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Simultaneous nephrectomy during kidney transplantation for polycystic kidney disease does not detrimentally impact comorbidity and graft survival

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World Journal of Transplantation 2022年第5期12卷 100-111页

作者： Tom Darius Sébastien Bertoni Martine De Meyer Antoine Buemi Arnaud Devresse Nada Kanaan Eric Goffin Michel Mourad Surgical and Abdominal Transplantation Unit University Clinics Saint LucBrussels 1200Belgium Division of Nephrology University Clinics Saint LucBrussels 1200Belgium

BACKGROUND The lack of space,as an indication for a native unilateral nephrectomy for positioning a future kidney graft in the absence of other autosomal dominant polycystic kidney disease-related symptoms,remains controversial.AIM To evaluate the surgical comorbidity and the impact on graft survival of an associated ipsilateral native nephrectomy during isolated kidney transplantation in patients with autosomal dominant polycystic kidney disease.METHODS One hundred and fifty-four kidney transplantations performed between January 2007 and January 2019 of which 77 without(kidney transplant alone(KTA)group)and 77 with associated ipsilateral nephrectomy(KTIN group),were retrospectively reviewed.Demographics and surgical variables were analyzed and their respective impact on surgical comorbidity and graft survival.RESULTS Creation of space for future graft positioning was the main reason(n=74,96.1%)for associated ipsilateral nephrectomy.No significant difference in surgical comorbidity(lymphocele,wound infection,incisional hernia,wound hematoma,urinary infection,need for blood transfusion,hospitalization stay,Dindo Clavien classification and readmission rate)was observed between the two study groups.The incidence of primary nonfunction and delayed graft function was comparable in both groups[0%and 2.6%(P=0.497)and 9.1%and 16.9%(P=0.230),respectively,in the KTA and KTIN group].The 1-and 5-year graft survival were 94.8%and 90.3%,and 100%and 93.8%,respectively,in the KTA and KTIN group(P=0.774).The 1-and 5-year patient survival were 96.1%and 92.9%,and 100%and 100%,respectively,in the KTA and KTIN group(P=0.168).CONCLUSION Simultaneous ipsilateral native nephrectomy to create space for graft positioning during kidney transplantation in patients with autosomal dominant polycystic kidney disease does not negatively impact surgical comorbidity and short-and long-term graft survival.

关键词： Autosomal dominant polycystic kidney disease Complications Kidney transplantation graft survival Unilateral nephrectomy Surgical comorbidity

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Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study

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World Journal of Transplantation 2024年第1期14卷 130-140页

作者： Geisiane Custodio Andrew Maykon Massutti Aline Caramori Taynara Gonçalves Pereira Augusto Dalazen Gabriela Scheidt Ludmilla Thomazini Cristiane Bauermann Leitão Tatiana Helena Rech Department of Intensive Care Unit Hospital Santa IsabelBlumenau-Santa Catarina CEP-89010906Brazil Transplant Division Hospital Santa IsabelBlumenau-Santa Catarina CEP-89010906Brazil School of Medicine Universidade Regional de Blumenau(FURB)Blumenau-Santa Catarina CEP-89010906Brazil School of Medicine Universidade Federal do Rio Grande do SulPorto Alegre 90035-903Brazil Departement of Endocrinology Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do SulPorto Alegre 90035-903Rio Grande do SulBrazil Department of Internal Medicine Hospital de Clínicas de Porto AlegreDivision of Intensive Care MedicinePorto Alegre 90035-903Brazil

BACKGROUND Prolonged donor hepatectomy time may be implicated in early and late complications of liver transplantation.AIM To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients,mainly early allograft dysfunction.METHODS This multicenter retrospective study included brain-dead donors and adult liver graft recipients.Donor-recipient matching was obtained through a crossover list.Clinical and laboratory data were recorded for both donors and recipients.Donor hepatectomy,cold ischemia,and warm ischemia times were recorded.Primary outcome was early allograft dysfunction.Secondary outcomes included need for retransplantation,length of intensive care unit and hospital stay,and patient and graft survival at 12 months.RESULTS From January 2019 to December 2021,a total of 243 patients underwent a liver transplant from a brain-dead donor.Of these,57(25%)developed early allograft dysfunction.The median donor hepatectomy time was 29(23–40)min.Patients with early allograft dysfunction had a median hepatectomy time of 25(22–38)min,whereas those without it had a median time of 30(24–40)min(P=0.126).CONCLUSION Donor hepatectomy time was not associated with early allograft dysfunction,graft survival,or patient survival following liver transplantation.

