Donor T. N. F. alpha Linked to Worse Kidney Grafts 02/06/26
Welcome to Cardiology Today – Recorded February 06, 2026. This episode summarizes 5 key cardiology studies on topics like heart transplantation and Cytomegalovirus. Key takeaway: Donor T. N. F. alpha Linked to Worse Kidney Grafts.
Article Links:
Article 1: Safety-Net Kidney Transplantation After Heart Transplantation: Early Real-World Outcomes Under the New Policy. (The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation)
Article 2: A Molecular Reappraisal of Quilty Lesions: Insights from Tissue and Circulating Biomarkers in Heart Transplantation. (The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation)
Article 3: Circulating TNFα in deceased donors promotes kidney injury and associates with inferior short- and long-term graft function and survival. (American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons)
Article 4: Frequency of Viral Monitoring to Detect Cytomegalovirus Infection and Prevent Disease in Solid Organ Transplant Recipients: An International, Multicenter Cohort Study. (American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons)
Article 5: Abelacimab vs Rivaroxaban in Older Individuals With Atrial Fibrillation: A Prespecified Analysis of the Phase 2b AZALEA-TIMI 71 Trial. (JAMA cardiology)
Full episode page: https://podcast.explainheart.com/podcast/donor-t-n-f-alpha-linked-to-worse-kidney-grafts-02-06-26/
📚 Featured Articles
Article 1: Safety-Net Kidney Transplantation After Heart Transplantation: Early Real-World Outcomes Under the New Policy.
Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41643794
Summary: Among 4650 adult heart transplant recipients during the first 24 months of policy implementation, 987 patients, or 21.2 percent, met Safety-Net Kidney Transplantation eligibility within one year of heart transplantation. These eligible patients demonstrated significantly lower one-year survival compared with heart transplant recipients who did not meet eligibility criteria. The data highlights a substantial proportion of heart transplant recipients requiring subsequent kidney transplantation and indicates a clear association between this eligibility and adverse survival outcomes.
Article 2: A Molecular Reappraisal of Quilty Lesions: Insights from Tissue and Circulating Biomarkers in Heart Transplantation.
Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41643793
Summary: Quilty lesions are characterized by nodular T-lymphocyte infiltrates found in the endocardium of transplanted hearts. The clinical significance of these lesions remains controversial, with their precise relationship to rejection not fully understood in clinical practice. This study utilized tissue-based transcriptomic diagnostics, specifically Molecular Microscope Analysis, to investigate the link between Quilty lesions and cardiac rejection. Understanding the impact of Quilty lesions on clinical outcomes for heart transplant recipients represents a critical area of ongoing research.
Article 3: Circulating TNFα in deceased donors promotes kidney injury and associates with inferior short- and long-term graft function and survival.
Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41644055
Summary: N. F. alpha in deceased donors promotes kidney injury and associates with inferior short- and long-term graft function and survival. This study found that circulating Tumor Necrosis Factor alpha in deceased donors promotes kidney injury in transplant recipients. High levels of donor Tumor Necrosis Factor alpha were associated with inferior short-term graft function and reduced long-term graft survival. The data indicated a direct link between systemic inflammation in deceased donors, as measured by Tumor Necrosis Factor alpha and its receptors Tumor Necrosis Factor Receptor 1 and Tumor Necrosis Factor Receptor 2, and detrimental post-transplant kidney outcomes. These findings underscore the critical impact of donor inflammatory status on kidney transplant success and inform strategies for donor management.
Article 4: Frequency of Viral Monitoring to Detect Cytomegalovirus Infection and Prevent Disease in Solid Organ Transplant Recipients: An International, Multicenter Cohort Study.
Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41644054
Summary: Cytomegalovirus disease in solid organ transplant recipients is preventable through antiviral prophylaxis or preemptive therapy. However, the optimal frequency for Cytomegalovirus monitoring to detect infection and prevent disease remains unclear in clinical practice. An ongoing debate exists regarding the necessity of Cytomegalovirus surveillance after antiviral prophylaxis has concluded. This international multicenter cohort study examined the associations between different monitoring frequencies and the incidence of Cytomegalovirus infection and disease in solid organ transplant recipients.
Article 5: Abelacimab vs Rivaroxaban in Older Individuals With Atrial Fibrillation: A Prespecified Analysis of the Phase 2b AZALEA-TIMI 71 Trial.
