Solid Organ Transplantation Research Articles

Marginal zone B cells are required for optimal humoral responses to allograft

Antibody-mediated rejection (AMR) is among the leading causes of graft failure in solid organ transplantation. However, AMR treatment options are limited by an incomplete understanding of the mechanisms underlying de novo donor-specific antibody (DSA) generation. The development of pathogenic isotype-switched DSA in response to transplanted allografts is typically attributed to follicular B cells undergoing germinal center reaction whereas the contribution of other B cell subsets has not been previously addressed. The current study investigated the role of recipient marginal zone B cells (MZ B cells) in DSA responses using mouse models of heart and renal allotransplantation. MZ B cells rapidly differentiate into antibody-secreting cells in response to allotransplantation. Despite the selective depletion of follicular B cells in heart allograft recipients, MZ B cells are sufficient for T-dependent IgM and early IgG DSA production. Furthermore, the presence of intact MZ B cell subset is required to support the generation of pathogenic isotype-switched DSA in renal allograft recipients containing donor-reactive memory helper T cells. These findings are the first demonstration of the role of MZ B cells in humoral alloimmune responses following solid organ transplantation and identify MZ B cells as a potential therapeutic target for minimizing de novo DSA production and AMR in transplant recipients.

Cure models, survival probabilities, and solid organ transplantation for patients with colorectal cancer

A previous cancer diagnosis can preclude patients from consideration for solid organ transplantation. Statistical models may improve candidate selection. We fitted statistical cure models and estimated 5-year cancer-specific survival (5yCSS) for colorectal cancer patients in the United States using registry data. The median cure probability at cancer diagnosis for patients in the general population was 0.67. Among 956 colorectal cancer patients who underwent solid organ transplantation, the median time since diagnosis was 6.3 years and the median 5yCSS at transplantation was 0.96. Patients with a 5yCSS below 0.90 had increased posttransplant cancer-specific mortality (hazard ratio 3.31, 95% CI 1.52-7.21). Compared with recently published guidelines, our models suggested shorter wait times for some groups of colorectal cancer patients (eg, stage IIA cancers) and longer wait times for others (stages IIB, IIIB, IIIC, IV). In conclusion, colorectal cancer patients undergoing solid organ transplantation had excellent prognoses, reflecting selection incorporating existing guidelines and clinical judgment. Nonetheless, 5yCSS probabilities estimated from cure models offer additional prognostic information for patients considered for transplantation and identify situations where current guidelines might be revised. We developed a web-based tool for clinicians to calculate 5yCSS probabilities for use in transplant evaluation for individual colorectal cancer patients (https://dceg.cancer.gov/tools/risk-assessment/calculator-of-colorectal-cancer-survival-probability).

P.052: Is celulitis always cellulitis? Unusual manifestation of cryptococcosis in solid organ transplantation: A case report.

P.052: Is celulitis always cellulitis? Unusual manifestation of cryptococcosis in solid organ transplantation: A case report.

202.3: Donor-transmitted cancer in organ donation and solid organ transplantation in Germany from 2016-2023.

202.3: Donor-transmitted cancer in organ donation and solid organ transplantation in Germany from 2016-2023.

Donor-derived bartonellosis in solid organ transplant recipients from unhoused donors in Alberta

Bartonella quintana infection is rarely described to be transmitted through solid organ transplant (SOT). We report a cluster of using donor-derived B quintana infection and the attack rate from Bartonella seropositive donors. In this retrospective study of SOT recipients that received an organ from an unhoused deceased donor (UDD) in Alberta in 2022-2023, serology testing for Bartonella was performed indirect immunofluorescent assay on UDDs and recipients of UDDs with positive serology. Titers ≥1:64 were considered positive. During the study period, 31/32 UDDs were tested for immunoglobulin G to Bartonella (20 negative, 11 positive for B quintana and/or B henselae). Thirty-two organs were transplanted from the 11 seropositive donors. Six SOT recipients developed bartonellosis secondary to B quintana (4 SOT recipients received organs from 3 seropositive donors, and 2 SOT recipients from 1 UDD with no stored sample for testing). The attack rate for clinical disease from positive donors was 12.5% (4/32). The main presentation was skin nodules/papules (median 5.5 months) with bacillary angiomatosis in 4/6. Bartonella serology was positive in 5/6 SOT recipients (initially negative in 2) and blood B quintana quantitative polymerase chain reaction in 1. None had visceral involvement. All donors had history of substance use. This outbreak of bartonellosis reinforces the potential for unexpected donor-transmitted infections. Clinicians should be aware of high transmission of B quintana through transplant from infected UDDs.

