Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosupp...Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.展开更多
Green transplant refers to the realization of the importance of understanding and improving the environmental footprint of transplantation through sustainable practices.This involves assessing the entire transplantati...Green transplant refers to the realization of the importance of understanding and improving the environmental footprint of transplantation through sustainable practices.This involves assessing the entire transplantation process including preoperative evaluation,donation,organ and patient transportation,surgery,postoperative recovery,and follow-up.This is a topic that has not been fully addressed yet,but its importance is being increasingly appreciated in surgery.The aim of this study was to investigate the carbon footprint associated with transplantation and propose sustainable mitigating solutions.A comprehensive review of the existing literature on transplantation was conducted and supplemented with findings from the broader fields of surgical and perioperative care,given the scarcity of available data.The analysis identified the most involved environmental factors and attempted to offer practical solutions based on current sustainability practices.Notably,no study has yet examined the carbon footprint associated with the entire transplantation procedure.Only five studies have attempted to assess the environmental impact of kidney or liver transplants,but they focused,almost explicitly,on specific steps of the process.By employing an extrapolative methodology from the broader surgical field,we determined that the primary contributors to the environmental impact of transplantation are energy,consumables and materials,anesthesia and pharmaceuticals,transportation,and water.This review offers practical solutions utilizing the 5R framework,emphasizing sustainability to ensure transplantation remains clinically and environmentally relevant.展开更多
Microplastic contamination has emerged as a threat in transplantation,with evidence of its presence in human tissues and potential to compromise grafts.Transplant recipients,vulnerable due to immunosuppression and sur...Microplastic contamination has emerged as a threat in transplantation,with evidence of its presence in human tissues and potential to compromise grafts.Transplant recipients,vulnerable due to immunosuppression and surgical exposure,face risk from microplastics via airborne particles,surgical materials,and organ preservation systems.These particles trigger inflammation,oxidative stress,and immune dysregulation—pathways critical in rejection.Microplastics support biofilm formation,potentially facilitating antimicrobial resistance in clinical settings.Despite this risk,transplant-specific research is lacking.We urge action through environmental controls,material substitutions,and procedural modifications,alongside research targeting exposure pathways,biological impact,and mitigation strategies.Transplantation has historically led medical innovation and must do so in confronting this environmental challenge.Leadership from global transplant societies is essential to protect recipients and ensure safe procedures.展开更多
器官移植技术的问世,挽救了无数终末期疾病患者的生命。在这项涉及医学、急症、心理、伦理、法律法规等多维度的系统工程中,器官捐献协调员扮演着生命纽带的特殊角色[1]。作为长期奋战在移植一线的临床医生,笔者深切体会到,器官捐献协...器官移植技术的问世,挽救了无数终末期疾病患者的生命。在这项涉及医学、急症、心理、伦理、法律法规等多维度的系统工程中,器官捐献协调员扮演着生命纽带的特殊角色[1]。作为长期奋战在移植一线的临床医生,笔者深切体会到,器官捐献协调员队伍的专业化程度直接影响着器官捐献成功率与转化率、医疗团队协作效率及公众信任度。当前我国人体器官分配与共享计算机系统(China Organ Transplant Response System,COTRS)的2023年统计数据显示,中国登记等待器官移植的人数已超过16万人,而公民逝世后捐献案例仅6451例,大量患者在苦苦等待器官移植,且部分患者在等待中去世。这种供需间的巨大鸿沟不仅源于传统观念的桎梏,更折射出器官捐献协调员专业能力建设这一关键环节的滞后。本文将从移植医生角度讨论器官捐献协调员专业化建设的必要性及策略,旨在推动器官捐献协调员专业化建设的进一步发展,促进我国器官移植事业的高质量发展。展开更多
BACKGROUND Organ transplantation has emerged as a globally prevalent therapeutic modality for end-stage organ failure,yet the post-transplantation trajectory is increasingly complicated by a spectrum of metabolic sequ...BACKGROUND Organ transplantation has emerged as a globally prevalent therapeutic modality for end-stage organ failure,yet the post-transplantation trajectory is increasingly complicated by a spectrum of metabolic sequelae,with obesity emerging as a critical clinical challenge.AIM To systematically review the multifactorial mechanisms underlying obesity following organ transplantation and to integrate evidence from pharmacological,behavioral,and molecular perspectives,thereby providing a foundation for targeted interventions.METHODS We conducted a systematic search in PubMed and Web of Science for literature published from 2020 to 15 July 2025.The search strategy