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MEDICAL SCIENCES (2241 journals)            First | 1 2 3 4 5 6 7 8 | Last

Showing 601 - 800 of 3562 Journals sorted alphabetically
F&S Science : Official journal of the American Society for Reproductive Medicine     Open Access  
Facial Plastic Surgery & Aesthetic Medicine     Full-text available via subscription   (Followers: 3)
Facta Universitatis, Series : Medicine and Biology     Open Access  
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Practice     Hybrid Journal   (Followers: 17)
Family Practice & Palliative Care     Open Access   (Followers: 5)
Family Practice Management     Full-text available via subscription   (Followers: 4)
Faridpur Medical College Journal     Open Access  
FEM : Revista de la Fundación Educación Médica     Open Access  
Finlay : Revista de Enfermedades no Transmisibles     Open Access  
Fisioterapia     Full-text available via subscription   (Followers: 2)
Fisioterapia & Saúde Funcional     Open Access  
Flugmedizin · Tropenmedizin · Reisemedizin - FTR     Hybrid Journal  
FMC - Formación Médica Continuada en Atención Primaria     Full-text available via subscription  
Folia Medica     Open Access  
Folia Medica Indonesiana     Open Access  
Folia Morphologica     Full-text available via subscription  
Folia Phoniatrica et Logopaedica     Full-text available via subscription   (Followers: 1)
Fontanus     Open Access  
Food Hydrocolloids for Health     Open Access  
Foodborne Pathogens and Disease     Hybrid Journal   (Followers: 11)
Foot & Ankle Specialist     Hybrid Journal   (Followers: 4)
Foot and Ankle Clinics     Full-text available via subscription   (Followers: 12)
Foot and Ankle Online Journal     Full-text available via subscription   (Followers: 6)
Forensic Science International : Mind and Law     Open Access   (Followers: 4)
Forum Medycyny Rodzinnej     Hybrid Journal  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontières     Full-text available via subscription   (Followers: 3)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Medical Technology     Open Access  
Frontiers in Medicine     Open Access   (Followers: 2)
Frontiers in Network Physiology     Open Access   (Followers: 2)
Frontiers in Neuroprosthetics     Open Access   (Followers: 6)
Frontiers in Synaptic Neuroscience     Open Access   (Followers: 2)
Frontiers in Tropical Diseases     Open Access  
Frontiers of Medical and Biological Engineering     Hybrid Journal  
Frontiers of Medicine     Hybrid Journal   (Followers: 2)
Fuss & Sprunggelenk     Hybrid Journal  
Future Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Future Prescriber     Hybrid Journal  
Future Science OA     Open Access  
Gaceta Médica Boliviana     Open Access  
Gaceta Médica Espirituana     Open Access  
Galen Medical Journal     Open Access  
Galician Medical Journal     Open Access   (Followers: 1)
Galle Medical Journal     Open Access  
Gefäßmedizin Scan     Hybrid Journal  
Gender and the Genome     Open Access   (Followers: 1)
Gene Expression     Full-text available via subscription   (Followers: 1)
General Reanimatology     Open Access  
Genes     Open Access   (Followers: 2)
Genome Instability & Disease     Hybrid Journal  
Geoforum     Hybrid Journal   (Followers: 25)
Gestão e Desenvolvimento     Open Access  
Ghana Medical Journal     Open Access   (Followers: 1)
GigaScience     Open Access   (Followers: 4)
Gimbernat : Revista d’Història de la Medicina i de les Ciències de la Salut     Open Access  
Glia     Hybrid Journal   (Followers: 5)
Global Advances in Health and Medicine     Open Access  
Global Bioethics     Open Access   (Followers: 5)
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Journal     Open Access   (Followers: 2)
Global Journal of Integrated Chinese Medicine and Western Medicine     Open Access  
Global Journal of Cancer Therapy     Open Access  
Global Journal of Fertility and Research     Open Access  
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Infectious Diseases and Clinical Research     Open Access  
Global Journal of Medical and Clinical Case Reports     Open Access  
Global Journal of Obesity, Diabetes and Metabolic Syndrome     Open Access   (Followers: 1)
Global Journal of Perioperative Medicine     Open Access  
Global Journal of Rare Diseases     Open Access  
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Reproductive Health     Open Access  
Grande Medical Journal     Open Access  
Growth Factors     Hybrid Journal   (Followers: 2)
GSTF Journal of Advances in Medical Research     Open Access  
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi     Open Access  
Hamdan Medical Journal     Open Access  
Hämostaseologie     Hybrid Journal   (Followers: 5)
Hämostaseologie     Open Access  
Hand     Hybrid Journal   (Followers: 4)
Hand Clinics     Full-text available via subscription   (Followers: 6)
Hand Therapy     Hybrid Journal   (Followers: 11)
Hard Tissue     Open Access  
Head & Face Medicine     Open Access   (Followers: 1)
Head and Neck Cancer Research     Open Access  
Head and Neck Tumors     Open Access  
Health Information : Jurnal Penelitian     Open Access  
Health Matrix : The Journal of Law-Medicine     Open Access  
Health Notions     Open Access  
Health Science Journal of Indonesia     Open Access  
Health Science Reports     Open Access   (Followers: 1)
Health Sciences and Disease     Open Access   (Followers: 1)
Health Sciences Review     Open Access  
Health Security     Hybrid Journal   (Followers: 1)
Healthcare Technology Letters     Open Access  
Hearing, Balance and Communication     Hybrid Journal   (Followers: 6)
Hearts     Open Access   (Followers: 1)
HEC Forum     Hybrid Journal   (Followers: 1)
Heighpubs Otolaryngology and Rhinology     Open Access  
Heilberufe     Hybrid Journal  
HeilberufeSCIENCE     Hybrid Journal  
Heilpflanzen     Hybrid Journal   (Followers: 4)
Helicobacter     Hybrid Journal  
HemaSphere     Open Access   (Followers: 2)
