BK virus infection is a marker of poor immune recovery, especially after kidney or allogeneic cell transplantation. Because of the challenges associated with BK virus infection and the lack of effective treatments, there is a growing interest in novel approaches, such as adoptive cellular therapy, that aim to restore antiviral immunity and promote viral clearance. Our clinical trial assessed the feasibility, safety, and efficacy of administering third-party, BK virus-specific cytotoxic T lymphocytes (CTLs) used to treat allogeneic HCT patients and kidney transplant patients with biopsy-proven BK-virus nephropathy. Comprehensive clinical assessments and correlative studies were performed. The study included six patients after kidney-transplantation and five HCT recipients. Viremia declined in most evaluable patients by Day 45 after BKCTL infusion. No new instances of graft-versus-host disease, kidney-transplant rejection, graft failure, or infusion-related toxicities were attributed to the treatment. Antiviral activity (as assessed by interferon-γ secretion) did not differ between infused BKV-CTLs given to kidney-transplant versus allogeneic SCT recipients. In this study, we longitudinally tracked the in vivo persistence of adoptively transferred BKV-CTLs and demonstrated their sustained functional activity. This therapy could be promising in KT and SCT patients with recent-onset BK-virus viremia.

Achieving long-term survival after lung transplantation remains a major challenge. Outcome determinants have expanded beyond pathophysiology to include quality of life and patient-reported outcomes. This review summarizes key prognostic factors associated with outcomes and suggests integrated strategies to improve them. The primary determinants of long-term survival are chronic lung allograft dysfunction (CLAD), infection, and malignancy. Various agents have been investigated for preventing and treating CLAD. Beyond these, managing comorbidities such as renal failure, metabolic disorders, and gastrointestinal dysfunction is crucial. Furthermore, patient-reported outcomes involving both physical and psychosocial aspects (e.g., frailty and sleep disturbance) have emerged as vital prognostic markers. To manage these multifaceted risks, real-time data pipelines (e.g., the Quality in Lung Transplant Initiative) and remote tools including home spirometry facilitate early detection of graft dysfunction. Multidisciplinary interventions, including rehabilitation, adherence support, and artificial intelligence-driven technologies, have shown promise in improving outcomes. Improving long-term outcomes in lung transplantation requires a comprehensive approach that extends beyond traditional CLAD management. Structured, multicomponent programs integrating data-driven surveillance with multidisciplinary care provide a robust model for early detection and intervention for graft failure and comorbidities, ultimately prolonging survival and quality of life.

Immune checkpoint inhibitors (ICIs) have emerged as promising agents for the management of advanced HCC. By reducing tumour burden, ICIs may serve as a downstaging/bridging tool to improve transplant candidacy. The aim of this study was to assess the safety of patients receiving pre-LT ICIs. Multicenter, retrospective cohort study from January 2018 to December 2024, including 48 patients who received ICIs prior to LT (ICI cohort). A control cohort (non-ICI cohort) was built (1:3) using propensity score matching including 144 patients who underwent LT for HCC without prior ICI. Within the ICI cohort (N = 48) rejection occurred in 9 patients (18.8%), all biopsy-proven, with a median onset of 31 days post-LT (12.0-182.0). The median washout period was 60 days (13-96). Patients experiencing rejection had shorter washout periods (p = 0.029). All rejection episodes were successfully managed; two were steroid-resistant, one requiring re-transplantation. There were no rejection-related deaths. Of the 5 patients with HCC recurrence, 60% received ICI for < 90 days (p = 0.027). Comparison between the ICI and non-ICI cohort revealed no significant differences in rejection rates (18.8% vs. 19.4%, p = 0.916), graft failure, HCC recurrence, or overall mortality. Overall survival (OS) did not differ between ICI and non-ICI patients (p = 0.625) or between those with and without rejection (p = 0.119). Rejection was not associated with increased mortality, with deaths primarily attributed to infection or HCC recurrence. Our results demonstrate that rejection rates were similar in patients receiving ICIs pre-LT and it can be safely managed.

