Journals American Journal of Transplant...

American Journal of Transplantation
Ian McCulloh, Darren Stewart, Kevin Kiernan, Ferben Yazicioglu, Heather Patsolic, Christopher Zinner, Sumit Mohan, Laura Cartwright
Due to the breadth of factors that might affect kidney transplant decisions to accept an organ or wait for another, presumably "better" offer, a high degree of heterogeneity in decision-making exists among transplant surgeons and hospitals. These decisions do not typically include objective predictions regarding the future availability of equivalent or better-quality organs, nor the likelihood of patient death while waiting for another organ. To investigate the impact of displaying such predictions on organ donation decision making, we conducted a statistically designed experiment involving 53 kidney transplant professionals, where kidney organ offers were presented via an online application and systematically altered to observe effects on decision making...
March 21, 2023: American Journal of Transplantation
Jon J Snyder, Cory R Schaffhausen, Allyson Hart, David A Axelrod, Dorrie Dils, Richard N Formica, A Osama Gaber, Heather F Hunt, Jennifer Jones, Sumit Mohan, Rachel E Patzer, Sean P Pinney, Lloyd E Ratner, Dirk Slaker, Darren Stewart, Zoe A Stewart, Sean Van Slyck, Bertram L Kasiske, Ryutaro Hirose, Ajay K Israni
In July 2022, the Scientific Registry of Transplant Recipients (SRTR) hosted an innovative, multistakeholder consensus conference to identify information and metrics desired by stakeholders in the transplantation system, including patients, living donors, caregivers, deceased donor family members, transplant professionals, organ procurement organization professionals, payers, and regulators. Crucially, patients, caregivers, living donors, and deceased donor family members were included in all aspects of this conference, including serving on the planning committee, participating in preconference focus groups and learning sessions, speaking at the conference, moderating conference sessions and breakout groups, and shaping the conclusions...
March 21, 2023: American Journal of Transplantation
Robert J Stratta
No abstract text is available yet for this article.
March 16, 2023: American Journal of Transplantation
Phoebe Wood, Yuan-Shung Huang, Lucia Sanchez, Eimear Kitt, Peter L Abt, Therese Bittermann
Data on the potential benefits and risks of induction therapy in pediatric liver transplantation (LT) are limited. This was a retrospective cohort study of 2,748 pediatric LT recipients at 26 children's hospitals between 1/1/2006-5/31/2017 using data from the Pediatric Health Information System (PHIS) linked to the United Network for Organ Sharing database. Induction regimen was obtained from PHIS day-by-day pharmacy resource utilization. Cox proportional hazards evaluated the association of induction regimen (none/corticosteroid-only, non-depleting, depleting) on patient and graft survival...
March 16, 2023: American Journal of Transplantation
Khadijah Breathett, Ryan H Yee, Natalie Pool, Megan C Hebdon, Shannon M Knapp, Elizabeth Calhoun, Nancy K Sweitzer, Molly Carnes
Advanced heart failure (AHF) therapy allocation is vulnerable to bias related to subjective assessments and poor group dynamics. Our objective was to determine whether an implementation strategy for AHF team members could feasibly contribute to organizational and culture change supporting equity in AHF allocation. Using pretest-posttest design, the strategy included an 8-week multi-component training on bias reduction, standardized numerical social assessments, and enhanced group dynamics at an AHF center. Evaluations of organizational and cultural change included pretest-posttest AHF team member surveys, transcripts of AHF meetings to assess group dynamics using a standardized scoring system, and posttest interviews guided by framework for implementing a complex strategy...
March 15, 2023: American Journal of Transplantation
Anat R Tambur, Oriol Bestard, Patricia Campbell, Anita S Chong, Marta Crespo, Mandy L Ford, Howard M Gebel, Sebastiaan Heidt, Michelle Hickey, Annette Jackson, Vasilis Kosmoliaptsis, Carmen Lefaucheur, Kevin Louis, Roslyn B Mannon, Michael Mengel, Anna Morris, David F Pinelli, Elaine F Reed, Carrie Schinstock, Jean-Luc Taupin, Nicole Valenzuela, Chris Wiebe, Peter Nickerson
No abstract text is available yet for this article.
March 13, 2023: American Journal of Transplantation
Mary G Bowring, Jessica M Ruck, Mitchell G Bryski, William Werbel, Aaron A R Tobian, Allan B Massie, Dorry L Segev, Christine M Durand
No abstract text is available yet for this article.
