1
|
Pourmand G, Karbalai Saleh S, Mehrsai A, Gooran S, Khajavi MR, Razeghi E, Rahbar M, Pourhossein M, Dehghani S. Severity of Mitral Regurgitation before and after Kidney Transplantation. Int J Organ Transplant Med 2019; 10:167-169. [PMID: 33312461 PMCID: PMC7722517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- G. Pourmand
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| | - S. Karbalai Saleh
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Mehrsai
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| | - S. Gooran
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| | - M. R. Khajavi
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| | - E. Razeghi
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| | - M. Rahbar
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| | - M. Pourhossein
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| | - S. Dehghani
- Urology Research Center,Tehran University of Medical Science,Tehran,Iran
| |
Collapse
|
2
|
|
3
|
Pourmand GR, Dehghani S, Saraji A, Khaki S, Mortazavi SH, Mehrsai A, Sajadi H. Relationship between Post-kidney Transplantation Antithymocyte Globulin Therapy and Wound Healing Complications. Int J Organ Transplant Med 2012; 3:79-84. [PMID: 25013627 PMCID: PMC4089281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Wound healing disorders are probably the most common post-transplantation surgical complications. It is thought that wound healing disturbance occurs due to antiproliferative effects of immunosuppressive drugs. On the other hand, success of transplantation is dependent on immunosuppressive therapies. Antihuman thymocyte globulin (ATG) has been widely used as induction therapy but the impact of this treatment on wound healing is not fully understood. OBJECTIVE To investigate wound healing complications after ATG therapy in renal transplant recipients. METHODS The medical records of 333 kidney transplant recipients were assessed for wound healing disorders. Among these patients, 92 received ATG and 5 doses of 1.5 mg/kg ATG along with the standard protocol of drugs. RESULTS The mean age of patients was 38.9 years. Of 333 recipients, 92 (23.7%) received ATG; 21 (6.3%) developed wound healing complications. There was a significant relationship between ATG therapy and wound complications (p=0.034). Also, women were more likely to develop wound healing disorders than men (p=0.002). No statistical difference was observed between age and wound healing complication (p=0.28). There was no significant difference between the mean duration of hospitalization between ATG and Non-ATG group (p=0.9). CONCLUSION ATG increases the risk of overall wound complications. It is needed to pay more attention to the patients treated with this immunosuppressant to avoid the risk of re-interventions, lessen the duration of hospitalization and decrease the impairment of graft function.
Collapse
Affiliation(s)
- G. R. Pourmand
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S. Dehghani
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Sanaz Dehghani, Urology Research Center, Sina Hospital, Hasan Abad Sq, Imam Khomeini St, Tehran, Iran
Tel/Fax: +98-21-6670-1041
E-mail:
| | - A. Saraji
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S. Khaki
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,Students’ Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - S. H. Mortazavi
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,Students’ Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Mehrsai
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - H. Sajadi
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Salem S, Pourmand G, Kosari F, Mehrsai A. POD-01.03 Role of Estrogen, Progesterone and Androgen Receptors on Formation and Progression of Urothelial Carcinoma of The Bladder. Urology 2011. [DOI: 10.1016/j.urology.2011.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
5
|
