Chronic rejection is arguably the main obstacle to long-term graft survival. Yet, clinical trials focusing on this condition are disappointingly scarce. Significant advances in treating chronic rejection cannot happen if there is no conduit for testing novel therapies. Here, we identified the main hurdles holding back clinical trials for chronic rejection and outlined a series of actions to address these roadblocks. We suggest that a new strategic plan combining expertise in basic and clinical research and leveraging complementary resources be launched to specifically target chronic rejection and achieve long-awaited progress. We only need the will.
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http://dx.doi.org/10.1097/TP.0000000000005081 | DOI Listing |
Transplant Proc
January 2025
Respiratory Medicine Department, Lung Transplant Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
Shortened telomere length (STL) is associated with increased rates of interstitial lung diseases, malignancy, hematological disorders, and immunosuppressive treatment toxicities. In this single-center retrospective study, we aim to determine whether patients with interstitial lung diseases who have STL, as determined by quantitative PCR of buccal epithelial cells, exhibit worse post-transplant outcomes compared to recipients with normal telomere length. In our series of 26 patients, STL was associated with a higher incidence of chronic kidney disease following lung transplantation (100% vs 55%, P = .
View Article and Find Full Text PDFBiomaterials
December 2024
School of Biological and Health Systems Engineering, Arizona State University, 550 East Orange St., Tempe, AZ, 85281, USA. Electronic address:
Insulin-secreting allogeneic cell therapies are a promising treatment for type 1 diabetes, with the potential to eliminate hypoglycemia and long-term complications of the disease. However, chronic systemic immunosuppression is necessary to prevent graft rejection, and the acute risks associated with immunosuppression limit the number of patients who can be treated with allogeneic cell therapies. Islet macroencapsulation in a hydrogel biomaterial is one proposed method to reduce or eliminate immune suppression; however, macroencapsulation devices suffer from poor oxygen transport and limited efficacy as they scale to large animal model preclinical studies and clinical trials.
View Article and Find Full Text PDFTransplant Proc
January 2025
Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain. Electronic address:
Background: Antibody-mediated rejection (ABMR) has become one of the leading causes of chronic lung graft dysfunction. However, in lung transplantation, this entity is sometimes difficult and controversial to diagnose. It is mainly caused by the appearance of donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA), although there are situations with C4d deposits in biopsy in the absence of circulating DSA.
View Article and Find Full Text PDFTransplantation
January 2025
Department of Medicine, Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.
Chronic rejection is arguably the main obstacle to long-term graft survival. Yet, clinical trials focusing on this condition are disappointingly scarce. Significant advances in treating chronic rejection cannot happen if there is no conduit for testing novel therapies.
View Article and Find Full Text PDFAm J Obstet Gynecol
December 2024
Department of Gynecology, Obstetrics and Neonatology, General University Hospital in Prague and First Faculty of Medicine, Charles University, Prague, Czech Republic. Electronic address:
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