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Progress and Recent Advances in Solid Organ Transplantation

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A topical collection in Transplantology (ISSN 2673-3943). This collection belongs to the section "Solid Organ Transplantation".

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Dr. Charat Thongprayoon

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Collection Editor

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Interests: artificial intelligence; machine Learning; nephrology; acute kidney injury; clinical nephrology; kidney transplantation
Special Issues, Collections and Topics in MDPI journals

Dr. Wisit Cheungpasitporn

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Collection Editor

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Interests: artificial Intelligence; machine learning; meta-analysis; acute kidney injury; clinical nephrology; kidney transplantation
Special Issues, Collections and Topics in MDPI journals

Dr. Wisit Kaewput

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Collection Editor

Department of Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
Interests: machine learning; kidney transplantation; observational studies; statistical analysis; epidemiology
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Topical Collection Information

Dear Colleagues,

There have been significant improvements in the short-term survival following solid organ transplantation due to advances in immunosuppression and transplant techniques. However, long-term graft survival has lagged relatively behind and has now become one of the main problems in solid organ transplantation.

In this Topical Collection, we are making a call to action to stimulate researchers and clinicians to submit their invaluable studies of solid organ transplantation, including issues related to donors, allograft, and patient survival following transplantation that will provide additional knowledge and skills in the field of transplantation research, ultimately to improve outcomes after solid organ transplantation. Original investigations, review articles, as well as short communications are especially welcome.

Potential topics include, but are not limited to, the following:

Advances in kidney transplant immunosuppression;

Advances in pancreas transplant immunosuppression;

Advances in liver transplantation;

Advances in heart transplantation;

Advances in lung transplantation;

Advances in kidney procurement and transplantation;

Antibody-mediated rejection: new approaches to prevention and management;

APOL1 genotype and kidney transplantation outcomes;

BK virus nephropathy and kidney transplantation;

Bone disease after kidney transplantation;

Cardiovascular complications after renal transplantation;

Cell-free DNA and active rejection in solid organ allografts;

Clinical outcomes of kidney transplantation in older end-stage renal disease patients;

Donor-specific antibody and graft outcomes in kidney transplant recipients;

Evaluation of the living kidney donor candidate;

Infectious complications after solid organ transplantation;

Combined liver-kidney transplantation;

Management of acute rejection of solid organ transplant;
Pancreas and kidney transplants: new lease on life;

Pediatric kidney transplantation in the new era;

Post-transplantation diabetes in solid organ transplant recipients;

Post-transplant lymphoproliferative disorder in solid organ transplant recipients;

Recent advances in perioperative management for kidney transplantation;

Recurrent glomerulonephritis after kidney transplantation;

Risks and complications in living kidney donors;

Treatment of chronic antibody-mediated rejection after solid organ transplantation.

Best regards,

Dr. Charat Thongprayoon
Dr. Wisit Cheungpasitporn
Dr. Wisit Kaewput
Collection Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Transplantology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

transplantation
kidney transplantation
liver transplantation
heart transplantation
pancreas transplantation
lung transplantation
immunosuppression
kidney donor
organ procurement
renal transplantation
post-transplant lymphoproliferative disorder

Related Special Issue

Progress and Recent Advances in Solid Organ Transplantation in Journal of Clinical Medicine (14 articles)

Published Papers (9 papers)

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2024

Jump to: 2022, 2021, 2020

7 pages, 199 KiB

Open AccessCase Report

From Normal Renal Function to Renal Replacement Therapy after Liver Transplantation: A Case Report

by Samuel Mangold, Gergely Albu, Julien Maillard, Florence Aldenkortt and Eduardo Schiffer

Transplantology 2024, 5(2), 65-71; https://doi.org/10.3390/transplantology5020007 - 11 Apr 2024

Viewed by 238

Abstract

Postoperative renal failure significantly impacts long-term renal function and the overall survival of patients receiving liver transplantation (LT), being a crucial factor in their morbidity and mortality. It is difficult to define whether the causes of renal failure are solely related to surgery or anaesthesia during liver transplantation (LT). Indeed, liver disease requiring liver transplantation is often the cause of preoperative renal failure. We report a case of a 62-year-old patient undergoing LT for cholangiocarcinoma that led to acute kidney injury postoperatively while his preoperative renal function was normal. This report highlights the major influence that the surgical and anaesthetic procedure can have on renal function and identifies the factors that may have led to renal replacement therapy being required for this patient. Full article

