Indian Journal of Transplantation最新文献

{"title":"Transplant Outcomes and Weight Management in Renal Disease Study.","authors":"Manish Lalwani, Rizwan Alam, Selvin Sundar Raj Mani, Joseph Johny, Jeethu Joseph Eapen, Athul Thomas, Elenjickal Elias John, Suceena Alexander, Vinoi George David, Santosh Varughese","doi":"10.4103/ijot.ijot_33_25","DOIUrl":"10.4103/ijot.ijot_33_25","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to assess the impact of weight gain on patient and graft survival in renal transplant recipients over a 10-year period.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted on 716 renal transplant recipients aged 18-67 at a tertiary care center in South India. Weight change was assessed at 1 year and at the last follow-up, with significant weight gain defined as an increase of more than 5%. Data on baseline characteristics, comorbidities, and transplant-related factors were collected. Statistical analyses, including Log Rank and Mantel-Cox tests, were used to evaluate the impact of weight gain on survival outcomes, while logistic regression identified factors influencing weight gain and loss.</p><p><strong>Results: </strong>At 1-year posttransplant, 70% of patients experienced weight gain, with 54.1% showing significant increases. Significant weight gain at 1 year was not associated with improved patient survival. However, at the last follow-up, 79.3% of patients had gained weight, with 68.7% showing significant increases. Significant weight gain at the last follow-up was associated with improved graft and patient survival. Factors influencing weight gain included age at transplant (odds ratio [OR] =1.05), female gender (OR = 1.40), and cytomegalovirus (CMV) viremia (OR = 1.25). Factors influencing weight loss included age (OR = 1.07), pretransplant hypertension (OR = 1.50), posttransplant hypertension (OR = 1.45), and CMV viremia (OR = 1.30). However, excessive weight gain culminating in Class II obesity was associated with reduced patient survival.</p><p><strong>Conclusion: </strong>Significant weight gain after renal transplantation is common and linked to improved graft and patient survival at the last follow-up. These findings emphasize the need for monitoring weight posttransplant and implementing targeted interventions to manage weight gain, potentially enhancing long-term outcomes for transplant recipients.</p>","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"19 3","pages":"362-370"},"PeriodicalIF":0.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dematiaceous Fungal Infections in Kidney Transplant Recipients - Case Series.","authors":"Chilaka Rajesh, Madhurima Ponmar, Athul Thomas, Jeethu Joseph Eapen, Elenjickal Elias John, Anna T Valson, Suceena Alexander, Vinoi George David, Joy Sarojini Michael, Santosh Varughese","doi":"10.4103/ijot.ijot_112_24","DOIUrl":"10.4103/ijot.ijot_112_24","url":null,"abstract":"<p><p>This retrospective, single-center study analyzed the clinical profile and outcomes of dematiaceous fungal infections in kidney transplant recipients over a 12-year period (2010-2022). Out of 1,041 transplant recipients, 69 developed major fungal infections, with dematiaceous fungi accounting for 8.6% of cases (<i>n</i>=6). These infections affected predominantly middle-aged adults (mean age 47 ± 13.1 years), with a slight male predominance. Most patients received kidneys from live-related donors and were maintained on standard immunosuppressive regimens. Dematiaceous fungal infections manifested on average 3.43 ± 1.8 years post-transplant, presenting as skin lesions, arthritis, or sinusitis. Diagnosis was confirmed through culture and histopathology, revealing phaeohyphomycosis in most cases. Management included long-term oral itraconazole therapy with regular monitoring; only one patient experienced a recurrence after five years. The findings underscore the need for heightened clinical suspicion in transplant recipients presenting with atypical skin or joint lesions, and highlight the importance of early microbiological and histopathological assessment. Prompt antifungal therapy, often alongside surgical intervention, is essential to prevent disease progression.</p>","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"19 2","pages":"271-275"},"PeriodicalIF":0.