8,606 results match your criteria American Journal Of Transplantation[Journal]


Induction of ferroptosis selectively eliminates senescent tubular cells.

Am J Transplant 2022 May 23. Epub 2022 May 23.

Department of Nephrology and Hypertension, Medical School Hannover, Germany.

The accumulation of senescent cells is an important contributor to kidney aging, chronic renal disease and poor outcome after kidney transplantation. Approaches to eliminate senescent cells with senolytic compounds have been proposed as novel strategies to improve marginal organs. While most existing senolytics induce senescent cell clearance by apoptosis, we observed that ferroptosis, an iron catalyzed subtype of regulated necrosis, might serve as an alternative way to ablate senescent cells. Read More

View Article and Full-Text PDF

Low-dose IL-2 prevents murine chronic cardiac allograft rejection: Role for IL-2-induced T regulatory cells and exosomes with PD-L1 and CD73.

Am J Transplant 2022 May 23. Epub 2022 May 23.

Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.

To determine the effects and immunological mechanisms of low-dose interleukin 2 (IL-2) in a murine model of chronic cardiac allograft rejection (BALB/c to C57BL/6) after costimulatory blockade consisting of MR1 (250 μg/ip day 0) and CTLA4-Ig (200 μg/ip day 2), we administered low-dose IL-2 (2000 IU/day) starting on post-transplant day 14 for 3 weeks. T regulatory (Treg) cell infiltration of the grafts was determined by immunohistochemistry; circulating exosomes by western blot and aldehyde bead flow cytometry; antibodies to donor MHC by immunofluorescent staining of donor cells; and antibodies to cardiac self-antigens (myosin, vimentin) by ELISA. We demonstrated that costimulation blockade after allogeneic heart transplantation induced circulating exosomes containing cardiac self-antigens and antibodies to both donor MHC and self-antigens, leading to chronic rejection by day 45. Read More

View Article and Full-Text PDF

Post-Pancreatic Transplant Enteric Leaks: The Role of the Salvage Operation.

Am J Transplant 2022 May 20. Epub 2022 May 20.

Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health; Madison, WI.

Enteric drainage in pancreas transplantation is complicated by enteric leak in 5-8%, frequently necessitating pancreatectomy. Pancreatic salvage outcomes are not well studied. Risk factors for enteric leak were examined and outcomes of attempted graft salvage were compared to immediate pancreatectomy. Read More

View Article and Full-Text PDF

Response to "Non-local kidney transplantation and transplant outcomes".

Am J Transplant 2022 May 19. Epub 2022 May 19.

Division of Transplantation, Department of Surgery, Emory University School of Medicine, Atlanta, GA.

View Article and Full-Text PDF

Real-world experience with available, outpatient COVID-19 therapies in solid organ transplant recipients during the Omicron surge.

Am J Transplant 2022 May 18. Epub 2022 May 18.

Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA.

The SARS-CoV-2 pandemic continues to place a substantial burden on healthcare systems. Outpatient therapies for mild-to-moderate disease have reduced hospitalizations and deaths in clinical trials, but the real-world effectiveness of monoclonal antibodies and oral antiviral agents in solid organ transplant recipients (SOTR) with COVID-19 is largely uncharacterized. We conducted a single-center, retrospective review of 122 SOTR diagnosed with COVID-19 in the outpatient setting during the Omicron surge to address this knowledge gap. Read More

View Article and Full-Text PDF

Social Determinants of Health Data in Solid Organ Transplantation: National Data Sources and Future Directions.

Am J Transplant 2022 May 18. Epub 2022 May 18.

Departments of Surgery and Population Health Sciences, Duke University School of Medicine, Durham, North, Carolina.

Health equity research in transplantation has largely relied on national data sources, yet the availability of social determinants of health (SDOH) data varies widely among these sources. We sought to characterize the extent to which national data sources contain SDOH data applicable to end-stage organ disease (ESOD) and transplant patients. We reviewed 10 active national data sources based in the United States. Read More

View Article and Full-Text PDF

Extracellular vesicles derived from patients with Antibody-Mediated Rejection induce tubular senescence and endothelial to mesenchymal transition in renal cells.

Am J Transplant 2022 May 18. Epub 2022 May 18.

Unit of Nephrology, Dialysis and Renal Transplantation - Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.

Extracellular vesicles (EV) are emerging mediators in several diseases; however, their role in the pathophysiology of antibody-mediated allograft rejection (AMR) has been poorly investigated. Here, we investigated the role of EV isolated from AMR patients in inducing tubular senescence and endothelial to mesenchymal transition (EndMT) and analyzed their miRNA expression profile. By multiplex-bead flow cytometry, we characterized the immunophenotype of plasma AMR-derived EV and found a prevalent platelet and endothelial cell origin. Read More

View Article and Full-Text PDF

Effectiveness of first, second, and third COVID-19 vaccine doses in solid organ transplant recipients: A population-based cohort study from Canada.

