Holgersenbryan9840
After undergoing deceased donor liver transplant, the patient's serum bilirubin levels and prothrombin time began to decrease. The histology of the excised liver was compatible with hepatic sinusoidal obstructive syndrome. After being treated for pneumonia, pulmonary edema, and cytomegalovirus viremia, the patient was discharged 2 months after transplant. read more At 18 months after liver transplant, although he was treated for fungal pneumonia and is being considered for kidney transplant due to unsuccessful weaning from renal replacement therapy, the patient has shown stable liver function and no signs of either graft-versus-host disease or a relapse of acute lymphocytic leukemia. In conclusion, although severe sinusoidal obstructive syndrome in the setting of stem cell transplant has a poor prognosis, we suggest that deceased donor liver transplant should be considered in the treatment of select patients with life-threatening liver dysfunction after hematopoietic stem cell transplant.
Renal transplant with ABO-incompatible donors expands the donor pool. Earlier studies have focused the use of protocol biopsies in ABO-incompatible transplant patients. Our study described outcomes of indication (for cause) renal biopsies and clinical outcomes in patients with ABO-incompatible renal transplant.
This retrospective study included 164 patients from January 2012 to June 2019. Biochemical parameters, serial immunoglobulin G anti-ABO titers, and class I and II donor-specific antibody findings were obtained from hospital records, and renal graft biopsies were reviewed according to the Banff 2017 update.
We analyzed the results of 65 biopsies from 54 patients. Biopsy-proven acute antibody-mediated rejection (12.8%) was found to be more prevalent than acute cellular rejection (1.8%). Patients with antibodymediated rejection all had microvascular inflammation (g+ptc score of 2 or more, where g+ptc is the sum of the glomerulitis and peritubular capillaritis scores) and were positive for C4d. Acuteantibody-mediated rejection.
The microvascular inflammation score (g+ptc score of 2 or higher) is more reliable than diffuse C4d positivity to determine antibody-mediated rejection in ABO-incompatible transplants because diffuse C4d positivity may also be seen in etiologies unrelated to antibody-mediated rejection. Acute tubular injury with C4d positivity without microvascular injury does not confirm antibody-mediated rejection. We suggest that Banff classification be updated in ABO-incompatible transplants to include diagnostic criteria for the diagnosis of antibody-mediated rejection.
This study aimed to assess awareness toward eye donation and the effects of COVID-19 on perceptions about eye donation in an urban community of West Bengal, India.
Eligible adults residing in the area under study were chosen by simple random sampling and interviewed using a predesigned and pretested data collection schedule to assess awareness and perception. Based on their total awareness score, the participants were classified as having good awareness or poor awareness toward eye donation.
Among 423 participants, 52.0% were male, 34.0% were 18 to 30 years old, 38.3% were educated up to secondary level, and 85.6% had eye disease in their family. Of total participants, 70.2% had heard about eye donation, with 59.9% of this group having knowledge of eye donation only after death and 57.9% having knowledge that donation must occur within 6 hours of death. In addition, 52.9% were aware about donation from home, 30.6% said only the cornea is transplantable, and 52.2% knew it can be preserved. Participants with higher education, higher socioeconomic status, and outside of the house occupational engagement had significantly higher chance of good eye donation awareness. Of total participants, 32.0% said that COVID-19 could be transmitted through eye donation, with 58.2% of participants opining that the pandemic was not a suitable time to consider donation of eyes.
COVID-19 has had a negative impact on eye donation perceptions. Although most of our participants had heard about eye donation, their awareness regarding important aspects about eye donation were still lacking, thus calling for a more focused action plan and implementation of the same.
COVID-19 has had a negative impact on eye donation perceptions. Although most of our participants had heard about eye donation, their awareness regarding important aspects about eye donation were still lacking, thus calling for a more focused action plan and implementation of the same.Guillain-Barre syndrome is an acute immune-mediated demyelinating, polyneuropathy, which is usually provoked by a preceding infection. Guillain-Barre syndrome lies within the spectrum of disimmune neuropathies and usually occurs in immunocompromised patients because it is theoretically contradictory. Guillain-Barre syndrome in liver transplant recipients has been rarely reported. Here, we present a case of a patient who had undergone a deceased donor liver transplant and who developed symptoms of Guillain-Barre syndrome in the posttransplant period. We postulated that reactivation of varicella-zoster virus in our patient triggered the autoimmune-related peripheral neuropathy leading to Guillain-Barre syndrome; another etiology for this complication may be autoimmune hepatitis, as also shown in our patient.
In children who undergo renal transplant, vesicoureteral reflux on the transplanted kidney is a serious complication that may result in organ loss. In this study, we aimed to evaluate the results of endoscopic and open surgical techniques in the treatment of patients with recurrent urinary tract infections and vesicoureteral reflux after renal transplant.
The files of pediatric patients who underwent renal transplant in our hospital between January 2016 and January 2019 were evaluated retrospectively. In this single-center analysis, we investigated the incidence of vesicoureteral reflux in the kidney transplant recipients and the results of various approaches to treat it.
Eighty pediatric patients underwent renal transplant between January 2016 and January 2019. Fourteen of those patients (17.5%, 7 female and 7 male) were diagnosed with vesicoureteral reflux in the postoperative period. Twelve of 14 patients received endoscopic injections as the first treatment. Clinical or radiological success was achieved in 5 patients (5 of 15 injection treatments, 33%); in 4 patients (4/12, 33.