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        <title>Transplant International | New and Recent Articles</title>
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        <description>RSS Feed for Transplant International | New and Recent Articles</description>
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        <pubDate>2026-07-09T21:39:29.902+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16830</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16830</link>
        <title><![CDATA[Simultaneous kidney–islet transplantation from a donor after circulatory death using normothermic regional perfusion]]></title>
        <pubdate>2026-07-09T00:00:00Z</pubdate>
        <category>Letter to the Editor</category>
        <author>Laure Esposito</author><author>Orianne Villard</author><author>Thibault Austry</author><author>Christophe Broca</author><author>John Devos</author><author>Guillaume Ducos</author><author>Diane Osinski</author><author>Nelly Puech</author><author>Cedric Idri</author><author>Thibault Boisroux</author><author>Stéphanie Ruiz</author><author>Chloe Medrano</author><author>Thomas Prudhomme</author><author>Mokrane Fatima</author><author>Nassim Kamar</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.17169</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.17169</link>
        <title><![CDATA[Correction: Transplantation of older DCD livers in the machine perfusion era: a U.S. cohort study]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Emmanouil Giorgakis</author><author>Ioannis A. Ziogas</author><author>Dimitrios Moris</author><author>Dimitrios N. Varvoglis</author><author>Charalampos Theocharopoulos</author><author>Dor Yoeli</author><author>Megan A. Adams</author><author>Andrew S. Barbas</author><author>Martin I. Montenovo</author><author>Melissa Chen</author><author>Sorabh Kapoor</author><author>Esteban Calderon</author><author>Andrew M. Moon</author><author>Sasha Deutch-Link</author><author>Hersh Shroff</author><author>Neil D. Shah</author><author>Oren K. Fix</author><author>A. Sidney Barritt</author><author>Amit K. Mathur</author><author>Trevor L. Nydam</author><author>Chirag S. Desai</author><author>Paulo N. Martins</author><author>Andrea Schlegel</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16459</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16459</link>
        <title><![CDATA[Patient perspectives on the ethics and acceptability of perfusion techniques for organ transplantation: a qualitative study]]></title>
        <pubdate>2026-07-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jaden Blazier</author><author>Eline M. Bunnik</author><author>Valerie Kortekaas</author><author>Esther W. de Bekker-Grob</author><author>Maartje H. N. Schermer</author><author>Niels van der Kaaij</author><author>Robert Minnee</author><author>Olivier Manintveld</author><author>Jeroen De Jonge</author><author>Emma K. Massey</author>
        <description><![CDATA[Perfusion technologies preserve and/or improve organ viability by restoring circulation to donor organs either outside the body (machine perfusion, MP) or inside the body of the deceased donor (normothermic regional perfusion, NRP). Ethical debates surrounding perfusion raise questions about its acceptability for transplant recipients. This study explores patient perspectives on perfusion techniques and preferences regarding informed consent. Five online focus groups were conducted with 32 kidney, liver, and heart patients, both pre- and post-transplant. Sessions were analyzed using qualitative content analysis in Atlas.ti. Participants were generally accepting of MP and NRP, valuing clinical benefits. However, they were more hesitant toward NRP due to ethical concerns about post-mortem use of the donor’s body and potential emotional impacts on donor families. Drivers of acceptance were patients’ medical urgency and certainty that donor and donor family were respected. Most participants wanted to receive detailed information about perfusion techniques. While patients were broadly accepting of perfusion techniques, NRP raised more concerns than MP. To ensure ethical implementation and social acceptability as these technologies evolve, patient perspectives should be embedded into perfusion guidelines, informed consent processes, and policy development.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16661</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16661</link>
        <title><![CDATA[Allograft nephrectomy: a systematic review of immunological consequences and management of immunosuppressants]]></title>
        <pubdate>2026-07-03T00:00:00Z</pubdate>
        <category>Systematic Review and Meta-Analysis</category>
