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Transplantation
Journal Prestige (SJR): 1.557
Citation Impact (citeScore): 3
Number of Followers: 25  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0041-1337 - ISSN (Online) 1534-6080
Published by LWW Wolters Kluwer Homepage  [301 journals]
  • Organ Transplantation in Kuwait and the Recent Initiation of a Liver
           Program

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      Authors: Jamal; Mohammad; AlMahmeed, Husain; AlGhanem, Mansour; AlMatooq, Maen; Sadek, Adnan; AlMousawi, Mustafa; Al-Sabah, Salman; Vilca Melendez, Hector; Rela, Mohamed; Heaton, Nigel; Jassem, Wayel
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Research Highlights

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      Authors: Adigbli; George; Berlin, Claudia; Issa, Fadi
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Organoid Transplantation: New Avenues to Treat Short Bowel Syndrome

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      Authors: Gentilini; María Virginia; Rumbo, Martín; Gondolesi, Gabriel E.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Integrating APOL1 Kidney-risk Variant Testing in Live Kidney Donor
           Evaluation: An Expert Panel Opinion

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      Authors: Doshi; Mona D.; Gordon, Elisa J.; Freedman, Barry I.; Glover, Craig; Locke, Jayme E.; Thomas, Christie P.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Unraveling the Genomic Architecture of the CYP3A Locus and ADME Genes for
           Personalized Tacrolimus Dosing

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      Authors: Gabardi; Steven
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Ribavirin to the Rescue: Natural Killer–Cell Function After Hepatitis C
           Virus Treatment in Liver Transplant Recipients

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      Authors: Calabrese; Daniel R.
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Opportunity in a Crisis: We Can Do Better

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      Authors: Gallagher; Tom K.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Pneumocystis jirovecii: The Changing Landscape for Prophylaxis

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      Authors: Pruett; Timothy L.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • The Potential Role for N-Acetylcysteine in Improving Procurement and
           Preservation Strategies in Liver Transplantation—A Commentary

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      Authors: Panayotova; Guergana G.; Lunsford, Keri E.; Guarrera, James V.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • COVID-19 in Solid Organ Transplant Recipients in Spain Throughout 2020:
           Catching the Wave'

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      Authors: Coll; Elisabeth; Fernández-Ruiz, Mario; Padilla, María; Moreso, Francesc; Hernández-Vicente, Ana; Yañez, Iñigo; Molina, María; Vázquez-Sánchez, Teresa; Crespo, Marta; Facundo, Carme; Rodríguez-Ferrero, María Luisa; Ruiz Fuentes, María Carmen; Loinaz, Carmelo; Bernal, Gabriel; Melilli, Edoardo; Bravo, Carlos; Diekmann, Fritz; Lladó, Laura; García-Álvarez, Teresa M.; Salcedo, Magdalena; Beneyto, Isabel; Castells, Lluis; Alonso, Rodrigo; Rodríguez-Benot, Alberto; Díaz-Corte, Carmen; Graus, Javier; Ortiz-Bautista, Carlos; García-Cosío, María Dolores; Hinojal, Rosa; Peña, Lucía; Domínguez-Gil, Beatriz; on behalf of the Spanish Group for the Study of COVID-19 in Transplant Recipients.
      Abstract: imageBackground. Few studies have analyzed differences in clinical presentation and outcomes in solid organ transplant (SOT) recipients with coronavirus disease 2019 (COVID-19) across different pandemic waves.Methods. In this multicenter, nationwide, prospective study, we compared demographics and clinical features, therapeutic management, and outcomes in SOT recipients diagnosed with COVID-19 in Spain before (first wave) or after (second wave) 13 July 2020.Results. Of 1634 SOT recipients, 690 (42.2%) and 944 (57.8%) were diagnosed during the first and second periods, respectively. Compared with the first wave, recipients in the second were younger (median: 63 y [interquartile range, IQR: 53–71] versus 59 y [IQR: 49–68]; P < 0.001) and less likely to receive anti-severe acute respiratory syndrome coronavirus 2 drugs (81.8% versus 8.1%; P < 0.001), with no differences in immunomodulatory therapies (46.8% versus 47.0%; P = 0.931). Adjustment of immunosuppression was less common during the second period (76.4% versus 53.6%; P < 0.001). Hospital admission (86.7% versus 58.1%; P < 0.001), occurrence of acute respiratory distress syndrome (34.1% versus 21.0%; P < 0.001), and case-fatality rate (25.8% versus 16.7%; P < 0.001) were lower in the second period. In multivariate analysis, acquiring COVID-19 during the first wave was associated with an increased risk of death (OR: 1.47; 95% confidence interval [CI], 1.12-1.93; P = 0.005), although this impact was lost in the subgroup of patients requiring hospital (OR: 0.97; 95% CI, 0.73-1.29; P = 0.873) or intensive care unit admission (OR: 0.65; 95% CI, 0.35-1.18; P = 0.157).Conclusions. We observed meaningful changes in demographics, therapeutic approaches, level of care, and outcomes between the first and second pandemic waves. However, outcomes have not improved in the more severe cases of posttransplant COVID-19.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • The Magnitude and Functionality of SARS-CoV-2 Reactive Cellular and
           Humoral Immunity in Transplant Population Is Similar to the General
           Population Despite Immunosuppression

