Indian Journal of Transplantation最新文献_第2页

Deceased-Donor renal transplantation: A single-center experience from a tertiary care hospital in North India 已故捐赠者肾移植：北印度一家三级护理医院的单中心经验

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Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_53_22

S. Chadha, D. Choudhury, V. Goel, Anurag Gupta, V. Tiwari, V. Bhargava, M. Malik, Ashwani K Gupta, A. Bhalla, D. Rana

{"title":"Deceased-Donor renal transplantation: A single-center experience from a tertiary care hospital in North India","authors":"S. Chadha, D. Choudhury, V. Goel, Anurag Gupta, V. Tiwari, V. Bhargava, M. Malik, Ashwani K Gupta, A. Bhalla, D. Rana","doi":"10.4103/ijot.ijot_53_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_53_22","url":null,"abstract":"Introduction: Deceased-donor renal transplants can help cope up with the increasing demand of renal allografts in India. We evaluated the outcomes of deceased-donor renal transplantation at our center. Methods: This retrospective study analyzed the donor and recipient characteristics along with graft and patient survival in deceased-donor renal transplant recipients at our center between April 2011 and October 2021. Results: The mean age of recipients (n = 21) and deceased donors was 48 ± 9.4 and 39.3 ± 8.7 years, respectively. Male:female ratio among recipients was 1.6:1 while that in donors was 2:1. Chronic glomerulonephritis (71.4%) was the most common native kidney disease. Most patients received antithymocyte globulin (80.9%) as induction and tacrolimus-based triple-drug regimen (80.4%) as maintenance therapy. The median follow-up duration was 32.8 months. Graft dysfunction was reported in 57.1% (n = 12/21) patients; acute tubular necrosis was the most common reason (n = 5). Six patients died, and sepsis was the most common reason for death (n = 3/6; 50%); 66.7% (n = 4/6) deaths occurred within the first 6 months. The mean graft survival time was 106.2 months (95% confidence interval: 95.4–116.6). The cumulative proportion of graft survival was 95.2% (n = 20/21) at 3 and 5 years. The cumulative proportion of patient survival was 80.9% at 3 years and 76.2% at 5 years. Conclusion: Patient outcomes over 5 years follow-up were good and suggest that deceased-donor transplants should be encouraged along with living-donor transplants to cover the huge demand–supply mismatch in renal replacement therapy.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"236 - 240"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48929599","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}

引用次数: 0

Combined laparoscopic appendectomy and open kidney implantation in a transplant recipient: The need, timing, and route of surgery - A case report 联合腹腔镜阑尾切除术和开放肾移植术:手术的需要，时机和途径-一个病例报告

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Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_134_20

Somasundaram Soundappan, Sambandam Swaminathan, Hulagi Jayanth, Kanchi Prabhu

引用次数: 0

ABO-Incompatible and human leukocyte antigen-incompatible kidney transplant in a highly sensitized patient with hepatitis-B 高度致敏的乙型肝炎患者的ABO血型不相容和人类白细胞抗原不相容肾移植

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Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_6_23

Suhas S. Bavikar, Vaibhav Ganjewar, A. Oswal, Purva Bavikar

引用次数: 0

Breaking the barrier: Successful kidney transplant in two patients from a SARS-CoV-2-Infected deceased donor in India: Case report and short review 突破障碍:印度一名感染sars - cov -2的已故捐赠者的两名患者成功进行肾脏移植:病例报告和简短回顾

IF 0.3

Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_95_22

Sudeep Prakash, B. Datt, B. Kumar, Abhishek Shukla

{"title":"Breaking the barrier: Successful kidney transplant in two patients from a SARS-CoV-2-Infected deceased donor in India: Case report and short review","authors":"Sudeep Prakash, B. Datt, B. Kumar, Abhishek Shukla","doi":"10.4103/ijot.ijot_95_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_95_22","url":null,"abstract":"There is the acute shortage of organs in India due to very low deceased organ donation rate. The COVID-19 pandemic had a huge impact on organ transplant programs, leading to slowing down of these programs worldwide. At present, with the SARS-CoV-2 infection becoming endemic and frequently presenting as asymptomatic or mild infection, deceased donors are likely to be incidentally positive for this infection. Most guidelines worldwide advocate rejecting the organs from such donors. Utilization of organs from these donors can improve the donor pool. Data suggest that carefully selected nonlung organs from such donors, with asymptomatic or mild SARS-CoV-2 infection, dying of other causes, are not associated with adverse outcomes. We present the cases of two end-stage kidney disease patients on hemodialysis, who were transplanted with kidneys from a deceased donor, infected with SARS-CoV-2 virus. Over 3 months of follow-up, the patients did not show any sign of COVID-19 infection or COVID-related kidney dysfunction and are now maintaining normal kidney function. This was the first incident of a successful kidney transplant from donor infected with SARS-CoV-2 virus, in India.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"255 - 257"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44617356","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}

