Indian Journal of Transplantation最新文献

{"title":"A child with vacterl association for deceased donor renal transplantation: Perioperative anesthetic management concerns","authors":"Nilesh Vaniya, Virali Trivedi, K. Vora, Amrita Singh","doi":"10.4103/ijot.ijot_76_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_76_22","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70758230","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":"Rare Presentation of Acute Abdomen in a Posttransplant Patient","authors":"Akila Viswanathan, Vidyashankar Panchangam, Govardhan Reddy, Shashank Shetty, Vinay Bhat, Naresh Bhat, Tripti Kaur","doi":"10.4103/ijot.ijot_71_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_71_23","url":null,"abstract":"Infective complications continue to be a big hurdle to patient and graft survival after transplantation. Fungal infections can occur anytime posttransplant. They often present with nonspecific symptoms leading to a delay in diagnosis and treatment. Pain abdomen in a posttransplant patient should always be evaluated in detail to rule out invasive fungal infections. Here, we present a case of gastric mucormycosis presenting as acute abdomen in a diabetic patient who was a 1-month posttransplant.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"283 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135801991","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":"Tac(hy)rolimus: A Case of Tacrolimus-induced Tachycardia","authors":"Madhav Hande, Mohammed Fahad Khan, Sudarshan Ballal, Sundar Sankaran","doi":"10.4103/ijot.ijot_64_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_64_23","url":null,"abstract":"The Editor, The case involves a 35-year-old female patient who had end-stage renal disease due to IgA nephropathy and was planned for a kidney transplant with her mother as the donor. She was started on tacrolimus 4 mg/day on postoperative day-2 (POD-2) as a part of the pretransplant regimen. Approximately 1 h after receiving the medication, she developed palpitations, and her heart rate increased to 134/min from the baseline of 78/min. The symptoms resolved spontaneously after 5–6 h, and further doses of tacrolimus were not given pretransplant. However, again, after the introduction of tacrolimus posttransplant on the first POD, the patient developed tachycardia [Figure 1], palpitations, and shortness of breath 45 min later. An electrocardiogram revealed sinus tachycardia, and echocardiogram was normal. The patient’s troponin I levels remained normal, and there were no serial ST-T changes observed. Her serum electrolytes such as sodium, potassium, calcium, and magnesium were also normal. Tacrolimus was stopped; however, the levels were not checked, and the patient continued with cyclosporine, mycophenolate mofetil, and steroid. Holter monitoring was conducted, which was normal. No active bleeding, fever, or other offending drugs were found. The patient was doing well at 5 months posttransplant, with a creatinine level of 1.2 mg/dl. The tachycardia was presumed to be a side effect of tacrolimus due to the temporal relationship and reproducibility with rechallenges.Figure 1: Electrocardiogram showing sinus tachycardiaTacrolimus is an immunosuppressive agent that is used to prevent organ rejection after transplantation. However, its use has been associated with various cardiovascular complications, including tachycardia and arrhythmias. In a case report by Erdoğan et al., a 13-year-old boy who underwent kidney transplantation developed sinus tachycardia after receiving tacrolimus.[1] The authors noted that tacrolimus-induced sinus tachycardia is a common finding in kidney transplant recipients, particularly in the early posttransplant period. However, the exact mechanism of tacrolimus-induced tachycardia is not clear. It is believed to be related to the drug’s effect on the autonomic nervous system, leading to sympathetic activation and increased heart rate. The authors suggested that careful monitoring of heart rate and blood pressure is essential in patients receiving tacrolimus.[1] In another case report by Kim et al., a 36-year-old male who underwent kidney transplantation developed supraventricular arrhythmia after receiving tacrolimus.[2] The authors noted that tacrolimus-induced arrhythmias are rare but can be life-threatening. Finally, Hodak et al. reported a case of QT prolongation and near-fatal cardiac arrhythmia after intravenous administration of tacrolimus in a liver transplant recipient. The authors suggested that tacrolimus-induced QT prolongation may be related to the drug’s effect on ion channels in cardiac myocytes.[3] In conclus","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135839652","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":"The First Face Transplant: The Face of Isabelle Dinoire","authors":"Sri Harsha Boppana, Shreya Sriram, Godugu Swathi, L. V. Simhachalam Kutikuppala, S. V. Kalyani Ponnaganti, Sai Kiran Kuchana","doi":"10.4103/ijot.ijot_62_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_62_22","url":null,"abstract":"Dear Editor, Since the 1990s, face transplants have received a great deal of press and public attention around the world. Isabelle Dinoire, the first woman who received a face transplant, became the center of attraction after undergoing an innovative surgical procedure. The first ethical approval for a face transplant in the world, was obtained by Agich and Siemionow’s team at the Cleveland Clinic in Ohio. The approach of Ohio scientists was based on more of a practical approach performed by a surgical team in Amiens, France.