Hot Off the Press


Reviewed and edited by Enver Akalin, M.D

Natural Antibodies are Associated with Rejection and Long-Term Renal Allograft Loss in a Multicenter International Cohort

Sarah See et al.
Transplantation. ():10.1097/TP.0000000000004472, January 05, 2023
DOI: 10.1097/TP.0000000000004472
This study investigated the role of pre and posttransplant natural immunoglobulin G antibodies (Nabs) reactive to varied antigenic structures, including apoptotic cells to allograft outcome. This is a retrospective, multicenter study including 980 kidney transplant recipients across 4 centers. Baseline sera for 714 of 980 patients were collected at the time of transplant or within 7 d before transplantation, whereas baseline sera for 204 of 980 patients were collected between 7 d to 1 mo before transplantation. Elevated pretransplant Nabs were associated with graft loss (hazard ratio [HR] 2.71; 95% confidence interval [CI], 1.15-6.39; P  =  0.0232), the composite endpoint of graft loss or severe graft dysfunction (HR 2.40; 95% CI, 1.13-5.10; P = 0.0232), and T cell–mediated rejection (odds ratio [OR] 1.77; 95% CI, 1.07-3.02; P = 0.0310). In patients with high pretransplant Nabs, the subsequent development of posttransplant Nabs was associated with both T cell–mediated rejection (OR 3.64; 95% CI, 1.61-8.36; P = 0.0021) and mixed rejection (OR 3.10; 95% CI, 1.02-9.75; P = 0.0473). Finally, elevated pre- and posttransplant Nabs combined with DSAs were associated with increased risk of composite outcomes (HR 3.97; 95% CI, 1.51-10.43; P = 0.0052) and T cell–mediated rejection (OR 7.28; 95% CI, 2.16-25.96; P = 0.0016).

Higher Fasting Pretransplant C-peptide Levels in Type 2 Diabetics Undergoing Simultaneous Pancreas-kidney Transplantation Are Associated With Posttransplant Pancreatic Graft Dysfunction

Sandesh Parajuli et al.
Transplantation. ():10.1097/TP.0000000000004489, January 05, 2023
DOI: 10.1097/TP.000000000000448
This study investigated the relationship between the pretransplant fasting C-peptide level and posttransplant graft function and failure among T2DM patients who have undergone simultaneous pancreas and kidney (SPK) transplants. Patients were categorized into 3 groups: low (≤2 ng/mL), medium (>2–8 ng/mL), and high (>8 ng/mL). There were a total of 76 SPK recipients (low, n = 14; medium, n = 47; high, n = 15). A total of 16 recipients reached the composite outcome of uncensored graft failure (n = 8) or need for anti-diabetic agents (n = 8) posttransplant. None of the recipients in the low C-peptide group reached the composite outcome endpoint, whereas 11 (23.4%) (including 6 uncensored graft failures) in the medium group and 5 (33.3%) (including 2 uncensored) in the high group reached the composite outcome. In a fully adjusted model, each pretransplant C-peptide unit was not associated with an increased risk of the composite outcome, GF, or death-censored composite outcomes. However, in multivariate analysis with limited adjustment, pretransplant C-peptide was associated with the composite outcome (hazard ratio: 1.18, 95% confidence interval, 1.01-1.38; P = 0.03) and death-censored composite outcome (hazard ratio: 1.20; 95% confidence interval, 1.01-1.42; P = 0.03). Although the small sample size, higher levels of pretransplant C-peptide may be associated with inferior posttransplant outcomes that include graft dysfunction.

2023 International Transplantation Science Meeting

The ITS 2023 committee is extending the abstract submission deadline to January 16, 2023 at 23:59 EST due to the general demand from the basic science community.

Transplantation Updates

Transplantation - Highlighted Tweets

Donor-derived cell-free DNA (dd-cfDNA) fraction and quantity have both been shown to be associated with allograft rejection. The present study compared the relative predictive power of each of these variables to the combination of the two, and developed an algorithm incorporating both variables to detect active rejection in renal allograft biopsies.

Adoptive transfer of regulatory T cells (Treg) can induce transplant tolerance in preclinical models by suppressing alloantigen-directed inflammatory responses; clinical translation was so far hampered by the low abundance of Treg with allo-specificity in the peripheral blood.

Transplantation Direct - Highlighted Tweet

Delayed graft function (DGF) is a major complication of deceased donor kidney transplantation. Saline (0.9% sodium chloride) is a commonly used intravenous fluid in transplantation but may increase the risk of DGF because of its high chloride content. Better Evidence for Selecting Transplant Fluids (BEST-Fluids), a pragmatic, registry-based, double-blind, randomized trial, sought to determine whether using a balanced low-chloride crystalloid solution (Plasma-Lyte 148) instead of saline would reduce DGF. We sought to evaluate the generalizability of the trial cohort by reporting the baseline characteristics and representativeness of the trial participants in detail.

In the News 



Staff Directory


The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6