        <author>Arnaud Del Bello</author><author>Anna Goujon</author><author>Diana Kassab</author><author>Thomas Prudhomme</author><author>Alexandre Frontczak</author><author>Thibault Culty</author>
        <description><![CDATA[Allograft nephrectomy (AN) is a serious complication of kidney transplantation. Beyond surgical morbidity, AN has important immunological implications. We performed a systematic review to synthesize current evidence on the immunological impact of AN and post-allograft failure immunosuppressive strategies. A systematic review was conducted according to PRISMA guidelines. PubMed/Medline® was searched for studies published from 01/2000 to 03/2026 on transplantectomy indications and surgical techniques. Eligible designs included meta-analyses, randomized trials, and prospective or retrospective studies evaluating the immunological impact of AN and/or immunosuppression management before, during, or after graft removal in adult or pediatric kidney transplant recipients returning to dialysis. Consistent evidence indicates that immunosuppression withdrawal is the principal driver of allosensitization after graft failure. Multiple studies demonstrated marked increases in anti-HLA antibodies following the cessation of immunosuppression, regardless of nephrectomy status. When AN was performed under maintained immunosuppression, its independent effect on sensitization and retransplant outcomes appeared limited. Meta-analyses showed comparable survival after retransplantation, although higher PRA levels, delayed graft function, and acute rejection were more frequent in patients with prior nephrectomy. Allosensitization after graft failure is primarily driven by immunosuppression withdrawal/reduction rather than AN itself. Individualized immunosuppressive management balancing immunological and infectious risks is essential.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16246</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16246</link>
        <title><![CDATA[Undersized lung grafts in chronic obstructive pulmonary disease transplant recipients: risk factor or acceptable compromise?]]></title>
        <pubdate>2026-07-01T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yujiro Kubo</author><author>Juan José Giron</author><author>Guillermo Rodríguez Dávila</author><author>Felipe Alayza Avendaño</author><author>Diletta Mongiello</author><author>Pablo Cordero Iglesias</author><author>Alejandra Romero Román</author><author>Silvana Crowley</author><author>Andrea Mariscal</author><author>José Manuel Naranjo Gómez</author><author>Nuria María Novoa Valentín</author><author>David Gomez-de-Antonio</author>
        <description><![CDATA[Size matching is an important concern during lung allocation for lung transplantation (LTx). Although some mismatch is accepted—often favoring larger grafts for patients with chronic obstructive pulmonary disease (COPD)—the optimal strategy remains unclear. This study evaluated the impact of graft size mismatch on postoperative outcomes in COPD. We retrospectively reviewed 130 of 491 patients who underwent LTx at a single center between January 2013 and December 2023. Patients were classified into three groups based on donor-to-recipient predicted total lung capacity ratio: undersized (<0.9), size-matched (0.9–1.1), and oversized (≥1.1). Donor and recipient characteristics were collected. Primary graft dysfunction (PGD) was the primary endpoint; overall survival was secondary. Of the 130 patients, 17 (13%) received undersized grafts, 67 (52%) size-matched grafts, and 46 (35%) oversized grafts. The undersized group had a lower incidence of PGD at 48 and 72 h than other groups (p < 0.01 and p = 0.02). Grade 3 PGD at 72 h was less frequent among groups (p = 0.03). Overall survival was higher in the undersized group (p = 0.018 and p = 0.045). Oversized grafts may not be optimal for LTx in COPD. Undersized grafts appear to be a viable strategy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.15736</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.15736</link>
        <title><![CDATA[Surgical residents’ career interests in transplantation surgery in Germany – a nationwide survey]]></title>
        <pubdate>2026-07-01T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Aghnia Jolanda Putri</author><author>Karim Bouhadjer</author><author>Arzu Oezcelik</author><author>Silvio Nadalin</author><author>Markus Guba</author><author>Christoph Michalski</author><author>Peri Husen</author>
