Transplantology | Issue Cover Collection Published in 2024
We are delighted to present a list of Issue Cover Articles selected for display in volume 5 of Transplantology (ISSN: 2673-3943). These articles cover a wide range of topics, including rare diseases, neuromuscular diseases, cardiovascular genetics in clinical practice, diagnostic methods and sequencing studies, etc. We hope you will find something of interest among these exceptional publications.
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1. “Pre-Emptive Kidney Retransplantation from Deceased Donors” Cover Story: There is uncertainty about the best approach to replacement treatment for kidney transplant recipients with chronic terminal graft dysfunction, since a retransplant could be performed before resuming dialysis and a dilemma exists regarding the discontinuance of immunosuppressive therapy. On the one hand, this group of patients represents a high-risk group upon returning to dialysis, since they have greater morbidity and mortality in the first months due to infectious and cardiovascular causes if the immunosuppression is maintained. On the other hand, those recipients in whom immunosuppression is withdrawn are more likely to develop sensitization and subsequently less likely to have a successful retransplantation; moreover, they often develop graft intolerance syndrome. |
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2. “Robotic Surgical Techniques in Transplantation: A Comprehensive Review” Cover Story: In the field of surgery, the performance of organ transplants in a minimally invasive manner has always represented a significant technical challenge. The advent of the robotic approach has enhanced the ease with which highly complex surgical procedures that demand high levels of technical skill are performed. Furthermore, robotic transplants are significantly improving patient outcomes, particularly in the obese population. The purpose of this review is to provide an overview of the current state of robotics applications for transplant surgery. Kidney transplants were the first to be performed using a fully robotic approach. |
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3. “The Impact of Alloantibodies on Clinical VCA Outcomes and the Need for Immune Tolerance” Cover Story: Vascularized composite allotransplantation has achieved superior outcomes compared to standard reconstructive surgical techniques. However, the long-term use of immunosuppressive medications necessary to control rejection results in significant post-transplant morbidity and mortality. Despite prolonged immunotherapy, donor-specific antibodies often develop, leading to chronic rejection and delayed graft failure. Thus, developing safe and effective tolerance strategies is crucial. This review examines recent findings on alloantibody-mediated rejection in clinical VCAs and emphasizes the need for tolerance-inducing approaches that could significantly enhance graft outcomes and patient quality of life. |
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4. “Outcomes of Simultaneous Liver–Kidney Transplant Recipients According to Pre-Transplant Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the United States” Cover Story: Portal hypertension, a common consequence of cirrhosis, significantly impacts morbidity and mortality. Transjugular intrahepatic portosystemic shunt (TIPS) is frequently used as a bridge to liver transplant. It alleviates severe portal hypertension complications by shunting blood from the portal vein to systemic circulation. In patients with cirrhosis and advanced kidney dysfunction, simultaneous liver and kidney transplantation (SLK) offers substantial survival benefits. SLK candidates with TIPS may be sicker and more sensitized due to higher blood transfusion needs. TIPS can worsen pulmonary hypertension, a predictor of poor transplant outcomes. This study examines long-term outcomes of SLK recipients based on TIPS status, using data from the Scientific Registry of Transplant Recipients for comprehensive tracking of graft and recipient survival. |