Post Transplant Research Articles

P.301: Calcification of JJ catheter post renal transplantation about two cases.

P.301: Calcification of JJ catheter post renal transplantation about two cases.

Green synthesis, chemical characterization, anti-osteoarthritis properties of Cu nanoparticles

In our latest study, we assessed the effectiveness of a green copper nanoparticle formulation containing curcumin on the chick’s knee joint injury. The NPs were characterized using FE-SEM, TEM, XRD, and EDX techniques. The primary cultured chondrocytes were utilized to check the nanoparticles effectiveness on chondrogenesis in the orthopedic experiments. Subsequently, we assessed the functional restoration post copper nanoparticles transplantation using an osteoarthritis articular model in the knee. Histological, PCR, and western blot analyses were conducted to investigate the underlying mechanisms. The XRD results exhibited the CuO formula for CuNPs and a spherical shape with a size <60 nm was obtained for the NPs from the TEM and FE-SEM images. The presence signals in EDX diagram including signals at 0.22 keV for C Lα, 0.51 keV for O Lα, and 0.93 keV for Cu Lα approve the formation of Cu NPs. The use of nanoparticles effectively inhibited abnormal fibrosis and angiogenesis at the injury site. The nanoparticles presence in the histological test resulted in rised synthesis of cartilage matrix and proliferation of chondrocytes, while also reducing the formation of abnormal vasculature. The study unveiled that the use of nanoparticles accelerated the healing process following an injury after three weeks. Furthermore, we highlighted the beneficial effects of copper nanoparticles in promoting cartilage formation in a laboratory setting. In the immunological domain, the copper nanoparticles demonstrated a decrease in the quantities of IL-1β, TNF-α, p-p65, and MMPs expression. This phenomenon could potentially be attributed to the cellular redox homeostasis modulation associated with the Nrf2 pathway. In conclusion, the results of this research confirmed the positive efficacy of copper nanoparticles containing curcumin in accelerating the osteoarthritis articular cartilage repair.

345.9: The mechanism research of intrahepatic glutamine metabolism promoting the differentiation of GARP Tregs to reshape the immune tolerance microenvironment post liver transplantation.

345.9: The mechanism research of intrahepatic glutamine metabolism promoting the differentiation of GARP Tregs to reshape the immune tolerance microenvironment post liver transplantation.

P.220: BK virus associated Urothelial cancer in the background of BK polyomavirus nephropathy post renal transplantation: A case report and review of literature.

P.220: BK virus associated Urothelial cancer in the background of BK polyomavirus nephropathy post renal transplantation: A case report and review of literature.

P.238: Nephrotic syndrome early post kidney transplantation - rare manifestation of acute rejection.

P.238: Nephrotic syndrome early post kidney transplantation - rare manifestation of acute rejection.

440.6: Efficacy and safety of 6-month sacubitril/valsartan administration in post-renal transplant patients; possibly contribution to long-term graft survival?

440.6: Efficacy and safety of 6-month sacubitril/valsartan administration in post-renal transplant patients; possibly contribution to long-term graft survival?

P.523: A case report of acute myeloid leukemia post-renal transplant.

P.523: A case report of acute myeloid leukemia post-renal transplant.

P.199: A cross sectional study of the medium term outcomes in living donor renal transplant recipients developing ATN in the immediate post transplant period.

P.199: A cross sectional study of the medium term outcomes in living donor renal transplant recipients developing ATN in the immediate post transplant period.

201.2: Patients remaining donor specific antibody (DSA) negative post transplantation have more regulated and fewer antigen specific Th-1 cell responses to mismatched donor human leucocyte antigens (HLA) versus those who develop DSA.

201.2: Patients remaining donor specific antibody (DSA) negative post transplantation have more regulated and fewer antigen specific Th-1 cell responses to mismatched donor human leucocyte antigens (HLA) versus those who develop DSA.

37: The Manchester experience of total lymphoid irradiation for chronic rejection post lung transplant

37: The Manchester experience of total lymphoid irradiation for chronic rejection post lung transplant

Similar recurrence and survival in pre- and post-renal transplant papillary thyroid cancer: data from a 1507 recipient registry

Similar recurrence and survival in pre- and post-renal transplant papillary thyroid cancer: data from a 1507 recipient registry

Kidney Transplantation and Cellular Immunity Dynamics: Immune Cell Alterations and Association with Clinical and Laboratory Parameters.