Hemoglobin     Hybrid Journal  
Hepatology, Medicine and Policy     Open Access  
HERALD of North-Western State Medical University named after I.I. Mechnikov     Open Access  
Herald of the Russian Academy of Sciences     Full-text available via subscription  
Herzschrittmachertherapie + Elektrophysiologie     Hybrid Journal  
Highland Medical Research Journal     Full-text available via subscription  
Hipertensión y Riesgo Vascular     Full-text available via subscription  
HIV Australia     Full-text available via subscription   (Followers: 3)
Homeopathy     Hybrid Journal   (Followers: 1)
Homoeopathic Links     Hybrid Journal  
Hong Kong Physiotherapy Journal     Open Access   (Followers: 14)
Horizonte Medico     Open Access  
Hormones : International Journal of Endocrinology and Metabolism     Hybrid Journal  
Hospital a Domicilio     Open Access  
Hospital Practices and Research     Open Access  
Hospital Topics     Hybrid Journal   (Followers: 1)
Hua Hin Sook Jai Klai Kangwon Journal     Open Access  
Huisarts en wetenschap     Hybrid Journal   (Followers: 4)
Human & Veterinary Medicine - International Journal of the Bioflux Society     Open Access   (Followers: 4)
Human Factors in Healthcare     Open Access  
Human Fertility     Hybrid Journal   (Followers: 4)
Humanidades Médicas     Open Access  
I.P. Pavlov Russian Medical Biological Herald     Open Access  
Iatreia     Open Access  
Ibnosina Journal of Medicine and Biomedical Sciences     Open Access  
IDCases     Open Access  
IEEE Journal of Biomedical and Health Informatics     Hybrid Journal   (Followers: 14)
IEEE Journal of Electromagnetics, RF and Microwaves in Medicine and Biology     Hybrid Journal  
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 5)
IEEE Open Journal of Engineering in Medicine and Biology     Open Access   (Followers: 1)
IEEE Transactions on Medical Robotics and Bionics     Hybrid Journal   (Followers: 3)
IEEE/ACM Transactions on Computational Biology and Bioinformatics     Hybrid Journal   (Followers: 18)
IJID Regions     Open Access   (Followers: 1)
IJS Global Health     Open Access  
IJU Case Reports     Open Access  
iLiver     Open Access   (Followers: 3)
Im OP     Hybrid Journal  
Image Analysis & Stereology     Open Access   (Followers: 1)
IMAGING     Full-text available via subscription   (Followers: 1)
Imaging in Medicine     Open Access  
Imaging Journal of Clinical and Medical Sciences     Open Access   (Followers: 1)
Imam Journal of Applied Sciences     Open Access  
Indian Journal of Ayurveda and lntegrative Medicine Klue     Open Access   (Followers: 3)
Indian Journal of Burns     Open Access   (Followers: 2)
Indian Journal of Clinical Medicine     Open Access  
Indian Journal of Community and Family Medicine     Open Access   (Followers: 2)
Indian Journal of Community Medicine     Open Access   (Followers: 1)
Indian Journal of Health Sciences and Biomedical Research KLEU     Open Access   (Followers: 2)
Indian Journal of Medical Microbiology     Open Access   (Followers: 1)
Indian Journal of Medical Research     Open Access   (Followers: 3)
Indian Journal of Medical Sciences     Open Access   (Followers: 2)
Indian Journal of Medical Specialities     Hybrid Journal  
Indian Journal of Otology     Open Access   (Followers: 1)
Indian Journal of Public Health     Open Access   (Followers: 1)
Indian Journal of Transplantation     Open Access  
Indian Spine Journal     Open Access  
Indo-Pacific Journal of Phenomenology     Open Access   (Followers: 1)
Indonesia Journal of Biomedical Science     Open Access   (Followers: 1)
Indonesian Biomedical Journal     Open Access  
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Medicine     Open Access  
Indonesian Journal of Tropical and Infectious Disease     Open Access  
Infant Observation: International Journal of Infant Observation and Its Applications     Hybrid Journal   (Followers: 1)
Inflammation     Hybrid Journal   (Followers: 3)
Inflammation Research     Hybrid Journal   (Followers: 4)
Info Diabetologie     Full-text available via subscription   (Followers: 1)
Infodir : Revista de Información científica para la Dirección en Salud     Open Access  
Informatics in Medicine Unlocked     Open Access  
Injury Prevention     Hybrid Journal   (Followers: 6)
InnovAiT     Hybrid Journal   (Followers: 1)
Innovare Journal of Health Science     Open Access  
Innovare Journal of Medical Science     Open Access  
Innovation in Aging     Open Access   (Followers: 1)
Inside Precision Medicine     Full-text available via subscription   (Followers: 4)
Insights in Biology and Medicine     Open Access  
Integrative and Complementary Therapies     Full-text available via subscription   (Followers: 4)
Integrative Medicine Insights     Open Access   (Followers: 1)
Integrative Medicine International     Open Access   (Followers: 1)
Integrative Medicine Research     Open Access   (Followers: 3)
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 12)
Intelligence-Based Medicine     Open Access  
Intelligent Medicine     Open Access   (Followers: 1)
intensiv     Hybrid Journal   (Followers: 1)
interactive Journal of Medical Research     Open Access  
Interdisciplinary Perspectives on Infectious Diseases     Open Access  
Interdisciplinary Sciences : Computational Life Sciences     Hybrid Journal   (Followers: 2)
Internal Medicine     Open Access   (Followers: 1)
International Biomechanics     Open Access   (Followers: 1)
International Health     Hybrid Journal   (Followers: 5)
International Health Trends and Perspectives     Open Access  
International Journal for Numerical Methods in Biomedical Engineering     Hybrid Journal   (Followers: 2)
International Journal for Vitamin and Nutrition Research     Hybrid Journal   (Followers: 10)
International Journal of Academic Medicine     Open Access   (Followers: 1)
International Journal of Advance in Medical Science     Open Access  
International Journal of Advanced Medical and Health Research     Open Access  

