The Authors’ Reply: Glycocalyx Damage Within Human Liver Grafts Correlates With Graft Injury and Postoperative Graft Function After Orthotopic Liver Transplantation
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Letters to the Editor Source Type: research

Glycocalyx as a Useful Marker of Endothelial Injury in Liver Transplantation: The Role of Preservation Solution
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Letters to the Editor Source Type: research

COVID-19 Early After a Deceased Donor Kidney Transplant Surgery
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Letters to the Editor Source Type: research

Living Donor Liver Transplantation During the COVID-19 Pandemic: “Elective” but “Necessary”
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Letters to the Editor Source Type: research

Does Sex, Race, and the Size of a Kidney Transplant Candidate’s Social Network Affect the Number of Living Donor Requests? A Multicenter Social Network Analysis of Patients on the Kidney Transplant Waitlist
Background. A kidney transplant candidate’s social network serves as a pool of potential living donors. Sex and racial differences in network size, network strength, and living donor requests may contribute to disparities in living donor kidney transplantation. Methods. In this multicenter cross-sectional study, we performed an egocentric network analysis via a telephone survey of 132 waitlisted candidates (53% female and 69% Black) to identify demographic and network factors associated with requesting living kidney donations. Results. Female participants made requests to more network members than m...
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Efficacy and Safety of Direct Oral Anticoagulants in Kidney Transplantation: A Single-center Pilot Experience
Conclusions. DOACs appear to be effective and safe anticoagulants in KTRs with stable renal function. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Mucosa and Rejection in Facial Vascularized Composite Allotransplantation: A Systematic Review
Conclusions. The mucosa of facial allotransplants is one of the primary targets of rejection. The data indicates that higher-grade skin rejection does not occur in absence of mucosal rejection. Further investigations are needed to elucidate the exact role of mucosal biopsies for fVCA patient management. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Proton Pump Inhibitors, But Not H2-receptor Antagonists, Are Associated With Incident Fractures Among Kidney Transplant Recipients
Conclusions. Use of PPIs, but not H2RAs, is associated with a higher risk of major fractures among KTRs. Clinicians should individualize PPI use in KTRs, evaluating the risks and benefits of prescribing and continuing PPIs in KTRs. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Early Posttransplant Mobilization of Monocytic Myeloid-derived Suppressor Cell Correlates With Increase in Soluble Immunosuppressive Factors and Predicts Cancer in Kidney Recipients
Conclusions. Early posttransplant mobilization of M-MDSCs predicts cancer and adds risk as an independent factor. M-MDSC may favor an immunosuppressive environment that promotes tumoral development. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Effect of Different Types of Messages on Readiness to Indicate Willingness to Register for Organ Donation During Driver’s License Renewal in Japan
Conclusions. This study found that reciprocity and loss-framed messages promoted the readiness to register for organ donation among individuals from a Japanese urban area. Mandatory distribution of prompt messages at every driver’s license centers in Japan would be recommended. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Real-world Outcomes With Rituximab-based Therapy for Posttransplant Lymphoproliferative Disease Arising After Solid Organ Transplant
Conclusions. Our data support R-Mono as initial therapy for PTLD arising after renal or liver transplantation. However, upfront R-CHOP may benefit selected high-risk cases in whom rapid attainment of response is desirable. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Late Onset Invasive Pulmonary Aspergillosis in Lung Transplant Recipients in the Setting of a Targeted Prophylaxis/Preemptive Antifungal Therapy Strategy
Background. Invasive pulmonary aspergillosis (IPA) is a significant cause of morbidity and mortality in lung transplant recipients (LTRs). It is unclear how a targeted prophylaxis/ preemptive antifungal therapy strategy impacts the incidence of IPA beyond the first-year posttransplant. Methods. This is a retrospective cohort of LTRs from January 2010 to December 2014. We included all LTRs who survived beyond the first year and followed them until death or 4 years postoperatively. Incidence of probable/proven IPA and Aspergillus colonization were assessed as per International Society for Heart and Lung Transplant...
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