Journal: JAMA cardiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41637102
Summary: I. M. I. 71 Trial. Older individuals with atrial fibrillation face a strong risk of bleeding when using currently available anticoagulants. Factor X. I. inhibition represents a promising anticoagulant strategy with the potential for an improved safety profile in this vulnerable population. The phase two b A. Z. A. L. E. A. – T. I. M. I. 71 trial evaluated the safety of abelacimab, a novel Factor X. I. inhibitor, against rivaroxaban. Patients with atrial fibrillation were randomized to receive either monthly subcutaneous abelacimab at 90 mg or 150 mg, or daily oral rivaroxaban at 20 mg, with dose adjustments for renal impairment.
📝 Transcript
Today’s date is February 06, 2026. Welcome to Cardiology Today. Here are the latest research findings.
Article number one. Safety-Net Kidney Transplantation After Heart Transplantation: Early Real-World Outcomes Under the New Policy. Among 4650 adult heart transplant recipients during the first 24 months of policy implementation, 987 patients, or 21.2 percent, met Safety-Net Kidney Transplantation eligibility within one year of heart transplantation. These eligible patients demonstrated significantly lower one-year survival compared with heart transplant recipients who did not meet eligibility criteria. The data highlights a substantial proportion of heart transplant recipients requiring subsequent kidney transplantation and indicates a clear association between this eligibility and adverse survival outcomes.
Article number two. A Molecular Reappraisal of Quilty Lesions: Insights from Tissue and Circulating Biomarkers in Heart Transplantation. Quilty lesions are characterized by nodular T-lymphocyte infiltrates found in the endocardium of transplanted hearts. The clinical significance of these lesions remains controversial, with their precise relationship to rejection not fully understood in clinical practice. This study utilized tissue-based transcriptomic diagnostics, specifically Molecular Microscope Analysis, to investigate the link between Quilty lesions and cardiac rejection. Understanding the impact of Quilty lesions on clinical outcomes for heart transplant recipients represents a critical area of ongoing research.
Article number three. Circulating T. N. F. alpha in deceased donors promotes kidney injury and associates with inferior short- and long-term graft function and survival. This study found that circulating Tumor Necrosis Factor alpha in deceased donors promotes kidney injury in transplant recipients. High levels of donor Tumor Necrosis Factor alpha were associated with inferior short-term graft function and reduced long-term graft survival. The data indicated a direct link between systemic inflammation in deceased donors, as measured by Tumor Necrosis Factor alpha and its receptors Tumor Necrosis Factor Receptor 1 and Tumor Necrosis Factor Receptor 2, and detrimental post-transplant kidney outcomes. These findings underscore the critical impact of donor inflammatory status on kidney transplant success and inform strategies for donor management.
Article number four. Frequency of Viral Monitoring to Detect Cytomegalovirus Infection and Prevent Disease in Solid Organ Transplant Recipients: An International, Multicenter Cohort Study. Cytomegalovirus disease in solid organ transplant recipients is preventable through antiviral prophylaxis or preemptive therapy. However, the optimal frequency for Cytomegalovirus monitoring to detect infection and prevent disease remains unclear in clinical practice. An ongoing debate exists regarding the necessity of Cytomegalovirus surveillance after antiviral prophylaxis has concluded. This international multicenter cohort study examined the associations between different monitoring frequencies and the incidence of Cytomegalovirus infection and disease in solid organ transplant recipients.
Article number five. Abelacimab vs Rivaroxaban in Older Individuals With Atrial Fibrillation: A Prespecified Analysis of the Phase 2b AZALEA-T. I. M. I. 71 Trial. Older individuals with atrial fibrillation face a strong risk of bleeding when using currently available anticoagulants. Factor X. I. inhibition represents a promising anticoagulant strategy with the potential for an improved safety profile in this vulnerable population. The phase two b A. Z. A. L. E. A. – T. I. M. I. 71 trial evaluated the safety of abelacimab, a novel Factor X. I. inhibitor, against rivaroxaban. Patients with atrial fibrillation were randomized to receive either monthly subcutaneous abelacimab at 90 mg or 150 mg, or daily oral rivaroxaban at 20 mg, with dose adjustments for renal impairment.
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🔍 Keywords
heart transplantation, Cytomegalovirus, post-transplant survival, preemptive therapy, cardiac rejection, safety-net transplantation, Quilty lesions, solid organ transplant, T-lymphocytes, rivaroxaban, kidney transplantation, renal dysfunction, anticoagulation, antiviral prophylaxis, Tumor Necrosis Factor alpha, kidney injury, endomyocardial biopsy, deceased donors, atrial fibrillation, graft function, Factor X. I. inhibition, abelacimab, graft survival, viral monitoring.
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