[1] Benoit Lengele, one of the surgeons involved, speculated a premeditated strategy, for the entire team to surreptitiously complete the process and contemplate each step thoroughly. Bernard Devauchelle was the pioneer in maxillofacial surgery. He and his team along with Jean-Michel Dubernard, a French pioneer transplant specialist have executed the first hand transplant on on November 27, 2005.[2] Unlike previous attempts, the French team submitted a case-by-case proposal for Dinoire rather than on behalf of hypothetical patients. Dinoire’s psychological and physical rehabilitation was aided by an interdisciplinary team based in Lyon and Amiens, and the procedure was not made public until after it had taken place. Because the procedure was leaked to a British newspaper, the face transplant became public much sooner than the team had planned.[3] After the continuous medical procedures, there was transmogrification in social, ethical, and clinical disagreements. After the initial facial transplant, the pool of thoughts drifted to immediate postoperative care rather than the indications of the surgery. Dinoire was apparently asymptomatic in the postoperative period and was completely fit both immunologically and functionally. She was able to perform all her duties within 12 weeks of the posttransplant period.[4] After 5 years of surgical innovation, Dinoire encountered that she was not able to eat, drink, or talk normally, but in subsequent publications around the same time, the surgeons emphasized the psychological and social benefits of undergoing a transplant over the functional issues Dinoire faced with a passing mention of her new life by virtue of her new face. The surgeons mainly focused on cosmetic outcomes. Functional and immunological outcomes were not emphasized despite the fact that she had previously been treated for two episodes of acute rejection. She also had renal failure and cervical cancer which could have stemmed from immunosuppressive medication. Dinoire died of lung cancer on April 1, 2016, at the age of 49.[5] Apprehending the importance of additional facial transplants, The Royal College of Surgeons delineated exigencies for successful facial transplants. Nonetheless, Peter Butler on October 25, 2006, the day before the publication of exigencies received ethical clearance from Royal Hospital, London, for performing four facial transplants. Financial support and sponsorship Nil. Conflicts of interest The","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135839893","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":"Pure Red Cell Aplasia Caused by Parvovirus B19 Infection in an Early Kidney Transplant Recipient","authors":"Sashi Kiran Annavarajula, Majed Abdul Basit Momin, Augustina Prabhu Deepthi, Rubina Hassan, Rathore Rahul Dev Singh","doi":"10.4103/ijot.ijot_52_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_52_23","url":null,"abstract":"Dear Editor, Posttransplant anemia has a wide range of etiologies and may be associated with higher morbidity and mortality rates. Parvovirus B19 (PV B19) has an affinity for infecting erythroid progenitor cells and causes severe hypoplasia or aplasia, leading to anemia. The bone marrow cytology examination provides an early clue for the possibility of PV B19; additionally, serological estimation of immunoglobulin M and IgG antibodies, complement levels, and molecular amplification techniques to detect PV B19 DNA aid in the diagnosis of PV B19. In the 1st month after kidney transplant, we encountered a patient with pure red cell aplasia caused by a PV B19 infection. A bone marrow aspirate cytology, low complement levels, and PV B19 DNA real-time polymerase chain reaction aided us in the early identification of the disease and a prompt reduction in immunosuppression resulted in a favorable outcome without the need for blood transfusion. A 39-year-old male with end-stage renal disease due to diabetic nephropathy who was on maintenance hemodialysis for the past 2 years underwent a deceased donor renal transplantation. He received anti-thymocyte globulin (ATG), cumulative dose of 2 mg/kg body weight and methylprednisolone, cumulative dose of 1.25 g, as induction therapy. He also received tacrolimus (trough level of 7.2 μg/l by the 5th postoperative day [POD]), mycophenolate mofetil (MMF, 2 g/day) from the day 0, and prednisolone (15 mg/kg) POD 3. He also received cotrimoxazole and valganciclovir as part of standard prophylaxis against pneumocystis and cytomegalovirus (CMV). The allograft kidney functioned well and serum creatinine reached a trough of 0.9 mg/dL from a pretransplant level of 6.5 mg/dL [Figure 1]. During his follow-up visit on POD 25, it was found that he had developed anemia. His hemoglobin level steadily dropped from 14.5 g/dL to 6.5 g/dL by POD 52 [Figure 2]. He was asymptomatic