To date, all large-scale randomized controlled trials for COVID-19 vaccines have excluded solid organ transplant recipients; therefore, the effectiveness and safety of COVID-19 vaccines in preventing coronavirus infection using COVID-19 vaccines in patients with heart transplants have not been sufficiently studied. This paper presents the characteristics of humoral and cellular immunity in heart transplant recipients following vaccination against coronavirus infection. The study group consisted of 40 patients who underwent orthotopic heart transplantation between 2019 and 2014. They were vaccinated twice with the Vero Cell vaccine (China) or received a 3-dose vaccination with Gam-COVID-Vac (Sputnik V, Russia) booster. 63% of vaccinated individuals with no previous COVID-19 history and 85% of patients with a history of COVID-19 were to develop humoral post-vaccination immunity. The humoral response in patients who seroconverted before vaccination showed high level of virus-specific IgG antibodies to SARS-CoV-2 S protein during the post-vaccination period, with a statistically increase observed 9-12 months after the booster. The specific cellular response to the SARS-CoV-2 S and N proteins remained low throughout the entire follow-up period, and was recorded in 5-40% of heart transplant recipients. A significantly increased number of S- and N-specific T cells was observed 4-6 months after the secondary immunization. Starting from 21-28 days after the primary vaccination and continuing for a year after the booster, increased plasmablasts (CD27highCD38high B cells) were observed, correlating with neutralizing and spike-specific antibodies. In heart transplant recipients, vaccination against coronavirus infection does not result in increased serum autoantibodies (RF-IgG and IgA-RF, anti-SSR, cardiolipin IgG, β2-glycoprotein IgG, ANA, ANCA-Pro, anti-SLA/LP, anti-GD-IgA). In our study, vaccinated heart transplant recipients with a history of coronavirus infection showed an increased level of anti-IFN-α antibodies for 9-12 months after the basic vaccination. This finding, when associated with HLA alleles, must be taken into account for identifying patients at a potential risk of a severe disease.

Graft rejection, early allograft dysfunction (EAD), and poor diagnostic accuracy are some of the challenges that still need to be addressed, even though liver transplantation (LT) has the potential to help patients with end-stage liver disease (ESLD) significantly. Traditional procedures, such as liver biopsies and liver function tests (LFTs), often fail to identify abnormalities early and with accuracy. Genomic RNA sequencing (RNA-Seq) has recently emerged as a powerful approach for identifying molecular markers of immune activity and graft healing. This study provides a comprehensive review of the current achievements in RNA-Seq applications for liver transplantation by comparing biomarker profiles of liver biopsies and peripheral blood mononuclear cells (PBMCs). We highlight the success and challenges of integrating RNA-seq into clinical processes by critically examining its consistency, diagnostic importance, and translational potential. Furthermore, we evaluated the possibility of novel diagnostic algorithms and multi-omics techniques for improving early diagnosis, risk profiling, and personalized immunosuppression. This study highlights the gaps in cross-cohort repeatability, clinical validation, and standardization to improve long-term transplant outcomes. This highlights the need for integrated multicenter approaches driven by biomarkers and provides recommendations for further studies.

Tissue engineering offers alternatives when it comes to health problems such as trauma or pathologies. One of them is the scaffolds, which provide a favorable architecture, mechanics, and biocompatibility for the fixation of cells. Therefore, the following research aims to design and simulate scaffolds with mixed geometric structures to create a hybrid architecture for osseointegration while maintaining structural properties similar to subchondral bone and hyaline cartilage. Three scaffolds were designed for this purpose, with mixed geometric shapes inside: squares for trabecular bone, hexagons for subchondral bone, and octagons for hyaline cartilage, each with a specific pore size according to the architecture and biomechanics of each tissue. SolidWorks computer-aided design software to design unit cells for each particular tissue, followed by the Ansys Workbench integrated simulation platform to simulate the loads produced by an average-weight adult typically used in walking. We used two specific materials (Hydroxyapatite and Vitreous Humor with sodium alginate) that are part of the hydrogel for its possible future use in the 3D printing of these models. Different results were obtained from the models presented. Still, the truncated pore and gradual pore models were found to be close to the actual parameters for subchondral bone and cartilage, respectively, giving Young's modulus of 1049.5124 MPa in the subchondral bone region and 9.4086 MPa in the cartilage region. Therefore, we concluded that combining the architectures of these two models into one offered the possibility of creating a scaffold capable of mimicking the osteochondral complex.

