1. Trends in the epidemiology of paediatric kidney transplantation in Europe between 2010 and 2021 : an ESPN/ERA Registry studyIris R. Montez de Sousa, Ann Christin Gjerstad, Augustina Jankauskiene, Brankica Spasojević-Dimitrijeva, Burkhard Tönshoff, Cyrielle Parmentier, Diamant Shtiza, Varvara Askiti, György Reusz, Gregor Novljan, 2026, izvirni znanstveni članek Povzetek: Background. Kidney transplantation (KT) is the preferred treatment for paediatric patients with kidney failure, but information on trends in paediatric KT in Europe is lacking. We aimed to report on time trends in paediatric (0–17 years) KT rates and recipient characteristics in Europe between 2010 and 2021. Methods . Thirty-one countries contributing data from 2010 to 2021 on paediatric KT to the European Society for Paediatric Nephrology/European Renal Association Registry were included. We reported trends in KT rates [per million age-related population (pmarp)], overall and by patient subgroup for Europe, and at macro-economic and country-specific levels. We also reported clinical variables in the first year post-KT. The 2020–21 period was analysed separately to account for the COVID-19 pandemic. Results . The paediatric KT rate was stable at ≈5 pmarp between 2010 and 2019, and about one-fourth were pre-emptive KTs. In 2020–21 the KT rate was 5.6 pmarp. In low–, middle– and high–gross domestic product (GDP) countries, KT rates (pmarp) were 2.1, 6.1 and 7.6, respectively, and increased in low-GDP countries by 4.1% per year from 2010 to 2019, mainly in the youngest recipients. The proportion of pre-emptive KT increased only in middle-GDP countries. Low-GDP countries showed a higher prevalence of short stature while high-GDP countries showed more overweight/obese, hypertensive and anaemic patients. Conclusions . The rate of paediatric KT in Europe has remained stable, with differences between GDP groups. Low-GDP countries had the lowest KT rates, but with an increasing trend over time. Opportunities to further increase access to paediatric KT should be explored.
Ključne besede: epidemiology, Europe, kidney transplantation, trends
Objavljeno v DiRROS: 19.03.2026; Ogledov: 41; Prenosov: 25
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2. Robot-assisted lateral pancreaticojejunostomy in a patient with chronic pancreatitis and history of liver transplantationBoštjan Plešnik, Jan Grosek, Blaž Trotovšek, Aleš Tomažič, Miha Petrič, 2026, drugi znanstveni članki Povzetek: A 52‑year‑old female patient with a history of liver transplantation due to alcoholic liver cirrhosis presented with persistent post‑prandial pain, leading to substantial weight loss of 16 kg. The findings of contrast‑enhanced computed tomography were consistent with the diagnosis of chronic pancreatitis, and endoscopic treatment provided no functional improvement. The patient was scheduled for a robot‑assisted lateral pancreaticojejunostomy which was performed after initial lysis of adhesions from her prior liver transplantation. The procedure was completed safely using the robotic da Vinci Xi platform in 180 min, with an estimated blood loss of 300 mL. During the post‑operative course, anaemia was noted and treated with a blood transfusion, and the patient was discharged on the post‑operative day 4. The patient fully recovered without post‑prandial pain and began regaining weight 1 month after the procedure. To the best of our knowledge, this is the first report of a successful robot‑assisted lateral pancreaticojejunostomy following prior liver transplantation.
Ključne besede: robotic surgery, lateral pancreaticojejunostomy, chronic pancreatitis, liver transplantation
Objavljeno v DiRROS: 16.03.2026; Ogledov: 107; Prenosov: 61
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3. Long-term outcome after combined or sequential liver and kidney transplantation in children with infantile and juvenile primary hyperoxaluria type 1Sebastian Loos, Markus J. Kemper, Kaja Schmaeschke, Uta Herden, Lutz Fischer, Bernd Hoppe, Tanja Kersnik-Levart, Enke Grabhorn, Raphael Schild, Jun Oh, 2023, izvirni znanstveni članek Povzetek: Introduction: Combined or sequential liver and kidney transplantation (CLKT/SLKT) restores kidney function and corrects the underlying metabolic defect in children with end-stage kidney disease in primary hyperoxaluria type 1 (PH1). However, data on long-term outcome, especially in children with infantile PH1, are rare. Methods: All pediatric PH1-patients who underwent CLKT/SLKT at our center were analyzed retrospectively. Results: Eighteen patients (infantile PH1 n=10, juvenile PH1 n = 8) underwent transplantation (CLKT n=17, SLKT n = 1) at a median age of 5.4 years (1.5–11.8). Patient survival was 94% after a median follow-up of 9.2 years (6.4–11.0). Liver and kidney survival-rates after 1, 10, and 15 years were 90%, 85%, 85%, and 90%, 75%, 75%, respectively. Age at transplantation was significantly lower in infantile than juvenile PH1 (1.6 years (1.4–2.4) vs. 12.8 years (8.4–14.1), P = 0.003). Median follow-up was 11.0 years (6.8–11.6) in patients with infantile PH1 vs. 6.9 years (5.7–9.9) in juvenile PH1 (P = 0.15). At latest follow-up kidney and/or liver graft loss and/or death showed a tendency to a higher rate in patientswith infantile vs. juvenile PH1 (3/10 vs. 1/8, P=0.59). Discussion: In conclusion, the overall patient survival and long-term transplant outcome of patients after CLKT/SLKT for PH1 is encouraging. However, results in infantile PH1 tended to be less optimal than in patients with juvenile PH1.
