Donor Graft Research Articles

Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome

Hypothermic oxygenated machine perfusion (HOPE) has become an integral technique to enhance donor graft function in liver transplantation (LiTx). This study compares early posttransplant outcomes of mono-HOPE (portal vein perfusion only) versus dual- HOPE (both portal vein and hepatic artery perfusion). A retrospective analysis was conducted on 183 LiTx recipients, with 90 receiving mono-HOPE and 93 receiving dual-HOPE grafts. Propensity Score Matching (PSM) was applied, resulting in a matched cohort of 146 patients. Primary outcomes included one-year patient and graft survival, and non-anastomotic biliary strictures (NAS). Secondary outcomes included hospital length of stay (HLS). One-year patient survival was 81.7% in the mono-HOPE and 81.7% in the dual-HOPE group, and overall survival did not differ (p = 0.990). One-year death-censored graft survival was similarly comparable (91.2% vs. 93.3%, p = 0.893). NAS were observed in 10.96% in the mono-HOPE and 8.22% in the dual-HOPE group (p = 0.574). The median HLS was 29 days for both groups. Results suggest that dual-HOPE did not significantly improve patient or graft survival, nor did it reduce NAS or HLS compared to mono-HOPE. Assuming that larger cohorts and long-term follow-up data confirm this, additional cannulation of the hepatic artery during machine perfusion in hypothermic conditions may not be beneficial.

P-2275. Impact of Epstein-Barr Virus (EBV) Donor Serostatus on Post-transplant Mortality and Post-Transplant Lymphoproliferative Disorder in Thoracic Organ Transplant EBV-Seropositive Recipients: Data from the Organ Procurement and Transplantation Network

Abstract Background Epstein Barr Virus (EBV) donor positive (D+) serostatus is a risk factor for Post-Transplant Lymphoproliferative Disorder (PTLD) in EBV-seronegative recipients. The impact of donor EBV serostatus on mortality and PTLD in EBV-seropositive recipients (R+) in thoracic organ transplant (TOT) is unknown.Table 1.Baseline demographic and clinical characteristics of EBV D-/R+ and EBV D+/R+ TOT recipients Methods Using the Organ Procurement and Transplantation Network database, we identified 47,201 EBV R+ TOT recipients between 01/2004 – 12/2021. The primary exposure was EBV D+ and the primary outcomes were death and PTLD. Multivariable Cox regression models were used to assess the relationship between donor EBV serostatus and the outcome of death and PTLD.Figure 1.Kaplan-Meier survival plots for EBV D-/R+ (solid line) versus EBV D+/R+ (dashed line) post heart (red line) and lung (blue line) transplantation Results Of 47,201 EBV R+ TOT recipients, 48.5% were lung and 51% were heart transplant recipients. The majority (93.4%) were EBV D+/R+, with median age of 59 years and 66.8% males. EBV D-/R+ and D+/R+ TOT recipients differed in CMV donor and recipient status, donor median age, sex, and graft failure (Table 1). The incidence rate of death was 7.2 per 100 person-years in EBV D+/R+ compared to 6.9 per 100 person-years in EBV D-/R+, p=0.156. Survival did not differ by EBV donor status, but it was lower in lung transplant (Figure 1). The incidence rate of PTLD was 0.26 per 100-person years in EBV D+/R+ compared to 0.33 per 100-person years in EBV D-/R+, p= 0.073. EBV D+ status was not associated with increased hazard of death in both univariable (crude hazard ratio [HR] of 1.05; confidence interval [CI], 0.98-1.11; p=0.15) and multivariable analyses (adjusted HR of 0.96; 95% CI, 0.90-1.02; p=0.14), after controlling for donor age, CMV D+ status, and the following recipient factors: age, sex, race, insurance, pre-transplant life support, pre-transplant malignancy, rejection, and graft failure. EBV D+ status was associated with decreased hazard of PTLD when adjusting for recipient age and graft failure (adjusted HR of 0.74; 95% CI, 0.56-0.98; p=0.03). In subgroup analyses by organ, EBV D+ status was associated with decreased hazard of PTLD in lung (adjusted HR of 0.56; 95% CI, 0.40-0.78; p=0.001) but not in heart transplant recipients (adjusted HR of 1.18; 95% CI, 0.71-1.96; p =0.50) (Figure 2).Figure 2.Kaplan-Meier PTLD-free survival plots for EBV D-/R+ (solid line) versus EBV D+/R+ (dashed line) post heart (red line) and lung (blue line) transplantation Conclusion Among EBV-seropositive TOT recipients, EBV D- status may be associated with increased risk of PTLD, particularly in lung transplant recipients. Disclosures Alissa J. Inc, MD, MSc, Takeda: Honoraria Sara Belga, MD, MPH, Takeda, Moderna, AstraZeneca, GSK: Advisor/Consultant|Takeda, Moderna, AstraZeneca, GSK: Grant/Research Support|Takeda, Moderna, AstraZeneca, GSK: Honoraria