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Similar Journals
Journal Cover
Indian Journal of Transplantation
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2212-0017 - ISSN (Online) 2212-0025
Published by Medknow Publishers Homepage  [448 journals]
  • COVID-19 and transplantation – A pathway to rebuild
           transplantation services

    • Authors: Darius F Mirza, Thamara Perera
      Pages: 1 - 2
      Abstract: Darius F Mirza, Thamara Perera
      Indian Journal of Transplantation 2022 16(1):1-2

      Citation: Indian Journal of Transplantation 2022 16(1):1-2
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_32_22
      Issue No: Vol. 16, No. 1 (2022)
       
  • NOTTO guidelines for vaccine-induced thrombotic thrombocytopenia in organ
           donation and transplantation

    • Authors: Vivek B Kute, Sonal Asthana, Subhash Gupta, Sanjay K Agarwal, Swarnalatha Guditi, Manisha Sahay, Sujoy Pal, S Sudhindran, Ashish Sharma, Sandeep Seth, Alla Gopala Krishna Gokhale, Milind Dhahir Hote, Arpita Ray Chaudhury, Arvinder Singh Soin, Mohamed Rela, Rajesh Malhotra, Virinder K Bansal, Devinder Singh Rana, Rajneesh Sahai, Vasanthi Ramesh
      Pages: 3 - 7
      Abstract: Vivek B Kute, Sonal Asthana, Subhash Gupta, Sanjay K Agarwal, Swarnalatha Guditi, Manisha Sahay, Sujoy Pal, S Sudhindran, Ashish Sharma, Sandeep Seth, Alla Gopala Krishna Gokhale, Milind Dhahir Hote, Arpita Ray Chaudhury, Arvinder Singh Soin, Mohamed Rela, Rajesh Malhotra, Virinder K Bansal, Devinder Singh Rana, Rajneesh Sahai, Vasanthi Ramesh
      Indian Journal of Transplantation 2022 16(1):3-7
      From the context of organ donation, COVID-19 vaccine-induced thrombotic thrombocytopenia (VITT) is important as there is an ethical dilemma in utilizing versus discarding organs from potential donors succumbing to VITT. This consensus statement is an attempt by the National Organ and Tissue Transplant Organization (NOTTO) apex technical committees, India, to formulate the guidelines for deceased organ donation and transplantation in relation to VITT to help in appropriate decision-making. VITT is a rare entity, but a meticulous approach should be taken by the organ procurement organization's (OPO) team in screening such cases. All such cases must be strictly notified to the national authorities (NOTTO) as a resource for data collection and ensuring compliance with protocols in the management of adverse events following immunization. Organs from any patient who developed thrombotic events up to 4 weeks after adenoviral vector-based vaccination should be considered to be linked to VITT and investigated appropriately. The viability of the organs must be thoroughly checked by the OPO, and the final decision in relation to organ use should be decided by the expert committee of the OPO team consisting of a virologist, a hematologist, and a treating team. Considering the organ shortage, in case of suspected/confirmed VITT, both clinicians and patients should consider the risk‒benefit equation based on limited experience. An appropriate written informed consent of potential recipients and family members should be obtained before the transplantation of organs from suspected or proven VITT donors.
      Citation: Indian Journal of Transplantation 2022 16(1):3-7
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_135_21
      Issue No: Vol. 16, No. 1 (2022)
       
  • Consensus statement on organ donation from COVID-positive deceased
           donors-Indian Society of Organ Transplantation, Liver Transplant Society
           of India and Indian Society for Heart and Lung Transplantation

    • Authors: Sonal Asthana, Vivek Kute, Unmil Shah, Ravi Mohanka, Manisha Sahay, Chinnadurai R, Swati Rajagopal, Sujata Patwardhan, Narayan Prasad, Sandeep Guleria, Shyam Bansal, Arpita Roy Choudhary, Deepak S Ray, Sanjay Kolte, Sanjeev Gulati, Sandeep Seth, Sanjay K Agarwal, Jai Prakash Ojha, PP Varma, Sunil Shroff
      Pages: 8 - 16
      Abstract: Sonal Asthana, Vivek Kute, Unmil Shah, Ravi Mohanka, Manisha Sahay, Chinnadurai R , Swati Rajagopal, Sujata Patwardhan, Narayan Prasad, Sandeep Guleria, Shyam Bansal, Arpita Roy Choudhary, Deepak S Ray, Sanjay Kolte, Sanjeev Gulati, Sandeep Seth, Sanjay K Agarwal, Jai Prakash Ojha, PP Varma, Sunil Shroff
      Indian Journal of Transplantation 2022 16(1):8-16
      COVID has drastically impacted organ donation across the world, leading to untold misery for thousands of patients who have been waiting for organs. Early rules on the use of organs from COVID positive or affected donors were stringent due to the fear of spread of disease or thrombotic complications in patients who received these organs. However much has changed in the past two years. Most of our adult population has either been infected with COVID, or has received two doses of vaccine, or both. The current variant, despite being more infective, is associated with mild disease, especially in those who have been vaccinated Our armamentarium against severe COVID has improved dramatically in the past year- we have effective vaccines, monoclonal antibodies for treatment of mild COVID in high risk patients and post exposure and antiviral prophylaxis and treatment which can substantially reduce the risk of severe COVID requiring ICU admission. The risk of transmission of COVID infection has to be balanced against the risk of patients dying with end organ disease. We will have to learn to live with COVID- this also means investigating whether organs from donors who are, or have been COVID positive can be used with acceptable risk –benefit in selected patients with end stage organ failure. This document is a summary of evidence and information regarding donor screening for SARS-CoV-2 and considerations for organ acceptance from donors with a history of COVID-19.
      Citation: Indian Journal of Transplantation 2022 16(1):8-16
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_29_22
      Issue No: Vol. 16, No. 1 (2022)
       
  • On the way to mandate booster vaccine dose of coronavirus disease 2019 for
           transplant recipients: A narrative review of literature

    • Authors: Vivek B Kute, Sudeep Nimish Desai, Hari Shankar Meshram, Kinjal Narendra Shah, Sanshriti Chauhan, Vineet V Mishra, Manisha Sahay
      Pages: 17 - 25
      Abstract: Vivek B Kute, Sudeep Nimish Desai, Hari Shankar Meshram, Kinjal Narendra Shah, Sanshriti Chauhan, Vineet V Mishra, Manisha Sahay
      Indian Journal of Transplantation 2022 16(1):17-25
      Coronavirus disease 2019 (COVID-19) vaccine efficacy, especially against severe disease is known to wane over time. We examined current knowledge of COVID-19 vaccine booster dose in solid organ transplant recipients (SOTR). We have systematically searched PubMed, EMBASE, MEDLINE, Scopus and Google Scholar with the following MeSH terms: “SARS-CoV-2 vaccine,” or “COVID-19 vaccine,” and “organ transplantation” and “booster” or “third dose.” This review article examines a number of studies including guidelines from professional societies examining the safety as well as increased immunogenicity of a booster dose among SOTR. Equitable distribution of vaccines across the globe is the need of the hour. While some countries are well into the booster dose phase, the lower-income countries are languishing behind with primary doses for their health workers. Available reports suggest less efficacy of COVID-19 vaccine in SOTR suggesting booster dose for them. Several studies highlighted the safety and efficacy of COVID-19 vaccines booster dose among SOTR. SOTR should also continue to adhere to all safety and COVID-19 appropriate behaviors. There is a growing need for alternative strategies to improve protection. As Omicron cases rise around the world, India announced that COVID-19 vaccination for children aged 15–18 years and “precautionary (booster) doses” would be administered to healthcare and frontline workers and people above 60 years of age with comorbidities from January 2022. In near future, with increased availability of vaccinations, all SOTR will have access to booster dose in a phased manner.
      Citation: Indian Journal of Transplantation 2022 16(1):17-25
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_7_22
      Issue No: Vol. 16, No. 1 (2022)
       
  • Organ donation after circulatory determination of death in India: A joint
           position paper

