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  1. Article ; Online: Preterm birth buccal cell epigenetic biomarkers to facilitate preventative medicine.

    Winchester, Paul / Nilsson, Eric / Beck, Daniel / Skinner, Michael K

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 3361

    Abstract: ... from both parents. The mother (165 DMRs) and female child (136 DMRs) at p < 1e-04 had the highest number of DMRs and ...

    Abstract Preterm birth is the major cause of newborn and infant mortality affecting nearly one in every ten live births. The current study was designed to develop an epigenetic biomarker for susceptibility of preterm birth using buccal cells from the mother, father, and child (triads). An epigenome-wide association study (EWAS) was used to identify differential DNA methylation regions (DMRs) using a comparison of control term birth versus preterm birth triads. Epigenetic DMR associations with preterm birth were identified for both the mother and father that were distinct and suggest potential epigenetic contributions from both parents. The mother (165 DMRs) and female child (136 DMRs) at p < 1e-04 had the highest number of DMRs and were highly similar suggesting potential epigenetic inheritance of the epimutations. The male child had negligible DMR associations. The DMR associated genes for each group involve previously identified preterm birth associated genes. Observations identify a potential paternal germline contribution for preterm birth and identify the potential epigenetic inheritance of preterm birth susceptibility for the female child later in life. Although expanded clinical trials and preconception trials are required to optimize the potential epigenetic biomarkers, such epigenetic biomarkers may allow preventative medicine strategies to reduce the incidence of preterm birth.
    MeSH term(s) Biomarkers/metabolism ; Child ; DNA ; DNA Methylation ; Epigenesis, Genetic ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mouth Mucosa/metabolism ; Premature Birth/genetics
    Chemical Substances Biomarkers ; DNA (9007-49-2)
    Language English
    Publishing date 2022-03-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-07262-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Protection Conferred by Delta and BA.1/BA.2 Infection Against BA.4/BA.5 Infection and Hospitalization: A Retrospective Cohort Study.

    Winchester, Nicole E / Shrestha, Nabin K / Kim, Priscilla / Tereshchenko, Larisa G / Rothberg, Michael B

    The Journal of infectious diseases

    2023  Volume 227, Issue 6, Page(s) 800–805

    Abstract: ... confidence interval, .8%-21.8%]); P = .04) and minimal protection against hospitalization (10.7% [4.9%-21.7%]; P ... 1%; P < .001) protection against BA.4/BA.5 reinfection and 18.8% (10.3%-28.3%; (P < .001) protection ...

    Abstract Background: Severe acute respiratory syndrome coronavirus 2 immunity has declined with subsequent waves and accrual of viral mutations. In vitro studies raise concern for immune escape by BA.4/BA.5, and a study in Qatar showed moderate protection, but these findings have yet to be reproduced.
    Methods: This retrospective cohort study included individuals tested for coronavirus disease 2019 by polymerase chain reaction during Delta or BA.1/BA.2 and retested during BA.4/BA.5. The preventable fraction (PF) was calculated as ratio of the infection to the hospitalization rate for initially positive patients divided by the ratio for initially negative patients, stratified by age and adjusted for age, sex, comorbid conditions, and vaccination using logistic regression.
    Results: A total of 20 987 patients met inclusion criteria. Prior Delta infection provided no protection against BA.4/BA.5 infection (adjusted PF, 11.9% [95% confidence interval, .8%-21.8%]); P = .04) and minimal protection against hospitalization (10.7% [4.9%-21.7%]; P = .003). In adjusted models, prior BA.1/BA.2 infection provided 45.9% (95% confidence interval, 36.2%-54.1%; P < .001) protection against BA.4/BA.5 reinfection and 18.8% (10.3%-28.3%; (P < .001) protection against hospitalization. Up-to-date vaccination provided modest protection against reinfection with BA.4/BA.5 and hospitalization.
    Conclusions: Prior infection with BA.1/BA.2 and up-to-date vaccination provided modest protection against infection with BA.4/BA.5 and hospitalization, while prior Delta infection provided minimal protection against hospitalization and none against infection.
    MeSH term(s) Humans ; Reinfection ; Retrospective Studies ; COVID-19/prevention & control ; Hospitalization ; Hepatitis D
    Language English
    Publishing date 2023-01-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiad003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: SAP-expressing T peripheral helper cells identify systemic lupus erythematosus patients with lupus nephritis.