Background/Objectives: The purpose of this study was to evaluate numerical changes in immune cells after successful kidney transplantation and associate their recovery with clinical and laboratory factors. Methods: In 112 kidney transplant recipients, we performed flow cytometry to evaluate counts of CD4+, CD8+, and regulatory T cells (Tregs), as well as natural killer (NK) cells, before kidney transplantation (T0) and three (T3), six (T6), and twelve (T12) months later. The results were associated with the recipient's age, cold ischemia time (CIT), the type of donor, dialysis method and vintage, and graft function in one year. Results: Total and CD8+ T cell counts increased gradually one year post transplantation in comparison with pre-transplantation levels, whereas the number of CD4+ T cells and Tregs increased, and the number of NK cells decreased in the first three months and remained stable thereafter. The recipient's age was negatively correlated with total, CD4+, and Treg counts at T12, whereas CIT affected only total and CD4+ T cell count. Moreover, recipients receiving kidneys from living donors presented better recovery of all T cell subsets at T12 in comparison with recipients receiving kidneys from cadaveric donors. Patients on peritoneal dialysis had increased numbers of total and CD8+ T cells, as well as NK cells. Finally, estimated glomerular filtration rate was positively correlated with Treg level and potentially CD4+ T cells one-year post transplantation. Conclusions: Successful kidney transplantation results in the recovery of most T cell subsets. Lower recipient age and better graft function contribute to increased T cell counts, whereas donor type and dialysis modality are the most important modifiable factors for optimal immune recovery.

Seven-years post allogeneic hematopoietic stem cell transplantation pure red cell aplastic anemia cured with daratumumab: A case report and review of literature

BACKGROUND Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is currently the only viable method of curing patients with acute myeloid leukaemia. In 30% to 50% of patients, donors and recipients have some level of ABO blood group incompatibility. ABO blood group incompatibility can cause antibodies against the donor's red blood cells to persist in the recipient's body, resulting in a delay of several months in the recovery of red blood cells. A number of different treatments have been reported for post-transplant pure red cell aplastic anaemia (PRCA), such as plasmapheresis, donor lymphocyte infusions, anti-thymocyte globulin, rituximab and steroids. CASE SUMMARY A 41-year-old female diagnosed with acute myeloid leukaemia underwent peripheral blood allogeneic haematopoietic stem cell transplantation in November 2013 from an HLA matched unrelated donor. The donor was AB-positive and the recipient was O-positive. The patient was diagnosed with PRCA three months after receiving the donor stem cell transplant. After failing multiple lines of therapy, the patient applied for daratumumab. After receiving three doses of daratumumab, the patient developed a reticulocyte response and no longer required blood transfusions. CONCLUSION The use of daratumumab anti-CD38 for the remove of plasma cells is safe and effective and may be tried for refractory patients with PRCA after undergoing allo-HSCT for ABO incompatibility.

Clinical outcomes of lung transplant recipients with pre-transplant Mycobacterium avium complex infection.

Lung transplant recipients (LTRs) are at risk for Mycobacterium avium complex (MAC) infections, in part due to the presence of structural lung disease pre-transplant and relatively higher levels of immunosuppression post-transplant. There is a lack of data regarding outcomes of LTR with MAC infections pre-transplant. This is a single-center retrospective analysis of patients who received lung transplants (LTs) from 2013 to 2020 with 1) evidence of MAC on culture or polymerase chain reaction before or at the time of transplant or 2) granulomas on explant pathology and positive acid-fast bacillus stains with no other mycobacteria identified. Patients were deemed to have MAC pulmonary disease (MAC-PD) if they met the American Thoracic Society/Infectious Disease Society of America criteria. Fourteen patients (14/882, 2%) met inclusion criteria. Seven patients (7/14, 50%) had pre-transplant MAC-PD, four of whom had cavitary disease. None of the 14 patients had smear-positive cultures at the time of transplant. Two patients in our cohort received treatment for MAC before transplant. Thirteen patients were bilateral LTR (13/14, 93%). One single LTR was the sole patient to receive MAC treatment post-transplant. No patients developed MAC-PD after transplant. The bilateral LTR in our cohort did not develop MAC-PD despite not receiving MAC treatment post-transplant. It is possible source control was achieved with native lung explantation. Our observations suggest patients may not uniformly require pre- or post-transplant MAC treatment if they are smear-negative and undergo bilateral LT.

