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Place-based heterogeneity in lung transplant recipient outcomes Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-12 Wayne M. Tsuang, Rocio Lopez, Anne Tang, Marie Budev, Jesse D. Schold
Place is defined as a social or environmental area of residence with meaning to a patient. We hypothesize there is an association between place and the clinical outcomes of lung transplant recipients in the United States. In a retrospective cohort study of transplants between January 1, 2010 and December 31, 2019 in the Scientific Registry of Transplant Recipients, multivariable Cox regression models
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De novo posttransplant membranous nephropathy following BNT162b2 mRNA COVID-19 vaccine in a kidney transplant recipient. Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-12 Nathalie Chavarot,Michael Padden,Lucile Amrouche,Stéphanie Malard,Anne Scemla,Rebecca Sberro-Soussan,Juliette Léon,Christophe Legendre,Jean Paul Duong,Julien Zuber,Dany Anglicheau,Marion Rabant,Pierre Isnard
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More is Better… Until it is Worse: Can Organ Placement Processes Scale to an Increasingly Complex System? Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-11 Joel T Adler,S Ali Husain
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Letter to the Editor Re: Letter by Naesens et al. Microvascular inflammation: Gene expression changes do not necessarily reflect pathogenesis. DOI: 10.1111/ajt.17136. Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-11 Philip F Halloran,Katelynn S Thomsen
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Influence of Organ Quality on the Observed Association Between Deceased Donor Kidney Procurement Biopsy Findings and Graft Survival Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-10 S. Ali Husain, Kristen L. King, David C. Cron, Krista L. Lentine, Joel T. Adler, Sumit Mohan
Deceased donor kidney procurement biopsies findings are the most common reason for kidney discard. Retrospective studies have found inconsistent associations with post-transplant outcomes but may have been limited by selection bias because kidneys with advanced nephrosclerosis from high-risk donors are typically discarded. We conducted a retrospective cohort study of kidneys transplanted in the United
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First report of auxiliary liver transplantation for severe cholangiopathy after SARS-CoV-2 respiratory infection Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-05 Mohamed Rela, Muthukumarassamy Rajakannu, Fadl H. Veerankutty, Mukul Vij, Ashwin Rammohan
Post-coronavirus disease 2019 (COVID-19) cholangiopathy (PCC) is a new entity observed in patients recovering from severe COVID-19 pneumonia. Most patients recover with cholestasis improving over a period of time. In some patients cholestasis is severe and persists or progresses to liver failure necessitating liver transplant. We present a previously healthy 50-year-old man who developed PCC with peak
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American Journal of Transplantation: Volume 22, Number 8, August 2022 Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-03
On the cover: The long-term health and well-being of live kidney donors is a primary concern and responsibility of the transplantation community. Thus far, research has predominantly focused on risks of hypertension, proteinuria, development of chronic kidney disease, progression to end stage renal disease and overall mortality. In this issue, Engels et al. (page 2006) examine cancer risk using data
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Targeting Inequities in Kidney Transplantation Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-03 Lara C. Pullen
This month's installment of “The AJT Report” delves into the long-existing racial disparities in kidney transplantation, and the strategies that can be implemented to achieve health equity. We also report on a new proposed rule to expand Medicare coverage for transplant patients.
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Induction of fetomaternal tolerance? Suppressing B cells! Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-03 Wenhao Chen, Xian C. Li
Suppression of B cells by trophoblast-derived glucans induces fetomaternal tolerance.