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Mycobacterial Infections in Kidney Transplant Recipients - Case Reports.","authors":"Chilaka Rajesh, Utkarash Mishra, Athul Thomas, Jeethu Joseph Eapen, Sabina Yusuf, Elenjickal Elias John, Anna T Valson, Suceena Alexander, Vinoi George David, Joy Sarojini Michael, Santosh Varughese","doi":"10.4103/ijot.ijot_74_24","DOIUrl":"10.4103/ijot.ijot_74_24","url":null,"abstract":"<p><p>To study the clinical profile and outcomes of rare mycobacterial infections such as nontuberculous mycobacteria (NTM) and <i>Mycobacterium leprae</i> kidney transplant recipients. This is a retrospective analysis of clinical outcomes of the uncommon infections in renal allograft recipients over 22 years during 2000-2022 from a tertiary care center in southern India; the clinical data were obtained from electronic medical records of nephrology and clinical microbiology departments. Institutional review board approved this study vide minute number 13641 dated 02.12.2020. A total of 1970 patients underwent renal transplantation at our institute, from January 1, 2000, to December 31, 2022. During this period, five patients were diagnosed with mycobacterial infections, three of whom had NTM infections and two with <i>Mycobacterium leprae</i> infections. The patients were all diagnosed by isolating organism in blood and/or pus cultures. All patients were similarly managed initially with a reduction of immunosuppressive drugs and appropriate antibiotics as per protocol. At present, there is no standard serodiagnostic test available to reliably detect patients with rare infections. Initial cultures may yield negative results due to slow growth and inconsistent colony appearance. Our research revealed that the majority of patients had negative sputum cultures and negative Gram stains. Therefore, it is essential to maintain a high level of suspicion and conduct thorough investigations in postrenal transplant recipients to achieve early diagnosis, administer appropriate treatment, and prevent disease spread.</p>","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"19 1","pages":"80-84"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General Characteristics and Design Taxonomy of Chatbots for COVID-19: Systematic Review.","authors":"Wendell Adrian Lim, Razel Custodio, Monica Sunga, Abegail Jayne Amoranto, Raymond Francis Sarmiento","doi":"10.2196/43112","DOIUrl":"10.2196/43112","url":null,"abstract":"<p><strong>Background: </strong>A conversational agent powered by artificial intelligence, commonly known as a chatbot, is one of the most recent innovations used to provide information and services during the COVID-19 pandemic. However, the multitude of conversational agents explicitly designed during the COVID-19 pandemic calls for characterization and analysis using rigorous technological frameworks and extensive systematic reviews.</p><p><strong>Objective: </strong>This study aims to describe the general characteristics of COVID-19 chatbots and examine their system designs using a modified adapted design taxonomy framework.</p><p><strong>Methods: </strong>We conducted a systematic review of the general characteristics and design taxonomy of COVID-19 chatbots, with 56 studies included in the final analysis. This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to select papers published between March 2020 and April 2022 from various databases and search engines.</p><p><strong>Results: </strong>Results showed that most studies on COVID-19 chatbot design and development worldwide are implemented in Asia and Europe. Most chatbots are also accessible on websites, internet messaging apps, and Android devices. The COVID-19 chatbots are further classified according to their temporal profiles, appearance, intelligence, interaction, and context for system design trends. From the temporal profile perspective, almost half of the COVID-19 chatbots interact with users for several weeks for >1 time and can remember information from previous user interactions. From the appearance perspective, most COVID-19 chatbots assume the expert role, are task oriented, and have no visual or avatar representation. From the intelligence perspective, almost half of the COVID-19 chatbots are artificially intelligent and can respond to textual inputs and a set of rules. In addition, more than half of these chatbots operate on a structured flow and do not portray any socioemotional behavior. Most chatbots can also process external data and broadcast resources. Regarding their interaction with users, most COVID-19 chatbots are adaptive, can communicate through text, can react to user input, are not gamified, and do not require additional human support. From the context perspective, all COVID-19 chatbots are goal oriented, although most fall under the health care application domain and are designed to provide information to the user.</p><p><strong>Conclusions: </strong>The conceptualization, development, implementation, and use of COVID-19 chatbots emerged to mitigate the effects of a global pandemic in societies worldwide. This study summarized the current system design trends of COVID-19 chatbots based on 5 design perspectives, which may help developers conveniently choose a future-proof chatbot archetype that will meet the needs of the public in the face of growing demand for a better pandemic response.