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      Authors: Thieme; Constantin J.; Anft, Moritz; Paniskaki, Krystallenia; Blazquez-Navarro, Arturo; Doevelaar, Adrian; Seibert, Felix S.; Hoelzer, Bodo; Justine Konik, Margarethe; Meister, Toni L.; Pfaender, Stephanie; Steinmann, Eike; Moritz Berger, Marc; Brenner, Thorsten; Kölsch, Uwe; Dolff, Sebastian; Roch, Toralf; Witzke, Oliver; Schenker, Peter; Viebahn, Richard; Stervbo, Ulrik; Westhoff, Timm H.; Babel, Nina
      Abstract: imageBackground. The ability of transplant (Tx) patients to generate a protective antiviral response under immunosuppression is pivotal in COVID-19 infection. However, analysis of immunity against SARS-CoV-2 is currently lacking.Methods. Here, we analyzed T cell immunity directed against SARS-CoV-2 spike-, membrane-, and nucleocapsid-protein by flow cytometry and spike-specific neutralizing antibodies in 10 Tx in comparison to 26 nonimmunosuppressed (non-Tx) COVID-19 patients.Results. Tx patients (7 renal, 1 lung, and 2 combined pancreas-kidney Txs) were recruited in this study during the acute phase of COVID-19 with a median time after SARS-CoV-2-positivity of 3 and 4 d for non-Tx and Tx patients, respectively. Despite immunosuppression, we detected antiviral CD4+ T cell-response in 90% of Tx patients. SARS-CoV-2–reactive CD4+ T cells produced multiple proinflammatory cytokines, indicating their potential protective capacity. Neutralizing antibody titers did not differ between groups. SARS-CoV-2–reactive CD8+ T cells targeting membrane- and spike-protein were lower in Tx patients, albeit without statistical significance. However, frequencies of anti-nucleocapsid–protein-reactive, and anti-SARS-CoV-2 polyfunctional CD8+ T cells, were similar between patient cohorts. Tx patients showed features of a prematurely aged adaptive immune system, but equal frequencies of SARS-CoV-2–reactive memory T cells.Conclusions. In conclusion, a polyfunctional T cell immunity directed against SARS-CoV-2 proteins as well as neutralizing antibodies can be generated in Tx patients despite immunosuppression. In comparison to nonimmunosuppressed patients, no differences in humoral and cellular antiviral-immunity were found. Our data presenting the ability to generate SARS-CoV-2–specific immunity in immunosuppressed patients have implications for the handling of SARS-CoV-2–infected Tx patients and raise hopes for effective vaccination in this cohort.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • SARS-Cov-2 Seroprevalence in a French Kidney Transplant Center Located
           Within a “High-risk” Zone

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      Authors: Caillard; Sophie; Benotmane, Ilies; Meidinger, Céline; Jegou, Vanessa; Ludwiller, Sandra; Rihon, Anne; Desmarquets, Audrey; Steinmetz, Lucille; Morvan, Murielle; Kedjam, Karima; Bigot, Amandine; Roy, Danielle; Schmitt, Dominique; Marx, David; Bassand, Xavier; Perrin, Peggy; Gautier Vargas, Gabriela; Cognard, Noelle; Olagne, Jérome; Braun, Laura; Heibel, Francoise; Martzloff, Jonas; Moulin, Bruno; Fafi Kremer, Samira
      Abstract: imageBackground. Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in kidney transplant recipients (KTRs) remain rare. We sought to shed further light on this issue by conducting a single-center study in a kidney transplant center located in one of the France’s highest risk zone (Grand Est) for coronavirus disease 2019 (Covid-19) during the initial disease outbreak.Methods. To this aim, we used a survey approach coupled with systematic investigation of SARS-CoV-2 serology in a cohort of 1390 KTRs.Results. SARS-CoV-2 serologies were available for 780 survey respondents, among whom 48 had anti-SARS-CoV-2 antibodies (total seroprevalence: 6.2%). Thirty-five of the 48 seropositive KTRs had previously received a diagnosis of Covid-19, whereas the remaining 13 patients were not known to be infected (8 asymptomatic cases). Specifically, 18.7% of seropositive KTRs and 1.1% of the entire cohort were asymptomatic. Household exposure was found to markedly increase the risk of SARS-CoV-2 transmission.Conclusions. Our findings demonstrate that the overall SARS-CoV-2 seroprevalence in KTRs living in one of the France’s highest risk zone for Covid-19 during the first French lockdown was as low as 6.3%. Rapid and strict implementation of protective measures could have significantly mitigated virus spread even in an area of high virus circulation.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Safety and Reactogenicity of 2 Doses of SARS-CoV-2 Vaccination in Solid
           Organ Transplant Recipients