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Persistent abdominal pain in kidney transplant recipient. Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-01 Iivo Hetemäki,Heli Eronen,Seppo Kortelainen,Petri Koskinen
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De novo SIX2 activation in human kidneys treated with neonatal kidney stem/progenitor cells Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-01 Fanny Oliveira Arcolino, Sarah Hosgood, Sara Akalay, Nina Jordan, Jean Herman, Tegwen Elliott, Koenraad Veys, Kurt Vermeire, Ben Sprangers, Michael Nicholson, Lambertus van den Heuvel, Elena Levtchenko
During development, nephron structures are derived from a SIX2+ stem cell population. After 36 weeks of gestation, these cells are exhausted, and no new nephrons are formed. We have previously described a non-invasive strategy to isolate and expand the native SIX2+ kidney stem cells from the urine of preterm neonates, named neonatal kidney stem/progenitor cells (nKSPC). Here, we investigated the safety
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The current status of stem cell-based therapies during ex vivo graft perfusion: an integrated review of four organs Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-27 S. H. Luijmes, M. M. A. Verstegen, M. J. Hoogduijn, L. Seghers, R. C. Minnee, E. A. F. Mahtab, Y. J. H. J. Taverne, M. E. J. Reinders, L. J. W. van der Laan, J. de Jonge
The use of extended criteria donor grafts is a promising strategy to increase the number of organ transplantations and reduce waitlist mortality. However, these organs are often compromised and/or damaged, are more susceptible to preservation injury, and are at risk for developing post-transplant complications. Ex vivo organ perfusion is a novel technology to preserve donor organs while providing oxygen
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An initiative to increase organ donor registration among persons with HIV Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-23 Ghady Haidar, Divya Bhamidipati, Linda Despines, Colleen Sullivan, Susan Stuart, J. Michael Beckham, Deborah K. McMahon, Peter Veldkamp
To the Editor: Solid organ transplantation (SOT) is considered standard of care for persons with HIV (PWH) and end-stage organ failure.1 However, PWH experience higher waitlist mortality compared to HIV-uninfected individuals. Under the HIV Organ Policy Equity (HOPE) Act, it is acceptable to perform transplants using organs from deceased donors with HIV into recipients with HIV.1 However, there remains
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Gene expression profiling using deceased donor kidney biopsies to predict graft outcomes—We are not there yet Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-28 Ilkka Helanterä, Gillian Divard
The field of organ transplantation has seen enormous developments in creating and validating new biomarkers or composite risk scores as prognostic tools to predict graft outcomes.1 Most of these tools rely on findings or events after transplantation, and the field would benefit greatly from a reliable prognostic method to identify high-risk patients already at the time of transplantation. Although
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Islet allografts expressing a PD-L1 and IDO fusion protein evade immune rejection and reverse preexisting diabetes in immunocompetent mice without systemic immunosuppression Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-27 Pradyut K. Paul, Rahul Das, Travis Drow, Emily A. Nylen, Arnaldo Henrique de Souza, Zunyi Wang, Michael W. Wood, Dawn B. Davis, Dale E. Bjorling, Jacques Galipeau
Allogeneic islet transplantation is a promising experimental therapy for poorly controlled diabetes. Despite pharmacological immunosuppression, long-term islet engraftment remains elusive. Here, we designed a synthetic fusion transgene coupling PD-L1 and indoleamine dioxygenase [hereafter PIDO] whose constitutive expression prevents immune destruction of genetically engineered islet allograft transplanted
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Long-term outcome of patients undergoing resection versus transplantation for neuroendocrine liver metastases meeting the Milan Criteria Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-23 Marianna Maspero, Roberta Elisa Rossi, Carlo Sposito, Jorgelina Coppa, Davide Citterio, Vincenzo Mazzaferro
Liver resection is considered the treatment of choice for resectable neuroendocrine liver metastases (NELM), while liver transplantation is currently reserved for highly selected unresectable patients. We retrospectively analyzed data from consecutive patients undergoing either curative resection or transplantation for liver-only NELM meeting Milan Criteria at a single center between 1984 and 2019
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Expected effect of the lung composite allocation score system on US lung transplantation Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-23 Maryam Valapour, Carli J. Lehr, Andrew Wey, Melissa A. Skeans, Jonathan Miller, Erika D. Lease
Efforts are underway to transition the current lung allocation system to a continuous distribution framework whereby multiple factors are simultaneously combined into a Composite Allocation Score (CAS) to prioritize candidates for lung transplant. The purpose of this study was to compare discrete CAS scenarios with the current concentric circle–based allocation system to assess their potential effects