Children with non-malignant hematological disorders (NMHD) often require numerous red blood cell transfusions prior to hematopoietic stem cell transplant (HSCT), leading to iron overload. Ferritin and liver iron concentration (LIC) are used to estimate the degree of iron overload to determine eligibility for HSCT, but neither marker has been definitively associated with poorer HSCT outcomes in pediatric cohorts. We conducted a multicenter retrospective cohort study using PEDSnet to examine the association between elevated pre-HSCT ferritin and LIC and HSCT outcomes, and to evaluate iron reduction therapy post-transplant. 580 patients with a pre-HSCT ferritin and 260 patients with a pre-HSCT LIC were studied. Patients with high pre-HSCT ferritin >2500 ng/mL had decreased 3-year overall survival (adjusted HR 2.31, 1.06-5.04). A sensitivity analysis demonstrated this trend only in patients with severe aplastic anemia (SAA). Elevated ferritin was associated with a markedly increased risk of bacteremia after HSCT in patients with SAA (HR 3.33, 1.72 - 6.44). Elevated pre-HSCT LIC >5 mg Fe/g dry weight was not associated with decreased survival, bacteremia, graft failure, or veno-occlusive disease (VOD). VOD was assessed only in patients undergoing busulfan-based transplant. Post-transplant, 63% of patients in the multicenter analysis had an elevated ferritin, while 68% had an elevated LIC. Chelation and phlebotomy were equally effective in reducing post-HSCT iron. These results challenge the use of LIC as the gold standard for iron-related risk stratification in HSCT. Further research into peri-HSCT iron management is necessary in an era of expanding availability of HSCT for NMHD.

IntroductionAnterior cruciate ligament (ACL) reconstruction is widely performed, yet insufficient tendon-bone healing remains a key contributor to graft failure. Stem cell-based interventions, including mesenchymal stem cells (MSCs) and stem cell-derived products (e.g., exosomes/extracellular vesicles), have shown potential to enhance tendon-bone integration in preclinical models. However, findings across animal studies are heterogeneous and have not been comprehensively synthesized. This review aims to evaluate the effects of stem cell-based therapies on tendon-bone healing after ACL reconstruction in animal models.Methods and analysisThis protocol follows PRISMA-P. We will search PubMed, Embase, Scopus, SPORTDiscus, Web of Science, and the Cochrane Library from inception to the final search date. Controlled animal studies comparing ACL reconstruction with stem cell-based interventions versus controls will be included. Primary outcomes are biomechanical properties (ultimate failure load and stiffness). Secondary outcomes include micro-CT measures of bone integration (e.g., bone volume fraction, bone mineral density) and histological outcomes (e.g., interface maturation or validated scoring systems). Risk of bias will be assessed using SYRCLE’s tool. Random-effects meta-analyses will be performed, with prespecified subgroup analyses by stem cell type, delivery method, animal species, and follow-up time. Sensitivity analyses and publication-bias assessments will be conducted where appropriate.PROSPERO registrationCRD420251137985.

Anterior cruciate ligament (ACL) reconstruction is widely performed, yet insufficient tendon-bone healing remains a key contributor to graft failure. Stem cell-based interventions, including mesenchymal stem cells (MSCs) and stem cell-derived products (e.g., exosomes/extracellular vesicles), have shown potential to enhance tendon-bone integration in preclinical models. However, findings across animal studies are heterogeneous and have not been comprehensively synthesized. This review aims to evaluate the effects of stem cell-based therapies on tendon-bone healing after ACL reconstruction in animal models. This protocol follows PRISMA-P. We will search PubMed, Embase, Scopus, SPORTDiscus, Web of Science, and the Cochrane Library from inception to the final search date. Controlled animal studies comparing ACL reconstruction with stem cell-based interventions versus controls will be included. Primary outcomes are biomechanical properties (ultimate failure load and stiffness). Secondary outcomes include micro-CT measures of bone integration (e.g., bone volume fraction, bone mineral density) and histological outcomes (e.g., interface maturation or validated scoring systems). Risk of bias will be assessed using SYRCLE's tool. Random-effects meta-analyses will be performed, with prespecified subgroup analyses by stem cell type, delivery method, animal species, and follow-up time. Sensitivity analyses and publication-bias assessments will be conducted where appropriate. CRD420251137985.