    Gartshteyn, Yevgeniya / Geraldino-Pardilla, Laura / Khalili, Leila / Bukhari, Shoiab / Lerrer, Shalom / Winchester, Robert J / Askanase, Anca D / Mor, Adam

    Frontiers in immunology

    2024  Volume 15, Page(s) 1327437

    Abstract: ... CD8 T cells in SLE compared with controls (55.5 ± 2.6 vs. 41.3 ± 3.4, p=0.007, and 52.5 ± 3.0 vs. 39.2 ... 2.8, p=0.007 respectively). In CD4 T cells, the highest SAP expression was in the TPH subset ...

    Abstract Introduction: T follicular (TFH) and peripheral helper (TPH) cells have been increasingly recognized as a pathogenic subset of CD4 T cells in systemic lupus erythematosus (SLE). The SLAM Associated Protein (SAP) regulates TFH and TPH function by binding to the co-stimulatory signaling lymphocyte activation molecule family (SLAMF) receptors that mediate T cell - B cell interactions. SAP and SLAMF are critical for TPH-dependent B cell maturation into autoantibody-producing plasma cells that characterize SLE pathogenesis. We hypothesized that SAP-expressing TPH cells are involved in the pathogenesis of lupus nephritis (LN).
    Methods: Peripheral blood mononuclear cells (PBMC) were isolated using density gradient separation from whole blood. Cells were stained for cell surface markers, followed by permeabilization and staining of intracellular SAP for spectral flow cytometry analysis. We also analyzed SAP expression from renal infiltrating LN T cells using the available single-cell RNA sequencing (scRNA seq) Accelerated Medicines Partnership (AMP) SLE dataset.
    Results: PBMC from 30 patients with SLE (34 ± 10 years old, 83% female), including 10 patients with LN, were analyzed. We found an increase in total SAP-positive CD4 and CD8 T cells in SLE compared with controls (55.5 ± 2.6 vs. 41.3 ± 3.4, p=0.007, and 52.5 ± 3.0 vs. 39.2 ± 2.8, p=0.007 respectively). In CD4 T cells, the highest SAP expression was in the TPH subset. The frequency of SAP
    Conclusion: The expansion of SAP-expressing T helper cells was associated with LN in our cohort and verified using scRNA-seq data of renal infiltrating T cells. Improved SLAM and SAP signaling understanding can identify new therapeutic targets in LN.
    MeSH term(s) Humans ; Female ; Young Adult ; Adult ; Male ; Lupus Nephritis/metabolism ; Leukocytes, Mononuclear/metabolism ; Signaling Lymphocytic Activation Molecule Associated Protein/metabolism ; Lupus Erythematosus, Systemic/metabolism ; T-Lymphocytes, Helper-Inducer/metabolism
    Chemical Substances Signaling Lymphocytic Activation Molecule Associated Protein
    Language English
    Publishing date 2024-03-14
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2024.1327437
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Characteristics of Firearm Injury by Injury Intent: The Need for Tailored Interventions.

    Kirkendoll, Shelbie D / Hink, Ashley B / Kuhls, Deborah A / Rivara, Frederick P / Sakran, Joseph V / Agoubi, Lauren L / Winchester, Alex S / Richards, Jacy / Hoeft, Christopher / Patel, Bhavin / Michaels, Holly / Nathens, Avery B

    The journal of trauma and acute care surgery

    2024  

    Abstract: Introduction: While the U.S. has high quality data on firearm-related deaths, less information is available on those who arrive at trauma centers alive, especially those discharged from the emergency department. This study sought to describe ... ...