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      Authors: Ou; Michael T.; Boyarsky, Brian J.; Motter, Jennifer D.; Greenberg, Ross S.; Teles, Aura T.; Ruddy, Jake A.; Krach, Michelle R.; Jain, Vedant S.; Werbel, William A.; Avery, Robin K.; Massie, Allan B.; Segev, Dorry L.; Garonzik-Wang, Jacqueline M.
      Abstract: imageBackground. We studied the safety and reactogenicity SARS-CoV-2 mRNA vaccines in transplant recipients because immunosuppressed patients were excluded from vaccine trials.Methods. US transplant recipients were recruited into this prospective cohort study through social media; those who completed the full vaccine series between December 9, 2020 and March 1, 2021 were included. We collected demographics, medical history, and safety information within 7 d after doses 1 and 2 (D1, D2). Associations between characteristics and reactions were evaluated using modified Poisson regression.Results. We studied 741 transplant recipients who underwent BNT162b2 (54%) or mRNA-1273 (46%) vaccination. Median (interquartile range) age was 60 (44–69) y, 57% were female, and 10% were non-White. Although local site reactions decreased after D2 (85% D1 versus 78% D2, P 
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Prospective Clinical, Virologic, and Immunologic Assessment of COVID-19 in
           Transplant Recipients

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      Authors: Marinelli; Tina; Ferreira, Victor H.; Ierullo, Matthew; Ku, Terrance; Lilly, Les; Kim, S. Joseph; Schiff, Jeffrey; Sidhu, Aman; McDonald, Michael; Hosseini-Moghaddam, Seyed M.; Husain, Shahid; Rotstein, Coleman; Majchrzak-Kita, Beata; Kulasingam, Vathany; Humar, Atul; Kumar, Deepali
      Abstract: imageBackground. Several studies have described the clinical features of COVID-19 in solid-organ transplant recipients. However, many have been retrospective or limited to more severe cases (hospitalized) and have not routinely included serial virological sampling (especially in outpatients) and immunologic assessment.Methods. Transplant patients diagnosed with COVID-19 based on a respiratory sample PCR were prospectively followed up to 90 d. Patients provided consent for convalescent serum samples and serial nasopharyngeal swabs for SARS-CoV-2 antibody (antinucleoprotein and anti-RBD) and viral load, respectively.Results. In the 161 SOT recipients diagnosed with COVID-19, the spectrum of disease ranged from asymptomatic infection (4.3%) to hospitalization (60.6%), supplemental oxygen requirement (43.1%), mechanical ventilation (22.7%), and death (15.6%). Increasing age (OR, 1.031; 95% CI, 1.001-1.062; P = 0.046) and ≥2 comorbid conditions (OR, 3.690; 95% CI, 1.418-9.615; P = 0.007) were associated with the need for supplemental oxygen. Allograft rejection was uncommon (3.7%) despite immunosuppression modification. Antibody response at ≥14 d postsymptoms onset was present in 90% (anti-RBD) and 76.7% (anti-NP) with waning of anti-NP titers and stability of anti-RBD over time. Median duration of nasopharyngeal positivity was 10.0 d (IQR, 5.5–18.0) and shedding beyond 30 d was observed in 6.7% of patients. The development of antibody did not have an impact on viral shedding.Conclusions. This study demonstrates the spectrum of COVID-19 illness in transplant patients. Risk factors for severe disease are identified. The majority form antibody by 2 wk with differential stability over time. Prolonged viral shedding was observed in a minority of patients. Reduction of immunosuppression was a safe strategy.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Hemodynamic Instability During Liver Transplantation in Patients With
           

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      Authors: Bezinover; Dmitri; Mukhtar, Ahmed; Wagener, Gebhard; Wray, Christopher; Blasi, Annabel; Kronish, Kate; Zerillo, Jeron; Tomescu, Dana; Pustavoitau, Aliaksei; Gitman, Marina; Singh, Anil; Saner, Fuat H.
      Abstract: imageHemodynamic instability (HDI) during liver transplantation (LT) can be difficult to manage and increases postoperative morbidity and mortality. In addition to surgical causes of HDI, patient- and graft-related factors are also important. Nitric oxide–mediated vasodilatation is a common denominator associated with end-stage liver disease related to HDI. Despite intense investigation, optimal management strategies remain elusive.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Frailty in Lung Transplantation: Candidate Assessment and Optimization

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      Authors: Agarwal; Ankita; Neujahr, David C.
      Abstract: imageThe concept of frailty has gained considerable interest in clinical solid-organ transplantation over the past decade. Frailty as a phenotypic construct to describe a patient’s risk from biologic stresses has an impact on posttransplant survival. There is keen interest in characterizing frailty in lung transplantation, both to determine which patients are suitable candidates for listing and also to prepare for their care in the aftermath of lung transplantation. Here, we review the current status of research on frailty in lung transplant candidates and recipients. This review will highlight areas of uncertainty for frailty in clinical lung transplantation that are likely to impact the state-of-the-art in the field for the next decade.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Kidney Allograft Fibrosis: Diagnostic and Therapeutic Strategies

