- N Engl J Med 2022; 386:2295-2302
Three patients with Schimke immuno-osseous dysplasia who underwent sequential bone marrow and kidney transplantation continued to have normal renal function without immunosuppression at 22 to 34 months.
- N Engl J Med 2022; 386:2332-2333
Stunning advances in human transplantation have been tempered by the immunologic consequences of histoincompatibility between donor and recipient — namely, allograft rejection after solid-organ transplantation and graft-versus-host disease (GVHD) after hematopoietic stem-cell (bone marrow) transplantation (HSCT). The separation of GVHD from the graft-versus-tumor effect and the induction of functional immune...
- N Engl J Med 2022; 386:1871-1873
In light of the recent clinical cases of pig-to-human kidney and heart transplantation, taking stock of progress in xenotransplantation can help us set realistic expectations for clinical adoption of this promising technology.
- N Engl J Med 2022; 386:1889-1898
Genetically modified pig kidney xenografts were transplanted into two brain-dead human recipients. The xenografts functioned immediately and showed no evidence of acute rejection on serial biopsy over a period of 54 hours. The serum creatinine level decreased in both recipients.
- N Engl J Med 2021; 385:2451-2462
Dramatic advancements in the use of synthetic and mechanical devices to replace tissues have been made, but restoring tissue and organ structure and function remains challenging. This review discusses the origins, innovations, and future of regenerative medicine and transplantation, which are closely intertwined.
- N Engl J Med 2021; 385:1699-1699
A 49-year-old woman with a history of kidney transplantation presented with headache and umbilicated skin papules. Levels of cryptococcal antigen in the serum and cerebrospinal fluid were high. A skin biopsy was performed, and a diagnosis of disseminated cryptococcosis was confirmed.
- N Engl J Med 2021; 385:1233-1234
Solid-organ transplant recipients have an increased risk of contracting diseases that are preventable through vaccination.1 Much emphasis has been placed on ensuring completion of pretransplantation immunization, because the immunosuppressive therapy that prevents graft rejection may decrease the immune response to vaccines.1 The current Covid-19 pandemic has...
- N Engl J Med 2021; 385:1244-1246
It is known that people receiving immune suppressive therapy, such as recipients of solid-organ transplants, have a suboptimal response to SARS-CoV-2 vaccination. In a randomized, double-blind trial, a third dose of the mRNA-1273 vaccine was compared with placebo. The third dose of vaccine produced a significant boost in neutralizing antibodies.
- N Engl J Med 2021; 385:729-743
This review discusses demographics, survival, and risks in kidney transplantation since the mid-1990s. It addresses postoperative events that impede long-term survival, as well as factors relevant to racial or ethnic minority recipients and health care coverage for immunosuppressive agents.
- N Engl J Med 2021; 385:661-662
Solid-organ transplant recipients receiving immunosuppressive therapy appear to have a poor response to Covid-19 vaccination. A group of 101 consecutive transplant recipients received two doses of the BNT162b2 vaccine 1 month apart and a third dose 2 months after the second dose; 40% had antibodies after the second dose and...
- N Engl J Med 2021; 385:451-460
A 41-year-old woman with presumed Alport’s syndrome was admitted with bloody stools and rectal pain. Six months earlier, she had undergone deceased-donor renal transplantation. On admission, the blood pressure was 85/46 mm Hg, the hemoglobin level 6 g per deciliter, and the platelet count 0 per microliter. A diagnostic test...
- N Engl J Med 2020; 383:99-101
For patients with advanced kidney disease, especially hospitalized patients, dialysis may be presented as the opposite end of the treatment spectrum from comfort care. Collaborative efforts and amended policies could allow patients to have a better range of options.
- N Engl J Med 2020; 382:493-496
With a clear understanding of his terminal prognosis, W.B. wanted to donate his organs before he died — but the legal and ethical hurdles proved insurmountable. In Canada, where medical assistance in dying is now legal, some patients are able to fulfill this last wish.
- N Engl J Med 2020; 382:576-577
Medical assistance in dying followed by organ donation is new to North America. If chosen, this path offers potential donors the opportunity to fulfill their last requests and may also affect transplant waiting lists. This letter discusses organ donation after euthanasia and its implications.
- N Engl J Med 2020; 382:195-197
In this case report, a low level of human immunodeficiency virus was shown to be transferred during transplantation of a kidney from an HIV-positive donor to an HIV-positive recipient, even though the recipient was receiving antiretroviral therapy.
- N Engl J Med 2019; 381:1387-1389
Extending the organ donor pool is needed. In this report, investigators from South Africa report the 5-year outcomes of renal transplantation in human immunodeficiency virus (HIV)–positive patients who received organs from HIV-positive donors.
- N Engl J Med 2019; 380:2273-2274
This letter discusses the recent decrease in the number of patients on the kidney-transplant waiting list in the United States, probably because of changes in deceased-organ donation, screening and handling of organs that were previously deemed to be unacceptable, and the opioid epidemic.
- N Engl J Med 2019; 380:1918-1928
This study explored gene-disrupting variants as risk factors for allosensitization in kidney transplant recipients. Genomic collision at the LIMS1 locus, which encodes a minor histocompatibility antigen, was associated with allograft rejection and production of anti-LIMS1 IgG2 and IgG3.
- N Engl J Med 2019; 380:1464-1472
A 49-year-old man with HIV infection and chronic kidney disease was evaluated in the kidney transplantation clinic because of declining kidney function. Management decisions were made.