ライフサイエンスコーパス: DCD

1 DCD grafts in particular are associated with ischemic-ty

2 DCD is an important form of organ donation.

3 DCD kidneys with WIT>48 minutes had a higher risk of all

4 Biliary anastomotic strictures occurred in 1 DCD patient and 3 DBD patients.

5 In total, 441 cases were included: 115 DCD and 326 DBD grafts.

6 al (DBD HR, 0.71; 95% CI, 0.46-1.10; P = 12; DCD HR, 0.99; 95% CI, 0.58-1.73; P = 1.00).

7 ors fulfilling expanded criteria status (41% DCD vs. 32% DBD; p = 0.01).

8 d at our center between 2006 and 2010 (65.5% DCD, 34.5% donation after brain death [DBD]) were review

9 Between 2002-2003 and 2011-2012, 430 (54%) DCD and 361 (46%) donation after brain death (DBD) kidne

10 ent survival for liver is 77% (DBD) and 68% (DCD), heart 67%, and lung 52% (DBD).

11 Among the 12,831 DCD kidneys transplanted, kidneys with WIT</=48 minutes

12 identified--DBD-SCD (n=154), DBD-ECD (n=93), DCD-SCD (n=78), and DCD-ECD (n=34).

13 ame actual DCD, 82 (17%) were attempted as a DCD but did not progress to donation, and 81 (16%) trans

14 programme in improving balance deficits in a DCD population.

15 graft outcomes for pediatric recipients of a DCD kidney.

16 on frequency-matched patients who received a DCD kidney transplant between August 2007 and August 200

17 pients listed for HCC of which 91 received a DCD.

18 Children receiving a DCD kidney transplant have good renal allograft survival

19 015; Austria only occasionally transplants a DCD liver; other Eurotransplant countries do not have ac

20 ex where more males were transplanted with a DCD donor (62.7%) vs (48.3%, P = 0.048).

21 Eurotransplant countries do not have active DCD programs.

22 ized potential DCDs, 331 (67%) became actual DCD, 82 (17%) were attempted as a DCD but did not progre

23 n and preventing serious complications after DCD transplantation.

24 An outbreak of A. baumannii emerging after DCD renal transplantation was tracked to understand the

25 rombolytic donor flush, may prevent IC after DCD LT.

26 al setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown.

27 uly 2011 (era II), to improve outcomes after DCD LT, measures were taken to minimize CIT, operative t

28 Data were collected for all DCD donors between 1/2011 and 9/2014.

29 47 blockade in a syngeneic and an allogeneic DCD rat kidney transplant model.

30 Among DCD transplants (n=1943), PSC and non-PSC patients showe

31 1.032; 95% CI, 1.008-1.056; P = 0.008), and DCD graft (OR 3.913; 95% CI 1.200-12.767; P = 0.024) as

32 (n=154), DBD-ECD (n=93), DCD-SCD (n=78), and DCD-ECD (n=34).

33 CI in the LD group and 18 hr in the DBD and DCD groups, gene expression levels were similar to those

34 P = 0.15) did not differ between the DBD and DCD groups.

35 d equal proportions of living donor, DBD and DCD kidney transplants.

36 t survivals were similar between DCD-ECD and DCD-SCD cohorts (1 year, 90% and 93%; 2 years, 81% and 9

37 , and E-selectin in DBD compared with LD and DCD kidneys.

38 CD kidneys in pediatric transplantation, and DCD allocation algorithms may need to be reviewed in vie

39 ation is not always possible after attempted DCD.

40 , 1.31; 95% CI, 0.62-2.78; P = 0.47) between DCD and DBD pancreas transplants.

41 Furthermore, the interaction between DCD transplant and PSC was significant (HR = 1.76, P = 0

42 ensored graft survivals were similar between DCD-ECD and DCD-SCD cohorts (1 year, 90% and 93%; 2 year

43 ar patient and graft survival rates for both DCD and DBD were 100%.

44 t source of kidneys for transplantation, but DCD donor transplantation is less common in the United S

45 t multimodal approach to assessing candidate DCD hearts.

