Cholangiocarcinoma (CCA) has rising incidence and mortality rates. Outcomes from combination systemic, loco-regional therapy (LRT) and liver transplantation (LT) are improving, but more granular data are needed to inform evidence-based management, including patient selection and immunosuppression.

Various clinicopathologic markers, such as 1-year serum creatinine (Cr), have been used to prognosticate kidney allografts after transplantation. However, a contemporary analysis of their relationship with long-term graft survival is lacking. This study aimed to analyze recent data on the association of prognostic factors with kidney allograft survival in patients who underwent transplantation in the modern era.

The aim of this study was to explore strategies for postoperative infection prevention and treatment, and how they might help to improve the prognosis in liver transplant recipients with liver failure.

We present the case of a 54-year-old female patient with a history of treated hepatitis B who underwent living-related kidney transplantation from her son. The timing of the transplantation and immediate postoperative period was uneventful, with no significant complications. However, within 3 months, she was repeatedly hospitalized because of persistent jaundice, abdominal pain, and diarrhea, and liver function tests indicated considerable liver injury. Extensive investigations have revealed an occult hepatitis C virus infection that occurred before transplantation. The patient subsequently developed acute fulminant liver failure accompanied by severe gastrointestinal bleeding. Despite aggressive medical management, her condition deteriorated rapidly, leading to death. This case underscores the importance of comprehensive viral screening in transplant recipients, particularly those with risk factors or symptoms of hepatitis C virus infection, to prevent potentially life-threatening complications following transplantation.

Cytomegalovirus (CMV) is one of the most common opportunistic infections affecting solid organ transplant recipients (SOTRs). In this article, we presented the case of a 39-year-old patient with end-stage renal disease after kidney transplantation with refractory CMV infection, who was successfully treated with maribavir for the first time in Poland. The use of maribavir resulted in a significant reduction of CMV viremia in ganciclovir/valganciclovir-resistant CMV infection and resolution of CMV disease symptoms in the absence of drug-related adverse events.

Although postrenal transplant surgical site infections are relatively uncommon, we present the case of a 72-year-old diabetic and hypertensive male patient who developed a delayed peri-graft abscess and severe surgical site infection due to a closed drain exit site infection 1 month following a living-related kidney transplant. While the transplant itself was successful and the patient had passed the pretransplant psychosocial evaluation, their post-transplant noncompliance and unresolved social barriers-such as missed outpatient follow-up appointments-significantly contributed to these complications. This case highlights the limitations of relying solely on pretransplant evaluations and, therefore, emphasizes the critical need for a comprehensive predischarge psychosocial assessment. Such an assessment is particularly vital, especially in elderly patients, as it helps identify and address risks for noncompliance and barriers to follow-up care. To address these challenges, we propose implementing a predischarge psychosocial scoring system that evaluates psychological well-being, social support, cognitive function, understanding of the care plan, and potential obstacles. By identifying high-risk patients, this tool can, in turn, guide tailored interventions to improve adherence. Consequently, a structured predischarge assessment system becomes essential for optimizing post-transplant care, enhancing outcomes, and reducing complications.

While kidney transplantation can improve both quality and quantity of life in patients with renal disease, there are well-described possible surgical and medical complications. Of these complications, donor-derived infections represent a source of morbidity and mortality. Donor-derived aspergillosis is a rare source of these infections. Given the limited number of reported cases of donor-derived aspergillosis, we present a case that resulted in multisystem organ failure, graft loss, and death.

The recipient was a 50-year-old man with blood type O who was referred to our department for a pre-emptive ABO-incompatible kidney transplantation (KTx), with his wife as the donor whose blood was type A. However, both of the T and B cell complement-dependent crossmatch and flow cytometric crossmatch tests showed positive results. Even though donor-specific antibodies were negative by Luminex, we did not recommend transplantation and he had received dialysis therapy for 3 years. We conducted a re-evaluation of crossmatch tests. IgM and anti-B antibody were eliminated from the recipient's sera by the processing with dithiothreitol and the absorption mixing type B red blood cells. However, crossmatch tests still showed positive. Then, we eliminated anti-A antibody by the absorption mixing type A red blood cells. T- and B-cell crossmatch tests turned to negative, suggesting anti-A antibody in the recipient's sera binds to type A substance onto the donor's T and B lymphocytes. The recipient received an ABO-incompatible KTx with our standard desensitization therapy. Immediate graft function was achieved without any rejection.

