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Open Access Review

Risk Assessment in Clinical Histocompatibility Testing: Challenges, Strategies, and Future Directions

Received: 15 July 2025;  Published: 25 November 2025;  doi: 10.21926/obm.transplant.2504260

Abstract

Though the role of clinical histocompatibility testing is fundamental to successful transplant, systematic risk assessment and mitigation strategies remain underutilised in this domain. This review addresses risk identification, analysis, and control measures across the pre-analytical, analytical, and post-analytical phases of clinical histocompatibility testing, in line with international standards such as ISO 15189:2022. A structured, risk-based quality management system (QMS) is imperative for ensuring accurate [...]

138 691

Open Access Original Research

Immunologic Response after COVID-19 Vaccination in Heart Transplant Recipients

Received: 30 June 2025;  Published: 21 October 2025;  doi: 10.21926/obm.transplant.2504259

Abstract

To date, all large-scale randomized controlled trials for COVID-19 vaccines have excluded solid organ transplant recipients; therefore, the effectiveness and safety of COVID-19 vaccines in preventing coronavirus infection using COVID-19 vaccines in patients with heart transplants have not been sufficiently studied. This paper presents the characteristics of humoral and cellular immunity in heart transplant recipients following vaccination against coronavirus infection. The study group consisted of 40 patients who u [...]

275 1452

Open Access Review

Antibody-Mediated Rejection in Kidney Transplantation: Immunopathogenesis, Innate–Adaptive Crosstalk, and Therapeutic Advances

Received: 17 April 2025;  Published: 10 September 2025;  doi: 10.21926/obm.transplant.2503258

Abstract

Antibody-mediated rejection (ABMR) remains a major barrier to long-term graft survival in kidney transplantation. Defined by the presence of donor-specific antibodies (DSAs) and characteristic histological changes, such as C4d deposition in peritubular capillaries, ABMR can present acutely, chronically, or subclinically, often manifesting as graft dysfunction. Recent advances in genomic profiling and diagnostic assays have improved our understanding of its pathophysiology, yet therapeutic strategies remain limited. [...]

669 8533

Open Access Review

Precision Medicine in Liver and Lung Transplantation: Integrating Immunology, Regenerative Therapies, and Computational Advances

Received: 25 May 2025;  Published: 09 September 2025;  doi: 10.21926/obm.transplant.2503257

Abstract

Liver and lung transplantation remain among the most intricate and resource-intensive arenas in modern medicine, challenged by organ scarcity, immunological complexities, and the persistent threat of rejection. According to recent WHO and UNOS reports, approximately 100,000 patients globally await liver transplants annually, with only 30-40% receiving transplants, resulting in waitlist mortality rates of 15-20%. Similarly, lung transplant demand exceeds supply by a factor of 4:1, with 5-year survival rates remainin [...]

510 2893

Open Access Review

The Essentials of Cell-Mediated Immunity Assays for the Management of CMV Infection after Solid Organ Transplantation

Received: 12 March 2025;  Published: 04 September 2025;  doi: 10.21926/obm.transplant.2503256

Abstract

Provided that cell-mediated immunity (CMI) is known to be vital in managing CMV infection post-transplant along with improving methods to predict the development of cytomegalovirus (CMV) following transplant, CMV-specific-cell-mediated immunoassays have been developed, commercially and research based, to be used in conjunction with pre-transplant CMV serological testing and prophylaxis to help tailor an individual care plan post-transplant. In this review, we assess the status of CMV CMI assays, and their potential [...]

352 2470

Open Access Original Research

Duration of Hospitalization is Associated with the Gut Microbiome in Patients Undergoing Hematopoietic Stem Cell Transplantation: Early Results from a Randomized Trial of Home Versus Hospital Transplantation

Received: 24 April 2025;  Published: 25 August 2025;  doi: 10.21926/obm.transplant.2503255

Abstract

Home-based hematopoietic stem cell transplantation (HCT) is an innovative care model with growing interest, but its impact on the gut microbiome remains unexplored in a randomized setting. We present interim results from the first randomized controlled trials (RCT) evaluating the effect of HCT location—home versus hospital—on gut microbial diversity and antimicrobial resistance (AMR) gene carriage. We hypothesize that patients randomized to undergo home HCT would have higher gut taxonomic diversity and lower AMR ge [...]

1016 3520

Open Access Short Report

Donor-Derived Cell-Free DNA Assessment in a Predominantly Hispanic/Latino Lung Transplant Population: Single-Center Analysis

Received: 31 March 2025;  Published: 21 July 2025;  doi: 10.21926/obm.transplant.2503254

Abstract

The demographics of lung transplant (LT) recipients show an evolution towards increased minority racial/ethnic representation, thanks to an increased focus on inclusion in LT access, healthcare and outcomes. Herein we assess potential differences in LT allograft health in a predominantly Hispanic/Latino (HL) vs Non-Latino/White (NLW) cohort during surveillance for acute rejection by analyzing the fraction of donor-derived cell-free DNA (dd-cfDNA%), a plasma biomarker of allograft injury. Of 245 LT recipients, media [...]

411 2471

Open Access Case Report

Checkpoint Inhibition Followed by CAR-T Cell Therapy in Refractory PMLBCL: Immunologic Response and Fertility Preservation in a Young Patient

Received: 22 February 2025;  Published: 18 June 2025;  doi: 10.21926/obm.transplant.2502253

Abstract

Primary mediastinal large B-cell lymphoma (PMLBCL) is an aggressive B-cell malignancy that may exhibit resistance to standard chemoimmunotherapy. Novel immunotherapeutic strategies, including checkpoint inhibitors and chimeric antigen receptor T-cell (CAR-T) therapy, are being explored in cases that are refractory to treatment. We report the case of a 29-year-old patient with refractory PMLBCL who was treated with pembrolizumab as a bridging therapy followed by axicabtagene ciloleucel (CAR-T) after failing R-CHOP a [...]

453 2743

Open Access Original Research

Modern UNOS Data Reveals Septuagenarians Have Inferior Heart Transplant Survival

Received: 10 November 2024;  Published: 11 June 2025;  doi: 10.21926/obm.transplant.2502252

Abstract

While heart transplantation is increasingly performed in the United States for elderly patients, survival outcomes have primarily been analyzed in single-center studies. The few existing long-term studies have indicated no difference in HTx outcomes between patients ≥70 years and 60-69 years age, but these studies only assessed to 5-years post-transplant and included data from the 1980-90s, introducing significant variance due to poorer outcomes in that era. We analyzed the UNOS database from 1987-2020, stratified [...]

520 3289

Open Access Review

Integrating RNA-Seq Biomarkers and Diagnostic Algorithms to Improve Liver Transplant Outcomes: A Comprehensive Review

Received: 21 February 2025;  Published: 09 June 2025;  doi: 10.21926/obm.transplant.2502251

Abstract

Graft rejection, early allograft dysfunction (EAD), and poor diagnostic accuracy are some of the challenges that still need to be addressed, even though liver transplantation (LT) has the potential to help patients with end-stage liver disease (ESLD) significantly. Traditional procedures, such as liver biopsies and liver function tests (LFTs), often fail to identify abnormalities early and with accuracy. Genomic RNA sequencing (RNA-Seq) has recently emerged as a powerful approach for identifying molecular markers o [...]

831 6140

Open Access Review

Mechanisms of Action of Ready-to-Use Therapies in Hematologic Malignancies: From Clinical Impact to Future Directions

Received: 23 January 2025;  Published: 06 June 2025;  doi: 10.21926/obm.transplant.2502250

Abstract

Off-the-shelf cellular therapies, utilizing allogeneic T cells derived from healthy donors, represent a promising alternative to autologous chimeric antigen receptor T-cell (CAR-T) therapies for the treatment of hematological malignancies such as leukemias and lymphomas. Unlike autologous approaches, which require the patient’s own cell collection, modification, and expansion, off-the-shelf therapies can be prepared in advance, substantially reducing treatment timelines, decreasing costs, and improving global acces [...]

480 2840

Open Access Original Research

Illness Perceptions and Their Impact on Treatment Adherence among Renal Transplant Patients in the COVID-19 Pandemic

Received: 17 December 2024;  Published: 16 May 2025;  doi: 10.21926/obm.transplant.2502249

Abstract

Although immunosuppressive drugs are essential and effective in improving the health status of renal transplant patients, they also make them more vulnerable to the risk of infection with COVID-19, which has become a significant concern for many patients. Perhaps this is what makes their way of thinking and perception impact their adherence to taking immunosuppressants. Therefore, this study reveals the possibility of an impact of illness perception and some sociodemographic and clinical factors on treatment adhere [...]