</p>","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"11 1","pages":"e43112"},"PeriodicalIF":0.2,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68438473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generic Tacrolimus in Kidney Transplant Patients at Jordan University Hospital","authors":"Ayman M. Wahbeh, Lina Ayman Wahbeh","doi":"10.4103/ijot.ijot_13_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_13_23","url":null,"abstract":"Abstract Background: Tacrolimus is the immunosuppressive drug of choice for kidney transplant patients, but its cost is very high in the total drug cost for patients with renal disease. Lower drug costs can be achieved with generic tacrolimus. For this reason, the Ministry of Health mandated to implementation of a switch to generic form and so we wanted to evaluate whether a switch could be safely performed and to observe the effect of this on kidney function. Subjects and Methods: In this observational study, 28 stable kidney transplant patients taking Prograf®(Astellas) were switched to a generic Pangraf®(Pancea) in a 1:1 dose ratio and were followed up for 6 months. Plasma creatinine levels and trough concentrations of tacrolimus were recorded three times on Prograf® and weekly for 4 weeks, then monthly after conversion to Pangraf®. Results: Tacrolimus mean C 0 levels were 6.97 ± 0.92 ng/mL before and 7.4 ± 1.23 ng/mL after conversion ( P = 0.22). Mean serum creatinine values were 1.13 ± 0.53 mg/dL and 1.15 ± 0.54 mg/dL before and after conversion, respectively ( P = 0.27). Conclusion: Switching from branded tacrolimus to generic tacrolimus seems possible and safe, but close monitoring is essential.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135204464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Social Virtue of Youth as a Catalyst in the Dynamics of Eye Donation","authors":"Rakesh Thakur, Sumita Kumari","doi":"10.4103/ijot.ijot_28_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_28_23","url":null,"abstract":"Abstract Background: The dynamics of eye donation and corneal transplantation is a beacon of hope in the life of a corneal blind person for sight restoration. Social virtues like altruism and helping others are reflected in the promotion of organ donation and in the metaphorical reference ‘gift of life’. Youth is not merely a future potential donor, but also a transmitter of eye donation. Aim: The aim of the study was to outline various facets of eye donation among students using KAP model, to explore the role of youth on eye donation and to measure the relationship between the willingness for eye donation and different components of students. Materials and Methods: A questionnaire administrated to 1179 students of Panjab University and its five affiliated colleges in Chandigarh, India. Results: Only 3.5% of respondents were found to have a good level of knowledge regarding the subject. Nearly 21.8% of respondents expressed a positive attitude towards eye donation. There were only 2.6% of respondents who showed a high level of practice. Over 92.6% of respondents indicated that youth could play a positive role in the promotion of eye donation. The socio-demographic variables of the respondents, such as age, gender, and education level had a linear relationship with the level of knowledge, attitude, and practice ( P ≤ 0.01). Conclusion: Findings showed a hypothetical relationship between knowledge, attitude and practice in context of eye donation. There was a poor level of knowledge, neutral attitude and low level of practice among students regarding eye donation.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135204466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttransplant Thrombotic Microangiopathy","authors":"Mohammed Fahad Khan, Vishwanath Siddini, Sudarshan Ballal, Ankit Mathur","doi":"10.4103/ijot.ijot_32_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_32_23","url":null,"abstract":"Abstract 24 year old lady who was diagnosed with chronic kidney disease stage 5 in 2016 underwent a pre-emptive live related renal transplant in the same year. She had kidney allograft dysfunction and eventually lost the transplant kidney in 2019 requiring hemodialysis. She underwent a deceased donor renal transplant in February 2022. She developed allograft dysfunction with a creatinine of 2.5 mg/dl in October 2022, and a renal allograft biopsy subsequently showed Thrombotic microangiopathy , arteriolar form . There were no features of rejection in the biopsy and Donor specific antibody done by Luminex lysate method was negative. Her Single antigen bead done subsequently was also negative. CMV DNA PCR was not detectable. Tacrolimus was switched to Cyclosporine, however her allograft function continued to worsen. Complement mutation analysis was negative and acquired complement defects were also not detected. Subsequently, Single antigen bead for non HLA antibodies showed positivity for MICA antibodies. She underwent 7 sessions of plasmapheresis and her renal functions did not improve and her creatinine continued to increase to 4.2 mg/dl. Complement activating assay for these MICA antibodies was positive. She was treated with two doses of 300 mg Eculizumab in December 2022, her allograft functions in February 2023 have improved to 2 mg/dl. This case highlights the extensive evaluation for post transplant TMA, the use of non HLA antibody assays and complement activating assays of these antibodies to decide on appropriate use of Eculizumab for salvaging transplant allograft.