    Abstract Introduction: While the U.S. has high quality data on firearm-related deaths, less information is available on those who arrive at trauma centers alive, especially those discharged from the emergency department. This study sought to describe characteristics of patients arriving to trauma centers alive following a firearm injury, postulating that significant differences in firearm injury intent might provide insights into injury prevention strategies.
    Methods: This was a multi-center prospective cohort study of patients treated for firearm-related injuries at 128 U.S. trauma centers from 3/2021-2/2022. Data collected included patient-level sociodemographic, injury and clinical characteristics, community characteristics, and context of injury. The outcome of interest was the association between these factors and the intent of firearm injury. Measures of urbanicity, community distress, and strength of state firearm laws were utilized to characterize patient communities.
    Results: 15,232 patients presented with firearm-related injuries across 128 centers in 41 states. Overall, 9.5% of patients died, and deaths were more common among law enforcement and self-inflicted (SI) firearm injuries (80.9% and 50.5%, respectively). These patients were also more likely to have a history of mental illness. SI firearm injuries were more common in older White men from rural and less distressed communities, whereas firearm assaults were more common in younger, Black men from urban and more distressed communities. Unintentional injuries were more common among younger patients and in states with lower firearm safety grades whereas law enforcement-related injuries occurred most often in unemployed patients with a history of mental illness.
    Conclusions: Injury, clinical, sociodemographic, and community characteristics among patients injured by a firearm significantly differed between intents. With the goal of reducing firearm-related deaths, strategies and interventions need to be tailored to include community improvement and services that address specific patient risk factors for firearm injury intent.
    Level of evidence: Level III, Prognostic/Epidemiological.
    Language English
    Publishing date 2024-04-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000004344
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Initial Assessment of the Effect of ProvenCare on Lung Cancer Surgical Quality.

    Facktor, Matthew A / Odell, David D / Wood, Douglas E / Feinglass, Joseph / Winchester, David P

    The Annals of thoracic surgery

    2021  Volume 114, Issue 3, Page(s) 898–904

    Abstract: ... resection (63.4% vs 49.4%; P < .001). There was no difference in 30-day mortality (1.4% vs 1.3% lobectomy [P ... 84]; 3.4% vs 2.0% all other resections [P = .054]) or STS indicator complications (10.8% vs 9.9 ... lobectomy [P = .21]; 9.2% vs 9.4% all other resections [P = .92]). When controlling for patient-level ...

    Abstract Background: ProvenCare is a joint initiative of the American College of Surgeons Commission on Cancer, Geisinger, and The Society of Thoracic Surgeons (STS) to standardize evidence-based practices in the delivery of surgical lung cancer care. This study compares outcomes of ProvenCare patients with the STS Database.
    Methods: Best practice elements were agreed on through expert consensus meetings. ProvenCare elements were used to direct care. Compliance was monitored while clinical outcomes were collected within the STS General Thoracic Surgery Database (GTSD). ProvenCare patient outcomes were compared with outcomes in all other STS GTSD patients. Univariable and multivariable logistic regression models compared morbidity and mortality.
    Results: A total of 2026 patients at 23 ProvenCare hospitals were compared with 71 565 control patients at 311 hospitals from 2010 to 2016. ProvenCare patients were more likely to receive guideline-recommended staging evaluations and more likely to have mediastinal staging performed during resection (63.4% vs 49.4%; P < .001). There was no difference in 30-day mortality (1.4% vs 1.3% lobectomy [P = .84]; 3.4% vs 2.0% all other resections [P = .054]) or STS indicator complications (10.8% vs 9.9% lobectomy [P = .21]; 9.2% vs 9.4% all other resections [P = .92]). When controlling for patient-level clinical and demographic risk factors, the likelihood of perioperative morbidity and mortality was not significantly different (odds ratio [OR], 1.07 [95% CI, 0.77-1.47] lobectomy; OR, 0.97 [95% CI, 0.62-1.50] all other resections).
    Conclusions: Variability in preoperative evaluation of patients with lung cancer represents an opportunity to improve quality of care. ProvenCare increased use of guideline-recommended preoperative processes, which may improve cancer outcomes and survival, without resulting in differences in short-term surgical outcomes.
    MeSH term(s) Databases, Factual ; Humans ; Lung Neoplasms/surgery ; Pneumonectomy/methods ; Societies, Medical ; Thoracic Surgery
    Language English
    Publishing date 2021-08-27
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2021.07.080
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Role of epigenetics in the etiology of hypospadias through penile foreskin DNA methylation alterations.