Ključne besede: hyperoxaluria, infantile, juvenile, transplantation, outcome
Objavljeno v DiRROS: 10.03.2026; Ogledov: 130; Prenosov: 105
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5. A cross-sectional study of the role of epithelial cell injury in kidney transplant outcomesPhilip F. Halloran, Jessica Chang, Martina Mackova, Katelynn Madill-Thomsen, Enver Akalin, Tarek Alhamad, Sanjiv Anand, Miha Arnol, Rajendra Baliga, Mirosław Banasik, Nika Kojc, Željka Večerić-Haler, 2025, izvirni znanstveni članek Povzetek: Background: Expression of acute kidney injury-associated (AKI-associated) transcripts in kidney transplants may reflect recent injury and accumulation of epithelial cells in "failed repair" states. We hypothesized that the phenomenon of failed repair could be associated with deterioration and failure in kidney transplants. Methods: We defined injury-induced transcriptome states in 4,502 kidney transplant biopsies injury-induced gene sets and classifiers previously developed in transplants. Results: In principal component analysis (PCA), PC1 correlated with both acute and chronic kidney injury and related inflammation and PC2 with time posttransplant. Positive PC3 was a dimension that correlated with epithelial remodeling pathways and anticorrelated with inflammation. Both PC1 and PC3 correlated with reduced survival, with PC1 effects strongly increasing over time whereas PC3 effects were independent of time. In this model, we studied the expression of 12 "new" gene sets annotated in single-nucleus RNA-sequencing studies of epithelial cells with failed repair in native kidneys. The new gene sets reflecting epithelial-mesenchymal transition correlated with injury PC1 and PC3, lower estimated glomerular filtration rate, higher donor age, and future failure as strongly as any gene sets previously derived in transplants and were independent of nephron segment of origin and graft rejection. Conclusion: These results suggest 2 dimensions in the kidney transplant response to injury: PC1, AKI-induced changes, failed repair, and inflammation; and PC3, a response involving epithelial remodeling without inflammation. Increasing kidney age amplifies PC1 and PC3.
Ključne besede: molecular diagnosis, nephrology, organ transplantation, transplantation
Objavljeno v DiRROS: 09.03.2026; Ogledov: 142; Prenosov: 58
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6. Is salvage autologous stem cell transplantation still a viable treatment option in relapsed myeloma patients?Luka Čemažar, Matevž Škerget, Barbara Skopec, 2025, izvirni znanstveni članek Povzetek: Background and Objectives: The role of salvage autologous stem cell transplantation (SAT) in relapsed multiple myeloma (MM) has been increasingly questioned, particularly with the emergence of novel immunotherapies and cellular therapies. This study aimed to evaluate the efficacy of SAT in a cohort of patients with relapsed MM following their first autologous stem cell transplantation (ASCT). Materials and Methods: A retrospective analysis was conducted on 78 patients from our institutional registry who underwent SAT for relapsed MM between April 2008 and October 2023. The primary endpoint was the progression-free survival (PFS), with secondary endpoints including the overall survival (OS) and overall response rates (ORRs) on day +100 after SAT. Results: The median age of the patients was 62 years (range: 48–78), and 32% were female. Most patients (81%) received reinduction therapy before SAT. The median PFS and OS from SAT were 24 months (95% CI: 20–36) and 76 months (95% CI: 48-NR), respectively. The ORR was 85%, and 65% achieved at least a very good partial response (VGPR). No significant differences in the PFS were found between subgroups based on the maintenance following SAT (hazard ratio (HR) = 0.93, 95% CI: 0.48–1.8, p = 0.831), cytogenetic risk (standard vs. high-risk) (HR = 0.98, 95% CI: 0.49–1.99, p = 0.969), age (<60 years vs. ≥60 years) (HR = 0.96, 95% CI: 0.5–1.85, p = 0.912) or number of prior treatment lines (<3 vs. ≥3) (HR = 0.186, 95% CI: 0.95–3.61, p = 0.069). The duration of remission after the first ASCT did not influence the PFS or OS following SAT (HR = 1.63, 95% CI: 0.78–3.39, p = 0.193 and HR = 1.2, 95% CI: 0.46–3.09, p = 0.7130). Conclusions: Salvage autologous stem cell transplantation remains a viable treatment option for patients with relapsed MM, particularly in resource-limited countries or for patients who prefer short, fixed-duration therapy. However, as is known from previous studies, maintenance therapy is crucial for achieving longer PFS. In this study, no statistically significant factors were identified to predict the benefit, underscoring the need for further research to optimize patient selection.