引用次数: 0

Tobacco chewing and oral cancer in a renal transplant recipient 咀嚼烟草与肾移植患者口腔癌的关系

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Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_58_23

Rakesh Shinde, N. Prasad

引用次数: 1

A prospective observational study to know the origin of lymphorrhea in post-renal transplant patients using creatine phosphokinase and lactate dehydrogenase 应用肌酸激酶和乳酸脱氢酶了解肾移植后患者淋巴漏起源的前瞻性观察研究

IF 0.3

Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_41_22

Eeshansh Khare, D. Sarkar, Debojyoti Bhattacharjee, D. Pal

{"title":"A prospective observational study to know the origin of lymphorrhea in post-renal transplant patients using creatine phosphokinase and lactate dehydrogenase","authors":"Eeshansh Khare, D. Sarkar, Debojyoti Bhattacharjee, D. Pal","doi":"10.4103/ijot.ijot_41_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_41_22","url":null,"abstract":"Introduction: Renal transplantation provides the best result as a long-term renal replacement therapy. Lymphorrhea is considered a common surgical complication of renal transplantation. Although nonsurgical factors are also associated, it is primarily due to damage and improper ligation of lymphatic vessels draining donor kidney and perivascular lymphatics of iliac vessels. Lymphorrhea is associated with prolongation of hospital stay and increased chances of infection and it may lead to lymphocele formation. Hence, to localize the origin of postoperative lymphorrhea in transplant recipients in wake for its definitive management, the enzymatic activity of the two enzymes, namely, creatine phosphokinase (CPK) and Lactate dehydrogenase (LDH) in the drain fluid was evaluated. Materials and Methods: A total of 68 renal transplant recipients (including live and deceased-donor [DD] transplantation) were evaluated for2 years. The enzymatic value of CPK and LDH was calculated in perigraft drain fluid. It was compared with the values of CPK and LDH in postradical cystectomy pelvic drain fluid and simple renal cortical cyst fluid. The average value of CPK in pelvic drain fluid and LDH in renal cortical cyst fluid was considered as their baseline value in lymphatics draining lower limb and renal lymphatics, respectively. Results: The source for postoperative lymphorrhea in DD and live-related donor was iliac lymphatics, whereas in live unrelated donor, it was iliac and graft kidney lymphatics. Conclusion: Drain fluid assessment for CPK and LDH activity can localize the origin of lymphatic leak in renal transplant recipients.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"215 - 219"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48846489","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}

引用次数: 0

A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications 器官捐献和移植中疫苗诱导的血栓性血小板减少症的叙述性回顾:当前的证据和意义

IF 0.3

Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_12_22

V. Kute, S. Chauhan, N. Prasad, H. Meshram

{"title":"A narrative review of vaccine-induced thrombotic thrombocytopenia in organ donation and transplantation: Current evidence and implications","authors":"V. Kute, S. Chauhan, N. Prasad, H. Meshram","doi":"10.4103/ijot.ijot_12_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_12_22","url":null,"abstract":"Vaccine-induced thrombotic thrombocytopenia (VITT) has been recently linked with coronavirus disease (COVID-19) vaccines. It becomes crucial for the transplant communities to have a rigorous approach for accepting VITT donors, as the reports of such transplantation have been associated with thrombotic complications, graft loss, and deaths. The magnitude of facing a VITT donor in transplantation practices is unknown and also the management protocol. However, as per the limited data, it is better to avoid such transplants, and in the case of emergency transplants, the risk-benefit ratio should be weighed. All transplantation from VITT donors should be appropriately counseled before procurement. The organs should undergo deliberate examination for functionality by clinical, laboratory, and radiological parameters. In doubtful cases, a preimplantation biopsy is mandated to rule out any thrombosis. VITT donors are suggested to be treated with newer oral anti-coagulation and intravenous immunoglobulin. Platelet transfusion is best avoided in a VITT donor. There is no established protocol for any modification in surgical procedure, anesthesia, or immunosuppressive medicines in the recipients. The recipients should undergo extensive clinical and laboratory monitoring for any possible complications. No prophylactic therapy is recommended at present but candidates with a history of any COVID-19 vaccine within 30 days, should be avoided. In summary, the evidence for diagnosis and management of VITT donors is based only on a few reports, but with current knowledge, it is advisable to take a multidisciplinary approach to assess all benefits and risks before accepting or discarding organs.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"169 - 173"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47314594","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}

