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Rethinking the Impact of Pretransplant Malignancy (Pre-TM) on Double Lung Transplantation (DLT) Eligibility: An Analysis of 23,291 DLT Recipients medRxiv. Transplant. Pub Date : 2024-03-16 Wongi Woo, Hye Sung Kim, Ankit Bharat, Young Kwang Chae
Background: Given the increasing need for lung transplants among older patients with a history of cancer, this study analyzed database registry to assess outcomes for DLT recipients with Pre-TM. Methods: This study evaluated the United Network for Organ Sharing (UNOS) registry for adult DLT performed between 2005 and 2023. Patients with a history of previous or multi-organ transplants, and those with
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Sex-Mismatching in Isolated Heart Transplant Confers No Postoperative Risk medRxiv. Transplant. Pub Date : 2024-02-27 Reid Dale, Matthew Leipzig, Nataliya Bahatyrevich, Katharine Casselman Pines, Quidong Chen, Jeffrey Teuteberg, Joseph Woo, Maria Currie
Background: For heart transplantation, optimal donor-recipient matching is an important factor in the ongoing development of the United Network for Organ Sharing (UNOS) continuous distribution framework. Donor-recipient sex-mismatch has decreased since the 1990s, but this may be related to the risk posed by size mismatching, particularly when donor hearts are undersized. Thus, the impact of sex-mismatching
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Molecular signatures of chronic antibody-mediated rejection in human liver transplants medRxiv. Transplant. Pub Date : 2024-02-08 Bastian Engel, Ahmed Alaswad, Alejandro Campos-Murguia, Martijn Zoodsma, Anne Klingbeil, Kinan Chihab, Emily A. Bosselmann, Sophia Heinrich, Björn Hartleben, Danny D. Jonigk, Murielle Verboom, Michael Hallensleben, Robert Geffers, Heiner Wedemeyer, Cheng-Jian Xu, Elmar Jaeckel, Yang Li, Richard Taubert
Background&Aims The role of antibody-mediated rejection (ABMR) after liver transplantation (LT) remains controversial. Chronic ABMR (cABMR) is often subclinical and potentially missed without surveillance biopsies (svLbx) which are not established in most LT centers. Transcriptome analysis previously characterized molecular changes in T cell-mediated rejection (TCMR) after solid organ transplantation
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Effect of Urinary tract infection on the outcome of the Allograft in patients with Renal transplantation medRxiv. Transplant. Pub Date : 2024-02-08 Rahul Sai Gangula, Mahesh Eswarappa, Rajashekar Reddy, Gireesh Mathihally Siddaiah, Gurudev Konana, Hamsa Reddy, Pooja Prakash Prabhu, Yousuff Mohammad, Lia Sara Anish
Background Urinary Tract Infections (UTIs) are the second most common cause of graft dysfunction, accounting for significant morbidity, and are associated with poor graft and patient survival. This study aimed to determine the association between post-renal transplant UTI and graft outcomes.
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Disturbed sleep is associated with worse patient-reported outcomes and chronic lung allograft dysfunction after lung transplantation medRxiv. Transplant. Pub Date : 2024-01-23 Aric A Prather, Ying Gao, Legna Betancourt, Rose C Kordahl, Anya Sriram, Chiung-Yu Huang, Steven R Hays, Jasleen Kukreja, Daniel R Calabrese, Aida Venado, Bhavya Kapse, John R Greenland, Jonathan P Singer
Many lung transplant recipients fail to derive the expected improvements in functioning, HRQL, or long-term survival. Sleep may represent an important, albeit rarely examined, factor influencing lung transplant outcomes. Within a larger cohort study, 141 lung transplant recipients completed the Medical Outcomes Study (MOS) Sleep Scale along with a broader survey of patient-reported outcome (PRO) measures
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INTRAVENOUS VITAMIN C SUPPLEMENTATION IN ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT RECIPIENTS: SALUTARY IMPACT ON CLINICAL OUTCOMES medRxiv. Transplant. Pub Date : 2023-12-25 Gary Simmons, Roy Sabo, May Aziz, Erika Martin, Robyn J. Bernard, Manjari Sriparna, Cody McIntire, Elizabeth Krieger, Donald F. Brophy, Ramesh Natarajan, Alpha Fowler, Catherine H. Roberts, Amir Toor
Intravenous (IV) vitamin C improves organ function and reduces inflammation in sepsis, an inflammatory state like the post-hematopoietic stem cell transplant (SCT) milieu. The safety and efficacy of parenteral vitamin C after allogeneic hematopoietic stem cell transplant (HSCT) were evaluated in a phase I/II trial and clinical outcomes compared with a propensity score - matched historical control.
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Selection bias in reporting of median waiting times in organ transplantation medRxiv. Transplant. Pub Date : 2023-12-18 Simon Schwab, Andreas Elmer, Daniel Sidler, Lisa Straumann, Ueli Stürzinger, Franz Immer
Median organ waiting times published by transplant organizations around the world may be biased when death or censoring is disregarded. This can lead to too optimistic waiting times for all organ waiting lists, but most strikingly in kidney transplantation, and as a consequence, may deceive patients on the waiting list, transplant physicians, and healthcare policy maker. In this cohort study of all
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Urinary Cell Gene Signature of Acute Rejection in Kidney Allografts medRxiv. Transplant. Pub Date : 2023-12-19 Thalia Salinas, Carol Li, Catherine Snopkowski, Vijay K Sharma, Darshana M Dadhania, Karsten Suhre, Thangamani Muthukumar, Manikkam Suthanthiran
Introduction. A kidney allograft biopsy may display acute T cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), or concurrent TCMR + ABMR (MR). Development of noninvasive biomarkers diagnostic of all three types of acute rejection is a useful addition to the diagnostic armamentarium. Methods. We developed customized RT-qPCR assays and measured urinary cell mRNA copy number in 145 biopsy-matched
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Increased Donor Inhibitory KIR Are Associated with Reduced GVHD and Improved Survival Following HLA Matched Unrelated Donor HCT in Pediatric Acute Leukemia medRxiv. Transplant. Pub Date : 2023-12-15 Elizabeth Krieger, Rehan Qayyum, Amir Toor
Killer immunoglobulin-like receptor (KIR) and KIR-ligand (KIRL) interactions play an important role in natural killer cell-mediated effects after hematopoietic stem cell transplantation (HCT). Previous work has shown that accounting for known KIR-KIRL interactions may identify donors with optimal NK cell-mediated alloreactivity in the adult transplant setting.