15 pages, 3524 KiB

Open AccessArticle

Personality Changes Associated with Organ Transplants

by Brian Carter, Laveen Khoshnaw, Megan Simmons, Lisa Hines, Brandon Wolfe and Mitchell Liester

Transplantology 2024, 5(1), 12-26; https://doi.org/10.3390/transplantology5010002 - 17 Jan 2024

Viewed by 8517

Abstract

Personality changes have been reported following organ transplantation. Most commonly, such changes have been described among heart transplant recipients. We set out to examine whether personality changes occur following organ transplantation, and specifically, what types of changes occur among heart transplant recipients compared to other organ recipients. A cross-sectional study was conducted in which 47 participants (23 heart recipients and 24 other organ recipients) completed an online survey. In this study, 89% of all transplant recipients reported personality changes after undergoing transplant surgery, which was similar for heart and other organ recipients. The only personality change that differed between heart and other organ recipients and that achieved statistical significance was a change in physical attributes. Differences in other types of personality changes were observed between these groups but the number of participants in each group was too small to achieve statistical significance. Overall, the similarities between the two groups suggest heart transplant recipients may not be unique in their experience of personality changes following transplantation, but instead such changes may occur following the transplantation of any organ. With the exception of physical attributes, the types of personality changes reported were similar between the two groups. These finding indicate that heart transplant recipients are not unique in their reported experience of personality changes following organ transplantation. Further studies are needed to deepen our understanding of what causes these personality changes. Full article

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2022

Jump to: 2024, 2021, 2020

15 pages, 2465 KiB

Open AccessArticle

Long-Term Outcomes of Kidney Transplant Recipients with Glomerulonephritides by Induction Type and Steroid Avoidance

by Prasanth Ravipati, Scott Jackson, Gizem Tumer, Patrick H. Nachman and Samy M. Riad

Transplantology 2022, 3(1), 68-82; https://doi.org/10.3390/transplantology3010007 - 11 Feb 2022

Viewed by 3015

Abstract

Kidney transplant programs have different approaches to induction immunosuppression, and conflicting data exist on the role of steroid maintenance in recipients with glomerulonephritis (GN). GN patients are unique because of a higher risk for immune system exhaustion due to prior exposure to immunosuppressants to treat their GN; this raises questions regarding the optimal immunosuppression needed for transplant success and reduction of complications. We sought to assess the effect of induction type and steroid maintenance on the recipient and kidney graft survival in those with IgA nephropathy (IgAN), systemic lupus erythematosus related GN (SLE), small-vessel vasculitis (SVV), and anti-glomerular basement membrane disease (anti-GBM). We analyzed the Scientific Registry of Transplant Recipients (SRTR) database for adult, primary kidney recipients with the above glomerulonephritides through September 2019. Kaplan–Meier curves were generated to examine kidney graft and recipient survival. We used multivariable Cox proportional hazard models to investigate the impact of induction type and steroid maintenance in each group separately. Our study included 9176 IgAN, 5355 SLE, 1189 SVV, and 660 anti-GBM recipients. Neither induction type nor steroid maintenance therapy influenced recipient or death-censored graft survival in this cohort of recipients. Our findings provide an opportunity for recipients with a history of one of the studied glomerulonephritides to receive a more tailored immunosuppression regimen, considering their previous exposure to immunosuppressants. Full article

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2021

Jump to: 2024, 2022, 2020

13 pages, 1242 KiB

Open AccessArticle

A Retrospective Review of Calcineurin Inhibitors’ Impact on Cytomegalovirus Infections in Lung Transplant Recipients

by Rita Nogueiras-Álvarez, Víctor Manuel Mora-Cuesta, José Manuel Cifrián Martínez, María Ángeles de Cos Cossío and María del Mar García Sáiz

Transplantology 2021, 2(4), 478-490; https://doi.org/10.3390/transplantology2040045 - 30 Nov 2021

Viewed by 2379

Abstract

Immunosuppressive therapy reduces the risk for allograft rejection but leaves recipients susceptible to infections. Cytomegalovirus (CMV) is one of the most frequent causes for infection after transplantation and increases the risk for allograft rejection. As lung transplant recipients (LTRs) need to be under immunosuppression for life, they are a vulnerable group. To determine the potential association between the development of CMV infection and the calcineurin inhibitor (CNI) blood levels within previous 90 days, a retrospective review of LTRs was performed. Data from recipients who underwent a lung transplantation (LTx) at our center from January 2011 to December 2018 were collected. The studied recipients, after case/control matching, included 128 CMV-infection cases. The median time from the transplant to the first positive CMV viral load was 291.5 days. In our study, more patients were treated with tacrolimus (91.9%) than with cyclosporine (8.1%). Drug blood levels at selected timepoints showed no statistically significant difference between cases and controls. However, we found that CMV infection was more frequent in the donor-seropositive/recipient-seronegative group, interstitial lung disease (ILD) recipients, LTRs who underwent basiliximab induction, cyclosporine treated recipients, and LTRs with lymphopenia (at the time of CMV infection and 90 days before). In this review of LTRs, no association between the CNI blood level and CMV infection was seen, although other immunity-related factors were found to be influencing, i.e., basiliximab induction, cyclosporine treatment, and lymphopenia. Full article