        <description><![CDATA[The sustainability of transplantation surgery (TS) relies on the ability to attract and retain the next generation of surgeons. This study aims to assess how surgical residents perceive TS as a career pathway in Germany, and to identify barriers in choosing TS as a career. An anonymous 30-item online survey was distributed to surgical residents at all transplant centers registered with the Deutsche Stiftung Organtransplantation (DSO, German Organ Procurement Organization). Quantitative data were analyzed using SPSS (version 29), free-text responses underwent thematic content analysis. Sixty-eight complete surveys were analyzed. TS was considered by 25% of respondents as a subspecialty training. Transplant-specific education was occasional or absent, though desired by >80%. Motivators included personal interest, patient care, and career development, while barriers were structural: lack of defined fellowship programs and limited autonomy during residency. Structured fellowship programs (46%), mentorship (27%) and enhanced operative autonomy (25%) were identified as key factors to encourage recruitment of surgeons in their early career stages. Surgical residents in their early career stages in Germany regard TS as an appealing career option. A structured training framework is a perceived unmet need to enhance recruitment to TS. Transplantation surgery, workforce sustainability, medical education]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16548</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16548</link>
        <title><![CDATA[Landscape of current practices and future perspectives in living donor kidney donation in Europe: proceedings of a pan-European symposium by the European kidney transplant association section of the European Society for Organ Transplantation]]></title>
        <pubdate>2026-07-01T00:00:00Z</pubdate>
        <category>Meeting Report</category>
        <author>Andreas Kousios</author><author>Marije Baas</author><author>Anna Manonelles</author><author>Fernanda Ortiz</author><author>Elvana Rista</author><author>Rachel Thomas</author><author>Carmen Lefaucheur</author><author>Emin Baris Akin</author><author>Lorna Marson</author>
        <description><![CDATA[Living donor kidney transplantation (LDKT) offers superior outcomes for most patients with end-stage kidney disease (ESKD), yet its uptake across Europe remains highly variable. This proceedings article summarizes key themes from a pan-European symposium held in November 2025 in Prague, organized by the European Kidney Transplant Association (EKITA) in collaboration with the DESCaRTES Working Group. Discussions highlighted substantial heterogeneity in LDKT activity across Europe, driven by differences in healthcare capacity, legal frameworks, donor evaluation practices, and access to kidney exchange programmes. Marked inequities persist between regions, particularly in the Balkans and Western Balkans, for women those who are socioeconomically disadvantaged, ethnic minority populations, paediatric and elderly patients and individuals with obesity. The symposium identified wide variation in donor selection criteria, risk assessment, informed consent practices, and long-term donor follow-up, despite existing international guidelines. Emerging strategies to address these challenges include harmonisation of donor evaluation and consent, expansion of paired and cross-border kidney exchange programmes, increased use of unspecified kidney donation, and adoption of innovative surgical and immunological approaches to safely broaden donor eligibility. Advances in outcome measurement, including validated surrogate endpoints, machine learning methods, and integrated, harmonised transplant registries, were discussed as critical tools to improve quality, transparency, and research efficiency. Collectively, the proceedings underscore the need for coordinated clinical, policy, and data-driven solutions to reduce inequities and unlock the full potential of LDKT across Europe, with implications for international transplant practice.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16083</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16083</link>
        <title><![CDATA[Incidence, predictors and outcomes following primary graft dysfunction after cardiac transplantation]]></title>
        <pubdate>2026-06-30T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Isabella Lepore</author><author>Jonatan Oras</author><author>Andreas Wallinder</author><author>Maria Tholén</author><author>Aldina Pivodic</author><author>Göran Dellgren</author>