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Dynamic establishment and maintenance of the human intestinal B cell population and repertoire following transplantation medRxiv. Transplant. Pub Date : 2023-11-16 Jianing Fu, Thomas Hsiao, Elizabeth Waffarn, Wenzhao Meng, Katherine D. Long, Kristjana Frangaj, Rebecca Jones, Alaka Gorur, Areen Shtewe, Muyang Li, Constanza Bay Muntnich, Kortney Rogers, Wenyu Jiao, Monica Velasco, Rei Matsumoto, Masaru Kubota, Steven Wells, Nichole Danzl, Shilpa Ravella, Alina Iuga, Elena-Rodica Vasilescu, Adam Griesemer, Joshua Weiner, Donna L. Farber, Eline T. Luning Prak, Mercedes
It is unknown how intestinal B cell populations and B cell receptor (BCR) repertoires are established and maintained over time in humans. Following intestinal transplantation (ITx), surveillance ileal mucosal biopsies provide a unique opportunity to map the dynamic establishment of gut lymphocyte populations. Using polychromatic flow cytometry that includes HLA allele group-specific mAbs distinguishing
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Deceased donor kidney function is determined by branch chained amino acid metabolism during ex vivo normothermic perfusion medRxiv. Transplant. Pub Date : 2023-11-16 Armin Ahmadi, Jacquelyn Min-Ung Yu, Jennifer E. Loza, Brian Christopher Howard, Ivonne Palma, Peter Adam Than, Naeem Makarm G Goussous, Junichiro Sageshima, Baback Roshanravan, Richard V. Perez
Current kidney perfusion protocols are not optimized for addressing the ex vivo physiological and metabolic needs of the kidney. Ex vivo normothermic perfusion (EVNP) may be utilized to distinguish high-risk kidneys to determine suitability for transplantation. We assessed the association of tissue metabolic changes with changes in kidney injury biomarkers and functional parameters in eight deceased
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Factor H-related protein 3 (FHR-3) Deposition in Kidney Allografts - Localization and Correlation with Complement Activation. medRxiv. Transplant. Pub Date : 2023-10-25 Felix Poppelaars, Nicole Schafer, Anita H. Meter-Arkema, Shrey Purohit, Bernardo Faria, Mariana Gaya da Costa, V. Michael Holers, Mohamed R. Daha, Diana Pauly, Marc A Seelen, Joshua M. Thurman
Introduction: Factor H-related proteins (FHRs) have emerged as novel players in complement-mediated diseases, as they exhibit structural resemblances to factor H but lack the regulatory domains, enabling them to antagonize factor H and increase complement activation through several activities. Despite the widely importance of the complement system in kidney transplantation, FHRs have not been studied
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Synergistic impact of three complement polymorphisms in the donor, not the recipient, on long-term kidney allograft survival. medRxiv. Transplant. Pub Date : 2023-10-25 Felix Poppelaars, Mariana Gaya da Costa, Bernardo Faria, Siawosh K. Eskandari, Vojtech Petr, V. Michael Holers, Mohamed R. Daha, Stefan P. Berger, Jeffrey Damman, Marc A Seelen, Joshua M. Thurman
Background: Genetic analysis in transplantation offers potential for personalized medicine. Given the crucial role of the complement system in renal allograft injury, we investigated in kidney transplant pairs the impact of complement polymorphisms on long-term outcomes. Methods: In this observational cohort study, we analyzed polymorphisms in C3 (C3R102G), factor B (CFBR32Q), and factor H (CFHV62I)
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COST AND UTILIZATION TRENDS OF PERCUTANEOUS KIDNEY BIOPSY IN KIDNEY TRANSPLANT PATIENTS: A 4-YEAR CLAIMS DATA ANALYSIS medRxiv. Transplant. Pub Date : 2023-10-13 Adrian Vilalta
Objective: This study evaluated patterns of utilization and costs of percutaneous kidney biopsies in kidney transplant patients. Methods: The IBM Treatment Pathways tool was used to interrogate cohorts selected from the IBM MarketScan dataset. Analyses were done for both adult and pediatric patients. Differences in biopsy paid amounts and utilization patterns were assessed for commercial payers, Medicare
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Age-Modulated Immuno-Metabolic Proteome Profiles of Deceased Donor Kidneys Predict 12-Month Posttransplant Outcome medRxiv. Transplant. Pub Date : 2023-10-13 Philip D Charles, Sarah Fawaz, Rebecca H Vaughan, Simon Davis, Priyanka Joshi, Iolanda Vendrell, Ka Ho Tam, Roman Fischer, Benedikt M Kessler, Edward J Sharples, Alberto Santos, Rutger J Ploeg, Maria Kaisar
Background: Organ availability limits kidney transplantation, the best treatment for end-stage kidney disease. Deceased donor acceptance criteria have been relaxed to include older donors with higher risk of inferior posttransplant outcomes. Donor age, although significantly correlates with transplant outcomes, lacks granularity in predicting graft dysfunction. Better characterization of the biological
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Predicting Individualized Outcomes for Deceased Kidney Donor Waitlisted Candidates and Recipients medRxiv. Transplant. Pub Date : 2023-10-03 Igor Litvinovich, Yue-Harn Ng, Kelly Chong, Christos Argyropoulos, Yiliang Zhu
Kidney transplantation remains the optimal treatment for end-stage kidney disease (ESKD). However, the persistent disparity between the demand and supply of deceased donor (DD) kidneys underscores the need for better tools to assess transplant outcomes and donor kidney quality. The current Kidney Allocation System (KAS) relies on the Kidney Donor Risk Index (KDRI) to quantify DD kidney quality, yet
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MODELING CYSTIC FIBROSIS PATIENT PROGNOSIS: NOMOGRAMS TO PREDICT LUNG TRANSPLANTATION AND SURVIVAL PRIOR TO HIGHLY EFFECTIVE MODULATOR THERAPY medRxiv. Transplant. Pub Date : 2023-09-26 Annalisa Piccorelli, Jerry Nick