53054 PD-1 Inhibitor Use for Skin Malignancies in Patients with Solid Organ and Bone Marrow Transplants: Graft Rejection, Treatment Responses, and Survival

53054 PD-1 Inhibitor Use for Skin Malignancies in Patients with Solid Organ and Bone Marrow Transplants: Graft Rejection, Treatment Responses, and Survival

Effectiveness of a video-based intervention in improving skin cancer risk awareness and preventative behaviors among a diverse population of solid organ transplant recipients

Effectiveness of a video-based intervention in improving skin cancer risk awareness and preventative behaviors among a diverse population of solid organ transplant recipients

P.427: The clinical pharmacist interventions among solid organ transplant recipients admitted to ICU.

P.427: The clinical pharmacist interventions among solid organ transplant recipients admitted to ICU.

247.9: Factors influencing the torque teno virus (TTV) viral load in a sizable population of solid organ transplant recipients.

247.9: Factors influencing the torque teno virus (TTV) viral load in a sizable population of solid organ transplant recipients.

P.467: Emerging patterns: Solid organ transplantation trends in India.

P.467: Emerging patterns: Solid organ transplantation trends in India.

302.6: Atypical cervical cytology in solid organ transplantation patients: 20 years of experience in a single center.

302.6: Atypical cervical cytology in solid organ transplantation patients: 20 years of experience in a single center.

243.2: Crowdfunding for solid organ transplants in the United States: A rising trend.

243.2: Crowdfunding for solid organ transplants in the United States: A rising trend.

V-212.5: Candida colonization and candidemia among pediatrics solid organ transplantation: A one year experience.

V-212.5: Candida colonization and candidemia among pediatrics solid organ transplantation: A one year experience.

54425 Intralesional 5-fluorouracil monotherapy for low-risk squamous cell carcinoma in solid organ transplant recipients

54425 Intralesional 5-fluorouracil monotherapy for low-risk squamous cell carcinoma in solid organ transplant recipients

P.152: Respiratory multiplex PCR could predict morbidity and mortality in solid organ transplant patients.

P.152: Respiratory multiplex PCR could predict morbidity and mortality in solid organ transplant patients.

P.432: Short-term outcomes of cardiac surgery in patients with previous abdominal solid organ transplant: A tertiary center experiences.

P.432: Short-term outcomes of cardiac surgery in patients with previous abdominal solid organ transplant: A tertiary center experiences.

P.428: Our experiences with oXiris® hemofilter among solid organ transplant recipients with septic shock in intensive care unit.

P.428: Our experiences with oXiris® hemofilter among solid organ transplant recipients with septic shock in intensive care unit.

P.417: Free microvascular tissue transfers in solid organ transplant candidates and recipients.

P.417: Free microvascular tissue transfers in solid organ transplant candidates and recipients.

P.151: Multinational, retrospective study assessing treatment patterns, outcomes, and healthcare resource utilization in solid organ transplant recipients with cytomegalovirus infection and intolerance to anti-cytomegalovirus treatments.

P.151: Multinational, retrospective study assessing treatment patterns, outcomes, and healthcare resource utilization in solid organ transplant recipients with cytomegalovirus infection and intolerance to anti-cytomegalovirus treatments.

V-112.2: A systematic review and meta-analysis on the effects of antiviral prophylaxis in preventing posttransplant lymphoproliferative disease in solid organ transplant recipients.

V-112.2: A systematic review and meta-analysis on the effects of antiviral prophylaxis in preventing posttransplant lymphoproliferative disease in solid organ transplant recipients.