503 3247

Open Access Review

What Is the Current Status of Single Lung Transplantation? A Literature Review

Received: 19 September 2024;  Published: 27 April 2025;  doi: 10.21926/obm.transplant.2502248

Abstract

Lung transplantation (LTx) is the gold standard for the surgical treatment of end-stage lung disease. Ongoing discussions persist whether single lung transplantation (SLT) or bilateral lung transplantation (BLT) lead to better patient outcomes and quality of life. This study analyzed 58 peer-reviewed articles from 1990 to 2024, comparing SLT and BLT across several parameters, including indications for transplantation, overall survival, pulmonary hypertension, complications, chronic rejection, functional status, and [...]

618 8405

Open Access Review

Updates in Liver Transplantation for Alcohol-Related Liver Disease

Received: 30 November 2024;  Published: 17 April 2025;  doi: 10.21926/obm.transplant.2502247

Abstract

The prevalence of alcohol use disorder (AUD) and alcohol-related liver disease (ALD) has increased in the last two decades. ALD is currently the most common indication for both waitlist additions and liver transplant (LT) in the United States, including alcohol-associated cirrhosis, alcohol-associated hepatitis (AH), and acute-on-chronic liver failure (ACLF). ALD also has a significant global disease burden. LT in ALD is a complex paradigm that poses both medical and ethical challenges, requiring a multidisciplinar [...]

708 6938

Open Access Case Report

When Immunity Falls Short: Meningoencephalitis Despite Vaccination - A Case Report

Received: 13 June 2024;  Published: 09 April 2025;  doi: 10.21926/obm.transplant.2502246

Abstract

Varicella-zoster virus (VZV) significantly impacts the central and peripheral nervous systems, particularly in immunocompromised individuals. This case report details a rare presentation of VZV meningoencephalitis in a 42-year-old woman with interstitial lung disease and connective tissue disease undergoing lung transplant evaluation who presented with a thunderclap headache and a new-onset seizure. Despite normal initial MRI findings, further investigation with PCR of the cerebrospinal fluid (CSF) revealed the pre [...]

508 3326

Open Access Review

Poly ε-Caprolactone Scaffolds: Advancements in Bone Regeneration and Grafting

Received: 20 October 2024;  Published: 02 April 2025;  doi: 10.21926/obm.transplant.2502245

Abstract

In orthopedics and oncology, benign and malignant bone lesions pose significant clinical challenges. Malignant tumors, like osteosarcomas and multiple myeloma, pose substantial health dangers and can spread common and mostly non-life-threatening benign lesions, including non-sizing fibromas and unicameral bone cysts. Treatment plans for bone lesions may involve radiation, chemotherapy, and surgical excision, depending on their type. Combining stem cell research, bioactive materials, and advanced scaffold design, cu [...]

637 6914

Open Access Review

Cytomegalovirus Management in Solid Organ Transplant Recipients

Received: 11 November 2024;  Published: 01 April 2025;  doi: 10.21926/obm.transplant.2502244

Abstract

Cytomegalovirus (CMV) remains a significant cause of morbidity and mortality in solid organ transplant (SOT) recipients. Despite advancements in prophylaxis and antiviral therapy, CMV continues to pose clinical challenges in transplant medicine. This review provides a comprehensive overview of CMV, exploring its pathophysiology, epidemiology, and clinical presentation in SOT patients, in whom CMV infection can lead to direct organ involvement and systemic symptoms. Additionally, CMV has indirect effects, including [...]

687 10110

Open Access Case Report

Pregnancy-Associated Spontaneous Coronary Artery Dissection: Anesthetic Considerations

Received: 29 August 2024;  Published: 20 March 2025;  doi: 10.21926/obm.transplant.2501243

Abstract

Spontaneous coronary artery dissection (SCAD) accounts for one-third of all peripartum myocardial infarction. Peripartum SCAD is associated with increased severity. We surmise that altered maternal cardiac physiology increases susceptibility to SCAD and warrants consideration when managing cardiac ischemia. One week after vaginal delivery, a 35-year-old woman with no known medical history developed multivessel SCAD and cardiogenic shock after attempted percutaneous coronary intervention, requiring rescue CABG and p [...]

681 3839

Open Access Review

Review of Heterotopic Heart Transplantation Models in Rats

Received: 21 October 2024;  Published: 14 March 2025;  doi: 10.21926/obm.transplant.2501242

Abstract

Heterotopic heart transplantation (HHT) in rats is a valuable tool for cardiac transplantation research. While abdominal HHT has been established in rats for nearly 90 years, novel approaches involving cervical and femoral techniques have also been explored. The abdominal HHT model, despite its long history, is technically demanding and has a steep learning curve. In contrast, the cervical HHT model enables surgeons with more basic microsurgical skills to achieve competency more quickly while producing comparable o [...]

746 4149

Open Access Review

Allogeneic Stem Cell Transplantation: Current Status and Future Directions

Received: 03 August 2024;  Published: 12 March 2025;  doi: 10.21926/obm.transplant.2501241

Abstract

Allogeneic stem cell transplantation (allo-SCT) improves the treatment of hematopoietic cancer and non-malignant disease. In this case, stem cells from a genetically similar but not identical donor may stimulate immune-mediated tumor cell destruction. Allogeneic stem cell transplantation, or allo-SCT, has significantly extended the life expectancy of numerous people. Nevertheless, complications such as infections, graft-versus-host disease (GVHD), and recurrence continue. This paper provides a thorough analysis of [...]

680 7799

Open Access Original Research

Design and Simulation of Computational Models of Hybrid Scaffolds Representative of Subchondral Bone and Hyaline Cartilage

Received: 22 August 2024;  Published: 07 March 2025;  doi: 10.21926/obm.transplant.2501240

Abstract

Tissue engineering offers alternatives when it comes to health problems such as trauma or pathologies. One of them is the scaffolds, which provide a favorable architecture, mechanics, and biocompatibility for the fixation of cells. Therefore, the following research aims to design and simulate scaffolds with mixed geometric structures to create a hybrid architecture for osseointegration while maintaining structural properties similar to subchondral bone and hyaline cartilage. Three scaffolds were designed for this p [...]

474 3377

Open Access Review

The Role of Pulmonary Rehabilitation in Lung Transplantation for Cystic Fibrosis

Received: 11 December 2024;  Published: 03 March 2025;  doi: 10.21926/obm.transplant.2501239

Abstract

Cystic fibrosis (CF) is a genetic disorder that significantly impacts respiratory function, leading to progressive lung damage and ultimately respiratory failure. Lung transplantation (LTx) is a critical intervention for CF patients with end-stage lung disease, offering improved survival and quality of life. Pulmonary rehabilitation (PR) plays a pivotal role both preoperatively and postoperatively in optimizing outcomes for LTx candidates and recipients. Pre-transplant PR interventions, including exercise programs, [...]

766 5844

Open Access Original Research

Management of Atrial Fibrillation after Kidney Transplant: Do We Need a New Metric?

Received: 06 December 2024;  Published: 27 February 2025;  doi: 10.21926/obm.transplant.2501238

Abstract

To evaluate the bleeding risk associated with anticoagulation (AC) in kidney transplant patients with post-operative atrial fibrillation (AF). We conducted a retrospective analysis of all adult kidney transplant recipients performed from October 2012 to February 2019 at our institution, the University of North Carolina at Chapel Hill, which accounted for 428 transplants. Variables assessed included AF occurrence, AC use, bleeding complications, stroke and bleeding risk stratification in AF (determined using CHA2DS2 [...]

463 3787

Open Access Original Research

Integrating Telemonitoring in COPD Exacerbations Care: A Multinational Study Using the Alsayed System for Applied Medical-Care Improvement (ASAMI) Database

Received: 26 August 2024;  Published: 25 February 2025;  doi: 10.21926/obm.transplant.2501237

Abstract

This study was designed to investigate the ability of telemonitoring involving a secure electronic database called “Alsayed System for Applied Medical-Care Improvement” (ASAMI) to detect at least 95% of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This prospective observational study, which took place over 16 months in 2022-2023, was based at a medical center in Jordan. The study group participants were patients with COPD (from seven countries) with mixed levels of airflow limitation sever [...]

