Potential Implication of HLA-DQ Heterodimer High-Resolution Typing on Kidney Transplant Outcomes and Equity
AbstractPurpose of ReviewTo evaluate the potential implications of HLA-DQ αβ heterodimer high-resolution typing on clinical decision-making in solid organ transplantation.Recent FindingLack of HLA-DQ αβ heterodimer high-resolution typing information impacts cPRA calculations for patients on the waitlist and thus can affect their priority in organ allocation algorithms. It can further affect the number of potential compatible organ offers that they can receive.SummaryWe believe that the compiled data highlight the need for a thorough evaluation by the OPTN/UNOS, to assure equity for patients in need of organ transplanta...
Source: Current Transplantation Reports - August 19, 2023 Category: Transplant Surgery Source Type: research
Pregnancy in Living Kidney Donors: An Evidence-Based Review
AbstractPurpose of ReviewTo review the current studies and guidelines on the risk of adverse pregnancy outcomes in female kidney donors.Recent FindingsLiving kidney donors include a significant number of women of child-bearing age. Safety and possible risks of pregnancy after donation are a concern for female kidney donor candidates. Some studies indicate a higher risk of preeclampsia, gestational hypertension, and preterm birth in women after kidney donation. Considering the increasing prevalence of living kidney donors, maternal and fetal outcomes following living kidney donation are an active area of research.SummaryGui...
Source: Current Transplantation Reports - August 17, 2023 Category: Transplant Surgery Source Type: research
The Effects of Aging on Solid Organ Transplantation —Characteristics and Consequences of Immunosenescence
AbstractPurpose of reviewTo discuss how T, natural killer (NK), and B cell aging modifies outcomes of organ transplantation, the transplant recipient ’s efficacy to vaccines, susceptibility to reactivation of latent viral infections, as well as organ quality and function.Recent findingsThe aged immune system is characterized by a decline in na ïve T cells and an increase of memory T cells, many of which also express innate markers. NK cells demonstrate a decline in cytokine secretion, cytotoxicity, and immune recognition. A population of pro-inflammatory B lymphocytes termed age-associated B cells (ABCs) expands with ag...
Source: Current Transplantation Reports - August 4, 2023 Category: Transplant Surgery Source Type: research
Heart-Kidney Allocation Policy and Proposals Impact Equity of Access for Patients with End-Stage Kidney Disease
AbstractPurpose of ReviewTo summarize contemporary evidence describing the most appropriate candidates for simultaneous heart kidney transplantation (SHK), estimates of how SHK affects the entire transplantation system and implications of recently enacted SHK allocation policy on kidney transplantation.Recent FindingsSHK has benefits for both dialysis-dependent patients and non-dialysis-dependent patients with eGFRs up to approximately 40 mL/min/1.73 m2. Additionally, there is emerging data that patients with left ventricular assist devices may be inferior candidates for SHK. Recent modelling has also shown that multiorgan...
Source: Current Transplantation Reports - August 3, 2023 Category: Transplant Surgery Source Type: research
Novel Imaging Technologies for Accurate Assessment of Cardiac Allograft Performance
AbstractPurpose of the ReviewThe current lack of objective and quantitative assessment techniques to determine cardiac graft relative viability results in risk-averse decision-making, which negatively impact the utilization of cardiac grafts. The purpose of this review is to highlight the current deficiencies in cardiac allograft assessment before focusing on novel cardiac assessment techniques that exploit conventional and emerging imaging modalities, including ultrasound, magnetic resonance, and spectroscopy.Recent FindingsExtensive work is ongoing by the scientific community to identify improved objective metrics and to...
Source: Current Transplantation Reports - July 17, 2023 Category: Transplant Surgery Source Type: research
Adverse Cardiovascular Events in Post-Renal Transplant Patients, a Retrospective Study of Five Hundred Cases Over Twenty-Two Years
ConclusionRTR are at an extremely high risk of adverse CV events. CV complications (CHF, ischemic heart diseases, LVH, and arrhythmias) are the leading causes of death in RTR. (Source: Current Transplantation Reports)
Source: Current Transplantation Reports - July 3, 2023 Category: Transplant Surgery Source Type: research
The Functional Adaptability of Hyporesponsive T Cells and Its Impact on Transplant Outcomes
AbstractPurpose of ReviewThe functional adaptability of hyporesponsive T cells in precluding transplant acceptance is not well recognized. This review aims to highlight the impact of this mechanism on transplant outcomes and explore potential strategies to overcome this challenge.Recent FindingsHyporesponsive T cells exist in two major distinct states: anergy and exhaustion. In response to infection, alloreactive anergic T cells can differentiate into IFN- γ producing effector cells, leading to the abrogation of transplant acceptance. Depleting anergic T cells has been shown to promote transplant acceptance under infectio...
