Just Released - Transplantation Direct - June 2023 Issue
The Transplantation Direct June issue is now available online. Organ donation continues to be a hot topic, with a report from a large OPO regarding a systematic approach to decrease donor kidney non-use. Also in kidney transplantation, studies are presented on the highly predictive value of walking ability and brain natriuretic peptide for waitlist removal and serum creatinine (versus biopsy) for predicting antibody-mediated rejection, as well as studies on using antibodies to mask MHC I antigens during ex vivo organ perfusion (pig) in alloimmunized recipients, and key differences regarding presentation and workup of cases of lithiasis versus encrusted pyelitis. In liver transplantation, we have articles on markers distinguishing primary nonfunction from early graft dysfunction, characterization of outcomes and complications with steroid use, and experiences with pure laparoscopic donor right hepatectomy from an experienced Southeast Asian Center. For our lung transplant readership, the use of tixagevimab-cilgavimab in COVID-19+ transplant recipients with breakthrough infections is evaluated, relative versus absolute changes in donor-derived cell-free DNA is compared for diagnosis of acute allograft dysfunction, and a case of postmortem vascular Ehlers Danlos syndrome is reported. In islet transplantation, there is an analysis of cognitive outcomes in recipients. Experimentally, we have an article on the potential role of extracellular vesicle-associated GARP/TGF:LAP production as a mechanism immune tolerance. For further details on all these studies, please visit the Transplantation Direct open-access website!
Transplantation Direct - In Conversation with Matthew Weiss
Last month we published a very special series of articles resulting from an international organ and tissue donation and transplantation legislation and policies forum. We recently caught up with Matthew Weiss to speak about the 2021 Forum and the publications that came out of this important collaboration.
Monoclonal gammopathy of renal significance (MGRS) defines disorders characterized by direct or indirect kidney injury caused by a monoclonal immunoglobulin produced by a B-cell or plasma-cell clone that does not meet current hematologic criteria for therapy. MGRS-associated kidney diseases are diverse and can result in the development of end-stage kidney disease. The current paradigm states that the underlying hematologic condition should be treated and in deep remission before kidney transplantation can be performed because recurrence has been reported for all MGRS-associated kidney diseases.
When discovered in the early 2000s, interleukin-33 (IL-33) was characterized as a potent driver of type 2 immunity and implicated in parasite clearance, as well as asthma, allergy, and lung fibrosis. Yet research in other models has since revealed that IL-33 is a highly pleiotropic molecule with diverse functions. These activities are supported by elusive release mechanisms and diverse expression of the IL-33 receptor, STimulation 2 (ST2), on both immune and stromal cells. Interestingly, IL-33 also supports type 1 immune responses during viral and tumor immunity and after allogeneic hematopoietic stem cell transplantation.
Prolonged-release tacrolimus (PRT) may offer improved outcomes after kidney transplantation compared with immediate-release tacrolimus (IRT). However, data on outcomes beyond 5-y posttransplantation are lacking.
There is limited documentation of hematogenous transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in non–lung transplants from infected donors to uninfected recipients.