    • Authors: Avnish Kumar Seth, Ravi Mohanka, Sumana Navin, Alla Gopala Krishna Gokhale, Ashish Sharma, Anil Kumar, Bala Ramachandran, KR Balakrishnan, Darius F Mirza, Dhvani Mehta, Kapil G Zirpe, Kumud Dhital, Manisha Sahay, Srinagesh Simha, Radha Sundaram, Rahul Anil Pandit, Raj Kumar Mani, Roop Gursahani, Subhash Gupta, Vivek Kute, Sunil Shroff
      Pages: 26 - 41
      Abstract: Avnish Kumar Seth, Ravi Mohanka, Sumana Navin, Alla Gopala Krishna Gokhale, Ashish Sharma, Anil Kumar, Bala Ramachandran, KR Balakrishnan, Darius F Mirza, Dhvani Mehta, Kapil G Zirpe, Kumud Dhital, Manisha Sahay, Srinagesh Simha, Radha Sundaram, Rahul Anil Pandit, Raj Kumar Mani, Roop Gursahani, Subhash Gupta, Vivek Kute, Sunil Shroff
      Indian Journal of Transplantation 2022 16(1):26-41
      Organ donation following circulatory determination of death (DCDD) has contributed significantly to the donor pool in several countries, without compromising the outcomes of transplantation or the number of donations following brain death (BD). In India, majority of deceased donations happen following BD. While existing legislation allows for DCDD, there have been only a few reports of kidney transplantation following DCDD from the country. This document, prepared by a multi-disciplinary group of experts, reviews the international best practices in DCDD and outlines the path for furthering the same in India. The ethical, medical, legal, economic, procedural, and logistic challenges unique to India for all types of DCDD based on the Modified Maastricht Criteria have been addressed. India follows an opt-in system for organ donation that does not allow much scope for uncontrolled DCDD categories I and II. The practice of withdrawal of life-sustaining treatment (WLST) in India is in its infancy. The process of WLST, laid down by the Supreme Court of India, is considered time-consuming, possible only in patients in a permanent vegetative state, and considered too cumbersome for day-to-day practice. In patients where continued medical care is determined to be futile following detailed and repeated assessment, the procedure for WLST, as laid down and published by Vidhi Centre for Legal Policy in conjunction with leading medical experts is described. In controlled DCDD (category-III), the decision for WLST is independent of and delinked from the subsequent possibility of organ donation. Once families are inclined toward organ donation, they are explained the procedure including the timing and location of WLST, consent for antemortem measures, no-touch period, and the possibility of stand down and return to the intensive care unit without donation. While donation following neurologic determination of death (DNDD) is being increasingly practiced in the country, there are instances where the cardiac arrest occurs during the process of declaration of BD, before organ retrieval has been done. Protocol for DCDD category-IV deals with such situations and is described in detail. In DCDD category V, organ donation may be possible following unsuccessful cardiopulmonary resuscitation of cardiac arrest in the intensive care. An outline of organ-specific requisites for kidney, liver, heart, and lung transplantation following DCDD and the use of techniques such as normothermic regional perfusion and ex vivo machine perfusion has been provided. With increasing experience, the outcomes of transplantation following DCDD are comparable to those following DBDD or living donor transplantation. Documents and checklists necessary for the successful execution of DCDD in India are described.
      Citation: Indian Journal of Transplantation 2022 16(1):26-41
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_61_21
      Issue No: Vol. 16, No. 1 (2022)
       
  • Issues and concerns in the management of progressive allograft
           dysfunction: A narrative review

    • Authors: Urmila Anandh, Pradeep Deshpande
      Pages: 42 - 47
      Abstract: Urmila Anandh, Pradeep Deshpande
      Indian Journal of Transplantation 2022 16(1):42-47
      Nephrologists taking care of dialysis patients are increasingly encountering patients returning to dialysis after a failed transplant. These patients have a different pathophysiology and their medical issues differ from transplant-naïve dialysis patients. Prolonged cumulative immunosuppression and long-term exposure to chronic kidney disease (CKD) pathology are major factors responsible for increased complications and mortality. Often, their CKD-related issues are managed suboptimally as the emphasis is mostly on endeavors related to protecting allograft function. Managing their immunosuppression and allograft-related symptomatology poses serious challenges. There is also a dilemma as to whether the failed allograft should be left in situ or not. Considerate and appropriate decisions are required when these kidney allograft failure patients are offered re-transplantation. This review aims to address the major issues faced by transplant nephrologists in managing patients with allograft failure.
      Citation: Indian Journal of Transplantation 2022 16(1):42-47
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_114_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • A study of visual outcome in deep anterior lamellar

    • Authors: Superna Mahendra, Srinivas Prasad Killani, Swathi Pola
      Pages: 48 - 55
      Abstract: Superna Mahendra, Srinivas Prasad Killani, Swathi Pola
      Indian Journal of Transplantation 2022 16(1):48-55
      Introduction: Deep anterior lamellar keratoplasty is a surgical procedure for removing the corneal stroma down to Descemet's membrane. It is most useful for the treatment of corneal disease in the setting of a normally functioning endothelium. Materials and Methods: Patients attending Sarojini Devi Eye Hospital were screened. Twenty-eight eyes of 23 patients with anterior corneal pathologies and who had a best-corrected visual acuity of less than 6/60 and not improving beyond it were included in the study. Results: Conditions in which the pathology is limited to the anterior stroma and sparing the endothelium, lamellar keratoplasty as a procedure offers many advantages with fewer risks of complications. Conclusion: Corneal pathologies involving anterior stroma are better treated with DALK with fewer complications.
      Citation: Indian Journal of Transplantation 2022 16(1):48-55
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_58_21
      Issue No: Vol. 16, No. 1 (2022)
       
  • Clinical outcome of ABO-Incompatible kidney transplant with low baseline
           anti-A/B antibody titer without the use of plasma exchange - A
           retrospective study

    • Authors: Tarun Kumar Jeloka, Anand Dharaskar, Ravindra Singh
      Pages: 56 - 60
      Abstract: Tarun Kumar Jeloka, Anand Dharaskar, Ravindra Singh
      Indian Journal of Transplantation 2022 16(1):56-60
      Background: The outcome of ABO-incompatible (ABOi) transplant (Tx) may be compromised because of the need for added immunosuppression. Many centers still use plasma exchange (PEX) even when anti-A/B titers are low. We compared the outcome of ABOi kidney Tx with low baseline anti-A/B titers without PEX to those with high titers managed with PEX and to ABO-compatible (ABOc) Tx. Materials and Methods: In this retrospective study, all adult kidney Tx done at our institute were eligible. Patients <18 years of age, deceased donor transplant recipients, and those with hepatitis B, C or HIV infections at the time of transplant were excluded from this analysis. Outcomes including biopsy-proven AR, estimated glomerular filtration rate (eGFR) (Modification of Diet in Renal Disease equation), infections, and patient and graft survival were determined in ABOi kidney Tx with low baseline anti-A/B antibody titers managed without PEX (Group A). These outcomes were compared to a contemporary cohort of those with high titers and use of PEX (Group B) and ABOc Tx (Group C). Continuous variables were compared by Student's t-test and categorical variables with Chi-square test. Patient and graft survival was calculated by Kaplan–Meier curve and compared between the groups by log-rank test. Results: Baseline characteristics reveal no difference in recipients and donor factors such as age, gender, and HLA match. Initial immunoglobulin G anti-A/B titers were higher in Group B as compared to Group A (P = 0.04), but final titers pretransplant were similar (P = 0.6). Biopsy-proven rejections were not different between Groups A and B or Groups A and C. Serum creatinine and eGFR at 1 month and at last follow-up were also similar in all the groups. Infections were seen in 22.2% of the patients in Group A, 44.4% in Group B, and 27.7% in Group C. Patient survival and death-censored graft survival were similar in all three groups. Conclusion: This retrospective study shows that patients with low baseline anti-ABO antibodies managed without PEX are safe and have similar outcomes such as patient and graft survival, rejections, infections, and renal function.
      Citation: Indian Journal of Transplantation 2022 16(1):56-60
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_60_21
      Issue No: Vol. 16, No. 1 (2022)
       