Pourmand G, Solgi G, Mytilineos J, Gadi V, Paul B, Mehrsai A, Taherimahmoudi M, EbrahimiRad M, Saraji A, Asadpoor A, Nikbin B, Amirzargar A. MP-06.18 Augmentation of Chimerism by Donor Bone Marrow Cells Infusion in Kidney Allograft Recipients. Urology 2011. [DOI: 10.1016/j.urology.2011.07.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Pourmand G, Saraji A, Sajadi H, Mehrsai A, Nikoobakht M, Razeghi E, Rahbar M, Dehghani S. UP-03.033 Is Anti-thymocyte Globulin Therapy Considered a Risk Factor for Post Kidney Transplantation Cytomegalovirus Infection? Urology 2011. [DOI: 10.1016/j.urology.2011.07.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
7
|
Pourmand G, Saraji A, Dehgani S, Mehrsai A, Karami A, Shokohida W. UP-02.220 Exraperitoneal Orthotopic Radical Cystoprostatectomy Approach Can Improve Postoperative Morbidity. Urology 2011. [DOI: 10.1016/j.urology.2011.07.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
8
|
Salem S, Mehrsai A, Pourmand G. UP-02.094 Prospective Evaluation of Serum Triglyceride Concentration and Prostate Cancer Risk in a Multicenter Study. Urology 2011. [DOI: 10.1016/j.urology.2011.07.912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Pourmand G, Salem S, Mehrsai A. MP-07.08 Serum Uric Acid as a Risk Predictor for Erectile Dysfunction Severity. Urology 2011. [DOI: 10.1016/j.urology.2011.07.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
10
|
Pourmand G, Salem S, Hosseini M, Allameh F, Mehrsai A. UP-02.095 Serum Calcium as a Protective Marker Against Prostate Cancer: Role of Associated Factors. Urology 2011. [DOI: 10.1016/j.urology.2011.07.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
Pourmand G, Saraji A, Dehghani S, Mehrsai A, Nikoobakht M, Sajadi H, Hadadi A, Razeghi E, Rahbar M, Hosseini H, Rezaeidanesh M. UP-03.034 Is There a Relation Between Post Kidney Transplantation Antithymocyte Globulin Therapy and Wound Healing Disturbance? Urology 2011. [DOI: 10.1016/j.urology.2011.07.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
12
|
Salem S, Mehrsai A, Kosari F, Pourmand G. MP-04.03 Prognostic Significance of Her-2/neu Overexpression in Primary Urothelial Carcinoma of the Bladder: A Comparative Analysis. Urology 2011. [DOI: 10.1016/j.urology.2011.07.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
13
|
Taherimahmoudi M, Ahmadi H, Mehrsai A, Pourmand G. Plasma adiponectin concentration and insulin resistance: role of successful kidney transplantation. Transplant Proc 2010; 42:797-800. [PMID: 20430175 DOI: 10.1016/j.transproceed.2010.03.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Adiponectin (ADPN) has been reported to be inversely correlated with insulin resistance (IR) in uremic subjects and following kidney transplantation. Kidneys have been suggested to play a part in ADPN clearance. This study sought to evaluate this hypothesis. We enrolled 67 candidates with end-stage renal disease (ESRD) along with 30 healthy unrelated donors. Plasma ADPN, IR (based on the homeostasis model assessment for IR index), and glomerular filtration rates were compared between control and patient groups. The correlations of the aforementioned variables were also compared in the patient group 1 day before and 14 days following transplantation. The changes in measured parameters were also compared with control group values. The glomerular filtration rate was significantly decreased among recipients. ADPN levels were remarkably higher in the patient group before transplantation when compared with healthy subjects (P<.001) and remained significantly higher thereafter (P<.001). Insulin resistance was higher, albeit not significantly, among ESRD patients compared with controls (P>.05) and it increased following transplantation (P=.03). There was no correlation between ADPN, IR, and glomerular filtration rate in normal individuals or ESRD patients before or after transplantation. It is our assumption that mechanisms other than kidney function are probably involved in ADPN metabolism in ESRD patients and in the immediate phase following transplantation. It does not seem that ADPN substantially affects IR either in ESRD or transplantation patients.