G-CSF-primed bone marrow transplantation experience in 350 matched sibling donor grafts for Severe Thalassemia.

For matched related hematopoietic cell donor transplantation (HCT) for non-malignant diseases most centres prefer bone marrow (BM) over peripheral stem cell (PBSC) grafts due to increased risk of chronic GVHD associated with the latter. BM generally entails delayed neutrophil and platelet recovery compared to PBSC transplants. G-CSF-primed bone marrow (G-BM) has been associated with faster hematological recovery while retaining a decreased risk of GVHD. Moreover, it may allow for reduced marrow collection volumes. We retrospectively analysed our experience with G-BM as graft source from July 2015 to February 2023 across 350 consecutive first matched sibling transplants in children with severe thalassemia in four centres in India. We observed that G-BM is associated with rapid hematological recovery with relatively low rates of CMV reactivation (16%), low rates of moderate to severe GVHD (grade 3-4 acute GVHD was 5% and moderate to severe chronic GVHD was 3%), reduced marrow collection volumes (12.5 ml/Kg of donor's weight), and thus is potentially safer for both donors and recipients compared with standard bone marrow. This observation was made in a relatively homogenous cohort of multiply transfused patients with thalassemia who are at high risk of rejection. None of the donors required third-party blood transfusion irrespective of donor-recipient weight discrepancy. Our experience suggests that G-BM is associated with prompt engraftment and very low rates of moderate or severe GVHD. It also appears to be safe for donors and decrease the risk for third-party red cell transfusions. Finally, its relatively easy and inexpensive to collect. G-BM should be strongly considered as a preferable graft source in matched-related donor transplantations for thalassemia and potentially other transplant indications.

Determining the effectiveness of nano-propolis in wound healing at the graft donor site: a randomized clinical trial

Determining the effectiveness of nano-propolis in wound healing at the graft donor site: a randomized clinical trial

Artificial Intelligence in Predicting Ocular Hypertension After Descemet Membrane Endothelial Keratoplasty.

Descemet membrane endothelial keratoplasty (DMEK) has emerged as a novel approach in corneal transplantation over the past two decades. This study aims to identify predisposing risk factors for post-DMEK ocular hypertension (OHT) and develop a preoperative predictive model for post-DMEK OHT. Patients who underwent DMEK at Gangnam Severance Hospital between 2017 and 2024 were included in the study. Four machine learning models-XGBoost, random forest, CatBoost, and logistic regression-were trained to assess feature importance and develop a predictive classifier. An ensemble of these four models was used as the final predictive model. The ensemble model identified clinically significant patients for prediction or exclusion. A total of 106 eyes from patients who underwent DMEK were analyzed, with 31 eyes (29.2%) experiencing post-DMEK OHT. The final ensemble model achieved clinically significant classification for 61 eyes (57.5%) in the total patient population. Significant risk factors identified in all four models included angle recess area (ARA), best-corrected visual acuity, donor graft size, angle-to-angle distance, crystalline lens rise, and central corneal thickness. The average accuracy, precision, recall, area under the receiver operating characteristic curve, and area under the precision-recall curve values of the ensemble model obtained by a 5-fold cross-validation were 80.2%, 60.0%, 59.7%, 82.3%, and 68.0%, respectively. This study identified significant risk factors for post-DMEK OHT and highlighted the importance of ocular topographic measures in risk assessment. The development of a final machine learning model to differentiate between clinically predictable patient groups demonstrates the clinical utility of the proposed model for predicting post-DMEK OHT.

