فهرست مطالب

International Journal of Organ Transplantation Medicine
Volume:6 Issue: 1, Winter 2015

  • تاریخ انتشار: 1393/11/03
  • تعداد عناوین: 6
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  • M. Sagi, Roglu, O. Gunay, E. Balci Page 1
    Background
    Attitudes of medical and law personnel towards organ donation are very important.
    Objective
    To compare the attitudes of the medical and law students towards organ donation.
    Methods
    498 students in the 1st and 4th grades of the medical and law faculties of Erciyes University, Kayseri, Turkey, in 2011–12 academic year, were included in this study. A questionnaire consisting of 31 questions on socio-demographic characteristics of the students and their attitudes towards organ donation and transplantation was administered to the participants.
    Results
    The percentage of the students who donated organs was 1%. Approximately, 48% of the medical students and 34% of the law students stated that they think to donate organs. The percentage of the students with a positive attitude towards organ donation was found significantly higher among the medical students than the law students, and higher among the 4th grade compared to the 1st grade.
    Conclusion
    The percentages of the students who have donated organs and think to donate are rather low. Medical students’ attitude towards organ donation was more positive than the law students.
  • R. Rasool, Q. Yousuf, Kz Masoodi, Ia Bhat, Za Shah, Ia Wani Wani Page 8
    Background
    Even after adequate immunosuppression therapy, acute rejection continues to be the single most important cause of graft dysfunction after renal transplantation. Renal allograft biopsy continues to be the reference standard, though certain clinical and biochemical parameters are helpful in assessment of these patients. Renal allograft rejection is mediated by T lymphocytes, expressing cell surface interleukin-2 receptors (IL-2R) which has been suggested as a marker of acute rejection episodes after organ transplantation.
    Objective
    To determine the pre- and post-transplantation serum soluble IL-2R levels in live related kidney transplant patients to predict acute rejection episodes.
    Methods
    Serial serum samples from 75 recipients and 41 healthy controls were assessed for soluble IL- 2R levels by ELISA. The outcome of the graft was also determined for each recipient.
    Results
    The mean±SD serum soluble IL-2R levels in renal allograft recipients with rejection were significantly (p<0.001) higher than those without rejection (329.85±59.22 vs 18.12±11.22 pg/mL). The elevation of serum soluble IL-2R was evident in acute rejection episodes and found before elevation of serum creatinine. The higher values of serum soluble IL-2R in the rejection group were significantly reduced after recovery of allograft function by adequate anti-rejection therapy. 36.4% of patients in the rejection group had proven positive biopsies for the rejection and higher creatinine values, which was found to be statistically significant (p<0.001). A cohort of 41 healthy controls showed significantly (p<0.05) lower serum soluble IL-2R concentrations (15.27±7.79 pg/mL) when compared with the rejection group.
    Conclusion
    Serum soluble IL-2R concentrations showed significant correlation with the acute rejection episodes in the renal allograft recipients. Prediction of soluble IL-2R levels might help the early detection of rejection episodes, which may pave way for the management of immunosuppression regimes and better graft functioning.
  • Z. Musavi, N. Azarpira, Mh Sangtarash, M. Kordi, K. Kazemi, B. Geramizadeh, Sa Malek, Hosseini Page 14
    Background
    New-onset diabetes after transplantation (NODAT) is a serious complication in transplant recipients. Transcription factor-7-like 2 (TCF7L2) is a Wnt signaling-associated transcription factor that plays an important role in β-cell proliferation and insulin secretion. The association between TCF7L2 SNP rs7903146 and NODAT was documented in renal transplant patients.
    Objective
    To determine the association between TCF7L2 rs7903146 variants and the risk of NODAT after liver transplantation.
    Methods
    This study was conducted on 140 liver transplant recipients who had received tacrolimusbased immunosuppressive drugs. The patients were divided into NODAT (n=70) and non-NODAT (n=70) groups and were genotyped using PCR-RFLP. In addition, 100 normal subjects were considered as the comparison group.