541 4185

Open Access Review

Introduction to COVID-19 Vaccines and Kidney Transplant Recipient

Received: 03 August 2024;  Published: 24 February 2025;  doi: 10.21926/obm.transplant.2501236

Abstract

COVID-19 has presented considerable health hazards, particularly for immunocompromised persons, such as kidney transplant recipients. This population experiences increased susceptibility due to the immunosuppressive treatments necessary to avert organ rejection, potentially resulting in a diminished immune response to immunizations. The implementation of COVID-19 vaccinations has been essential in alleviating these dangers. Studies demonstrate differing levels of vaccine efficacy among kidney transplant recipients, [...]

508 5062

Open Access Review

Maribavir for Management of Cytomegalovirus in Lung Transplant Recipients: A Case Series and Literature Review

Received: 15 November 2024;  Published: 20 February 2025;  doi: 10.21926/obm.transplant.2501235

Abstract

Lung transplant recipients represent a high-risk group for cytomegalovirus (CMV) infection and disease, even among solid organ transplant (SOT) recipients, due to multiple factors. Additionally, CMV has significant consequences in this group including pneumonitis, acute rejection, and chronic lung allograft dysfunction. For the past two plus decades, treatment of CMV in SOT recipients has been limited to off-label use of 4 antiviral medications associated with significant toxicities including myelosuppression and n [...]

918 8394

Open Access Review

Acute Liver Failure Due to Assumed Drug Induced Liver Injury but Lack of Any Validated Causality Algorithm: Evidence by 36 Cohort Reports with 21,709 Cases

Received: 08 January 2025;  Published: 14 February 2025;  doi: 10.21926/obm.transplant.2501234

Abstract

Liver transplantation (LT) can be the only option for patients with acute liver failure (ALF) where medical approaches are ineffective. Causes of ALF are multiple and commonly easily detectable, but uncertainty remained on the role of drug-induced liver injury (DILI) within the published ALF cohorts. Therefore, an analysis was undertaken to clarify which drugs may have caused the DILI and how the diagnosis of the liver injury was established. Using the PubMed database and Google Science, the search term of acute li [...]

744 4618

Open Access Research Article

Embracing Time: The (Dis)Comfort of Life After Allogeneic Stem Cell Transplants

Received: 19 September 2024;  Published: 06 February 2025;  doi: 10.21926/obm.transplant.2501233

Abstract

Allogeneic Stem Cells Transplantation (ASCT) and, consequently, the chronicity associated with this life event has a growing prevalence and a significant impact on the life and daily life of each person who experiences it. The growing number of ASCT survivors highlights the need to reflect on the unique challenges they face throughout their recovery. To understand the meaning of the encounter with time in the lived experience of comfort for survivors of ASCT. Qualitative approach using van Manen's phenomenology of [...]

392 2782

Open Access Short Review

Versatility of the Axillary Intra-Aortic Balloon Pump in Adult Cardiac Surgery

Received: 23 July 2024;  Published: 22 January 2025;  doi: 10.21926/obm.transplant.2501232

Abstract

The axillary intra-aortic balloon pump (ax-IABP) has been proposed as an alternative to the femoral IABP, particularly for patients with comorbidities rendering them unsuitable for fem-IABP insertion. Patient mobilisation with the ax-IABP in situ is deemed an additional potential benefit. We reviewed our experience with the ax-IABP. A single-centre retrospective review of all adult patients undergoing cardiac surgery (including heart transplantation) in a UK quaternary cardiac surgery centre between 2017 and 2021 w [...]

453 3062

Open Access Original Research

Efficiency of Pre-Expanded Anterior Supraclavicular Artery Pedicled Skin Flaps: A Meta-Analysis Study

Received: 27 March 2024;  Published: 13 January 2025;  doi: 10.21926/obm.transplant.2501231

Abstract

The supraclavicular artery flap presents a promising solution for facial reconstruction challenges since 1997, surpassing limitations of traditional methods like the deltopectoral flap. Its extended pedicle and thin, pliable epidermis offer reliable outcomes with minimal donor site morbidity, making it a preferred choice for head and neck reconstruction. This systematic review evaluates the efficacy of pre-expanded supraclavicular artery flaps based on a comprehensive analysis. In accordance with the Preferred Repo [...]

445 2905

Open Access Original Research

Leukocytosis is Common Following Pediatric Liver Transplant for Biliary Atresia but Should be Interpreted with Caution

Received: 23 September 2024;  Published: 10 January 2025;  doi: 10.21926/obm.transplant.2501230

Abstract

Infection is a leading cause of short-term morbidity and mortality in pediatric patients after liver transplant (LT). Diagnosing infection in this population can be challenging, requiring consideration of laboratory results and clinical context. The prevalence and significance of post-operative leukocytosis has not yet been explored in children after LT. Our goals were to characterize post-transplant leukocytosis in pediatric patients after LT for biliary atresia (BA) and evaluate the relationship between post-LT l [...]

537 3934

Open Access Editorial

Acknowledgement to Reviewers of OBM Transplantation in 2024

Received: 02 January 2025;  Published: 02 January 2025;  doi: 10.21926/obm.transplant.2501229

Abstract

The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2024. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal’s editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers can download a certificate of recognition directly from our submission system. Additionally, reviewers can sign up to t [...]

349 2103

Open Access Original Research

Tacrolimus Therapeutic Response, Pharmacokinetics and Adherence in Liver Transplant Recipients

Received: 20 August 2024;  Published: 13 December 2024;  doi: 10.21926/obm.transplant.2404228

Abstract

A high intra and interindividual pharmacokinetics variability characterize Tacrolimus. Data regarding factors influencing its pharmacokinetics and pharmacodynamics in liver transplantation are limited. This study aimed to assess tacrolimus therapeutic response, pharmacokinetics and adherence in liver transplant recipients. The study was conducted at the Clinical Pharmacology Department for 12 years, from January 2009 to March 2021. We included liver transplant patients treated with tacrolimus referred to our depart [...]

717 7066

Open Access Original Research

A Phase I/II Randomized Trial of Higher Dose mRNA-1273 Boosters in Lung Transplant Recipients

Received: 16 August 2024;  Published: 20 November 2024;  doi: 10.21926/obm.transplant.2404227

Abstract

Higher-dose mRNA booster vaccines have not been well studied for transplant recipients. This study evaluated the safety, reactogenicity and immunogenicity of higher dose mRNA-1273 booster vaccines among lung transplant recipients (LTRs). This phase 1/2 open-label randomized clinical trial of higher-dose mRNA-1273 booster vaccination enrolled nineteen adult LTRs into the 50 µg (n = 8) vs. 100 µg (n = 11) groups before enrollment was terminated due to the availability of the bivalent mRNA-1273.222 vaccine [...]

604 3390

Open Access Research Article

Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Fanconi Anemia: Results of a Single Center with a Fludarabine-Based Conditioning Regimen

Received: 29 June 2024;  Published: 11 November 2024;  doi: 10.21926/obm.transplant.2404226

Abstract

Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) remains the only curative treatment for bone marrow failure (BMF) and hematologic complications of Fanconi anemia (FA). The evolution remains affected by the toxicity, the risk of graft failure, and clonal evolution. This study aimed to identify factors affecting outcomes in FA patients after allo-HSCT. We included FA patients who underwent allo-HSCT between January 2006 and December 2021. The conditioning regimen was cyclophosphamide/fludarabine (Cy/Fl [...]

802 4889

Open Access Case Report

Use of Plasma-Rich in Growth Factors (PRGF) in the Treatment of Acne

Received: 26 April 2024;  Published: 03 October 2024;  doi: 10.21926/obm.transplant.2404225

Abstract

Acne is a chronic inflammatory condition affecting the pilosebaceous units of the skin, characterized by the formation of papules, cysts, comedones, pustules, nodules, and scars. These lesions are typically located on the face and shoulders, although they can extend to the trunk, arms, and legs. In regenerative medicine, biomolecules are fundamental to tissue regeneration. The use of growth factors from autologous platelet-rich plasma emerges as a promising alternative in the treatment of acne and scars. This study [...]

649 6387

Open Access Review

Current and Future Applications of Machine Perfusion and Other Dynamic Preservation Strategies in Liver Transplantation

Received: 12 May 2024;  Published: 30 August 2024;  doi: 10.21926/obm.transplant.2403224

Abstract

Machine perfusion (MP) techniques, which simulate physiological conditions to allow for the assessment and preservation of organ viability, are currently applied in various solid organ transplantation fields. Owing to the growing demand for liver transplants and the scarcity of available donor livers, MP offers a practical solution for recovering high-risk grafts and increasing the number of potentially usable donor organs. Furthermore, testing and administering novel therapies to allografts may also become advanta [...]

