using donor level variables available at the time of organ offer.
UNOS policy change benefits high-priority patients without harming those at low priority
Aaron M. Wolfson, Eugene C. DePasquale, Michael W. Fong, Kruti Pandya, Leon Zhou, Eric S. Kawaguchi, Sunu S. Thomas, Ajay S. Vaidya
doi : 10.1111/ajt.17173
The heart transplantation policy change (PC) has improved outcomes in high-acuity (Old 1A, New 1–3) patients, but the effect on low-priority (Old 1B/2, New 4–6) patients is unknown. We sought to determine if low-priority patient outcomes were compromised by benefits to high-priority patients by evaluating for interaction between PC and priority status (PS). We included adult first-time heart transplant candidates and recipients from the UNOS registry during a 19-month period before and after the PC.
Characteristics and outcomes of heart transplant recipients with a pretransplant history of malignancy
Jong-Chan Youn, Darae Kim, Kyung An Kim, Jin-Jin Kim, In-Cheol Kim, Hye Sun Lee, Jin-Oh Choi, Eun-Seok Jeon, Keith Nishihara, Evan P. Kransdorf, David H. Chang, Michelle M. Kittleson, Jignesh K. Patel, Danny Ramzy, Fardad Esmailian, Jon A. Kobashigawa
doi : 10.1111/ajt.17186
We aimed to investigate the characteristics and outcomes of HTx recipients with a history of pretransplant malignancy (PTM). Among 1062 HTx recipients between 1997 and 2013, 73 (7.1%) patients had PTMs (77 cancer cases). We analyzed post-HTx outcome, recurrence of PTM, and development of de novo malignancies.
Long-term follow-up of acute and chronic rejection in heart transplant recipients from hepatitis C viremic (NAT+) donors
Maxine W. Stachel, Marjan Alimi, Navneet Narula, Erin E. Flattery, Yuhe Xia, Abhinay Ramachandran, Tajinderpal Saraon, Deane Smith, Alex Reyentovich, Randal Goldberg, Bernard S. Kadosh, Louai Razzouk, Stuart Katz, Nader Moazami, Claudia G. Gidea
doi : 10.1111/ajt.17190
The long-term safety of heart transplants from hepatitis C viremic (NAT+) donors remains uncertain. We conducted a prospective study of all patients who underwent heart transplantation at our center from January 2018 through August 2020. Routine testing was performed to assess for donor-derived cell-free DNA, acute cellular rejection (ACR), antibody-mediated rejection (AMR), and cardiac allograft vasculopathy (CAV). Allograft dysfunction and mortality were also monitored.
Airway replacement using stented aortic matrices: Long-term follow-up and results of the TRITON-01 study in 35 adult patients
Emmanuel Martinod, Dana M. Radu, Ilaria Onorati, Ana Maria Santos Portela, Marine Peretti, Patrice Guiraudet, Marie-Dominique Destable, Yurdagül Uzunhan, Olivia Freynet, Kader Chouahnia, Boris Duchemann, Jamal Kabbani, Cyril Maurer, Pierre-Yves Brillet, Léa Fath, Esteban Brenet, Christian Debry, Camille Buffet, Laurence Leenhardt, Dominique Clero, Nicolas Julien, Nicolas Vénissac, François Tronc, Hervé Dutau, Charles-Hugo Marquette, Charles Juvin, Guillaume Lebreton, Yves Cohen, Elie Zogheib, Sadek Beloucif, Carole Planès, Christophe Trésallet, Morad Bensidhoum, Hervé Petite, Hélène Rouard, Makoto Miyara, Eric Vicaut
doi : 10.1111/ajt.17137
Over the past 25 years, we have demonstrated the feasibility of airway bioengineering using stented aortic matrices experimentally then in a first-in-human trial (n = 13). The present TRITON-01 study analyzed all the patients who had airway replacement at our center to confirm that this innovative approach can be now used as usual care.
Expected effect of the lung Composite Allocation Score system on US lung transplantation
Maryam Valapour, Carli J. Lehr, Andrew Wey, Melissa A. Skeans, Jonathan Miller, Erika D. Lease
doi : 10.1111/ajt.17160
Efforts are underway to transition the current lung allocation system to a continuous distribution framework whereby multiple factors are simultaneously combined into a Composite Allocation Score (CAS) to prioritize candidates for lung transplant.