Ključne besede: salvage autologous stem cell transplantation, relapsed multiple myeloma
Objavljeno v DiRROS: 09.03.2026; Ogledov: 109; Prenosov: 62
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7. Advancing allogeneic hematopoietic stem cell transplantation outcomes through immunotherapy : a comprehensive review of optimizing non-CAR donor T-lymphocyte infusion strategiesStefania Braidotti, Marilena Granzotto, Debora Curci, Barbara Faganel Kotnik, Natalia Maximova, 2024, pregledni znanstveni članek Povzetek: Optimized use of prophylactic or therapeutic donor lymphocyte infusions (DLI) is aimed at improving clinical outcomes in patients with malignant and non-malignant hematological diseases who have undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). Memory Tlymphocytes (CD45RA−/CD45RO+) play a crucial role in immune reconstitution post-HSCT. The infusion of memory T cells is proven to be safe and effective in improving outcomes due to the enhanced reconstitution of immunity and increased protection against viremia, without exacerbating graft-versus-host disease (GVHD) risks. Studies indicate their persistence and efficacy in combating viral pathogens, suggesting a viable therapeutic avenue for patients. Conversely, using virus-specific T cells for viremia control presents challenges, such as regulatory hurdles, cost, and production time compared to CD45RA-memory T lymphocytes. Additionally, the modulation of regulatory T cells (Tregs) for therapeutic use has become an important area of investigation in GVHD, playing a pivotal role in immune tolerance modulation, potentially mitigating GVHD and reducing pharmacological immunosuppression requirements. Finally, donor T cell-mediated graft-versus-leukemia immune responses hold promise in curbing relapse rates post-HSCT, providing a multifaceted approach to therapeutic intervention in high-risk disease scenarios. This comprehensive review underscores the multifaceted roles of T lymphocytes in HSCT outcomes and identifies avenues for further research and clinical application
Ključne besede: hematopoietic stem cell transplantation, T lymphocyte, memory T cells, virus-specific T cells, graft-versus-host disease, graft-versus-leukemia
Objavljeno v DiRROS: 26.02.2026; Ogledov: 168; Prenosov: 67
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8. Prognostic factors and survival outcomes of first CNS relapse in childhood acute lymphoblastic leukemia : results from the ALL-IC REL 2016 studyVolkan Hazar, Monika Makiya, Koray Yalçın, Juan Tadecilla Cadiu, Federico Manni, Andrea Reyes Barragan, Marko Kavčič, Tomaž Prelog, Janez Jazbec, 2026, izvirni znanstveni članek Povzetek: Acute lymphoblastic leukemia (ALL) is among the most curable pediatric cancers, yet relapse involving the central nervous system (CNS) remains a major therapeutic obstacle. In this prospective cohort, 97 children (aged 1.1–18.2 years) experiencing their first CNS relapse were enrolled in the ALL-IC REL study. Relapses were classified as isolated CNS (i-CNS, n = 43) or combined CNS (c-CNS, n = 54), and patients received treatment through standard- or high-risk regimens, encompassing chemotherapy, cranial irradiation, and allogeneic stem cell transplantation. The estimated 2-year event-free survival was 40.0%, and overall survival 49.4%, closely matching outcomes reported internationally. Survival rates were comparable across i-CNS and c-CNS relapses, while induction failure occurred more frequently in c-CNS. Multivariable analysis identified female sex, T-cell phenotype, and very early relapse as independent predictors of poor prognosis. These results underscore the critical necessity for risk-adapted therapy techniques and the incorporation of innovative medicines into forthcoming procedures.