The Association Between Macroscopic Arteriosclerosis of the Renal Artery, Microscopic Arteriosclerosis, Organ Discard, and Kidney Transplant Outcome
Conclusions. Macroscopic arteriosclerosis of the renal artery was independently associated with kidney discard and somewhat associated with primary nonfunction posttransplant. However, there was no effect of arteriosclerosis on delayed graft function, estimated glomerular filtration rate at 1 y, or long-term graft survival. Our results are valid only after inevitable exclusion of discarded kidneys that had on average more arteriosclerosis. Hence, conclusions should be interpreted in the light of this potential bias. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Assessing the Complex Causes of Kidney Allograft Loss
Conclusions. In conclusion, this study provides better insight in the eventual causes of graft failure, and their relative contribution, highlighting the weight of nonimmune causes. Future efforts aimed to improve outcome after kidney transplantation should align with the relative weight and expected impact of targeting these causes. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Using Geographic Catchment Areas to Measure Population-based Access to Kidney Transplant in the United States
Conclusions. Patterns of TRR-based kidney transplant rates differ from waitlist-based rates, indicating that current metrics may not reflect transplant access in the broader population. TRRs define populations served by transplant centers and could enable future studies of how transplant centers can improve access for patients in their communities. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Angiotensin II Type-1 Receptor Antibodies Are Associated With Active Allograft Dysfunction Following Pediatric Liver Transplantation
Background. Angiotensin II type-1 receptor (AT1R) antibodies have been associated with rejection and allograft loss in solid organ transplantation and may act synergistically with HLA donor-specific antibodies (DSA). Our aims were to assess the prevalence of AT1R antibodies and determine if they were associated with allograft dysfunction in pediatric liver transplant recipients. Methods. We performed a retrospective, cross-sectional study of HLA DSA and AT1R antibodies in 2 cohorts of pediatric liver transplant recipients: a stable control cohort with normal allograft function (n = 70) who consente...
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Simultaneous Liver Kidney Transplant in Elderly Patients With Chronic Kidney Disease: Is There an Appropriate Upper Age Cutoff?
Background. The aging of liver transplant (LT) recipients, the weighting of the model for end-stage liver disease score, and the increased prevalence of nonalcoholic steatohepatitis has led to an increased number of older LT recipients with pre-LT chronic kidney disease (CKD). There are limited data on the impact of increased recipient age on post-simultaneous liver-kidney (SLK) transplant outcomes among patients with CKD, leading some centers to employ subjective age cutoffs for potential SLK recipients. Methods. We evaluated United Network for Organ Sharing data of adult SLK recipients from February 27, 2002, ...
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Preoperative Stratification of Liver Transplant Recipients: Validation of the LTRS
Background. The liver transplant risk score (LTRS) was developed to stratify 90-day mortality of patients referred for liver transplantation (LT). We aimed to validate the LTRS using a new cohort of patients. Methods. The LTRS stratifies the risk of 90-day mortality of LT recipients based on their age, body mass index, diabetes, model for end-stage liver disease (MELD) score, and need for dialysis. We assessed the performance of the LTRS using a new cohort of patients transplanted in the United States between July 2013 and June 2017. Exclusion criteria were age (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Live Confocal Imaging as a Novel Tool to Assess Liver Quality: Insights From a Murine Model
Background. In an experimental murine liver clamping model, we aimed to investigate the efficacy of real-time confocal microscopy (RCM) in assessing viability of steatotic livers in comparison to standard assessment tools, including histopathological evaluation. Methods. C57Bl/6 mice were subjected to a methionine-choline-deficient diet causing nonalcoholic fatty liver disease or to Lieber DeCarli diet causing ethanol-induced liver injury. Untreated animals served as controls. Liver biopsies were analyzed following challenge with 45 min of warm ischemia time and either 4 h of reperfusion or 24 h of cold storage....
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Basic Science—Liver Source Type: research

Mechanism of Transplanted Islet Engraftment in Visceral White Adipose Tissue
Conclusions. Visceral WAT is an important candidate for islet transplantation. Adhesion factors and adiponectin might contribute to islet engraftment into WAT. Further studies to elucidate the detailed mechanism are necessary. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research

The Prolyl Hydroxylase Inhibitor Dimethyl Oxalyl Glycine Decreases Early Gastrointestinal GVHD in Experimental Allogeneic Hematopoietic Cell Transplantation
Conclusions. Taken together, we show protective effects of DMOG on early gut GVHD and improved survival in a model of allogeneic hematopoietic cell transplantation, providing the rationale for further evaluation of PHIs, in the prevention and treatment of acute GVHD. (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research

Interleukin-6: An Important Mediator of Allograft Injury
Interleukin-6 (IL-6) is a cytokine with critical innate and adaptive immunity functions. Its diverse immunological and physiological actions include direction of immune cell differentiation, initial response to invading pathogens and ischemic injury, sustained plasma cell growth, and immunoglobulin production. IL-6 transcriptional dysregulation is commonly seen in patients with autoimmune or inflammatory disorders. Emerging information suggests that IL-6 transcription is upregulated in patients with kidney and heart transplant rejection and may account for perpetuation of inflammatory responses in the allograft, leading to...
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Reviews Source Type: research