Collapse
Affiliation(s)
- M Taherimahmoudi
- Urology Research Center, Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran
| | | | | | | |
Collapse
|
14
|
Pourmand G, Saraji A, Dehgani S, Mehrsai A, Nikoobakht M, Talibnajad M, Razeghi E, Rahbar M, Hosseini H, Pourmand N, Pourmand S, Zahedikia M, Porhussein M, Heidari F. Should post kidney transplantation hyperlipidemia considered a risk factor for graft function? Int J Organ Transplant Med 2010; 1:131-7. [PMID: 25013579 PMCID: PMC4089231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hyperlipidemia is a common problem after kidney transplantation. OBJECTIVE To uncover the real impact of post kidney transplantation hyperlipidemia on graft function and survival, and to determine whether it is just a biochemical phenomenon after using immunosuppressant or a part of disease pathology. METHODS 330 kidney transplants were managed in Sina Hospital Kidney Transplantation Unit affiliated to Tehran University of Medical Sciences, Tehran, Iran from September 1994 till February 2010. The demographic characteristics of the patients, causes of chronic kidney diseases, history of pretransplantation dialysis, pretransplantation comorbidities (e.g., hypertension, diabetes mellitus [DM], hyperlipidemia and coronary artery disease), rejection episodes, status of infection with cytomegalous virus [CMV], post-transplantation DM, hyperlipidemia, ischemic heart disease [IHD], and graft and patient survival were recorded. A serum creatinine level >2 mg/dL was considered as "graft deterioration," and return to dialysis as "graft loss." According to the presence or absence of post kidney transplantation hypercholesterolemia (>200 mg/dL) or hypertriglyceridemia (>200 mg/dL), the patients were classified into "hyperlipidemic" or "non-hyperlipidemic." The presence of clinical or paraclinical coronary artery disease was also determined in both groups. RESULTS The incidence of hyperlipidemia elevated from 8% to 50% before and after transplantation. 2.7% developed clinical IHD. 13% of hyperlipidemics and 22% of non-hyperlipidemics developed graft deterioration. Among hyperlipidemics with deteriorated grafts 40% had premorbid diseases, 68% had CMV infection and 82% had hypertension. Only 22% had previous acute rejection and 27% received deceased kidney transplant. CONCLUSIONS post kidney transplantation hyperlipidemia is just an associated phenomenon secondary to the use of immunosuppressant medications, which have no obvious impact on renal graft function and can be easily controlled by instituting dietary modifications and use of modern antilipid medications. Post kidney transplantation CMV infection and hypertension are considered as the main threatening risk for renal graft-even more dangerous than acute or chronic rejections.
Collapse
Affiliation(s)
- G. Pourmand
- Correspondence: G. Pourmand, MD,
Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
E-mail:
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Taherimahmoudi M, Ahmadi H, Mehrsai A, Rezaeidanesh M, Wahhabaghai H, Pourmand G. UP-1.151: Adiponectin and Insulin Resistance: Comparison of Healthy Subjects, Uremic Patients and Kidney Transplant Recipients. Urology 2009. [DOI: 10.1016/j.urology.2009.07.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
16
|
Pourmand G, Saraji A, Salem S, Mehrsai A, Nikoobakht M, Taherimahmoudi M, Rezaeidanesh M, Asadpour A. MP-03.07: Could Prophylactic Monoclonal Antibody Blocker Injection Help Kidney Graft Survival? Urology 2009. [DOI: 10.1016/j.urology.2009.07.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Salem S, Mehrsai A, Abdi S, Saboury B, Shokohideh V, Pourmand G. MP-11.08: Erectile Dysfunction Severity as a Surrogate Marker for Coronary Artery Disease. Urology 2009. [DOI: 10.1016/j.urology.2009.07.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Salem S, Mehrsai A, Baradaran N, Pourmand G. MP-19.01: Extracorporeal Shock Wave Lithotripsy Effects on Kidney Function: Assessed by Nuclear Scintigraphy. Urology 2009. [DOI: 10.1016/j.urology.2009.07.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Salem S, Mehrsai A, Pourmand G. POD-02.04: Major Dietary Factors and Risk of Prostate Cancer Among Iranian Male Population. Urology 2009. [DOI: 10.1016/j.urology.2009.07.1198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