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      Authors: Saritas; Turgay; Kramann, Rafael
      Abstract: imageInterstitial fibrosis with tubule atrophy (IF/TA) is the response to virtually any sustained kidney injury and correlates inversely with kidney function and allograft survival. IF/TA is driven by various pathways that include hypoxia, renin-angiotensin-aldosterone system, transforming growth factor-β signaling, cellular rejection, inflammation, and others. In this review, we will focus on key pathways in the progress of renal fibrosis, diagnosis and therapy of allograft fibrosis. This review discusses the role and origin of myofibroblasts as matrix producing cells and therapeutic targets in renal fibrosis with a particular focus on renal allografts. We summarize current trends to use multiomic approaches to identify new biomarkers for IF/TA detection and to predict allograft survival. Furthermore, we review current imaging strategies that might help to identify and follow-up IF/TA complementary or as alternative to invasive biopsies. We further discuss current clinical trials and therapeutic strategies to treat kidney fibrosis.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Unraveling the Genomic Architecture of the CYP3A Locus and ADME Genes for
           Personalized Tacrolimus Dosing

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      Authors: Yoon; Jihoon G.; Song, Seung Hwan; Choi, Sungkyoung; Oh, Jaeseong; Jang, In-Jin; Kim, Young Jin; Moon, Sanghoon; Kim, Bong-Jo; Cho, Yuri; Kim, Hyo Kee; Min, Sangil; Ha, Jongwon; Shin, Ho Sik; Yang, Chul Woo; Yoon, Hye Eun; Yang, Jaeseok; Lee, Min Goo; Park, Jae Berm; Kim, Myoung Soo; the Korean Organ Transplantation Registry (KOTRY study group
      Abstract: imageBackground. Tacrolimus (TAC) is an immunosuppressant widely prescribed following an allogenic organ transplant. Due to wide interindividual pharmacokinetic (PK) variability, optimizing TAC dosing based on genetic factors is required to minimize nephrotoxicity and acute rejections.Methods. We enrolled 1133 participants receiving TAC from 4 cohorts, consisting of 3 with kidney transplant recipients and 1 with healthy males from clinical trials. The effects of clinical factors were estimated to appropriately control confounding variables. A genome-wide association study, haplotype analysis, and a gene-based association test were conducted using the Korea Biobank Array or targeted sequencing for 114 pharmacogenes.Results. Genome-wide association study verified that CYP3A5*3 is the only common variant associated with TAC PK variability in Koreans. We detected several CYP3A5 and CYP3A4 rare variants that could potentially affect TAC metabolism. The haplotype structure of CYP3A5 stratified by CYP3A5*3 was a significant factor for CYP3A5 rare variant interpretation. CYP3A4 rare variant carriers among CYP3A5 intermediate metabolizers displayed higher TAC trough levels. Gene-based association tests in the 61 absorption, distribution, metabolism, and excretion genes revealed that CYP1A1 are associated with additional TAC PK variability: CYP1A1 rare variant carriers among CYP3A5 poor metabolizers showed lower TAC trough levels than the noncarrier controls.Conclusions. Our study demonstrates that rare variant profiling of CYP3A5 and CYP3A4, combined with the haplotype structures of CYP3A locus, provide additive value for personalized TAC dosing. We also identified a novel association between CYP1A1 rare variants and TAC PK variability in the CYP3A5 nonexpressers that needs to be further investigated.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Ribavirin Improves NK Cell IFNγ Response During Sofosbuvir-based DAA
           Therapy in HCV-infected Liver Transplant Recipients

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      Authors: Adenugba; Akinbami; Hornung, Matthias; Weigand, Kilian; Peschel, Georg; Junger, Henrik; Kupke, Paul; Lang, Hauke; Marquardt, Jens U.; Zimmermann, Tim; Geissler, Edward K.; Schlitt, Hans J.; Werner, Jens M.
      Abstract: imageBackground. Chronic hepatitis C virus (HCV) infection is characterized by activation of natural killer (NK) cells. Here, we asked whether HCV elimination by sofosbuvir-based direct-acting antivirals (DAAs) and the addition of ribavirin (RBV) improve NK cell function in liver transplant (LTx) recipients.Methods. We analyzed NK cell degranulation and interferon (IFN)γ-response along with STAT1 and STAT4 phosphorylation in 29 HCV-infected LTx recipients and 17 HCV-infected patients during DAA treatment.Results. Compared with uninfected LTx recipients, NK cells from HCV-infected LTx recipients were polarized toward cytotoxicity with increased CD107a-degranulation (10.1% versus 14.6%; P = 0.0263) and reduced capacity to produce IFNγ (43.0% versus 26.7%; P = 0.0002). The altered phenotype of NK cells in HCV-infected LTx recipients was accompanied by increased STAT1 (44.6% versus 87.4%; P 
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • The Surge in Deceased Liver Donors Due to the Opioid Epidemic: Is It Time
           to Split the Difference'