Vascular flow alteration is a dominant pattern of liver pathology in patients with orthotopic lung transplants: a retrospective observational study.

The number of orthotopic lung transplants (OLT) has skyrocketed since the 1960s, generating an ever-increasing cohort of post-OLT patients. Many challenges exist in the post-OLT timeframe, including donor graft dysfunction, infection, malignancy, and immunosuppression-related conditions. A rather elusive topic in the posttransplant setting remains the impact of the underlying disease process and donor lungs on other organ systems and the complications arising from the complex physiologic interactions. The liver represents a vital organ often impacted in many ways by the lung transplant procedure. Also, there is a higher likelihood of adverse outcomes in OLT recipients who have significant liver pathology. Yet little is known about the morphologic changes in liver after patients have received an OLT. In this study we retrospectively reviewed liver pathology cases obtained after the patient received an OLT. Histology was reviewed by three pathologists and evaluated with a standardized checklist format. In our cohort, we found morphologic features of hepatic injury in the form of vascular outflow obstruction, nodular regenerative hyperplasia, portal vessel changes, and steatosis/steatohepatitis, but there was a striking absence of advanced fibrosis in our cohort. Here we present the first comprehensive account of morphologic changes in livers of post-OLT patients. We believe that this information will aid clinical decision-making during monitoring of hepatic function and fibrosis in patients with OLT and other complex pulmonary diagnoses.

Mechanical Vibration Regulates Differentiation and Proliferation of Neural Stem Cells

Abstract For the regeneration of the central nervous system, neural stem cells have been proposed as graft donors. Conventional studies have used biochemical factors to induce their differentiation into neurons and to enhance axon elongation. However, few studies have been reported on the effects of mechanical factors on neural stem cells. In this study, we show that mechanical vibration directs the differentiation of neural stem cells into neuronal cells, elongates their axons, and increases the number of differentiated cells. We found that the 25 Hz and 0.5 G vibration promoted the differentiation of neural stem cells into neuronal-marker-positive cells by twice the number in the control conditions and increased the number of differentiated cells with axons longer than 10 μm by 1.5-fold more than the control conditions. Furthermore, we found that the total number of differentiated and undifferentiated cells in the vibration condition reached threefold more than the control condition and that this effect depended on the frequency and acceleration. We anticipate our system to facilitate further studies using mechanical vibration such as regenerative therapy using neural stem cells and the elucidation of differentiation mechanisms in neural stem cells.

Basal Cell Carcinoma Arising in a Previous Full-Thickness Graft Donor Site: A Case Report and Comprehensive Literature Review.

Background/Objectives: Basal cell carcinoma (BCC), the most common skin malignancy, typically occurs in sun-exposed areas but can develop in atypical locations, such as scars, burns, and skin graft donor sites. BCC arising specifically in full-thickness skin graft donor sites is exceptionally rare. This study presents a unique case of BCC occurring 16 years post-graft harvesting and provides a comprehensive literature review to analyze clinical patterns, possible etiopathogenesis, and treatment strategies. Methods: A case report was described and a comprehensive literature review was conducted using PubMed, Scopus, and Web of Science (up to November 2024). Studies were screened for cases of BCC involving skin graft donor and recipient sites. Extracted data included demographics, graft type, latency period, histopathology, treatment, and outcomes. Results: A 68-year-old woman presented with biopsy-confirmed mixed nodular and micronodular BCC at the donor site of a full-thickness skin graft 16 years after its use for nasal reconstruction. Surgical excision with clear margins resulted in complete resolution without recurrence. A literature analysis revealed seven cases of graft-associated BCC, predominantly affecting older females. Partial-thickness grafts were frequently involved, with latency periods ranging from 1 to 61 years. Nodular BCC was the most common histological subtype, and surgical excision remained the primary and most effective treatment. Conclusions: Although rare, BCC can develop in skin graft donor sites after prolonged latency. Chronic trauma, impaired vascularization, and genetic alterations likely contribute to tumorigenesis. Lifelong surveillance, early detection, and timely intervention are critical to improving outcomes.

Efficacy of the Direct Anterior Chamber Air Replacement Method During Descemet Stripping Automated Endothelial Keratoplasty.