incorporated terms including“obesity”,“overweight”and“post organ transplantation”.Only randomized controlled trials,meta-analyses,and systematic reviews were included.Non-empirical publications and irrelevant studies were excluded.Data extraction and quality assessment were performed by two independent reviewers,with disagreements resolved by a third researcher.RESULTS A total of 1457 articles were initially identified,of which 146 met the inclusion criteria.These studies encompassed liver,kidney,heart,and lung transplant recipients.Key findings indicate that immunosuppressive drugs-especially corticosteroids and calcineurin inhibitors-promote hyperphagia,insulin resistance,and dyslipidemia.Post-transplant sedentary behavior and hypercaloric diets further contribute to positive energy balance.At the molecular level,immunosuppressants disrupt adipokine signaling(e.g.,leptin and adiponectin),induce inflammatory and oxidative stress responses,and activate adipogenic pathways leading to lipid accumulation.CONCLUSION Post-transplant obesity arises from a complex interplay of pharmacological,behavioral,and molecular factors.A multidisciplinary approach-incorporating pharmacological modification,nutritional management,physical activity,and molecular-targeted therapies-is essential to mitigate obesity and improve transplant outcomes.Further large-scale and mechanistic studies are warranted to establish evidence-based preventive and treatment strategies.展开更多
文摘Artificial intelligence(AI)is increasingly recognized as a transformative force in the field of solid organ transplantation.From enhancing donor-recipient matching to predicting clinical risks and tailoring immunosuppressive therapy,AI has the potential to improve both operational efficiency and patient outcomes.Despite these advancements,the perspectives of transplant professionals-those at the forefront of critical decision-making-remain insufficiently explored.To address this gap,this study utilizes a multi-round electronic Delphi approach to gather and analyses insights from global experts involved in organ transplantation.Participants are invited to complete structured surveys capturing demographic data,professional roles,institutional practices,and prior exposure to AI technologies.The survey also explores perceptions of AI’s potential benefits.Quantitative responses are analyzed using descriptive statistics,while open-ended qualitative responses undergo thematic analysis.Preliminary findings indicate a generally positive outlook on AI’s role in enhancing transplantation processes,particularly in areas such as donor matching and post-operative care.These mixed views reflect both optimism and caution among professionals tasked with integrating new technologies into high-stakes clinical workflows.By capturing a wide range of expert opinions,the findings will inform future policy development,regulatory considerations,and institutional readiness frameworks for the integration of AI into organ transplantation.
文摘Green transplant refers to the realization of the importance of understanding and improving the environmental footprint of transplantation through sustainable practices.This involves assessing the entire transplantation process including preoperative evaluation,donation,organ and patient transportation,surgery,postoperative recovery,and follow-up.This is a topic that has not been fully addressed yet,but its importance is being increasingly appreciated in surgery.The aim of this study was to investigate the carbon footprint associated with transplantation and propose sustainable mitigating solutions.A comprehensive review of the existing literature on transplantation was conducted and supplemented with findings from the broader fields of surgical and perioperative care,given the scarcity of available data.The analysis identified the most involved environmental factors and attempted to offer practical solutions based on current sustainability practices.Notably,no study has yet examined the carbon footprint associated with the entire transplantation procedure.Only five studies have attempted to assess the environmental impact of kidney or liver transplants,but they focused,almost explicitly,on specific steps of the process.By employing an extrapolative methodology from the broader surgical field,we determined that the primary contributors to the environmental impact of transplantation are energy,consumables and materials,anesthesia and pharmaceuticals,transportation,and water.This review offers practical solutions utilizing the 5R framework,emphasizing sustainability to ensure transplantation remains clinically and environmentally relevant.
