Showing 7 results for Renal Transplant
Shahidi Sh, Seirafian Sh, Shayegan Nia B, Adilipoor H,
Volume 64, Issue 9 (9-2006)
Abstract
Background: Long term use of immunosuppressive therapy in transplant
recipients in order to prevent acute and chronic rejection increases the long
term risk of cancer. This study evaluates the incidence of different organs’
cancer after renal transplantation and immunosuppressive therapy.
Methods: This is a retrospective analysis of malignant tumors in renal graft
recipients with more than one year graft survival. Patients were assessed
according to their age, sex, diagnosis of cancer, immunosuppressive drugs,
donors and period of dialysis before transplantation.
Results: Evaluating all existing files in selected private clinics in Isfahan 350
patients were reviewed and 289 of them had entrance criteria. A total of 186
men and 103 women (mean age: 42.17±13.09 years) were included. They were
followed up over a mean period of 52.46±33.24 months. A total of six cases
(2.1%) of cancer were diagnosed in six recipients: All patients with cancer
were male with a mean age of 51.17±14.7 years (range: 26-68 years). Tumor
presented at a mean time of 51 months (rang: 15-82 months) after
transplantation. There were two patients with BCC, two patients with SCC and
two patients with lymphoma. Two patients died of progressive malignant
disease. Age, period of dialysis before transplantation, and using
immunosuppressive and anti-rejection drugs had no significant impact on
development of post transplant malignancy.
Conclusion: The frequency of tumors in these patients is lower than what
reported by other centers, probably due to short period of follow up and low
incidence of cancer in our general population. The risk of malignancy was 28
fold higher among transplant recipients than in general population. High risk
of cancer in this group, confirms the necessity of routine examination for
organ transplant recipients both before and after transplantation.
Ahmadi F, Naseri R, Lessan Pezeshki M,
Volume 66, Issue 7 (10-2008)
Abstract
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Background: Cyclosporine
is one of the main immunosuppressors used for renal transplant recipients, and
is given to prevent transplant rejection. Although the drug increases the
survival of patients and grafted organs, it has some side effects independent
of its effect on the immune system that are usually ignored. In this study, we
evaluate the effect of cyclosporine on serum Mg levels and metabolic side
effects in renal graft patients.
Methods: In this study, we followed 157 renal
transplant recipients (62 females and 95 males) who were being treated with cyclosporine at a
private clinic to prevent transplant rejection. The patients were first physically
examined and then blood samples were obtained in order to measure levels of
cyclosporine, Mg, creatinine, fasting blood sugar, lipids, calcium,
phosphorus, and uric acid levels. We then analyzed the data for correlations between
serum Mg
levels, cyclosporine and other metabolic complications.
Results: The mean levels of Mg and
cyclosporine were 196±0.31mg/dl and 371±192 μg/dl, respectively. Hypomagnesemia was detected in 16 patients (10.2%).There was
a significant negative correlation (p<0.05) between levels of Mg and cyclosporine levels (r=-0.53), serum
creatinine (r=-0.61), plasma LDL (r=-0.3), fasting blood sugar (r=-0.60) and uric
acid (r=-0.36), and no correlation (p>0.05) between levels of Mg and calcium (r=0.2), phosphorus (r=-0.01),
triglycerides (r=0.06) and HDL (r=-0.08). Mean levels of cyclosporine, creatinine, LDL, fasting
blood sugar and uric acid in patients with hypomagnesemia were significantly
different from those patients with normal serum Mg levels (p<0.05). There
was no significant difference between the two groups with regard to mean total
cholesterol, HDL, calcium and phosphorus (p>0.05).
Conclusion: According to the results of this and previous studies,
there is a significant correlation between cyclosporine levels and
hypomagnesemia as well as other biomedical complications secondary to
hypomagnesemia. Therefore, we recommend routine serum Mg determination and greater
attention to hypomagnesemic patients to prevent further complications.
