K. Kumar, Jeena K. Sathyan, M. Prasannan, Vishnu Urs, B. Prasannan, V. Unni
{"title":"Utility of protocol biopsy in the management of renal allograft recipients","authors":"K. Kumar, Jeena K. Sathyan, M. Prasannan, Vishnu Urs, B. Prasannan, V. Unni","doi":"10.4103/ijot.ijot_50_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_50_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":"70755608","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}
Muthu Veeramani, Nivedita Chandran, M. Kannan, A. Kurien
{"title":"Synchronous urological malignancies in a renal allograft recipient","authors":"Muthu Veeramani, Nivedita Chandran, M. Kannan, A. Kurien","doi":"10.4103/ijot.ijot_6_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_6_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":"70756107","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}
V. Goyal, S. Mittal, Praveenkumar Shekhrajka, Ganesh Nimje
{"title":"Anesthesia management in a patient with situs inversus totalis posted for kidney transplantation: A rare case report","authors":"V. Goyal, S. Mittal, Praveenkumar Shekhrajka, Ganesh Nimje","doi":"10.4103/ijot.ijot_85_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_85_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":"70758123","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}
SaurabhDileep Khiste, Jangamani Ravi, V. Siddini, S. Ballal, D. Dubey, NS Devanand
{"title":"Bad aortoiliac vessels: Not a contraindication for renal transplantation","authors":"SaurabhDileep Khiste, Jangamani Ravi, V. Siddini, S. Ballal, D. Dubey, NS Devanand","doi":"10.4103/ijot.ijot_92_21","DOIUrl":"https://doi.org/10.4103/ijot.ijot_92_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":"70758185","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}
Shruti Tapiawala, Suchita Jogale, Bharat V. Shah, Anuradha Raman
{"title":"Is Lysate-based Human Leukocyte Antigen Crossmatch a Reliable Method to Contraindicate a Transplant?","authors":"Shruti Tapiawala, Suchita Jogale, Bharat V. Shah, Anuradha Raman","doi":"10.4103/ijot.ijot_53_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_53_23","url":null,"abstract":"The presence of preformed cytotoxic donor-specific antibodies (DSAs) has been associated with inferior allograft outcomes in the immediate posttransplant period. Since the 1970s, the primary method for determining the presence of DSAs has been the complement-dependent cytotoxicity crossmatch. Solid phase assays on the Luminex platform were introduced in India in 2010 in the form of human leukocyte antigen antibody screening, single antigen bead (SAB) assay and lysate-based crossmatch (LumXM) to identify low titer antibodies, which are deleterious to allograft. Instead of SAB, LumXM has been popularly used in India to identify DSAs and also called DSA crossmatch, which is not recommended or validated in International literature for denying or accepting to transplant a patient due to its fallacies. We are reporting three cases which showcase the flawed nature of this test and the implications of this test on day to day practice in transplantation.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"60 3 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":"135801990","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":"Towards Deceased Organ Donation in Haryana, India: Mapping Awareness, Perceptions, and Implementation Challenges amongst the Medical Community","authors":"Varun Sreedhar, Roop Kunwar Singh, Arushi Sharan","doi":"10.4103/ijot.ijot_61_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_61_22","url":null,"abstract":"Export Introduction: The Transplantation of Human Organs Act (THOA) provided legal status to brain death as a form of death in 1994. However, even after three decades, the deceased organ donation rate in India stands at a mere 0.52 per million population, crucially due to a lack of brain death awareness, and an absence of institutionalized protocols for deceased donations. Objectives: By taking the case of the state of Haryana, this article seeks to understand the existing state of brain death awareness among professionals working in the medical community, and identify the implementation challenges that would be involved in instituting a state-level policy for donations from deceased persons. Materials and Methods: This paper adopts a qualitative approach, utilizing in-depth interviews with doctors in the districts of Rohtak and Charkhi Dadri in Haryana, and transplant coordinators across the state to gather a nuanced understanding of the issue. Results: The research finds that brain death awareness is lacking among doctors, along with the necessary