Personalized Medicine in Organ Transplantation 2nd Edition

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (5 April 2024) | Viewed by 1328

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Guest Editor
Chief of Transplant, Medical Director of Kidney Transplantation, Division of Nephrology, University of Texas Medical Branch, Galveston, TX, USA
Interests: kidney transplantation; transplant surgery; organ transplantation; organ donation; transplant immunology; transplant medicine
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Special Issue Information

Dear Colleagues,

Since the first successful human-to-human kidney transplant between identical twins in 1954, personalized medicine has permeated the field of transplantation due to the intricacies of donor-recipient matching. Indeed, transplantation has been nearly synonymous with personalized medicine, requiring specialized approaches to ABO blood typing, HLA classification, infectious disease treatment and prophylaxis, medication dosing, and surgical techniques. In the current era of precision medicine initiatives, the field of transplantation is ripe for innovation that is accelerating at a pace akin to Moore’s Law. Practitioners in the field are constantly striving to provide the best possible care for patients in the context of shifting multi-level regulations and an urgency to meet the increasing demands for transplantable organs. Despite the progress, solutions to ongoing problems remain elusive, such as equitable allocation policies, pre-transplant risk assessment, optimal induction and maintenance immunosuppression regimens, and intelligent allograft monitoring protocols. All these and more are needed to ensure improved allograft and patient survival while minimizing the risk of infectious and other complications.

This Special Issue of the Journal of Personalized Medicine aims to highlight some of the latest studies applying precision medicine to improve the care of people with end-stage organ disease who are in need of or have undergone transplantation.

Dr. Muhammad Mujtaba
Guest Editor

Manuscript Submission Information

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Keywords

  • organ transplantation
  • kidney transplantation
  • liver transplantation
  • heart transplantation
  • personalized medicine
  • precision medicine

Published Papers (2 papers)

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Research

10 pages, 1137 KiB  
Article
Clinical Factors Affecting the Rate of Liver Regeneration in Living Donors after Right Hepatectomy
by Minkyoung Kim, Suk-Won Suh, Eun Sun Lee, Sanggyun Suh, Seung Eun Lee and Yoo Shin Choi
J. Pers. Med. 2024, 14(5), 458; https://doi.org/10.3390/jpm14050458 - 26 Apr 2024
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Abstract
Sufficient liver regeneration after a right hepatectomy is important in living donors for preventing postoperative hepatic insufficiency; however, it differs for each living donor so we investigated the clinical factors affecting the rate of liver regeneration after hepatic resection. This retrospective case–control study [...] Read more.
Sufficient liver regeneration after a right hepatectomy is important in living donors for preventing postoperative hepatic insufficiency; however, it differs for each living donor so we investigated the clinical factors affecting the rate of liver regeneration after hepatic resection. This retrospective case–control study investigated fifty-four living donors who underwent a right hepatectomy from July 2015 to March 2023. Patients were classified into 2 groups by the remnant/total volume ratio (RTVR): Group A (RTVR < 30%, n = 9) and Group B (RTVR ≥ 30%, n = 45). The peak postoperative level of total bilirubin was more elevated in Group A than in Group B (3.0 ± 1.1 mg/dL vs. 2.3 ± 0.8 mg/dL, p = 0.046); however, no patients had hepatic insufficiency or major complications. The rates of residual liver volume (RLV) growth at Postoperative Week 1 (89.1 ± 26.2% vs. 53.5 ± 23.7%, p < 0.001) were significantly greater in Group A, and its significant predictors were RTVR (β = −0.478, p < 0.001, variance inflation factor (VIF) = 1.188) and intraoperative blood loss (β = 0.247, p = 0.038, VIF = 1.182). In conclusion, as the RLV decreases, compensatory liver regeneration after hepatic resection becomes more prominent, resulting in comparable operative outcomes. Further studies are required to investigate the relationship between hematopoiesis and the rate of liver regeneration. Full article
(This article belongs to the Special Issue Personalized Medicine in Organ Transplantation 2nd Edition)
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11 pages, 1361 KiB  
Article
Risk Factors for Recurrence of Primary Sclerosing Cholangitis after Liver Transplantation: Single-Center Data
by Elisa Catanzaro, Enrico Gringeri, Nora Cazzagon, Annarosa Floreani, Umberto Cillo, Patrizia Burra and Martina Gambato
J. Pers. Med. 2024, 14(3), 222; https://doi.org/10.3390/jpm14030222 - 20 Feb 2024
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Abstract
Background: Primary sclerosing cholangitis (PSC), comprising 5–15% of European liver transplantation (LT) cases, poses a significant challenge due to the risk of post-transplant disease recurrence (rPSC). This single-center study aimed to determine the rPSC rate and long-term post-LT outcomes in PSC patients and [...] Read more.
Background: Primary sclerosing cholangitis (PSC), comprising 5–15% of European liver transplantation (LT) cases, poses a significant challenge due to the risk of post-transplant disease recurrence (rPSC). This single-center study aimed to determine the rPSC rate and long-term post-LT outcomes in PSC patients and to identify potentially modifiable risk factors of rPSC. Methods: All PSC patients receiving LT at Padua Hospital from 1993 to 2021 were included. Recipient data were collected pre-LT, at LT, and during the follow-up. Donor and LT features were recorded. The rPSC rate was assessed according to Mayo Clinic criteria. Patient and graft survival were reported. Results: Thirty-three patients were included. The main indication of LT was decompensated cirrhosis (70%). Nine patients (27%) developed rPSC during a median follow-up of 59 months (45–72). A longer cold ischemia time (p = 0.026), donor female gender (p = 0.049), inflammatory bowel disease reactivation (IBD) post LT (p = 0.005) and hepaticojejunostomy (p = 0.019) were associated with a higher risk of rPSC. Graft and patient survival at 1, 5 and 10 years post LT, 94%, 86%, 74% and 97%, 89%, 77% respectively, were not affected by rPSC development. Conclusion: Specific donor and surgical features might increase the risk of rPSC. Identifying predictive factors for rPSC to prevent graft loss is challenging but could lead to a more personalized organ allocation and follow-up in PSC transplanted patients. IBD reactivation might have a pathogenic role in rPSC. In our single-center experience, rPSC did not affect patient and graft survival. Full article
(This article belongs to the Special Issue Personalized Medicine in Organ Transplantation 2nd Edition)
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