Indian Journal of Transplantation最新文献

{"title":"Perioperative predictors of postoperative short-term morbidity to donor after donor nephrectomy for renal transplantation","authors":"Ambala Rajeevan, Midhun P. Gopalakrishnan","doi":"10.4103/ijot.ijot_116_21","DOIUrl":"https://doi.org/10.4103/ijot.ijot_116_21","url":null,"abstract":"Introduction: Transplantation has been established as a superior mode of renal replacement therapy now. The demand for renal transplantation exceeds the available organs by far and this shortage led to an increase of renal transplantations from living donors. In this context, we did this study to find out perioperative predictors of postoperative short-term morbidity to donor after donor nephrectomy for renal transplantation. Patients and Methods: This was a retrospective study done in a urology tertiary care center from January 1, 2015, to December 31, 2019, among patients who underwent donor nephrectomy for renal transplantation. The sample size was 202. Data were collected using a pro forma and the same were analyzed by appropriate statistical methods using SPSS software. Results: Perioperative factors correlated to paralytic ileus on Pearson's correlation analysis were body mass index and right-sided donor nephrectomy. However, no perioperative factor was found to be predictive of paralytic ileus on regression analysis. Preoperative pyuria and postoperative total white blood cell count were correlated as well as predictive of wound infection. Conclusion: This study shows perioperative predictive factors related to postoperative short-term morbidity to donor and different grades and types of postoperative morbidity among donors after donor nephrectomy in renal transplantation within the first 6 months of surgery.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"185 - 189"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49281885","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":"Morphology of lungs in pulmonary lymphangioleiomyomatosis – A unique case of bilateral lungs and heart transplant","authors":"S. Chandanwale, Y. Ingale, P. Patel, A. Verma","doi":"10.4103/ijot.ijot_21_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_21_23","url":null,"abstract":"Pulmonary lymphangioleiomyomatosis (LAM) is an extremely rare low–grade neoplasm. It occurs either sporadically or with tuberous sclerosis complex. Sporadic type usually affects women in reproductive age group. The patient usually gives a history of dyspnea of long duration. With characteristic clinical findings including high-resolution computed tomography findings, a diagnosis of pulmonary LAM can be suspected. Histopathology findings in some cases can be subtle. Cells of LAM consistently express smooth muscle markers such as smooth muscle actin and desmin on immunohistochemistry. Cells also express melanocytic marker such as HMB-45, Melan-A, and microphthalmia transcription factor. Due to the scarcity of reports on morphological features in pulmonary LAM, we are tempted to report morphological features of lungs in a 36-year-old female who successfully underwent bilateral lung and heart transplant at a tertiary care center.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"258 - 261"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45780940","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 allograft survival: Incidence and risk factors associated with graft dysfunction","authors":"F. Alalawi, Kashif Gulzar, A. Seddik, Hind Alnour, Maseer Ahmad, S. Najad, Osman Osman, Hussain Yousif, M. Railey, A. Alhadari","doi":"10.4103/ijot.ijot_93_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_93_22","url":null,"abstract":"Background: Renal transplantation is considered the best available therapy for patients suffering from end-stage kidney disease. Improvement in allograft outcome, patient survival, and quality of life are the most important indicators of the effectiveness of renal transplantation. Short-term allograft survival has improved significantly, however, long-term allograft survival and associated risk factors need to be studied. Objectives: This single-center study aims to determine the incidence of long-term graft dysfunction (GD) and the associated risk factors among renal transplant recipients in Dubai Hospital, Dubai, United Arab Emirates. Materials and Methods: A single-center longitudinal cohort analysis of 506 renal transplant follow-up recipients' allograft functions was analyzed through a detailed chart review. We hypothesized that different recipients' characteristics such as age (present and age at the time of transplantation), gender, history of acute rejection, posttransplant viral infections (hepatitis B virus, hepatitis C virus [HCV], Cytomegalovirus, BK virus), and comorbid would affect allograft function in renal transplant recipients. Allograft dysfunction is defined as a 15%–20% increase in creatinine from baseline. We assessed the incidence of allograft dysfunction and associated risk factors. Results: The median age of transplant recipients and the age at the time of transplantation were 55 ± 21 and 39 ± 14.93 years, respectively. About 61.85% (n = 313) of the transplant population were males. The incidence of allograft dysfunction in the study period was 57.15%. In our study population, 1-, 5-, and 10-year graft survival rate was 98.62%, 82.35%, and 54.90%, respectively. Independent risk factors include age, male gender, history of acute rejection, HCV infection, and diabetes mellitus (DM). Posttransplant DM (PTDM) is not associated with GD. Conclusion: Allograft dysfunction is quite common among renal transplant recipients. Independent risk factors in our analysis include age, male gender, history of acute rejection, HCV infection, and DM. PTDM is not associated with GD.