resources for brain death declarations to become practice. There is also an evident district-wise variation in the responses of doctors when it comes to the potential challenges of instituting a brain death declaration standard operating procedure. It offers recommendations for improved implementation of organ transplant policies and scaling up of deceased donations. Conclusion: To unearth the potential that deceased organ donation holds, some immediate measures that can be taken include mapping all the functional organ retrieval facilities across the state and their closest civil hospitals or postgraduate medical institutions with trauma centres, and focusing on the sensitization of the medical functionaries with respect to brain death and its identification.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"25 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":"135839632","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":"Knowledge, Attitude, and Practices Regarding Organ Donation among Blood Donors – A Comparative Study with Nonblood Donors at a Rural Tertiary Care Hospital in Central India","authors":"Aryan Sunil Mehta, Abhay Vilas Deshmukh, Pratiksha Moreshwar Sonkusale, Mudita Nitin Joshi, Anupama Gupta","doi":"10.4103/ijot.ijot_51_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_51_23","url":null,"abstract":"Export Introduction: Organ transplantation is the most preferred treatment for many end-stage organ diseases. However, its rate is relatively low in India. There is a gross discrepancy between the number of people requiring organ transplantation due to failure and the organ donor pool. It is expected that the donors can easily accept the idea of organ donation as they are already involved in acts of humanitarianism. Aims: This study aimed to compare knowledge, attitudes, and practices regarding organ donation among blood donors and nonblood donors. Materials and Methods: It was a cross-sectional analytical study among two groups: blood donors and nonblood donors, conducted over 2 months. A standardized questionnaire proforma was prepared, which consisted of questions to assess the person’s knowledge, attitude, and awareness about organ donation. Results: A total of 754 people participated in the study. Of which, 722 were enrolled after strict inclusion and exclusion criteria. Three hundred and sixty-one were blood donors, and 361 were nonblood donors. There was a comparatively large difference in knowledge, attitude, and practices among blood donors regarding organ donation compared to nondonors. It was statistically significant (P < 0.05). Conclusion: The blood donors had significantly more knowledge, attitude, and practices regarding organ donation than nondonors. Even though blood donors had a positive attitude toward organ donation, only 42 participants have committed to organ donation to date. If we can bridge the gap and provide the basic knowledge regarding organ donation, it can help to build a positive attitude regarding the same in society. An awareness campaign regarding organ donation can be conducted in the community regularly to promote the process of organ donation.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"47 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":"135839655","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":"Apolipoprotein L1 Genetic Testing in Prospective Kidney Donors: Have We Reached a Breakthrough or an Impasse?","authors":"Subashri Mohanasundaram, M. Edwin Fernando","doi":"10.4103/ijot.ijot_66_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_66_23","url":null,"abstract":"Export Molecular testing, including apolipoprotein L1 (APOL1) sequencing, has recently become more accessible for use in the clinical setting. Although there is a strong association between APOL1 and kidney disease, only a small minority of African American kidney disease patients are estimated to have an APOL1 high-risk genotype. In addition, the lifetime risk for developing kidney disease among individuals with two risk alleles is estimated to be very low. The low prevalence suggests that it follows a two-hit model, where a secondary factor, such as environmental or genomic modifiers, is required to develop kidney disease. We still have a limited appreciation of factors that can act as a “second hit,” and it is unclear whether the hyperfiltration that follows donor nephrectomy constitutes as a “second hit” for the disease. One does not yet know the burden of APOL1 risk alleles among prospective living donors. Now that APOL1 genetic testing is available, and in the absence of prospective data, the role of APOL1 genotyping in live kidney donor candidate selection remains uncertain. There are several ethical issues concerning the use of genetic testing to determine donor eligibility, which can impact the development of policy around APOL1 genetic testing, release of results, and counseling.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"25 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":"135839659","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}