20
|
Mehrsai A, Salem S, Taherimahmoudi M, Ahmadi H, Baradaran N, Nikoobakht M, Rezaeidanesh M, Wahhabaghai H, Mansouri D, Pourmand G. UP-1.155: Role of Resistive Index Measurement in Diagnosis of Acute Rejection Episodes Following Successful Kidney Transplantation. Urology 2009. [DOI: 10.1016/j.urology.2009.07.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
21
|
Pourmand G, Hashemian E, Salsabili N, Saraji A, Mehrsai A, Akbari F. UP-2.055: Factors Influencing the Outcome of ICSI in Azoospermic Patients. Urology 2009. [DOI: 10.1016/j.urology.2009.07.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
22
|
Salem S, Mehrsai A, Pourmand G. MP-19.12: Prospective Evaluation of Short-Term Complications and Results after Extracorporeal Shock Wave Lithotripsy: A Large Scale Analysis. Urology 2009. [DOI: 10.1016/j.urology.2009.07.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Salem S, Mehrsai A, Baradaran N, Pourmand G. UP-3.050: Preoperative Supraphysiological Nandrolone Phenpropionate Administration in Men Undergoing Open Prostatectomy. Urology 2009. [DOI: 10.1016/j.urology.2009.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
24
|
Pourmand G, Solgi G, Mehrsai A, Niknam M, Ebrahimi Rad M, Saraji A, Asadpour A, Moheiydin M, Nikbin B, Amirzargar A. MP-03.08: Effect of Donor Bone Marrow Cells Infusion on Alloimmunization in Kidney Allograft Patients. Urology 2009. [DOI: 10.1016/j.urology.2009.07.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
25
|
Mehrsai A, Afshar Pad M, Rezaeidanesh M, Wahhabaghai H, Pourmand G. UP-1.078: Effects of Pentoxifylline on Testicular Torsion in Rats. Urology 2009. [DOI: 10.1016/j.urology.2009.07.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Pourmand G, Saraji A, Salem S, Mehrsai A, Nikoobakht MR, Taherimahmoudi M, Rezaeidanesh M, Asadpour A. Could prophylactic monoclonal antibody improve kidney graft survival? Transplant Proc 2009; 41:2794-6. [PMID: 19765437 DOI: 10.1016/j.transproceed.2009.07.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study was designed to evaluate the impact of daclizumab monoclonal antibody on early and late kidney graft survival. MATERIALS AND METHODS From 2007 to 2008, 57 kidney transplant recipients were followed for a mean of 9.3 months. Twenty-three patients received 1 mg/kg daclizumab 24 hours before and 14 days after transplantation. In contrast, 34 patients (controls) did not receive daclizumab. The same immunosuppressive protocol was administered to all participants: oral prednisolone, mycophenolate mofetil, and cyclosporine. Delayed graft function (DGF), acute rejection, prednisolone pulses and/or antithymoglobulin (ATG), cytomegalovirus (CMV) infection, urinary tract infection (UTI), as well as early and late graft function were compared between the two groups. RESULTS The mean age in cases and controls was 39.7 and 37.1 years, respectively. The occurrence of DGF was 4% versus 3%; reversible acute rejection, 16% versus 14.5%, and irreversible acute rejection 0% versus 9% (P < .05) for treated versus control groups, respectively. ATG was used in 21% versus 23%, and pulse prednisolone 26% versus 20%, respectively. In case and control groups, the mean creatinine levels were 1.4 mg/dL versus 1.35 mg/dL at discharge. At last follow-up, it was 1.35 mg/dL versus 1.2 mg/dL, respectively. CMV infection occurred in 30% versus 35%, and UTI in 17% versus 19% of treated versus controls, respectively. CONCLUSION The prophylactic administration of daclizumab improved early graft survival and prevented irreversible acute rejection.