This study aimed to describe a novel technique of direct anterior chamber (AC) air replacement (DACAR) for the management of Descemet stripping automated endothelial keratoplasty (DSAEK) in postvitrectomized eyes and eyes with previous glaucoma surgery. DACAR was performed after a corneal donor graft was transplanted through a wound using the pull-through technique. DACAR involves stabilizing the graft with forceps while introducing air into the AC via an infusion cannula to ensure complete air exchange. The air was maintained in the AC at all times using a vitrectomy machine. The air pressure was maintained at 30 mm Hg for 15 minutes. The DACAR technique was performed in 34 patients, and conventional pull-through technique DSAEK was performed in 32 high-risk patients. The DACAR group had shorter DSAEK surgical procedures (P = 0.009) and a lower incidence of corneal graft detachment in the early postoperative period (P < 0.001) than the conventional DSAEK group. DACAR is performed in patients having previously undergone vitrectomy or glaucoma surgery to prevent corneal graft detachment during the early postoperative period and to reduce the length of surgery.

Donor Regulatory T-Cell Therapy to Prevent Graft-Versus-Host Disease.

Allogeneic hematopoietic cell transplantation (HCT) is a curative therapy limited by graft-versus-host disease (GVHD). In preclinical studies and early-phase clinical studies enrichment of donor regulatory T cells (Tregs) appears to prevent GVHD and promote healthy immunity.We enrolled 44 patients on an open-label, single-center, phase 2 efficacy study investigating if a precision selected and highly purified Treg cell therapy manufactured from donor mobilized peripheral blood improves one-year GVHD-free relapse free survival (GRFS) after myeloablative conditioning (trial NCT01660607). We compared this study arm to a concomitant standard of care (SOC) cohort. All donor Treg cell products were successfully manufactured and administered without cryopreservation within 72 hours. Participants had a one-year incidence of acute grade III-IV GVHD of 7%, moderate to severe chronic GVHD of 11% and non-relapse mortality rate of 4.5%. The primary endpoint of significantly improved one-year GRFS was achieved at 64% evaluated against a predicted incidence of 40% (p = 0.002) with a realized incidence of 36% in the SOC comparitor. For those trial patients whow developed grade II-IV acute GVHD, 91% responded to front-line steroid therapy wheras 50% responded in the SOC comparator group. Trial participants had a reduced incidence and burden of GVHD and improved GRFS, as compared to rates common to highly variable unmanipulated donor grafts and multi-agent immune suppression.

Evaluating the impact of donor eGFR and HLA-DR mismatch on graft survival in living donor kidney transplants.

This study assesses the impact of human leukocyte antigen (HLA)-DR mismatch and donor-estimated glomerular filtration rate (eGFR) on outcomes of living donor kidney transplantation (LDKT), which are especially relevant to the availability of multiple donors and paired kidney exchanges. Using data from the Scientific Registry of Transplant Recipients (SRTR), we retrospectively analyzed graft survival in adult LDKT recipients transplanted between January 2013 and September 2022. Recipients with 0 HLA-DR mismatches were compared to those with 1-2 HLA-DR mismatches. Cox models assessed the association between donor eGFR and graft and patient survival, stratifying by a) HLA-DR mismatches, and b) HLA-DR mismatches and recipient age. Among 44,080 recipients, 7,195 had 0 HLA-DR mismatches and 36,885 had 1-2 HLA-DR mismatches. The recipients' mean age was 49.1 for the 0 HLA-DR mismatch group and 50.4 for the 1-2 HLA-DR mismatch group. The donors' mean age was 43.1 and 43.8, with an eGFR of 101.0 and 99.9 ml/min, respectively. A higher donor eGFR was associated with better graft survival. Stratified analyses showed higher donor eGFR levels reduced the risk of graft loss in cases with DR mismatch (p < 0.001) but not in cases without HLA-DR mismatch (p = 0.81). This effect was significant for recipients aged 18-39 and over 60. Similar results were observed for patient survival. Higher donor eGFR was associated with lower risks of graft loss and patient death in the HLA-DR mismatch group but not the 0 HLA-DR mismatch group. These results emphasize the importance of considering both HLA-DR matching and donor kidney function, particularly for younger recipients to avoid sensitization for future transplants.

No Association Between Donor Variables and Clinically Significant Outcomes, Reoperations, and Failure After Osteochondral Allograft Transplantation.