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Awarding additional MELD points to the shortest waitlist candidates improves sex disparity in access to liver transplant in the United States Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-24 Sarah Bernards, Eric Lee, Ngai Leung, Mustafa Akan, Kyra Gan, Huan Zhao, Monika Sarkar, Sridhar Tayur, Neil Mehta
Since the introduction of the MELD-based allocation system, women are now 30% less likely than men to undergo liver transplant (LT) and have 20% higher waitlist mortality. These disparities are in large part due to height differences in men and women though no national policies have been implemented to reduce sex disparities. Patients were identified using the Scientific Registry of Transplant Recipients
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mTOR inhibitors, mycophenolates, and other immunosuppression regimens on antibody response to SARS-CoV-2 mRNA vaccines in solid organ transplant recipients Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-23 Sunjae Bae, Jennifer L. Alejo, Teresa P. Y. Chiang, William A. Werbel, Aaron A. R. Tobian, Linda W. Moore, Ashrith Guha, Howard J. Huang, Richard J. Knight, A. Osama Gaber, R. Mark Ghobrial, Mara A. McAdams-DeMarco, Dorry L. Segev
A recent study concluded that SARS-CoV-2 mRNA vaccine responses were improved among transplant patients taking mTOR inhibitors (mTORi). This could have profound implications for vaccine strategies in transplant patients; however, limitations in the study design raise concerns about the conclusions. To address this issue more robustly, in a large cohort with appropriate adjustment for confounders, we
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Adult living donor liver transplant for hepatorenal syndrome: Sooner better than later Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-20 Tiffany C. L. Wong, Nazia Selzner
Hepatorenal syndrome (HRS) is a severe complication of end-stage liver disease and without medical treatment or transplantation, the patient survival is often short.1 Furthermore, the chance to recover kidney function in HRS patients after transplantation decreases in patients requiring dialysis for more than a few weeks. As such, timely transplantation of these patients is necessary to allow full
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Renal inflamm-aging provokes intra-graft inflammation following experimental kidney transplantation Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-19 An He, Attia Sarwar, Linda Marie Laura Thole, Janine Siegle, Arne Sattler, Muhammad Imtiaz Ashraf, Vanessa Proß, Carolin Stahl, Theresa Dornieden, Yasmin Bergmann, Paul Viktor Ritschl, Susanne Ebner, Karolin Wiebke Hublitz, Efstathios Gregorios Stamatiades, Roman David Bülow, Peter Boor, Katja Kotsch
Donor age is a major risk factor for allograft outcome in kidney transplantation. The underlying cellular mechanisms and the recipient's immune response within an aged allograft have yet not been analyzed. A comprehensive immunophenotyping of naïve and transplanted young versus aged kidneys revealed that naïve aged murine kidneys harbor significantly higher frequencies of effector/memory T cells, whereas
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The 21st Century Cures Act and psychosocial electronic documentation in solid organ transplantation: Potential harms and practical strategies Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-16 Gerald Scott Winder, Erin G. Clifton
Recent health system initiatives and government legislation have enhanced electronic health information (EHI) sharing in the healthcare technology environment. These measures are favorably viewed by most patients and clinicians. The 21st Century Cures Act, whose final rules went into effect in the United States in 2021, prohibits information blocking practices except in the case of potential harm.
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An additional dose of viral vector COVID-19 vaccine and mRNA COVID-19 vaccine in kidney transplant recipients: A randomized controlled trial (CVIM 4 study) Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-16 Jackrapong Bruminhent, Chavachol Setthaudom, Pattaraphorn Phornkittikorn, Pongsathon Chaumdee, Somsak Prasongtanakij, Supanart Srisala, Kumthorn Malathum, Sarinya Boongird, Arkom Nongnuch, Montira Assanatham, Laor Nakgul, Nutaporn Sanmeema, Angsana Phuphuakrat, Sasisopin Kiertiburanakul
Immunogenicity following an additional dose of Coronavirus disease 2019 (COVID-19) vaccine was investigated in an extended primary series among kidney transplant (KT) recipients. Eighty-five KT participants were randomized to receive either an mRNA (M group; n = 43) or viral vector (V group; n = 42) vaccine. Among them, 62% were male, with a median (IQR) age of 50 (43–59) years and post-transplantation
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An international multicenter validation study of the Toronto listing criteria for pediatric intestinal transplantation Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-14 Amin J. Roberts, Paul W. Wales, Sue V. Beath, Helen M. Evans, Jonathan Hind, David Mercer, Theodoric Wong, Jason Yap, Christina Belza, Yaron Avitzur
