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Background: Osteochondral allograft transplantation (OCAT) can be performed without the need for blood-type matching or anti-rejection medications. However, other donor-recipient mismatch variables could influence outcomes. Therefore, it is critical to examine the impacts of sex and age mismatching on functional OCA survival., Methods: Prospectively collected data for patients undergoing primary knee OCAT enrolled in a lifelong outcomes registry were analyzed for functional OCA survival based on sex- and age-matched and -mismatched cohorts. Treatment failure was defined as the need for OCAT revision surgery or knee arthroplasty., Results: 162 donor-recipient pairs were analyzed; 57 (35.2%) were sex-mismatched and 89 (54.9%) were age-mismatched. Sex-mismatched OCATs were not associated with a significantly different cumulative graft survival rate when compared to sex-matched OCATs (78.9% vs 75.2% p = 0.324). Age-mismatched OCATs were not associated with a significantly different cumulative graft survival rate when compared to age-matched OCATs (71.6% vs 81.5% p = 0.398). When adjusting for sex, BMI, concomitant procedures, and surgery type, age-mismatched and sex-mismatched OCATs were not significantly associated with higher likelihood for treatment failure., Conclusion: By analyzing functional graft survival rates for donor-recipient sex- or age-mismatched OCAs following primary OCAT, the results of the present study support current donor-recipient matching protocols for OCA transplantation in the knee. Based on current evidence, donor-recipient blood-type, sex-, and age-matching are not required for safe and effective primary OCAT in the knee. However, further studies are imperative for defining modifiable variables that further optimize safety and outcomes while maximizing donor tissue quality, availability, access, and use., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: James P Stannard is a paid consultant and receives research support from Arthrex, Inc; is a paid consultant for DePuy, A Johnson & Johnson Company; is on the editorial or governing board for the Journal of Knee Surgery; receives research support from National Institutes of Health (NIAMS & NICHD); is a paid consultant for Orthopedic Designs North America; is a paid consultant for Smith & Nephew; receives publishing royalties, financial or material support from Thieme; and receives research support from the U.S. Department of Defense. Aaron Stoker receives IP royalties from Musculoskeletal Transplant Foundation. Clayton William Nuelle is a board or committee member for AAOS; is a board or committee member for the American Orthopaedic Society for Sports Medicine; receives other financial or material support from AO Foundation; is a paid presenter or speaker for Arthrex, Inc; is on the editorial or governing board, receives publishing royalties, financial or material support from Arthroscopy; is a board or committee member for Arthroscopy Association of North America; is a paid consultant for Guidepoint Consulting; and is a paid presenter or speaker for Vericel, Inc. James L Cook receives research support from AANA; receives research support from AO Trauma; receives IP royalties, is a paid consultant and receives research support from Arthrex, Inc; is a paid consultant for Bioventus; is a paid consultant for Boehringer Ingelheim; is a paid consultant and receives research support from Collagen Matrix Inc; receives research support from GE Healthcare; is on the editorial or governing board for the Journal of Knee Surgery; is a board or committee member for Midwest Transplant Network; is a board or committee member, receives IP royalties and research support from Musculoskeletal Transplant Foundation; receives research support from the National Institutes of Health (NIAMS & NICHD); receives research support from OREF; receives research support from Orthopaedic Trauma Association; receives research support from PCORI; receives research support from Regenosine; receives research support from SITES Medical; receives publishing royalties, financial or material support from Thieme; is a paid consultant for Trupanion; and receives research support from U.S. Department of Defense., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The safety and efficacy of direct-acting antiviral therapies have allowed the transplantation of organs from hepatitis C virus (HCV)-viremic donors into uninfected recipients. This novel strategy contrasts with the previous standard-of-care practice of limiting the transplantation of HCV infected-donor organs to HCV-infected recipients, or all too often, discarding viable organs. In this review, we summarize the published literature about the safety and feasibility of transplanting organs from HCV-viremic donors, the challenges that hinder wider adoption of this strategy, and future research needs., (Published by Elsevier Inc.)

The evaluation of organ donors is of critical importance in all areas of solid organ transplantation. Donor characteristics have been shown to have robust effects on heart transplant recipient outcomes, and evaluation of the donor for suitability for heart transplantation is therefore very comprehensive. The donor evaluation process is composed of several steps, beginning with the identification of a potential organ donor and ending with the transplantation of a donor heart. The purpose of this review is to dissect the complex process of donor evaluation into its component steps and to highlight the diverse approaches used by transplant clinicians around the world to optimize outcomes at each step. We provide a summary of donor characteristics that have been associated with increased recipient mortality and discuss areas of uncertainty. Recent additions to the literature present novel insights and solutions to vexing problems in donor evaluation, such as how to make a more accurate assessment of allograft quality. Continued advancement in the evaluation of donors is essential to maintain heart transplantation as a viable therapy that provides excellent long-term survival for patients with end-stage heart failure., (Published by Elsevier Inc.)