Collapse
Affiliation(s)
- G Pourmand
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Taherimahmoudi M, Ahmadi H, Baradaran N, Montaser-Kouhsari L, Salem S, Mehrsai A, Kalantar E, Jahani Y, Pourmand G. Cytomegalovirus Infection and Disease Following Renal Transplantation: Preliminary Report of Incidence and Potential Risk Factors. Transplant Proc 2009; 41:2841-4. [DOI: 10.1016/j.transproceed.2009.07.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
28
|
Saraji A, Pourmand G, Mehrsai A, Taherimahmodi M, Nikoobakht M, Asadpour A, Nikbin B, Tajik N, Emamzadeh A. Microchimerism and renal transplantation: doubt still persists. Transplant Proc 2007; 39:948-50. [PMID: 17524859 DOI: 10.1016/j.transproceed.2007.03.082] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We sought to study microchimerism in a group of kidney transplant recipients. MATERIALS AND METHODS In this study, the peripheral blood microchimerism (PBM) after renal transplantation was retrospectively evaluated in 32 male-to-female recipients of living unrelated or cadaveric donor renal transplants. Using a nested polymerase chain reaction (PCR) amplification specific for SRY region of the Y chromosome, microchimerism was detected with a sensitivity of 1:1,000,000. Recipients were compared according to the presence of PBM, acute and chronic rejection episodes, type of allotransplant, recipient and donor age at transplantation, previous male labor or blood transfusion, allograft function (serum creatinine level), and body mass index. RESULTS Among 32 recipients, 7 (21.9%) were positive for PBM upon multiple testing at various posttransplant times. All microchimeric recipients had received kidneys from living unrelated donors. No significant difference was observed with regard to other parameters. In addition the acute rejection rate in the microchimeric group was 3 (42%) versus 4 (16%) in the nonmicrochimeric recipients (not significant). CONCLUSION Our results suggested better establishment of microchimerism after living donor kidney transplantation. However, doubt persists concerning the true effect of microchimerism after renal transplantation. It seems that microchimerism alone has no major protective role upon renal allograft survival.
Collapse
Affiliation(s)
- A Saraji
- Urology Research Center, Kidney Transplantation Unit, Tehran, Iran.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Abstract
OBJECTIVES Functioning nephron mass namely, the number of nephrons in the grafted kidney, is one of the nonimmunologic factors that may have some impact on long-term graft survival. The aim of this study was to assess the impact of donor nephron mass on graft outcome in the recipient. MATERIALS AND METHODS From 1989 to 2005, 1000 renal transplants were performed at our center. The 217 studied cases were followed for an average of 8 years. All patients received grafts from living donors. The weight of the grafted kidney (donor nephron mass) as well as the recipient's body mass index (BMI) were measured at the time of operation. Nephron mass index (NMI) was defined as the ratio of donor nephron mass to recipient BMI. Associations between variables were tested by logistic regression and Pearson correlation using the SAS system and S-plus statistical software. To evaluate graft function, we determined serum creatinine values, acute rejection episodes and chronic nephropathy. RESULTS Mean NMI was 8.07 +/- 0.2 and mean creatinine level was 1.43 +/- 0.4 mg/dL. There were 32 cases (14.7%) of acute rejection, who were managed successfully with antithymocyte globulin (ATG) in 28 cases. Four patients lost their grafts. There were 15 cases (7%) of graft loss due to chronic rejection. Using Pearson correlation, we observed no association between NMI and mean serum creatinine level. Logistic regression showed a significant relation between NMI and acute rejection (P<.05) with an odds ratio of 2.0. There was no significant correlation between NMI and chronic rejection. CONCLUSIONS The lower the NMI, the greater the short-term graft loss. However, in the long term, no significant correlation was found between graft survival and NMI. Also, mean creatinine level was not significantly different among patients regardless of NMI.