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      Authors: Yoeli; Dor; Choudhury, Rashikh A.; Nydam, Trevor L.; Pomposelli, James J.; Goss, John A.; Pomfret, Elizabeth A.; Wachs, Michael E.; Adams, Megan A.
      Abstract: imageBackground. This study aimed to compare trends in use of drug overdose (DO) donors in adult versus pediatric liver transplants and the utilization of split liver transplantation in this donor population.Methods. The United Network for Organ Sharing database was reviewed for deceased donor liver transplants from March 2002 to December 2017. Recipients were categorized by donor mechanism of death. Donor splitting criteria was defined as age 3 times the normal limit, and body mass index ≤ 28 kg/m2.Results. Adult liver transplants from DO donors increased from 2% in 2002 to 15% in 2017, while pediatric liver transplants from DO donors only increased from
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • The Potential Role of Efficacy and Safety Evaluation of N-Acetylcysteine
           Administration During Liver Procurement. The NAC-400 Single Center
           Randomized Controlled Trial

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      Authors: Gómez-Gavara; Concepción; Moya-Herraiz, Ángel; Hervás, David; Pérez-Rojas, Judith; LaHoz, Agustín; López-Andújar, Rafael
      Abstract: imageBackground. N-acetylcysteine infusions have been widely used to reduce ischemia/reperfusion damage to the liver; however, convincing evidence of their benefits is lacking.Objective. To perform the largest randomized controlled trial to compare the impact of N-acetylcysteine infusion during liver procurement on liver transplant outcomes.Methods. Single center, randomized trial with patients recruited from La Fe University Hospital, Spain, from February 2012 to January 2016. A total of 214 grafts were transplanted and randomized to the N-acetylcysteine group (n = 113) or to the standard protocol without N-acetylcysteine (n = 101). The primary endpoint was allograft dysfunction (Olthoff criteria). Secondary outcomes included metabolomic biomarkers of oxidative stress levels, interactions between cold ischemia time and alanine aminotransferase level and graft and patient survival (ID no. NCT01866644).Results. The incidence of primary dysfunction was 34% (31% in the N-acetylcysteine group and 37.4% in the control group [P = 0.38]). N-acetylcysteine administration reduced the alanine aminotransferase level when cold ischemia time was longer than 6 h (P = 0.0125). Oxidative metabolites (glutathione/oxidized glutathione and ophthalmic acid) were similar in both groups (P > 0.05). Graft and patient survival rates at 12 mo and 3 y were similar between groups (P = 0.54 and P = 0.69, respectively).Conclusions. N-acetylcysteine administration during liver procurement does not improve early allograft dysfunction according to the Olthoff classification. However, when cold ischemia time is longer than 6 h, N-acetylcysteine improves postoperative ALT levels.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Characteristics, Trends, and Outcomes of Liver Transplantation for Primary
           Sclerosing Cholangitis in Female Versus Male Patients: An Analysis From
           the European Liver Transplant Registry

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      Authors: Berenguer; Marina; Di Maira, Tommaso; Baumann, Ulrich; Mirza, Darius F.; Heneghan, Michael A.; Klempnauer, Jurgen L.; Bennet, William; Ericzon, Bo-Goran; Line, Pål-Dag; Lodge, Peter A.; Zieniewicz, Krzysztof; Watson, Christopher J. E.; Metselaar, Herold J.; Adam, René; Karam, Vincent; Aguilera, Victoria; all the other contributing centers (www.eltr.org Intestine Transplant Association (ELITA
      Abstract: imageBackground. The influence of sex on primary sclerosing cholangitis (PSC), pre- and postliver transplantation (LT) is unclear. Aims are to assess whether there have been changes in incidence, profile, and outcome in LT-PSC patients in Europe with specific emphasis on sex.Methods. Analysis of the European Liver Transplant Registry database (PSC patients registered before 2018), including baseline demographics, donor, biochemical, and clinical data at LT, immunosuppression, and outcome.Results. European Liver Transplant Registry analysis (n = 6463, 32% female individuals) demonstrated an increasing number by cohort (1980–1989, n = 159; 1990–1999, n = 1282; 2000–2009, n = 2316; 2010–2017, n = 2549) representing on average 4% of all transplant indications. This increase was more pronounced in women (from 1.8% in the first cohort to 4.3% in the last cohort). Graft survival rate at 1, 5, 10, 15, 20, and 30 y was 83.6%, 70.8%, 57.7%, 44.9%, 30.8%, and 11.6%, respectively. Variables independently associated with worse survival were male sex, donor and recipient age, cholangiocarcinoma at LT, nondonation after brain death donor, and reduced size of the graft. These findings were confirmed using a more recent LT population closer to the current standard of care (LT after the y 2000).Conclusions. An increasing number of PSC patients, particularly women, are being transplanted in European countries with better graft outcomes in female recipients. Other variables impacting outcome include donor and recipient age, cholangiocarcinoma, nondonation after brain death donor, and reduced graft size.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis
           and Meta-regression of Survival Rates