  • Clinicopathologic features of polyomavirus nephropathy: Our experience - A
           retrospective observational study

    • Authors: Ramya Veduruvada, Nishika Madireddy, Soundarya Samskruthi Koyya, Swarnalatha Guditi, Gangadhar Taduri, Sree Bhushan Raju, Megha Shantveer Uppin
      Pages: 61 - 66
      Abstract: Ramya Veduruvada, Nishika Madireddy, Soundarya Samskruthi Koyya, Swarnalatha Guditi, Gangadhar Taduri, Sree Bhushan Raju, Megha Shantveer Uppin
      Indian Journal of Transplantation 2022 16(1):61-66
      Introduction: Polyomavirus nephropathy (PVN) is now being frequently encountered in renal transplant recipients receiving highly potent immunosuppressive drugs and has emerged as an important cause of allograft loss. In this study, we tried to study the clinical and morphological features while incorporating the latest Banff 2018 classification of PVN and correlating it with graft outcomes. Materials and Methods: This was a retrospective study including ten patients with biopsy-proven PVN. The risk factors, clinical, histomorphological, and immunohistochemical features of all the patients were studied. We scored the intrarenal polyomavirus load and Banff interstitial fibrosis as described by Banff 2018 working group. Results: There were 6 male and 4 female patients and the mean age at the time of biopsy was 42.5 ± 10.8 years. All patients were on triple immunosuppression and the mean transplant duration to the time of diagnosis was 6.98 ± 4 months. The mean serum creatinine at the time of biopsy was 2.73 ± 1.12 mg/dl. A prior history of antibody-mediated rejection was present in two patients. All ten biopsies showed tubular epithelial basophilic, intranuclear inclusions suggestive of BK virus which was confirmed by positivity for SV40 antigen on immunohistochemistry (IHC). As per the Banff 2018 classification, seven biopsies were categorized as Class 2 and three were class 3. On follow-up, three patients went into graft loss, five patients had persistent graft dysfunction, and two expired. Conclusion: PVN is an important cause of renal dysfunction and premature allograft loss. Light microscopy for viral cytopathic changes aided by IHC with SV40 is essential for the diagnosis of PVN. The Banff scheme of classification is helpful in predicting the prognosis. It is important to diagnose PVN and differentiate it from rejection for appropriate management.
      Citation: Indian Journal of Transplantation 2022 16(1):61-66
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_115_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Determinants of physical performance in Indian kidney-transplant
           recipients: A prospective observational study

    • Authors: Harda H Shah, Nehal Shah, Vivek Kute, Himanshu V Patel, Pankaj Shah
      Pages: 67 - 76
      Abstract: Harda H Shah, Nehal Shah, Vivek Kute, Himanshu V Patel, Pankaj Shah
      Indian Journal of Transplantation 2022 16(1):67-76
      Background: Physical performance refers to the functional demonstration of task. Little is known about physical performance among Indian kidney-transplant recipients (KTRs). The objective of the present study was to evaluate the physical performance among Indian KTRs and to find its determinants from transplant, demographic, or behavior components. Methodology: In this single-center, prospective observational study, 149 KTRs with estimated glomerular filtration rate (eGFR) ≥45 ml/min/1.72 m2 and posttransplant duration (PTD) >6 months were enrolled. Physical performance was evaluated by 6 minute walk distance (6MWD), dominant hand grip strength (DHGS), numbers of 1 minute sit to stand (1MSTS), and time taken to perform 5 times sit to stand (5xSTS). Multivariate analysis was performed between transplant-related components (PTD, dialysis vintage, eGFR, and comorbidity); health behavioral components (total physical activity [TPA], sedentary time, fear of activity participation, body mass index, abdominal circumference); demographic components (age and gender); and each of the physical performance measures. Results: The average 6MWD was 392 ± 96.2 meters, the DHGS was 33.1 ± 6.8 kg, the number of 1MSTS repetitions was 24.0 ± 3.7/min, and the time taken to do 5xSTS was 10.6 ± 1.9 s among participants. When adjusted for cofounders with multivariable analyses, the health behavior of habitual physical activity was statistically significantly (P < 0.001) associated with all aspects of physical performance. Conclusion: Relatively low physical performance was seen among KTRs. Behavior of participation in physical activity contributed to the positive change in all aspects of physical performance against transplant and demographic variables, and it is the major determinant of physical performance.
      Citation: Indian Journal of Transplantation 2022 16(1):67-76
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_117_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Epidemiology, risk factors, and major outcomes in post kidney transplant
           infections at National Hospital Kandy: A cross-sectional, pilot study

    • Authors: M A Ayesha Nayanamali, A M Muditha Piyumali Athapaththu, B M Duminda Bandara Basnayake, T G Nadeeka Shyamali Gunarathne, Abdul W M. Wazil, R M Buddhisha S. S. Mahanama, Brammah U. E W. D. R. Thangarajah, Nishantha Nanayakkara
      Pages: 77 - 83
      Abstract: M A Ayesha Nayanamali, A M Muditha Piyumali Athapaththu, B M Duminda Bandara Basnayake, T G Nadeeka Shyamali Gunarathne, Abdul W M. Wazil, R M Buddhisha S. S. Mahanama, Brammah U. E W. D. R. Thangarajah, Nishantha Nanayakkara
      Indian Journal of Transplantation 2022 16(1):77-83
      Background: Postkidney transplant (PKT) infections are associated with significant morbidity and mortality, especially in the early posttransplant period. The type of infection, associated risk factors, and predicted outcomes of the infections are essential for targeted appropriate management. Scientific published data, especially in local settings, are lacking. This study was conducted to assess the epidemiology, risk factors, and major outcomes of PKT infections requiring hospitalization. Methods: This was a prospective observational study, conducted at the Nephrology and Transplant Unit, National Hospital Kandy, Sri Lanka, for a period of 2 months from December 1, 2018, to January 30, 2019. Results: A total of 38 infectious episodes were recorded in 35 kidney recipients. The most common type of infection was urinary tract infection (UTI) noted in 36.6% (n = 14) of cases. The most frequent organisms isolated were coliform (7.9%, n = 3). Seven potential risk factors including age, gender, comorbidities, source of kidney, induction modality, enhancement therapy, and months after renal transplant were evaluated. Among those potential risk factors, age was significantly associated with gastrointestinal tract infections (P = 0.033). There was a significant association between the gender and the severity of infections (P = 0.047). Majority of patients discharged from the hospital following complete recovery. Three patients were offered intensive care, two developed acute renal failure requiring renal replacement therapy and one was expired. Conclusion: The most common type of infection in PKT patients is UTI. Patient's age is significantly associated with gastrointestinal infections. Large-scale studies warrant for adequately concluding risk factors, epidemiology, and outcomes.
      Citation: Indian Journal of Transplantation 2022 16(1):77-83
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_132_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Turn around time in matched unrelated donor search workup national versus
           international registries: Retrospective study