Eslami M, Mehrpooya M, Broumand B, Seifi S,
Volume 67, Issue 1 (4-2009)
Abstract
Background: Uric acid as a final product of purine metabolism has a role of risk factor for cardiovascular disease with less clear mechanism in general population. The aim of this study was Assessing and finding association between uric acid levels and CAD as a risk factor in renal transplant candidates and if we can predict need to revascularization according to uric acid level as an important measure.
Methods: This is a cross-sectional study that has been studied since April 2007 up to December 2008, in imam Khomeini and pars hospitals in Tehran. Inclusion criteria were patients with ESRD, more than 40 years who were candidates for renal transplantations. They underwent coronary angiography without regarding clinical cardiac symptom or results of noninvasive tests (for avoiding referral bias) and simultaneous analysis of serum uric acid level and results of this two producers were analyzed. Excluding criteria were patients who didn't tend to coronary angiography, those who hadn't adequate artery access, or potential co morbidity so that angiography was impossible and life expectancy less than 6 month.
Results: 56 (24 females and 32 males) were constituted. 89.3% (50) of patients had coronary artery disease. The average of uric acid level was significantly different in patients with and without CAD [7.62±1.07mg/dl and 5.95±1.29mg/dl respectively] (p=0.0024). Moreover, there was statistically significant difference in serum uric level between patients who were candidate for revascularization and the others [7.89±0.79mg/dl and 6.2±1.27mg/dl respectively] (p<0.001).
Conclusion: It seems that serum uric acid can be considered as a cardiovascular risk factor in renal transplant candidates and also as a predictor for related treatment.
Khalkhali H, Hajizadeh E, Kazemnezad A, Ghafari Moghadam A,
Volume 67, Issue 8 (11-2009)
Abstract
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Background: Although the short-term results of kidney transplantation have improved greatly
during the past decades, the long-term results have not improved according.
Graft loss due to chronic allograft dysfunction (CAD)
is a major concern in renal transplant recipients (RTRs).
There is little data about disease progression in this patient population. In
this paper, we investigated history of kidney function as the pattern, waiting
time and rate of pass from intermediate stages in RTR
with CAD.
Methods: In a single-center retrospective study, 214 RTRs
with CAD investigated at the Urmia University Hospital urmia,
Iran from 1997 to 2005.
Kidney function at each visit assessed with GFR.
We apply NKF and K/DOQI
classification of chronic kidney disease (CKD)
staging system to determine pattern of disease progression per stage in this
group of patients.
Results: The pure death-censored graft loss was 26%
with mean waiting time 81.7 months. 100%
of RTRs passed from stage I
to II in mean waiting time 26.3
months. The probability of prognostic factors transition from stage II
to III was 88.9%
with mean waiting time 25.5 months, transition from
III to IV
was 55.7% with mean waiting time of 24.9
months and transition for stage 4 to IV
was 53.5% with mean waiting time of 18.2
months. In overall rate of transition from stage i to j in patients with stage III
at the beginning of the study (time of start CAD's
process) was faster than others.
Conclusions: This
study revealed, that kidney function in first years after transplantation is
one of the most important II to III
of survival probability per stage and death-censored graft loss.
Therefore care of RTRs in first year could
potentially increase long-term kidney survival.
Nuraei A, Khajenouri R, Soleimani M, Dabbagh A,
Volume 68, Issue 4 (7-2010)
Abstract
Background: Patients with chronic renal disease, if not treated appropriately, will be usually terminated into an irreversible stage known as End Stage Renal Disease (ESRD), the final stage of kidney disease. End stage renal disease patients cannot excrete the appropriately potassium ion through the kidney. Among the crystalloid solutions, normal saline is devoid of potassium so it is used in a widespread manner in renal transplant patients. High doses of this solution may cause hyperchloremic metabolic acidosis that is accompanied by extracellular potassium shift and impaired splanchnic perfusion. The aim of this study was to assess the effects of two types of solutions, normal saline vs. lactated ringer in these patients during the perioperative period. Methods: In a double blind clinical trial, 108 patients were randomly assigned in two groups (54 in each), while were assimilated regarding all aspects except for the type of the crystalloid solution. Age, weight, duration of the surgery, total volume of the infused crystalloid, central venous pressure and sex were all assessed.