Place-based heterogeneity in lung transplant recipient outcomes
Wayne M. Tsuang, Rocio Lopez, Anne Tang, Marie Budev, Jesse D. Schold
doi : 10.1111/ajt.17170
Place is defined as a social or environmental area of residence with meaning to a patient. We hypothesize there is an association between place and the clinical outcomes of lung transplant recipients in the United States. In a retrospective cohort study of transplants between January 1, 2010, and December 31, 2019, in the Scientific Registry of Transplant Recipients, multivariable Cox regression models were used to test the association between place (through social and environmental factors) with readmission, lung rejection, and survival.
Lung transplantation for interstitial lung disease in idiopathic inflammatory myositis: A cohort study
Amélie Rivière, Clément Picard, Cristina Berastegui, Victor Manuel Mora, Vincent Bunel, Laurent Godinas, Elena Salvaterra, Valeria Rossetti, Laurent Savale, Dominique Israel-Biet, Xavier Demant, Julien Bermudez, Federica Meloni, Peter Jaksch, Jesper Magnusson, Laurence Beaumont, Michael Perch, Jean-François Mornex, Christiane Knoop, John-David Aubert, Baptiste Hervier, Hilario Nunes, Marc Humbert, Jens Gottlieb, Yurdagul Uzunhan, Jérôme Le Pavec
doi : 10.1111/ajt.17177
In patients with interstitial lung disease (ILD) complicating classical or amyopathic idiopathic inflammatory myopathy (IIM), lung transplantation outcomes might be affected by the disease and treatments. Here, our objective was to assess survival and prognostic factors in lung transplant recipients with IIM-ILD.
Prognostic implications of and clinical risk factors for acute lung injury and organizing pneumonia after lung transplantation: Data from a multicenter prospective cohort study
Elizabeth N. Pavlisko, Megan L. Neely, Heather Kopetskie, David M. Hwang, Carol F. Farver, W. Dean Wallace, Andrea Arrossi, Peter Illei, Michelle L. Sever, Jerry Kirchner, Courtney W. Frankel, Laurie D. Snyder, Tereza Martinu, Michael Y. Shino, Lorenzo Zaffiri, Nikki Williams, Mark A. Robien, Lianne G. Singer, Marie Budev, Wayne Tsuang, Pali D. Shah, John M. Reynolds, S. Sam Weigt, John A. Belperio, Scott M. Palmer, Jamie L. Todd
doi : 10.1111/ajt.17183
We determined prognostic implications of acute lung injury (ALI) and organizing pneumonia (OP), including timing relative to transplantation, in a multicenter lung recipient cohort. We sought to understand clinical risks that contribute to development of ALI/OP.
Antiviral toxicities in pediatric solid organ transplant recipients
Molly Hayes, Craig L. K. Boge, Anna Sharova, Daniel Vader, Marina Mitrou, Despoina M. Galetaki, Yun Li, Kevin J. Downes
doi : 10.1111/ajt.17171
Prophylaxis with valganciclovir (VGCV) is used routinely to prevent cytomegalovirus (CMV) infections in at-risk pediatric solid organ transplant (SOT) recipients. However, the rate and factors associated with toxicities in this population are not well-described. We conducted a retrospective cohort study of children undergoing SOT at our hospital from January 2012–June 2018.
Epidemiology of surgical site infections after solid organ transplants in the period 2015–2019: A single-center retrospective cohort study
Manuela Carugati, Sana Arif, Debra Lynn Sudan, Bradley Henry Collins, John Carroll Haney, Jacob Niall Schroder, John Michael Reynolds, Sarah Stamps Lewis, Michael Edwards Yarrington, Rachel Ann Miller, Barbara Dudley Alexander
doi : 10.1111/ajt.17189
Surgical site infections (SSI) are severe complications of solid organ transplant (SOT). This retrospective study assessed the epidemiology of and outcomes associated with invasive primary SSI (IP-SSI) occurring within 3 months of transplantation in adult SOT recipients at Duke University over a 5-year period (2015–2019).
Epidemiology and outcomes of bone and joint infections in solid organ transplant recipients
Truong-Thanh Pham, Diego O. Andrey, Susanne Stampf, Sara H. Burkhard, Cédric Hirzel, Johnathan Tschopp, Kathrin Ullrich, Carol Strahm, Peter W. Schreiber, Noémie Boillat-Blanco, Christian Garzoni, Nina Khanna, Oriol Manuel, Nicolas J. Mueller, Domizio Suva, Christian van Delden, Ilker Uçkay, Dionysios Neofytos, the Swiss Transplant Cohort Study
doi : 10.1111/ajt.17184
Bone and joint infection (BJI) epidemiology and outcomes in solid organ transplant recipients (SOTr) remain largely unknown. We aim to describe BJI in a multi-center cohort of SOTr (Swiss Transplant Cohort Study). All consecutive SOTr with BJI (01.05.2008–31.12.2019) were included. A nested case–control study to identify risk factors for BJI was performed.
