فهرست مطالب
International Journal of Organ Transplantation Medicine
Volume:7 Issue: 2, Spring 2016
- تاریخ انتشار: 1395/02/13
- تعداد عناوین: 7
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Page 61World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for-date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults, if they receive kidney replacement therapy including dialysis and transplantation, while only a minority of children may require this ultimate intervention. Because there are disparities in access to care, effort is needed so that those children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that World Kidney Day will inform the general public, policymakers and caregivers about the needs and possibilities surrounding kidney disease in childhood.Keywords: Renal insufficiency, Chronic, Congenital abnormalities, Nephrosis, lipoid
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Page 69BackgroundSplitting a liver for utilization in adult/pediatric recipients has been shown to decrease mortality on the wait list without increasing the overall risk of long-term graft failure compared to a whole graft. However, splitting a single donor organ for two adult recipients, full-right-full-left split liver transplantation (FRFLSLT), to overcome organ shortage is still considered controversial.ObjectiveThis study assessed the outcome of FRFLSLT comparing full-right (FR) and full-left (FL) with whole liver (WL) allografts in adults (19982010) using UNOS standard transplant analysis and research (STAR) file.MethodsUnadjusted allograft and patient survival were estimated using Kaplan-Meier survival curves. Adjusted analyses of survival were conducted controlling for propensity for WL allograft.ResultsThere were 83,313 cases of WL, 651 FR and 117 FL. Significant differences were evident in the unadjusted cohort between recipients who received FR and FL including donor, cold ischemic time, and days on transplant waiting list. Use of FL allograft resulted in a trend toward lower graft and patient survival compared to WL and FR, which was not statistically significant (p=0.07). In the matched cohort, FL hemiliver allograft had no detrimental effect on the allograft or patient survival after split liver transplantation when compared to FR and WL.ConclusionAfter adjusting for donor and recipient characteristics, there was no difference in allograft or patient survival with the use of FL, FR, or WL after liver transplantation in adults. FRFLSLT is a valuable and safe option to expand the donor pool.Keywords: Liver transplantation, Waiting Lists, Mortality, Allograft survival, Patient survival, Survival analysis
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Page 77BackgroundMyocardial performance index (MPI) or Tei index is a Doppler-derived index of combined systolic and diastolic myocardial function, calculated as the sum of isovolumetric relaxation time (IRT) and isovolumetric contraction time (ICT) divided by the ejection time (ET).ObjectiveTo evaluate the right and left ventricular systolic and diastolic function using MPI in children before and after liver transplantation.MethodsA cross-sectional study was conducted on 30 children with liver cirrhosis before liver transplantation, 30 age-matched comparison group at least 6 months after liver transplantation, and 30 agedmatched children without history of heart disease in Nemazi Liver Transplant Center, Shiraz, Iran, from April 2012 to April 2014. Echocardiographic evaluation was carried out with a GE Vivid 3 echocardiographic machine, using a 3-MHz probe with tissue Doppler imaging (TDI) software using conventional and TDI method.ResultsThe mean±SD left ventricle Tei index in patients was 0.33±0.02 before liver transplantation, 0.34±0.02 after liver transplantation, and 0.33±003 in the comparison group (p=0.36). The mean±SD right ventricular Tei index was 0.35±0.04 in patients before transplantation, 0.36±0.46 after liver transplantation, and 0.28±0.04 in the comparison group (pConclusionLeft ventricular MPI with Doppler echocardiography was correlated with CTP score. Right ventricular MPI was significantly increased in patients with cirrhosis and did not improve 6 months after transplantation.Keywords: Myocardium, Karnofsky performance Status, Liver transplantation, Child, Tei index, Liver cirrhosis
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Page 85BackgroundMetabolic syndrome (MetSx) is common among liver transplant recipients. It contributes to morbidity and mortality.ObjectiveTo determine the prevalence of MetSx in patients undergoing liver transplantation (LTx) in Iran.Methods202 liver transplant recipients of both sexes completed this study. Relevant information including age, sex, the underlying disease, systolic and diastolic blood pressure, waist circumference, fasting serum levels of blood sugar (FBS), triglyceride (TG), and HDL-cholesterol were measured. The prevalence of MetSx was evaluated at 1, 3, 6, 9, and 12 months after LTx.ResultsThe prevalence of MetSx was 36.6% after 1 month that decreased to 28.2% after 12 months of follow-up. The lowest prevalence of MetSx (27.7%) was observed 9 months after LTx. Our data showed a decrease in TG and an increase in HDL-C level and no significant changes in blood pressure, waist circumference and FBS during the study period.ConclusionThe prevalence of MetSx after LTx is high when compared to the normal population. It seems that a change in diet after transplantation may affect the prevalence of MetSx.Keywords: Metabolic syndrome, Transplant recipients, Hyperglycemia, Hyperlipidemias, Liver transplantation, Prevalence
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Page 91BackgroundDerivation of induced pluripotent stem cells (iPSCs) from various adult somatic cells through over-expression of pluripotent genes could allow for the unlimited autologous supply in regenerative medicine. On the other hand the generation of various progenitors from bone-marrow mesenchymal stem cells (MSCs) is justly well established.ObjectiveIn this study we compared the expression level of pluripotent genes oct4, c-myc, sox-2, nanog, klf4 and lin28 in iPSCs and MSCs derived from bone marrow. Also the potential of osteogenesis of iPSCs and bone-marrow MSCs were compared.MethodsWe analyzed the expression level of oct4, sox-2, c-myc, klf4, nanog and lin28 genes in human MSCs derived from iPSCs and MSCs by cell culture and real-time PCR. Also the expression level of osteocalcin and osteopontin in both groups were evaluated.ResultsWe found that the expression of osteogenic markers in differentiated iPSCs to osteoblast were higher than bone-marrow MSCs. While the levels of pluripotency genes oct4, c-myc and klf4 in iPSCs were significantly (pConclusionIt seems that the higher expression of osteopontin and osteocalcin in MSCs compared to iPSCs may be due to other factors (besides pluripotency) required for differentiation of stem cells to osteoblast.Keywords: Induced pluripotent stem cells, Mesenchymal stromal cells, Gene expression profiling, Osteogenesis, Xite transcript, mouse [Supplementary Concept], Genes, myc, sox2 protein, xenopus [Supplementary Concept]
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Page 99Knowledge of the renal vascular anatomy greatly contributes to the success of surgical, invasive and radiological procedures of the retroperitoneal region. In todays era of transplant, this knowledge is of utmost importance in performing donor nephrectomy so that number of fatal intra-operative complications can be prevented. Herein, we report on a rare anomaly of left renal vein in which dual retro-aortic left renal veins were noted and one of them drained into the left common iliac vein.Keywords: Aorta, Transplantation, Nephrectomy, Renal veins, Iliac Vein
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Page 102Middle East, with more than 650 million inhabitants, has one the lowest mean donation rate in the world in the context of organ procurement from deceased donors withKeywords: Tissues, Human, Organ transplantation, Tissue, Organ Procurement, Tissue banks