667 10770

Open Access Review

Platelets as Regenerative Cells, Hundreds of Opportunities in Sight

Received: 21 May 2024;  Published: 13 August 2024;  doi: 10.21926/obm.transplant.2403223

Abstract

Platelets were the last to be discovered of the three formed blood elements. Several scientists have been interested in them, recognizing them as cells other than leukocytes and erythrocytes. Its job in hemostasis and thrombosis is currently known. Platelets contain growth factors and secrete cytokines, which have roles in inflammation and tissue regeneration processes. This is why platelet concentrates have been widely used in regenerative medicine, an emerging field that involves biomolecules, cells, and scaffold [...]

523 3801

Open Access Review

Machine Perfusion of Donor Hearts – The Recovery and Transplantation of Previously Unrecoverable Hearts

Received: 02 April 2024;  Published: 05 August 2024;  doi: 10.21926/obm.transplant.2403222

Abstract

Heart transplantation remains the gold standard treatment for end-stage heart failure. With an increasing population and improving medical therapy there is an increasing number of patients who would benefit from heart transplantation but are unable to receive one due to a shortage of suitable donor organs. This ongoing need, and significant limitations with traditional cold static storage (CSS), have driven the development of machine perfusion technology that have expanded the donor pool. Machine perfusion is divid [...]

843 5263

Open Access Review

BK Virus-Associated Nephropathy in Adult Patients Post Kidney Transplantation: What Progress in 30 Years of History?

Received: 24 January 2024;  Published: 25 July 2024;  doi: 10.21926/obm.transplant.2403221

Abstract

Completely unknown before the 90s and exceptional up to the 2000s, BK virus nephropathy (BKvN), usually known as polyomavirus-associated nephropathy, has emerged as a significant and severe viral complication in kidney transplantation (KT). More than twenty years after Gardner's discovery of BKv in 1971, Purighalla described, in 1995, the first case of BKvN. Four years later in 1999, Nickeleit et al. published a first series of five cases of BKvN and made very precious and pertinent contributions to understanding t [...]

747 10364

Open Access Research Article

Impact of Intravenous Immunoglobulin Replacement Therapy on Hypogammaglobulinemia and Infection in Lung Transplant Recipients

Received: 29 January 2024;  Published: 03 July 2024;  doi: 10.21926/obm.transplant.2403220

Abstract

Secondary hypogammaglobulinemia (HGG) from immunosuppression therapy in lung transplant recipients has been associated with increased mortality, morbidity and higher risk of infection. Intravenous immunoglobulin (IVIG) for the treatment of HGG post-lung transplant is not well studied with conflicting evidence regarding efficacy. This single-center, retrospective cohort study analyzed adult lung transplant recipients with HGG receiving ≥1 dose of IVIG 0.3-0.5 g/kg. Resolution of HGG (IgG > 600 mg/dL wi [...]

598 5442

Open Access Original Research

Detection of Activated Pepsin in Bronchoalveolar Lavage and Acute Cellular Rejection in Lung Transplant Recipients

Received: 23 February 2024;  Published: 21 June 2024;  doi: 10.21926/obm.transplant.2402219

Abstract

Activated pepsin (pepA) in bronchoalveolar lavage (BAL) fluid may be a biomarker of gastric aspiration. We sought to i) evaluate the association of pepA in BAL fluid with acute cellular rejection (ACR) in a cohort of lung transplant recipients (LTRs), ii) assess the association between pepA and isolation of typical gastrointestinal microorganisms from BAL fluid, and iii) explore the accuracy of using pepA concentration as a biomarker of ACR. After IRB approval, we conducted a retrospective observational study analy [...]

794 5019

Open Access Case Report

Management of Calcareous Corneal Degeneration from Medication Washout to Corneal Transplantation. Case Series and Review of the Literature

Received: 27 February 2024;  Published: 07 June 2024;  doi: 10.21926/obm.transplant.2402218

Abstract

Calcareous corneal degeneration is a rare disease characterized by calcium phosphate deposition into the deep corneal layers. Corneal calcification has a multifactorial origin and is associated with various systemic and ocular conditions. Several treatment options showed promising results in the management of this disorder. Herein, two cases of calcareous degeneration occurring postoperatively in patients undergoing surgery for retinal detachment (case #1) and glaucoma (case #2) were reported. Despite normal serum [...]

670 6483

Open Access Original Research

Circulating lncRNAs HOTTIP and HOTAIR as Potential Biomarkers in Crigler-Najjar Syndrome: A Preliminary Report from Shiraz Liver Transplant Research Center

Received: 05 May 2024;  Published: 04 June 2024;  doi: 10.21926/obm.transplant.2402217

Abstract

Crigler-Najjar syndrome (CNS) is a rare autosomal recessive disorder characterized by impaired bilirubin metabolism, leading to neurotoxic unconjugated bilirubin accumulation. Liver transplantation remains the only effective treatment, highlighting the need for novel diagnostic and therapeutic approaches. Long non-coding RNAs (lncRNAs) have emerged as potential biomarkers in various diseases, including cancer. This study aimed to evaluate the expression of lncRNAs HOTTIP and HOTAIR in CNS patients and healthy contr [...]

748 5079

Open Access Original Research

Is Donation after Circulatory Determination of Death in Japan Uncontrolled or Controlled?

Received: 15 February 2024;  Published: 03 June 2024;  doi: 10.21926/obm.transplant.2402216

Abstract

Using donation after circulatory determination of death (DCD) donors has been shown to be a potential means of increasing the number of donors for organ transplantation. The purpose of this study was to examine the published practice of DCD in Japan to properly define their practice as controlled or uncontrolled. Through the Web of Science database, we systematically searched articles describing uncontrolled DCD, controlled DCD or Maastricht classification. A total of 12 articles (ten articles related to kidney, on [...]

623 5628

Open Access Review

Advances in Managing Infections in Lung Transplantation: A Review

Received: 21 November 2023;  Published: 10 May 2024;  doi: 10.21926/obm.transplant.2402215

Abstract

Transplanted lung allografts are particularly susceptible to infection among SOT due to the constant exposure to the environment, aggressive immunosuppressive strategies, and impaired clearance mechanisms after denervation of the transplanted lung. Though prophylactic antimicrobial, antifungal, and antiviral regimens are used as preventive strategies to mitigate the risk of infection, complications related to allograft infection remain one of the primary causes of morbidity and mortality after lung transplantation. [...]

735 5784

Open Access Original Research

Frequency of Unplanned Readmissions Following Lung Transplantation During the SAR-COV-2 Pandemic When Hospital Resources Were Strained

Received: 19 October 2023;  Published: 08 May 2024;  doi: 10.21926/obm.transplant.2402214

Abstract

Despite the concerted efforts by lung transplant recipients (LTR) and their medical teams, hospital readmissions are common in the first year following transplantation. Reasons for unplanned readmissions include allograft rejection, infections, and respiratory failure before the SARS-COV-2 pandemic. Clinical predictors of readmissions have changed over time with the higher risk factors of acceptable criteria for recipients and donors. We aimed to assess more recent readmission rates based on group classifications t [...]

1098 5431

Open Access Original Research

Low Mortality Associated with COVID-19 Infection in Lung Transplant Recipients at a Single Center

Received: 15 October 2023;  Published: 28 April 2024;  doi: 10.21926/obm.transplant.2402213

Abstract

Lung Transplant Recipients (LTR) are particularly vulnerable to severe infection, hospitalization, and death due to community acquired respiratory viruses. As a result, the global SARS-Cov-2 pandemic poses a higher risk to this population. We aim to study the lung function, severity of infection and mortality among LTR at a single center. A retrospective chart review was performed on all LTR at the University of San Diego, California Medical Center between June 2020 and September 2022. Spirometry was performed at 1 [...]

720 4803

Open Access Original Research

Contribution of a Single Islet Transplant Program to Basic Researchers in North America, Europe, and Asia through Distributing Human Islets

Received: 23 February 2024;  Published: 23 April 2024;  doi: 10.21926/obm.transplant.2402212

Abstract

There has been a steady expansion in islet isolation and transplantation activity worldwide. In addition to preparing human islets for transplantation, we have been providing human islets to basic researchers. The aim of this study was to review the activity of distribution of human islets to basic researchers in North America, Europe, and Asia, and to investigate if there are any differences in utilization rate of islets among three continents. We reviewed our islet isolation batch files, donor records, and docume [...]