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13 pages, 652 KiB

Open AccessReview

Epitope-Level Matching—A Review of the Novel Concept of Eplets in Transplant Histocompatibility

by André Renaldo, Adriel Roa-Bautista, Elena González-López, Marcos López-Hoyos and David San Segundo

Transplantology 2021, 2(3), 336-347; https://doi.org/10.3390/transplantology2030033 - 06 Sep 2021

Cited by 2 | Viewed by 5328

Abstract

The development of de novo donor-specific antibodies is related to the poor matching of the human leukocyte antigen (HLA) between donor and recipient, which leads to dismal clinical outcomes and graft loss. However, new approaches that stratify the risks of long-term graft failure in solid organ transplantation have emerged, changing the paradigm of HLA compatibility. In addition, advances in software development have given rise to a new structurally based algorithm known as HLA Matchmaker, which determines compatibility at the epitope rather than the antigen level. Although this technique still has limitations, plenty of research maintains that this assessment represents a more complete and detailed definition of HLA compatibility. This review summarizes recent aspects of eplet mismatches, highlighting the most recent advances and future research directions. Full article

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21 pages, 1183 KiB

Open AccessReview

Kidney Failure after Liver Transplantation

by Eloïse Colliou, Arnaud Del Bello, David Milongo, Fabrice Muscari, Marion Vallet, Ivan Tack and Nassim Kamar

Transplantology 2021, 2(3), 315-335; https://doi.org/10.3390/transplantology2030032 - 30 Aug 2021

Cited by 3 | Viewed by 8186

Abstract

One-third of patients with cirrhosis present kidney failure (AKI and CKD). It has multifactorial causes and a harmful effect on morbidity and mortality before and after liver transplantation. Kidney function does not improve in all patients after liver transplantation, and liver transplant recipients are at a high risk of developing chronic kidney disease. The causes of renal dysfunction can be divided into three groups: pre-operative, perioperative and post-operative factors. To date, there is no consensus on the modality to evaluate the risk of chronic kidney disease after liver transplantation, or for its prevention. In this narrative review, we describe the outcome of kidney function after liver transplantation, and the prognostic factors of chronic kidney disease in order to establish a risk categorization for each patient. Furthermore, we discuss therapeutic options to prevent kidney dysfunction in this context, and highlight the indications of combined liver–kidney transplantation. Full article

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7 pages, 4958 KiB

Open AccessFeature PaperArticle

Reducing Opioid Dependence and Improving Patient Experience for Living Kidney Donors with Transversus Abdominis Plane Block

by Vincent Do, Elizabeth Cohen, Danielle J. Haakinson, Ranjit Deshpande and Ramesh K. Batra

Transplantology 2021, 2(1), 57-63; https://doi.org/10.3390/transplantology2010006 - 25 Feb 2021

Viewed by 1870

Abstract

Rapid recovery after laparoscopic living donor nephrectomy (LLDN) for kidney donation is highly desirable for living kidney donors. To uphold rapid recovery, good analgesia with minimal adverse effects, including those related to opioid dependence, is essential. A pre-operative transversus abdominis plane (TAP) block with liposomal bupivacaine can effectively aid in perioperative pain management, while reducing opioid requirements. We conducted a single-center retrospective study involving patients 18 years and older who underwent LLDN to determine whether a TAP block with liposomal bupivacaine is efficacious in pain management after LLDN, while reducing opioid use. The study group comprised of patients who received a preoperative TAP block with liposomal bupivacaine in place of hydromorphone patient-controlled analgesia (PCA) and the control group included patients who received hydromorphone PCA post-operatively. Both groups were supplemented with oral and intravenous analgesics for breakthrough pain, as needed. The primary endpoint was reduction in post-operative opioid use in morphine milligram equivalents (MME). Secondary endpoints included: post-operative pain scores, postoperative length of stay, and re-hospitalizations within 7 days of discharge. Sixty-six patients were included in our study, with 33 in each group. Patients in both groups were well matched demographically. The study group who received TAP block demonstrated a significant reduction in post-operative opioid use (92.05 MME vs. 53.98 MME, p < 0.05) when compared to the control group who received hydromorphone PCA. Both groups achieved similar analgesia with comparable pain scores. There was no difference between postoperative hospital lengths of stay for both groups. Two patients in the control group were re-admitted due to small bowel obstruction within seven days of discharge. In conclusion, TAP block with liposomal bupivacaine significantly reduced postoperative opioid use, while also proving to be safe, efficacious and feasible in patients undergoing LLDN. Full article