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"190 - 197"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48760398","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":"Advancing the quality of life after transplantation","authors":"N. Prasad","doi":"10.4103/ijot.ijot_62_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_62_23","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"167 - 168"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47355777","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":"A plant pathogen in a human host! A case report and a review of literature","authors":"N. Jose, R. Alam, V. Balaji, T. Kodiatte, J. Eapen, E. John, S. Varughese","doi":"10.4103/ijot.ijot_92_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_92_22","url":null,"abstract":"In this case report, we present a renal transplant recipient who developed an infection due to a plant pathogen – Pantoea agglomerans. This pathogen is a rare organism with no case reports in a renal transplant recipient from India so far. A 50-year-old renal transplant recipient presented with fever for 20 days associated with productive cough and upper back pain. She had received her graft kidney 8 months earlier in a deceased donor program in her local state. In the immediate postoperative period, she had one episode of a mixed rejection, which required a course of antithymocyte globulin and plasmapheresis. On examination, tenderness was noted in her upper back over the cervical and thoracic vertebrae. Her computed tomography scan showed a collection over the cervical vertebrae and consolidation in the lung. Blood culture grew P. agglomerans. P. agglomerans is a rare plant pathogen usually occurring after trauma involving organic debris being deposited within the body. Spontaneously occurring infection is seen only in special situations such as immunocompromised states, malignancy, or excessive antacid use. It has been known to cause lung infections, bone and joint infections, and fever with systemic signs. Spontaneously occurring infections like in this patient are very rare with a handful of case reports worldwide. In an immunocompromised host, a multitude of infections can occur. This case report highlights the importance of removing unnecessary medication from our transplant recipients and optimizing immunosuppression while pursuing the underlying microbiologic cause of infection aggressively.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"252 - 254"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43229245","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":"Influence of ABO compatibility on haploidentical hematopoietic stem-cell transplant","authors":"R. Sawant, S. Sen, Deepali Naker","doi":"10.4103/ijot.ijot_134_21","DOIUrl":"https://doi.org/10.4103/ijot.ijot_134_21","url":null,"abstract":"Introduction: Allogenic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for hematologic malignancies. Nowadays, usually, haploidentical stem cell transplant is performed across the ABO blood group barrier; however, the effect of ABO incompatibility on haploidentical hematopoietic stem-cell transplantation is still uncertain. Methodology: Retrospective analysis of data of patients who underwent haploidentical hematopoietic stem-cell transplantation at our hospital was performed. The patient cohort was classified in to two arms: ABO compatible and ABO-incompatible haploidentical stem cell transplantation. ABO-incompatible was further categorized as major mismatch, minor mismatch and bidirectional mismatch. The average follow-up period was 6 months posttransplant for which the following parameters were studied: (a) engraftment kinetics for white blood cell (WBC) and platelets, (b) graft rejection, (c) overall graft survival, (d) graft-versus-host disease (GVHD), and (e) clinical variation in outcome for patients receiving peripheral blood stem cell/bone marrow harvest (BMH) as the source of stem cells. Results: The median age of recipients for both ABO compatible and ABO incompatible was 24 years and most of them were parent-offspring transplants. A total of 39 patients underwent haploidentical stem cell transplantation during the study period. Our cohort consisted of 23 ABO-compatible patients and 17 ABO incompatible patients. Out of these 17, 6 were major mismatch, 11 were minor mismatch and none were bidirectional mismatch. Of these 39 patients, 82% (32/39) engrafted within the normal expected time frame. The average days to WBC and platelet engraftment in these subgroups were noted to be as follows: Major – 12 and 18 days, compatible – 9 and 17 days, and minor – 10 and 17 days, respectively. Graft failure was observed in 20% (8/39) of patients, of which 4 patients had undergone ABO-compatible transplants while 4 patients had undergone minor ABO incompatible transplants. In this study, we observed that major ABO incompatibility had severe risk of GVHD (17%) compared to compatible (39%) and minor (27%) blood group mismatch. The overall survival rate in 6 months was equal (70%) in both arms. 5/39 patients, i.e., 12% received BMH as the source of stem cells, of these 80% are alive. Conclusion: Haploidentical transplants done in patients with ABO-incompatible donors had outcomes comparable to the ABO-compatible group. The risk of severe GVHD did not increased in the ABO mismatch group. Recipient of BMH had a marginally better graft survival.