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135204465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caution While Sailing Uncharted Seas-response to Organ Donation after Circulatory Determination of Death in India","authors":"Jagadish S. Jamboti","doi":"10.4103/ijot.ijot_4_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_4_23","url":null,"abstract":"1Department of Nephrology and Transplantation, Fiona Stanley Hospital, Murdoch, Australia 2Department of Medicine and Pharmacology, School of Medicine, University of Western, Australia Corresponding Author: Dr. Jagadish S. Jamboti, Department of Nephrology and Transplantation, Fiona Stanley Hospital, 11, Robin Warren Drive, Murdoch 6150. Western Australia, Australia. E-mail: [email protected] Received January 07, 2023 Received in revised form May 10, 2023 Accepted May 20, 2023","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135204467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal transplant biopsies: Recommended guidelines on minimum dataset reporting","authors":"Pallav Gupta, S. Gowrishankar","doi":"10.4103/ijot.ijot_54_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_54_22","url":null,"abstract":"Renal allograft biopsies are essential in posttransplant setting to be able to accurately diagnose graft pathologic changes and help in guiding patient management. Banff schema has been long providing guidance to transplant pathologists to accurately diagnose and score the severity of rejections in allograft biopsies. However, there is no standardized minimal data set to report renal transplant biopsies, thereby making it difficult for renal physicians to understand changes in transplant biopsies to adequately manage patients. The present brief review article shall provide guidelines on minimal data set reporting for renal transplant biopsies to bring uniformity in reporting in the whole country.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"241 - 244"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48001559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organ donation – Perception and practices among health science graduates in Southern India","authors":"Seetharaman Narayanan, Jeevithan Shanmugam, M. Sundharam, Mohan Kumar","doi":"10.4103/ijot.ijot_22_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_22_23","url":null,"abstract":"Background: Organ donation rates in India are among the lowest globally. The complex interplay of social, religious, and media influences behind organ donation in today's social milieu is not fully understood. Health-care professionals are in a unique position to influence popular perception on organ donation through their practices. Objectives: The objective of this study was to explore organ donation-related perceptions and practices among health science students from southern India. Methods: A cross-sectional questionnaire-based, online descriptive study was carried out among undergraduate health science students from the medical, nursing, and allied health science streams in Coimbatore, western Tamil Nadu. A total of 618 respondents participated in the online survey conducted during the summer 2021. Statistical analysis was done using IBM SPSS version 27 statistical package. Results: The general awareness levels and perceptions regarding organ donation were fairly high, and 83.1% were interested in becoming an organ donor. Even though a sizable proportion (37.4%) were ready to pledge right away, many did not know how to take the next step – the actual pledging for organ donation. Apprehensions relating to organ donation fell under few major themes – concerns of misuse of organ donation platforms for monetary gains; cumbersome legal procedures; family, social, and religious beliefs; and influences of popular media. Conclusions: Despite a fair degree of knowledge, the practice of organ donation seems to be relatively low among the participants, owing to a multitude of reasons. If enabled appropriately, health science graduates would be the perfect ambassadors for promoting organ donation in the society.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"220 - 228"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45280899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}