Cytomegalovirus (CMV) has a negative impact on overall posttransplant rehabilitation. While infection often manifests as gastrointestinal disease, pneumonitis, nephritis and others, it may be associated with psychotic symptoms. The role of CMV in etiology of schizophrenia has already been recognized but it was never described in the posttransplant psychosis. We present a case depicting development of psychosis 10 years post kidney transplantation associated with CMV disease.

Although active malignancy is a contraindication to lung transplantation, there is increasing uncertainty as to what constitutes "active" malignancy given the rapidly changing therapeutic armamentarium and overall survival of patients with malignancy. Chronic myeloid leukemia (CML) is an example of a previously fatal malignancy that has been transformed into a chronic disease with close-to-normal life expectancy since the advent of tyrosine kinase inhibitor (TKI) therapy. However, it remains relatively unknown if lung transplantation could successfully be performed in patients with CML. We describe the course of a 34-year-old woman with cystic fibrosis and advanced lung disease who was diagnosed with CML while undergoing lung transplant evaluation. She was initiated on imatinib with optimal treatment response; she achieved major molecular response (MMR) and deep molecular response (DMR) at 8 and 10 months of treatment, respectively. She developed progressive respiratory failure and underwent bilateral lung transplantation at close to 3 years after achieving MMR. At 6 years post-transplant, she has excellent graft function and remains in DMR on imatinib. Treated CML in DMR should be regarded as inactive malignancy and should not preclude patients from life-saving transplant consideration. Our case also demonstrates the feasibility of long-term immunosuppression on TKI therapy.

Genetic mutations are increasingly recognized as significant contributors to post-transplant complications. Common genetic conditions, such as short telomere syndrome (STS), lymphangioleiomyomatosis, cystic fibrosis (CF), and alpha-1 antitrypsin deficiency (AAT), have been documented to influence outcomes in lung transplant recipients. Here, we present a case of hereditary transthyretin (ATTR) cardiac amyloidosis leading to heart failure in a 71-year-old female, six years after undergoing a single-lung transplantation (LTx) for interstitial lung disease. This case report highlights the need for awareness of genetic predispositions, including rare conditions such as hereditary ATTR amyloidosis, among individuals being considered for solid organ transplantation.

To summarize the nursing experience of a patient who underwent a second transplantation after the failure of the first allogeneic hematopoietic stem cell transplantation. The patient received personalized narrative nursing care through externalization, deconstruction, rewriting, and reshaping to improve treatment and nursing compliance and to assist in symptom management. Additionally, narrative nursing was applied to provide psychological counseling to the primary caregiver, helping both the patient and their family to establish confidence in overcoming the disease. After careful narrative nursing and symptom management, the patient's white blood cells were successfully engrafted after 57 days of hospitalization, allowing for a smooth transition out of the clean laminar flow ward. After 8 days of treatment in a general ward, the patient's own hematopoiesis recovered, and symptoms such as oral mucositis, nausea, vomiting, and hemorrhagic cystitis improved, leading to a successful discharge. Narrative nursing has a supportive role for patients undergoing a second allogeneic hematopoietic stem cell transplantation and their primary caregivers. It is recommended that future studies construct relevant programs to provide theoretical support for the application of narrative nursing in clinical care.

Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication of long-term peritoneal dialysis. Characterized by thickening of the peritoneal membrane, EPS leads to bowel encapsulation, ultrafiltration failure, and bowel obstruction. This study describes the case of a 61-year-old man with a history of hypertension and end stage renal disease requiring peritoneal dialysis for ten years who developed EPS after cadaveric renal transplantation. The patient experienced recurrent episodes of abdominal distension, ascites, and ileus starting 10 days after transplantation. Diagnostic imaging and histological examination confirmed EPS, as defined by a podoplanin score of 2 with diffuse accumulation of podoplanin-positive fibroblastic cells in the peritoneal membrane. Early intervention with corticosteroids and tamoxifen led to gradual improvement and stabilization of his condition. This case not only emphasizes the importance of early diagnosis of EPS but also highlights the importance of timely treatment to promote favorable outcomes for patients with this potentially devastating disease.