Deciding which patients would benefit from intestinal transplantation (IT) remains an ethical/clinical dilemma. New criteria** Burghadt KM et al. AJT 2015;15:1674–81. were proposed in 2015: ≥2 intensive care unit (ICU) admissions, loss of ≥3 central venous catheter (CVC) sites, and persistently elevated conjugated bilirubin (CB ≥ 75 μmol/L) despite 6 weeks of lipid modification strategies. We performed
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Single-center analysis of organ offers and workload for liver and kidney allocation Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-13 Vikrant Reddy, Briget da Graca, Eric Martinez, Richard Ruiz, Sumeet K. Asrani, Giuliano Testa, Anji Wall
The volume of abdominal organ offers received by the Baylor Simmons Transplant Institute has increased over time, resulting in a higher workload for our donor call team. To quantify the increase in organ offers, determine the characteristics of these offers, and estimate the impact on our transplant center workload, we collected center-specific organ offer data from May 2019 to July 2021 using the
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Organ transplantation using COVID-19-positive deceased donors Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-13 Matthew J. Bock, Gabrielle R. Vaughn, Peter Chau, Jennifer A. Berumen, John J. Nigro, Elizabeth G. Ingulli
The COVID-19 pandemic has influenced organ transplantation decision making. Opinions regarding the utilization of coronavirus disease-2019 (COVID-19) donors are mixed. We hypothesize that COVID-19 infection of deceased solid organ transplant donors does not affect recipient survival. All deceased solid organ transplant donors with COVID-19 testing results from March 15, 2020 to September 30, 2021 were
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Cerebral cortical activity after withdrawal of life-sustaining measures in critically ill patients Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-13 Teneille E. Gofton, Loretta Norton, Geoffrey Laforge, Raechelle Gibson, Derek Debicki, Eyad Althenayan, Nathan Scales, Amanda Van Beinum, Laura Hornby, Sam Shemie, Sonny Dhanani, Marat Slessarev
Establishing when cerebral cortical activity stops relative to circulatory arrest during the dying process will enhance trust in donation after circulatory determination of death. We used continuous electroencephalography and arterial blood pressure monitoring prior to withdrawal of life sustaining measures and for 30 min following circulatory arrest to explore the temporal relationship between cessation
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A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-13 Marwan M. Azar, Sarah Turbett, David Gaston, Melissa Gitman, Raymund Razonable, Sophia Koo, Kimberly Hanson, Camille Kotton, Fernanda Silveira, David B. Banach, Sankha S. Basu, Archana Bhaskaran, Lara Danziger-Izakov, Jennifer Dien Bard, Ronak Gandhi, Benjamin Hanisch, Teny M. John, Audrey R. Odom John, Alyssa R. Letourneau, Me-Linh Luong, Gabriela Maron, Steve Miller, Andrea Prinzi, Ilan Schwartz
The last decade has seen an explosion of advanced assays for the diagnosis of infectious diseases, yet evidence-based recommendations to inform their optimal use in the care of transplant recipients are lacking. A consensus conference sponsored by the American Society of Transplantation (AST) was convened on December 7, 2021, to define the utility of novel infectious disease diagnostics in organ transplant
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A multi-institutional study of renal outcomes and renal-related pregnancy outcomes in uterus transplant recipients Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-13 Deirdre Sawinski, Liza Johannesson, Jakub Kristek, Jiri Fronek, Kathleen E. O'Neill, Anthony Gregg, Giuliano Testa, Paige M. Porrett
Uterus transplantation (UTx) is an effective treatment option for uterine factor infertility. However, the need for immunosuppression and congenital renal anomalies that coexist with uterine agenesis in about 30% of women with Mayer-Rokitansky-Kuster-Hauser syndrome create a risk for renal dysfunction. We therefore examined renal function trajectory and related pregnancy complications in an international
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Interleukin 24 promotes cell death in renal epithelial cells and is associated with acute renal injury Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-08 Katharina Schütte-Nütgen, Maria Edeling, Dominik Kentrup, Barbara Heitplatz, Veerle Van Marck, Alexander Zarbock, Melanie Meersch-Dini, Hermann Pavenstädt, Stefan Reuter
Ischemia–reperfusion injury is a major cause of acute kidney injury. Many cytokines are involved in the pathogenesis of renal ischemia–reperfusion injury. IL24 is a member of the IL10 family and has gained importance because of its apoptosis-inducing effects in tumor disease besides its immunoregulative function. Littles is known about the role of IL24 in kidney disease. Using a mouse model, we found
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Outcomes following SARS-CoV-2 infection in individuals with and without solid organ transplantation—A Danish nationwide cohort study Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-08 Maria Overvad, Anders Koch, Bente Jespersen, Finn Gustafsson, Tyra Grove Krause, Christian Holm Hansen, Steen Ethelberg, Niels Obel