46 Although clinical DCD lung, liver, and kidney transplantation are well est

47 Comparing DCD and DBD groups, recipient median age (28.4 vs 20.1 m

48 Thirty consecutive DCD LTs were performed prospectively in era II.

49 During the timeframe considered, DCD donation was attempted in 169 patients.

50 In contrast, DCD kidneys show only mild up-regulation of inflammatory

51 Eight controlled DCD donors underwent NRP from which 3 livers, 2 pancreas

52 Most DCD kidneys are from controlled DCD (cDCD; Maastricht category III).

53 donation and exploring methods of converting DCD to DBD donors.

54 This overview examines current DCD practices, identifies problems and challenges, and s

55 Using current DCD criteria, pancreas transplantation is a viable alter

56 raft and patient survival compared with DBD, DCD SLK provides an acceptable option for SLK, with a su

57 We show here that deoxycytidine deaminase (DCD)-deficient mutants of Escherichia coli are hypersens

58 CD) within the donation after cardiac death (DCD) and donation after brain stem death (DBD) cohorts.

59 procurement in donation after cardiac death (DCD) donation in 1 participating center, each liver graf

60 Increasingly, donation after cardiac death (DCD) donors are used in view of the organ donor shortage

61 er grafts from donation after cardiac death (DCD) donors have resulted in reservations with their wid

62 donor (ECD) or donation after cardiac death (DCD) grafts than patients in the SWTR (P < 0.0001 for al

63 enal allografts donated after cardiac death (DCD) in a porcine animal model of transplantation.

64 d in simulated Donation after Cardiac Death (DCD) in porcine kidneys to measure intrarenal perfusion.

65 lication after donation after cardiac death (DCD) kidney transplants, but the impact of DGF on graft

66 eath (DBD) and donation after cardiac death (DCD) kidneys before donation, after cold ischemia and af

67 often allocated a donor after cardiac death (DCD) liver as a solution for waiting times.

68 ol provided by donation after cardiac death (DCD) liver transplantation.

69 Donation after cardiac death (DCD) to overcome the donor organ shortage is well accept

70 has the use of donation after cardiac death (DCD).

71 increase in donors after circulatory death (DCD) (from 1.1 pmp to 7.9 pmp) while the numbers of dono

72 r EGL were donation after circulatory death (DCD) (odds ratio [OR] 2.88; p = 0.006), expanded criteri

73 T) between donation after circulatory death (DCD) and donation after brain death (DBD) grafts with th

74 howed that donation after circulatory death (DCD) canine hearts can be resuscitated if perfused with

75 Donation after circulatory death (DCD) donor pool remains underutilized for liver transpla

76 Donation after circulatory death (DCD) donors are an important source of kidneys for trans

77 ys from potential elderly circulatory death (DCD) donors are declined.

78 tion using donation after circulatory death (DCD) donors is associated with inferior outcomes compare

79 Bank (NEOB) donors after circulatory death (DCD) donors were analyzed between July 1, 2009, and June

80 Organ donation after circulatory death (DCD) has been endorsed by the World Health Organization

81 While donation after circulatory death (DCD) has expanded options for organ donation, many who w

82 gh rate of donation after circulatory death (DCD) in the Netherlands.

83 Donation after circulatory death (DCD) is current clinical practice to increase the donor

84 ivers from donation after circulatory death (DCD) is increasing, but concerns exist regarding outcome

85 Organ donation after circulatory death (DCD) is increasingly being used as a means of addressing

86 ations for donation after circulatory death (DCD) is the prediction that death will occur within a re

87 d Kingdom, donation after circulatory death (DCD) kidney transplant activity has increased rapidly, b

88 Donation after circulatory death (DCD) kidney transplantation has acceptable renal allogra

89 ngle-organ donation after circulatory death (DCD) kidneys preserved with HMP with those preserved usi

90 praisal of donation after circulatory death (DCD) kidneys.

91 ntation of donation after circulatory death (DCD) livers is limited by poor outcomes, but its applica

92 itation of donation after circulatory death (DCD) lungs.

93 Donation after circulatory death (DCD) makes a significant contribution to the transplant

94 Hearts donated following circulatory death (DCD) may represent an additional source of organs for tr

95 controlled donation after circulatory death (DCD) program and the controversies surrounding it.

96 Donation after circulatory death (DCD) provides an alternative pathway to deceased organ t

97 covered from donors after circulatory death (DCD) suffer warm ischemia before cold storage which may

98 ed to donate organs after circulatory death (DCD) using a standardized DCD protocol.