807 6593

Open Access Review

Thrombotic Microangiopathy in Solid Organ Transplantation

Received: 31 January 2024;  Published: 10 April 2024;  doi: 10.21926/obm.transplant.2402211

Abstract

Thrombotic Microangiopathy (TMA) is a syndrome characterized by microangiopathic hemolytic anemia (MAHA) and thrombocytopenia. The presence of schistocytes on peripheral smear, a negative Coombs test, elevated lactate dehydrogenase, increased reticulocyte count and low haptoglobin are often the clues for MAHA. The microvascular process often targets vasculature in kidneys, brain, gastrointestinal system, heart, and skin. A timely diagnosis and treatment are often crucial to prevent severe end organ damage and death [...]

1597 11421

Open Access Review

Management of Steatosis in Living Donors: Where Do We Stand?

Received: 23 October 2023;  Published: 01 April 2024;  doi: 10.21926/obm.transplant.2402210

Abstract

With the progressive rise in rates of liver transplantation, stagnant donor pool, and social factors, living donor liver transplantation (LDLT) forms the majority of liver transplantations performed in Asian countries. As the global prevalence of metabolic-associated fatty liver disease (MAFLD) is increasing, around 17-25% of all the prospective donors turn out to be steatotic at the time of evaluation and, as such, rejected for donor hepatectomy, thereby considerably reducing the living donor pool. Steatotic graft [...]

794 5654

Open Access Review

Airway Complications after Lung Transplantation

Received: 12 September 2023;  Published: 27 March 2024;  doi: 10.21926/obm.transplant.2401209

Abstract

Lung transplantation in patients with end stage lung disease can improve survival and quality of life. Airway complication incidence varies between 2-33%, but the true incidence is difficult to determine due to a lack of validated classification systems. There are many risk factors for post lung transplant airway complications, the most common being anastomotic ischemia, pulmonary infections, surgical technique and allograph dysfunction. Common complications include formation of granulation tissue, anastomotic sten [...]

948 7005

Open Access Communication

Calculated Human Leucocyte Antigens Evolutionary Divergence (cHED)

Received: 15 December 2023;  Published: 11 March 2024;  doi: 10.21926/obm.transplant.2401208

Abstract

Human Leucocyte Antigens (HLA) constitute a highly polymorphic set of genes pivotal to the immune response. The HLA heterozygous advantage hypothesis assumes that heterozygous individuals at the HLA level have a wider range of peptides for T cell recognition than homozygous individuals. Consequently, they possess an enhanced capacity to trigger a targeted immune reaction. The divergent allele advantage hypothesis is an extension of heterozygous advantage, considering the excessive sequence divergence between allele [...]

798 5950

Open Access Review

Chronic Lung Allograft Dysfunction, a Review in 2023

Received: 25 May 2023;  Published: 20 February 2024;  doi: 10.21926/obm.transplant.2401207

Abstract

Chronic allograft dysfunction (CLAD) is one of the leading causes of death after lung transplantation [1]. CLAD is a progressive and irreversible decline in lung function after transplant, manifested as an obstructive, restrictive, or mixed ventilatory impairment without any identifiable etiology as infection or acute rejection. Multiple risk factors have been associated with this condition. Despite its significant effect on the mortality of transplanted patients, there is still a lack of powerfully effective thera [...]

1184 13981

Open Access Original Research

Evaluation of Total Parenteral Nutrition in the Autologous Transplantation Setting in Patients with AML: A Retrospective Exploratory Analysis

Received: 29 July 2023;  Published: 04 February 2024;  doi: 10.21926/obm.transplant.2401206

Abstract

Malnutrition remains a clinical challenge in AML patients undergoing autologous hematopoietic stem cell transplantation (ASCT), leading to physical deconditioning and prolonged hospitalization. Prospective data are mainly lacking to identify those patients who may particularly benefit from parenteral nutrition in this setting. This observational, non-randomized, retrospective, exploratory cohort study assessed the nutritional development in patients following high-dose chemotherapy (HDCT) with ASCT and explored the [...]

916 5495

Open Access Editorial

Acknowledgement to Reviewers of OBM Transplantation in 2023

Received: 03 January 2024;  Published: 04 January 2024;  doi: 10.21926/obm.transplant.2401205

Abstract

The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2023. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal’s editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers can download a certificate of recognition directly from our submission system. Additionally, reviewers can sign up to t [...]

550 3699

Open Access Original Research

Immune-Suppression Modulation in Solid Organ Transplant Recipients Admitted for COVID-19

Received: 14 June 2023;  Published: 01 December 2023;  doi: 10.21926/obm.transplant.2304204

Abstract

SARS-CoV-2 infection has significantly impacted solid organ transplant (SOT) recipients, who are at high risk of disease and worse outcomes. Moreover, therapeutic management in this population is not precise yet. Our study aimed to evaluate the overall survival of SOT recipients and predictive factors for mortality. We also aimed to assess the impact of antiviral treatments and immunosuppressant changes on overall mortality and to evaluate the length of hospital stay of SOT compared to the general population. This [...]

812 5062

Open Access Review

Lung Donor Selection and Management: An Updated Review

Received: 09 July 2023;  Published: 23 November 2023;  doi: 10.21926/obm.transplant.2304203

Abstract

The shortage of donor lungs for transplantation is a major challenge, resulting in longer waitlist times for patients with a higher risk of waitlist mortality. It is crucial to continue promoting awareness about organ donation through legislation, public campaigns, and health care provider education. Only a small number of cadaveric donors meet the ideal criteria for lung donation, leaving many lungs unused. Donor lung utilization can be improved by carefully considering the extended-criteria donors, actively parti [...]

1280 15439

Open Access Review

Acute Rejection of the Lung Allograft: Phenotypes and Management

Received: 08 June 2023;  Published: 21 November 2023;  doi: 10.21926/obm.transplant.2304202

Abstract

Treatment options for end stage lung diseases are limited to stabilizing lung failure, decreasing disease progression, and symptom management, but significant reversal of lost lung function is often not possible. For well selected patients, lung transplantation may be a viable option to improve both longevity and quality of life. Though outcomes for lung transplant recipients have improved over several decades, long term survival still lags behind that of other solid organ transplant recipients. Longevity after lun [...]

1019 10596

Open Access Review

HLA Typing and Donor-Specific Antibody Screening in Kidney Transplantation: Bridging the Past to the Future

Received: 15 March 2023;  Published: 06 November 2023;  doi: 10.21926/obm.transplant.2304201

Abstract

Human leukocyte antigens (HLA) are unique proteins expressed on the surface of human cells, playing a pivotal role in the immune system, particularly in the contexts of infection, cancer, and transplantation. The widespread adoption of HLA typing methods has become an essential component in assessing donor-recipient compatibility, a crucial limiting factor in solid organ transplantation. In general, the greater the disparity between a donor's and recipient's HLA types, the higher the likelihood of provoking an allo [...]

1215 10710

Open Access Research Article

Peri-transplant Treatment with Ceftaroline in Kidney Transplant Recipients at Risk of Donor-derived MRSA Infections: A Case Series

Received: 19 July 2023;  Published: 01 November 2023;  doi: 10.21926/obm.transplant.2304200

Abstract

The rising prevalence of MDR pathogens has a significant impact on the recipients' outcome, as this increases the risk of graft complications and makes the management of the peri-transplant phase more difficult. Among the different MDR germs, Methicillin-resistant Staphylococcus aureus (MRSA) represents one of the most frequently isolated pathogens. We report for the first time the off-label use of Ceftaroline in six kidney transplant recipients with donor peritransplantation MRSA bacteremia at the Division of Kidn [...]

989 5803

Open Access Short Review

Utility of MEST and MEST-C Scoring in IgA Nephropathy in Kidney Transplantation: A Mini Review

Received: 26 June 2023;  Published: 13 October 2023;  doi: 10.21926/obm.transplant.2304199

Abstract

IgAN is a major cause of end-stage kidney disease (ESKD) leading to kidney transplantation in a significant proportion of patients. However, its recurrence in transplanted kidneys can lead to graft loss. The rate of graft loss attributable to IgAN after transplantation is variably reported in different retrospective cohorts. Previous reports describe recurrence rates of 22-58% with a 1.3% to 16% rate of graft loss. Accurate diagnosis and prediction of graft loss are important for planning effective therapies to imp [...]

933 6366

Open Access Review

Multimodal Pain Management of Liver Transplantation: What Is New?