Background. The duration of time a person with cystic fibrosis (pwCF) spends on the lung transplant waitlist is dependent on waitlist and post-transplant survival probabilities and can extend up to 2 years. Understanding the characteristics involved with lung transplant and survival prognoses may help guide decision making by the patient, the referring CF Center and the transplant team. Methods. This
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COST AND UTILIZATION TRENDS OF ENDOMYOCARDIAL BIOPSY IN HEART TRANSPLANT PATIENTS: A 4-YEAR CLAIMS DATA ANALYSIS medRxiv. Transplant. Pub Date : 2023-09-13 Adrian Vilalta
Objective: This study evaluated patterns of utilization, complications, and costs of endomyocardial biopsies (EMB) in heart transplant patients. Methods: The IBM Treatment Pathways tool was used to analyze claims data selected from the IBM MarketScan de-identified, HIPAA-compliant dataset. Differences in EMB paid amounts and utilization patterns were assessed for commercial payers and Medicare for
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Left Ventricular Assist Device Outcomes and Strategy 5 Years from Heart Transplant Allocation Score Change medRxiv. Transplant. Pub Date : 2023-09-12 Jacob Aaron Agronin, Meredith Brown, Hannah Calvelli, Val Rakita, Yoshiya Toyoda, Mohammed Kashem
Background: The United Network for Organ Sharing (UNOS) adopted new criteria for the heart allocation score on 10/18/2018 to reflect changing trends of candidates' mortality while awaiting transplant. We examined the impact of these policy changes on rates of left ventricular assist device (LVAD) implantation and outcomes post-transplant from a relatively newer UNOS database. Methods: The UNOS registry
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Interpretable Machine Learning in Kidney Offering: Multiple Outcome Prediction for Accepted Offers medRxiv. Transplant. Pub Date : 2023-08-25 Achille Salaun, Simon Knight, Laura Ruth Wingfield, Tingting Zhu
The decision to accept an organ offer for transplant, or wait for something potentially better in the future, can be challenging. Especially, clinical decision support tools predicting transplant outcomes are lacking. This project uses interpretable methods to predict both graft failure and patient death using data from previously accepted kidney transplant offers. Precisely, using more than twenty
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SARS-CoV-2 variants Omicron BA.4/5 and XBB.1.5 significantly escape T cell recognition in solid organ transplant recipients vaccinated against the ancestral strain medRxiv. Transplant. Pub Date : 2023-08-21 Torin Halvorson, Sabine Ivison, Qing Huang, Gale Ladua, Demitra M. Yotis, Dhiraj Mannar, Sriram Subramaniam, Victor H. Ferreira, Deepali Kumar, Sara Belga, PREVenT Study Group, Megan Levings
Background: Immune-suppressed solid organ transplant recipients (SOTRs) display impaired humoral responses to COVID-19 vaccination, but T cell responses are incompletely understood. The highly infectious SARS-CoV-2 variants Omicron BA.4/5 and XBB.1.5 escape neutralization by antibodies induced by vaccination or infection with earlier strains, but T cell recognition of these lineages in SOTRs is unclear
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Routine surveillance of kidney allograft rejection using a fully automated urinary CXCL9 and CXCL10 immunoassay medRxiv. Transplant. Pub Date : 2023-07-28 Claire Tinel, Virginia Sauvaget, Laila Aouni, Baptiste Lamarthee, Charlotte Leclaire, Christophe Legendre, Pierre Marquet, Corinne Normand, Marion Rabant, Fabiola Terzi, Dany Anglicheau
Background For kidney transplant recipients, assessing non-invasively the individualized risk of acute rejection is one of the most unmet need. Urinary chemokines are one of the short-term most promising biomarkers, because of their simple and low-cost analytical method in easily accessible samples, and their high diagnostic performance consistently assessed over the last decade. In this study, we
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Benefit versus Risk of Endomyocardial Biopsy for Heart Transplant Patients in the Contemporary Era medRxiv. Transplant. Pub Date : 2023-07-28 Vincenzo Cusi, Florin Vaida, Nicholas Wettersten, Nicholas Rodgers, Yuko Tada, Bryn Gerding, Barry Greenberg, Marcus Anthony Urey, Eric Adler, Paul Jaegu Kim
Background: The reference standard of detecting acute rejection (AR) in adult heart transplant (HTx) patients is an endomyocardial biopsy (EMB). The majority of EMBs are performed in asymptomatic patients. However, the benefit of diagnosing and treating AR compared to the risk of EMB complications has not been compared in the contemporary era (2010-current). Objectives: This study compared treated
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Role of renal venous oxygen pressure for renal function monitoring after related living-donor kidney transplantation: cohort study medRxiv. Transplant. Pub Date : 2023-06-22 Diego Escarramán-Martínez, Montserrat Fernández-Bravo, Ashuin Kammar-García, Manuel Alberto Guerrero-Gutiérrez, Héctor David Meza-Comparán, Javier Mancilla-Galindo, Jesús Salvador Sánchez-Díaz, Emilio Cendejas-Ríos, Carla Adelina Escorza-Molina, Lorena Noriega-Salas, Germán Bernaldez-Gómez
Introduction: Monitoring of renal function after kidney transplantation (KT) is performed by measuring serum creatinine (SCr), urine volumes (UV), and glomerular filtration rate (GFR). Other methods based on oxygen metabolism such as the renal venous oxygen pressure (PrvO2) may be useful. We aimed to explore the correlation between PrvO2 and SCr, UV, and GFR five days after KT (SCr5, UV5, and GFR5
