Transplantation

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Article Surgery

First clinical-grade porcine kidney xenotransplant using a human decedent model

Paige M. Porrett, Babak J. Orandi, Vineeta Kumar, Julie Houp, Douglas Anderson, A. Cozette Killian, Vera Hauptfeld-Dolejsek, Dominque E. Martin, Sara Macedon, Natalie Budd, Katherine L. Stegner, Amy Dandro, Maria Kokkinaki, Kasinath Kuravi, Rhiannon D. Reed, Huma Fatima, John T. Killian, Gavin Baker, Jackson Perry, Emma D. Wright, Matthew D. Cheung, Elise N. Erman, Karl Kraebber, Tracy Gamblin, Linda Guy, James F. George, David Ayares, Jayme E. Locke

Summary: This study suggests that major obstacles to human xenotransplantation have been overcome through in vivo experimentation, and identifies areas where new knowledge is needed to optimize outcomes.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

OPTN/SRTR 2020 Annual Data Report: Liver

A. J. Kwong, N. H. Ebel, W. R. Kim, J. R. Lake, J. M. Smith, D. P. Schladt, M. A. Skeans, J. Foutz, K. Gauntt, M. Cafarella, J. J. Snyder, A. K. Israni, B. L. Kasiske

Summary: The COVID-19 pandemic had a significant impact on transplant programs and outcomes, but the number of liver transplants performed in the United States reached a record high. Living donation activity decreased, but the survival rates for patients with liver transplants continued to improve. The liver transplant waitlists for both adults and children decreased in size, and a new liver distribution policy based on acuity circles was implemented. The predominant indication for liver transplants among adults in 2020 was alcohol-associated liver disease.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Letter Surgery

Efficiency of a boost with a third dose of anti-SARS-CoV-2 messenger RNA-based vaccines in solid organ transplant recipients

Arnaud Del Bello, Florence Abravanel, Olivier Marion, Chloe Couat, Laure Esposito, Laurence Lavayssiere, Jacques Izopet, Nassim Kamar

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Immunology

The RECOVAC Immune-response Study: The Immunogenicity, Tolerability, and Safety of COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant

Jan-Stephan F. Sanders, Frederike J. Bemelman, A. Lianne Messchendorp, Carla C. Baan, Debbie van Baarle, Rob van Binnendijk, Dimitri A. Diavatopoulos, Sophie C. Frolke, Daryl Geers, Corine H. GeurtsvanKessel, Gerco den Hartog, Marieke van der Heiden, Celine Imhof, Marcia M. L. Kho, Marion P. G. Koopmans, S. Reshwan K. Malahe, Wouter B. Mattheussens, Renate van der Molen, Djenolan van Mourik, Ester B. M. Remmerswaal, Nynke Rots, Priya Vart, Rory D. de Vries, Ron T. Gansevoort, Luuk B. Hilbrands, Marlies E. J. Reinders

Summary: In kidney patients, the immunogenicity, tolerability, and safety of COVID-19 vaccination vary. Kidney transplant recipients have a poor immune response, while patients with CKD G4/5 and those on dialysis have a comparable response to the control group. Dialysis patients and transplant recipients experience fewer adverse events after vaccination.

TRANSPLANTATION (2022)

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Article Engineering, Biomedical

2021 ELSO Adult and Pediatric Anticoagulation Guidelines

Ali B. McMichael, Lindsay M. Ryerson, Damian Ratano, Eddy Fan, David Faraoni, Gail M. Annich, Graeme MacLaren, Giles J. Peek, Marie E. Steiner, Ravi R. Thiagarajan

Summary: These guidelines provide educational information for adult and pediatric anticoagulation in extracorporeal membrane oxygenation, aiming to support physicians and other health professionals in assessing and managing patients undergoing ECLS / ECMO. However, they are not consensus recommendations and do not guarantee successful outcomes. Adherence to guidelines should be coupled with clinical judgment and individual patient consultation.