99 (DBD) and Donation after Circulatory Death (DCD) were included.

100 occur with donation after circulatory death (DCD) would significantly increase the donor pool for liv

101 (40%) from donation after circulatory death (DCD), of which nine were transplanted.

102 btained from donors after circulatory death (DCD).

103 rs in the UK donate after circulatory death (DCD).

104 rain death (DBD) or after circulatory death (DCD).

105 psies from donation after circulatory death (DCD, n = 36, mean warm ischemia time = 2 min) and donati

106 15,122), and donors after circulatory death (DCD, n=8,395) kidney transplant recipients were identifi

107 on after circulatory determination of death (DCD) increased fourfold in the past decade.

108 livers (9 donation after circulatory death [DCD] and 3 from brain-dead donors), median Donor Risk In

109 30, 2015 (donation after circulatory death [DCD] donors).

110 h the nitrification inhibitor Dicyandiamide (DCD) was the only management strategy that consistently

111 en with developmental coordination disorder (DCD).

112 inuous domain (CD) and discontinuous domain (DCD) structure predictions.

113 from neurologically brain dead (NBD) donors, DCD kidneys had a higher adjusted odds ratio of discard

114 sue plasminogen activator (tPA) flush during DCD procurements.

115 Normothermic regional perfusion used during DCD abdominal organ retrieval may reduce ischemic organ

116 h acceptable transplant outcomes for elderly DCD kidneys and may increase transplant numbers from an

117 ionally more kidney transplants from elderly DCD donors (23.4%) than the rest of the United Kingdom (

118 dual transplants were performed from elderly DCD donors.

119 on is warranted if the allocation of elderly DCD grafts to elderly recipients is to be expanded.

120 sion analysis, elderly recipients of elderly DCD kidneys experienced more delayed graft function and

121 sion analysis, elderly recipients of elderly DCD kidneys had a 5-year mortality risk higher than that

122 ipients, 63.8% of those who received elderly DCD kidneys, 45.5% of those who received elderly DBD kid

123 It may be useful to explore DCD donor family satisfaction to identify other options

124 rscores the reluctance to recover extrarenal DCD organs since lack of medical therapy to support inad

125 d transplants from 2002 to 2012 with a first DCD kidney.

126 For DCD, the primary nonfunction rate was 5% and delayed gra

127 from a mean of 3.6 to 4.0 per donor and for DCD donors from 2.2 to 2.6.

128 was similar (94% vs 95%; P = 0.70), but for DCD donor kidneys, DCGS was lower in those allocated via

129 vs 52 mL/min per 1.73 m; P = 0.01), but for DCD kidneys, there was no difference (45 vs 48 mL/min pe

130 conferred the same survival disadvantage for DCD and DBD kidneys.

131 tive median CCI was significantly higher for DCD grafts (53.4 vs 47.2; P = 0.041).

132 median follow-up of 50.5 (+/-3.7) months for DCD and 66.8 (+/-1.5) months for DBD.

133 ITBL, is needed to improve the outcomes for DCD grafts.

134 The national outcomes for DCD LT have improved over the last 12 years.

135 LT, but the CCI increases significantly for DCD recipients in 6 months after transplantation.

136 injury and transplant outcome is similar for DCD and DBD kidneys.

137 , but the spectrum of scores was similar for DCD and DBD kidneys.

138 tion rate during the index hospital stay for DCD and DBD LT, but the CCI increases significantly for

139 d compared it with standard cold storage for DCD heart preservation.

140 hermic oxygenated perfusion (HOPE), used for DCD liver grafts, is based on cold perfusion for 1 hour

141 6 subjects received SLK from DBD and 98 from DCD.

142 olated from the donors' preserved fluid from DCD (donation after cardiac death) renal transplantation

143 ystematically review recipient outcomes from DCD donors and where possible compared these with donor

144 that the metabolic imbalance resulting from DCD deficiency affects the assembly of the outer membran

145 ed, transplantation of hearts retrieved from DCD donors has reached clinical translation only recentl

146 Kidney, liver, and patient survival from DCD donors were inferior to DBD at 1, 3, and 5 years (P=

147 ed from the 81 donors that transitioned from DCD to actual DBD, including 24 heart, 70 liver, 12 sing

148 Kidney transplantation from DCD now represents a significant part of the overall tra

149 enter outcomes for kidneys transplanted from DCD donors over 70 years old, using preimplantation biop

150 Twenty-one (1.2%) of these were from DCD donors, 955 (53.9%) from DBD donors, and 796 (44.9%)

151 symmetry comparison, is applied for further DCD detections.