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Multiple imputation strategies for missing event times in a multi-state model analysis medRxiv. Transplant. Pub Date : 2023-06-20 Elinor Curnow, Rachael Hughes, Kate Birnie, Kate Tilling, Michael J Crowther
In clinical studies, multi-state model (MSM) analysis is often used to describe the sequence of events that patients experience, enabling better understanding of disease progression. A complicating factor in many MSM studies is that the exact event times may not be known. Motivated by a real dataset of patients who received stem cell transplants, we considered the setting in which some event times
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Personalized Tacrolimus Dosing After Liver Transplantation: A Randomized Clinical Trial medRxiv. Transplant. Pub Date : 2023-06-03 Jeffrey Khong, Megan Lee, Curtis Warren, Un Bi Kim, Sergio Duarte, Kenneth A. Andreoni, Sunaina Shrestha, Mark W. Johnson, Narendra R. Battula, Danielle M. McKimmy, Thiago Beduschi, Ji-Hyun Lee, Derek M. Li, Chih-Ming Ho, Ali Zarrinpar
Background Inter- and intra-individual variability in tacrolimus dose requirements mandates empirical clinician-titrated dosing that frequently results in deviation from a narrow target range. Improved methods to individually dose tacrolimus are needed. Our objective was to determine whether a quantitative, dynamically-customized, phenotypic-outcome-guided dosing method termed Phenotypic Personalized
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Soluble DNA Concentration in the Perfusate is a Predictor of Post-Transplant Renal Function in Hypothermic Perfused Kidney Allografts medRxiv. Transplant. Pub Date : 2023-05-21 Sergio Duarte, Anne-Marie Carpenter, Matthew Willman, Duncan Lewis, Curtis Warren, Isabella Angeli-Pahim, Werviston De Faria, Georgios Vrakas, Ashraf El Hinnawi, Thiago Beduschi, Narendra Battula, Ali Zarrinpar
Introduction Hypothermic machine perfusion (HMP) has greatly facilitated kidney allograft preservation. However, tissue damage still occurs during HMP, deleteriously affecting post-transplant graft function. Therefore, improved methods to assess organ quality and to predict post-transplant graft function and survival are needed. We propose that soluble DNA (sDNA) measured in HMP perfusate can used
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Carboxypeptidase B2 gene polymorphisms in the donor associate with kidney allograft loss medRxiv. Transplant. Pub Date : 2023-05-14 Felix Poppelaars, Siawosh K. Eskandari, Jeffrey Damman, Ashley Frazer-Abel, V. Michael Holers, Bradley P. Dixon, Mohamed R. Daha, Jan-Stephan F. Sanders, Marc A. Seelen, Bernardo Faria, Mariana Gaya da Costa, Joshua M. Thurman
Introduction Plasma carboxypeptidase B2 (CPB2) is an enzyme that cleaves C-terminal amino acids from proteins, thereby regulating their activities. CPB2 has anti-inflammatory and anti-fibrinolytic properties and can therefore be protective or harmful in disease. We explored the impact of functional carboxypeptidase B2 gene (CPB2) polymorphisms on graft survival following kidney transplantation.
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Diffusion-limited O2 release in human kidneys perfused with stored blood medRxiv. Transplant. Pub Date : 2023-05-10 Richard Dumbill, Julija Rabcuka, Simon Knight, James Hunter, John Fallon, Daniel Voyce, Jacob Barrett, Matt Ellen, Annemarie Weissenbacher, Tetuko Kurniawan, Slawomir Blonski, Piotr Korczyk, Rutger Ploeg, Constantin Coussios, Peter Friend, Pawel Swietach
A central dogma in physiology is that oxygen release at tissues is not diffusion-limited because gas exchange at capillaries is rapid. This assertion has influenced clinical care, which focuses on optimising oxygen delivery through improving blood flow and oxygen content, rather than oxygen unloading from red blood cells (RBCs). Since storage of blood causes profound changes that slow oxygen release
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Effect of cell isolation magnetic particles on DNA quantification by UV absorbance spectrophotometry medRxiv. Transplant. Pub Date : 2023-04-26 Izza Usman Bajwa, Samuel Sigaud
Magnetic particles are commonly used to isolate specific cell types from blood samples. Residual particles present in the genomic DNA extracted from these cells can interfere with concentration measurements by UV absorbance spectrophotometry. In this study, we determined the degree of inaccuracy of DNA quantification by UV spectrophotometry, in the context of the lineage-specific chimerism analysis
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Donor Bone Marrow Derived Macrophage Engraftment into the Central Nervous System of Allogeneic Transplant Patients medRxiv. Transplant. Pub Date : 2023-04-25 Anisha M. Loeb, Siobhan S. Pattwell, Soheil Meshinchi, Antonio Bedalov, Keith R. Loeb
Hematopoietic stem cell transplantation is a well known treatment of hematologic malignancies wherein nascent stem cells provide a regenerating marrow and immunotherapy against the tumor. The progeny of hematopoietic stem cells also populate a wide spectrum of tissues, including the brain, as bone marrow derived macrophages similar to microglial cells. We developed a sensitive and novel combined IHC
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Transcriptomic analyses reveal regional signatures in lung allograft recipients medRxiv. Transplant. Pub Date : 2023-04-03 Patricia Agudelo-Romero, Kak-Ming Ling, Melanie A. Lavender, Jeremy P. Wrobel, Michael Musk, Stephen M Stick, Anthony Kicic
Background Long term outcomes of allograft recipients are compromised by the development of chronic lung allograft dysfunction (CLAD) promoting bronchiolitis obliterans syndrome (BOS). We established baseline transcriptomic profiles of both the large and small airway epithelial cells (referred as LAEC and SAEC, respectively) to identify regional differences irrespective of initiating disease.