Vaccinations in Paediatric Solid Organ Transplant Candidates and Recipients.

Solid organ transplant (SOT) candidates and recipients are a fragile population, in which the presence of a pre-transplant disease leading to organ insufficiency and the post-transplant immunosuppressive treatment expose them to an increased risk of infectious diseases. The best intervention to guarantee efficient prevention of infections, with optimal cost-benefit ratio, is represented by vaccination programs; however, the response to vaccines needs that the immune system maintains a good function. This is even more relevant at paediatric age, when specific immunological conditions make transplant candidates and recipients particularly vulnerable. Paediatric patients may be naïve to most infections and may have incomplete immunization status at the time of transplant listing due to their age. Moreover, the unaccomplished development of a mature immune system and the immunosuppressive regimen adopted after transplant might affect the efficacy of post-transplant vaccinations. Therefore, every effort should be made to obtain the widest vaccination coverage before the transplantation, whenever possible. This review reports the most relevant literature, providing information on the current approach to the vaccinations in paediatric SOT candidates and recipients.

Application of donor predicted heart mass in heart transplant recipients with left ventricular assist device

IntroductionAn association between predicted heart mass (PHM) and post heart transplantation outcomes has been well established; however, there is limited data on the effect of donor PHM on recipients bridged with a durable left ventricular assist device (LVAD). This retrospective observational study seeks to challenge the theoretical benefit of oversizing donor hearts for recipients bridged with LVADs. MethodsAnalysis of the United Network for Organ Sharing (UNOS) database revealed 10,806 adult patients with one of three durable LVADs (HeartMate 2, HeartMate 3 [HM3], HeartWare [HVAD]) between January 1, 2015 and December 31, 2021. Baseline characteristics were compared between seven equally sized groups based on donor-to-recipient PHM. Univariable and multivariable Cox regression analyses were constructed to evaluate the effect of PHM size-matching on the primary outcome of 1-year post-transplant survival. Further analyses were performed specifically on HM3 patients and with PHM as a continuous variable. ResultsMultivariable analysis revealed that severely undersized donor hearts (PHM ratio < 0.86) resulted in worse outcomes with respect to 1-year mortality (HR 1.30; CI 1.03-1.64, p=0.03). There was no significant benefit to oversizing donor hearts. Similar results were found in patients bridged to transplant with HM3. ConclusionSimilar to prior studies on heart transplant recipients, recipients bridged with durable LVAD had worse outcomes when using severely undersized donor hearts. Oversized donor hearts did not significantly improve 1-year mortality, compared to size-matched references. These results were consistent in a subgroup analysis of patients bridged only with HM3 LVADs.

Wrapping stem cells with wireless electrical nanopatches for traumatic brain injury therapy

Electrical stimulation holds promise for enhancing neuronal differentiation of neural stem cells to treat traumatic brain injury. However, once the stem cells leave the stimulating material and migrate post transplantation, electrical stimulation on them is diminished. Here, we wrap the stem cells with wireless electrical nanopatches, the conductive graphene nanosheets. Under electromagnetic induction, electrical stimulation can thus be applied in-situ to individual nanopatch-wrapped stem cells on demand, stimulating their neuronal differentiation through a MAPK/ERK signaling pathway. Consequently, 41% of the nanopatch-wrapped stem cells differentiate into functional neurons in 5 days, as opposed to only 16.3% of the unwrapped ones. The brain injury male mice implanted with the nanopatch-wrapped stem cells and exposed to a rotating magnetic field 30 min/day exhibit significant recovery of brain tissues, behaviors, and cognitions, within 28 days. This study opens up an avenue to individualized electrical stimulation of transplanted stem cells for treating neurodegenerative diseases.

Unraveling the spectrum of airway complications following lung transplantation: a comprehensive overview.