March 10, 2023: American Journal of Transplantation
Sadhana Shankar, Ashwin Rammohan, Vasanthakumar Gunasekaran, Gomathy Narasimhan, Rajesh Rajalingam, Kumar Palaniappan, Rathnavel Kanagavelu, Akila Rajakumar, Ilankumaran Kaliamoorthy, Mohamed Rela
Anatomical variations of left hepatic vein (LHV) are observed in nearly a third of left lateral segment (LLS) donors in living donor liver transplantation (LDLT). There is paucity of studies and no structured algorithm for customised outflow reconstruction in LLS grafts with variant anatomy. Analysis of a prospectively collected database of 296 LLS paediatric LDLT was done to identify different venous drainage patterns of segments 2 (V2) and 3 (V3). LHV anatomy was classified into three types: type 1(n=270, 91...
March 9, 2023: American Journal of Transplantation
Reed W Kamyszek, Suman L Sood, Christopher J Sonnenday, Neehar D Parikh, Amanda Westman, Michael J Englesbe, Seth A Waits, Meredith E Barrett, Robert J Fontana, Sathish S Kumar
Liver transplantation in patients with end-stage liver disease and co-existing hemophilia A has been described. Controversy exists over perioperative management of patients with factor (F) VIII inhibitor predisposing to hemorrhage. We describe the case of a 58-year-old male with a history of hemophilia A and FVIII inhibitor eradicated with rituximab prior to living donor liver transplantation, without recurrence of inhibitor. We also provide perioperative management recommendations from our successful multidisciplinary approach...
March 8, 2023: American Journal of Transplantation
Keri-Ann Buchanan-Peart, Javier Pagan, Eric Matin, Joshua Turkeltaub, Peter Reese, David S Goldberg
Despite data demonstrating increased utilization of kidneys from hepatitis C virus (HCV)-infected donors, it is unknown whether: 1) this is due to an increase in the donor pool or improved organ utilization, and 2) data from early pilot trials was temporally associated with changes in organ utilization. We used data from the Organ Procurement and Transplantation Network of all kidney donors and recipients of kidney transplants from 1/1/2015-3/31/2022 to evaluate temporal changes using Joinpoint regression. Our primary analyses compared donors based on their HCV viremic status (HCV-infected vs...
March 7, 2023: American Journal of Transplantation
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
No abstract text is available yet for this article.
March 6, 2023: American Journal of Transplantation
Jemma H Larson, Sujeong Jin, Michael Loschi, Sara Bolivar Wagers, Govindarajan Thangavelu, Michael C Zaiken, Cameron McDonald-Hyman, Asim Saha, Ethan G Aguilar, Brent Koehn, Mark J Osborn, Angela Panoskaltsis-Mortari, Kelli P A Macdonald, Geoffrey R Hill, William J Murphy, Jonathan S Serody, Ivan Maillard, Leslie S Kean, Sangwon V Kim, Dan R Littman, Bruce R Blazar
Damage to the gastrointestinal tract following allogeneic hematopoietic stem cell transplantation is a significant contributor to the severity and perpetuation of graft-versus-host disease. In preclinical models and clinical trials, we showed that infusing high numbers of regulatory T-cells reduces graft-versus-host disease incidence. Despite no change in in vitro suppressive function, transfer of ex vivo expanded regulatory T-cells transduced to overexpress G-protein coupled receptor 15 or C-C Motif Chemokine Receptor 9, specific homing receptors for colon or small intestine, respectively, lessened graft-versus-host disease severity in mice...
March 4, 2023: American Journal of Transplantation
Lara C Pullen
No abstract text is available yet for this article.
March 4, 2023: American Journal of Transplantation
Amy P Rossi, Simon Tremblay, Cyd M Castro-Rojas, Ashley A Burg, Krishna M Roskin, Jenna M Gehman, Adele Rike-Shields, Rita R Alloway, Paul Brailey, David Allman, David A Hildeman, E Steve Woodle
To date, plasma cell (PC) targeted therapies have been limited by suboptimal PC depletion and antibody rebound. We hypothesized this is in part due to PC residence in protective bone marrow (BM) microenvironments. The purpose of this proof-of-concept study was to examine the effects of the CXCR4 antagonist, plerixafor, on PC BM residence, its safety profile (alone and in combination with the proteasome inhibitor, bortezomib), and the transcriptional impact on BMPCs in HLA-sensitized kidney transplant candidates...