Results: The two groups were the same regarding the results gained for pre- and post- operative parameters. Follow up assessments did not show any difference between the two groups regarding above variables.
Conclusions: The results of this study demonstrated that both of the crystalloid
solutions assessed, normal saline and lactated ringer solution, are safe for using in patients undergoing surgical operation and there is not a risk of hyperkalemia in renal transplant patients receiving lactated ringer. This study was performed on live kidney transplants and the results were not applicable to cadaver transplants.
Sedghipour M, Tabatabaei Sah, Sadadi F, Kamal Hedayat D, Nikdoost F, Sate H, Ghorbani Yekta B,
Volume 69, Issue 11 (2-2012)
Abstract
Background: Persistence of left ventricular hypertrophy (LVH) in renal transplant recipients is associated with unfavorable outcomes. Calcineurin-inhibitor (CNI) nephrotoxicity is a major cause of morbidity and mortality after kidney transplantation. In this study we compared sirolimus (SRL) with calcineurin-inhibitor as primary immunosuppressants for the attenuation of left ventricular hypertrophy in renal transplantation recipients.
Methods: In this prospective cohort study done in Shariati Hospital in 2010, we evaluated the effects of sirolimus and CNI on LVH of 55 renal transplant recipients. The cases (19) received sirolimus while the controls (36) received CNI while being matched for age and duration of transplantation. Data regarding blood pressure (BP), hemoglobin, serum creatinine, uric acid and lipid concentrations were assessed and changes in left ventricular (LV) mass were evaluated by echocardiography over a one-year follow-up.
Results: Left ventricular mass significantly decreased (P=0.0001) in the SRL group but blood pressure did not differ between the two groups. LV mass and LV mass index both decreased significantly (P≤0.05) but the difference was not associated with changes in BP. The difference in interventricular septal thickness at end diastole (IVSD) and posterior wall diameter (PWD) were significant (P≤0.05) in the SRL group but the difference in end diastolic diameter (EDD) was not significant.
Conclusion: Conversion from CNI to SRL-based immunosuppressive therapy in RTRs is safe and SRL may decrease LVH. SRL seems to be safe and improve renal function without cardiac compromise in kidney transplant recipients.
Mr Pourmand, M Keshtvarz, Mm Soltan Dallal , M Talebi, R Bakhtiari, Gh Pourmand,
Volume 71, Issue 2 (5-2013)
Abstract
Background: Renal transplantation is the treatment of choice in patients with end-stage renal disease. Urinary tract infection (UTI) is one of the most common complications after renal transplantation and it has serious consequences. The aim of this study was assessing UTIs in renal transplanted patients and evaluation of risk factors associated with post-transplant UTI.
Methods: In this prospective study, 173 patients (48 hospitalized patients and 125 outpatients) were enrolled in this study. These renal transplant recipients evaluated for bacterial urinary tract infection in urology research center at Sina Hospital. After collecting urine samples from symptomatic and asymptomatic patients, urinalysis and colony count were performed. Identification of bacteria was performed by routine microbiological tests in the Department of Pathobiology, School of Public Health, Tehran, Iran, in 2011.
Results: UTI was observed in 47 patients and the most prevalent microorganism was Escherichia coli (E.coli) 18(38.2%). Nearly 71% of UTI cases were diagnosed during the first three months post transplantation. Risk factors for post transplant UTI were female gender, age, length of hospitalization and diabetes mellitus. Female patients were more susceptible than males (OR=0.50 and P=0.047) to infection. There were no significant difference between diabetes mellitus and UTI. Most of the isolated bacteria were susceptible to imipenem and resistant to tetracycline and trimethoprim- sulfamethoxazole.
Conclusion: Our study confirmed that bacterial infections remain as the most common infectious complication in the early post-transplant period, and antibiogram rather than empirical treatment is needed to find the best effective antibiotics. Moreover, risk factors such as female gender, increased age and length of hospitalization are predisposing factors to increased urinary tract infection in renal transplantation.