Collapse
Affiliation(s)
- M Taherimahmoudi
- Urology Research Center, Medical Sciences/University of Tehran, Tehran, Iran
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
OBJECTIVES We examined the relation of various age, gender, diabetes, hypertension, and graft function with the prevalence of femoral and lateral cutaneous nerves sensory and/or motor disturbances after kidney transplantation. MATERIALS AND METHODS Among 129 patients who underwent kidney transplantation from April 2001 to March 2002. We excluded, 10 due to preoperative sensory disturbances. We evaluated the prevalence of sensory and/or motor disturbances preoperatively by physical examination and postoperatively by both physical and electromyography examinations. The clinical findings were correlated with the following risk factors: age, gender, preoperative dialysis duration, background diseases. (e.g., diabetes, hypertension), graft weight, nephron mass index, operative and retraction time, and rejection episodes. RESULTS At 1 to 9 days postoperatively, 31 ng (26%) patients, suffered neuropathy of the lateral cutaneous nerve and 4 (3.3%), femoral neuropathy. No meaningful relation was detected between the incidence of neuropathy and these risk factors. The probability of neuropathy was greater among diabetics, hypertensives, women, and those with graft rejection episodes. All of these complaints were temporary. CONCLUSIONS Post-kidney transplant femoral and/or lateral cutaneous nerve neuropathy is a prevalent complication particularly in diabetic, hypertensive, and female patients. Neuropathy is also more evident after graft rejection.
Collapse
Affiliation(s)
- M Nikoobakht
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | | | |
Collapse
|
31
|
Taherimahmoudi M, Moosavi S, Mehrsai A, Nikoobakht M, Emamzadeh A, Pourmand G. POS-03.130: The effect of successful renal transplantation on erectile dysfunction. Urology 2007. [DOI: 10.1016/j.urology.2007.06.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
32
|
Pourmand G, Emamzadeh A, Moradi K, Taherimahmoudi M, Mehrsai A, Nikoobakht M. POD-04.04: Serum selenium level and prostate cancer: case-control study. Urology 2007. [DOI: 10.1016/j.urology.2007.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
33
|
Nikoobakht M, Emamzadeh A, Abedi A, Mehrsai A, Taherimahmoudi M, Pourmand G. POS-01.111: TUL or ESWL is the approach of choice for upper ureter stones management: a comparative study. Urology 2007. [DOI: 10.1016/j.urology.2007.06.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
Pourmand G, Salem S, Mehrsai A, Taherimahmoudi M, Ebrahimi R, Pourmand MR. Infectious complications after kidney transplantation: a single-center experience. Transpl Infect Dis 2007; 9:302-9. [PMID: 17511823 DOI: 10.1111/j.1399-3062.2007.00229.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Infectious complications after renal transplantation are associated with significant morbidity and mortality. The prevalence of infections in transplant recipients varies from country to country. This study sought to assess the overall incidence of post-transplant infectious complications at our research center in Iran, compared with other centers in the world. Between 2002 and 2004, 179 renal transplantations were performed in our center. Of these, 142 were studied and followed for 1 year. Immunosuppressive regimens were cyclosporine, mycophenolate mofetil, and prednisolone. The overall incidence of infections was 54.2%. The most common sites of infections were the urinary tract (41.5%) and the respiratory tract (6.3%). The most frequent causes of infections were Klebsiella (24%) and cytomegalovirus (CMV) (17.6%). Wound infection occurred in 4.9% of the patients. Three (2.1%) patients developed hepatitis C and 2 (1.4%) had mycobacterial infections. There was no case of Pneumocystis pneumonia. Overall mortality was 7.7%. Infection-related mortality was 3.5%. In conclusion, this study identifies infections as the cause of morbidity and mortality in the post-transplant period. There was a low incidence of tuberculosis (<2% yearly) and a high incidence of CMV disease in our recipients.