March 3, 2023: American Journal of Transplantation
Jeffrey J Gaynor, Marina M Tabbara, Gaetano Ciancio, Gennaro Selvaggi, Jennifer Garcia, Akin Tekin, Rodrigo Vianna
In testing the prognostic value of the occurrence of an intervening event (clinical event that occurs post-transplant), 3 proper statistical methodologies for testing its prognostic value exist (time dependent covariate, landmark, and semi-Markov modelling methods). However, time-dependent bias has appeared in many clinical reports, whereby the intervening event is statistically treated as a baseline variable (as if it occurred at transplant). Using a single-center cohort of 445 intestinal transplant cases to test the prognostic value of 1st acute cellular rejection (ACR) and severe (grade of) ACR on the hazard rate of developing graft loss, we demonstrate how the inclusion of such time-dependent bias can lead to severe underestimation of the true hazard ratio (HR)...
March 3, 2023: American Journal of Transplantation
Jon Kobashigawa, Shelley Hall, Palak Shah, Barry Fine, Phil Halloran, Annette M Jackson, Kiran K Khush, Kenneth B Margulies, Maryam Mojarrad Sani, Jignesh K Patel, Nikhil Patel, Eliot Peyster
In heart transplantation, the use of biomarkers to detect the risk of rejection has been evolving. In this setting, it is becoming less clear as to what is the most reliable test or combination of tests to detect rejection and to assess the state of the alloimmune response. Therefore, a virtual expert panel was organized in heart and kidney transplantation to evaluate emerging diagnostics and how they may be best utilized to monitor and manage transplant patients. This manuscript covers the heart content of the conference and is a work product of the American Society of Transplantation's Thoracic and Critical Care Community of Practice...
March 2, 2023: American Journal of Transplantation
Milad Rezvani, Kathleen M Campbell, Carlos E Prada, Anna L Peters
Liver transplantation risks transferring a genetic defect in metabolic pathways, including the urea cycle. We present a case of pediatric liver transplantation complicated by metabolic crisis and early allograft dysfunction (EAD) in a previously healthy unrelated deceased donor. Allograft function improved with supportive care and retransplantation was avoided. Because the hyperammonemia suggested an enzymatic defect in the allograft, genetic testing from donor-derived DNA revealed a heterozygous mutation in the ASL gene, which encodes the urea cycle enzyme argininosuccinate lyase...
March 2, 2023: American Journal of Transplantation
Christie P Thomas, Reem Daloul, Krista L Lentine, Reginald Gohh, Prince M Anand, Hila Milo Rasouly, Asif A Sharfuddin, Johannes S Schlondorff, Nancy M Rodig, Margaret E Freese, Neetika Garg, Brian K Lee, Yasar Caliskan
The growing accessibility and falling costs of genetic sequencing techniques has expanded the utilization of genetic testing in clinical practice. For living kidney donation, genetic evaluation has been increasingly used to identify genetic kidney disease in potential candidates, especially in those of younger ages. However, genetic testing on asymptomatic living kidney donors remains fraught with many challenges and uncertainties. Not all transplant practitioners are aware of the limitations of genetic testing, are comfortable with selecting testing methods, comprehending test results, or providing counsel, and many do not have access to a renal genetic counselor or a clinical geneticist...
March 1, 2023: American Journal of Transplantation
Ali Turan, Lei Zhang, Mohammad Tarique, Vahap Ulker, Feyza Nur Arguc, Darshan Badal, Esma S Yolcu, Haval Shirwan
Instant blood-mediated inflammatory reaction (IBMIR) is initiated by innate immune responses that cause substantial islet loss following intraportal transplantation. Thrombomodulin (TM) is a multifaceted innate immune modulator. We report the generation of a chimeric form of this molecule with streptavidin (SA-TM) for transient display on the surface of islets modified with biotin to mitigate IBMIR. SA-TM protein expressed in insect cells showed the expected structural and functional features. SA-TM converted protein C into activated protein C, blocked phagocytosis of xenogeneic cells by mouse macrophages, and inhibited neutrophil activation...
February 28, 2023: American Journal of Transplantation
Jarrod E Dalton, Carli J Lehr, Paul R Gunsalus, Lyla Mourany, Maryam Valapour
No abstract text is available yet for this article.
February 17, 2023: American Journal of Transplantation
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