ASAIO JOURNAL (2022)

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Article Surgery

Intensity of mycophenolate mofetil treatment is associated with an impaired immune response to SARS-CoV-2 vaccination in kidney transplant recipients

Marta Kantauskaite, Lisa Mueller, Thilo Kolb, Svenja Fischer, Jonas Hillebrandt, Katrin Ivens, Marcel Andree, Tom Luedde, Hans M. Orth, Ortwin Adams, Heiner Schaal, Claudia Schmidt, Eva Koenigshausen, Lars C. Rump, Joerg Timm, Johannes Stegbauer

Summary: Kidney transplant recipients (KTRs) have a weaker immune response to SARS-CoV-2 vaccination compared to controls, with mycophenolate mofetil (MMF) treatment being the strongest predictor for impaired response. Adjusting MMF dose may improve the immune response in KTRs.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Cardiac & Cardiovascular Systems

Third dose of the BNT162b2 vaccine in heart transplant recipients: Immunogenicity and clinical experience

Yael Peled, Eilon Ram, Jacob Lavee, Amit Segev, Shlomi Matezki, Anat Wieder-Finesod, Rebecca Halperin, Michal Mandelboim, Victoria Indenbaum, Itzchak Levy, Leonid Sternik, Ehud Raanani, Arnon Afek, Yitshak Kreiss, Yaniv Lustig, Galia Rahav

Summary: This study investigated the safety and immunogenicity of a third dose of the Pfizer BNT162b2 vaccine in heart transplant patients. The results showed that the third dose had a low rate of adverse events and elicited a strong immune response.

JOURNAL OF HEART AND LUNG TRANSPLANTATION (2022)

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Editorial Material Surgery

OPTN/SRTR 2020 Annual Data Report: Heart

M. Colvin, J. M. Smith, Y. Ahn, M. A. Skeans, E. Messick, R. Goff, K. Bradbrook, J. Foutz, A. K. Israni, J. J. Snyder, B. L. Kasiske

Summary: This article discusses the challenges faced in the third year of the new adult heart allocation policy in light of the COVID-19 pandemic. It provides data on the number of new listings, adult and pediatric heart transplants performed, and posttransplant mortality rates. While there has been a slight increase in short-term mortality rates, there is a steady downward trend in longer-term mortality.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Immunology

Real-world Effectiveness of the Pfizer-BioNTech BNT162b2 and Oxford-AstraZeneca ChAdOx1-S Vaccines Against SARS-CoV-2 in Solid Organ and Islet Transplant Recipients

Chris J. Callaghan, Lisa Mumford, Rebecca M. K. Curtis, Sarah Williams, Heather Whitaker, Nick Andrews, Jamie Lopez Bernal, Ines Ushiro-Lumb, Gavin J. Pettigrew, Douglas Thorburn, John L. R. Forsythe, Rommel Ravanan

Summary: The study in England found that vaccination of SOT recipients against SARS-CoV-2 can reduce infection-related mortality, with better outcomes seen in recipients of the ChAdOx1-S vaccine. However, overall protection remains inferior to that in the general population.

TRANSPLANTATION (2022)

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Article Surgery

Tixagevimab/cilgavimab pre-exposure prophylaxis is associated with lower breakthrough infection risk in vaccinated solid organ transplant recipients during the omicron wave

Ayman Al Jurdi, Leela Morena, Mariesa Cote, Emily Bethea, Jamil Azzi, Leonardo Riella

Summary: The use of tixagevimab/cilgavimab in vaccinated solid organ transplant recipients during the Omicron wave is safe and associated with a lower risk of breakthrough SARS-CoV-2 infection. Adverse events are uncommon, and most are mild.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Biophysics

Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022

John A. Snowden, Isabel Sanchez-Ortega, Selim Corbacioglu, Grzegorz W. Basak, Christian Chabannon, Rafael de la Camara, Harry Dolstra, Rafael F. Duarte, Bertram Glass, Raffaella Greco, Arjan C. Lankester, Mohamad Mohty, Benedicte Neven, Regis Peffault de Latour, Paolo Pedrazzoli, Zinaida Peric, Ibrahim Yakoub-Agha, Anna Sureda, Nicolaus Kroeger

Summary: The EBMT has updated recommendations on indications for HCT and encourages harmonization of practice to aggregate experience. JACIE accreditation standards and reference to COVID-19 guidance are recommended for decision making.