关键词： Brain death Hepatectomy Liver transplantation Early allograft dysfunction graft survival

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Predicting outcomes after kidney transplantation: Can Pareto’s rules help us to do so?

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World Journal of Transplantation 2024年第1期14卷 9-11页

作者： Fernando M Gonzalez Francisca Gonzalez Cohens Department of Nephrology Faculty of MedicineUniversidad de ChileSantiago 7500922Chile Web Intelligence Centre Faculty of Physics and Mathematical SciencesSantiago 7500922Chile

Kidney transplantation is the best option for kidney replacement therapy,even considering that most of the times the grafts do not survive as long as their recipients.In the Khalil et al's experience,published in this issue of the Journal,they analyze their second kidney graft survival and describe those significant predictors of early loss.This editorial comments on the results and put in perspective that most of the times,long-term graft survival could be inadvertently jeopardized if the immunosuppressive therapy is reduced or withdrawn for any reason,and that it could happen frequently if the transplant physician intends to innovate with the clinical care without proper evidence-based data.

关键词： Kidney transplantation graft survival Acute rejection Interstitial fibrosis and tubular atrophy Immunosuppression

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Evaluation of corneal graft survival in mice model

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International Journal of Ophthalmology(English edition) 2013年第5期6卷 577-582页

作者： Guo-Ling Chen Jing-Jing Zhang Jun Zhao Da-Jiang Wang Han Zhang Department of Ophthalmology the Second Hospital of Shandong University Department of Ophthalmology the Third People's Hospital of Jinan The General Hospital of Liaohe Oil Field The General Hospital of People's Liberation Army

·AIM: To investigate the characteristics and criterion of graft rejection in mice model. ·METHODS: C57BL/6 or BALB/c mice corneal grafts were grafted onto BALB/c hosts. Each group was divided into two subgroups according to the corneal opacity scores 12d after transplantation. The characteristics of opacity and neovascularization were observed. Mice of the 12 th , 50 th day after transplantation, the grafts biopsy of mice in allogeneic group 1, which opacity score exceed 3, were prepared for histological observation and those restore transparent were endothelial stained. ·RESULTS: There was no difference of corneal opacity score on the 7 th and 12 th day after operation; the histological results had no disparity between syngeneic group and allogeneic group. On the 12 th day after surgery, the turbidity curve was apparent in grafts with opacity score grafts with opacity score reached 3 in allogeneic group 1. Different rejection performance was observed in tissue sections on the 50 th day after surgery. ·CONCLUSION: grafts, opacity score exceeds 3 from the 7 th to the 12 th day after operation could not be judged as a rejection. We should pay more attention to the variation of grafts opacity since 12d after corneal transplantation.·

关键词： corneal transplantation graft survival experimental study

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Diabetes mellitus is not associated with worse short term outcome in patients older than 65 years old post-liver transplantation

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World Journal of Hepatology 2023年第2期15卷 274-281页

作者： Saad Alghamdi Shaden Alamro Dhari Alobaid Elwy Soliman Ali Albenmousa Khalid Ibrahim Bzeizi Saleh Alabbad Saleh A Alqahtani Dieter Broering Waleed Al-Hamoudi Liver and Small Bowel Health Centre Department KFSHRCRiyadh 11211Saudi Arabia Department of Medicine KFSHRCRiyadh 11211Saudi Arabia Department of Internal Medicine Minia UniversityMinya 61519Egypt Division of Gastroenterology and Hepatology Johns Hopkins UniversityBaltimoreMD 21287United States Liver Disease Research Center Department of MedicineCollege of MedicineKing Saud UniversityRiyadh 11451Saudi Arabia