and his systemic examination was unremarkable except for pallor. Peripheral blood smears showed normocytic, normochromic RBCs. Other hematological blood parameters such as total white blood cell and platelet counts were normal. The complement levels (C3 and C4) were low. Biochemical parameters such as serum iron studies, Vitamin B12, and folic acid levels were normal. The viral serology for HIV-1, HIV-2, anti-hepatitis C antibody, and hepatitis B surface antigen were nonreactive. Reverse transcription polymerase chain reaction (RT-PCR) for CMV was undetectable (<57.1 copies/mL) by RT-PCR. A bone marrow aspiration (BMA) was performed and it showed cellular marrow with erythroid hypoplasia with maturation arrest. Many basophilic pronormoblasts with intranuclear inclusions were seen. Few cells showed pseudopod/dog-ear-like projections that favored PV B19 infection [Figure 3]. PV B19 was detectable by RT-PCR. The immunosuppression dose was reduced following the bone marrow cytology and RT-PCR results. The dose of prednisolone was reduced to 10 mg/day and MMF was ","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135839898","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":"BK virus nephropathy in renal transplantation and the effect of intravenous immunoglobulin: A prospective longitudinal single-center study in South Asia","authors":"K. Ganesh, MAbi Abraham, R. Thomas, J. Kumar, S. Simon","doi":"10.4103/ijot.ijot_43_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_43_22","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70755906","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 outcomes in allografts with multiple versus single renal arteries","authors":"S. Bansal, D. Rathi, F. Zafar, P. Ghosh, R. Khera, R. Ahlawat","doi":"10.4103/ijot.ijot_95_21","DOIUrl":"https://doi.org/10.4103/ijot.ijot_95_21","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70758268","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":"Not so sweet!!: Posttransplant diabetes ‒ An update for the nephrologist","authors":"N. Jose, S. Varughese","doi":"10.4103/ijot.ijot_97_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_97_22","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70758436","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":"Cladophialophora bantiana brain abscess after pediatric liver transplant: A report of a long-term survivor","authors":"S. Rao, Vivek Boreddy, M. Zameer, Ashley D'cruz","doi":"10.4103/ijot.ijot_23_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_23_22","url":null,"abstract":"","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"3 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70755209","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":"Transfusion Support in the First 100 Days of Allogeneic, Matched, Related Hematopoietic Stem Cell Transplant","authors":"Prashant Pandey, Divya Setya, Esha Kaul, Shweta Ranjan, Supriya Kumari","doi":"10.4103/ijot.ijot_66_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_66_22","url":null,"abstract":"Export Background: Patients receiving hematopoietic stem-cell transplantation (HSCT) require extensive transfusion support until red blood cell (RBC) and platelet engraftment occurs. The present study was planned to assess the trend of blood component transfusion in the first 100 days of ABO-compatible (ABOc) and ABO-incompatible (ABOi) allogeneic matched, related HSCT. Materials and Methods: This was a prospective study conducted in the department of transfusion medicine at a large tertiary health-care center between 2016 and 2019. Data of component-wise transfusion from the day of transplant to 100 days posttransplant were collected in all allogeneic matched, related peripheral blood HSCT recipients. Results: During the study duration, there were 62 matched, related HSCT. Of these, 38 were ABOc HSCT, and 24 were ABOi HSCT. The mean CD34+ cell dose harvested by apheresis was 7.7 and 6.2 million/kg for ABOc and ABOi categories, respectively. The most common component transfused was platelets (9.15 mean random donor platelet concentrates [RDPCs] units, 4.45 mean single donor platelet concentrates [SDPCs] units issued), followed by red cells (6.9 mean RBC units issued), with fresh frozen plasma (FFP) (3.2 mean FFP units issued) being the least frequently requested component. The mean number of red cells, RDPC, SDPC, and FFP issued for transfusion in the ABOc category were 7.1, 8.7, 5.5, and 2.3, respectively, while it was 6.7, 9.6, 3.4, and 4.1 in ABOi category, respectively. The component-wise difference in the number of units transfused in the first 100 days was not found to be statistically significant (P < 0.05) between the two categories. Conclusions: Contrary to the usual belief that ABOi transplants require more transfusions, the transfusion practices at the present center did not show a significant difference in component-wise transfusions between the two categories. A restrictive transfusion strategy was an important measure in reducing the number of transfusions.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"235 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135839899","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}