Avoiding grafts with ischemic time (IT) >6h continues to be advised in pediatric heart transplant (HTx). We sought to evaluate the association between IT and clinical outcomes in a geographically remote center. This was a retrospective single-center analysis of patients transplanted between 01/1995 and 12/2020. Baseline characteristics and post-HTx outcomes were compared across three IT groups (6h)

Thoracoabdominal normothermic regional perfusion (TA-NRP) would likely expand the quantity and quality of organs procured after controlled circulatory-death donation in the United States, yet its ethical permissibility remains contested. We surveyed a representative sample of U.S. adults (n = 975) with the goal of assessing their perspectives on the ethical permissibility of TA-NRP. After reading a

Population-based studies evaluating long-COVID-19 prevalence in transplant recipients are limited. We examined risk of new-incident multi-systemic sequelae post-SARS-CoV-2 Omicron infection in a retrospective population-based cohort of transplant recipients, versus test-negatives. National COVID-19/healthcare-claims databases were utilised to construct cohorts of all Singaporean adult transplant recipients

The efficacy and post-transplant outcomes of desensitization therapy in highly sensitized heart transplant (HT) candidates are unknown. In this retrospective cohort study, 57 HT candidates with pre-HT calculated panel reactive antibody (cPRA) level of >50% for anti-HLA antibodies with mean fluorescence intensity (MFI) > 10,000, who were treated with desensitization therapy were identified. Post-treatment

The emergence of IgE antibodies specific for donor MHC has been observed in murine transplant models and kidney transplant recipients. While IgE's significance in allergies and other TH2-type diseases is well-documented, its potential role in transplant rejection remains largely unexplored. Besides its involvement in immediate-type allergic hypersensitivity reactions via its high-affinity receptor

Females have higher rates of rejection and allograft failure not due to death compared to males. Offspring living kidney donor transplants provide an opportunity to assess the role of maternal immune memory in outcome differences between sexes. Among adult living kidney donor recipients in the Scientific Registry of Transplant Recipients from 2000 to 2018, the cumulative incidence of graft loss was

Regulatory T cells (Tregs) can reverse inflammation in animal models. We conducted a randomized controlled clinical trial of Treg therapy in kidney transplant recipients with subclinical graft inflammation (NCT02711826). The primary endpoint was the change in graft inflammation on a follow-up biopsy 6 months after Treg infusion. The trial accrued 8 control group participants and 7 polyclonal Treg group

Rehospitalization in the first year after pediatric kidney transplant (KT) is common but poorly understood. Using linked data between the Scientific Registry for Transplant Recipients and the Pediatric Health Information System databases, frequency, causes, and risk factors for rehospitalization in the first year were examined across 36 pediatric hospitals. 29% of incident pediatric KT recipients were

The use of allocation out of sequence (AOOS) of donor kidneys has increased in recent years in the US. The impact on candidate and recipient outcomes is unknown. Using data from the Scientific Registry of Transplant Recipients, we analyzed 83 811 adult candidates who were listed for a single-kidney transplant between January 1, 2022, and December 31, 2023, to compare waitlist outcomes between candidates

We report a case series of 2 lung transplant recipients with chronic, multidrug-resistant Mycobacterium abscessus infections unresponsive to conventional antibiotic therapy, who received intravenous bacteriophage treatment for 12 months under compassionate use. Both patients showed clinical improvement and resolution of the radiological opacities. Gene expression in blood samples collected before and

The 2013 U.S. Public Health Service (PHS) guideline for screening organ donors for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) designated donors with social and behavioral characteristics associated with HIV, HBV, and HCV for transmission as increased risk donors (IRDs) and was associated with an underutilization of IRD organs. In 2020, the PHS guideline

Kidney transplant recipients are prescribed medications to prevent Pneumocystis jirovecii pneumonia (PJP), but there is no consensus regarding the optimal duration of therapy. We used linked health care databases in Alberta, Canada, to describe patterns of PJP prophylactic prescriptions in incident adult kidney transplant recipients (2008-2019) to compare clinical outcomes in recipients taking short-term