Received: 14 May 2023;  Published: 13 October 2023;  doi: 10.21926/obm.transplant.2304198

Abstract

Liver transplantation (LT) is a life-saving treatment representing the only viable option for patients suffering from end-stage liver disease (ESLD) or acute liver failure. Patients who undergo LT require a multidisciplinary approach to postoperative pain management. However, pain management in this context is often inadequately explored. Limited options exist for proper pain control in patients with hepatic failure, mainly due to the increased risk of kidney and multi-organ failure. In LT candidates, specific anal [...]

1611 12431

Open Access Review

Lung Transplantation: Selection of Candidates

Received: 07 August 2023;  Published: 11 October 2023;  doi: 10.21926/obm.transplant.2304197

Abstract

Lung transplantation is a last-resort treatment option for patients with end stage lung disease. The procedure is being performed more frequently and scientific advances continue to be made, but the median post-transplant survival is far shorter than other solid organ transplant recipients. Candidate selection is a resource intensive process that attempts to balance risks of the procedure with the benefits of much higher quality of life. Transplant centers must weigh disease specific considerations, medical comorbi [...]

2480 13548

Open Access Original Research

A Urinary Proteomics Approach to Predict Treatment Response in Acute Antibody-Mediated Rejection

Received: 12 July 2023;  Published: 25 September 2023;  doi: 10.21926/obm.transplant.2303196

Abstract

Acute antibody-mediated rejection (AMR) is a severe complication affecting kidney allografts' long-term survival. Timely detection and appropriate treatment of AMR are crucial for improving graft outcomes. This study aimed to discover non-invasive urinary biomarkers that can predict the response to therapy in patients with AMR. Materials and Methods: In this case-control study, urine samples from 21 biopsy-proven AMR patients underwent proteomics using label-free quantification. The patients were divided into two g [...]

911 5801

Open Access Research Article

Oral Versus Intravenous Anti-CMV Preemptive Strategies in Allogeneic Stem Cell Transplant Patients with CMV Reactivation: Experience from the National Center of Bone Marrow Transplantation, Tunis, Tunisia

Received: 12 April 2023;  Published: 12 September 2023;  doi: 10.21926/obm.transplant.2303195

Abstract

Cytomegalovirus (CMV) infection is a common and severe complication following allogeneic stem cell transplantation (ASCT) and requires effective preemptive antiviral therapy. Both oral and intravenous (IV) antiviral agents effectively reduce CMV viral load and achieve viral clearance. Studies comparing oral and IV anti-CMV preemptive treatment in ASCT patients with CMV reactivation showed a potential difference in treatment response and safety profiles between the two administration routes. We retrospectively compa [...]

867 6214

Open Access Case Report

A Rare and Complex Case of Multifactorial Thrombotic Microangiopathy in A Kidney Transplant Recipient: Interplay Between Antibody Mediated Rejection, Tacrolimus Toxicity, Cytomegalovirus Disease and BNT162b2mRNA Vaccine

Received: 11 May 2023;  Published: 04 September 2023;  doi: 10.21926/obm.transplant.2303194

Abstract

Thrombotic microangiopathy (TMA) in kidney transplant recipients is uncommon and difficult to manage, often with poor graft outcomes [1]. This is a complex and interesting case of an older, highly sensitised kidney transplant recipient who presented with de novo post-transplant TMA in the setting of antibody mediated rejection (ABMR), with other drivers being tacrolimus toxicity, cytomegalovirus (CMV) infection and anti-SARS-CoV-2 BNT162b2 mRNA vaccination. This led to rapid, irrecoverable graft loss. 76-year-old f [...]

928 6020

Open Access Original Research

Lung Transplantation for COVID-19 Related Lung Disease: A Follow-Up Study of Outcomes from a Medium-Size Lung Transplant Programd

Received: 01 May 2023;  Published: 17 July 2023;  doi: 10.21926/obm.transplant.2303193

Abstract

In the United States of America, COVID-19 acute respiratory distress syndrome (ARDS) and post-COVID pulmonary fibrosis (PCPF) are raising indications for lung transplant (LT). Another indication for LT is underlying fibrosis with SARS-CoV-2 induced interstitial lung disease exacerbation or rapid progressing fibrosis. Only a few centers have reported on their long-term outcomes after LT for COVID-19. Single center retrospective chart review of patients transplanted for COVID-19 related lung disease. The Henry Ford H [...]

974 6212

Open Access Review

BK Virus Infection and Its Management in Renal Transplantation: An Update

Received: 10 April 2023;  Published: 14 July 2023;  doi: 10.21926/obm.transplant.2303192

Abstract

BK virus (BKV) is a common opportunistic pathogen in kidney transplant recipients and one of the most challenging causes of allograft dysfunction and loss. Although over-immunosuppression remains the primary risk factor for BKV infection after transplantation, male gender, older recipient age, prior rejection episodes, degree of human leukocyte antigen mismatching, prolonged cold ischemia time, BK virus serostatus and ureteral stent placement have all been implicated as risk factors. Routine screening post-renal tr [...]

1447 14324

Open Access Original Research

Identification of Potential Predictive and Diagnostic Urinary Biomarkers for Acute Rejection in Renal Transplant Recipients: A Proteomics Study

Received: 25 May 2023;  Published: 07 July 2023;  doi: 10.21926/obm.transplant.2303191

Abstract

Acute rejection (AR) is one of the main predictors of long-term survival of allograft. The development of noninvasive diagnostic biomarkers of AR is an unmet need for the timely detection. This study aimed to identify novel detective biomarkers of AR by analyzing the urine proteome profile of transplant patients. Forty-two transplant patients including 30 biopsy-proven AR patients (including antibody and T-cell mediated rejection) and 12 transplant patients with stable renal function (control group) were enrolled. [...]

976 6316

Open Access Review

Biomarkers in the Management of the Lung Transplant Allograft: A Focus on Donor-derived Cell-free DNA

Received: 16 March 2023;  Published: 26 June 2023;  doi: 10.21926/obm.transplant.2302190

Abstract

Advances in the use of molecular biomarkers to guide management of lung transplant recipients are emerging. One such biomarker, donor-derived cell-free DNA (dd-cfDNA), has the potential to alter traditional approaches of lung transplant management, including the detection of acute rejection or infection, surveillance monitoring strategies, risk stratification of vulnerable patient populations and molecular phenotyping of various forms of allograft injury. The emergence of novel genetic and epigenetic approaches uti [...]

916 6999

Open Access Original Research

Kidney Transplantation in Nigeria: A Single Centre’s Early Surgical Experience and Outcomes

Received: 19 March 2023;  Published: 19 June 2023;  doi: 10.21926/obm.transplant.2302189

Abstract

With the rise in the population of patients with End-stage Renal Disease (ESRD) in Nigeria, there is an increased demand for Renal Replacement Therapy (RRT) including kidney transplantation (KT). We present our initial surgical experience and early outcomes with KT at a Nigerian transplant center over 2 years. A 2-year retrospective review of patients who underwent KT was done. Data of both kidney donors and recipients were recorded in designed proformas. Extracted information included demographic characteristics, [...]

2268 19938

Open Access Short Communication

Surgical Tips for Improving Success Rate of Deep Anterior Lamellar Keratoplasty in Keratoconus

Received: 20 April 2023;  Published: 15 June 2023;  doi: 10.21926/obm.transplant.2302188

Abstract

This article aims to provide some personal surgical tips to increase the success rate of deep anterior lamellar keratoplasty (DALK), a very advantageous yet complex procedure for treating keratoconus. The most troublesome surgical step is obtaining a successful pneumatic dissection of the deep stromal tissue, allowing the exposure of a deep cleavage plane. The following tips may aid the trainee surgeon in mastering this step, among others: performing a deep trephination, using intraoperative anterior segment optica [...]

852 6458

Open Access Editorial

Prospects of Platelet-Rich Plasma in Regenerative Medicine

Received: 25 May 2023;  Published: 02 June 2023;  doi: 10.21926/obm.transplant.2302187

Abstract

Platelet-rich plasma (PRP) is a promising tool in regenerative medicine because it stimulates tissue repair and regeneration. PRP contains a high concentration of platelets, growth factors, and cytokines involved in the healing process. This editorial paper aims to give an overview of PRP in regenerative medicine and its potential applications in various medical fields such as orthopedics, dentistry, dermatology, and wound healing. PRP can be integrated with other regenerative therapies, such as stem cell and gene [...]

