فهرست مطالب

Organ Transplantation Medicine - Volume:10 Issue:4, 2019
  • Volume:10 Issue:4, 2019
  • تاریخ انتشار: 1398/09/13
  • تعداد عناوین: 6
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  • H Ilkhanipoor, M Ahangar Davoodi*, S M Dehghani, H Karamifar, S M Abdollahzadeh Pages 155-161
    Background

     Particular requirements of pediatric and adolescent liver-transplant (LT) recipients necessitate the evaluation of such population from the endocrine viewpoint.

    Objective

     To determine the endocrine disorders among LT recipients.

    Methods

     129 LT recipients younger than 18 years, and at least 6 months post-LT with no pervious history of endocrine disorders were included in the study. Demographic, anthropometric and biochemical data were collected.

    Results

     36% of cases had evidence of impaired fasting glucose; the problem, however, was dramatically resolved (decreased to 2.3%) by using of prediabetic diet. Identifying only 1 case of primary hypothyroidism indicated that thyroid dysfunction seems not to be a prevalent finding in the patients. 3 cases of rickets and no case of parathyroid dysfunction were identified. 11% of the study population were hypocalcemic (2 had rickets as well). Pubertal condition in 3 patients and delayed puberty before LT in 6 remained the same; further evaluation revealed they had hypogonadotropic hypogonadism.

    Conclusion

     Regular monitoring for development of diabetes and hypocalcemia is indicated. Evaluation of those with delayed puberty for receiving sexual hormones is also recommended.

    Keywords: Liver transplantation, Endocrine system, Diabetes mellitus, Thyroid diseases
  • P. F. Müller*, M. Kunzelmann, K. Wilhelm, A. Miernik, C. Gratzke, A. Jud, P. Pisarski, B. Jänigen Pages 162-166
    Background

     Insertion of ureteral catheters is a common procedure in kidney transplantation. The stent is usually removed by cystoscope. Magnetic ureteral stents may be an alternative to conventional stents.

    Objective

     To assess the functional efficacy and feasibility of magnetic double J (DJ) stents in kidney transplant recipients.

    Methods

     We used 6 Fr (diameter), 22 cm (length) magnetic DJs. We examined 7 cases of exclusively ABO-identical living donations. Stent were removed 10–12 days after transplantation. Ureteral Stent Symptoms Questionnaire (USSQ) and visual analog scale (VAS) were used to determine quality of life and pain of the recipients. The total removal time was recorded and cost reduction was calculated.

    Results

     Removal of the magnetic DJ was successful in all cases. The mean±SD duration of the removal was 3.4±1.6 min. The mean±SD overall pain score on the VAS during the procedure was 2.6±1.1. Using this technique was associated with a cost reduction of € 130.

    Conclusion

     Using magnetic ureteral stents is a feasible option for living donation AB0-identical kidney transplant recipients.

    Keywords: Kidney transplantation, Ureteral obstruction, Cystoscopy, Urinary catheters
  • G Pourmand, S Karbalai Saleh*, A Mehrsai, S Gooran, M R Khajavi, E Razeghi, M Rahbar, M Pourhossein, S Dehghani Pages 167-169
    Background

     Perivalvular and valve involvement are prevalent in patients with end-stage renal disease (ESRD), especially in younger patients compared with normal population. Kidney transplantation improves the prognosis of these patients. Patients with cardiac valvular disease is also be improved following kidney transplantation.

    Objective

     To evaluate the impact of renal transplantation on the severity of mitral regurgitation (MR).

    Methods

     We studied 95 kidney transplantation candidates in Sina Hospital. The patients underwent echocardiography preoperatively and at the 3rd, 6th, and 12th months post-operatively.

    Results

     Pre-operatively, the average MR fraction was 30%; MR volume 30 mL/beat; mitral valve mean gradient 1.8 mm Hg; mitral valve area 4.6 cm2; and mitral annular size 3 cm. No significant difference was observed among the measurements made at the 3rd, 6th, and 12th months post-operatively.

    Conclusion

     There was no significant association between the variables measured pre- and post-operatively. The reason might be the fact that patients with ESRD in Iran do not have to expect long transplant waiting lists and dialysis cannot affect their heart adversely.