V. U. Lakshmi, Dinesh Balakrishnan, Manzoor Koyakutty, M. P. Narmadha
{"title":"Graft-derived Cell-free DNA as a Rejection Biomarker and a Monitoring Tool for Immunosuppression in Liver Transplantation","authors":"V. U. Lakshmi, Dinesh Balakrishnan, Manzoor Koyakutty, M. P. Narmadha","doi":"10.4103/ijot.ijot_56_23","DOIUrl":"https://doi.org/10.4103/ijot.ijot_56_23","url":null,"abstract":"Export Graft-derived cell-free DNA (gd-cfDNA) can be referred to as short fragments of DNA originating from the necrosis or apoptosis of allograft cells, released into the blood. Circulating free DNA, or cell-free DNA, is a pioneering biomarker with various potentials in medical diagnosis, including the early detection of prenatal birth defects in pregnancy, cancer, and its recurrence, and allograft dysfunction in various types of transplantation. Gd-cfDNA has a short half-life (<1.5 h), and this helps detect graft injury promptly. The quantity of gd-cfDNA depends on the size of the grafted organ as well as its integrity. The principles for differentiating the donor-derived cfDNA from the recipient-derived one include a selection of single-nucleotide polymorphism, then targeted amplification and sequencing of the cfDNA in the sample. Then, the heterozygous genome in the recipient’s sample is analyzed statistically and the level of dd-cfDNA is estimated. In liver transplantation, it can be applied to detect common complications such as acute rejection, personalize the immunosuppression doses according to the patient’s condition, and diagnose infections associated with the transplantation. In this narrative review, we spotlight the relevance of gd-cfDNA in liver transplant, the methods used to quantify it, different types of rejections, the exclusion criteria for gd-cfDNA, and its future perspectives.","PeriodicalId":37455,"journal":{"name":"Indian Journal of Transplantation","volume":"51 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":"135839895","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":"An Unusual Case of Early Cytomegalovirus Retinitis with UTI, Invasive Pulmonary Aspergillosis, Klebsiella Pneumonia in a Renal Allograft Recipient","authors":"Preeti Chaudhary, Himansu Sekhar Mahapatra","doi":"10.4103/ijot.ijot_74_22","DOIUrl":"https://doi.org/10.4103/ijot.ijot_74_22","url":null,"abstract":"Cytomegalovirus (CMV) remains the most common opportunistic infection after a kidney transplant. CMV retinitis is a rare manifestation of CMV invasive disease and is potentially threatening to vision in immunocompromised individuals. Invasive aspergillosis (IA) is one of the major causes of invasive fungal infection in kidney transplant recipients. Posttransplant CMV significantly increases the risk of IA in solid organ transplants. However, simultaneous or superadded opportunistic infections are rare and often delay the diagnosis. We report a case of early CMV retinitis in a renal transplant recipient, who initially developed extended-spectrum beta-lactamase-positive Escherichia coli cystitis at 2 weeks posttransplant. At 4 weeks posttransplant, he developed CMV retinitis managed with intravenous and intravitreal ganciclovir. At around 6 weeks, he developed persistent low-grade fever and pancytopenia without any specific systemic symptoms with initial sterile cultures sterile and normal imaging except for high-resolution computed tomography chest, which was suggestive of fungal pneumonia. Bronchoscopy and bronchoalveolar lavage were done, which came positive for aspergillus colonies. The patient improved with Amphotericin B, which was later changed to oral voriconazole. A few days later, the patient again deteriorated with new-onset fever, cough, and expectoration, which were diagnosed with Klebsiella pneumonia by imaging supported by sputum culture, which was managed by appropriate antibiotics. CMV and IA are both uncommon opportunistic infections and simultaneous or superadded infection with bacterial pneumonia is very rare. In the presence of persistent symptoms, early suspicion of another infection is crucial for patient management and long-term prognosis.","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":"135838174","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}