1024 7188

Open Access Original Research

Effect of Foot Reflexology on Laboratory Tests after Kidney Transplantation Surgery: A Secondary Analysis of a Parallel Randomized Controlled Trial Study

Received: 21 December 2022;  Published: 02 June 2023;  doi: 10.21926/obm.transplant.2302186

Abstract

Foot reflexology has improved numerous physical and psychological symptoms in patients. The researchers in this study aimed to investigate the effect of foot reflexology on laboratory parameters, intake/output/weight and medication regimen after kidney transplant surgery. The research was a secondary analysis of a parallel randomized controlled trial. The research included patients who were admitted to the transplantation ward. The stratified randomization approach divided 53 eligible patients into two groups: foot [...]

1001 9453

Open Access Case Report

Successful Kidney Transplantation of Two Patients with Donors Positive for Severe Acute Respiratory Syndrome Coronavirus Infection

Received: 09 January 2023;  Published: 23 May 2023;  doi: 10.21926/obm.transplant.2302185

Abstract

Despite preventative measures, including vaccination, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection may result in severe illness, particularly in immunosuppressed transplant recipients. This has had a negative impact on organ donation and transplantation rates. However, the risk of transmission from SARS-CoV-2 positive donors to kidney transplant recipients is unknown. We describe 2 cases of successful kidney transplantation from SARS-CoV-2 positive donors. Case 1: 38-year old unvaccinated fe [...]

912 5733

Open Access Short Review

Brief Review: Pancreatic Islet Transplantation for Type 1 Diabetes in Humans

Received: 13 February 2023;  Published: 17 May 2023;  doi: 10.21926/obm.transplant.2302184

Abstract

Pancreatic islet transplantation (ITx) has moved from the experimental phase of development to a position of an accepted and appropriate procedure to apply in clinical medicine. The primary indication for use of ITx is for management of dangerous and recurrent hypoglycemia secondary to use of exogenous insulin for management of hyperglycemia in people with type 1 diabetes. ITx involves procurement of a pancreas donated by a person who has died. The organ is taken to a specialized laboratory for isolation of islets [...]

1027 11252

Open Access Research Article

Short-Term Impact of Hematopoietic Stem Cell Transplantation in Leukemia Patients on Bone Bio Markers, Electrolytes and Blood Profile

Received: 30 September 2022;  Published: 25 April 2023;  doi: 10.21926/obm.transplant.2302183

Abstract

Hematopoietic stem cell transplantation (HSCT) or Bone Marrow Transplantation (BMT) has significantly improved the survival rates of patients suffering from hematological malignancies. However, the cure can only be achieved at the price of morbidity and long-term complications such as bone diseases leading to fractures and osteopenia. Several studies have reported the impact of organ transplants on bone metabolism, electrolytes and blood profile. This prospective observational clinical study aims at elucidating the [...]

973 8016

Open Access Case Report

A Case of Disseminated Cryptococcus Post-Kidney Transplant

Received: 28 October 2022;  Published: 19 April 2023;  doi: 10.21926/obm.transplant.2302182

Abstract

Cryptococcosis is a common invasive fungal infection in solid organ transplant recipients (SOTR) that can be challenging to manage. We discuss a case of disseminated cryptococcosis in a transplant recipient. A 26-year-old woman with a history of ESRD from C1q nephropathy, living-related kidney transplant in early 2012, and allograft nephrectomy in 2015, received a deceased donor kidney transplant (DDKT). Induction after the first transplant was anti-thymocyte globulin (ATG) and maintenance immunosuppression (IS) in [...]

1281 7742

Open Access Original Research

Normal Saline vs Plasma-Lyte A Use Intra- and Post-Operatively in Adult Kidney Transplant Recipients

Received: 13 February 2023;  Published: 18 April 2023;  doi: 10.21926/obm.transplant.2302181

Abstract

Fluid management intra- and post-operatively for kidney transplant recipients (KTR) is essential to maintain adequate perfusion to the kidney. 0.9% normal saline (NS) is commonly used, but it can cause hyperchloremic metabolic acidosis, which may result in hyperkalemia and lead to delayed graft function (DGF). Plasma-Lyte A (PA) is an alternative option that has a lower amount of chloride and a neutral pH, which may offset the risk of hyperkalemia. The aim of this study is to determine the incidence of DGF in KTRs [...]

964 7181

Open Access Original Research

Robust Outcomes for Hispanic Lung Transplant Recipients in the United States

Received: 28 November 2022;  Published: 10 April 2023;  doi: 10.21926/obm.transplant.2302180

Abstract

Race, while a social construct, has a strong effect on a person’s health. There is limited data on racial disparities within lung transplantation (LTx), especially for Hispanic recipients. Therefore, the aim of this study was to identify inequalities that may involve this population. We analyzed historical data from the Organ Procurement and Transplantation Network (OPTN) and performed a retrospective review of Hispanic and Caucasian patients who underwent lung transplantation in the United States between May [...]

922 6705

Open Access Review

A Breath of Fresh Air - Lung Transplantation Has Come of Age

Received: 11 January 2023;  Published: 04 April 2023;  doi: 10.21926/obm.transplant.2302179

Abstract

A boundless spectrum of chronic lung diseases is said to effect over 500 million persons globally. Lung transplantation is a well-established therapeutic option for patients suffering from end-stage lung diseases, however waitlist mortality and primary graft failure remain major determinants as post-transplantation 5-year survival is just above 50 percent. Recent innovations in lung transplantation have been aimed at increasing organ availability, improving allograft quality, function, and longevity. Ex-vivo Lung P [...]

1032 7834

Open Access Original Research

Mobilization of Autologous Peripheral Blood Stem Cells (PBSC) in CD20+ Lymphoma Patients Using RICE, Granulocyte-Colony Stimulating Factor (G-CSF) and Plerixafor

Received: 06 May 2022;  Published: 30 March 2023;  doi: 10.21926/obm.transplant.2301178

Abstract

RICE is salvage therapy for treating CD20+non-Hodgkin lymphoma (NHL). It is combined with G-CSF to collect autologous peripheral blood stem cells (aPBSC). Little data exists, though, on the combination of G-CSF and Plerixafor after RICE in mobilizing adequate number of CD34 cells and the product’s immune content. We report on the results of twenty CD20+ NHL patients after RICE, G-CSF and Plerixafor were given to collect aPBSC. The median number of cells collected was 12.92 × 106 CD34 cells/kg (range 5.4 [...]

802 6070

Open Access Original Research

Monitoring Survival Following Lung Transplantation with Inclusion of Unaccounted Risks

Received: 07 November 2022;  Published: 14 March 2023;  doi: 10.21926/obm.transplant.2301177

Abstract

Lung transplant (LTx) survival and quality of life have been steadily improving, partially from changes in candidate selection for transplantation. There are well-known high-risk factors that lead to poor LTx outcomes, which may be referred to as ‘accounted’ risks. However, there are also other ‘unaccounted’ risks that are not included in the existing model for expected LTx survival to help programs for resource allocation. We performed a retrospective cohort study of all LTx recipients over the age of 18 at UC San [...]

868 6314

Open Access Short Report

Impact of Sex and Age at Lung Transplantation on Long-Term Survival of Patients with Cystic Fibrosis

Received: 20 November 2022;  Published: 01 March 2023;  doi: 10.21926/obm.transplant.2301176

Abstract

Careful selection of lung transplant (LT) recipients with cystic fibrosis (CF) may improve outcomes; therefore, we studied the impact of sex and age at the time of LT on long-term survival of patients with CF. LT recipients with CF who received post-LT care at our center between July 1, 2007 and April 30, 2021 were included. The primary outcome was death or retransplantation. Cox proportional hazard analysis and the Kaplan-Meier method were used. Of 59 included LT recipients, the median age at first LT was 28 (22, [...]

880 6243

Open Access Original Research

Non-Renal Factors Associated with Simultaneous Liver-Kidney Transplant in Patients with End-Stage Liver Disease and Stage 3-5 Chronic Kidney Disease Not Requiring Dialysis

Received: 19 August 2022;  Published: 21 February 2023;  doi: 10.21926/obm.transplant.2301175

Abstract

We aimed to identify the non-renal risk factors for simultaneous liver-kidney transplantation (SLKT) vs. liver transplantation alone (LTA) in end-stage liver disease (ESLD) patients with estimated glomerular filtration rate (eGFR) <60 ml/min, not on dialysis. Using organ procurement and transplantation network data, we studied adult ESLD patients who received deceased-donor SLKT or LTA in July 2002-Mar 2016 with a 4-point modification of renal disease (MDRD) equation-estimated glomerular filtration rate (eGFR) s [...]