    Kaefer, Martin / Rink, Richard / Misseri, Rosalia / Winchester, Paul / Proctor, Cathy / Ben Maamar, Millissia / Beck, Daniel / Nilsson, Eric / Skinner, Michael K

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 555

    Abstract: Abnormal penile foreskin development in hypospadias is the most frequent genital malformation in male children, which has increased dramatically in recent decades. A number of environmental factors have been shown to be associated with hypospadias ... ...

    Abstract Abnormal penile foreskin development in hypospadias is the most frequent genital malformation in male children, which has increased dramatically in recent decades. A number of environmental factors have been shown to be associated with hypospadias development. The current study investigated the role of epigenetics in the etiology of hypospadias and compared mild (distal), moderate (mid shaft), and severe (proximal) hypospadias. Penile foreskin samples were collected from hypospadias and non-hypospadias individuals to identify alterations in DNA methylation associated with hypospadias. Dramatic numbers of differential DNA methylation regions (DMRs) were observed in the mild hypospadias, with reduced numbers in moderate and low numbers in severe hypospadias. Atresia (cell loss) of the principal foreskin fibroblast is suspected to be a component of the disease etiology. A genome-wide (> 95%) epigenetic analysis was used and the genomic features of the DMRs identified. The DMR associated genes identified a number of novel hypospadias associated genes and pathways, as well as genes and networks known to be involved in hypospadias etiology. Observations demonstrate altered DNA methylation sites in penile foreskin is a component of hypospadias etiology. In addition, a potential role of environmental epigenetics and epigenetic inheritance in hypospadias disease etiology is suggested.
    MeSH term(s) Child ; Humans ; Male ; Foreskin/metabolism ; DNA Methylation ; Hypospadias/genetics ; Hypospadias/metabolism ; Epigenesis, Genetic ; Genomics
    Language English
    Publishing date 2023-01-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-27763-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi.

    Gattrell, William T / Logullo, Patricia / van Zuuren, Esther J / Price, Amy / Hughes, Ellen L / Blazey, Paul / Winchester, Christopher C / Tovey, David / Goldman, Keith / Hungin, Amrit Pali / Harrison, Niall

    PLoS medicine

    2024  Volume 21, Issue 1, Page(s) e1004326

    Abstract: Background: In biomedical research, it is often desirable to seek consensus among individuals who have differing perspectives and experience. This is important when evidence is emerging, inconsistent, limited, or absent. Even when research evidence is ... ...