The National Kidney Registry’s voucher program provides a novel methodology to increase directed and nondirected living kidney donation. Standard vouchers, launched in 2014, allow a donor to donate to an unknown recipient on behalf of an individual who needs a transplant. Family vouchers (FVs), launched in 2019, allow a Good Samaritan donor to donate and provide vouchers to loved ones who do not have

Normothermic regional perfusion (NRP) is a postmortem technique that restores oxygenated blood flow to transplantable organs in situ after death determination in donation after circulatory death to improve organ viability and function. Although observational evidence strongly suggests NRP is superior to conventional rapid organ recovery, it has generated ethical controversy internationally. Although

Implantation of cultured allogeneic thymus tissue (CTTI) into athymic human recipients generates functional recipient-derived naïve T cells that are tolerant to the donor. Currently, CTTI is always performed with 12 to 21 days of thymus procurement to avoid culture-related changes that could be detrimental to its reconstitution potential. We demonstrate here that cultured thymus tissue can be cryopreserved

Physician assistant (PA)-led donor recovery models have been shown to be safe and effective in lung transplantation, but data on their application in heart transplantation (HT) are limited. We conducted an observational cohort study at a high-volume heart transplant center to compare outcomes of adult HTs between 2020 and 2024 using allografts recovered by PA-led vs non–PA-led recovery teams. A total

The Bombay blood group is an exceptionally rare phenotype characterized by the absence of H antigen on red blood cells due to mutations in the FUT1 gene and absence of H substance in secretions from concurrent FUT2 deficiency. These individuals produce potent anti-H antibodies in addition to anti-A and anti-B antibodies, posing unique challenges in transfusion and solid organ transplantation. We report

The demand for liver transplantation compounds the challenges of achieving justice. Scarcity raises questions about how candidate review committees determine which patients are suitable for transplantation, particularly for perceived patient-induced diseases (PPIDs). PPIDs are conditions arising partly from behaviors considered to be within the patient’s control. We explore ethical issues in using

Colorectal cancer (CRC) incidence rises posttransplant, though the mechanism remains unclear. We hypothesize that impaired immunosurveillance of kidney transplant recipients (KTRs) allows progression along the serrated pathway, increasing only immunogenic deficient mismatch repair (dMMR) CRC incidence and not proficient mismatch repair CRC. The nationwide transplant, pathology, and cancer registries

Bloodstream infections (BSIs) are common and are associated with high mortality rates. Few studies have examined the heterogeneity of clinical characteristics in solid organ transplant (SOT) recipients with BSIs. We used machine learning (ML) to identify clinically distinct subtypes in SOT and non-SOT BSI patients. We applied unsupervised ML to clinical variables collected within 48 hours of index

Xenotransplantation received US Food and Drug Administration approval for clinical trials in humans, and highly sensitized patients—those with antibodies against major histocompatibility complex (MHC)—are among the groups that stand to benefit. There is no method to characterize and compare the MHC differences across different species. A database of all pig, rhesus, and human amino acid MHC sequences

We sought to understand the potential impacts of a rapidly evolving donor pool on the annual recalibration of the kidney donor profile index (KDPI). Using Organ Procurement and Transplantation Network data, we examined the kidney donor risk index (KDRI) among deceased donors whose kidneys were recovered for transplantation from 2011 to 2024. We mimicked the Organ Procurement and Transplantation Network's

Neutralizing antibodies (NAbs) have been proposed as biomarkers for stratifying BK polyomavirus (BKPyV) replication risk, while torque teno virus (TTV) viral load is recognized as a global immunomarker in kidney transplantation. This study investigates their combined utility to improve BKPyV DNAemia risk assessment in 187 patients within 12 months posttransplant. BKPyV DNAemia occurred in 19% of recipients

Maribavir has demonstrated promising efficacy in treating refractory cytomegalovirus (CMV) infections among solid organ transplant recipients; however, factors influencing favorable outcomes remain uncertain. We conducted a retrospective cohort study that involved 88 kidney transplant recipients (KTRs) from 22 transplantation centers, all of whom had refractory CMV infections treated with maribavir