Collapse
Affiliation(s)
- G Pourmand
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | |
Collapse
|
35
|
Pourmand G, Emamzadeh A, Moosavi S, Mehrsai A, Taherimahmoudi M, Nikoobakht M, Saraji A, Salem S. Does Renal Transplantation Improve Erectile Dysfunction in Hemodialysed Patients? What is the Role of Associated Factors? Transplant Proc 2007; 39:1029-32. [PMID: 17524883 DOI: 10.1016/j.transproceed.2007.03.038] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the effect of successful renal transplantation on improvement of erectile function in hemodialysis (HD) patients and the relationship between the degree of patient response and other factors. MATERIALS AND METHODS From September 2002 to November 2005, erectile function of 64 patients on HD for at least 6 months was evaluated pretransplantation and 6 months posttransplantation by International Index of Erectile Function, version 5 (IIEF-5). Sixty four age-matched persons without renal impairment were enrolled as control group to compare erectile dysfunction (ED) prevalence with the HD group. We evaluated duration of HD, age, and site of arterial anastomosis. In an attempt to find predictors of improvement of ED, after kidney transplantation, we performed linear regression analysis with a backward method. RESULTS The prevalence of ED in HD patients was 87.5%. Although there were some differences in the prevalence of ED between patients older versus younger than 50 years, the difference was not statistically significant. There was no relationship between the duration of dialysis and the severity of ED in HD group. Compared to the pretransplant IIEF-5 score (13.59), there was significant improvement (19.16). In an attempt to find predictors of ED improvement, we used a linear regression analysis with backward method. Pretransplant IIEF-5 score, age at the time of transplant, and anastomosis to the common iliac artery showed significant associations with improvement, but the duration of dialysis and anastomosis to internal iliac or external iliac artery did not. CONCLUSION The incidence of ED among hemodialyzed patients is high. Kidney transplantation is the key treatment for this complaint. ED has a major negative impact on the quality of life and family relations. Its treatment is associated with improvement of psychogenic factors. ED is a sensitive topic and many patients will not spontaneously discuss it with their physician, so better to include potency evaluation in posttransplantation list evaluations.
Collapse
Affiliation(s)
- G Pourmand
- Urology Research Center, Sina Hospital, Hasan Abad sq, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Pourmand G, Nasseh H, Sarrafnejad A, Mojtahedi A, Mehrsai A, Hamidi Alamdari D, Nourijelyani K, Emamzadeh A. UP-02.87. Urology 2006. [DOI: 10.1016/j.urology.2006.08.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
37
|
Nikoobakht M, Pourmand G, Mehrsai A, Emamzadeh A. UP-03.68. Urology 2006. [DOI: 10.1016/j.urology.2006.08.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
38
|
Nikoobakht M, Mehrsai A, Saraji A, Meysami A, Emamzadeh A. UP-03.69. Urology 2006. [DOI: 10.1016/j.urology.2006.08.934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
39
|
Pourmand G, Nikoobakht M, Mehrsai A, Taherimahmoudi M, Saraji A, Emamzadeh A. UP-01.60. Urology 2006. [DOI: 10.1016/j.urology.2006.08.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
40
|
Mehrsai A, Mansoori D, Taheri Mahmoudi M, Sina A, Seraji A, Pourmand GH. A comparison between clinical and pathologic staging in patients with bladder cancer. Urol J 2004; 1:85-9. [PMID: 17874391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE To determine the accuracy of clinical staging methods of bladder cancer and TURBT results in estimating the pathologic stage of tumor. MATERIALS AND METHODS Thirty two patients who had undergone radical cystectomy were studied in this retrospective survey. The results of bimanual examination, cystoscopy, TURBT pathology report and the tumor contour in CT scan, (size, infiltrative deepness, pelvic lymph nodes involvement and hydronephrosis) were recorded. The type of surgery and pathologic report of cystectomy sample were analyzed as well. Then the results of bimanual examination, tumor size, hydronephrosis and CT scan findings including tumor infiltrative deepness, pelvic lymph adenopathy and TURBT findings were compared to pathologic results of cystectomy sample. RESULTS Seven patients were females and 25 were males. Their mean age was 62 (range 36 to 80) years. Gross hematuria and irritative urinary symptoms were the most common complaints. The duration between symptom manifestation and patient's referral was 5 days to 72 months (mean 12 months). Bimanual examination in estimating the extravesical involvement of tumor had a specificity of 82%, sensitivity of 46%, positive predictive value of 70% and negative predictive value of 63%. The size of tumor in determining extravesical involvement had a specificity of 41%, sensitivity of 93%, and positive predictive value of 58% and negative predictive value of 87%. Hydronephrosis was present in 15 patients of whom, 14(93%) had bladder muscle involvement. CT scan specificity was 70%, and sensitivity was 46% regarding pelvic lymph adenopathy and perivesical fat involvement. In TURBT report no muscle sample was observed in 11 cases, so that the interpretations of results were impossible. The reported grade of tumor was lower than pathologic sample of cystectomy in 4 patients. CONCLUSION Clinical staging in invasive bladder cancers has not high accuracy regarding the involvement of bladder surrounding fats and pelvic adenopathies. A tumor sized more than 5 cm could be sensitive in estimating extravesical involvement. Positive predictive value of hydronephrosis is considerable regarding bladder muscle involvement. Tumor understaging by TURBT is happened in high percentage of patients with invasive bladder cancer.