Mismatch between osteochondral allograft (OCA) donor and recipient sex has been shown to negatively affect outcomes. This study accounts for additional donor variables and clinically relevant outcomes. To evaluate whether donor sex, age, donor-recipient sex mismatch, and duration of graft storage affect clinical outcomes and failure rates after knee OCA transplantation. Cohort study; Level of evidence, 3. Patients undergoing knee OCA transplantation between 2003 and 2018 were prospectively followed. Inclusion criteria consisted of primary OCA transplantation and minimum 2-year follow-up. Patient descriptive data and allograft donor sex, age, and graft storage time before implantation were collected. Patients were evaluated for reoperation, failure, and achievement of clinically significant outcomes for International Knee Documentation Committee scores. Reoperation was defined as subsequent surgical intervention of the transplanted allograft, including second-look arthroscopy for graft evaluation, debridement, and loose body removal. Failure was defined as revision of the primary OCA transplantation or conversion to arthroplasty. A Kaplan-Meier curve determined cumulative survivability of OCA transplantations, and log-rank testing was used to compare survivorship between groups. Stepwise regression analysis was utilized to evaluate associations between donor variables and achievement of clinically significant outcomes, reoperation, and failure. A total of 372 patients undergoing OCA transplantation were included and followed for a mean 5.4 years (SD, 2.7; range, 2.0-16.3). Isolated OCA transplantation was performed in 45% of cases (169/372). A mismatch in donor and recipient sex was present for more female patients (90%) than male patients (10%; P < .001). Those who had a sex-mismatched graft more frequently underwent concomitant tibial tubercle osteotomy (P = .034). When controlling for patient sex, no other differences were seen between groups matched and mismatched by sex. Univariable and multivariable analysis found no significant difference in survival free from reoperation or failure on the basis of donor-recipient sex mismatch, donor age, or graft storage time before implantation. In contrast to previous historical data, no donor variables were associated with inferior clinical outcomes in patients who underwent OCA transplantation. These data can help inform graft selection, expedient recipient selection, and outcome optimization after OCA transplantation.

Extracorporeal Shock Waves Therapy for the Treatment of Acute and Chronic Wounds-A Prospective, Monocentric Clinical Trial to Examine the Effect of Shock Waves on Wound Healing.

The aim of our prospective blinded clinical study was to examine a possible improvement and acceleration of epithelialization by treatment with low-energy extracorporeal shock waves on skin graft donor and recipient sites in patients with chronic wounds. In addition, several secondary parameters were investigated to evaluate the compatibility of the therapeutic method, its influence on infection occurrence and bacterial colonization. A total of 35 patients were included in the study. Of these, 25 participants were assigned to the verum-placebo group and 10 to the sham treatment group. The study of the sham control group was done to exclude a possible "remote effect" of the placebo area. Depending on the group, the wound areas were treated with low-frequency shock waves, placebo, or sham. The examinations were performed immediately on Day 0 after surgical treatment and on Days 5, 7, 9, and 12 after surgery. To record long-term results, an additional evaluation of the wound situation was performed on Day 90. Epithelialization was statistically significantly accelerated by shock wave application at both skin graft recipient sites and donor sites (0.86 vs. 0.92, p < 0.05). Furthermore, the risk of wound infection was significantly reduced by using extracorporeal shock waves. Serious side effects were not reported. A repeated application of ESWT followed by standardized wound care was shown to significantly accelerate the time to re-epithelialization at the skin graft donor and recipient site compared with re-epithelialization time in patients of the sham/placebo group.

A Comprehensive Analysis of Moist Versus Non-Moist Dressings for Split-Thickness Skin Graft Donor Sites: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis evaluate the efficacy of moist versus non-moist dressings for split-thickness skin graft (STSG) donor sites, focusing on time to healing, pain management, and adverse events to guide clinical practice. A comprehensive literature search was conducted across databases including Ovid/MEDLINE, Embase, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and Scopus up to November 28, 2023. The study adhered to PRISMA guidelines. Eligible randomized controlled trials (RCTs) were assessed for quality using the Newcastle-Ottawa Scale and Cochrane risk-of-bias tool, with meta-analysis performed using the DerSimonian and Laird random-effects model. Out of 464 identified studies, 16 RCTs involving 1129 patients were included. Moist dressings such as Tegaderm, Hydrocolloid, Alginate, polyurethane, and hydrofiber showed a faster mean time to healing compared to non-moist dressings like Mepitel and paraffin-impregnated gauze. Hydrocolloid dressings were particularly effective in accelerating wound healing. Additionally, moist dressings were associated with lower pain levels during dressing removal and had comparable rates of adverse events. The evidence strongly supports the use of moist dressings, particularly Hydrocolloid, for STSG donor site coverage. These dressings promote faster healing and superior pain management. The study highlights the need for further research to address existing limitations and refine recommendations for optimal wound care interventions.

