Transplantation

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Article Surgery

mTOR inhibitors improve both humoral and cellular response to SARS-CoV-2 messenger RNA BNT16b2 vaccine in kidney transplant recipients

Giuseppe S. Netti, Barbara Infante, Dario Troise, Silvia Mercuri, Maddalena Panico, Federica Spadaccino, Valeria Catalano, Margherita Gigante, Simona Simone, Paola Pontrelli, Loreto Gesualdo, Elena Ranieri, Giuseppe Castellano, Giovanni Stallone

Summary: mTOR inhibitors (mTOR-I) treatment is associated with a better immune response to COVID-19 vaccine in kidney transplant recipients (KTR), not only by increasing vaccine-induced antibodies but also by stimulating anti-SARS-CoV-2 T cell response.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

Survival following liver transplantation for locally advanced, unresectable intrahepatic cholangiocarcinoma

Robert R. McMillan, Milind Javle, Sudha Kodali, Ashish Saharia, Constance Mobley, Kirk Heyne, Mark J. Hobeika, Keri E. Lunsford, David W. Victor, Akshay Shetty, Robert S. McFadden, Maen Abdelrahim, Ahmed Kaseb, Mukul Divatia, Nam Yu, Joy Nolte Fong, Linda W. Moore, Duc T. Nguyen, Edward A. Graviss, A. Osama Gaber, Jean-Nicolas Vauthey, R. Mark Ghobrial

Summary: Intrahepatic cholangiocarcinoma (iCCA) has traditionally been considered a contraindication for liver transplantation (LT), but recent studies have shown positive outcomes for LT after neoadjuvant therapy. A center developed a protocol for neoadjuvant therapy and LT for locally advanced, unresectable iCCA patients in 2010. Patients who underwent LT had a high overall survival rate at 1, 3, and 5 years, with a higher than expected proportion of patients with genetic alterations in fibroblast growth factor receptor (FGFR) and DNA damage repair pathways. Further research is needed to determine criteria for LT in iCCA and factors predicting survival.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

Response to American College of Physician's statement on the ethics of transplant after normothermic regional perfusion

Brendan Parent, Arthur Caplan, Nader Moazami, Robert A. Montgomery

Summary: This paper responds to the statement released by the American College of Physicians regarding the ethical issues surrounding normothermic regional perfusion and highlights the flaws in their conclusions. It argues that the practice of controlled donation after circulatory determination of death respects the dead donor rule and legal definition of death, while also honoring the wishes of the deceased and their loved ones.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Gastroenterology & Hepatology

Immunogenicity and Adverse Effects of the 2-Dose BNT162b2 Messenger RNA Vaccine Among Liver Transplantation Recipients

Yana Davidov, Keren Tsaraf, Oranit Cohen-Ezra, Mariya Likhter, Gil Ben Yakov, Itzchak Levy, Einav G. Levin, Yaniv Lustig, Orna Mor, Galia Rahav, Ziv Ben Ari

Summary: The study evaluated the safety and efficacy of the BNT162b2 vaccine among transplant recipients, showing that transplant recipients had lower immune responses after receiving the second dose compared to controls. Some recipients experienced mild adverse effects, with more occurrences in women than in men.

LIVER TRANSPLANTATION (2022)

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Article Transplantation

Renal gluconeogenesis: an underestimated role of the kidney in systemic glucose metabolism

David Legouis, Anna Faivre, Pietro E. Cippa, Sophie de Seigneux

Summary: Gluconeogenesis is a metabolic pathway that synthesizes glucose from non-hexose precursors and plays a critical role in glucose homeostasis. The kidney contributes significantly to systemic gluconeogenesis, with lactate being the main substrate. Factors such as insulin, cellular glucose levels, acidosis, and stress hormones regulate renal gluconeogenesis. Impaired renal gluconeogenesis in acute and chronic kidney disease can lead to systemic metabolic disturbances. This review highlights the importance of kidney gluconeogenesis and its implications in kidney disease.

NEPHROLOGY DIALYSIS TRANSPLANTATION (2022)

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Article Surgery

Neutralizing antibody response against the B.1.617.2 (delta) and the B.1.1.529 (omicron) variants after a third mRNA SARS-CoV-2 vaccine dose in kidney transplant recipients

Louise Benning, Christian Morath, Marie Bartenschlager, Heeyoung Kim, Marvin Reineke, Jorg Beimler, Mirabel Buylaert, Christian Nusshag, Florian Kaelble, Paula Reichel, Maximilian Toellner, Matthias Schaier, Katrin Klein, Vladimir Benes, Tobias Rausch, Susanne Rieger, Maximilian Stich, Burkhard Toenshoff, Niklas Weidner, Paul Schnitzler, Martin Zeier, Caner Susal, Thuong Hien Tran, Ralf Bartenschlager, Claudius Speer

Summary: Seroconversion after COVID-19 vaccination is compromised in kidney transplant recipients, and emerging variants pose an increasing threat to these patients. Following a third vaccine dose, neutralizing antibodies in kidney transplant recipients are significantly lower compared to healthy controls, with reduced efficacy against the B.1.1.529 (omicron) variant.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