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CT-based Machine Learning for Donor Lung Screening Prior to Transplantation medRxiv. Transplant. Pub Date : 2023-03-29 Sundaresh Ram, Stijn E Verleden, Madhav Kumar, Alexander J. Bell, Ravi Pal, Sofie Ordies, Arno Vanstapel, Adriana Dubbeldam, Robin Vos, Stefanie Galban, Laurens J. Ceulemans, Anna E. Frick, Dirk E. Van Raemdonck, Johny Verschakelen, Bart M. Vanaudenaerde, Geert M. Verleden, Vibha N Lama, Arne P. Neyrinck, Craig J. Galban
Background Assessment and selection of donor lungs remains largely subjective and experience based. Criteria to accept or decline lungs are poorly standardized and are not compliant with the current donor pool. Using ex vivo CT images, we investigated the use of a CT-based machine learning algorithm for screening donor lungs prior to transplantation.
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Impact of marginal donor to marginal recipient kidney transplant on delayed graft function and outcome medRxiv. Transplant. Pub Date : 2023-03-29 Federica Bocchi, Guido Beldi, Christian Kuhn, Federico Storni, Nathalie Müller, Daniel Sidler
The demographics of donor and recipient candidates for kidney transplantation (KT) have substantially changed. Recipients tend to be older and polymorbid and KT to marginal recipients is associated with delayed graft function (DGF), prolonged hospitalization, inferior long-term allograft function, and poorer patient survival. In parallel, donors are also older, suffer from several comorbidities, and
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Assessment and Improvement of Elixhauser Comorbidity Index for Predicting In-hospital Mortality in Heart Transplant Patients medRxiv. Transplant. Pub Date : 2023-03-29 Renxi Li
Background Heart transplant (HT) has a high in-hospital mortality of around 5%. Risk prediction in-hospital mortality can be informative for transplant candidacy and post-HT prognosis. Elixhauser Comorbidity Index (ECI) is an ICD diagnostic code-based comorbidity measurement tool that can predict in-hospital mortality. While it has been validated in the large in-patient population, the accuracy of
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mTOR inhibition improves the formation of functional T cell memory following COVID-19 vaccination of kidney transplant recipients medRxiv. Transplant. Pub Date : 2023-03-29 Griffith B. Perkins, Matthew J. Tunbridge, Cheng Sheng Chai, Christopher M. Hope, Arthur Eng Lip Yeow, Tania Salehi, Julian Singer, Bree Shi, Makutiro G. Masavuli, Zelalem Addis Mekonnen, Pablo Garcia-Valtanen, Svjetlana Kireta, Julie K. Johnston, Christopher J. Drogemuller, Beatrice Z. Sim, Shane M. Spencer, Benedetta C. Sallustio, Iain Comerford, George Bouras, Daniela Weiskopf, Alessandro Sette
Inadequate immune response to vaccination is a long-standing problem faced by immunosuppressed kidney transplant recipients (KTRs), requiring novel strategies to improve vaccine efficacy. In this study, the potential of mechanistic target of rapamycin inhibitors (mTORi) to improve T cell responses to COVID-19 vaccination was investigated. Following primary vaccination with adenoviral (ChAdOx1) or mRNA
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Phase II Study of Myeloablative 8/8- or 7/8-Matched Allotransplantation with Post-Transplant Cyclophosphamide, Tacrolimus, and Mycophenolate Mofetil: Marked Reduction in GVHD Risk Without Increased Relapse Risk Compared to Historical Cyclosporine/Methotrexate medRxiv. Transplant. Pub Date : 2023-03-29 Najla El Jurdi, Alex Hoover, Daniel O’Leary, Qing Cao, Ashish Gupta, Christen Ebens, Joseph Maakaron, Brian C. Betts, Armin Rashidi, Mark Juckett, Troy Lund, Veronika Bachanova, Margaret MacMillan, Jeffrey Miller, Paul Orchard, John Wagner, Gregory Vercellotti, Daniel Weisdorf, Kathryn Dusenbery, Stephanie Terezakis, Shernan Holtan
Introduction Graft-versus host disease (GVHD) is a major limitation to the success of allogeneic hematopoietic cell transplant (HCT). We hypothesized that the GVHD prophylaxis regimen of post-transplant cyclophosphamide (PTCy), tacrolimus (Tac) and mycophenolate mofetil (MMF) would reduce the incidence of GVHD in patients receiving a matched or single antigen mismatched HCT without an increase in risk
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Early left ventricular systolic function is a more sensitive predictor of adverse events after heart transplant medRxiv. Transplant. Pub Date : 2023-03-22 Zhenxing Sun, Yu Cai, Yujia Yang, Lei Huang, Yuji Xie, Shuangshuang Zhu, Chun Wu, Wei Sun, Ziming Zhang, Yuman Li, Jing Wang, Lingyun Fang, Yali Yang, Qing Lv, Nianguo Dong, Li Zhang, Haotian Gu, Mingxing Xie
Background: First-phase ejection fraction (EF1) is a novel measure of early systolic function. This study was to investigate the prognostic value of EF1 in heart transplant recipients. Methods: Heart transplant recipients were prospectively recruited at the Union Hospital, Wuhan, China between January 2015 and December 2019. All patients underwent clinical examination, biochemistry measures [brain
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CMS Final Rule for Organ Donation: Unintended Consequences of the Pancreas Research Loophole medRxiv. Transplant. Pub Date : 2023-03-20 David S Goldberg, Darius Chyou, Rachel Wulf, Matthew Wadsworth
CMS updated the Final Rule for OPO Conditions for Coverage on 11/20/2020 to include new OPO metrics, tiers of classification, and a new definition of a donor that included an individual with: a) at least 1 organ transplanted; or b) pancreas procured for research or islet cell transplantation. We conducted a retrospective cohort study using data from the OPTN/ UNOS. The number of pancreata procured
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Predicting Post-Liver Transplant Outcomes in Patients with Acute-on-Chronic Liver Failure using Expert-Augmented Machine Learning medRxiv. Transplant. Pub Date : 2023-03-05 Jin Ge, Jean C. Digitale, Cynthia Fenton, Charles E. McCulloch, Jennifer C. Lai, Mark J. Pletcher, Efstathios D. Gennatas
Background Liver transplantation (LT) is a treatment for acute-on-chronic liver failure (ACLF) but up to 40% mortality post-LT has been reported. Existing post-LT models in ACLF have been limited by small samples. In this study, we developed a novel Expert-Augmented Machine Learning (EAML) model to predict post-LT outcomes.