Corneal blindness has been a significant, in most cases, reversible cause of visual impairment worldwide due to donor deficiency and donor graft failure, which has encouraged the consideration of donor-independent techniques for regeneration. This review aims to discuss the advances in corneal organoid-based tissue engineering and its potential application in the translation to vision restoration. This review was conducted through an analysis of publications related to corneal organoids, biomaterials, bioprinting, preclinical models, and early human studies, published between 2005-2025 in Scopus, Web of Science, Google Scholar, PubMed, and WHO. In vitro corneal organoids from iPSCs and ESCs have a multilayered epithelium, stroma-like extracellular matrix, and intermittent endothelial phenotypes. In animal models and in vitro, they show lineage, light transmittance, and functional analysis indicators. Printing and microfabrication work with dECM gelMA bioinks. Despite batch variation, graft-scale production, endothelial pumps, and relevant aspects of translation, such as GMP-grade production, repeatability, biosafety certification, etc. It exhibited close to physiological transparency and biomechanics in quantifying with the original cornea, and demonstrates translational potential. The use of induced pluripotent stem cells and bioengineered corneal constructs has shown good first-in-human and preclinical trials. In conclusion, it is possible to say that the corneal organoid procedures are the potential solution to lessening reliance on donors and making therapeutic modalities as personalized as possible, but they demand standardized methodologies, GMP-level upscaling, solid safety data, and clinical trials before they can be adopted widely. This review presents a comprehensive overview of the progress in iPSC-derived corneal organoids, bio printing, and the development of biomaterials, and presents their respective advancements on their way to translation into the clinical setting in the field of corneal engineering and donor-independent restoration of vision.

Current Indications and Outcomes of Penetrating Keratoplasty in the United States: An IRIS® Registry (Intelligent Research in Sight) Study.

The posterolateral corner (PLC) of the knee comprises a complex arrangement of anatomical and biomechanical structures. Owing to their variability, small size, and the inconsistent terminology found in the literature, these structures have historically been referred to as the "dark side of the knee". This review aims to summarize the relevant anatomy and MR anatomy of the PLC stabilizers, illustrate key MRI findings in acute and chronic injuries, and provide practical considerations for structured diagnosis and reporting. The main stabilizers of this region include the lateral collateral ligament (LCL), the popliteofibular ligament (PFL), and the popliteus myotendinous complex. Together, these elements provide resistance against varus forces and external tibial rotation, with additional compensatory roles in the presence of cruciate ligament insufficiency. Injury mechanisms are diverse, commonly involving direct high-energy trauma, hyperextension, or rotational-varus-hyperextension stress in sports-related activities. Although PLC lesions represent nearly one-third of all ligamentous injuries of the knee, isolated involvement is uncommon, with frequent associations with posterior and anterior cruciate ligament tears. Accurate imaging evaluation, particularly with magnetic resonance imaging (MRI), is fundamental for timely diagnosis, guiding appropriate management, and reducing the risk of chronic posterolateral instability, cruciate graft failure, and progression to osteoarthritis.

Following implementation of the U.S. Kidney Allocation System (KAS) in 2014, deceased donor kidneys with a kidney donor profile index (KDPI) < 35% are prioritized for allocation to pediatric candidates. Early post-KAS data suggested this prioritization may have led to more frequent delayed graft function compared to pre-KAS, when pediatric allocation priority was based on donor age < 35 years. We sought to understand the impact of this allocation change on longer-term pediatric kidney transplant outcomes. We used SRTR data to identify all deceased donor kidney transplants with pediatric recipients during two eras: "Pre-KAS" (12/1/2009-11/30/2014) and "KAS" (12/1/2015-11/30/2020). We used Cox proportional hazards models to calculate the association between study era and all-cause graft failure (graft failure or death) after adjusting for recipient characteristics. Among 4502 included transplants, 2175 (48%) were in the pre-KAS era and 2327 (52%) in the KAS era. KAS-era donors were older (median age 23 years, 13% age ≥ 35 years vs. median age 21, 1% age ≥ 35 years), less likely to have diabetes and hypertension, and had lower serum creatinine. Transplantation during the KAS era was associated with a lower hazard of graft failure after adjusting for recipient characteristics (adjusted HR 0.690.790.91, p = 0.001). Results were similar in sensitivity analyses limited to recipients < 10 years old and recipients alive with a functioning graft 90 days post-transplant. KDPI-based prioritization of kidneys for pediatric allocation was associated with a lower risk of graft failure compared to donor age-based prioritization. Further refining donor risk scores may enable additional improvements in graft survival.