Source: Current Transplantation Reports - May 31, 2023 Category: Transplant Surgery Source Type: research
Engraftment of Kidney Organoids In Vivo
AbstractPurpose of ReviewKidney organoids are heterocellular structures grown in vitro that resemble nephrons. Organoids contain diverse cell types, including podocytes, proximal tubules, and distal tubules in contiguous segments, patterned along a proximal-to-distal axis. Human organoids are being explored for their potential as regenerative grafts, as an alternative to allograft transplants and hemodialysis. Earlier work, analyzing grafts of developing human kidney tissue and whole human embryonic kidney rudiments, serves as a baseline for organoid implantation experiments.Recent FindingsWhen transplanted into immunodefi...
Source: Current Transplantation Reports - April 25, 2023 Category: Transplant Surgery Source Type: research
Correction to: Secondary Hyperparathyroidism and Cognitive Decline
(Source: Current Transplantation Reports)
Source: Current Transplantation Reports - March 31, 2023 Category: Transplant Surgery Source Type: research
Prehabilitation in Adult Solid Organ Transplant Candidates
AbstractPurpose of ReviewTo highlight the importance of biological age in the context of prehabilitation and to present relevant research regarding prehabilitation prior to solid organ transplantation.Recent FindingsStudies on the effect of prehabilitation have been performed in kidney-, lung-, liver-, and heart transplant patient populations. Prior to kidney transplantation, exercise interventions have been shown to improve cardiopulmonary- and physical fitness and result in a decreased length of hospital stay postoperatively. Among lung transplant candidates, various methods of prehabilitation have been studied including...
Source: Current Transplantation Reports - March 25, 2023 Category: Transplant Surgery Source Type: research
Cellular Senescence and Frailty in Transplantation
AbstractPurpose of ReviewTo summarize the literature on cellular senescence and frailty in solid-organ transplantation and highlight the emerging role of senotherapeutics as a treatment for cellular senescence.Recent FindingsSolid-organ transplant patients are aging. Many factors contribute to aging acceleration in this population, including cellular senescence. Senescent cells accumulate in tissues and secrete proinflammatory and profibrotic proteins which result in tissue damage. Cellular senescence contributes to age-related diseases and frailty. Our understanding of the role cellular senescence plays in transplant-s...
Source: Current Transplantation Reports - March 21, 2023 Category: Transplant Surgery Source Type: research
Secondary Hyperparathyroidism and Cognitive Decline
AbstractPurpose of ReviewSecondary hyperparathyroidism (SHPT) likely contributes to the high prevalence of cognitive decline found among individuals with end-stage kidney disease (ESKD). Our objective is to critically evaluate the recent literature regarding the association between SHPT and cognitive decline and identify potential mechanisms.Recent FindingsNine studies assessing the relationship between SHPT and cognition have been published in the last two decades, each showing that elevated parathyroid hormone (PTH) levels were associated with cognitive decline. One also found structural changes within the brain related ...
Source: Current Transplantation Reports - March 15, 2023 Category: Transplant Surgery Source Type: research
Digital Slide and Simulation-Based Learning in Pre-Implantation Kidney Biopsies
AbstractAlthough controversial, procurement kidney biopsies and histology are commonly used in kidney allocation from deceased donors. The long series of models developed for this question, incorporating a variety of clinical and histologic variables, failed to properly predict the long-term graft survival. This failure could be explained by many factors, including the lack of expertise in terms of skilled available nephropathologists in the urgent setting of biopsies assessment. Simulation-based learning is a form of experiential learning that provides learners with a real-world-like opportunity to develop and practice th...
Source: Current Transplantation Reports - March 9, 2023 Category: Transplant Surgery Source Type: research
Delirium in Liver Transplantation
AbstractPurpose of ReviewDelirium has been recognized as an important complication and a risk factor for poor outcomes in community-dwelling older adults, general surgery patients, and kidney transplant recipients. Recently, there has been increased recognition of this prevalent issue and its association with poor outcomes among both adult and pediatric liver transplant recipients.Recent FindingsPost-transplant delirium occurs in up to 47% of liver transplant recipients. Numerous risk factors predispose these patients to delirium, including a history of alcoholic liver disease, older age, and higher model for end-stage liv...
Source: Current Transplantation Reports - February 11, 2023 Category: Transplant Surgery Source Type: research
Integrating Frailty into the Kidney Transplant Evaluation
AbstractPurpose of ReviewThis review presents an overview of the clinical syndrome of frailty and its association with kidney transplantation outcomes, recent developments in refining frailty assessment, and considerations for its implementation into kidney transplant evaluation.Recent FindingsRecent studies show that frailty is associated with adverse clinical outcomes before and after kidney transplantation, including decreased likelihood of listing and increased risks of mortality. However, frailty assessment has yet to be fully adopted by transplant centers; a study found that 40.9% of centers reported never assessing ...
Source: Current Transplantation Reports - January 30, 2023 Category: Transplant Surgery Source Type: research