    Results
    There was a significant difference (p<0.05) between the two study groups regarding donor and recipient age, recipient body mass index, and recipient fasting plasma glucose before the transplantation. No significant relationship was observed between TCF7L2 rs7903146 genotypes and development of NODAT. No significant difference was also found between the two groups in terms of the tacrolimus and mycophenolate mofetil daily dosage as well as tacrolimus blood level. However, the prednisolone daily dosage was significantly (p=0.01) higher in the NODAT group compared to those without NODAT. The majority of the patients in the NODAT group also had an episode of acute rejection. Furthermore, a significant difference was found between the transplant recipients and the comparison subjects regarding T allele (p<0.001, OR=1.96) and TT genotype (p<0.001, OR=3.47) frequencies.
    Conclusion
    No correlation was found between TCF7L2 genotypes and development of NODAT. Acute rejection and prednisolone pulse therapy predisposed the susceptible patients to NODAT.
  • Z. Bahador, Sm Dehghani, A. Bahador, S. Nikeghbalian, N. Hafezi, M. Bahador, Sa Malek, Hosseini Page 25
    Background
    So far numerous post-transplant outcome predictors have been studied to decrease the loss of resources and grafts after organ transplantation. The role of education, as a predictor, in liver transplantation outcome has so far been studied in several articles. However, in most of the studies it was evaluated as a surrogate for socioeconomic status or other variants. The absolute impact of parents’ education has rarely been studied. Adult patients are their own caregivers whereas pediatric liver transplantation recipients are mostly cared by their parents.
    Objective
    To evaluate the effect of level of patients'' education on the mortality and morbidity of pediatric liver transplant recipients.
    Methods
    We studied a group of 91 children who had undergone liver transplantation in our center from March 21, 2012 to July 21, 2013. In this retrospective study, patients’ medical charts and questionnaire were used to collect the necessary data. Post-transplantation mortality and complications were divided into two categories: Early (<6 months after liver transplantation), and late (≥6 months after the transplantation). Parents’ educational level was also categorized into 5 groups.
    Results
    Multivariate analysis of all groups showed that paternal education is an independent predictor of the late post-transplantation complications (p=0.024). Educational level of children’s mothers had no significant correlation with the late post-transplantation complications (p=0.45). Neither maternal (p=0.59) nor paternal (p=0.607) education had significant effect on the late post-transplantation mortality.
    Conclusion
    Paternal educational level of liver transplanted children is associated with the late post-transplantation complications.
  • O. Abdelaziz, K. Hosny, O. Elmalt, S. Emad, Eldin, A. Hosny Page 33
    There are few reports of portal vein thrombosis among living donor liver transplant donors and no published data on the management of this event. In this report, we present our experience in the diagnosis and management of this rare complication in two living donor liver transplantation donors who developed post-operative portal vein thrombosis. Both cases were successfully managed with intra-operative ultrasound-guided thrombectomy, vein patch venoplasty, and catheter-directed thrombolysis. The two donors are symptom-free two years after the event.
  • F. Yaylak, V. Ince, B. Barut, B. Unal, M. Kilic, S. Yilmaz Page 41
    We have previously reported our experience in inferior vena cava resection and reconstruction techniques during liver transplantation for Budd-Chiari syndrome. Herein, we present on a case that demonstrates the importance of experience in complex vascular reconstruction techniques for living donor liver transplantation. A 15-year-old boy was scheduled for living donor liver transplantation for Budd-Chiari syndrome. Venous occlusion was extended up to the right atrial orifice of the supra-hepatic vena cava. Retro- and supra-hepatic segments of the vena cava was resected. Inferior vena cava graft stored in deep-freeze was available. Venous reconstruction was performed with end-to-end atrio-caval anastomosis. Surgical treatment was completed with the implantation of the right liver lobe donated by the patient’s mother. Post-surgical course was uneventful.