Genetic Assessment of Living Kidney Transplant Donors: A Survey of Canadian Practices.

Kidney failure is a prevalent condition with tendency for familial clustering in up to 27% of the affected individuals. Living kidney donor (LKD) transplantation is the optimal treatment option; however, in Canada, more than 45% of LKDs are biologically related to their recipients which subjects recipients to worse graft survival and donors to higher future risk of kidney failure. Although not fully understood, this observation could be partially explained by genetic predisposition to kidney diseases. Genetic testing of potential LKDs may improve risk assessment and inform the safety of donation. The strategies to evaluate these donors are still evolving. In Canada, little is known about the practice of assessing for genetic conditions among LKDs. The aim was to examine the Canadian practices regarding LKDs genetic assessment. Questionnaires were sent to 23 Canadian adult transplant centers to examine their protocols for LKDs genetic assessment. The questionnaire comprised of 10 sections and 21 questions including case scenarios of different LKD encounters. Major domains of the survey addressed general demographics, information sharing practices, effect of mode of inheritance on candidacy decision, having a policy for LKD genetic evaluation, and case scenarios covering the following conditions: autosomal dominant polycystic kidney disease (ADPKD), Alport syndrome, Fabry disease, familial focal and segmental glomerulosclerosis (FSGS), atypical hemolytic uremic syndrome (aHUS), autosomal dominant tubulointerstitial kidney disease (ADTKD), sickle cell, and apolipoprotein L1 mutation (APOL1). The questionnaire was sent to the living-donor assessment committee representative (nephrologist) in adult and pediatric kidney transplant centers across Canada. In total, 16 of 23 Canadian centers responded to the survey. Of the 8 surveyed genetic conditions, ADPKD, Alport syndrome, and aHUS were the most frequently encountered. More centers have specific policies for donor evaluation for ADPKD (25%) and aHUS (21.4%) vs none to very few for other genetic conditions. The most cited guidelines are Kidney Disease Improving Global Outcomes (KDIGO), Canadian Society of Nephrology/Canadian Society of Transplantation (CSN/CST), and the Canadian Blood Services' Kidney Paired Donation Protocol. Canadian transplant centers follow a case-by-case approach rather than a standard protocol for genetic assessment of LKDs given that current guideline recommendations are based on expert opinion due to a lack of a reliable body of evidence. With the expected rise in utilization of the increasingly available genetic testing, early multidisciplinary assessment including medical geneticists has the potential to improve personalized management. Studies examining long-term donor and graft outcomes are needed to construct the basis for evidence-based recommendations and inform the safety of donations.

Donor Graft Steatosis Is Associated with Intrahepatic Hepatocellular Carcinoma Recurrence Following Liver Transplantation

Donor Graft Steatosis Is Associated with Intrahepatic Hepatocellular Carcinoma Recurrence Following Liver Transplantation

A Comparative Study Between Collagen Sheet Dressing and Conventional Paraffin Gauze Dressing to Donor Site in Patients Undergoing Split Skin Grafting

Introduction: Split skin grafting is a common procedure that causes partial thickness injury, typically treated with paraffin-soaked gauze. Re-epithelialization occurs in two weeks, but complications like pain, infection, and delayed healing can arise. This study aimed to compare collagen sheet dressing with conventional gauze dressing in reducing pain, promoting healing, and preventing infection in donor sites. Material and Methods: A prospective comparative study was conducted at a tertiary care hospital from December 2021 to January 2024. Fifty patients undergoing split skin graft surgery were assigned to either Group A (collagen sheet) or Group B (paraffin gauze). Outcomes such as pain, re-epithelialization, and infection were compared using descriptive statistics, chi-square, Fischer’s exact, and Student’s t-tests. P&lt;0.05 was considered significant. Results: The mean age of Group A and Group B was 53.92 and 56.6 years, respectively. Pain scores were significantly lower in the collagen group (P&lt;0.05). Epithelialization on day 10 was higher in the collagen group (85.2±5.09) compared to the conventional group (68.4±8). One patient in the conventional group had an infection, whereas none were observed in the collagen group. Conclusion: Collagen sheet dressing in split skin grafting donor sites results in reduced pain, faster epithelialization, and lower infection rates.