引用次数: 1

A clinical comparison of propofol and etomidate in patients with end-stage renal disease undergoing renal transplantation 异丙酚和依托咪酯在终末期肾病肾移植患者中的临床比较

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Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_11_23

Praveenkumar Shekhrajka, V. Goyal, Ganesh Nimje, Lipika Saxena, S. Mittal, B. Baj

{"title":"A clinical comparison of propofol and etomidate in patients with end-stage renal disease undergoing renal transplantation","authors":"Praveenkumar Shekhrajka, V. Goyal, Ganesh Nimje, Lipika Saxena, S. Mittal, B. Baj","doi":"10.4103/ijot.ijot_11_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_11_23","url":null,"abstract":"Background: Induction of anesthesia is a critical part of anesthetizing patients with end-stage renal disease, as they are at risk of wide hemodynamic fluctuation due to their pathophysiological alterations in the cardiovascular system. It is desirable to use pharmacological agents that provide hemodynamic stability with fewer adverse effects. Aims and Objectives: This study aimed to evaluate the effects of propofol and etomidate by comparing hemodynamic variables such as a change in mean arterial pressure (MAP) and heart rate (HR) during induction, laryngoscopy, and up to 10 min after tracheal intubation as a primary outcome and any associated adverse effect as a secondary outcome. Methods: After getting institutional ethical committee approval, 60 American Society of Anesthesiologist Grade III patients aged 20–60 years, scheduled for renal transplantation, were randomized into two groups (Group P: propofol 1% and Group E: etomidate). The dose of induction agents was targeted to achieve a bispectral index value of 40. Hemodynamic variables were recorded at induction, laryngoscopy, and up to 10 min after tracheal intubation. Adverse effects related to the study drug were recorded. Results: The decrease in MAP in Group P was statistically significant (P < 0.05) as compared to Group E, at induction of anesthesia. We observed a significant increase in HR at induction of anesthesia in Group E (P < 0.05). The incidence of myoclonus was 0 versus 73.3% in Groups P and E, respectively, while pain on injection and hypotension were more in Group P (P < 0.05). Conclusions: In conclusion, etomidate provides better hemodynamic stability with fewer adverse effects in patients with end-stage renal disease.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"229 - 232"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45057480","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}

引用次数: 0

Clinical outcomes of T-cell-mediated rejection in renal allografts 同种异体肾移植中T细胞介导的排斥反应的临床结果

IF 0.3

Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_89_22

E. Fernando, A. Chiniwalar, Poongodi Annadurai, K. Valavan, Sujit Surendran, N. S. Srinivasa Prasad

{"title":"Clinical outcomes of T-cell-mediated rejection in renal allografts","authors":"E. Fernando, A. Chiniwalar, Poongodi Annadurai, K. Valavan, Sujit Surendran, N. S. Srinivasa Prasad","doi":"10.4103/ijot.ijot_89_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_89_22","url":null,"abstract":"Background: T-cell-mediated rejection (TCMR) occurs in 10%–12% of renal allografts. TCMR manifests as a rise in serum creatinine, decreased urine output, fever, and graft tenderness. It has a negative impact on long-term allograft function. Hence, we did a retrospective analysis of patients with TCMR to know the pattern, risk factors, and treatment outcome. Materials and Methods: We analyzed retrospectively clinical characteristics, laboratory data, renal biopsy reports, precipitating factors, treatment modalities, and outcomes from case records and biopsy registers of 30 patients with TCMR between July 2019 and June 2021 in our institution. Results: Out of 30 patients studied, 80% were males and 20% were females. The mean age was 29.67 ± 8.8 years. Live-related renal transplantation accounted for 80% of patients. Native kidney disease was not known in 63%. The mean duration of rejection was 21.73 ± 23.24 months. Among the various risk factors studied, low tacrolimus levels were seen in 56.7%, which was statistically significant (P < 0.05). All the patients were treated for rejection, and improvement was seen in most and 10.7% showed no improvement. Conclusion: Most patients with TCMR improved with treatment. Inadequate immunosuppression was the risk factor for TCMR in the maximum number of our patients. Compliance was good in most patients.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"198 - 201"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48833139","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}

引用次数: 1

Tuberculosis and hepatitis C virus coinfection in a renal transplant recipient: A therapeutic challenge 肾移植受者结核和丙型肝炎病毒合并感染:治疗挑战

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Indian Journal of Transplantation Pub Date : 2023-04-01 DOI: 10.4103/ijot.ijot_27_23

V. Jayaprakash, A. Rathoon, Rishabh Gupta, S. Sreedhar

引用次数: 0