The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hospitalization and death, and the effects of SARS-CoV-2 vaccines in solid organ transplant recipients (SOTRs) is still debated. We performed a nationwide, population-based, matched cohort study, including all Danish SOTRs (n = 5184) and a matched cohort from the general population (n = 41 472). Cox regression analyses
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Incidence and severity of SARS-CoV-2 infections in liver and kidney transplant recipients in the post-vaccination era: Real-life data from Denmark Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-08 Sebastian Rask Hamm, Omid Rezahosseini, Dina Leth Møller, Josefine Amalie Loft, Johan Runge Poulsen, Jenny Dahl Knudsen, Martin Schou Pedersen, Kristian Schønning, Zitta Barrella Harboe, Allan Rasmussen, Søren Schwartz Sørensen, Susanne Dam Nielsen
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has been associated with a high risk of adverse outcomes in solid organ transplant (SOT) recipients in the pre-vaccination era. In this retrospective cohort study, we examined the incidence and severity of COVID-19 in kidney and liver transplant recipients in Denmark in the post-vaccination era, from December 27, 2020, to December 27, 2021. We
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COVID-19 therapeutics and outcomes among solid organ transplant recipients during the Omicron BA.1 era Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-08 Jessica Hedvat, Nicholas W. Lange, David M. Salerno, Ersilia M. DeFilippis, Danielle Kovac, Heather Corbo, Justin K. Chen, Jason Y. Choe, Jennifer H. Lee, Anastasia Anamisis, Douglas L. Jennings, Giovanna Codispodo, Tara Shertel, Robert S. Brown, Marcus R. Pereira
Treatment outcomes associated with the use of novel COVID-19 therapeutics in solid organ transplant recipients (SOTR) are not well described in the literature. The objective of this analysis was to characterize 30-day hospitalization and other key secondary endpoints experienced by outpatient SOTR with mild–moderate COVID-19 treated with nirmatrelvir/ritonavir (NR), sotrovimab, or no SARS-CoV-2 specific
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American Journal of Transplantation: Volume 22, Number 7, July 2022 Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-05
On the cover: Lymphocyte depletion is a current pillar of induction immunosuppression protocols, administered to rapidly and aggressively control the cellular response to the new allograft, thereby reducing the incidence and severity of early acute rejection. In this issue, two articles highlight cross-talk between T and B cell populations after lymphodepletion that may compromise the longterm efficacy
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T Cells Prepare for a Test: Can They Tolerate a Donor Heart? Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-05 Lara C. Pullen
This month's installment of “The AJT Report” explores the recently performed first heart/thymus double transplant of allogeneic processed thymus tissue in pediatric patients and the game-changing potential of this procedure. We also report on how a living donor transplant has been successful in treating unresectable colorectal liver metastases.
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Allograft rejection: Be aware of tissue-resident T cells Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-05 Xian C. Li
Skin-resident memory T cells independently mediate robust allograft rejection after alloantigen-sensitization.
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Acute hepatitis and adenovirus infection among children—Alabama, October 2021–February 2022 Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-05 Julia M. Baker, Markus Buchfellner, William Britt, Veronica Sanchez, Jennifer L. Potter, L. Amanda Ingram, Henry Shiau, Luz Helena Gutierrez Sanchez, Stephanie Saaybi, David Kelly, Xiaoyan Lu, Everardo M. Vega, Stephanie Ayers-Millsap, Wesley G. Willeford, Negar Rassaei, Hannah Bullock, Sarah Reagan-Steiner, Ali Martin, Elizabeth A. Moulton, Daryl M. Lamson, Kirsten St. George, Umesh D. Parashar, Aron
During October–November 2021, clinicians at a children's hospital in Alabama identified five pediatric patients with severe hepatitis and adenovirus viremia upon admission. In November 2021, hospital clinicians, the Alabama Department of Public Health, the Jefferson County Department of Health, and CDC began an investigation. This activity was reviewed by CDC and conducted consistent with applicable
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Congenital anatomic variations in a pancreas allograft: Is this consistent with safe transplant? Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-05 Sonal Walia, John A. Powelson, Andrew J. Lutz, Jonathan A. Fridell
American Journal of Transplantation Images in Transplantation – Continuing Medical Education (CME) Each month, the American Journal of Transplantation will feature Images in Transplantation, a journal-based CME activity, chosen to educate participants on current developments in the science and imaging of transplantation. Participants can earn 1 AMA PRA Category 1 Credit™ per article at their own pace