To evaluate the bleeding risk associated with anticoagulation (AC) in kidney transplant patients with post-operative atrial fibrillation (AF). We conducted a retrospective analysis of all adult kidney transplant recipients performed from October 2012 to February 2019 at our institution, the University of North Carolina at Chapel Hill, which accounted for 428 transplants. Variables assessed included AF occurrence, AC use, bleeding complications, stroke and bleeding risk stratification in AF (determined using CHA<sub>2</sub>DS<sub>2</sub>-VASc and HAS-BLED scores respectively), and renal function. Adjusted odds ratios, relative risk and linear estimates and their 95% confidence intervals and corresponding p-values were estimated to identify risk factors of interest using multivariate logistic regression and generalized linear and linear models. Of the 428 kidney transplant patients analyzed, 6.8% (n = 29) developed AF, and 51.7% (n = 15) of these patients received AC. Among those on AC, 73.3% (n = 11) experienced bleeding complications, and 36.4% (n = 4) required medical intervention. AC use was associated with higher odds of post-transplant interventions (OR = 4.62, 95% CI: 1.63-13.13, p = 0.0041), including a return to surgery (OR = 7.34, 95% CI: 2.32-23.25, p = 0.0007). Higher HAS-BLED scores correlated with increased odds of intervention (OR = 1.61, 95% CI: 1.1-2.36, p = 0.0143). Patients on AC also had higher creatinine levels at discharge and increased odds of delayed graft function (OR = 3.27, 95% CI: 1.45-7.35, p = 0.0042), longer hospital stays, and increased readmission rates. No patients developed a stroke during follow-up. Kidney transplant recipients with AF who receive AC face substantial bleeding risks. While CHA<sub>2</sub>DS<sub>2</sub>-VASc and HAS-BLED scores are valuable for assessing patients with AF, they may be inadequate for managing AF in post-kidney transplant or post-surgical settings. This study is the first to evaluate the risk of AC and early post-operative bleeding in kidney transplant recipients with new-onset AF.

This study was designed to investigate the ability of telemonitoring involving a secure electronic database called “Alsayed System for Applied Medical-Care Improvement” (ASAMI) to detect at least 95% of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This prospective observational study, which took place over 16 months in 2022-2023, was based at a medical center in Jordan. The study group participants were patients with COPD (from seven countries) with mixed levels of airflow limitation severity, and every participant was followed for six months. A customized, password-protected version of ASAMI was used to collect data during the study. The implemented diary included questions on daily symptoms such as cough, dyspnea, sputum, and daily physical activities. The detection of AECOPD events was initially based on daily questionnaires completed by patients, followed by the assessment of a healthcare practitioner. Eighty-seven participants were monitored for AECOPD. During the study, 78/87 (89.7%) patients presented with one or more exacerbation episodes. The mean (range) age was 59.7 (45-81) years, predominantly male (66%), with moderate airflow limitation (n = 42, 48%). Compliance with the provision of daily symptom data was very high, 98% over the entire study period. A total of 189 confirmed AECOPD episodes were reported. Almost all patients and practitioners showed favorable satisfaction with the role of the ASAMI-related service (96% reported a score of 10 satisfaction). The telemonitoring tool was able to detect 99% of AECOPD episodes. The novel ASAMI software was effective as a telemonitoring tool to detect the episodes of AECOPD. The tool was suggested for daily, continuous reporting of respiratory symptoms, with the key benefits being ease of use, patient acceptance, and collation of supplementary data when exacerbations occur. The effects of its widespread use on decision-making can be clarified by evaluating its impact on routine clinical decision-making.

COVID-19 has presented considerable health hazards, particularly for immunocompromised persons, such as kidney transplant recipients. This population experiences increased susceptibility due to the immunosuppressive treatments necessary to avert organ rejection, potentially resulting in a diminished immune response to immunizations. The implementation of COVID-19 vaccinations has been essential in alleviating these dangers. Studies demonstrate differing levels of vaccine efficacy among kidney transplant recipients, underscoring the necessity for customized vaccination approaches. This assessment appraises the safety, effectiveness, and immunological responses of COVID-19 vaccinations in kidney transplant recipients, highlighting the significance of educated vaccination policies. Comprehending these processes is crucial for enhancing COVID-19 protection in this high-risk population and guiding continuous public health initiatives.

LIDSEN series of journals are published by LIDSEN Publishing Inc, a non-profit scholarly Open Access publisher focused on biological, biomedical and medical studies. We aim to select ground-breaking research based on novelty, timeliness, scientific significance, potential audience interests, etc. We strive to provide an easily and freely accessible platform to researchers and practitioners in support of their novel and valuable ideas.