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Development of a self-monitoring system for lung transplant patients using information and communication technology: a pilot study medRxiv. Transplant. Pub Date : 2023-03-01 Yoshikazu Shinohara, Kazumichi Yamamoto, Muhammad Wannous, Masahiro Yanagiya, Masaaki Nagano, Kentaro Kitano, Masaaki Sato, Chihiro Konoeda, Jun Nakajima
Background Lung transplantation is the final option for end-stage respiratory diseases. Postoperative monitoring of patients’ physical condition and performance of appropriate interventions for any abnormalities are important to improve the long-term success of lung transplantation. In Japan, patients’ handwritten self-management charts are widely used to record data for home spirometry, vital signs
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Microbiota predict infections and acute graft-versus-host disease after pediatric allogeneic hematopoietic stem cell transplantation medRxiv. Transplant. Pub Date : 2023-02-10 Elisa Margolis, Gabriela Maron, Yilun sun, Ronald Dallas, Kim Allison, jose ferrolino, Hailey Ross, Amy Davis, Qidong Jia, Paige Turner, Victoria Mackay, Cara Morin, brandon triplett, Li Tang, Randall Hayden
Despite intensive prophylactic and pre-emptive measures, infections remain an important cause of morbidity and mortality in pediatric recipients of allogeneic hematopoietic cell transplantation (allo-HCT). Disruption of the gut microbiota has been linked to clinical outcomes after adult allo-HCT. The objective was to evaluate whether these or differing microbiota disruptions or signatures were associated
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The Effect of COVID-19 on Distracted Driving: A Survey Study medRxiv. Transplant. Pub Date : 2022-12-28 Ramina Javid, Eazaz Sadeghvaziri, Mansoureh Jeihani
The COVID-19 pandemic caused a significant shift in people’s travel behaviors and distractions while driving. This paper aims to investigate the impacts of the COVID-19 pandemic on distracted driving by comparing their behavior before and during the pandemic (from 3/1/2019 to 3/1/2021) in the state of Maryland using a stated preference online survey. Some 158 people were recruited for the survey. Participants
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Multicenter analysis of immunosuppressive medications on the subsequent risk of malignancy in solid organ transplant recipients medRxiv. Transplant. Pub Date : 2022-12-04 Reid Shaw, Ali Haque, Jack Fitzsimons, Adam Hamidi, Timothy O'Connor, Gregory Roloff, Bradford Bemiss, Eric Kallwitz, Patrick Hagen, Stephanie Berg
Solid organ transplant is a curative treatment for end organ disease. However, the immunosuppressive therapy required to prevent graft rejection increases the likelihood of developing a subsequent malignancy. This retrospective cohort study from a multi-center academic hospital system investigated solid organ transplantation, immunosuppression, and the risk of subsequent malignancy. Of the 5,591 patients
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Clinical impact using low dose mycophenolate mofetil with tacrolimus on acute rejection, infectious diseases and non-infectious complications in renal transplant: A Single Hospital Experience in Mexico. medRxiv. Transplant. Pub Date : 2022-12-01 Jorge Andrade-Sierra, Hernesto Hernandez Reyes, Enrique Rojas Campos, Ernesto G Cardona Munoz, Jose I Cerrillos Gutierrez, Eduardo Gonzalez Espinoza, Luis A Evangelista Carrillo, Miguel Medina Perez, Basilio Jalomo Martinez, Alejandra G Miranda Diaz, Victor M Martinez Mejia, Benjamin Gomez Navarro, Antonio de Jesus Andrade Ortega, Juan Jose Nieves hernandez, Claudia Mendoza Cerpa
Background. The evidence supporting a starting dose of 2 g/day of mycophenolate mofetil (MMF) in combination with tacrolimus (TAC) in renal transplant (RT) is still limited but maintaining the dose of less than 2g could result in worse clinical outcomes in terms of acute rejection (AR). Research Question: This study aim was to determine the association between AR, infectious and non-infectious complications
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Longitudinal analysis at three oral sites links oral microbiota to clinical outcomes in allogeneic hematopoietic stem-cell transplant medRxiv. Transplant. Pub Date : 2022-11-19 Vitor Heidrich, Franciele H. Knebel, Julia S. Bruno, Vinícius C. de Molla, Wanessa Miranda-Silva, Paula F. Asprino, Luciana Tucunduva, Vanderson Rocha, Yana Novis, Eduardo R. Fregnani, Celso Arrais-Rodrigues, Anamaria A. Camargo
Background Allogeneic hematopoietic stem-cell transplant (allo-HSCT) is a potentially curative therapy for several hematological disorders. Before stem-cell infusion, recipients undergo a conditioning regimen with chemo/radiotherapy and immunosuppressants, requiring the use of antibiotics to treat and prevent infections. This regimen promotes drastic alterations in the recipient′s microbiotas, including
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Bronchoalveolar lavage metabolome dynamics reflect underlying disease and chronic lung allograft dysfunction medRxiv. Transplant. Pub Date : 2022-11-18 Christian Martin, Kathleen S Mahan, Talia D Wiggen, Adam J Gilbertsen, Marshall I Hertz, Ryan C Hunter, Robert A Quinn
Background Progression of chronic lung disease often leads to the requirement for a lung transplant (LTX). Despite improvements in short-term survival after LTX, chronic lung allograft dysfunction (CLAD) remains a critical challenge for long-term survival. This study investigates the relationship between the metabolome of bronchoalveolar lavage fluid (BALF) collected longitudinally from subjects post-LTX