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Airway replacement using stented aortic matrices: Long-term follow-up and results of the TRITON-01 study in 35 adult patients Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-02 Emmanuel Martinod, Dana M. Radu, Ilaria Onorati, Ana Maria Santos Portela, Marine Peretti, Patrice Guiraudet, Marie-Dominique Destable, Yurdagül Uzunhan, Olivia Freynet, Kader Chouahnia, Boris Duchemann, Jamal Kabbani, Cyril Maurer, Pierre-Yves Brillet, Léa Fath, Esteban Brenet, Christian Debry, Camille Buffet, Laurence Leenhardt, Dominique Clero, Nicolas Julien, Nicolas Vénissac, François Tronc, Hervé
Over the past 25 years, we have demonstrated the feasibility of airway bioengineering using stented aortic matrices experimentally then in a first-in-human trial (n = 13). The present TRITON-01 study analyzed all the patients who had airway replacement at our center to confirm that this innovative approach can be now used as usual care. For each patient, the following data were prospectively collected:
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Microvascular inflammation: Gene expression changes do not necessarily reflect pathogenesis Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-02 Maarten Naesens, Olivier Thaunat, Michael Mengel
To the Editor: We read with great interest the manuscript by Halloran and the INTERCOMEX investigators recently published in AJT on the molecular phenotype of antibody-mediated kidney transplant rejection (ABMR).1 We described earlier that the intrarenal molecular signatures of ABMR histology did not differ between patients with and without HLA-DSA.2 The INTERCOMEX data now confirm that also molecularly
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CXCL9 and CXCL10 plasma levels: Potential keys to unlocking CLAD risk Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-02 Osnat Shtraichman, Joshua M. Diamond
The chemoattractants CXCL9 and CXCL10 are chemokines that bind to the shared receptor CXCR3, potentiating T cells, mononuclear cells, and natural killer (NK) cells. Previous studies demonstrated that presence of these chemokines in BAL samples preceded development of chronic lung allograft dysfunction (CLAD), suggesting their role in the development and prediction of CLAD.1, 2 In this issue, Shino
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Extracellular vesicles beyond biomarkers: Effectors of antibody-mediated rejection Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-01 Mélanie Dieudé, Marie-Josée Hébert
In the past decade, extracellular vesicles (EVs), small lipid bilayer particles of cellular origin, have been identified as mediators of intercellular communication, regulators of homeostatic and disease processes, and as diagnostic biomarkers. EV shows important advantages as biomarkers since their lipid bilayer can protect nucleic acids from degradation and proteins from proteolytic cleavage while
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Successful liver transplantation in patients with active SARS-CoV-2 infection Am. J. Transplant. (IF 9.369) Pub Date : 2022-07-01 Charles A. Mouch, Sophoclis P. Alexopoulos, Richard W. LaRue, Hannah P. Kim
The Coronavirus Disease 2019 (COVID-19) pandemic has substantially impacted solid organ transplantation, including temporary inactivation of waitlist candidates with COVID-19 infection. We report two cases of liver transplantation (LT) in individuals with asymptomatic COVID-19 infection. The first patient is a 68-year-old female with decompensated cirrhosis complicated by worsening frailty and sarcopenia
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Data carve out in the midst of the COVID-19 pandemic Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-29 Roslyn B. Mannon, Kiran K. Khush, Sumit Mohan, David M. Vock, Richard Knight, James Pittman, Christopher Zinner, Jeffrey P. Orlowski
In the viewpoint of Subramanian et al.,1 the authors suggest that the Scientific Registry of Transplant Recipients (SRTR) decision to implement a data “carve out” from March 13, 2020 to June 12, 2020, due to the COVID-19 pandemic, could potentially result in systematic geographic bias, particularly as viral prevalence has varied geographically. While the authors indicate that this particular statistical
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Center-level and region-level variations in liver transplantation practices following acuity circles policy change Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-27 Adam M. Burton, David S. Goldberg
Although early studies suggest the Acuity Circles (AC) allocation policy has increased access to deceased donor liver transplants (DDLTs) for patients with the highest MELD scores, changes in center- and region-level practices among patients with the highest MELD scores in response to AC are not well-characterized. OPTN/UNOS data were analyzed to compare center-level changes in the number of DDLTs
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Post-transplant mortality and graft failure after induction immunosuppression among Black heart transplant recipients in the United States Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-27 Soziema Salia, Elizabeth Mostofsky, Suruchi Gupta, Laura Lehman, Francisco J. Barrera, Lathan Liou, Shweta R. Motiwala, Murray A. Mittleman
Black heart transplant recipients are more likely to receive induction immunosuppression compared to other races because of higher rates of acute rejection, graft failure, and mortality. However, it is not known whether contemporary induction immunosuppression improves their post-transplant outcomes. To evaluate whether Black patients who were prescribed induction immunosuppression therapy have lower