Thrombotic Microangiopathy (TMA) is a syndrome characterized by microangiopathic hemolytic anemia (MAHA) and thrombocytopenia. The presence of schistocytes on peripheral smear, a negative Coombs test, elevated lactate dehydrogenase, increased reticulocyte count and low haptoglobin are often the clues for MAHA. The microvascular process often targets vasculature in kidneys, brain, gastrointestinal system, heart, and skin. A timely diagnosis and treatment are often crucial to prevent severe end organ damage and death. TMA is classified into primary and secondary forms. Primary TMA includes TTP and complement mediated or atypical hemolytic uremic syndrome (aHUS), often related to a mutation or deficiency and clinically expressed in the setting of a precipitant condition. Secondary TMA is a manifestation of underlying disorder and can occur in clinical scenarios associated with autoimmune disease, malignancy, infections, SOT (Solid Organ Transplant), pregnancy, HSCT (Hematopoietic Stem Cell Transplantation), medications, or methylmalonic acidemia. Transplant associated TMA (TA-TMA) can be complement mediated or aHUS and could be related to the ischemic reperfusion injury, induction regimen, calcineurin inhibitor (CNI) use, mammalian target of rapamycin (MTOR) inhibitor use, or could be infection related. Cost, access, and turnaround time are often the limitations for certain TTP and complement specific testing. Treatment should not be delayed while waiting for such tests. Treatment must be individualized based on the underlying cause of TMA. Terminal complement blockade utilizing monoclonal antibodies directed against C5 complement is the treatment for complement mediated TMA. C5 inhibitors have also been used successfully in treatment of secondary HUS cases where, unlike aHUS, defects in complement cannot be demonstrated. Such treatment has demonstrated improvement in renal function, MAHA and platelet counts.

With the progressive rise in rates of liver transplantation, stagnant donor pool, and social factors, living donor liver transplantation (LDLT) forms the majority of liver transplantations performed in Asian countries. As the global prevalence of metabolic-associated fatty liver disease (MAFLD) is increasing, around 17-25% of all the prospective donors turn out to be steatotic at the time of evaluation and, as such, rejected for donor hepatectomy, thereby considerably reducing the living donor pool. Steatotic grafts are a risk factor to both the recipient (primary nonfunction, delayed graft function, and mortality) and the donor (poor regeneration, higher blood loss, and prolonged hospital stay). Weight reduction and dietary optimization have been known to be associated with improvement in steatosis, and multiple interventions have been used in the past to reduce steatosis in these donors and be able to convert these donors from marginal steatotic donors to normal or low-risk donors and utilize these grafts. Most of these studies indicated the efficacy of these optimization protocols. They suggested similar outcomes in these previously steatotic donors compared to donors without steatosis at baseline, but these optimization protocols lack uniformity. This review article aims to highlight the rising prevalence of steatosis in living liver donors, assess the literature on pre-operative management options for steatosis donors, and study the efficacy, safety, and feasibility of these management options.

With the rise in the population of patients with End-stage Renal Disease (ESRD) in Nigeria, there is an increased demand for Renal Replacement Therapy (RRT) including kidney transplantation (KT). We present our initial surgical experience and early outcomes with KT at a Nigerian transplant center over 2 years. A 2-year retrospective review of patients who underwent KT was done. Data of both kidney donors and recipients were recorded in designed proformas. Extracted information included demographic characteristics, side of open donor nephrectomy (ODN), recipient anatomy, surgical techniques and postoperative outcomes. Data were analyzed using SPSS version 21. A total of 210 patients had KT during the period under review<em>. </em>Donors had an age range of 19 to 53 years with a mean of 30.8 3 ± 8.43 years while recipients aged between 9 and 73 years with a mean of 45.97 ± 13.71 years. There were 190 (90.5%) male and 20 (9.5%) female donors. One hundred fifty-four recipients were males (73.3%) and 56 (26.7%) were females. Left ODN was performed in 152 (72.4%) of cases and the commonest indication for right ODN was multiple left renal arteries. The allograft was placed in the right iliac fossa in 187 (89.0%) recipients with the external iliac artery preferred for anastomosis with the allograft renal artery in end-to-side fashion in 182 (86.7%) cases. The internal iliac artery was used in end-to-end fashion anastomosis in 28 (13.3%) of cases. Ureteroneocystostomy using the Modified Lich-Gregoir technique over a double-J stent was performed in all but 5 patients who had uretero-ureterostomies. Significant peri-operative hemorrhage necessitating blood transfusion was experienced in 9 donors and 26 recipients. There was a low complication rate in kidney donors. Allograft renal artery thrombosis, venous thrombosis, and arterial pseudo-aneurysms were encountered in 3, 2 and 4 recipients respectively. Kidney transplantation can be safely and routinely carried out in Nigeria. The early surgical outlook of both kidney donors and recipients was found to be excellent in this study.