BACKGROUND Non-alcoholic fatty liver disease is a global health care challenge and a leading indication of liver transplantation(LT).Hence,more patients with diabetes mellitus(DM)are undergoing LT,especially,above the age of 65.AIM To evaluate the impact of DM on short-term outcomes post-LT in patients over the age of 65.METHODS We collected data of patients who underwent LT from January 2001 until December 2019 using our electronic medical record.We assessed the impact of DM on short-term outcomes,one-year,post-LT based on the following variables:survival at one year;acute cellular rejection(ACR)rates;intensive care unit(ICU)and hospital length of stay;and readmissions.RESULTS Total of 148 patients who are 65 year or older underwent LT during the study period.The mean age is 68.5±3.3 years and 67.6%were male.The median Model for End-stage Liver Disease score at time of transplantation was 22(6-39),39%of patients had hepatocellular carcinoma and 77.7%underwent living donor LT.The one-year survival was similar between DM patients and others,91%.ACR occurred in 13.5%of patients(P=0.902).The median ICU stay is 4.5-day P=0.023.The rates of ICU and 90-d readmission were similar(P=0.821)and(P=0.194),respectively.CONCLUSION The short-term outcome of elderly diabetic patients undergoing LT is similar to others.The presence of DM in elderly LT candidates should not discourage physicians from transplant consideration in this cohort of patients.

关键词： Acute cellular rejection Diabetes mellitus Elderly graft survival Liver transplantation

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Role of biliary complications in chronic graft rejection after living donor liver transplantation

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World Journal of Hepatology 2022年第5期14卷 1050-1052页

作者： Aiman Obed Abdalla Bashir Anwar Jarrad Laszlo Fuzesi Hepatobiliary and Liver Transplant Unit Jordan HospitalAmman 52112Jordan Department of General Surgery Jordan HospitalAmman 52112Jordan Department of Hepatology Jordan HospitalAmman 52112Jordan Department of Pathology Faculty of MedicineUniversity AugsburgAugsburg 86156Germany

Postoperative biliary complications remain a substantial challenge after living donor liver transplantation,especially due to its heterogeneous clinical presentation.

关键词： Chronic graft rejection Biliary complications Living donor liver transplantation graft survival Cholangiopathy

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Qualifying the suitability of living donor livers for pediatric liver transplantation:are we doing the right thing?

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Hepatobiliary Surgery and Nutrition 2023年第3期12卷 462-464页

作者： Henkjan J.Verkade Frans C.J.Cuperus Aad P.van den Berg Division of Pediatric Gastroenterology and Hepatology Department of PediatricsUniversity of GroningenBeatrix Children’s HospitalUniversity Medical Center GroningenGroningenThe Netherlands Department of Gastroenterology and Hepatology University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands

Over the last decades,liver transplantation has become the standard care for many forms of end-stage liver disease,both in adults and in children.The prognosis after pediatric liver transplantation(pLT)has steadily increased up to a patient survival at 5 years of 85%and an estimated graft half life of 31 years(1,2).In the early days of pLT,the transplanted organ originated from deceased donors.Since 1990,adult-to-child living donor liver transplantation(LDLT)programs have developed,which rapidly gained popularity,particularly in Europe and Asia(2,3).A major stimulus for LDLT has been the limited availability of deceased donors.The indications for liver transplantation have expanded,particularly for adult patients,at a higher rate than the availability of donor organs.Moreover,the quality of donor organs has steadily declined,resulting in a decreased utilization of livers from deceased donors for transplantation(4).The limited availability of qualified deceased donor livers has further stimulated LDLT:in Europe,for example,the percentage of living donor organs used for pLT increased from 7%before 2000 to 40%since 2010(1).

关键词： Steatosis graft survival pediatric liver transplantation(pLT) patient survival

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Analysis of hepatitis C virus-positive organs in liver transplantation

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World Journal of Hepatology 2022年第9期14卷 1840-1843页

作者： Isabel Legaz Manuel Muro Department of Legal and Forensic Medicine Biomedical Research InstituteRegional Campus of International Excellence"Campus Mare Nostrum"Faculty of MedicineUniversity of MurciaMurcia 30100Spain Department of Immunology Service Instituto Murciano de Investigación BiosanitariaHospital Clínico Universitario Virgen de la ArrixacaMurcia 30120Spain

The authors of this study note that in liver transplantation(LT),the survival rates of hepatitis C virus(HCV)-positive donors and HCV-negative receivers are compa-rable to those of HCV-negative donors and recipients.Direct-acting antiviral(DAA)therapies have nearly 100%effectiveness in treating HCV.Between 2006 and 2016,the percentages of HCV-positive patients on the waiting list and HCVpositive LT recipients fell by 8.2 percent and 7.6 percent,respectively.Records from April 1,2014,in which the donor and receiver were both at least 18 years old and had a positive HCV status,were the only ones eligible for the study.The analysis for this study was restricted to the first transplant recorded for each patient using a data element that documented the number of prior transplants for each recipient,although some recipients appeared multiple times in the data set.HCV-positive recipients or people with fulminant hepatic failure were the main beneficiaries of primary biliary cirrhosis among HCV-positive donors.However,there is still a reticence to use HCV-positive donor organs in HCV recipients due to clinical and ethical considerations.Similar survival rates between HCV-positive donors and recipients and HCV-negative donors and receivers illustrate the efficacy of these DAA regimens.