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A regulated system of incentives for living kidney donation: Clearing the way for an informed assessment Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-25 Luke Semrau, Arthur J. Matas
The kidney shortage continues to be a crisis for our patients. Despite numerous attempts to increase living and deceased donation, annually in the United States, thousands of candidates are removed from the kidney transplant waiting list because of either death or becoming too sick to transplant. To increase living donation, trials of a regulated system of incentives for living donation have been proposed
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Utilization and outcomes of deceased donor SARS-CoV-2–positive organs for solid organ transplantation in the United States Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-22 Jesse D. Schold, Christine E. Koval, Alvin Wee, Mohamed Eltemamy, Emilio D. Poggio
Coronavirus disease-19 has had a marked impact on the transplant population and processes of care for transplant centers and organ allocation. Several single-center studies have reported successful utilization of deceased donors with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests. Our aims were to characterize testing, organ utilization, and transplant outcomes with donor
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Pretransplant kidney transcriptome captures intrinsic donor organ quality and predicts 24-month outcomes Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-22 Kellie J. Archer, Elissa Bardhi, Daniel G. Maluf, Jennifer McDaniels, Thomas Rousselle, Anne King, James D. Eason, Lorenzo Gallon, Enver Akalin, Thomas F. Mueller, Valeria R. Mas
With the development of novel prognostic tools derived from omics technologies, transplant medicine is entering the era of precision medicine. Currently, there are no established predictive biomarkers for posttransplant kidney function. A total of 270 deceased donor pretransplant kidney biopsies were collected and posttransplant function was prospectively monitored. This study first assessed the utility
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Elevated cell-free DNA in respiratory viral infection and associated lung allograft dysfunction Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-21 Katrina Bazemore, Nitipong Permpalung, Joby Mathew, Merte Lemma, Betelihim Haile, Robin Avery, Hyesik Kong, Moon Kyoo Jang, Temesgen Andargie, Shilpa Gopinath, Steven D. Nathan, Shambhu Aryal, Jonathan Orens, Hannah Valantine, Sean Agbor-Enoh, Pali Shah
Respiratory viral infection (RVI) in lung transplant recipients (LTRs) is a risk for chronic lung allograft dysfunction (CLAD). We hypothesize that donor-derived cell-free DNA (%ddcfDNA), at the time of RVI predicts CLAD progression. We followed 39 LTRs with RVI enrolled in the Genomic Research Alliance for Transplantation for 1 year. Plasma %ddcfDNA was measured by shotgun sequencing, with high %ddcfDNA
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E2F7 promotes mammalian target of rapamycin inhibitor resistance in hepatocellular carcinoma after liver transplantation Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-21 Sunbin Ling, Qifan Zhan, Guangjiang Jiang, Qiaonan Shan, Lu Yin, Rui Wang, Qingyang Que, Xuyong Wei, Shengjun Xu, Jiongjie Yu, Wei Zhou, Lincheng Zhang, Jiaqi Bao, Qianwei Ye, Renyi Su, Rongli Wei, Jimin Liu, Kangchen Chen, Jingrui Wang, Haiyang Xie, Shusen Zheng, Xin He, Jiajia Xiang, Xiao Xu
The mammalian target of rapamycin (mTOR) pathway is frequently deregulated and has critical roles in cancer progression. mTOR inhibitor has been widely used in several kinds of cancers and is strongly recommended in patients with hepatocellular carcinoma (HCC) after liver transplantation (LT). However, the poor response to mTOR inhibitors due to resistance remains a challenge. Hypoxia-associated resistance
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Transplant program evaluations in the middle of the COVID-19 pandemic Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-21 Jonathan Miller, Grace R. Lyden, David Zaun, Bertram L. Kasiske, Ryutaro Hirose, Ajay K. Israni, Jon J. Snyder
Potential regional variations in effects of COVID-19 on federally mandated, program-specific evaluations by the Scientific Registry of Transplant Recipients (SRTR) have been controversial. SRTR January 2022 program evaluations ended transplant follow-up on March 12, 2020, and excluded transplants performed from March 13, 2020 to June 12, 2020 (the “carve-out”). This study examined the carve-out's impact
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Tixagevimab/cilgavimab pre-exposure prophylaxis is associated with lower breakthrough infection risk in vaccinated solid organ transplant recipients during the omicron wave Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-21 Ayman Al Jurdi, Leela Morena, Mariesa Cote, Emily Bethea, Jamil Azzi, Leonardo V. Riella
The neutralizing monoclonal antibody combination of tixagevimab/cilgavimab has been shown to reduce the risk of SARS-CoV-2 infection in unvaccinated individuals during the Alpha (B.1.1.7) and Delta (B.1.617.2) waves. However, data on the efficacy and safety of tixagevimab/cilgavimab in vaccinated solid organ transplant recipients during the Omicron wave is limited. To address this, we conducted a retrospective