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      Authors: Ziogas; Ioannis A.; Giannis, Dimitrios; Economopoulos, Konstantinos P.; Hayat, Muhammad H.; Montenovo, Martin I.; Matsuoka, Lea K.; Alexopoulos, Sophoclis P.
      Abstract: imageBackground. Intrahepatic cholangiocarcinoma (iCCA) is a contraindication to liver transplantation in most centers worldwide. Therefore, only a few such cases have been performed in each individual center, and the need for a systematic review and meta-analysis to cumulatively pool these results is apparent.Methods. A systematic literature review was conducted using the MEDLINE and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement (end-of-search date: May 29, 2020). Meta-analyses of proportions were conducted to pool the overall survival (OS), recurrence-free survival (RFS), and overall recurrence rates using the random-effects model. Meta-regression was used to examine cirrhosis and incidental diagnosis as confounders on OS and RFS.Results. Eighteen studies comprising 355 patients and a registry study of 385 patients were included. The pooled 1-, 3-, and 5-y OS rates were 75% (95% CI, 64%-84%), 56% (95% CI, 46%-67%), and 42% (95% CI, 29%-55%), respectively. The pooled 1-, 3-, and 5-y RFS rates were 70% (95% CI, 63%-75%), 49% (95% CI, 41%-57%), and 38% (95% CI, 27%-50%), respectively. Cirrhosis was positively associated with RFS, while incidental diagnosis was not. Neither cirrhosis nor incidental diagnosis was associated with OS. The pooled overall recurrence rate was 43% (95% CI, 33%-53%) over a mean follow-up of 40.6 ± 37.7 mo. Patients with very early (single ≤2 cm) iCCA exhibited superior pooled 5-y RFS (67%; 95% CI, 47%-86%) versus advanced iCCA (34%; 95% CI, 23%-46%).Conclusions. Cirrhotics with very early iCCA or carefully selected patients with advanced iCCA after neoadjuvant therapy may benefit from liver transplantation under research protocols.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Liver Transplantation for Propionic Acidemia: Evidence From a Systematic
           Review and Meta-analysis

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      Authors: Zhou; Guang-Peng; Jiang, Yi-Zhou; Wu, Shan-Shan; Kong, Yuan-Yuan; Sun, Li-Ying; Zhu, Zhi-Jun
      Abstract: imageBackground. The worldwide experience of liver transplantation (LT) in the treatment of propionic acidemia (PA) remains limited and fragmented. This review aims to provide a comprehensive and quantitative understanding of posttransplant clinical outcomes in PA patients.Methods. MEDLINE, Embase, and the Cochrane Library databases were searched for studies focusing on PA patients who underwent LT. The pooled estimate rates and 95% confidence intervals (CIs) were calculated using a random-effects model with Freeman-Tukey double arcsine transformation.Results. Twenty-one studies involving 70 individuals were included. The pooled estimate rates were 0.95 (95% CI, 0.80-1.00) for patient survival and 0.91 (95% CI, 0.72-1.00) for allograft survival. The pooled estimate rates were 0.20 (95% CI, 0.05-0.39) for rejection, 0.08 (95% CI, 0.00-0.21) for hepatic artery thrombosis, 0.14 (95% CI, 0.00-0.37) for cytomegalovirus/Epstein-Barr virus infection, and 0.03 (95% CI, 0.00-0.15) for biliary complications. The pooled estimate rates were 0.98 (95% CI, 0.88-1.00) for metabolic stability, 1.00 (95% CI, 0.79-1.00) for reversal of preexisting cardiomyopathy, and 0.97 (95% CI, 0.78-1.00) for improvement of neurodevelopmental delay. A large proportion of patients achieved liberalization of protein intake posttransplant (pooled estimate rate 0.66 [95% CI, 0.35-0.93]).Conclusions. Despite the risk of transplant-related complications, LT is a viable therapeutic option in PA patients with satisfactory survival rates and clinical outcomes. Given the diversity in neurological assessment methods and the inconsistency in the achievement of dietary protein liberalization across different studies, consensus on neurological evaluation methods and posttransplant protein intake is necessary. Longer-term clinical outcomes of LT for PA warrants further investigation.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Clinical Outcomes After Liver Transplantation in Patients With
           Portopulmonary Hypertension

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      Authors: Cartin-Ceba; Rodrigo; Burger, Charles; Swanson, Karen; Vargas, Hugo; Aqel, Bashar; Keaveny, Andrew P.; Heimbach, Julie; Taner, Timucin; Nyberg, Scott; Rosen, Charles; Cajigas, Hector; DuBrock, Hilary; Krowka, Michael J.
      Abstract: imageBackground. Portopulmonary hypertension (POPH) is the presence of pulmonary arterial (PA) hypertension in patients with portal hypertension and is associated with significant morbidity and mortality. In a cohort of POPH patients, we describe the clinical outcomes of POPH patients who underwent liver transplantation (LT).Methods. Retrospectively collected data from a prospectively assembled cohort of all consecutive POPH adults evaluated in 3 transplant centers from 1996 to 2019.Results. From a cohort of 228 POPH patients, 50 patients underwent LT. Significant hemodynamic improvement after PA-targeted therapy was observed, with 58% receiving only monotherapy pretransplant. After LT, 21 (42%) patients were able to discontinue and remained off PA-targeted therapy. The 1-, 3-, and 5-y unadjusted survival rates after LT were 72%, 63%, and 60%, respectively. An elevated pulmonary vascular resistance (PVR) before LT was associated with worse survival rate (HR, 1.91; 95% CI, 1.07-3.74, P = 0.04). No survival difference was observed in those granted MELD exception or transplants performed before or after the year 2010.Conclusions. Significant number of POPH patients discontinued PA-targeted therapy after LT. Higher PVR before LT was associated with worse survival, as was monotherapy use. Despite effective PA-targeted therapies, POPH survival outcomes after LT in our cohort were modest and may reflect the need for more aggressive therapy.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • A Comprehensive Evaluation of Risk Factors for Pneumocystis jirovecii
           Pneumonia in Adult Solid Organ Transplant Recipients: A Systematic Review
           and Meta-analysis