Ključne besede: childhood, acute lymphoblastic leukemia, central nervous system relapse, prognostic factors, survival, hematopoietic stem cell transplantation
Objavljeno v DiRROS: 24.02.2026; Ogledov: 216; Prenosov: 72
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9. Invasive aspergillosis in liver transplant recipients in the current eraMuneyoshi Kimura, Matteo Rinaldi, Sagar Kothari, Maddalena Giannella, Shweta Anjan, Tereza Rojko, Marija Ribnikar, 2024, izvirni znanstveni članek Povzetek: Invasive aspergillosis (IA) is a rare but fatal disease among liver transplant recipients (LiTRs). We performed a multicenter 1:2 case-control study comparing LiTRs diagnosed with proven/probable IA and controls with no invasive fungal infection. We included 62 IA cases and 124 matched controls. Disseminated infection occurred only in 8 cases (13%). Twelve-week all-cause mortality of IA was 37%. In multivariate analyses, systemic antibiotic usage (adjusted odds ratio [aOR], 4.74; P ¼.03) and history of pneumonia (aOR, 48.7; P ¼ .01) were identified as independent risk factors associated with the occurrence of IA. Moreover, reoperation (aOR, 5.99; P ¼.01), systemic antibiotic usage (aOR, 5.03; P ¼.04), and antimold prophylaxis (aOR, 11.9; P ¼.02) were identified as independent risk factors associated with the occurrence of early IA. Among IA cases, Aspergillus colonization (adjusted hazard ratio [aHR], 86.9; P <.001), intensive care unit stay (aHR, 3.67; P ¼.02), disseminated IA (aHR, 8.98; P <.001), and dialysis (aHR, 2.93; P ¼.001) were identified as independent risk factors associated with 12-week all-cause mortality, while recent receipt of tacrolimus (aHR, 0.11; P ¼ .001) was protective. Mortality among LiTRs with IA remains high in the current era. The identified risk factors and protective factors may be useful for establishing robust targeted antimold prophylactic and appropriate treatment strategies against IA.
Ključne besede: invasive aspergillosis, liver transplantation, targeted antifungal prophylaxis
Objavljeno v DiRROS: 23.02.2026; Ogledov: 195; Prenosov: 76
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10. Chronic lung allograft dysfunction after lung transplantation : prevention, diagnosis and treatment in 44 European centresJens Gottlieb, Robin Vos, Peter Jaksch, Merel Hellemons, Are Martin Holm, Letizia Corinna Morlacchi, Matevž Harlander, 2025, izvirni znanstveni članek Povzetek: Background: There are limited data on optimal management of chronic lung allograft dysfunction (CLAD). We aimed to describe the variability of diagnostic and therapeutic practices in Europe. Methods: A structured questionnaire was sent to 71 centres in 24 countries. Questions were related to contemporary clinical practices for workup, monitoring and treatment of CLAD. The number of lung transplant procedures and patients in follow-up were collected. Results: 44 centres (62%) responded from 20 countries, representing 74% of European activity. The prevalence of CLAD was estimated at 9.1 cases per million population (25th and 75th percentiles of 4.4, 15.7). Preferred initial workup for probable CLAD consisted of chest computed tomography (CT) (inspiratory 91% and expiratory 74%), donor-specific antibody (DSA) measurement (86%), bronchoalveolar lavage (BAL) (85%) and transbronchial biopsy (81%). For monitoring of definite CLAD, inspiratory CT (67%), DSA (61%) and BAL (43%) were preferred. Body plethysmography was unavailable for 16% of cases. Prophylaxis was based on preventing infections (cytomegalovirus 99%, inhaled antibiotics 70% and antifungals 65%), tacrolimus-based immunosuppression (96%), azithromycin (72%) and universal proton pump inhibitor treatment (84%). First-line treatment of CLAD was based on azithromycin (82%) and steroid augmentation (74%). Photopheresis was used in 26% of cases. Conclusion: Current European practice CLAD detection is based on spirometry, inspiratory CT and DSA, with limited access to plethysmography and expiratory CT. Prophylactic treatment is based on azithromycin, tacrolimus-based immunosuppression and treatment of risk factors. No single treatment strategy is universally used, highlighting the need for an effective treatment of CLAD. The preferred firstline strategy is azithromycin and steroid augmentation.
Ključne besede: lung transplantation, rejection, CLAD, chronic lung allograft dysfunction
Objavljeno v DiRROS: 18.12.2025; Ogledov: 286; Prenosov: 179
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