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Unrelated Stem Cell Donor HLA Match Likelihoods in the US Registry Incorporating HLA-DPB1 Permissive Mismatching medRxiv. Transplant. Pub Date : 2022-11-17 Loren Gragert, Stephen Spellman, Bronwen Shaw, Martin Maiers
Donor-recipient HLA matching at the DPB1 locus improves the outcomes of hematopoietic cell transplantation (HCT). Retrospective outcomes studies found that in transplants matched for all 8 alleles of the A, B, C, and DRB1 loci at high resolution (8-of-8 match), few transplants were also allele-matched at the DPB1 locus. DPB1 allele matching was thought to be logistically impractical, however a DPB1-permissive
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No evidence of progressive pro-inflammatory cytokine storm in brain dead organ donors - A time course analysis using clinical samples medRxiv. Transplant. Pub Date : 2022-10-11 Katarzyna D Bera, Joel Tabak, Rutger J Ploeg
Organ donation after brain death (DBD) is an important source of transplanted organs as chronic undersupply means many patients die whilst awaiting a transplant. Improving organ quality and graft survival is key to reducing waiting lists. The interval between brain death confirmation and organ procurement offers an opportunity to reduce organ injury or encourage repair, yet data is lacking on the effects
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Tixagevimab-cilgavimab as an early treatment for COVID-19 in kidney transplant recipients medRxiv. Transplant. Pub Date : 2022-10-01 Ilies Benotmane, Jérôme Olagne, Gabriela Gautier-Vargas, Noëlle Cognard, Francoise Heibel, Laura Braun-Parvez, Nicolas Keller, Jonas Martzloff, Peggy Perrin, Romain Pszczolinski, Bruno Moulin, Samira Fafi-Kremer, Sophie Caillard
Objective: This single-center retrospective study evaluated the use of tixagevimab-cilgavimab as an early treatment for COVID-19 in kidney transplant recipients (KTRs) during the omicron wave. Methods: KTRs were deemed at high risk for moderate-to-severe COVID-19 in presence of at least one comorbidity (age >60 years, diabetes, obesity, or cardiovascular disease) associated with a weak humoral response
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Urinary cell mRNA profiling of kidney allograft recipients: Development of a portable protocol for noninvasive diagnosis of T cell mediated rejection and BK virus nephropathy medRxiv. Transplant. Pub Date : 2022-09-17 Thalia Salinas, Carol Li, Catherine Snopkowski, Gabriel Stryjniak, Divya Shankaranarayanan, Shady Albakry, Ruchuang Ding, Vijay K. Sharma, Steven P. Salvatore, Surya V. Seshan, Darshana M. Dadhania, Thangamani Muthukumar, Manikkam Suthanthiran
Background We developed urinary cell mRNA profiling for the noninvasive diagnosis of acute T cell mediated rejection (TCMR) and BK virus nephropathy (BKVN), two significant post-transplant complications. Our profiling protocol for the multicenter Clinical Trial of Transplantation-04 (CTOT-04) study consisted of centrifugation of urine to prepare cell pellets, washes, addition of an RNA preservative
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Humoral and cellular immune correlates of protection against COVID-19 in kidney transplant recipients medRxiv. Transplant. Pub Date : 2022-08-22 D. Kemlin, N. Gemander, S. Depickère, V. Olislagers, D. Georges, A. Waegemans, P. Pannus, A. Lemy, M. E. Goossens, I. Desombere, J. Michiels, M. Vandevenne, L. Heyndrickx, K.K. Ariën, A. Matagne, M.E. Ackerman, A. Le Moine, A. Marchant
As solid organ recipients are at high risk of severe COVID-19 and respond poorly to primary SARS-CoV-2 mRNA vaccination, they have been prioritized for booster vaccination. However, an immunological correlate of protection has not been identified in this vulnerable population. We conducted a prospective monocentric cohort study of 65 kidney transplant recipients who received three doses of SARS-CoV-2
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High-dimensional profiling of pediatric immune responses to solid organ transplantation medRxiv. Transplant. Pub Date : 2022-08-18 Mahil Rao, Meelad Amouzgar, James T. Harden, M. Gay Lapasaran, Amber Trickey, Brian Armstrong, Jonah Odim, Tracia Debnam, Carlos O. Esquivel, Sean C. Bendall, Olivia M. Martinez, Sheri M. Krams
Solid organ transplant remains a life-saving therapy for children with end-stage heart, lung, liver, or kidney disease; however, ∼25% of allograft recipients experience acute rejection within the first 12 months after transplant. Our ability to detect rejection early and to develop less toxic immunosuppressive agents is hampered by an incomplete understanding of the immune changes associated with rejection
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Vaccination of solid organ transplant recipients previously infected with SARS-CoV2 induces potent responses that extend to variants, including Omicron medRxiv. Transplant. Pub Date : 2022-07-14 Alok Choudhary, Mark Lerman, David Calianese, Salman Khan, Judson Hunt, Afzal Nikaein, Avi Z. Rosenberg, Jonathan I. Silverberg, Israel Zyskind, William Honnen, Dabbu K. Jaijyan, Erica Kalu, Abraham Pinter
Background Multiple factors affecting COVID19 vaccine induced antibody responses in SARS-CoV2 uninfected immunosuppressed solid organ transplant recipients have been reported; however, there is still a lack of information on non-ACE2 competing cross-CoV2 neutralizing functional antibodies induced in these cohorts, and similarly the vaccine efficacy in prior CoV2-infected immunosuppressed individuals