        <description><![CDATA[Primary graft dysfunction (PGD) is the leading cause of early morbidity and mortality after heart transplantation (HTx). We retrospectively analyzed 830 consecutive HTx performed between 1984 and 2021. After excluding patients <18 years and those with missing data, 667 adult recipients remained. ISHLT PGD criteria were applied and perioperative variables and outcomes were reviewed. PGD occurred in 70 patients (10.5%), including 41 (6.1%) with left ventricular PGD and 29 (4.3%) with right ventricular PGD. Most LV-PGD cases were severe (88%). Patients with PGD were younger and more frequently had pretransplant dialysis, ventricular assist device support, or prior cardiac surgery. No donor-related factors were associated with PGD. Recipient-related factors and longer cardiopulmonary bypass time were associated with increased risk. PGD was associated with prolonged mechanical ventilation and ICU stay, and increased need for mechanical circulatory support, dialysis, reoperation, and treatment for sepsis. Mortality or re-transplantation was significantly higher in PGD patients at 30 days (45% vs. 3%) and 1 year (51% vs. 8%; HR 6.89, 95% CI 4.01–11.83, p < 0.0001).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16462</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16462</link>
        <title><![CDATA[The Bucharest international European Society for Organ Transplantation consensus on paediatric controlled donation after circulatory determination of death]]></title>
        <pubdate>2026-06-30T00:00:00Z</pubdate>
        <category>Consensus Report</category>
        <author>Matthew J. Weiss</author><author>Marion J. Siebelink</author><author>Elena Cavazzoni</author><author>Maria A. Figini</author><author>Yasser Kazzaz</author><author>Silvio Nadalin</author><author>Thomas A. Nakagawa</author><author>Angie Scales</author><author>Beatriz Domínguez-Gil</author><author>Gabriel C. Oniscu</author><author>Umberto Cillo</author><author>Dominique E. Martin</author>
        <description><![CDATA[Paediatric controlled donation after circulatory determination of death (pcDCDD) is a well described pathway for deceased organ donation, but there has been wide variability in global uptake. There are substantial and differing barriers to pcDCDD across countries, including clinical, legal, and ethical issues. This process utilized a Delphi consensus methodology involving 30 international experts to develop recommendations to guide the development and operation of pcDCDD programs. Two survey rounds evaluated agreement on system requirements, donor identification, medical suitability, communication, end-of-life care, and ante-mortem interventions. Consensus recommendations emphasized the need for robust administrative and legal frameworks that explicitly support pcDCDD, multidisciplinary approaches for donor suitability assessment, and normalization of integrating donation into paediatric end-of-life care. The particularities of obtaining consent for both donation and antemortem interventions necessary for pcDCDD for patients that have never expressed a valid intent to donate were addressed. While our findings demonstrated international variability, strong consensus was obtained for multiple recommendations, suggesting the possibility of developing pcDCDD in varied international settings. The process also highlighted areas of knowledge gaps along the pcDCDD process that would benefit from sustained research.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16963</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16963</link>
        <title><![CDATA[Organoids for transplant research]]></title>
        <pubdate>2026-06-29T00:00:00Z</pubdate>
        <category>Special Issue Editorial</category>
        <author>Ekaterine Berishvili</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16481</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16481</link>
        <title><![CDATA[From graft survival to life: redefining success after pediatric liver transplantation]]></title>
        <pubdate>2026-06-24T00:00:00Z</pubdate>
        <category>Point of View</category>
        <author>Geraldine Dahlqvist</author><author>Clara Gautier</author><author>Xavier Stephenne</author>
        <description><![CDATA[Over four decades, pediatric liver transplantation represents a major medical achievement. Graft function and biochemical stability alone no longer define success. Recent data show that only a minority of long-term survivors meet composite criteria for “meaningful” survival, which includes psychological wellbeing, social integration, and treatment adherence. Growing up with a transplant shapes identity, autonomy, and life trajectory. Although many recipients achieve education, employment, and parenthood, patient-reported outcomes reveal persistent psychological distress, reduced health-related quality of life, and ongoing vulnerability. Mental health symptoms, limited health literacy, and gaps in disease understanding may compromise adherence and long-term outcomes. Substance use, while not necessarily more prevalent than in the general population, carries disproportionate risks in this fragile group and underscores the need for early, structured prevention. Transition from pediatric to adult care represents a critical pivotal and formative period, marked by increased risk of nonadherence and graft complications or graft loss, but also a unique opportunity to strengthen autonomy, psychoeducation, and self-management skills. We argue for a paradigm shift toward lifelong, multidisciplinary follow-up integrating psychological screening, structured transition pathways, and sustained health education. Pediatric transplantation has created long-term survivors. The next challenge is to ensure they become informed, autonomous, and psychologically supported adults.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16314</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16314</link>