Living Kidney Donor Evaluation
Long-term safety of living kidney donation (LKD), especially for young donors, has become a real matter of concern in the transplant community and may contribute to creating resistance to LKD. In this context, the criteria that govern living donor donations must live up to very demanding standards as well as adjust to this novel reality. In the first part, we review the existing guidelines published after 2010 and critically examine their recommendations to see how they do not necessarily lead to consistent and universal practices in the choice of specific thresholds for a parameter used to accept or reject a living donor ...
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Reviews Source Type: research

Molecular Analysis of Renal Allograft Biopsies: Where Do We Stand and Where Are We Going?
A renal core biopsy for histological evaluation is the gold standard for diagnosing renal transplant pathology. However, renal biopsy interpretation is subjective and can render insufficient precision, making it difficult to apply a targeted therapeutic regimen for the individual patient. This warrants a need for additional methods assessing disease state in the renal transplant. Significant research activity has been focused on the role of molecular analysis in the diagnosis of renal allograft rejection. The identification of specific molecular expression patterns in allograft biopsies related to different types of allogr...
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Reviews Source Type: research

Exploring the Relationship Between Circulating M-MDSC Numbers and Risk of Posttransplant Malignancy
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Commentaries Source Type: research

Preventing Pulmonary Aspergillosis: Can We Breathe Easy?
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Commentaries Source Type: research

Facing Elderly Recipients in Combined Liver-Kidney Transplantation
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Commentaries Source Type: research

Predicting Liver Transplant Patient Outcomes. Is a Validated Model Enough?
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Commentaries Source Type: research

Using Behavioral Economics to Increase Transplantation Through Commitments to Donate
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Commentaries Source Type: research

Integrated Risk Assessment Versus Age-Specific GFR Thresholds for Living Donor Candidate Evaluation
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: Commentaries Source Type: research

Frans H. J. Claas, PhD, Eurotransplant Reference Laboratory, Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center, Leiden, Netherlands
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: In View: People in Transplantation Source Type: research

Transplantation Tolerance: Expanded and Selective Roles for B Cells
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: In View: Game Changer Source Type: research

Research Highlights
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: In View: Research Highlights Source Type: research

Organ Transplantation in Puerto Rico
No abstract available (Source: Transplantation)
Source: Transplantation - November 21, 2020 Category: Transplant Surgery Tags: In View: Around the World Source Type: research

Histopathologic Findings in the Explant Lungs of a Patient With COVID-19 Treated With Bilateral Orthotopic Lung Transplant
No abstract available (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Letters to the Editor Source Type: research

Influence of Asymptomatic Carriers With COVID-19 on Transplantation Resumption in Wuhan
No abstract available (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Letters to the Editor Source Type: research

Estimated Glomerular Filtration Rate at Transplant Listing and Other Predictors of Post-Heart Transplant Mortality and the Development of ESRD
Background. Elevated serum creatinine at the time of heart transplant is an independent predictor of posttransplant end-stage renal disease (ESRD) and mortality. Patients who are at risk of ESRD should be identified before transplantation. We looked at the severity of CKD at the time of waitlisting on posttransplant ESRD and mortality. Methods. We analyzed the United Network of Organ Sharing transplant database from 2000 to 2017. Adults receiving their first heart transplant, and not on dialysis, were included in study. We divided our cohort into 4 groups based on their listing estimated glomerular filtration (eGFR) a...
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Survival Benefit of En Bloc Transplantation of Small Pediatric Kidneys in Children
Conclusions. En bloc transplantation of small pediatric kidneys in children is associated with superior long-term patient and graft survival. The increased risk of 1-y graft loss among en bloc recipients only appeared in the oldest era. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Inverse Association Between the Quantity of Human Peripheral Blood CXCR5+IFN-γ+CD8+ T Cells With De Novo DSA Production in the First Year After Kidney Transplant
Conclusions. Our data raise the possibility that human CXCR5+IFN-γ+CD8+ T cells are a homolog to murine CXCR5+IFN-γ+CD8+ T cells (termed antibody-suppressor CD8+ T cells) and that the quantity of CXCR5+IFN-γ+CD8+ T cells (or the ratio of CXCR5+IFN-γ+CD8+ T cells to Th1/Th2 CD4+ T cells) may identify recipients at risk for development of DSA. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

A Clinical Trial With Adoptive Transfer of Ex Vivo-induced, Donor-specific Immune-regulatory Cells in Kidney Transplantation—A Second Report
Conclusions. The adoptive transfer of autologous ex vivo-expanded Treg is 1 of the options to possibly induce alloimmune hyporesponsiveness. However, in the present study, further regimen optimization is still required and should be the focus of future investigations. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Reducing Donor-specific Antibody During Acute Rejection Diminishes Long-term Renal Allograft Loss: Comparison of Early and Late Rejection
Conclusions. In summary, significant differences exist across rejection phenotypes with respect to histological and DSA responses. The data suggest that DSA reduction may be associated with improved DCGS in both early and late AMR. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

