ABSTRACT Introduction Identifying suitable donors and optimizing transplant timing are critical in allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia. This retrospective study evaluated 124 Israeli adult AML patients (99 Jews, 25 Arabs) who underwent their first allo‐HSCT between 2012 and 2022. We assessed donor types, key transplantation time intervals, overall survival, and the impact of the COVID‐19 pandemic. Method Overall, 80.7% of patients received fully matched grafts. Donor type distribution differed significantly between ethnic groups ( p = 0.007): Israeli Arabs predominantly received matched related donors (64%) with few matched unrelated donors (8%), whereas Israeli Jews showed a balanced distribution (41.4% each). Despite these differences, there were no significant disparities in time from diagnosis to transplantation (119 vs. 122 days, p = 0.871) or in overall survival. The COVID‐19 pandemic was associated with prolonged time from coordinator referral to transplantation ( p < 0.001) but did not significantly affect overall survival ( p = 0.059). Conclusion In conclusion, differences in donor type by ethnicity did not translate into disparities in transplantation timing or overall survival. These findings highlight the resilience of the transplantation process and the importance of evaluating ethnicity within the context of a specific healthcare system.
ABSTRACT Introduction In 2022, Organ Procurement and Transplantation Network policy was revised to permit living kidney donation by carefully selected individuals with type 2 diabetes mellitus (T2DM), which had previously been prohibited. Early evaluation is needed to understand adoption of this practice and short‐term donor outcomes. Methods We performed a retrospective cohort study using U.S. national transplant registry data. Living kidney donors with and without pre‐existing T2DM from July 26, 2022 through December 31, 2025 were compared. We examined prevalence, temporal trends, donor characteristics, and early post‐donation outcomes. Five registry‐captured chronic kidney disease risk factors at donation were assessed: insulin dependence, smoking, hypertension, body mass index ≥30 kg/m 2 , and proteinuria. Results Among 21,827 donors, 46 (0.21%) had T2DM at donation. T2DM incidence increased from 7 donors in 2022 (0.11%) to 17 (0.26%) in 2025. T2DM donors were older than non‐T2DM donors (median 54y vs. 45y; p < 0.001), and 87% of T2DM donors had ≥1 additional risk factor for CKD. No T2DM donors died, initiated dialysis, or were added to the transplant waiting list. Median most recent eGFR within 2 years was 61 vs. 66 mL/min/1.73m 2 in donors with and without T2DM ( p = 0.20). eGFR <45 mL/min/1.73m 2 , was more frequent in donors with T2DM ( n = 4; 12% vs. n = 596; 4%; p = 0.03) and median 6‐month eGFR‐per‐kidney gain was 11 vs.15 mL/min/1.73m 2 , ( p = 0.12), and proteinuria was present in 12% of T2DM donors vs. 7% ( p = 0.23). Conclusions Living kidney donation by individuals with T2DM is uncommon but increasing. Though differences in early outcomes for T2DM vs. non‐T2DM donors were not statistically significant, these null findings are based on small sample sizes and should not be interpreted as evidence of long‐term safety. Careful donor selection and longer‐term follow‐up are needed to better define donor risk.
ABSTRACT Background Bone loss and fractures are critical post‐kidney transplantation (KT) complications. We evaluated age‐stratified screening practices, treatment patterns, and fracture incidence in a nationwide KT cohort. Methods Using the Korean National Health Insurance Service database (2003–2020), we analyzed 34 758 adult KT recipients. Screening practices (bone mineral density [BMD] testing), medication continuity, and incident fractures were assessed across age groups (< 50, 50–64, ≥ 65 years). Results During a median follow‐up of 8.4 years, 63.8% of recipients underwent BMD testing, but only 29.9% were screened within the first year post‐transplant. Overall fracture incidence was 1.2/100 person‐years (PY), increasing to 3.9/100 PY in recipients aged ≥ 65 (IRR 5.41 vs. < 50 years). The excess fracture risk in older recipients persisted across all post‐transplant time intervals (adjusted SHR 4.18, 4.23, and 3.61 for < 1, 1–5, and ≥ 5 years, respectively). Despite a 5.2‐ to 7.6‐fold increase in post‐KT fracture risk associated with a pre‐transplant fracture history, screening practices were not consistently intensified among younger patients with prior fractures. Conclusions Post‐transplant bone health management is characterized by delayed assessment and insufficient risk‐stratified screening. Risk‐adapted strategies are necessary to improve early screening and sustained therapy, particularly for high‐risk recipients.