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      Authors: Permpalung; Nitipong; Kittipibul, Veraprapas; Mekraksakit, Poemlarp; Rattanawong, Pattara; Nematollahi, Saman; Zhang, Sean X.; Steinke, Seema Mehta
      Abstract: imageBackground. There is no consensus guidance on when to reinitiate Pneumocystis jirovecii pneumonia (PJP) prophylaxis in solid organ transplant (SOT) recipients at increased risk. The 2019 American Society of Transplantation Infectious Diseases Community of Practice (AST IDCOP) guidelines suggested to continue or reinstitute PJP prophylaxis in those receiving intensified immunosuppression for graft rejection, cytomegalovirus (CMV) infection, higher dose of corticosteroids, or prolonged neutropenia.Methods. A literature search was conducted evaluating all literature from existence through April 22, 2020, using MEDLINE and EMBASE. (The International Prospective Register of Systematic Reviews registration number: CRD42019134204).Results. A total of 30 studies with 413 276 SOT recipients were included. The following factors were associated with PJP development: acute rejection (pooled odds ratio [pOR], 2.35; 95% confidence interval [CI], 1.69-3.26); study heterogeneity index [I2] = 23.4%), CMV-related illnesses (pOR, 3.14; 95% CI, 2.30-4.29; I2 = 48%), absolute lymphocyte count
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Determining the Level of Importance of Variables in Predicting Kidney
           Transplant Survival Based on a Novel Ranking Method

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      Authors: Taherkhani; Nasrin; Sepehri, Mohammad Mehdi; Khasha, Roghaye; Shafaghi, Shadi
      Abstract: imageBackground. Kidney transplantation is the best alternative treatment for end-stage renal disease. To optimal use of donated kidneys, graft predicted survival can be used as a factor to allocate kidneys. The performance of prediction techniques is highly dependent on the correct selection of predictors. Hence, the main objective of this research is to propose a novel method for ranking the effective variables for predicting the kidney transplant survival.Methods. Five classification models were used to classify kidney recipients in long- and short-term survival classes. Synthetic minority oversampling and random undersampling were used to overcome the imbalanced class problem. In dealing with missing values, 2 approaches were used (eliminating and imputing them). All variables were categorized into 4 levels. The ranking was evaluated using the sensitivity analysis approach.Results. Thirty-four of the 41 variables were identified as important variables, of which, 5 variables were categorized in very important level (“Recipient creatinine at discharge,” “Recipient dialysis time,” “Donor history of diabetes,” “Donor kidney biopsy,” and “Donor cause of death”), 17 variables in important level, and 12 variables in the low important level.Conclusions. In this study, we identify new variables that have not been addressed in any of the previous studies (eg, AGE_DIF and MATCH_GEN). On the other hand, in kidney allocation systems, 2 main criteria are considered: equity and utility. One of the utility subcriteria is the graft survival. Our study findings can be used in the design of systems to predict the graft survival.
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Evaluation of Recombinant Herpes Zoster Vaccine for Primary Immunization
           of Varicella-seronegative Transplant Recipients

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      Authors: L'Huillier; Arnaud G.; Hirzel, Cedric; Ferreira, Victor H.; Ierullo, Matthew; Ku, Terrance; Selzner, Nazia; Schiff, Jeffrey; Juvet, Stephen; Miao, Congrong; Schmid, D. Scott; Humar, Atul; Kumar, Deepali
      Abstract: imageBackground. Immunization of varicella-zoster virus (VZV)-seronegative solid organ transplant (SOT) patients using the live-attenuated varicella vaccine is generally contraindicated, leaving no widely applicable immunization option. The recombinant subunit herpes zoster vaccine (RZV) is indicated for VZV-seropositive persons to prevent shingles but could potentially also protect VZV-seronegative persons against varicella. We performed a safety and immunogenicity evaluation of RZV in VZV-seronegative SOT recipients as an option for protection.Methods. VZV-seronegative adult SOT patients with no history of varicella/shingles vaccine or disease were given 2 doses of RZV vaccine 2–6 mo apart. Blood was drawn prevaccination (V1), before the second dose (V2), and 4 wk after the second dose (V3). Humoral immunity (anti-glycoprotein E) and cell-mediated immunity were evaluated, with polyfunctional cells defined as cells producing ≥2 cytokines.Results. Among 31 eligible VZV-seronegative SOT patients screened, 23 were enrolled. Median age was 38 y and median time since transplant procedure was 3.8 y. The most frequent transplant types were liver (35%) and lung (30%). Median anti-glycoprotein E levels significantly increased from V1 to V3 (P = 0.001) and V2 to V3 (P 
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • SARS-CoV-2 Vaccination and Solid Organ Transplant Patients: Data Needed to
           Inform Safety and Efficacy