Interferon gamma (IFNG) is thought to play a central role in the pathogenesis of cardiac allograft vasculopathy (CAV) in patients with heart transplant (HTx). However, peripheral lymphocytes participating in the IFNG axis remain largely unknown in human CAV. Using peripheral blood mononuclear cells from International Society for Heart and Lung Transplant grade 2 or 3 CAV (high-grade CAV) and normal

Antibody-mediated rejection (AMR) remains a significant barrier to successful outcomes in both allo- and xenotransplantation. In this study, we investigate the efficacy of a novel recombinant endopeptidase, IceMG, which simultaneously cleaves IgG and IgM in rhesus macaques sensitized by sequential skin transplantations. A single intravenous dose of IceMG (2mg/kg) induced a significant but transient

Metabolic syndrome and obesity are prevalent and impact liver transplantation (LT) outcomes. Furthermore, the understanding of the complex physiology of obesity and availability of effective antiobesity interventions has developed rapidly. To bridge the current gap in practice guidance, the American Society for Transplantation Liver and Intestinal Community of Practice convened a controversies conference

Upon activation, macrophages undergo epigenetic and metabolic reprogramming, resulting in stronger responses to subsequent insults (trained immunity), and, in the case of transplant, in accelerated rejection. Erythropoietin (EPO), a kidney-produced erythropoietic hormone, exerts immunomodulatory effects through the ligation of EPO receptor (EPOR) expressed on myeloid cells, but its effects on trained

Recurrent primary biliary cholangitis (rPBC) after liver transplantation (LT) is thought to influence graft survival and long-term outcomes, yet its global burden and determinants remain poorly defined. We aimed to quantify the prevalence and incidence of histologically confirmed rPBC after LT and identify associated risk factors. We conducted a systematic review and meta-analysis in accordance with

The aim of this study was to assess the efficacy of end-ischemic hypothermic oxygenated perfusion (HOPE) used before liver transplantation (LT) with extended criteria donor (ECD) organs from donation after brain death (DBD) in reducing early allograft dysfunction (EAD) compared with static cold storage (SCS). Between 2019 and 2023, 262 ECD-DBD grafts from 8 French centers were randomly assigned for

Perfusion technology is increasingly used to assess and/or enhance organ viability by circulating blood or blood substitutes through organs, improving transplant outcomes. Both ex situ and in situ techniques present distinct ethical issues that must be considered during implementation. Perspectives of stakeholders can illuminate key concerns. This scoping review maps the literature on ethical and psychosocial

The nonmyeloablative conditioning regimen comprising total lymphoid irradiation (TLI) and antithymocyte globulin is used for allogeneic hematopoietic stem cell transplant patients. There is a need to safely intensify TLI+antithymocyte globulin to allow for the achievement of sustained mixed chimerism, particularly in cases where pre-existing autoimmunity poses a significant barrier to successful engraftment

Cardiovascular disease is the leading cause of morbidity and mortality among liver transplantation (LT) recipients. A panel of 24 experts from the International Liver Transplantation Society and the Liver Intensive Care Group of Europe convened to develop guidelines for preoperative cardiovascular assessment of LT candidates. The panel identified 7 areas required for standard cardiovascular preoperative

There are several stages in kidney transplantation during which epithelial injury and endothelial activation in the graft can occur. When acute tubular necrosis delays recovery of graft function, a biopsy is occasionally taken to estimate the risk of primary nonfunction, adapt immunosuppression, and eliminate acute rejection, a priority in recipients known to have anti-human leukocyte antigen (HLA)

De novo blood donor-specific human leukocyte antigen (HLA) antibodies (bDSA) from red cell transfusions can complicate solid organ transplantation, but the incidence rate is uncertain. We conducted a prospective observational study to assess the cumulative incidence rate of de novo bDSA in a cohort of patients with chronic kidney disease and no prior transplant, patients with prior kidney transplants

With the US Food and Drug Administration clearance of clinical trials of kidney xenotransplantation (XTx) in living humans, understanding the recipient experience is critical. Semistructured interviews with the 3 living XTx recipients identified core domains of the recipient’s experience, including quality of life (QoL), fears about XTx, and health care team communication and support. Transcribed interviews