Am J Transplant 2022 May 16. Epub 2022 May 16.

Department of Medicine (Nephrology), University of Ottawa and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Limited data exists on the effectiveness of a third COVID-19 vaccine dose in solid organ transplant recipients. We conducted a population-based cohort study using linked healthcare databases from Ontario, Canada to answer this question. We included solid organ transplant recipients (n=12,842) as of December 14, 2020, with follow-up until November 28, 2021. Read More

View Article and Full-Text PDF

Telemedicine Services for Living Kidney Donation: A U.S. Survey of Multidisciplinary Providers.

Am J Transplant 2022 May 16. Epub 2022 May 16.

Piedmont Transplant Institute, Atlanta, GA.

Individuals considering living kidney donation face geographic, financial, and logistical challenges. Telemedicine can facilitate healthcare access/care coordination. Yet difficulties exist in telemedicine implementation/sustainability. Read More

View Article and Full-Text PDF

Molecular diagnosis of ABMR with or without donor-specific antibody in kidney transplant biopsies: differences in timing and intensity but similar mechanisms and outcomes.

Am J Transplant 2022 May 16. Epub 2022 May 16.

Department of Pathology, Medical University of Warsaw, Warsaw, Poland.

We studied the clinical, histologic, and molecular features distinguishing DSA-negative from DSA-positive molecularly-defined antibody-mediated rejection (mABMR). We analyzed mABMR biopsies with available DSA assessments from the INTERCOMEX study: 148 DSA-negative vs. 248 DSA-positive, compared to 864 no rejection (excluding TCMR and Mixed). Read More

View Article and Full-Text PDF

Great expectations.

Am J Transplant 2022 Apr 5. Epub 2022 Apr 5.

The Emory Transplant Center and the Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

View Article and Full-Text PDF

Incidental peritoneal and hepatic lesions in a living kidney donor candidate.

Am J Transplant 2022 May;22(5):1489-1491

Division of Transplant Surgery, University of Texas Medical Branch, Galveston, Texas, USA.

View Article and Full-Text PDF

Reported cases of end-stage kidney disease-United States, 2000-2019.

Am J Transplant 2022 May;22(5):1483-1486

Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia, USA.

View Article and Full-Text PDF

Impact of having potential living donors on ethnic/racial disparities in access to kidney transplantation.

Am J Transplant 2022 May 6. Epub 2022 May 6.

Department of Surgery- Division of Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Racial/ethnic disparities persist in patients' access to living donor kidney transplantation (LDKT). This study assessed the impact of having available potential living donors (PLDs) on candidates' receipt of a kidney transplant (KT) and LDKT at two KT programs. Using data from our clinical trial of waitlisted candidates (January 1, 2014-December 31, 2019), we evaluated Hispanic and Non-Hispanic White (NHW) KT candidates' number of PLDs. Read More

View Article and Full-Text PDF

Body composition and the skeletal muscle compartment in liver transplantation: Turning challenges into opportunities.

Am J Transplant 2022 May 6. Epub 2022 May 6.

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.

Frailty, nutritional status, and body composition are increasingly under the spotlight of interest in various clinical scenarios including liver transplantation. To address the rapidly accumulating evidence in this field, recent European and North American practice guidelines have clearly underlined the clinical importance of nutritional status and body composition with adopting their assessment in patients with liver disease and in transplant candidates into their recommendations. While earlier reports, and therefore present guidelines, were focusing predominantly on quantitative alterations of the skeletal muscle mass (sarcopenia), recent studies have identified qualitative alterations such as intramuscular fat accumulation (myosteatosis) and sarcopenic obesity as emerging risk factors for poor clinical outcomes. Read More

View Article and Full-Text PDF

Non-local kidney transplantation and transplant outcomes.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA.

View Article and Full-Text PDF

Intravenous immunoglobulin contains high-titer neutralizing IgG antibodies to SARS-CoV-2.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.

View Article and Full-Text PDF

Evolving the surveillance and workup of heart transplant rejection: A real-world analysis of the Molecular Microscope Diagnostic System.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Division of Advanced Heart Failure, Baylor University Medical Center, Dallas, Texas, USA.