Pediatric solid organ transplant recipients demonstrate robust cell-mediated and humoral responses to three doses of mRNA SARS-CoV-2 vaccine
Julia S. Bratic, Hayley A. Gans, Sharon F. Chen, Niaz Banaei, Erica M. Johnston, Katherine Sear, Sarah Samreth, Sruti S. Nadimpalli
doi : 10.1111/ajt.17195
Pediatric solid organ transplant recipients (pSOTR) often demonstrate suboptimal vaccine responses and are not included in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine efficacy trials.
Short- and long-term complications after living donor ileal resection
Guosheng Wu, Chaoxu Liu, Xile Zhou, Long Zhao, Wentong Zhang, Mian Wang, Qingchuan Zhao, Tingbo Liang
doi : 10.1111/ajt.17193
Intestinal transplantation from deceased donors is the established procedure for patients with irreversible intestinal failure. However, a living-donor intestinal transplant has not been routinely performed yet because of undefined surgical risks to the donor. In this report, we reviewed our experience with living-donor ileal resection from May 1999 to December 2021.
IL-2 receptor engineering enhances regulatory T cell function suppressed by calcineurin inhibitor
Toshihito Hirai, Po-Yu Lin, Teresa L. Ramos, Federico Simonetta, Leon L. Su, Lora K. Picton, Jeanette Baker, Juliane K. Lohmeyer, K. Christopher Garcia, Robert S. Negrin
doi : 10.1111/ajt.17181
Clinical trials utilizing regulatory T cell (Treg) therapy in organ transplantation have shown promising results, however, the choice of a standard immunosuppressive regimen is still controversial. Calcineurin inhibitors (CNIs) are one of the most common immunosuppressants for organ transplantation, although they may negatively affect Tregs by inhibiting IL-2 production by conventional T cells.
Laparoscopic-assisted liver transplantation: A realistic perspective
Safi Dokmak, François Cauchy, Béatrice Aussilhou, Fédérica Dondero, Ailton Sepulveda, Olivier Roux, Claire Francoz, Olivia Hentic, Louis de Mestier, Philippe Levy, Philippe Ruszniewski, Maxime Ronot, Jérome Cros, Valérie Vilgrain, Valérie Paradis, Souhayl Dahmani, Emmanuel Weiss, Alain Sauvanet, François Durand, Mickael Lesurtel
doi : 10.1111/ajt.17118
Laparoscopic approach was rarely described in recipients for liver transplantation (LT). We report the feasibility and safety of laparoscopic-assisted LT (LA-LT) in patients with unresectable liver metastases of neuroendocrine tumors.
Clonal hematopoiesis confers an increased mortality risk in orthotopic heart transplant recipients
Fernando L. Scolari, Darshan H. Brahmbhatt, Sagi Abelson, Jessie J. F. Medeiros, Markus S. Anker, Nicole L. Fung, Madison Otsuki, Oscar Calvillo-Argüelles, Patrick R. Lawler, Heather J. Ross, Adriana C. Luk, Stefan Anker, John E. Dick, Filio Billia
doi : 10.1111/ajt.17172
Novel risk stratification and non-invasive surveillance methods are needed in orthotopic heart transplant (OHT) to reduce morbidity and mortality post-transplant. Clonal hematopoiesis (CH) refers to the acquisition of specific gene mutations in hematopoietic stem cells linked to enhanced inflammation and worse cardiovascular outcomes.
Deceased donor kidneys are discarded at higher rates when labeled as high kidney donor profile index
William Christian Crannell, James D. Perkins, Nicolae Leca, Catherine E. Kling
doi : 10.1111/ajt.17197
The kidney donor risk index (KDRI) and percentile conversion, kidney donor profile index (KDPI), provide a continuous measure of donor quality. Kidneys with a KDPI >85% (KDPI85) are referred to as “high KDPI.�
ABO-adjusted calculated panel reactive antibody (cPRA): A unified metric for immunologic compatibility in kidney transplantation
Loren Gragert, Matthew Kadatz, James Alcorn, Darren Stewart, Doris Chang, Jagbir Gill, Robert Liwski, Howard M. Gebel, John Gill, James H. Lan
doi : 10.1111/ajt.17175
Implementation of the kidney allocation system in 2014 greatly reduced access disparity due to human leukocyte antigen (HLA) sensitization. To address persistent disparity related to candidate ABO blood groups, herein we propose a novel metric termed “ABO-adjusted cPRA,� which simultaneously considers the impact of candidate HLA and ABO sensitization on the same scale.