Delayed chest closure (DCC) is a useful technique in cases with oversized lung grafts, pulmonary edema, and hemodynamic instability. Anatomically oversized lung grafts are potentially problematic in pediatric living-donor lobar lung transplantation (LDLLT), but rarely in an adult LDLLT. We experienced a case of anatomically oversized grafts in the adult LDLLT requiring DCC, although the grafts provided only 57.2% of the recipient's predicted forced vital capacity. Through 3-dimensional computed tomography volumetry, the volume of the donor's right lower lobe was illustrated as 108% of that of the recipient's right hemithorax, the volume of the donor left lower lobe was 143% of that of the recipient's left hemithorax. Her chest was closed without volume reduction 5 days after transplantation. Our experience illustrates the importance of anatomical size-matching even in an adult LDLLT and the usefulness of DCC as a perioperative management modality.

Autoimmune hemolytic anemia (AIHA) is a rare complication of ABO-matched hematopoietic stem cell transplantation (HSCT). Post-HSCT AIHA is diagnosed by a positive hemolysis laboratory work-up and positive direct antiglobulin testing with usually a pan-reactive antibody in indirect antiglobulin testing. In this case report, we describe the diagnosis of post-HSCT AIHA in a 62-year-old male patient and its management with combined immunosuppressive therapy with steroids, rituximab, and intravenous immunoglobulin to achieve transfusion independence and disease remission. Post-HSCT AIHA is generally refractory to treatment but this case highlights the role of combination immunosuppressive therapies to maximize the likelihood of transfusion independence.

Intravascular lithotripsy is a novel technique that treats calcified atherosclerotic disease using shock waves to disrupt the rigid plaque. It is an evolving technique with high reported success rates and minimal complications. Calcified plaque in the aorto-iliac arteries is highly prevalent in patients with renal impairment and is a major barrier to kidney transplantation. This case report is the first known successful application of intravascular lithotripsy for severe calcified iliac artery disease in a patient with end-stage renal disease (ESRD), in order to facilitate listing for kidney transplantation.

A 52-year-old woman with multiple myeloma and asymptomatic human T lymphotropic virus (HTLV)-I infection underwent an autologous stem cell transplantation. Eighteen days after transplantation, she developed fever, headache, ataxia, and tremors. Coinfection of human herpesvirus 6 and HTLV-I encephalitis was diagnosed.

Organ procurement injury is an underreported yet preventable cause of allograft loss. In cases where procurement injury occurs, innovative methods for reconstruction are necessary to minimize organ discard rates given the nationwide organ shortage. The liver and suprahepatic inferior vena cava (IVC) are particularly vulnerable to injury during multiorgan procurements when multiple procurements teams are present. We report an extreme case of suprahepatic IVC injury and our method for repair that resulted in successful transplantation and adequate post-transplant graft function.

Endobronchial Mycobacterium avium-intracellulare (MAI) infection has been described in immunocompromised patients but is rare among transplant recipients. We present a case of a 48-year-old male with a history of coal miners' pneumoconiosis who underwent bilateral lung transplantation. Ten months post-transplant, despite normal spirometry and absence of respiratory symptoms, routine surveillance bronchoscopy revealed multiple endobronchial polypoid lesions. Biopsy demonstrated non-necrotizing granulomatous inflammation, with cultures confirming MAI infection. This case underscores the importance of maintaining a high index of suspicion for atypical infections like MAI in lung transplant recipients, even in the absence of overt clinical symptoms. This case's unique presentation adds to our understanding of potential post-transplant complications and may help clinicians recognize similar presentations in the future.

A kidney with a duplicate ureter used as a graft in kidney transplantation poses a concern about the risk of suture failure at the ureterovesical anastomosis. Many institutions attempted to reduce complications by placing internal fistula stents, such as Double J Stents, at the anastomotic site. We actively place external fistula catheters in these high-risk cases at our hospital.

Hemophagocytic lymphohistiocytosis (HLH) is a rare and deadly disease that presents significant diagnostic challenges. The complexity of diagnosis and treatment is further increased among transplant recipients, yet reports on solid organ transplants, and specifically heart transplant recipients, remain scarce. Herein, we elucidate the diagnostic journey, clinical evolution, and therapeutic approach undertaken for a heart transplant recipient afflicted with hemophagocytic lymphohistiocytosis, followed by a review of the literature.