This review delves into the intricate landscape of airway complications post lung transplantation. With the rising prevalence of end-stage lung disease and the increasing number of lung transplantation worldwide, understanding and effectively managing airway complications are crucial. Given the nuanced nature of these complications and the array of treatment options available, this review aims to provide a comprehensive overview of how to identify, classify, mitigate risk factors for, and manage these complications. Several donor, recipient, and surgical risk factors are associated with the increased risk of airway complications. In managing these complications, bronchoscopic interventions, notably balloon dilation and stenting, are pivotal. Although self-expanding metallic stents offer versatility, silicone stents are preferred in certain scenarios for their durability. Emerging techniques such as biodegradable stents and advancing imaging modalities show promise in mitigating complications and improving outcomes. These findings underscore the significance of a multidisciplinary approach and personalized treatment algorithms in managing airway complications post lung transplantation. By elucidating specific indications and complications of treatment modalities, this review serves as a valuable resource for optimally managing airway complications. Ongoing research into novel interventions holds promise for further enhancing outcomes in this challenging clinical setting.

The effect of tocilizumab administration on inflammatory markers in COVID-19 patients

BackgroundThe COVID-19 outbreak was declared a worldwide emergency as a result of its rapid spread. The number of people infected with COVID-19 is increasing rapidly around the world, and pneumonia can develop in COVID-19 cases. The monoclonal antibody tocilizumab blocks the interleukin-6 receptor, which in turn reduces inflammation.Aimof the workThe study aims to determine how tocilizumab affects inflammatory markers, laboratory indices, and oxygen therapy.Subjects and methodsThis retrospective observational study aimed to assess the effect of tocilizumab on inflammatory markers, laboratory parameters, and short-term outcomes in COVID-19 cases. Data was collected from 55 patients with COVID-19 who tested positive for SARS-CoV-2 using PCR. These patients were admitted to Ain Shams University Specialized Hospital—Obour between June 1, 2021, and May 31, 2022.ResultsAfter tocilizumab administration, C-reactive protein levels decreased significantly, but there was no statistically significant change in hemoglobin, serum ferritin, or D-dimer levels. Following tocilizumab administration, the leukocyte counts, and platelet count increased significantly. There was a significant correlation between the presence of comorbidities in the studied patients (e.g., heart failure, post-renal transplantation, and hepatitis C virus) and the risk of mortality. The study's final result showed a significant decrease in platelet count in dead patients compared to discharged patients after receiving tocilizumab. Regarding oxygen therapy following tocilizumab administration, the use of face masks and non-rebreather facemasks was high in dead patients, while nasal prong usage was high in discharged patients. After receiving tocilizumab, there was an increase in the mean liters of oxygen required in dead patients compared to discharged patients.ConclusionAfter administration of tocilizumab in COVID-19 hospitalized patients who have progressing disease, there was highly and significantly decrease in CRP level with no statistically significant alteration in the levels of hemoglobin, serum ferritin, and D-dimer and an increase in TLC and platelets was observed. Following tocilizumab administration, there was a decrease in oxygen demands, an improvement in oxygen therapy and oxygen saturation. Tocilizumab is a recommended therapy option.

The Adolescent Transplant Recipient: An Overview of Neurocognitive Functioning and Implications for Long-Term Outcomes.

Solid organ transplantation (SOT) offers improved long-term survival for youth with end-stage organ disease. From a neurodevelopmental, cognitive, and academic perspective, children with solid organ transplant have a number of unique risk factors. While cognitive functioning may improve post-transplantation, it is important to understand the trajectory of neurocognitive development starting in transplant candidacy to evaluate the implications of early deficits. The aim of this paper is to describe the neurocognitive risks and long-term implications for adolescent transplant recipients. This paper provides an overview of neurocognitive functioning in youth with end-stage organ dysfunction with discussion of implications for adolescent transplant recipients. Post-transplant, adolescent, and young adult solid organ transplant recipients exhibit significant levels of executive dysfunction, with implications for decision-making, regimen adherence, and transition to adult transplant care. Transplantation may reduce the risk for poor long-term neurocognitive effects, yet adolescent transplant recipients remain at increased risk, particularly in executive functioning, which has implications for adherence and transition to adulthood. Baseline and follow-up assessments for youth with end-stage organ disease and transplant are important for the monitoring of neurocognitive development and may be used to mitigate risk for low adherence to post-transplantation treatment regimens and reduce barriers to transitioning to adult transplant care.