The Molecular Microscope Diagnostic System (MMDx) analyzes RNA transcripts of transplanted heart tissue to differentiate among T cell-mediated rejection (TCMR), antibody-mediated rejection (AMR), injury, and healthy tissue. However, little is known about its performance in relation to other modalities in a real-world heart transplant population. We evaluated whether MMDx performs in agreement with other validated modalities. Read More

View Article and Full-Text PDF

Antibody response to three SARS-CoV-2 mRNA vaccines in adolescent solid organ transplant recipients.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins Children's Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

View Article and Full-Text PDF

Ischemia reperfusion injury facilitates lung allograft acceptance through IL-33-mediated activation of donor-derived IL-5 producing group 2 innate lymphoid cells.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Department of Surgery, University of Maryland, Baltimore, Maryland, USA.

Pathways regulating lung alloimmune responses differ from most other solid organs and remain poorly explored. Based on our recent work identifying the unique role of eosinophils in downregulating lung alloimmunity, we sought to define pathways contributing to eosinophil migration and homeostasis. Using a murine lung transplant model, we have uncovered that immunosuppression increases eosinophil infiltration into the allograft in an IL-5-dependent manner. Read More

View Article and Full-Text PDF

cDCDD-NRP is consistent with US legal standards for determining death.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Department of Population Health, Division of Medical Ethics, NYU Langone Health, New York, New York, USA.

Donation after circulatory determination of death (DCDD) has increased organ donation rates in the US over the past decade within an established legal framework, which is consistent with and supports individual and family decisions regarding organ donation in the context of end-of-life care. A new application, controlled DCDD donation utilizing thoracoabdominal normothermic regional perfusion (NRP) protocols (cDCDD-NRP), provides the opportunity to maximize a donation decision by recovering additional organs for transplant, including the heart, and to limit the detrimental impact of warm ischemic time by perfusing organs in situ following the declaration of circulatory death. In this viewpoint, we narrate our rationale for why cDCDD-NRP is consistent within the existing legal framework for organ donation in the United States and recommend no changes to the Uniform Determination of Death Act. Read More

View Article and Full-Text PDF

Association between kidney retransplantation and survival according to age in the French national cohort of dialysis patients.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Université de Lorraine, Inserm, Centre d'Investigations Cliniques- 1433, and Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT, Nancy, France.

The mean age of patients returning to dialysis after a first kidney transplantation (KT) has increased in the past decades. We aimed to assess the association between second KT (2KT) and survival according to age at the time of return to dialysis. Data of 5334 patients registered in the French Renal Epidemiology and Information Network (REIN) (mean age 56. Read More

View Article and Full-Text PDF

Cancer risk in living kidney donors.

Am J Transplant 2022 May 5. Epub 2022 May 5.

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.

Living kidney donors are screened for transmissible diseases including cancer. Outcomes following donation are excellent, but concern exists regarding development of chronic kidney disease, and cancer risk is unknown. We used linked transplant and cancer registry data to identify incident cancers among 84,357 kidney donors in the United States (1995-2017). Read More

View Article and Full-Text PDF

Elevated islet prohormone ratios as indicators of insulin dependency in auto-islet transplant recipients.

Am J Transplant 2022 May 3. Epub 2022 May 3.

Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.

Pancreatic islet transplantation has therapeutic potential in type 1 diabetes and is also an established therapy in chronic pancreatitis. However, the long-term transplant outcomes are modest. Identifying indicators of graft function will aid the preservation of transplanted islets and glycemic control. Read More

View Article and Full-Text PDF

Sarcopenic visceral obesity is associated with increased post-liver transplant mortality in acutely ill patients with cirrhosis.

Am J Transplant 2022 Apr 29. Epub 2022 Apr 29.

Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, California, USA.

"Sarcopenic obesity" refers to a condition of low muscle mass in the context of obesity, though may be difficult to assess in patients with cirrhosis who are acutely ill. We aimed to define sarcopenic visceral obesity (SVO) using CT-based skeletal muscle index (SMI) and visceral-to-subcutaneous adipose tissue ratio (VSR) to examine its association with post-transplant mortality. We analyzed 116 adult inpatients with cirrhosis who were urgently listed and transplanted between 1/2005 and 12/2017 at 4 North American transplant centers. Read More

View Article and Full-Text PDF

Caregiver COVID-19 vaccination for solid organ transplant candidates.

Am J Transplant 2022 Apr 29. Epub 2022 Apr 29.

Department of Pediatrics, University of Washington, Seattle, Washington, USA.

An increasing proportion of transplant centers have implemented a mandate for vaccination against COVID-19 for solid organ transplant candidates. There has been comparatively little exploration of the ethical considerations of mandating vaccination of a candidate's primary caregiver, despite a high risk of transmission given the close nature of contact between the candidate and caregiver. We examine how a caregiver mandate can improve overall utility in organ allocation, particularly in circumstances where vaccine effectiveness at preventing transmission and serious disease is low among recipients but high in caregivers. Read More

View Article and Full-Text PDF