728 5888

Open Access Review

Cytomegalovirus and Kidney Transplantation: An Update

Received: 08 November 2022;  Published: 29 January 2023;  doi: 10.21926/obm.transplant.2301174

Abstract

Cytomegalovirus (CMV) infection is the most common infection affecting kidney transplant recipients [1]. CMV may be present as asymptomatic viremia or with symptoms ranging from mild to significant tissue-invasive disease [1,2,3]. Optimal kidney graft function and survival requires that transplant care teams carefully assess individual patient risk of CMV [2,3]. Appropriate patient surveillance and prophylaxis are essential to ensure the best long-term kidney transplant results. Effective treatment of CMV disease r [...]

1617 22976

Open Access Case Report

Lung Transplantation from A Donor with Previous SARS-CoV-2 Infection: 1-Year Outcomes

Received: 25 October 2022;  Published: 06 January 2023;  doi: 10.21926/obm.transplant.2301173

Abstract

Few reports have described successful lung transplantation from a donor with a history of SARS-CoV-2 infection, and outcomes beyond 3 to 6 months remain unknown. After weighing the urgency and life-saving benefits of lung transplantation against the risk of viral transmission, we successfully performed a bilateral lung transplant from a donor with confirmed SARS-CoV-2 infection with mild symptoms 2 months before donation. At 1 year after transplant, there is no evidence of donor-derived viral transmission, and allo [...]

873 5654

Open Access Editorial

Acknowledgement to Reviewers of OBM Transplantation in 2022

Received: 04 January 2023;  Published: 04 January 2023;  doi: 10.21926/obm.transplant.2301172

Abstract

The editors of OBM Transplantation would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2022. We greatly appreciate the contribution of expert reviewers, which is crucial to the journal’s editorial process. We aim to recognize reviewer contributions through several mechanisms, of which the annual publication of reviewer names is one. Reviewers receive a voucher entitling them to a discount on their next LIDSEN publication and can download a certificate of recog [...]

625 4711

Open Access Editorial

Islet Transplantation: How Much Have We Advanced and How to Keep Moving Forward?

Received: 11 December 2022;  Published: 19 December 2022;  doi: 10.21926/obm.transplant.2204171

846 6422

Open Access Original Research

Shifting Pancreas Transplantation Rates and Demographics are the Culmination of Many Strategic Policy Changes

Received: 06 September 2022;  Published: 21 November 2022;  doi: 10.21926/obm.transplant.2204170

Abstract

The 2014 Pancreas Allocation System established national qualifying criteria for simultaneous kidney pancreas (SPK) transplantation. The 2019 UNOS Pancreas Transplantation Committee Policy 11.3.B modified these guidelines to expand transplantation. Subsequent effects on recipient demographics have not been studied. We analyzed 81 SPK transplantations performed at our center from June 2014 to December 2020 to compare recipient demographics and outcomes before and after the 11.3.B policy change. National data were al [...]

956 6574

Open Access Opinion

"Let's Live Life - Let's Give Life": Donor Program Improvement as the Key to Transplantation Success in 21st Century - A Croatian Experience

Received: 30 August 2022;  Published: 15 November 2022;  doi: 10.21926/obm.transplant.2204169

Abstract

Transplantation is a widely accepted and successful life-saving treatment for hundreds of thousands of patients. However, transplant medicine still faces a number of obstacles. One of the most significant is the large disparity between the number of donors and recipients and the growing need for re-transplantation. In the last two decades, the improvement and organization of the national transplantation program in Croatia have resulted in a steadily increasing donor rate and therefore the transplantation numbers. A [...]

808 7300

Open Access Original Research

Hepatitis B Reactivation in HBsAg Negative Renal Transplant Patients with Evidence of Previous HBV Infection: A Not Neglectable Occurrence

Received: 22 June 2022;  Published: 26 October 2022;  doi: 10.21926/obm.transplant.2204168

Abstract

Hepatitis B virus (HBV) infection is frequent among patients with chronic kidney disease (CKD). HBV reactivation after kidney transplant (KT) is more common in patients with HBsAg+; however, it can also occur in previously infected individuals, particularly those with HBsAg negative and total antiHBc positive (HBsAg-/antiHBcT+). However, reactivation in this population has scarce and conflicting data. This study aimed to assess the reactivation risk in KT recipients with previous HBV infection (antiHBcT+). A retros [...]

1005 6587

Open Access Interview

An Interview with Prof. Haval Shirwan

Received: 09 October 2022;  Published: 17 October 2022;  doi: 10.21926/obm.transplant.2204167

737 5755

Open Access Original Research

The P2X7 Receptor Antagonist AZ10606120 Does Not Alter Graft-Versus-Host Disease Development and Increases Serum Human Interferon-γ in a Humanized Mouse Model

Received: 06 June 2022;  Published: 06 September 2022;  doi: 10.21926/obm.transplant.2203166

Abstract

Allogeneic hematopoietic stem cell transplantation is a curative therapy for hematological malignancies, but its efficacy is limited by graft-versus-host disease (GVHD). This life-threatening disorder develops when donor (graft) immune cells cause inflammatory damage to recipient (host) tissues. The immune cell receptor channel P2X7 and its ligand adenosine 5’-triphosphate (ATP) have been implicated in GVHD pathogenesis. Therefore, this signaling axis represents a potential therapeutic target. This study aime [...]

1067 8413

Open Access Short Communication

Promising Tactics with Certain Probiotics for the Treatment of Nephropathy in Hematopoietic Stem Cell Transplantation

Received: 02 May 2022;  Published: 30 August 2022;  doi: 10.21926/obm.transplant.2203165

Abstract

Hematopoietic stem cell transplantation (HSCT) is a standard form of cellular therapy for patients suffering from malignant hematological diseases. However, graft-versus-host disease (GVHD) is a very serious complication and a major cause of morbidity and mortality after allogeneic HSCT. Calcineurin inhibitors, such as cyclosporine, are widely used to enhance the survival of patients who have undergone HSCT. Unfortunately, both GVHD and cyclosporine occasionally cause nephropathy. Several studies have shown that th [...]

939 6352

Open Access Case Report

Bilateral Corneal Perforation in a Patient with Chronic Ocular Graft-Versus-Host Disease: A Case Report and Literature Review

Received: 17 June 2022;  Published: 02 August 2022;  doi: 10.21926/obm.transplant.2203164

Abstract

Graft-versus-host disease (GVHD) is a serious complication that may occur in patients receiving allogeneic hematopoietic stem cell transplant (HSCT). GVHD occurs because of the immunological reaction between the donor’s T cells and the recipient’s antigens; GVHD may develop in different tissues, including the eye. Corneal perforation is an uncommon but vision-threatening manifestation of GVHD. We reported the case of a 65-year-old male patient who developed corneal perforation sequentially in both eyes 3 years afte [...]

921 7181

Open Access Editorial

The Role of Cytochrome P450 2J2 in Cancer: Cell Protector, Therapeutic Target, or Prognostic Marker?

Received: 08 July 2022;  Published: 27 July 2022;  doi: 10.21926/obm.transplant.2203163

Abstract

Cytochrome P450 2J2 (CYP2J2) is one of the recently discovered enzymes that is involved in the metabolism of several drugs. It is mainly an extrahepatic enzyme which can, to some extent, explain some the drugs’ side effects such as cyclophosphamide (Cy). Cyclophosphamide is an alkylating agent that is commonly used in conditioning prior to stem cell transplantation. It is a prodrug that is bio-activated by several CYPs including CYP2J2. Cy is known to have several side effects and its extrahepatic activation by CYP [...]

1254 8565

Open Access Review

Antibody-Based Preparative Regimens for Cell, Tissue and Organ Transplantation

Received: 24 November 2021;  Published: 08 July 2022;  doi: 10.21926/obm.transplant.2203162

Abstract

The ability to successfully transplant cells and organs from a donor into an immunologically disparate recipient is one of the greatest treatment advances in the history of medicine. Nevertheless, acute and chronic rejection, graft versus host disease, and the inability to identify suitable donors continue to be challenges and limit broader application of cell and organ transplantation to the many patients that could benefit. Immunosuppression before and after allogeneic transplant has been found to dramatically im [...]

1302 12408

Open Access Interview

An Interview with Prof. Luca Brazzi

Received: 01 July 2022;  Published: 03 July 2022;  doi: 10.21926/obm.transplant.2203161

818 6322

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