BONE MARROW TRANSPLANTATION (2022)

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Article Surgery

Neutralization against Omicron variant in transplant recipients after three doses of mRNA vaccine

Deepali Kumar, Queenie Hu, Reuben Samson, Victor H. Ferreira, Victoria G. Hall, Matthew Ierullo, Beata Majchrzak-Kita, William Hardy, Anne-Claude Gingras, Atul Humar

Summary: The Omicron variant of the SARS-CoV-2 virus has become the dominant circulating strain globally, and three doses of mRNA COVID-19 vaccine are recommended for transplant recipients. However, there is limited research on the immunogenicity of mRNA vaccines specifically against the Omicron variant. This study analyzed the neutralization effects of Omicron in transplant recipients who received three doses of mRNA-1273 vaccine, and the results showed poor neutralizing responses against the Omicron variant in these patients.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

Early clinical experience with nirmatrelvir/ritonavir for the treatment of COVID-19 in solid organ transplant recipients

David M. Salerno, Douglas L. Jennings, Nicholas W. Lange, Danielle (Bley) Kovac, Tara Shertel, Justin K. Chen, Jessica Hedvat, Jenna Scheffert, Robert S. Brown, Marcus R. Pereira

Summary: The use of Nirmatrelvir/ritonavir (NR) in solid organ transplant recipients (SOTRs) with mild COVID-19 has not been described yet. The objective of this study was to evaluate outcomes among SOTRs and describe the drug-drug interaction of NR. The results show that the clinically significant interaction between NR and immunosuppressive agents can be reasonably managed with a standardized dosing protocol.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Letter Surgery

Nirmatrelvir/ritonavir use: Managing clinically significant drug-drug interactions with transplant immunosuppressants

Nicholas W. Lange, David M. Salerno, Douglas L. Jennings, Jason Choe, Jessica Hedvat, Danielle (Bley) Kovac, Jenna Scheffert, Tara Shertel, Lloyd E. Ratner, Robert S. Brown, Marcus R. Pereira

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

OPTN/SRTR 2020 Annual Data Report: Kidney

K. L. Lentine, J. M. Smith, A. Hart, J. Miller, M. A. Skeans, L. Larkin, A. Robinson, K. Gauntt, A. K. Israni, R. Hirose, J. J. Snyder

Summary: The year 2020 presented challenges for kidney transplantation, with a slight decrease in the total number of transplants and a significant decline in living donor transplants due to the COVID-19 pandemic. Racial disparities in living donor transplant access persist. Pediatric kidney transplants were also impacted, with a decrease in the total number of transplants and a continued decrease in deceased donor transplants among pediatric candidates.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Transplantation

Design, recruitment, and baseline characteristics of the EMPA-KIDNEY trial

William G. Herrington, Christoph Wanner, Jennifer B. Green, Sibylle J. Hauske, Parminder Judge, Kaitlin J. Mayne, Sarah Y. A. Ng, Emily Sammons, Doreen Zhu, Natalie Staplin, David Preiss, Will Stevens, Karl Wallendszus, Rejive Dayanandan, Carol Knott, Michael Hill, Jonathan Emberson, Susanne Brenner, Vladimir Cejka, Alfred K. Cheung, Zhihong Liu, Jing Li, Peiling Chen, Laiseong Hooi, Wen Liu, Takashi Kadowaki, Masaomi Nangaku, Adeera Levin, David Cherney, Roberto Pontremoli, Aldo Pietro Maggioni, Shinya Goto, Aiko Tomita, Rajat Deo, Katherine Tuttle, Jens Eilbracht, Stefan Hantel, Mark Hopley, Martin J. Landray, Colin Baigent, Richard Haynes

Summary: The EMPA-KIDNEY trial aims to evaluate the effects of empagliflozin on the risk of kidney disease progression or cardiovascular death in patients with chronic kidney disease. The trial includes a widely generalizable population of CKD patients and uses a streamlined design with minimal data collection. Results are anticipated in 2022.