152 MVA grouped DCD vs. DBD (p = 6.20 x 10(-12)) and 12 phospholipids we

153 hospital CCI was comparable for both groups (DCD 38.2; DBD 36.7; P = 0.429).

154 NRP retrievals from Maastricht category III DCD donors were performed at three UK centers.

155 and premortem heparin administration improve DCD liver transplant outcomes, thus allowing for the mos

156 This therapy has the potential to improve DCD kidney transplant outcomes in the human setting.

157 tion to identify other options for improving DCD donation.

158 In DCD and DBD kidneys, early apoptosis increased after CI.

159 se-3 was used to evaluate early apoptosis in DCD and DBD kidneys.

160 30 to 3.26), whereas there was a decrease in DCD (1.54 to 0.99) due to a large rise in donors who did

161 Similar pathways were also enriched in DCD donors after the first warm ischemia time.

162 Local expansion in DCD kidney transplant activity improves survival outcome

163 -controlled NEVKP improves renal function in DCD kidney transplantation.

164 ults may imply why delayed graft function in DCD kidneys does not have the deleterious effect it has

165 and ischemic cholangiopathy were greater in DCD recipients (32.6% vs. 15% [p < 0.001] and 9.1% vs. 1

166 of graft thrombosis was 1.67 times higher in DCD organs (95% CI, 1.04-2.67; P = 0.006).

167 aminotransferase was significantly higher in DCD recipients until 48 h after transplant (p < 0.001).

168 , and when CIT was between 6 and 24 hours in DCD transplants.

169 As warm ischemic time exposure increased in DCD groups, fewer hearts were functional during EVHP, an

170 Bax was increased in DCD kidneys, and Bcl-2 was decreased in DBD kidneys.

171 nary dysfunction, edema, and inflammation in DCD lungs, which are further reduced by A2AR agonism.

172 ecreases IRI and subsequent tissue injury in DCD renal allografts in a large animal transplant model.

173 ) and LysoPC (18:0), showed higher levels in DCD at pre-transplantation (q < 0.01).

174 omerular filtration rate (eGFR) was lower in DCD-ECD recipients at 12 months (41 vs. 53 mL/min, P=0.0

175 NRP in DCD donation facilitates organ recovery and may improve

176 worse graft survival were still observed in DCD recipients.

177 ience, both short- and long-term outcomes in DCD lung recipients are comparable to that of DBD lung r

178 has been almost solely because of a rise in DCD donation.

179 could potentially improve graft survival in DCD kidney transplants.

180 Short-term graft survival in DCD-ECD transplants was comparable to DCD-SCD and DBD-EC

181 eded to understand the potential to increase DCD donor transplantation in the United States.

182 We report how increased DCD kidney transplant activity influenced waitlisted out

183 distinguishing features of severely injured DCD hearts.

184 compared to the 5 years following, intended DCD donors increased 292% (1187 to 4652), and intended D

185 ingdom from 2000 to 2014 were separated into DCD, donation after brain death (DBD), and living donor

186 nd cold stored for 4 and 18 hours, mimicking DCD organ procurement and conventional preservation.

187 Anesthetized greyhounds underwent 30 minutes DCD by withdrawal of ventilation followed by assignment

188 With the use of the Cox model, DCD was a significant risk factor for kidney and liver a

189 d with DBD-ECD recipients also at 24 months, DCD-ECD recipients showed a lower graft function (median

190 Moreover, more DCD recipients underwent retransplantation for ITBL in t

191 Most DCD kidneys are from controlled DCD (cDCD; Maastricht ca

192 Nevertheless, DCD kidneys exhibit comparable function and survival to

193 country's 58 donor service areas, and 25% of DCD kidneys were recovered in only four donor service ar

194 ria), there are variations in all aspects of DCD practice.