OPTN/SRTR 2020 Annual Data Report: Pancreas

R. Kandaswamy, P. G. Stock, J. Miller, M. A. Skeans, J. White, J. Wainright, N. T. T. Kyaw, S. Niederhaus, A. K. Israni, J. J. Snyder

Summary: The number of pancreas transplants and new waitlist registrations decreased in 2020. Waiting times increased for certain types of transplants, but the rates of graft failure and other long-term outcomes showed consistent improvement over the past decade.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Engineering, Biomedical

ELSO Guidelines for Adult and Pediatric Extracorporeal Membrane Oxygenation Circuits

Evan F. Gajkowski, Guillermo Herrera, Laura Hatton, Marta Velia Antonini, Leen Vercaemst, Elaine Cooley

ASAIO JOURNAL (2022)

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Article Surgery

Anti-SARS-CoV-2 spike protein and neutralizing antibodies at 1 and 3 months after three doses of SARS-CoV-2 vaccine in a large cohort of solid organ transplant patients

Nassim Kamar, Florence Abravanel, Olivier Marion, Laure Esposito, Anne Laure Hebral, Chloe Medrano, Joelle Guitard, Laurence Lavayssiere, Olivier Cointault, Marie Betriace Nogier, Julie Belliere, Stanislas Faguer, Chloe Couat, Arnaud Del Bello, Jacques Izopet

Summary: The immunogenicity of the SARS-CoV-2 vaccine was enhanced by a third dose. A retrospective study on solid organ transplant patients found that two-thirds of them developed anti-SARS-CoV-2 antibodies after three doses, but one-third remained weak or non-protected. Antibody concentrations and protection levels decreased between 1 and 3 months after vaccination.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

Hypothermic oxygenated perfusion in extended criteria donor liver transplantation-A randomized clinical trial

Matteo Ravaioli, Giuliana Germinario, Gerti Dajti, Maurizio Sessa, Francesco Vasuri, Antonio Siniscalchi, Maria Cristina Morelli, Matteo Serenari, Massimo Del Gaudio, Chiara Zanfi, Federica Odaldi, Valentina Rosa Bertuzzo, Lorenzo Maroni, Andrea Laurenzi, Matteo Cescon

Summary: Hypothermic Oxygenated Perfusion (HOPE) of the liver can reduce the incidence of early allograft dysfunction (EAD) and failure in extended criteria donors (ECD) grafts. Compared to the traditional static cold storage (SCS) method, HOPE is associated with better graft survival.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Biophysics

Venetoclax and azacitidine followed by allogeneic transplant results in excellent outcomes and may improve outcomes versus maintenance therapy among newly diagnosed AML patients older than 60

Daniel A. Pollyea, Amanda Winters, Christine McMahon, Marc Schwartz, Craig T. Jordan, Rachel Rabinovitch, Diana Abbott, Clayton A. Smith, Jonathan A. Gutman

Summary: The combination therapy of venetoclax and azacitidine has shown promising results in treating AML patients over 60 years old, with potential for improved outcomes compared to maintenance therapy. In particular, allogeneic stem cell transplant following ven/aza treatment in newly diagnosed AML patients shows excellent outcomes, suggesting the need for further investigation to refine timing and patient selection for transplant.

BONE MARROW TRANSPLANTATION (2022)

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Article Surgery

Insufficient response to mRNA SARS-CoV-2 vaccine and high incidence of severe COVID-19 in kidney transplant recipients during pandemic

Tomas Reischig, Martin Kacer, Tomas Vlas, Petr Drenko, Lukas Kielberger, Jana Machova, Ondrej Topolcan, Radek Kucera, Stanislav Kormunda

Summary: This study found that the protection of SARS-CoV-2 mRNA vaccination against COVID-19 is limited in kidney transplant recipients, with some patients developing COVID-19 after vaccination having lower levels of anti-spike protein IgG. While some patients were able to produce higher IgG levels after COVID-19, overall humoral responses were not significant, leading to suboptimal efficacy post-vaccination.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Review Immunology

The Global Impact of COVID-19 on Solid Organ Transplantation: Two Years Into a Pandemic

Ailish Nimmo, Dale Gardiner, Ines Ushiro-Lumb, Rommel Ravanan, John L. R. Forsythe

Summary: The COVID-19 pandemic has had a significant global impact on solid organ transplantation, resulting in a reduction in transplant activity. However, over the past two years, mortality in SOT recipients has decreased, attributed to increased testing, adherence to interventions, development of treatments, and vaccination. Nonetheless, SOT recipients have lower vaccine efficacy and remain at an increased risk if they contract COVID-19.