NEPHROLOGY DIALYSIS TRANSPLANTATION (2022)

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Article Surgery

Changing trends in mortality among solid organ transplant recipients hospitalized for COVID-19 during the course of the pandemic

Madeleine R. Heldman, Olivia S. Kates, Kassem Safa, Camille N. Kotton, Sarah J. Georgia, Julie M. Steinbrink, Barbara D. Alexander, Marion Hemmersbach-Miller, Emily A. Blumberg, Ashrit Multani, Brandy Haydel, Ricardo M. La Hoz, Lisset Moni, Yesabeli Condor, Sandra Flores, Carlos G. Munoz, Juan Guitierrez, Esther I. Diaz, Daniela Diaz, Rodrigo Vianna, Giselle Guerra, Matthias Loebe, Robert M. Rakita, Maricar Malinis, Marwan M. Azar, Vagish Hemmige, Margaret E. McCort, Zohra S. Chaudhry, Pooja P. Singh, Kailey Hughes Kramer, Arzu Velioglu, Julie M. Yabu, Jose A. Morillis, Sapna A. Mehta, Sajal D. Tanna, Michael G. Ison, Ariella C. Derenge, David van Duin, Adrienne Maximin, Carlene Gilbert, Jason D. Goldman, Erika D. Lease, Cynthia E. Fisher, Ajit P. Limaye

Summary: Mortality among solid organ transplant recipients hospitalized for COVID-19 decreased between early and late 2020, with the late period showing lower mortality even after adjusting for baseline comorbidities. The use of corticosteroids and remdesivir increased, while the use of hydroxychloroquine and IL-6/IL-6 receptor inhibitors decreased between the two periods.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

OPTN/SRTR 2020 Annual Data Report: Lung

M. Valapour, C. J. Lehr, M. A. Skeans, J. M. Smith, E. Miller, R. Goff, T. Mupfudze, K. Gauntt, J. J. Snyder

Summary: In 2020, there was a decrease in the number of lung transplants performed and candidates added to the waiting list, along with a decline in lung donors. This can be attributed to the impact of the global COVID-19 pandemic. However, the median time to transplant continued to decrease and posttransplant survival rates remained stable.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Surgery

Kidney transplantation from triple-knockout pigs expressing multiple human proteins in cynomolgus macaques

David Ma, Takayuki Hirose, Grace Lassiter, Hajime Sasaki, Ivy Rosales, Taylor M. Coe, Charles G. Rickert, Rudy Matheson, Robert B. Colvin, Wenning Qin, Yinan Kan, Jacob Layer, Violette B. Paragas, Kathryn Stiede, Katherine C. Hall, Michele E. Youd, Luis M. Queiroz, William F. Westlin, Michael Curtis, Luhan Yang, James F. Markmann, Tatsuo Kawai

Summary: The study demonstrates that long-term survival of renal xenografts from TKO pigs can be achieved in cynomolgus monkeys through the expression of additional human transgenes. The level of CRP expression was found to be associated with recipient survival time.

AMERICAN JOURNAL OF TRANSPLANTATION (2022)

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Article Medicine, Research & Experimental

Progressive genetic modifications of porcine cardiac xenografts extend survival to 9 months

Muhammad M. Mohiuddin, Corbin E. Goerlich, Avneesh K. Singh, Tianshu Zhang, Ivan Tatarov, Billeta Lewis, Faith Sentz, Alena Hershfeld, Gheorghe Braileanu, Patrick Odonkor, Erik Strauss, Brittney Williams, Allen Burke, Jamie Hittman, Adnan Bhutta, Ali Tabatabai, Anuj Gupta, Todd Vaught, Lori Sorrells, Kasinath Kuravi, Amy Dandro, Will Eyestone, David J. Kaczorowski, David Ayares, Bartley P. Griffith

Summary: This study reports the survival of genetically engineered porcine cardiac xenografts in baboon recipients for almost 9 months. The selective multi-gene modifications significantly improve the survival of cardiac xenografts, offering hope for transplantation in humans.

XENOTRANSPLANTATION (2022)

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