        <title><![CDATA[Resilience of lung grafts to warm ischemia: assessment by ex vivo perfusion using functional and molecular analysis ]]></title>
        <pubdate>2026-06-24T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Antoine Premachandra</author><author>Florentina Pascale</author><author>Chloé Mimbimi</author><author>Sébastien Jacqmin</author><author>Luc Jouneau</author><author>Christophe Richard</author><author>Valérie Gelin</author><author>Claudia Bevilacqua</author><author>Jérôme Lecardonnel</author><author>Julie Rivière</author><author>Nicolas Bertho</author><author>Delphyne Descamps</author><author>Matthieu Glorion</author><author>Morgan Le Guen</author><author>Isabelle Schwartz-cornil</author><author>Edouard Sage</author>
        <description><![CDATA[To address the shortage of donor lungs, donation after circulatory death with extended warm ischemia (WI) is increasingly used. Normothermic ex vivo lung perfusion (EVLP) allows assessment and rehabilitation of WI lungs. However, the safety limits of WI duration remain unclear due to conflicting preclinical data and variations in clinical protocols across countries. Using a clinically-relevant pig model, we compared paired right (control) and left (WI) lungs from five donors. WI lungs experienced 2-h WI followed by 1-h cold preservation and 6-h EVLP, while control lungs underwent the same protocol without WI. Initial 2-h WI impaired compliance by 32% and increased vascular resistance by 25%, but both parameters normalized during EVLP. Oxidative and mitochondrial stress markers, cytokine release, histological injury, and edema showed no significant difference between control and WI lungs. During EVLP, both control and WI lungs exhibited similar transcriptomic responses in terms of the number of regulated genes (69/96) and their expression levels. Overall, EVLP reversed initial WI-associated functional impairments and led to convergent molecular profiles in WI and control lungs. These findings support the possibility of extending acceptable WI duration thresholds in lung transplantation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16919</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16919</link>
        <title><![CDATA[Joint exposure to plasma heavy metals and the risk of kidney graft failure]]></title>
        <pubdate>2026-06-23T00:00:00Z</pubdate>
        <category>Letter to the Editor</category>
        <author>Yaqin Yang</author><author>Pien Rawee</author><author>Mengjie Song</author><author>Antonio W. Gomes-Neto</author><author>Jacob van den Born</author><author>Martin H. De Borst</author><author>Daan J. Touw</author><author>Stephan J. L. Bakker</author><author>Ron T. Gansevoort</author><author>Michele F. Eisenga</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.17122</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.17122</link>
        <title><![CDATA[Correction: A discrete time simulation model for kidney allocation in Germany]]></title>
        <pubdate>2026-06-23T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Transplant International Production Office </author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16698</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16698</link>
        <title><![CDATA[Postoperative detection of Klebsiella pneumoniae in clinical cultures and recurrent primary sclerosing cholangitis after liver transplantation: a single-center retrospective cohort study]]></title>
        <pubdate>2026-06-22T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jun Ichikawa</author><author>Takashi Ito</author><author>Katsunori Sakamoto</author><author>Shinya Okumura</author><author>Daisuke Ueda</author><author>Tokuyuki Yamashita</author><author>Hiroki Aoyama</author><author>Ryo Ataka</author><author>Satoshi Ogiso</author><author>Kazuyuki Nagai</author><author>Yoichiro Uchida</author><author>Takamichi Ishii</author><author>Etsuro Hatano</author>