    • Authors: Vikash Chandra Mishra, Nikki Dey, Amit Kr Bhardwaj, Dinesh Chandra, Archana Anthwal, Vimarsh Raina
      Pages: 84 - 87
      Abstract: Vikash Chandra Mishra, Nikki Dey, Amit Kr Bhardwaj, Dinesh Chandra, Archana Anthwal, Vimarsh Raina
      Indian Journal of Transplantation 2022 16(1):84-87
      Background: Timeline is a key factor for hematopoietic stem cell transplant (HSCT) recipient. HSCT by matched unrelated donor (MUD) is a standard definitive therapeutic approach for many hematological disorders which are not amenable to chemotherapy and other conventional treatment. Aims and Objectives: The aim of the present study was to compare the turnaround time (TAT) involved in completion of MUD HSCT workup from an Indian registry (Genebandhu) with international registries. Materials and Methods: On receipt of pre-transplant matching request through a transplant physician, patient's human leukocyte antigen (HLA) type was entered in both Genebandhu and World Marrow Donor Association search tool for initiating a “search.” The software gave the descending order of the best possible matches by performing computational analysis. The search result was considered a “match” when potential 10/10 HLA match was found. The average TAT was calculated in the middle of search request and HLA confirmatory typing (CT) and infectious disease marker (IDM). Further, TAT was also determined between the infusion of harvested stem cell product and CT and IDM. At last, the total time engaged in completion of each MUD HSCT workup was determined and compared in national versus international registries. Results: The average TAT involved in between search request and CT and IDM was 71 days in case of global registry and 67 days in case of Genebandhu. Similarly, the average TAT involved between infusion of harvested cell product and CT and IDM testing in case of donor identified in global stem cell registry was 65 days whereas 45 days in case of Genebandhu. At last, the average time associated with the finishing of a MUD workup was 136 days in case of global registry, whereas 112 days in the case of Genebandhu at P ≤ 0.05 with a 95% confidence interval. Conclusion: To conclude, the average TAT obtained through this study clearly demonstrates the advantages in terms of donor availability for MUD HSCT through the national registry.
      Citation: Indian Journal of Transplantation 2022 16(1):84-87
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_143_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Role of pathogenic T-helper cells-17 in chronic antibody-mediated
           rejection in renal allograft recipients

    • Authors: Brijesh Yadav, Narayan Prasad, Vinita Agrawal, Manoj Jain, Vikas Agarwal
      Pages: 88 - 95
      Abstract: Brijesh Yadav, Narayan Prasad, Vinita Agrawal, Manoj Jain, Vikas Agarwal
      Indian Journal of Transplantation 2022 16(1):88-95
      Background: Both T-cell and B-cell activities are interlinked. The role of a new subset of T-helper cells (Th17), which is thought to be more pathogenic than other effector T cells, is not much studied in cases of chronic antibody-mediated rejection (CABMR). Therefore, we aimed to determine the circulating frequency of Th17, Pgp+ Th17, Pgp+ CD4T cell, and serum interleukin (IL)-17A cytokine level in patients of CABMR and stable graft function (SGF). Materials and Methods: We had recruited 42 patients of biopsy-proven CABMR (n = 32) and SGF (n = 10). The frequency of Pgp+ CD4Tcells, Pgp+ Th17 and Th17 cell was quantified in circulating blood by flow cytometry, and IL-17A level was determined in serum by ELISA techniques. Results: We observed that the frequency of Th17 cell (2.30 ± 1.15 and 4.46 ± 2.05; P = 0.003), Pgp+ CD4T (15.73 ± 4.38 and 25.27 ± 5.15; P < 0.001), and Pgp+ Th17 (0.78 ± 0.65 and 2.19 ± 0.93; P < 0.001) was higher in CABMR as compared to that of SGF. The ratio of Th17/CD4T cell (0.077 ± 0.045 and 0.14 ± 0.06; P = 0.004), and Pgp+ CD4T/CD4T cell (0.51 ± 0.14 and 0.81 ± 0.17, P < 0.001) was also higher in CABMR as compared to SGF. Serum cytokine IL-17A level was (42.39 ± 13.25 and 66.97 ± 18.27; P < 0.001) pg/ml was also higher in CABMR than that of SGF. The frequency of Pgp+ Th17 cell was positively correlating with 24-h proteinuria (r = 0.309; P = 0.04), serum creatinine (r = 0.423; P = 0.005), and negatively correlating with eGFR (r = −0.468; P = 0.002). Similarly, the frequency of Pgp+ CD4T cell was positively correlating with 24-h proteinuria (r = 0.351; P = 0.023), serum creatinine (r = 0.310; P = 0.04), and negatively correlating with eGFR (r = −0.414; P = 0.006). Conclusions: Higher Pgp+ TH17 cell is associated with CABMR, proteinuria, and graft dysfuntion.
      Citation: Indian Journal of Transplantation 2022 16(1):88-95
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_149_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Impact of pretransplant malnutrition on short-term clinical outcomes of
           liver transplantation - An exploratory study

    • Authors: Neha Bakshi, Kalyani Singh, Arvinder Singh Soin
      Pages: 96 - 100
      Abstract: Neha Bakshi, Kalyani Singh, Arvinder Singh Soin
      Indian Journal of Transplantation 2022 16(1):96-100
      Introduction: Malnutrition is highly prevalent among patients undergoing liver transplantation (LT) and can affect various clinical factors. The present study focuses on the impact of pretransplant malnutrition on various short-term outcomes of LT. Methods: Ninety LT recipients undergoing elective living donor LT were recruited in the study. Based on subjective global assessment (SGA), they were grouped as normal, moderate, and severely malnourished. Information regarding prognostic factors (Child-Turcotte-Pugh [CTP] and Model for End-Stage Liver Disease [MELD] scores), biochemical parameters (hemoglobin, TLC, platelets, bilirubin [T], serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, albumin, creatinine, and sodium), dietary intake, % weight loss, and short-term outcomes (hospital stay, intensive care unit days, blood unit usage during surgery, and dead and alive status after 1 year) were gathered. Results: The recipient evaluation showed that 54.4% of the patients were moderately malnourished and 27.8% of the patients were severely malnourished. The prognostic scores, CTP, and MELD significantly had higher scores in moderately and severely malnourished patients (P < 0.001 and P = 0.003). Among the biochemical parameters, hemoglobin, albumin, and sodium showed significantly lower levels in moderately and severely malnourished patients (P < 0.001, P = 0.02, and P = 0.01). The data also showed a significantly higher degree of ascites, % weight loss, and lower calorie intake among malnourished patients. A higher degree of malnutrition was associated with poor outcomes of LT; higher hospital stay (P = 0.014), packed red blood cell unit usage during surgery (P = 0.005), and deaths after 1 year of LT (P = 0.03). Conclusion: Pre-LT malnutrition by SGA was associated with poor short-term outcomes of LT with higher hospital stay and deaths. Hence, the present data emphasize the need for early nutrition intervention for improved surgery results.
      Citation: Indian Journal of Transplantation 2022 16(1):96-100
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_153_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Efficacy and safety of bortezomib in the treatment of active
           antibody-mediated rejection in adult kidney-transplant recipients: A
           single-center retrospective study