    Abstract Background: In biomedical research, it is often desirable to seek consensus among individuals who have differing perspectives and experience. This is important when evidence is emerging, inconsistent, limited, or absent. Even when research evidence is abundant, clinical recommendations, policy decisions, and priority-setting may still require agreement from multiple, sometimes ideologically opposed parties. Despite their prominence and influence on key decisions, consensus methods are often poorly reported. Our aim was to develop the first reporting guideline dedicated to and applicable to all consensus methods used in biomedical research regardless of the objective of the consensus process, called ACCORD (ACcurate COnsensus Reporting Document).
    Methods and findings: We followed methodology recommended by the EQUATOR Network for the development of reporting guidelines: a systematic review was followed by a Delphi process and meetings to finalize the ACCORD checklist. The preliminary checklist was drawn from the systematic review of existing literature on the quality of reporting of consensus methods and suggestions from the Steering Committee. A Delphi panel (n = 72) was recruited with representation from 6 continents and a broad range of experience, including clinical, research, policy, and patient perspectives. The 3 rounds of the Delphi process were completed by 58, 54, and 51 panelists. The preliminary checklist of 56 items was refined to a final checklist of 35 items relating to the article title (n = 1), introduction (n = 3), methods (n = 21), results (n = 5), discussion (n = 2), and other information (n = 3).
    Conclusions: The ACCORD checklist is the first reporting guideline applicable to all consensus-based studies. It will support authors in writing accurate, detailed manuscripts, thereby improving the completeness and transparency of reporting and providing readers with clarity regarding the methods used to reach agreement. Furthermore, the checklist will make the rigor of the consensus methods used to guide the recommendations clear for readers. Reporting consensus studies with greater clarity and transparency may enhance trust in the recommendations made by consensus panels.
    MeSH term(s) Humans ; Biomedical Research ; Checklist ; Consensus ; Policy ; Trust
    Language English
    Publishing date 2024-01-23
    Publishing country United States
    Document type Guideline ; Journal Article
    ZDB-ID 2185925-5
    ISSN 1549-1676 ; 1549-1277
    ISSN (online) 1549-1676
    ISSN 1549-1277
    DOI 10.1371/journal.pmed.1004326
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Anemia, hemoglobin concentration and cognitive function in the Longitudinal Ageing Study in India-Harmonized Diagnostic Assessment of Dementia (LASI-DAD) and the Health and Retirement Study.

    Winchester, Laura M / Newby, Danielle / Ghose, Upamanyu / Hu, Peifeng / Green, Hunter / Chien, Sandy / Ranson, Janice / Faul, Jessica / Llewellyn, David / Lee, Jinkook / Bauermeister, Sarah / Nevado-Holgado, Alejo

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: ... an association between anemia and poor memory (p=0.0054). We found a positive association between hemoglobin ... concentration and ten cognitive domains tested (β=0.041-0.071, p<0.05). The strongest association ... memory, β=0.061-0.071, p<0.005). Positive associations were also shown between the general cognitive ...

    Abstract Background: In India, anemia is widely researched in children and women of reproductive age, however, studies in older populations are lacking. Given the adverse effect of anemia on cognitive function and dementia this older population group warrants further study. The Longitudinal Ageing Study in India - Harmonized Diagnostic Assessment of Dementia (LASI-DAD) dataset contains detailed measures to allow a better understanding of anaemia as a potential risk factor for dementia.
    Method: 2,758 respondents from the LASI-DAD cohort, aged 60 or older, had a complete blood count measured from venous blood as well as cognitive function tests including episodic memory, executive function and verbal fluency. Linear regression was used to test the associations between blood measures (including anemia and hemoglobin concentration (g/dL)) with 11 cognitive domains. All models were adjusted for age and gender with the full model containing adjustments for rural location, years of education, smoking, region, BMI and population weights.Results from LASI-DAD were validated using the USA-based Health and Retirement Study (HRS) cohort (n=5720) to replicate associations between blood cell measures and global cognition.
    Results: In LASI-DAD, we showed an association between anemia and poor memory (p=0.0054). We found a positive association between hemoglobin concentration and ten cognitive domains tested (β=0.041-0.071, p<0.05). The strongest association with hemoglobin was identified for memory-based tests (immediate episodic, delayed episodic and broad domain memory, β=0.061-0.071, p<0.005). Positive associations were also shown between the general cognitive score and the other red blood count tests including mean corpuscular hemoglobin concentration (MCHC, β=0.06, p=0.0001) and red cell distribution width (RDW, β =-0.11, p<0.0001). In the HRS cohort, positive associations were replicated between general cognitive score and other blood count tests (Red Blood Cell, MCHC and RDW, p<0.05).
    Conclusion: We have established in a large South Asian population that low hemoglobin and anaemia are associated with low cognitive function, therefore indicating that anaemia could be an important modifiable risk factor. We have validated this result in an external cohort demonstrating both the variability of this risk factor cross-nationally and its generalizable association with cognitive outcomes.
    Language English
    Publishing date 2024-01-23
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2024.01.22.24301583
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Jonathan Schlefer, The Assumptions Economists Make (Cambridge, Mass., and London

    Stuart Winchester

    Nordicum-Mediterraneum, Vol 8, Iss 1, p D

    Belknap Press of Harvard University Press, 2012)

    2013  Volume 24

    Abstract: A review of the book by Jonathan Schlefer: The Assumptions Economists Make (Cambridge, Mass., and London: Belknap Press of Harvard University Press, 2012), €26,10 / £21.95 / US$28.95, 356pp HBK (English), ISBN: 9780674052260. ...