Lateral extra-articular tenodesis reduces graft failure without affecting functional outcomes after revision anterior cruciate ligament reconstruction: A retrospective comparative study with 6-year follow-up.

Impact of severe obesity on heart transplantation outcomes: A meta-analysis of survival and complications.

In partially matched Stem Cell Transplantation (SCT), the presence of Donor-Specific Anti-HLA antibodies (DSAs) is a critical factor contributing to graft rejection. This is particularly challenging for patients with restricted donor availability who need rapid access to transplantation. Managing DSAs before transplantation is essential to improve engraftment success and overall transplant outcomes in these high-risk individuals. The use of partially HLA-mismatched donors is increasingly favoured in transplantation, particularly in cases where fully matched donors are scarce or when time-sensitive procedures are required. However, the presence of DSAs has emerged as a major barrier to effective engraftment, posing a threat to transplant viability. This case describes the application of a desensitisation protocol in a highly sensitised patient with DSAs exceeding 5000 Mean Fluorescence Intensity (MFI). The approach included alternate-day Plasma Exchange (PLEX), rituximab and Intravenous Immunoglobulin (IVIg), all administered before proceeding with a partially matched stem cell transplant. Post-transplant, neutrophil engraftment was achieved on day 17 and platelet engraftment on day 23, both slightly delayed relative to expected norms. Other than mild to moderate gastrointestinal and febrile symptoms, which were managed medically, no acute complications such as primary graft failure or Graft-versusHost Disease (GvHD) were observed. At six-month follow-up, the patient demonstrated stable trilineage haematopoiesis with no evidence of relapse, graft failure, or chronic GvHD, highlighting the potential utility of desensitisation in overcoming DSA-mediated barriers to successful transplantation

Allogeneic Whole Eye Transplantation in Macaques Achieves 19-Day Graft Survival With Structural and Functional Viability.

Dynamic knee valgus as a predictor of graft rerupture after anterior cruciate ligament reconstruction: Influence of sex and graft type.

EMP1-driven ferroptosis in liver sinusoidal endothelial cells exacerbates hepatic ischemia-reperfusion injury via P38 MAPK.

Wireless, battery-free self-detecting smart arteriovenous graft for stenosis diagnosis in dialysis patients.

Long-term temporal trend in plaque eccentricity assessed through intravascular ultrasound imaging after heart transplantation.

Answer to the Letter on Corneal Endothelial Keratoprosthesis EndoArtin Patients with Glaucoma at High Risk of Graft Failure after Keratoplasty.

Immunoisolation devices containing therapeutic protein-secreting cells offer potential for long-term therapy without immune suppression. However, scar tissue formation driven by the foreign body response (FBR) hinders nutritional exchange and ultimately leads to graft failure. We previously showed that inhibiting the colony-stimulating factor-1 receptor (CSF1R) pathway in monocytes and macrophages can block the FBR to implanted materials. Here, we demonstrate that coencapsulation of slow-releasing CSF1R inhibitor (GW2580) crystals with human stem cell-derived β cells (SC-β) in alginate spheres enables stable glycemic control for 1 year in immune-competent diabetic C57BL/6 mice. In nonhuman primates (NHPs), GW2580 crystals similarly protected viable, glucose-responsive allogeneic β cells for 1 month without systemic immune suppression. In contrast, the same xenogeneic human SC-β cell formulation that functioned long-term in mice elicited extensive sphere overgrowth and graft failure in NHPs. Serum cytokine profiling and transcriptomic analysis of omental biopsies at day 30 revealed pronounced adaptive immune activation in xenogeneic recipients, including enrichment of CD4+ T cells, CD19+ B cells, and antigen-presenting cell programs marked by elevated MHC class II expression. Chemokines CCL17, CCL22, and CXCL13 were among the most highly up-regulated transcripts, mirroring responses observed previously with profibrotic alginate formulations without cells. These findings underscore the issues associated with xenogeneic cell sources in higher-order species yet indicate that targeting innate immune pathways with localized CSF1R inhibition may be sufficient to enable function of encapsulated allogeneic cell therapies.