        <description><![CDATA[Recurrent primary sclerosing cholangitis (rPSC) remains a significant challenge. Although Klebsiella pneumoniae (Kp) has been implicated in PSC pathogenesis, its association with rPSC remains unclear. We retrospectively analyzed 62 patients who underwent LT for PSC at our institution between 1996 and July 2024 and survived for more than 1 year. We assessed the association between Kp detection in postoperative clinical cultures and rPSC. rPSC was observed in 22 of 62 patients (35.5%). Kp was detected more frequently in the rPSC group than in the non-rPSC group (31.8% vs. 7.5%). In multivariate Cox regression analysis, Kp detection in clinical cultures (Hazard ratio: 3.83, 95% confidence interval: 1.44–10.21, p = 0.007) and identification of three or more bacterial species in clinical cultures (Hazard ratio: 0.31, 95% confidence interval: 0.12–0.78, p = 0.01) were indpendently associated with rPSC. Recurrence-free survival was significantly shorter in patients with Kp detection (10-year recurrence-free survival: 28% with Kp vs. 56.7% without Kp, p = 0.03). These findings suggest a potential association between postoperative Kp detection and rPSC.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.15840</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.15840</link>
        <title><![CDATA[Cold ischemia time exceeding 12 hours is a risk factor for delayed graft function and increased mortality in kidney transplant recipients within the eurotransplant senior program]]></title>
        <pubdate>2026-06-17T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Laura Matuschik</author><author>Lisa André</author><author>Philipp A. Holzner</author><author>Dietrich A. Ruess</author><author>Yakup Tanriver</author><author>Johanna Schneider</author><author>Bernd Jänigen</author>
        <description><![CDATA[With the age of those awaiting kidney transplantation (KTx) increasing, the Eurotransplant Senior Program (ESP) reduces median waiting time by > 1.5 years for patients aged ≥65 compared to standard allocation and doubles life expectancy compared with remaining on dialysis. However, older-donor organs are more vulnerable to prolonged cold ischemia time (CIT). To minimize CIT, both kidneys from one donor are regionally allocated, in our case, to a single transplant center. This study assesses the impact of CIT on delayed graft function (DGF) and long-term outcomes in consecutively transplanted ESP recipients from the same donor. We retrospectively analyzed 208 ESP KTx at Freiburg Transplant Center (1999–2019), focusing on 74 consecutively transplanted kidney pairs (recipients ranked “1” or “2”). DGF incidence was similar for rank 1 and rank 2 recipients. CIT >12 h significantly increased DGF risk versus CIT <8 h (adjusted OR 6.30; 95% CI 1.52–26.06; p = 0.011). Death-censored allograft survival was unaffected, but CIT >12 h tripled mortality risk (adjusted HR 3.19; 95% CI 1.44–7.49; p = 0.005). Consecutive transplantation does not disadvantage the second recipient if CIT remains <12 h. CIT >12 h independently predicts DGF and higher mortality, emphasizing the need to minimize ischemia time.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16406</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16406</link>
        <title><![CDATA[Sex-related differences in survival based on [18F]FDG PET/CT metabolic tumor volume after liver transplantation for colorectal liver metastases]]></title>
        <pubdate>2026-06-16T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Nadide Mutlukoca Stern</author><author>Svein Dueland</author><author>Pål-Dag Line</author><author>Trygve Syversveen</author><author>Harald Grut</author>
        <description><![CDATA[[18F]FDG PET/CT-derived metabolic tumor volume (MTV) is a strong prognostic biomarker in patients undergoing liver transplantation (LT) for non-resectable colorectal liver metastases (nCRLM). This study aimed to evaluate whether MTV-based survival outcomes after LT for nCRLM differ between males and females. Patients who underwent LT for nCRLM between 2006 and 2022 were included (n = 45). Baseline characteristics were compared using the Mann–Whitney U test and Fisher’s exact test. Overall survival (OS), disease-free survival (DFS), and survival after relapse (SAR) were estimated using Kaplan–Meier analysis with the log-rank test. Cox regression analyses including sex, dichotomized MTV, and an interaction term between sex and MTV were performed. Female patients had significantly shorter OS compared with male patients (median 58 vs. 92 months, p = 0.047). Low MTV was associated with significantly longer OS, DFS and SAR in both sexes. Among patients with high MTV, females had significantly shorter OS than males (median 25 vs. 59 months, p < 0.001). Females had more non-pulmonary recurrences than males (p = 0.006) and shorter median SAR than males (17 vs. 46 months, p < 0.001) with high MTV. A significant interaction between sex and MTV was observed, indicating a particularly adverse prognostic impact of high MTV in female patients.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16526</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16526</link>