    Keywords: Renal dysfunction, Mitral regurgitation, Renal, kidney transplantation
  • Z. Niknam, H. Zali*, V. Mansouri, M. Rezaei Tavirani, M. Omidi Pages 171-182
    Background

     The loss or dysfunction of bone tissue that observed after bone tumor resections and severe nonunion fractures afflicts 200 million people worldwide. Bone tissue engineering is a promising approach to repair osteoporotic fractures.

    Objective

     In this paper, polycaprolactone (PCL)/magnesium oxide (MgO)/graphene oxide (GO) nanofibrous scaffold was fabricated by electrospining method, and its biocompatibility and osteogenic differentiation of adipose-derived mesenchymal stem cells (MSCs) on this scaffold were evaluated and compared with pure PCL nanofibrous scaffold.

    Methods

     SEM analysis, DAPI staining and MTT assay were used to evaluation biocompatibility of PCL/ MgO/GO composite scaffold. In addition by ALP assay and proteomic approach, osteostimulatory effect of electrospun composite scaffold was investigated and the expression level of osteogenic markers including Runt-related transcription factor cbfa1/runx2 (runx2), collagen type I (Col1a1) and osteopontin (OPN) in MSCs seeded on PCL/MgO/GO composite scaffold was determined and compared with pure PCL scaffold. Then, RT-PCR technique was used to validate the level expression of these genes.

    Results

     The obtained results showed that adhesion, viability and ALP activity of MSCs on PCL/MgO/GO scaffold considerably enhanced compared with pure PCL. As well as proteomic and real-time analysis illustrated the expression of osteogenic markers including runx2, Col1a1 and OPN increased (>2-fold) in cells seeded on PCL/MgO/GO composite scaffold.

    Conclusion

     It was concluded that MgO and GO nanoparticles could improve the biocompatibility of PCL scaffold and enhance the osteogenic differentiation of MSCs.

    Keywords: Bone tissue engineering, Scaffold, Proteomics, Mesenchymal stem cells, Osteoblast
  • O M Walsh*, A R Holmes, A G Evans Pages 185-187

    Pulmonary vein thrombosis (PVT) is a rare condition seen almost exclusively in the first two weeks after lung transplantation or lobectomy. Subsequent embolic phenomena are uncommon. Herein, a 47-year-old male with a history of bilateral lung transplantation presented with transient episodes of acute dysphasia and right arm weakness. Brain MRI revealed cortical infarcts in the territory of the left middle cerebral artery. Transesophageal echocardiogram demonstrated a thrombus in the left lower pulmonary vein. This represents the latest manifestation of a PVT reported in the literature—6 years after redo transplantation and 13 years after the original surgery. Investigation for PVT should be considered in any patient with previous lung transplantation that presents with systemic emboli.

    Keywords: Emboli, Stroke, Cerebrovascular accident, Pulmonary vein thrombosis, Lung transplantation
  • Duarte*, J. Gameiro, C. Outerelo, E. Nogueira, J. A. Lopes Pages 188-190

    Anemia is a common finding after kidney transplantation (KT). Herein, we present a 34-year-old man who received a deceased-donor KT in 2017. Induction immunosuppression therapy consisted of thymoglobulin, tacrolimus (TAC) and methylprednisolone; the maintenance therapy included mycophenolate (MMF) 500 + 500 mg, TAC 4 + 4 mg and prednisolone (PD) 5 mg. One year after KT, he progressively developed dyspnea and fatigue. Laboratory exams revealed hypochromic microcytic anemia unresponsive to increasing doses of darbepoetin. Upper endoscopy and colonoscopy were normal. Bone marrow examination revealed erythroid hyperplasia with numerous proerythroblasts. Serology and viral load for human parvovirus B19 were both positive. Immunosuppression was reduced; he was treated with immunoglobulin. After one week, anemia improved. After 2 months the patient remained asymptomatic with stable hemoglobin. Although rare, PVB19 infection is a clinically significant infection that often presents as aplastic anemia in the post-transplantation period.

    Keywords: Refractory anemia, Kidney transplant, Parvovirus B19 infection