TRANSPLANTATION (2022)

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Article Surgery

Utilization and outcomes of deceased donor SARS-CoV-2-positive organs for solid organ transplantation in the United States

Jesse D. Schold, Christine E. Koval, Alvin Wee, Mohamed Eltemamy, Emilio D. Poggio

Summary: The impact of the coronavirus disease-19 on the transplant population and processes of care for transplant centers and organ allocation was examined in this study. The utilization of deceased donors with positive SARS-CoV-2 tests was characterized, and transplant outcomes were evaluated. The study found a significantly lower utilization of SARS-CoV-2 donors, but no evidence of reduced recipient graft survival. Practice variations were observed over time.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Letter Surgery

Antibody response to 2-dose SARS-CoV-2 mRNA vaccination in pediatric solid organ transplant recipients

Caroline X. Qin, Scott R. Auerbach, Olga Charnaya, Lara A. Danziger-Isakov, Noelle H. Ebel, Amy G. Feldman, Evelyn K. Hsu, John McAteer, Saeed Mohammad, Emily R. Perito, Ashley M. Thomas, Teresa P. Y. Chiang, Jacqueline M. Garonzik-Wang, Dorry L. Segev, Douglas B. Mogul

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Immunology

Correlation of Donor-derived Cell-free DNA With Histology and Molecular Diagnoses of Kidney Transplant Biopsies

Gaurav Gupta, Irfan Moinuddin, Layla Kamal, Anne L. King, Ryan Winstead, Moses Demehin, Le Kang, Pamela Kimball, Marlon Levy, Chandra Bhati, H. Davis Massey, Dhiren Kumar, Philip F. Halloran

Summary: This single-center prospective study examines the application of circulating donor-derived cell-free DNA (cfDNA), molecular microscope diagnostic system (MMDx), and traditional histology in kidney transplant rejection. The results show that MMDx provides higher precision than histology, but there are discrepancies between the two methods. Additionally, cfDNA correlates strongly with molecular acute kidney injury, indicating an association with tissue injury regardless of rejection characteristics.

TRANSPLANTATION (2022)

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Editorial Material Surgery

Ethical review of COVID-19 vaccination requirements for transplant center staff and patients

Olivia S. Kates, Peter G. Stock, Michael G. Ison, Richard D. M. Allen, Patrizia Burra, Jong Cheol Jeong, Vivek Kute, Elmi Muller, Alejandro Nino-Murcia, Haibo Wang, Anji Wall

Summary: The authors suggest that requiring healthcare workers and transplant candidates to be vaccinated against COVID-19 is ethically justified based on beneficence, net utility, and fiduciary duty. Implementation strategies should address concerns about autonomy and transparency. This argument could also apply to caregiver vaccination, resource allocation, and mandates for other vaccines. Global equity in vaccination is also emphasized.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Hematology

Antibody Response to SARS-CoV-2 Vaccination in Patients following Allogeneic Hematopoietic Cell Transplantation

Alice Huang, Caroline Cicin-Sain, Chloe Pasin, Selina Epp, Annette Audige, Nicolas J. Mueller, Jakob Nilsson, Andriyana Bankova, Nathan Wolfensberger, Oliver Vilinovszki, Gayathri Nair, Philipp Hockl, Urs Schanz, Roger D. Kouyos, Barbara Hasse, Annelies S. Zinkernagel, Alexandra Trkola, Markus G. Manz, Irene A. Abela, Antonia M. S. Mueller

Summary: Little information is available on the safety and efficacy of mRNA vaccines in immunocompromised patients. A study in Switzerland analyzed the immune responses of allo-HCT recipients to BNT162b2 and mRNA-1273 vaccines and found that factors such as age, immunosuppression, and disease relapse may influence the antibody response to the vaccines.

TRANSPLANTATION AND CELLULAR THERAPY (2022)

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Article Transplantation

Clinical utility of genetic testing in early-onset kidney disease: seven genes are the main players

Andrea Domingo-Gallego, Marc Pybus, Gemma Bullich, Monica Furlano, Laia Ejarque-Vila, Laura Lorente-Grandoso, Patricia Ruiz, Gloria Fraga, Mercedes Lopez Gonzalez, Juan Alberto Pinero-Fernandez, Lidia Rodriguez-Pena, Isabel Llano-Rivas, Raquel Saez, Anna Bujons-Tur, Gema Ariceta, Guirado Lluis, Roser Torra, Elisabet Ars

Summary: Genetic testing of 460 patients with early-onset CKD showed a global diagnostic yield of 65%, with cystic kidney diseases and tubulopathies having higher diagnostic rates. Seven genes accounted for the majority of genetically diagnosed patients.

NEPHROLOGY DIALYSIS TRANSPLANTATION (2022)

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Article Gastroenterology & Hepatology

The Effect of Acuity Circles on Deceased Donor Transplant and Offer Rates Across Model for End-Stage Liver Disease Scores and Exception Statuses

Andrew Wey, Samantha Noreen, Sommer Gentry, Matt Cafarella, James Trotter, Nicholas Salkowski, Dorry Segev, Ajay Israni, Bertram Kasiske, Ryutaro Hirose, Jon Snyder

Summary: The new liver allocation system, Acuity circles (AC), has a positive impact on the transplant rates of candidates with higher PELD/MELD scores, while exceptions can affect offer rates. The quality of liver donors may see minor changes with the use of donation after circulatory death (DCD) donors.

LIVER TRANSPLANTATION (2022)

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