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Transcriptional and spatial profiling of the kidney allograft unravels a central role for FcyRIII+ innate immune cells in rejection medRxiv. Transplant. Pub Date : 2022-07-10 Baptiste Lamarthée, Jasper Callemeyn, Yannick Van Herck, Asier Antoranz, Dany Anglicheau, Jan Ulrich Becker, Tim Debyser, Frederik De Smet, Katrien De Vusser, Maëva Eloudzeri, Amelie Franken, Wilfried Gwinner, Priyanka Koshy, Dirk Kuypers, Diether Lambrechts, Pierre Marquet, Marion Rabant, Ben Sprangers, Claire Tinel, Thomas Van Brussel, Amaryllis Van Craenenbroeck, Elisabet Van Loon, Thibaut Vaulet
Rejection remains the main cause of premature graft loss after kidney transplantation, despite the use of potent immunosuppression. This highlights the need to better understand the composition and the interactions of the alloreactive inflammatory infiltrate. We performed droplet-based single-cell RNA sequencing of 35,152 transcriptomes from 16 kidney transplant biopsies and generated cell-type specific
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Mitigation of gastrointestinal graft versus host disease with tocilizumab prophylaxis is accompanied by preservation of microbial diversity and attenuation of enterococcal domination medRxiv. Transplant. Pub Date : 2022-07-02 Saurabh Chhabra, Aniko Szabo, Annelie Clurman, Katelynn McShane, Nicholas Waters, Daniel Eastwood, Lisa Samanas, Teng Fei, Gabriel Armijo, Sameen Abedin, Walter Longo, Parameswaran Hari, Mehdi Hamadani, Nirav N. Shah, Lyndsey Runaas, James H. Jerkins, Marcel van den Brink, Jonathan U. Peled, William R. Drobyski
A common feature in the gastrointestinal (GI) tract during allogeneic hematopoietic stem cell transplantation is the loss of microbial diversity and emergence of opportunistic pathogens that can adversely impact survival. Consequently, preventing transplant-associated dysbiosis is an emerging strategy for optimizing treatment outcomes. In this study, we examined the effect of an extended tocilizumab
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Humoral Responses in the Omicron Era following Three-Dose SARS-CoV-2 Vaccine Series in Kidney Transplant Recipients medRxiv. Transplant. Pub Date : 2022-06-26 Caitríona M. McEvoy, Queenie Hu, Kento T. Abe, Kevin Yau, Matthew J. Oliver, Adeera Levin, Anne-Claude Gingras, Michelle A. Hladunewich, Darren A. Yuen
Background Kidney transplant recipients (KTR) have a diminished response to SARS-CoV-2 vaccination in comparison to immunocompetent individuals. Deeper understanding of the antibody response in KTRs following third-dose vaccination would enable identification of those who remain unprotected against Omicron and require additional treatment strategies.
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Host microRNAs are differentially expressed in EBV+ Post-transplant Lymphoproliferative Disorder solid-organ transplant recipients medRxiv. Transplant. Pub Date : 2022-06-21 Ayantika Sen, Jeanna Enriquez, Mahil Rao, Marla Glass, Yarl Balachandran, Sharjeel Syed, Clare J. Twist, Kenneth Weinberg, Scott D. Boyd, Daniel Bernstein, Amber Trickey, Dita Gratzinger, Brent Tan, Mary Gay Lapasaran, Mark A. Robien, Merideth Brown, Brian Armstrong, Dev Desai, George Mazariegos, Clifford Chin, Thomas Fishbein, Robert S. Venick, Akin Tekin, Heiner Zimmermann, Ralf U. Trappe, Ioannis
Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation (SOT). Predisposing factors include primary Epstein-Barr virus (EBV) infection, reactivation of EBV in recipient B cells, and decreased T cell immunity due to immunosuppression. Previously, we demonstrated that EBV infection markedly reshapes the microRNA (miR) landscape in EBV+ B cell lines
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Transplantation of solid organs recovered from deceased donors recently infected by SARS-CoV-2 in the United States medRxiv. Transplant. Pub Date : 2022-06-07 Jonathan M. Czeresnia, Helen Tsai, Maria Ajaimy, Clara Y. Tow, Snehal R. Patel, Ulrich P. Jorde, Shivank Madan, Vagish Hemmige
The COVID-19 pandemic has reduced access to solid organ transplantation, compounding organ shortages and waitlist mortality. A continued area of uncertainty is the safety of transplanting organs recovered from SARS-CoV-2 infected donors, as autopsies of patients who died with COVID-19 show that the virus can be found in extra-pulmonary organs. Case reports and series on transplantation of these organs
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Development and Validation of Multivariable Prediction Models of Serological Response to SARS-CoV-2 Vaccination in Kidney Transplant Recipients medRxiv. Transplant. Pub Date : 2022-06-02 Bilgin Osmanodja, Johannes Stegbauer, Marta Kantauskaite, Lars Christian Rump, Andreas Heinzel, Roman Reindl-Schwaighofer, Rainer Oberbauer, Ilies Benotmane, Sophie Caillard, Christophe Masset, Clarisse Kerleau, Gilles Blancho, Klemens Budde, Fritz Grunow, Michael Mikhailov, Eva Schrezenmeier, Simon Ronicke
Background Repeated vaccination against SARS-CoV-2 increases serological response in kidney transplant recipients (KTR) with high interindividual variability. No decision support tool exists to predict SARS-CoV-2 vaccination response in KTR. Methods We developed, internally and externally validated five different multivariable prediction models of serological response after the third and fourth vaccine