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Pregnancy after living kidney donation, a systematic review of the available evidence, and a review of the current guidance Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-18 Maria Pippias, Laura Skinner, Marlies Noordzij, Anna Varberg Reisæter, Daniel Abramowicz, Vianda S. Stel, Kitty J. Jager
Understanding and communicating the risk of pregnancy complications post-living kidney donation is imperative as the majority of living kidney donors (LKD) are women of childbearing age. We aimed to identify all original research articles examining complications in post-donation pregnancies and compared the quality and consistency of related guidelines. We searched Embase, MEDLINE, PubMed, society
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Breakthrough COVID-19 cases despite prophylaxis with 150 mg of tixagevimab and 150 mg of cilgavimab in kidney transplant recipients Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-17 Ilies Benotmane, Aurélie Velay, Gabriela Gautier-Vargas, Jérôme Olagne, Augustin Obrecht, Noëlle Cognard, Françoise Heibel, Laura Braun-Parvez, Nicolas Keller, Jonas Martzloff, Peggy Perrin, Romain Pszczolinski, Bruno Moulin, Samira Fafi-Kremer, Olivier Thaunat, Sophie Caillard
The cilgavimab−tixagevimab combination retains a partial in vitro neutralizing activity against the current SARS-CoV-2 variants of concern (omicron BA.1, BA.1.1, and BA.2). Here, we examined whether preexposure prophylaxis with cilgavimab−tixagevimab can effectively protect kidney transplant recipients (KTRs) against the omicron variant. Of the 416 KTRs who received intramuscular prophylactic injections
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Peripheral blood immune cell profiling of acute corneal transplant rejection Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-15 Jesper Hjortdal, Matthew D. Griffin, Marion Cadoux, W. John Armitage, Max Bylesjo, Peadar Mac Gabhann, Conor C. Murphy, Uwe Pleyer, Derek Tole, Bertrand Vabres, Malcolm D. Walkinshaw, Pierre-Antoine Gourraud, Matilde Karakachoff, Sophie Brouard, Nicolas Degauque
Acute rejection (AR) of corneal transplants (CT) has a profound effect on subsequent graft survival but detailed immunological studies in human CT recipients are lacking. In this multi-site, cross-sectional study, clinical details and blood samples were collected from adults with clinically diagnosed AR of full-thickness (FT)-CT (n = 35) and posterior lamellar (PL)-CT (n = 21) along with Stable CT
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A collaborative stewardship of OPOs and transplant centers to maintain equitable allocation when facilitating ex vivo organ preservation Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-15 Sanjay Kulkarni, Alexandra Glazier, George Lipkowitz, Francis Fynn-Tompson, Ann E. Woolley, Francis L. Delmonico
To the Editor: The transplant community is experiencing an expansion of ex vivo machine perfusion protocols for deceased donor organs with potential gains in organ utilization and the promise of improving graft function following transplantation.1-3 Many of these perfusion protocols are performed by non-Organ Procurement Organization (OPO) entities, such as transplant centers or for-profit companies
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Laparoscopic-assisted liver transplantation: A realistic perspective Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-15 Safi Dokmak, François Cauchy, Béatrice Aussilhou, Fédérica Dondero, Ailton Sepulveda, Olivier Roux, Claire Francoz, Olivia Hentic, Louis de Mestier, Philippe Levy, Philippe Ruszniewski, Maxime Ronot, Jérome Cros, Valérie Vilgrain, Valérie Paradis, Souhayl Dahmani, Emmanuel Weiss, Alain Sauvanet, François Durand, Mickael Lesurtel
Laparoscopic approach was rarely described in recipients for liver transplantation (LT). We report the feasibility and safety of laparoscopic-assisted LT (LA-LT) in patients with unresectable liver metastases of neuroendocrine tumors. Total hepatectomy was performed laparoscopically with graft implantation through an upper midline incision. Liver grafts were retrieved from deceased donors. From July
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American Journal of Transplantation: Volume 22, Number 6, June 2022 Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-08
On the cover: As the shortage of kidneys for transplantation continues to worsen, scrutiny of decision-making that determines kidney utilization inevitably intensifies. Two papers apply the magnifying glass to transplant center practices related to first receiving and then considering kidney offers. King et al. (page 1593) examine how centers use offer bypass filters - a tool developed to improve placement
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Transplant Moves One Step Closer to Creating a Purpose-Built Organ Am. J. Transplant. (IF 9.369) Pub Date : 2022-06-08 Lara C. Pullen
This month's installment of “The AJT Report” details an innovative treatment that demonstrates the potential to make blood types obsolete. We also discuss findings of a new study which suggests that a third COVID vaccination could benefit kidney transplant recipients.