A multi-institutional study of renal outcomes and renal-related pregnancy outcomes in uterus transplant recipients
Deirdre Sawinski, Liza Johannesson, Jakub Kristek, Jiri Fronek, Kathleen E. O'Neill, Anthony Gregg, Giuliano Testa, Paige M. Porrett
doi : 10.1111/ajt.17149
Uterus transplantation (UTx) is an effective treatment option for uterine factor infertility. However, the need for immunosuppression and congenital renal anomalies that coexist with uterine agenesis in about 30% of women with Mayer-Rokitansky-Kuster-Hauser syndrome create a risk for renal dysfunction.
Donor-derived acute myeloid leukemia in solid organ transplantation
Luigi Marchionni, Francisco Pereira Lobo, Rumen Kostadinov, Anna Serra, Federico Genzano Besso, Silvia Deaglio, Piero Stratta, Monica Berrino, Claudio Zanettini, Eddie Luidy Imada, Mohamed N. Omar, Gianluca Gaidano, Benedetto Bruno, Giuseppe Saglio, Antonio Amoroso
doi : 10.1111/ajt.17174
We report the transmission of acute myeloid leukemia (AML) undetected at donation from a deceased organ donor to two kidneys and one liver recipients. We reviewed the medical records, and performed molecular analyses and whole exome sequencing (WES) to ascertain AML donor origin and its molecular evolution.
Cerebral cortical activity after withdrawal of life-sustaining measures in critically ill patients
Teneille E. Gofton, Loretta Norton, Geoffrey Laforge, Raechelle Gibson, Derek Debicki, Eyad Althenayan, Nathan Scales, Amanda Van Beinum, Laura Hornby, Sam Shemie, Sonny Dhanani, Marat Slessarev
doi : 10.1111/ajt.17146
Establishing when cerebral cortical activity stops relative to circulatory arrest during the dying process will enhance trust in donation after circulatory determination of death. We used continuous electroencephalography and arterial blood pressure monitoring prior to withdrawal of life sustaining measures and for 30 min following circulatory arrest to explore the temporal relationship between cessation of cerebral cortical activity and circulatory arrest.
Tixagevimab/cilgavimab pre-exposure prophylaxis is associated with lower breakthrough infection risk in vaccinated solid organ transplant recipients during the omicron wave
Ayman Al Jurdi, Leela Morena, Mariesa Cote, Emily Bethea, Jamil Azzi, Leonardo V. Riella
doi : 10.1111/ajt.17128
The neutralizing monoclonal antibody combination of tixagevimab/cilgavimab has been shown to reduce the risk of SARS-CoV-2 infection in unvaccinated individuals during the Alpha (B.1.1.7) and Delta (B.1.617.2) waves.
mTOR inhibitors, mycophenolates, and other immunosuppression regimens on antibody response to SARS-CoV-2 mRNA vaccines in solid organ transplant recipients
Sunjae Bae, Jennifer L. Alejo, Teresa P. Y. Chiang, William A. Werbel, Aaron A. R. Tobian, Linda W. Moore, Ashrith Guha, Howard J. Huang, Richard J. Knight, A. Osama Gaber, R. Mark Ghobrial, Mara A. McAdams-DeMarco, Dorry L. Segev
doi : 10.1111/ajt.17158
A recent study concluded that SARS-CoV-2 mRNA vaccine responses were improved among transplant patients taking mTOR inhibitors (mTORi). This could have profound implications for vaccine strategies in transplant patients; however, limitations in the study design raise concerns about the conclusions.
First report of auxiliary liver transplantation for severe cholangiopathy after SARS-CoV-2 respiratory infection
Mohamed Rela, Muthukumarassamy Rajakannu, Fadl H. Veerankutty, Mukul Vij, Ashwin Rammohan
doi : 10.1111/ajt.17165
Post–coronavirus disease 2019 (COVID-19) cholangiopathy (PCC) is a new entity observed in patients recovering from severe COVID-19 pneumonia. Most patients recover with cholestasis improving over a period of time. In some patients, cholestasis is severe and persists or progresses to liver failure necessitating liver transplant.