关键词： Hepatitis C virus Liver transplant graft survival United network for organ sharing Direct-acting antiviral

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Is peri-transplant blood transfusion associated with worse transplant outcomes?A retrospective study

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World Journal of Transplantation 2023年第4期13卷 157-168页

作者： Muhammad A Bukhari Faisal K Alhomayani Hala S Al Eid Najla K Al-Malki Mutlaq Eidah Alotaibi Mohamed A Hussein Zainab N Habibullah Multi-organ Transplantation Center King Abdullah Medical CityMakkah 29123Saudi Arabia Department of Internal Medicine College of MedicineTaif UniversityTaif 23611Saudi Arabia Department of Pharmacy Alhada Armed Forces HospitalTaif 29123Saudi Arabia Department of Nephrology and Transplantation Alhada Armed Forces HospitalTaif 29123Saudi Arabia

BACKGROUND Blood transfusion is common during the peri-transplantation period.The incidence of immunological reactions to blood transfusion after kidney transplantation and their consequences on graft outcomes have not been extensively studied.AIM To examine the risk of graft rejection and loss in patients who received blood transfusion in the immediate peri-transplantation period.METHODS We conducted a single-center retrospective cohort study of 105 kidney recipients,among them 54 patients received leukodepleted blood transfusion at our center between January 2017 and March 2020.RESULTS This study included 105 kidney recipients,of which 80%kidneys were from living-related donors,14%from living-unrelated donors,and 6%from deceased donors.Living-related donors were mostly first-degree relatives(74.5%),while the rest were second-degree relatives.The patients were divided into transfusion(n=54)and non-transfusion(n=51)groups.The average hemoglobin level at which blood transfusion was commenced was 7.4±0.9 mg/dL.There were no differences between the groups in terms of rejection rates,graft loss,or death.During the study period,there was no significant difference in creatinine level progression between the two groups.Delayed graft function was higher in the transfusion group;however,this finding was not statistically significant.A high number of transfused packed red blood cells was significantly associated with increased creatinine levels at the end of the study.CONCLUSION Leukodepleted blood transfusion was not associated with a higher risk of rejection,graft loss,or death in kidney transplant recipients.

关键词： Transplantation Transfusion Rejection graft survival

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Impact of tacrolimus intra-patient variability in adverse outcomes after organ transplantation

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World Journal of Transplantation 2023年第5期13卷 254-263页

作者： Maria Clara Morais Maria Eduarda Soares Gabriela Costa Laura Guerra Nayana Vaz Liana Codes Paulo Lisboa Bittencourt School of Medicine Bahiana School of Medicine and Public HealthSalvador 40290-000BahiaBrazil School of Medicine Federal University of BahiaSalvador 40110-100BahiaBrazil Unit of Gastroenterology and Hepatology Portuguese HospitalSalvador 40130-030BahiaBrazil

Tacrolimus(Tac)is currently the most common calcineurin-inhibitor employed in solid organ transplantation.High intra-patient variability(IPV)of Tac(Tac IPV)has been associated with an increased risk of immune-mediated rejection and poor outcomes after kidney transplantation.Few data are available concerning the impact of high Tac IPV in non-kidney transplants.However,even in kidney transplantation,there is still a controversy whether high Tac IPV is indeed detrimental in respect to graft and/or patient survival.This may be due to different methods employed to evaluate IPV and distinct time frames adopted to assess graft and patient survival in those reports published up to now in the literature.Little is also known about the influence of high Tac IPV in the development of other untoward adverse events,update of the current knowledge regarding the impact of Tac IPV in different outcomes following kidney,liver,heart,lung,and pancreas tran-splantation to better evaluate its use in clinical practice.

关键词： Tacrolimus Intra-patient variability Rejection Organ transplantation graft survival Outcomes

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