    • Authors: Dharmendra Bhadauria, Sai Kumar, Monika Yachha, Anupma Kaul, Manas Ranjan Patel, Ravi Shankar Kushwaha, Manas R Behera, Narayan Prasad
      Pages: 101 - 106
      Abstract: Dharmendra Bhadauria, Sai Kumar, Monika Yachha, Anupma Kaul, Manas Ranjan Patel, Ravi Shankar Kushwaha, Manas R Behera, Narayan Prasad
      Indian Journal of Transplantation 2022 16(1):101-106
      Introduction: The management of active antibody-mediated rejection (ABMR) is evolving, and optimal treatment remains uncertain due to incomplete understanding of pathogenesis. Bortezomib is found to be useful in the treatment of active ABMR. We studied the efficacy and safety of bortezomib in renal-transplant recipients with active ABMR. Materials and Methods: We retrospectively included renal-transplant recipients with active ABMR, who received bortezomib as main management. Results: Eighteen live-related renal-transplant recipients of active ABMR were included. C4d was positive in 14 patients and negative in eight patients. Patients with active ABMR had a mean improvement in glomerular filtration rate (GFR) of 7, 10.5, and 15 ml/min/1.73 m2 at 3, 6, and 12 months, respectively, from baseline GFR. Improvement was significant at 3 (P = 0.009) and 6 months (P = 0.018) of follow-up. Conclusion: Bortezomib may be a safe and effective therapy in patients with active ABMR in patients.
      Citation: Indian Journal of Transplantation 2022 16(1):101-106
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_155_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Role of telemedicine in kidney transplant recipient in COVID 19 era

    • Authors: Vivek B Kute, Vaibhav Gupta, Himanshu V Patel, Subho Banerjee, Divyesh P Engineer, Harishankar Meshram, Vijay Navadia, Ansy H Patel
      Pages: 107 - 112
      Abstract: Vivek B Kute, Vaibhav Gupta, Himanshu V Patel, Subho Banerjee, Divyesh P Engineer, Harishankar Meshram, Vijay Navadia, Ansy H Patel
      Indian Journal of Transplantation 2022 16(1):107-112
      Introduction: Telemedicine represents an innovative but untested approach to maintain patient care and reduce the risk of COVID-19 exposure to patients, health-care workers, and the public. In this study, we evaluated the applicability and efficacy of telemedicine in a kidney transplant recipient (KTR) cohort in COVID 19 era. Materials and Methods: An observational cohort study was conducted at a tertiary-care public-sector kidney disease institute in western India between March and September 2020. We evaluated the reasons, modes, and outcomes of patient contacts by telemedicine in the KTR cohort. We also evaluated the utility of telemedicine across three age groups. Results: Of 840 participants, whose mean age was 38.78 ± 12.39 years, male to female ratio was 4:1. The most common mode of communication was WhatsApp (653, 77.7%) followed by in-person surrogates (126, 15%). Acceptability of telemedicine was significantly better in younger and middle-age groups (P < 0.00001) compared to the elderly. Request for drug delivery (n = 756) was the most common reason for contact overall and managed through postal parcels. KTRs (n = 200) and donors (n = 75) were evaluated for medical illnesses. The most common medical reasons for contact were for febrile illness (n = 120) and graft dysfunction (n = 60). COVID-19-related disease was diagnosed and managed in 80 KTRs and 2 donors. COVID-19 updates were given to all contacts. Conclusion: Telemedicine is underutilized in the care of the KTR cohort. Telemedicine can be used across all ages although it's best suited for young and middle age groups. The impact of telemedicine on short- and long-term patient outcomes is unclear and warrants further study.
      Citation: Indian Journal of Transplantation 2022 16(1):107-112
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_154_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Study of noninduction immunosuppression in intermediate-risk living donor
           kidney transplantation in rural population of India - A retrospective
           observational study

    • Authors: Ankit Data, Kshitija G Gadekar, Vajed R Mogal, Abhijeet S More, Sudhir Gajanan Kulkarni
      Pages: 113 - 118
      Abstract: Ankit Data, Kshitija G Gadekar, Vajed R Mogal, Abhijeet S More, Sudhir Gajanan Kulkarni
      Indian Journal of Transplantation 2022 16(1):113-118
      Introduction: Kidney transplant is a costly affair, especially in a developing country like India. The current study was carried out with the aim to analyze the clinical outcome retrospectively in terms of acute rejection (AR), graft survival, and patient survival in intermediate-risk recipients undergoing first renal transplant with Tacrolimus (TAC), Mycophenolic acid (MPA), and corticosteroid based triple maintenance immunosuppression in one of the most underprivileged population of the country who has to bear the cost of the induction agent not covered by any government scheme. Materials and Methods: It is a retrospective observational study. We included 101 patients, out of which 42 were in basiliximab group and 59 patients did not receive any induction agent. Apart from the induction, agent rest of the Immunosuppression protocol was same in all patients. The primary endpoint of the study was number of biopsy-proven AR within 1st year of transplantation. The secondary endpoints were patient and graft survival by 1 year. Results: Human leukocyte antigen mismatch and mean age of the patients in basiliximab group were significantly higher than noninduction group; otherwise, both groups were similar in all other baseline parameters. There was no significant difference between AR (21.43% v/s 18.64%), graft survival (97.30% v/s 98.15%), and patient survival (88.10% v/s 91.52%) at 1 year. Conclusion: Our study suggests that Induction immunosuppression may not be necessary for patients undergoing intermediate-risk living donor kidney transplant in the current scenario of TAC and MPA-based maintenance immunosuppression.
      Citation: Indian Journal of Transplantation 2022 16(1):113-118
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_70_21
      Issue No: Vol. 16, No. 1 (2022)
       