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      Authors: Ison; Michael G.; Avery, Robin; Blumberg, Emily; Chin-Hong, Peter; Halasa, Natasha; Kaul, Dan; Pergam, Steve; Theodoropoulos, Nicole M.; Wolfe, Cameron R.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Persistent Immunogenicity of the mRNA COVID-19 Vaccine in Patients
           Vaccinated Before Kidney Transplant

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      Authors: Yi; Stephanie G.; Eagar, Todd; Moore, Linda; Huang, Howard J.; Ibrahim, Hassan; Hobeika, Mark J.; McMillan, Robert; Podder, Hemangshu; Ghobrial, R. Mark; Gaber, A. Osama; Knight, Richard J.
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Immediate Impact of Induction Treatment on Postvaccination SARS-CoV-2
           Serology in Kidney Transplant Recipients

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      Authors: Mohamadou; I.; Nkok, J.; Galichon, P.; Cazenave, M.; Arzouk, N.; Ouali, N.; Rondeau, E.; Barrou, B.; Amiel, C.; Boutolleau, D.; Tourret, J.
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Antibody Kinetics and Durability in SARS-CoV-2 mRNA Vaccinated Solid Organ
           Transplant Recipients

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      Authors: Boyarsky; Brian J.; Chiang, Teresa P.-Y.; Teles, Aura T.; Greenberg, Ross S.; Krach, Michelle R.; Ou, Michael T.; Massie, Allan B.; Tobian, Aaron A. R.; Garonzik-Wang, Jacqueline M.; Segev, Dorry L.; Werbel, William A.
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Breakthrough COVID-19 Infections After mRNA Vaccination in Solid Organ
           Transplant Recipients in Miami, Florida

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      Authors: Anjan; Shweta; Natori, Yoichiro; Fernandez Betances, Anmary A.; Agritelley, Matthew S.; Mattiazzi, Adela; Arosemena, Leopoldo; Andrews, David M.; Simkins, Jacques; Guerra, Giselle; Abbo, Lilian M.
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • T-cell and Antibody Response After 2 Doses of the BNT162b2 Vaccine in a
           Belgian Cohort of Kidney Transplant Recipients

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      Authors: Devresse; Arnaud; Saad Albichr, Imane; Georgery, Hélène; Yombi, Jean Cyr; De Greef, Julien; Belkhir, Leila; Mzougui, Samy; Scohy, Anais; Darius, Tom; Buemi, Antoine; Goffin, Eric; Kabamba, Benoit; Kanaan, Nada
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Successful Liver Transplantation From a Deceased Donor With
           Vaccine-Induced Thrombotic Thrombocytopenia Causing Cerebral Venous Sinus
           and Hepatic Veins Thrombosis After ChAdOx1 nCov-19 Vaccination

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      Authors: Centonze; Leonardo; Lauterio, Andrea; De Carlis, Riccardo; Ferla, Fabio; De Carlis, Luciano
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Anti-SARS-CoV-2 Monoclonal Antibodies in Solid-organ Transplant Patients

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      Authors: Del Bello; Arnaud; Marion, Olivier; Vellas, Camille; Faguer, Stanislas; Izopet, Jacques; Kamar, Nassim
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Very Low Immunization Rate in Kidney Transplant Recipients After One Dose
           of the BNT162b2 Vaccine: Beware not to Lower the Guard!

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      Authors: Georgery; Hélène; Devresse, Arnaud; Yombi, Jean-Cyr; Belkhir, Leila; De Greef, Julien; Darius, Tom; Buemi, Antoine; Scohy, Anais; Kabamba, Benoit; Goffin, Eric; Kanaan, Nada
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Posttransplant Hypertension Matters!

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      Authors: Midtvedt; Karsten; Onsøien, Mari O.; Åsberg, Anders
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Reply to: Posttransplant Hypertension Matters!

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      Authors: Wyld; Melanie L. R.; De La Mata, Nicole L.; Masson, Philip; O’Lone, Emma; Kelly, Patrick J.; Webster, Angela C.
      Abstract: No abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
  • Plasmapheresis Decreases Belatacept Exposure: Requires Consideration for
           Dose and Frequency Adjustments

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      Authors: Jain; Ashokkumar; Xu, Ruichao; Venkataramanan, Raman; Farooq, Umar; Butt, Fauzia; Ghahramani, Nasrollah; Kadry, Zakiyah
      Abstract: imageNo abstract available
      PubDate: Fri, 01 Oct 2021 00:00:00 GMT-
       
 
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