    Abstract A review of the book by Jonathan Schlefer: The Assumptions Economists Make (Cambridge, Mass., and London: Belknap Press of Harvard University Press, 2012), €26,10 / £21.95 / US$28.95, 356pp HBK (English), ISBN: 9780674052260.
    Keywords assumptions ; DSGE ; crisis ; economics ; faith ; Keynes ; models ; Smith ; Social sciences (General) ; H1-99 ; Human ecology. Anthropogeography ; GF1-900
    Language English
    Publishing date 2013-03-01T00:00:00Z
    Publisher The University of Akureyri
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Trends in use and three-year outcomes of hepatitis C virus-viremic donor lung transplants for hepatitis C virus-seronegative recipients.

    Ruck, Jessica M / Zeiser, Laura B / Zhou, Alice L / Chidi, Alexis P / Winchester, Sophia L / Durand, Christine M / Ha, Jinny S / Shah, Pali D / Massie, Allan B / Segev, Dorry L / Merlo, Christian A / Bush, Errol L

    The Journal of thoracic and cardiovascular surgery

    2022  Volume 165, Issue 4, Page(s) 1587–1595.e2

    Abstract: ... D-/R- LT (all P > .1), as well as for high- (≥20/year) versus low-volume LT centers and high- (≥5 ... year) versus low-volume HCV D+/R- LT centers (all P > .5).: Conclusions: HCV D+/R- and HCV D-/R- LT ... < .001), and longer waitlist time (P = .002). HCV D+/R- LT had similar risk of acute rejection (adjusted ...

    Abstract Objective: The feasibility and 6-month outcome safety of lung transplants (LTs) from hepatitis C virus (HCV)-viremic donors for HCV-seronegative recipients (R-) were established in 2019, but longer-term safety and uptake of this practice nationally remain unknown.
    Methods: We identified HCV-seronegative LT recipients (R-) 2015-2020 using the Scientific Registry of Transplant Recipients. We classified donors as seronegative (D-) or viremic (D+). We used χ
    Results: HCV D+/R- LT increased from 2 to 97/year; centers performing HCV D+/R- LT increased from 1 to 25. HCV D+/R- versus HCV D-/R- LT recipients had more obstructive disease (35.7% vs 23.3%, P < .001), lower lung allocation score (36.5 vs 41.1, P < .001), and longer waitlist time (P = .002). HCV D+/R- LT had similar risk of acute rejection (adjusted odds ratio [aOR], 0.87; P = .58), extracorporeal membranous oxygenation (aOR, 1.94; P = .10), and tracheostomy (aOR, 0.42; P = .16); similar median hospital stay (P = .07); and lower risk of ventilator > 48 hours (aOR, 0.68; P = .006). Adjusting for donor, recipient, and transplant characteristics, risk of all-cause graft failure and mortality were similar at 30 days, 1 year, and 3 years for HCV D+/R- versus HCV D-/R- LT (all P > .1), as well as for high- (≥20/year) versus low-volume LT centers and high- (≥5/year) versus low-volume HCV D+/R- LT centers (all P > .5).
    Conclusions: HCV D+/R- and HCV D-/R- LT have similar outcomes at 3 years posttransplant. These results underscore the safety of HCV D+/R- LT and the potential benefit of expanding this practice further.
    MeSH term(s) Humans ; Hepacivirus ; Liver Transplantation ; Hepatitis C ; Tissue Donors ; Registries
    Language English
    Publishing date 2022-09-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2022.08.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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