  • Deception and deceit in living kidney transplant program

    • Authors: Trilly Rachel Mathew, Muneet Kaur Sahi, Sunil Shroff, Pallavi Kumar, Saurabh Pokhariyal, Salil Jain
      Pages: 119 - 126
      Abstract: Trilly Rachel Mathew, Muneet Kaur Sahi, Sunil Shroff, Pallavi Kumar, Saurabh Pokhariyal, Salil Jain
      Indian Journal of Transplantation 2022 16(1):119-126
      In India, the majority of kidney transplants are living donor transplants. The transplant law in India only permits donation from first degree relatives, spouses, grandparents and altruistic donation without any commercial intent. Donation that happens other than first degree relative require to go through the process of authorization by a committee that determines their intent of donation. In spite of the requirements that are clearly laid down in the Act, fake and fraudulent activities have been reported to make donations happen with a commercial intent. This paper is an attempt to inform and empower clinicians and transplant coordinators and give them the requisite skills that would help them to identify fraudulent relationships, detect discrepancies in the documents and help ensure that the hospital and the doctors follow the law of the land and not fall prey to fake documentation that has a commercial intent of donation. Sample cases have been studied based on their coordination and different ways of approaches to detect falsification of documents and tutoring of the donors by the family members or broker. It was seen that with the right approach that included thorough donor-recipient interrogation, close scrutinization of documents and keenly observing the donor-recipient relationship including their body language and attire, various discrepancies could be identified. All transplant teams should include a well-trained Transplant Coordinator who is alert to every case of a living donor recipient pair and makes a thorough assessment of the relationship by observing, interviewing and scrutinizing the documents of relationship to exclude fraud. Some recommendations have also been drawn up to minimize the risk of fraud.
      Citation: Indian Journal of Transplantation 2022 16(1):119-126
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_113_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • COVID-associated pulmonary aspergillosis in a post renal transplant
           patient

    • Authors: Manish R Balwani, Amit S Pasari, Amol Bhawane, Prasad Gurjar, Priyanka R Tolani
      Pages: 127 - 129
      Abstract: Manish R Balwani, Amit S Pasari, Amol Bhawane, Prasad Gurjar, Priyanka R Tolani
      Indian Journal of Transplantation 2022 16(1):127-129
      Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) is usually mild in general population, while in renal transplant patients, it can turn fatal. Some patients suffer from post COVID-19 secondary bacterial and fungal infections due to virus-induced immunosuppression. We here report a case of immediate post renal transplant patient who contracted COVID-19 illness and later developed pneumonitis which on BAL was found to be due to Aspergillus fumigatus. Through this case report, the author aims to highlight the importance of keeping check on post COVID-19 secondary opportunistic infections in post renal transplant patients. Early diagnosis with high index of suspicion is essential to start timely and effective treatment.
      Citation: Indian Journal of Transplantation 2022 16(1):127-129
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_67_21
      Issue No: Vol. 16, No. 1 (2022)
       
  • Posttransplant membranous nephropathy - A case report

    • Authors: Shabna Sullaiman, Prabhat Chauhan, Ashwani Kumar, Ritambhra Nada, Ranjana Minz, Vinod Kumar, Ashish Sharma, Sarbpreet Singh, Vivek Kumar, Manish Rathi, Harbir Singh Kohli, Raja Ramachandran
      Pages: 130 - 134
      Abstract: Shabna Sullaiman, Prabhat Chauhan, Ashwani Kumar, Ritambhra Nada, Ranjana Minz, Vinod Kumar, Ashish Sharma, Sarbpreet Singh, Vivek Kumar, Manish Rathi, Harbir Singh Kohli, Raja Ramachandran
      Indian Journal of Transplantation 2022 16(1):130-134
      Primary membranous nephropathy (PMN) is a common cause of adult-onset nephrotic syndrome. Anti-M-type phospholipase A2 receptor (PLA2R) antibodies are pathogenic and correlate with clinical outcomes. The role of anti-PLA2R in recurrent PMN is unclear. In the present manuscript, we report five cases of PMN who underwent kidney transplantation (KT) with varying titers of anti-PLA2R pre-kidney transplantation (KT). Two patients with anti-PLA2R in the second and third tertiles had a recurrence of PMN, whereas patients with a negative or anti-PLA2R in the first tertile had no recurrence. The report signals a heightened risk of PMN recurrence in patients with elevated anti-PLA2R antibody titer at KT.
      Citation: Indian Journal of Transplantation 2022 16(1):130-134
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_109_21
      Issue No: Vol. 16, No. 1 (2022)
       
  • Rectal carcinoma 27 years' postkidney transplant in a chronic
           hepatitis B patient - A case report

    • Authors: Sneha Haridas Anupama, Rajeevalochana Parthasarathy, Milly Mathew, Priya Haridas Anupama, Georgi Abraham
      Pages: 135 - 137
      Abstract: Sneha Haridas Anupama, Rajeevalochana Parthasarathy, Milly Mathew, Priya Haridas Anupama, Georgi Abraham
      Indian Journal of Transplantation 2022 16(1):135-137
      Here, we report a 72-year-old male with HBsAg-positive status who had a live sibling kidney transplant 27 years ago. He was on minimal maintenance immunosuppressive therapy with prednisolone and microemulsion cyclosporine. He presented with vague abdominal symptoms and was diagnosed to have moderately differentiated adenocarcinoma of the rectum, which was treated by low anterior resection with loop ileostomy and is currently undergoing radiotherapy.
      Citation: Indian Journal of Transplantation 2022 16(1):135-137
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_128_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • Spontaneous renal allograft rupture due to acute rejection in early
           post-transplant period – A case report

    • Authors: Suraj Godara, Karan Saraf
      Pages: 138 - 141
      Abstract: Suraj Godara, Karan Saraf
      Indian Journal of Transplantation 2022 16(1):138-141
      Renal allograft rupture (RAR) is a rare but lethal complication of renal transplantation. This can be a threat to the graft and patient survival. Over the decades, allograft nephrectomy has been the standard treatment for renal allograft rupture. But now, recent evidences suggest that graft salvage treatment can be safely done in complicated cases also. We describe a case of 30-year-old male who received a living donor kidney transplant and had spontaneous graft rupture in early post transplant period due to acute rejection. Graft was successfully repaired surgically, along with medical management and now the graft is functioning well.
      Citation: Indian Journal of Transplantation 2022 16(1):138-141
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_141_20
      Issue No: Vol. 16, No. 1 (2022)
       
  • The aeroplane takes off against the wind

    • Authors: Ganapathy Krishnan Subramaniam, Dhruva Sharma, Neha Sharma
      Pages: 142 - 143
      Abstract: Ganapathy Krishnan Subramaniam, Dhruva Sharma, Neha Sharma
      Indian Journal of Transplantation 2022 16(1):142-143

      Citation: Indian Journal of Transplantation 2022 16(1):142-143
      PubDate: Thu,31 Mar 2022
      DOI: 10.4103/ijot.ijot_42_21
      Issue No: Vol. 16, No. 1 (2022)
       
 
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