BK Polyomavirus-specific T Cells as a Diagnostic and Prognostic Marker for BK Polyomavirus Infections After Pediatric Kidney Transplantation
Conclusions. This study found that BKPyV-specific T cell levels may help to distinguish patients with transient, self-limiting BKPyV-DNAemia from those with persisting BKPyV-DNAemia and biopsy-proven BKPyVAN, who would benefit from individualized therapeutic interventions such as reduced immunosuppression. Thereby the risk for rejection because of unnecessary reduction of immunosuppression in case of self-limiting BKPyV-DNAemia can be minimized. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

HOUSES Index as an Innovative Socioeconomic Measure Predicts Graft Failure Among Kidney Transplant Recipients
Background. Despite extensive evaluation processes to determine candidacy for kidney transplantation, variability in graft failure exists. The role of patient socioeconomic status (SES) in transplantation outcomes is poorly understood because of limitations of conventional SES measures. Methods. This population-based retrospective cohort study assessed whether a validated objective and individual-level housing-based SES index (HOUSES) would serve as a predictive tool for graft failure in patients (n = 181) who received a kidney transplant in Olmsted County, MN (January 1, 1998 to December 8, 2016). Associations were a...
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Innate and Adaptive Immune Correlates of Chronic and Self-limiting EBV DNAemia in Solid-organ Transplant Recipients
Conclusions. CD is associated with a reduction of CD11c+ cells, CD4+ TN, and interferon-γ–producing EBV-specific CD4+ T cells, suggesting an interplay between innate and adaptive immune compartments may be important for regulating EBV DNAemia. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Patient Travel Distance and Post Lung Transplant Survival in the United States: A Cohort Study
Conclusions Travel distance was significantly associated with post lung transplant survival. However, this effect was relatively modest. Patient travel distance is an important component of access to lung transplant care. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

A Propensity Score–weighted Comparison of Outcomes Between Living and Standard Criteria Deceased Donor Kidney Transplant Recipients
Conclusions. After accounting for many important donor and recipient factors, we failed to observe a large difference in the risk of all-cause graft failure for recipients of a standard criteria deceased versus living donor. Some estimates were imprecise, which meant we could not rule out the presence of smaller clinically important effects. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Detection of Cryptic Mosaicism in X-linked Alport Syndrome Prompts to Re-evaluate Living-donor Kidney Transplantation
Conclusions. This finding unveils an early postzygotic event which can explain both the renal involvement and germline mosaicism. It changes the inheritance risk for each pregnancy raising it to 50% and underlines the need for different clinical management in the mother. This seems to indicate that a case-by-case more cautious approach is needed with mother-to-son kidney transplants. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

CXCL9 Predicts Severity at the Onset of Chronic Graft-versus-host Disease
Background. Chronic graft-versus-host disease (cGVHD) represents a double-edged sword. In its nonsevere form, cGVHD associates with better control of the malignant disease, thus highlighting graft-versus-leukemia effects. However, severe cGVHD leads to debilitating morbidity and increased nonrelapse mortality. The prediction of severe cGVHD, in particular at disease onset, is therefore of high importance for ensuing clinical decisions and overall success of allogeneic stem cell transplantations. CXC-chemokine ligand 9 (CXCL9) is an interferon-inducible chemokine of the CXC family and is increased in cGVHD. Endothelial ac...
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

The Association Between Vena Cava Implantation Technique and Acute Kidney Injury After Liver Transplantation
Background. Acute kidney injury (AKI) after liver transplantation is associated with increased morbidity and mortality. It remains controversial whether the choice of vena cava reconstruction technique impacts AKI. Methods. This is a single-center retrospective cohort of 897 liver transplants performed between June 2009 and September 2018 using either the vena cava preserving piggyback technique or caval replacement technique without veno-venous bypass or shunts. The association between vena cava reconstruction technique and stage of postoperative AKI was assessed using multivariable ordinal logistic regression. Causa...
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Association Between Neighborhood-level Socioeconomic Deprivation and the Medication Level Variability Index for Children Following Liver Transplantation
Conclusions. This is the first study to evaluate associations between neighborhood socioeconomic deprivation and an objective surrogate measure of medication adherence in children posttransplant. These findings suggest that neighborhood context may be an important consideration when assessing adherence. Differential rates of medication adherence may partly explain links between neighborhood factors and adverse health outcomes following pediatric liver transplantation. (Source: Transplantation)
Source: Transplantation - October 30, 2020 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research