        <title><![CDATA[Delayed graft function and long-term outcomes after deceased donor kidney transplantation: insights from mate-kidney analysis]]></title>
        <pubdate>2026-06-16T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Oscar A. Garcia Valencia</author><author>Ahmed Zeen Alabedeen Alrifai</author><author>Mohammed Y. Mahgoub</author><author>Girish Mour</author><author>Byron Smith</author><author>Andrew J. Bentall</author><author>Naim S. Issa</author><author>Caroline C. Jadlowiec</author><author>Alexander R. Cortez</author><author>Hatem Amer</author><author>Samy Riad</author>
        <description><![CDATA[Delayed graft function (DGF) is a frequent complication after deceased donor kidney transplantation, yet its long-term impact remains understudied. Heterogeneous populations, short follow-up, and inadequate control of donor-related factors have limited prior studies. Using the Scientific Registry of Transplant Recipients (2005–2024), we evaluated the association between DGF and long-term graft outcomes, including a mate-kidney (same donor, discordant DGF status) analysis to isolate its independent effect. We identified 103,678 dialysis-dependent deceased donor kidney recipients maintained on tacrolimus and mycophenolate. Mixed-effects Cox models, adjusted for donor, recipient, immunologic, and procurement factors. DGF occurred in 30.1% of recipients and was associated with increased death-censored graft failure (HR 1.40; 95% CI 1.33–1.47) and overall graft failure (HR 1.27; 95% CI 1.23–1.31). DGF recipients had higher rejection rates at 6 (6.0% vs. 4.7%) and 12 months (8.9% vs. 7.3%), longer hospital stay, and higher 1-year rehospitalization. In the mate-kidney analysis (6,818 donors), DGF remained strongly associated with death-censored graft failure (HR 1.58; 95% CI 1.39–1.80) and overall graft failure (HR 1.35; 95% CI 1.25–1.46), confirming the independent effect of DGF. DGF is a strong predictor of adverse long-term outcomes irrespective of rejection and warrants targeted prevention strategies and intensified follow-up.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16976</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16976</link>
        <title><![CDATA[Can european law keep pace with biomedical innovation? The reinvention of transplantation regulation]]></title>
        <pubdate>2026-06-16T00:00:00Z</pubdate>
        <category>News and Views</category>
        <author>Olivier Thaunat</author><author>Frank J. M. F. Dor</author><author>Umberto Cillo</author><author>Gabriel C. Oniscu</author><author>Ekaterine Berishvili</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16447</guid>
        <link>https://www.frontierspartnerships.org/articles/10.3389/ti.2026.16447</link>
        <title><![CDATA[Regulatory approach to manipulated organs in Europe: preserving human organs as non-commercial goods ]]></title>
        <pubdate>2026-06-16T00:00:00Z</pubdate>
        <category>Point of View</category>
        <author>Natividad Cuende</author><author>Ander Izeta</author><author>Beatriz Domínguez-Gil</author>
        <description><![CDATA[We welcome the European Commission’s initiative to amend the European Organ Directive within the framework of the proposed Biotech Act, intended to align it with recent scientific and technological advances, particularly organ manipulations aimed at improving transplant outcomes and human health. However, the amendment introduces a definition of organ processing that raises significant regulatory questions, particularly related to the exclusions it contains, which might allow human organs subjected to genetic or enzymatic manipulation to be regulated as medicinal products or as goods under industrial or commercial legal frameworks. The potential consequences of regulating human organs as medicines are reviewed, and awareness is raised of the risk of undermining the altruistic basis of donation and public trust in organ donation and transplantation systems. Moreover, this shift could jeopardise access to this life-saving therapy and threaten the economic sustainability of healthcare systems. Concurrently, potential risks associated with certain forms of manipulation (e.g., genetic modification of organs) must be rigorously assessed before their incorporation into clinical practice. We propose a distinctly European regulatory model that preserves the intrinsic value of human organs, promotes collaboration between medicines and transplant authorities, and enables biomedical innovation through companies providing services and technical solutions to healthcare systems.]]></description>
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