文摘Microplastic contamination has emerged as a threat in transplantation,with evidence of its presence in human tissues and potential to compromise grafts.Transplant recipients,vulnerable due to immunosuppression and surgical exposure,face risk from microplastics via airborne particles,surgical materials,and organ preservation systems.These particles trigger inflammation,oxidative stress,and immune dysregulation—pathways critical in rejection.Microplastics support biofilm formation,potentially facilitating antimicrobial resistance in clinical settings.Despite this risk,transplant-specific research is lacking.We urge action through environmental controls,material substitutions,and procedural modifications,alongside research targeting exposure pathways,biological impact,and mitigation strategies.Transplantation has historically led medical innovation and must do so in confronting this environmental challenge.Leadership from global transplant societies is essential to protect recipients and ensure safe procedures.
文摘器官移植技术的问世,挽救了无数终末期疾病患者的生命。在这项涉及医学、急症、心理、伦理、法律法规等多维度的系统工程中,器官捐献协调员扮演着生命纽带的特殊角色[1]。作为长期奋战在移植一线的临床医生,笔者深切体会到,器官捐献协调员队伍的专业化程度直接影响着器官捐献成功率与转化率、医疗团队协作效率及公众信任度。当前我国人体器官分配与共享计算机系统(China Organ Transplant Response System,COTRS)的2023年统计数据显示,中国登记等待器官移植的人数已超过16万人,而公民逝世后捐献案例仅6451例,大量患者在苦苦等待器官移植,且部分患者在等待中去世。这种供需间的巨大鸿沟不仅源于传统观念的桎梏,更折射出器官捐献协调员专业能力建设这一关键环节的滞后。本文将从移植医生角度讨论器官捐献协调员专业化建设的必要性及策略,旨在推动器官捐献协调员专业化建设的进一步发展,促进我国器官移植事业的高质量发展。
基金Supported by the National Natural Science Foundation of China,No.82305376the Youth Talent Support Project of the China Acupuncture and Moxibustion Association,No.2024-2026ZGZJXH-QNRC005+2 种基金the 2024 Jiangsu Province Youth Science and Technology Talent Support Project,No.JSTJ-2024-3802025 Jiangsu Provincial Science and Technology Think Tank Program Project,No.JSKX0125035and 2025 College Student Innovation Training Program Project,No.X202510315373。
文摘BACKGROUND Organ transplantation has emerged as a globally prevalent therapeutic modality for end-stage organ failure,yet the post-transplantation trajectory is increasingly complicated by a spectrum of metabolic sequelae,with obesity emerging as a critical clinical challenge.AIM To systematically review the multifactorial mechanisms underlying obesity following organ transplantation and to integrate evidence from pharmacological,behavioral,and molecular perspectives,thereby providing a foundation for targeted interventions.METHODS We conducted a systematic search in PubMed and Web of Science for literature published from 2020 to 15 July 2025.The search strategy incorporated terms including“obesity”,“overweight”and“post organ transplantation”.Only randomized controlled trials,meta-analyses,and systematic reviews were included.Non-empirical publications and irrelevant studies were excluded.Data extraction and quality assessment were performed by two independent reviewers,with disagreements resolved by a third researcher.RESULTS A total of 1457 articles were initially identified,of which 146 met the inclusion criteria.These studies encompassed liver,kidney,heart,and lung transplant recipients.Key findings indicate that immunosuppressive drugs-especially corticosteroids and calcineurin inhibitors-promote hyperphagia,insulin resistance,and dyslipidemia.Post-transplant sedentary behavior and hypercaloric diets further contribute to positive energy balance.At the molecular level,immunosuppressants disrupt adipokine signaling(e.g.,leptin and adiponectin),induce inflammatory and oxidative stress responses,and activate adipogenic pathways leading to lipid accumulation.CONCLUSION Post-transplant obesity arises from a complex interplay of pharmacological,behavioral,and molecular factors.A multidisciplinary approach-incorporating pharmacological modification,nutritional management,physical activity,and molecular-targeted therapies-is essential to mitigate obesity and improve transplant outcomes.Further large-scale and mechanistic studies are warranted to establish evidence-based preventive and treatment strategies.