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"181 - 184"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42923300","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":"Lived experiences and expectations of postkidney transplant patients: A phenomenological study","authors":"Priya, M. Dutta, D. Kenwar","doi":"10.4103/ijot.ijot_55_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_55_22","url":null,"abstract":"Background: Kidney transplantation is the treatment of choice for most of the patients with end-stage renal disease. Transplantation brings many responsibilities related to medication adherence, immunosuppression, prevention of infection, regular follow-ups, etc. To meet the challenges faced by postkidney transplant patients, there is a need for deeper understanding of how people with kidney transplant learn to adapt to life posttransplant. Aim: The present study aims to explore the lived experiences of postkidney transplant patients. Materials and Methods: A phenomenological research design was adopted. By using purposive sampling technique, 18 postkidney transplant patients were enrolled. Data were collected through unstructured interviews and analyzed by using descriptive statistics for quantitative and Colaizzi's method for qualitative data. Results: Based on participants' responses, total 9 themes and 26 subthemes were extracted after data analysis. The main themes emerged were as follows: relief from dialysis-associated problems, perceived social neglect before and after transplant, burden of posttransplant regimen, impact on occupation, attitude toward donor, posttransplant lifestyle modifications, concerns about future quality of life, effect on family and children, and facilitating agents in transplant process. Conclusion: The present study concluded that the quality of life of participants after transplantation had improved in terms of relief from the dialysis-associated suffering. Worries about duration of graft function, future health, and cost were prevalent. There is a need to provide additional information, multidimensional support, and interventions following transplantation that target these concerns. This may support kidney recipients, better prepare for adaptation to life after transplant, and lead to improvements in the patient experience.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"202 - 208"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44359124","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":"Factors influencing delayed graft function in deceased renal transplant: A single tertiary care center experience","authors":"D. Pal, P. Roy","doi":"10.4103/ijot.ijot_47_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_47_22","url":null,"abstract":"Introduction: Exponential increase in the number of chronic kidney disease cases and shortage of living renal donors have increased the demand of deceased donor renal transplant (DDRT) in India. Delayed graft function (DGF) is more commonly observed in deceased donor renal transplant recipient and is a risk factor for early graft loss. Materials and Methods: An ambispective observational analysis was conducted over 63 recipients of DDRT performed in our institute from January 2012 to January 2022. The donor factors, recipients' characteristics, and perioperative factors were analyzed for the association with DGF. Statistical analysis was undertaken using SPSS 27.0 software, considering P < 0.05 as statistically significant. Results: Among the 63 deceased donor renal transplant recipients, 16 (25.39%) developed DGF. The incidence of DGF was more in recipients with greater body mass index and previous sensitization. Recipients receiving kidneys from older, male, and hypertensive donors with less terminal urinary output were found to be more susceptible to develop DGF. Cold ischemia time was significantly prolonged in patients who developed DGF. The duration of hospital stay and serum creatinine level at the time of discharge and also during follow-up after 3 months were significantly higher in the DGF group. Although the stated observations persisted in the patients during the 12 months of follow-up, no statistically significant differences were found in the number of functional grafts. Conclusion: DGF has a detrimental effect on graft as well as recipient survival. A coordinated approach between the transplant team and intensivist can circumvent most of the factors leading to DGF, thus improving the overall outcome.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"209 - 214"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49310203","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":"Expected usefulness of the third dose of COVID-19 vaccine for organ transplant recipient adolescent","authors":"S. Yasri, V. Wiwanitkit","doi":"10.4103/ijot.ijot_79_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_79_22","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"270 - 271"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45203219","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":"Interval between doses of COVID-19 vaccine for transplant recipients: A comment","authors":"A. Kleebayoon, V. Wiwanitkit","doi":"10.4103/ijot.ijot_18_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_18_23","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"17 1","pages":"266 - 267"},"PeriodicalIF":0.3,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70754612","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}