195 This potential benefit of DCD pancreas donation warrants further study.

196 gher incidence of ischemic cholangiopathy of DCD compared with DBD recipients were improved by withdr

197 vided into 3 equal eras based on the date of DCD LT: era 1 (2003-2006), era 2 (2007-2010), and era 3

198 er prospective longitudinal cohort design of DCD eligible patients (n=318), with the primary binary o

199 vel variation in the recovery and discard of DCD kidneys is large.

200 suscitation, preservation, and evaluation of DCD hearts prior to transplantation.

201 HOPE of DCD kidneys was superior to other clinically used preser

202 However, the impact of DCD transplantation on PSC graft outcomes is unknown.

203 eference of the successful implementation of DCD that enables an expansion of deceased donation (incl

204 w that CD47mAb blockade decreased the IRI of DCD kidneys in rat transplant models.

205 The majority of DCD donors who proceeded did so within 30 min from time

206 atform to study rehabilitative mechanisms of DCD lungs.

207 tic cold storage (SCS) in a porcine model of DCD autotransplantation.

208 taining therapy (WLST) in a porcine model of DCD.

209 d crystalloid perfusion in a canine model of DCD: (1) facilitates aerobic metabolism and resuscitates

210 Considering that the number of DCD kidney transplants is destined to rise in the UK, we

211 h 2015, for studies reporting the outcome of DCD pancreas transplants.

212 We compared outcomes of DCD and DBD transplants with and without (standard crite

213 wever, little is known about the outcomes of DCD in SLK.

214 id option to continue optimizing outcomes of DCD kidney transplant.

215 Sharing database to compare the outcomes of DCD SLK to donation after brain death (DBD) and determin

216 Of the 74 pairs of DCD kidneys followed for a median of 1.9 years (408 pers

217 Pretransplant machine perfusion of DCD kidneys (vs. static storage) may reduce delayed graf

218 ing ex situ pretransplant organ perfusion of DCD organs has been encouraging in this regard.

219 romise for improved clinical preservation of DCD and marginal donor hearts.

220 ansplant Centre, with a higher proportion of DCD donors fulfilling expanded criteria status (41% DCD

221 h U.K. outcomes, for which the proportion of DCD:DBD kidney transplants performed is lower (25%; p <

222 Recipients of DCD kidneys with DGF experienced a higher incidence of o

223 obtained between 2008 and 2015, recovery of DCD kidneys varied substantially among the country's 58

224 Shortly after reperfusion of DCD grafts, pathways related to prolonged and worsening

225 le-center study of all LT since the start of DCD program (2001-2015).

226 HOPE treatment of DCD livers significantly decreased graft injury compared

227 mic injury may safely allow increased use of DCD kidneys with WIT>48 minutes.

228 R = 1.76, P = 0.015), indicating that use of DCD organs impacts graft survival more in PSC than non-P

229 We recommend cautious use of DCD transplantation in this population.

230 iatric DCD kidneys and from selective use of DCD/ECD kidneys, whereas a modest increase could result

231 Utilization of DCD organs is limited by hypoxia, hypotension, reduced--

232 imited by concern regarding the viability of DCD hearts.

233 Although there is uniform agreement on DCD donor candidacy (ventilator-dependent individuals wi

234 a fashion consistent with published data on DCD use in liver transplantation (LT).

235 n NMP was 11.5 h (range 3.3-22.5 h) with one DCD liver perfused for 22.5 h.

236 between the DCD and DBD groups (P = 0.42) or DCD and LD groups (P = 0.84).

237 ts (>/=18 years) who received a first DBD or DCD kidney during 2002-2012, and categorized them as you

238 ately 26% of those who received young DBD or DCD kidneys had an eGFR<30 ml/min per 1.73 m(2) (includi

239 intended donation after brain death (DBD) or DCD donors from April 2004 to March 2014.

240 rences for either outcome between the paired DCD and DBD patients (p = 0.162 and p = 0.519, respectiv

241 Using paired DCD kidney data from the Australia and New Zealand Dialy

242 lays dark degeneration of Purkinje cells (PC-DCD) of mitochondrial origin.

243 ncentrations, which subsequently triggers PC-DCD.

244 could accrue from increased use of pediatric DCD kidneys and from selective use of DCD/ECD kidneys, w

245 In addition, HOPE-perfused DCD livers achieved similar results as control donation

246 d by variable acirculatory standoff periods (DCD groups).

247 n in relation to imminent death of potential DCD donors.

248 curacy of these rules in a pool of potential DCD donors.