The Impact of Hypomagnesemia on the Long-Term Evolution After Kidney Transplantation.

Magnesium plays a crucial role in immune function, influencing immunoglobulin synthesis, antibody-dependent cytolysis, and other immune processes. In renal transplant patients, magnesium deficiency is primarily induced by calcineurin inhibitor treatment, through the reduction of magnesium transporter proteins in the renal tubules, leading to magnesium loss. To assess the correlation between serum magnesium levels and the long-term outcomes of renal graft and transplant recipients, we conducted a retrospective study on 87 patients who have had a transplant for more than 5 years, a period considered immunologically stable. We evaluated laboratory parameters such as glycemia, creatinine, total protein, and C-reactive protein (CRP), as well as demographic data, primary kidney disease, donor type, comorbidities, and infection incidence. This study revealed clinical stability at over 5 years post-transplantation, with no significant differences between the 5-15 and over-15-years groups with regard to major comorbidities, except for HCV infection (p = 0.018). Reduced magnesium levels were associated with impaired renal function (p = 0.017) and inflammatory syndrome (p = 0.012). Viral infections were correlated with living donor grafts (p = 0.05), hypoproteinemia, and decreased eGFR (estimated glomerular filtration rate), while bacterial infections, namely urinary tract infections (UTIs), were linked to reduced eGFR (p = 0.05, p = 0.046). Female patients with hypomagnesemia had a higher incidence of recurrent UTIs (p = 0.03). Hypomagnesemia correlates with increased infection risk in patients who received a renal transplant more than 5 years ago but does not significantly impact glycemic control or cardiovascular health.

Role of Fibroheal Ag Ointment in the Treatment of Partial Thickness Burns

Aim of this case report is to assess the role of Fibroheal ointment, a silk fibroin based pharmaceutical, in the treatment of partial thickness burns and split‐thickness skin graft donor sites. Clinical examination of the burn wounds before and after use Fibroheal ointment was done.

Use of Ex Situ Machine Perfusion for Liver Transplantation: The National Experience.

Machine perfusion (MP) for liver transplantation has become more widespread in the United States, but national studies on this growing practice are lacking. We investigated national use and outcomes of MP for liver transplantation. Adult (≥18 y) liver recipients transplanted between January 1, 2016 and September 30, 2023 in the United Network for Organ Sharing database were included. We used Cox regression to compare 1-y posttransplant recipient survival and all-cause graft failure by use of MP and performed subgroup analyses among circulatory death (DCD) and brain death (DBD) donors. Of 52 626 deceased donors with liver recovery, 1799 (3.5%) utilized MP. The proportion of all liver transplants using MP increased from 0.3% in 2016 to 15.5% in 2023. MP for DCD transplants increased from 0.8% in 2016 to 50.0% in 2023. Donors of MP grafts were older (47 [34-57] versus 42 [29-55] y, P < 0.001), had higher body mass indexes (28.3 [24.4-33.3] versus 27.3 [23.7-31.8] kg/m2, P < 0.001), and were more likely to be DCD (47.1% versus 9.3%, P < 0.001). Among DBD transplants, MP and non-MP DBD transplants had similar all-cause graft failure out to 1 y (adjusted hazards ratios, 1.12 [95% confidence interval, 0.87-1.43], P = 0.38). Among DCD transplants, MP recipients had improved survival out to 1 y (adjusted hazards ratios, 0.50 [95% confidence interval, 0.35-0.70], P < 0.001). MP use in liver transplantation is rapidly expanding and is associated with favorable outcomes compared with cold storage. MP is associated with increased posttransplant survival for DCD transplants, highlighting the potential for MP to expand utilization of DCD grafts.