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7 pages, 1886 KiB

Open AccessFeature PaperCase Report

Chronic Antibody-Mediated Liver Rejection: More than Meets the Eye

by Claudia Geraldine Rita, Ignacio Iturrieta-Zuazo, Rubén Ballester-González, Nieves Alonso-Alarcón, Esther Moreno-Moreno, José Luis Castañer-Alabau and Israel Nieto-Gañán

Transplantology 2021, 2(1), 1-7; https://doi.org/10.3390/transplantology2010001 - 03 Jan 2021

Cited by 1 | Viewed by 2500

Abstract

Understanding the role of donor-specific antibodies (DSAs) in liver transplantation remains an investigative priority. Acute and chronic rejection associated with DSAs have been described. However, most transplant protocols did not consider the presence of DSAs at the moment of liver transplantation (LTx) or for the follow-up. A 65-year-old man received an ABO-compatible LTx for cirrhosis. Ten years after the LTx, he presented with a progressive elevation of liver enzymes and bilirubin. The single antigen Luminex bead assay showed the presence of DSAs against several DQ2, DQ7, and DQ8 alleles. The patient received several desensitization treatments regarding the persistence of DSAs. The anatomopathological study confirms chronic rejection. Although in this case the immunohistochemical deposits of C4d were negative, the data revealed morphological criteria of chronic graft injury and DSAs’ incompatibilities explained by structural analysis. These data support an antibody-mediated rejection (AMR). It could be reasonable to establish a protocol for human leukocyte antigen (HLA) typing of every LTx donor and recipient as well as a periodic follow-up to assess the presence of DSAs. This will make it possible to carry out studies of donor–recipient incompatibility and to confirm the existence of probable cases of AMR. Full article

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2020

Jump to: 2024, 2022, 2021

12 pages, 227 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Timing of Nephrectomy and Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in the Era of Living Kidney Donation

by Rand T. S. Alkaissy, Alexander F. M. Schaapherder, Andrzej G. Baranski, J. Dubbeld, Andries E. Braat, Hwai-Ding Lam, W. N. Nijboer, J. Nieuwenhuizen, Dorottya K. de Vries, Volkert A. L. Huurman, Ian P. J. Alwayn and Koen E. A. van der Bogt

Transplantology 2020, 1(1), 43-54; https://doi.org/10.3390/transplantology1010005 - 21 Aug 2020

Cited by 2 | Viewed by 3570

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary disorders. Once progressed to end-stage renal disease, kidney transplantation may be needed. Whether and when to perform a (bilateral) native nephrectomy in case of end-stage renal failure are issues under debate. At our institution, with a growing number of living kidney donations, the general trend is to perform a native nephrectomy prior to transplantation. Our aim was to compare the outcomes of this approach to a nephrectomy during or after transplantation and to compare our findings to results reported in the literature. Data were prospectively collected from all ADPKD patients undergoing native nephrectomy and kidney transplantation at the Leiden University Medical Center between 2000–2017. A literature search was performed in the PubMed and Scopus databases. The clinical results were retrospectively reviewed and were stratified according to the timing of the nephrectomy. From the literature review, the most practiced approach was a combined unilateral nephrectomy and kidney transplantation. However, in our series, the favored approach was to perform a scheduled bilateral nephrectomy prior to kidney transplantation. A total of 114 patients underwent a native nephrectomy prior to (group 1, n = 85), during (group 2, n = 5), or after (group 3, n = 24) kidney transplantation. There were no statistically significant differences in postoperative morbidity after nephrectomy nor differences in kidney transplant outcome. Bilateral nephrectomy prior to kidney transplantation is a safe, controlled approach carrying minimal complication and mortality rates and facilitating a subsequent transplant procedure without mechanical or hemodynamic limitations for the graft. Full article

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Progress and Recent Advances in Solid Organ Transplantation

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2024

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2022

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2021

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2020

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