249 ally; p < 0.001), who received predominantly DCD kidneys from older donors (mean donor age 64 years),

250 ormally preserved (static cold preservation) DCD liver grafts (n = 50) from 2 well-established Europe

251 The PSC patients receiving DCD livers (n=75) showed greater overall graft failure (

252 Overall, 20% of recovered DCD kidneys were discarded, varying from 3% to 33% among

253 ore transplantation in a clinically relevant DCD model.

254 important benefits in preserving higher-risk DCD liver grafts.

255 ited evidence encourages the use of selected DCD kidneys in pediatric transplantation, and DCD alloca

256 tegration of these practices into a standard DCD protocol.

257 circulatory death (DCD) using a standardized DCD protocol.

258 aft injury compared with matched cold-stored DCD livers regarding peak alanine-aminotransferase (1239

259 In this retrospective study, DCD LTx recipients (n = 59) were compared with a cohort

260 We also report here that DCD-deficient mutants of E. coli are more sensitive to a

261 Our findings suggest that DCD and ECD transplantation are significant risk factors

262 The DCD participants were randomly assigned to either a FMT

263 With this approach, the DCD donor pool may be expanded.

264 3-year renal allograft survival between the DCD and DBD groups (P = 0.42) or DCD and LD groups (P =

265 For the DCD donors, the median donor warm ischemia duration was

266 ar renal allograft survival was 95.2% in the DCD group, 87.1% in the DBD group, and 92.9% in the LD g

267 Patient survival is 100% in the DCD group, 98.7% in the DBD group, and 98.9% in the LD g

268 y nor vascular complications occurred in the DCD group.

269 wever, the impact of donor extubation on the DCD heart has not been well characterized.

270 y-clustering algorithm is used to refine the DCD-linker locations.

271 ates aerobic metabolism and resuscitates the DCD heart, (2) provides functional and metabolic recover

272 sociated with a lower 1-year eGFR within the DCD cohort, with donor age (B=-0.42, P=0.002) being the

273 Therefore, DCD LTx can be considered a safe strategy that significa

274 Three DCD liver recipients developed cholangiopathy, and this

275 val in DCD-ECD transplants was comparable to DCD-SCD and DBD-ECD transplants albeit with poorer allog

276 Traditionally, DCD organ recovery involves cold thoracic and abdominal

277 could be discriminated from 'transplantable' DCD livers.

278 HOPE-treated DCD kidneys showed dramatically better function after tr

279 HOPE-treated DCD livers (n = 25) were matched and compared with norma

280 Donor liver quality in terms of graft type (DCD) has no influence on cancer related survival in tran

281 Neither did the graft variables of type (DCD vs DBD), donor age, steatosis, cold ischemic time, p

282 Patients undergoing DCD LT between 2003 and 2014 were obtained from the Unit

283 In a second step, perfused and unperfused DCD livers were compared with liver grafts from standard

284 PE-treated livers, whereas 18% of unperfused DCD livers needed retransplantation.

285 splants are not possible due to unsuccessful DCD organ donation.

286 who had direct experience with unsuccessful DCD and 5 focus groups with professionals involved in th

287 Minor increases in usable DCD kidneys could accrue from increased use of pediatric

288 There is reluctance to use DCD hearts, due to an inability to precisely identify he

289 with liver transplantation in children using DCD organs.

290 18 years and younger who underwent OLT using DCD organs between February 1, 1990, and November 30, 20

291 ears, 234 transplants were carried out using DCD grafts.

292 To compare outcomes in transplants using DCD and donation after brain death (DBD), propensity sco

293 (hazard ratio [HR]=0.72, P < 0.001), whereas DCD transplantation increased risk of graft failure (HR

294 e aim of this study was to determine whether DCD transplantation was associated with poorer cancer-re

295 We next evaluated whether DCD livers with steatotic and severe ischemic injury cou

296 hrombosis was not higher in recipients whose DCD donors were given antemortem heparin (P = 0.62).

297 controlled trial involving 88 children with DCD was conducted to evaluate the efficacy of a task-spe

298 ove the balance performance of children with DCD.

299 hs (33 vs. 54 mL/min, P<0.001) compared with DCD-SCD recipients.

300 Nevertheless, limited results with DCD pancreas, liver, and lung allografts (but not heart)