Successful heart transplantation from donation after euthanasia with distant procurement using normothermic regional perfusion and cold storage
Vincent Tchana-Sato, Gregory Hans, Janne Brouckaert, Olivier Detry, Johan Van Cleemput, Steffen Rex, Oceane Jaquet, Erwin De Troy, Mai-Linh Nguyen Trung, Arnaud Ancion, Raf Van den Eynde, Isabelle Lievens, Marc Gilbert Lagny, Marie-Hélène Delbouille, Jean Olivier Defraigne, Didier Ledoux, Filip Rega
doi : 10.1111/ajt.17204
While euthanasia has been legalized in a growing number of countries, organ donation after euthanasia is only performed in Belgium, the Netherlands, Spain, and Canada. Moreover, the clinical practice of heart donation after euthanasia has never been reported before.
A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients
Marwan M. Azar, Sarah Turbett, David Gaston, Melissa Gitman, Raymund Razonable, Sophia Koo, Kimberly Hanson, Camille Kotton, Fernanda Silveira, David B. Banach, Sankha S. Basu, Archana Bhaskaran, Lara Danziger-Isakov, Jennifer Dien Bard, Ronak Gandhi, Benjamin Hanisch, Teny M. John, Audrey R. Odom John, Alyssa R. Letourneau, Me-Linh Luong, Gabriela Maron, Steve Miller, Andrea Prinzi, Ilan Schwartz, Patricia Simner, Deepali Kumar, Transplant ID Diagnostics Consensus Conference Working Group
doi : 10.1111/ajt.17147
The last decade has seen an explosion of advanced assays for the diagnosis of infectious diseases, yet evidence-based recommendations to inform their optimal use in the care of transplant recipients are lacking.
Influenza incidence and vaccine effectiveness during the Southern Hemisphere Influenza season�Chile, 2022
MarÃÂa Fernanda Olivares Barraza, Rodrigo A. Fasce, Francisco Nogareda, Perrine Marcenac, Natalia Vergara Mallegas, Patricia Bustos Alister, Sergio Loayza, Anna N. Chard, Carmen Sofia Arriola, Paula Couto, Christian GarcÃÂa Calavaro, Angel Rodriguez, David E. Wentworth, Cristóbal Cuadrado, Eduardo Azziz-Baumgartner
doi : 10.1111/ajt.16685
Quantitative assessment of portal jump graft inflow following liver transplantation using 4D flow MRI
Steven C. Kim, Alexandra C. Bolognese, Sylvana GarcÃa-RodrÃguez, David D. Aufhauser
doi : 10.1111/ajt.17205
Data carve out in the midst of the COVID-19 pandemic
Roslyn B. Mannon, Kiran K. Khush, Sumit Mohan, David M. Vock, Richard Knight, James Pittman, Christopher Zinner, Jeffrey P. Orlowski
doi : 10.1111/ajt.17132
Microvascular inflammation: Gene expression changes do not necessarily reflect pathogenesis
Maarten Naesens, Olivier Thaunat, Michael Mengel
doi : 10.1111/ajt.17136
Letter to the Editor Re: Letter by Naesens et al. Microvascular inflammation: Gene expression changes do not necessarily reflect pathogenesis
Philip F. Halloran, Katelynn S. Madill-Thomsen
doi : 10.1111/ajt.17169
The carbon footprint of organ acquisition in the United States
Anji E. Wall, Trevor Borries, Vikrant Reddy, Sumeet K. Asrani, Giuliano Testa, James Trotter
doi : 10.1111/ajt.17196
An initiative to increase organ donor registration among persons with HIV
Ghady Haidar, Divya Bhamidipati, Linda Despines, Colleen Sullivan, Susan Stuart, J. Michael Beckham, Deborah K. McMahon, Peter Veldkamp
doi : 10.1111/ajt.17157
De novo posttransplant membranous nephropathy following BNT162b2 mRNA COVID-19 vaccine in a kidney transplant recipient
Nathalie Chavarot, Michael Padden, Lucile Amrouche, Stéphanie Malard, Anne Scemla, Rebecca Sberro-Soussan, Juliette Léon, Christophe Legendre, Jean Paul Duong, Julien Zuber, Dany Anglicheau, Marion Rabant, Pierre Isnard
doi : 10.1111/ajt.17166