Collapse
Affiliation(s)
- A Mehrsai
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | |
Collapse
|
41
|
Nikoobakht MR, Mehrsai A, Pourmand GH, Jaladat H, Nasseh HR. Management of Peyronie's disease by dermal grafting. UROLOGY JOURNAL 2004; 1:99-102. [PMID: 17874394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE To evaluate the results of plaque excision and dermal grafting in Peyronie's disease. MATERIALS AND METHODS Twenty seven patients were scheduled to undergo plaque excision and dermal grafting for Peyronie's disease. Potency, bending of erected penis, and having painful erection were evaluated in patients before and after operation. To evaluate erectile dysfunction, we used International Index of Erectile Function (IIEF) by interviewing the patients and filling questionnaires by their partners. Doppler ultrasonography was used to determine the vascular competence of penis before and after operation in 15 patients. RESULTS The disease was more prevalent between the ages of 40 and 60 years. Plaques were located as follows: dorsal in 18, right lateral in 6 and left lateral in 3. Mean plaque size was 11 (range 5 to 18) mm. After plaque excision and dermal grafting, penile deformity, erectile dysfunction, and painful erection had remained yet in 4 (15%) out of 27, 3 (16%) out of 19, and 3 (14%) out of 22, respectively. Doppler ultrasonographic study in 15 patients revealed improvement in peak systolic velocity (p<0.01). In addition, a decrease in end diastolic velocity was noted also that was not significant statistically (p=0.26). Resistive index did not improve after operation. CONCLUSION This procedure showed significant improvement in penile deformity (85% of cases), erectile dysfunction (84% of cases) and painful erection (86% of cases). We recommend plaque excision and dermal grafting as an effective procedure in treating Peyronie's disease.
Collapse
Affiliation(s)
- M R Nikoobakht
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | |
Collapse
|
42
|
|
43
|
Abstract
OBJECTIVE To assess the effect of successful renal transplantation on semen variables, sexual function and sex hormone profiles in a clinical trial. PATIENTS AND METHODS Thirty patients on haemodialysis underwent renal transplantation; before and after surgery, their sperm density, motility and morphology were analysed, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin and testosterone levels measured and compared, and sexual function assessed using an abbreviated version of the International Index of Erectile Function (IIEF), with a successful outcome defined as a level of satisfaction of 4 or 5 on a 5-point scale. The paired t-test was used to assess the statistically significance of differences in all analyses. RESULTS Sperm motility improved significantly (P < 0.001) but there were no significant changes in morphology or density (P = 0.33 and 0.068, respectively). Testosterone levels increased and FSH, LH and prolactin decreased significantly (P < 0.05) after renal transplantation. The IIEF showed that of the 30 patients, 14 were impotent before surgery and only six remained so afterward (P < 0.05). CONCLUSION Although sperm morphology and density did not improve after renal transplantation, there were highly significant changes in sperm motility. Hormonal levels in patients on haemodialysis improved after transplantation and returned to nearly normal; sexual function was also significantly better. Further studies are needed to confirm these results.
Collapse
Affiliation(s)
- F Akbari
- IVF Unit, Mirzakoochak Khan Hospital, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | |
Collapse
|
44
|
Mehrsai A, Khajehmougehi A, Afshar K, Emami M, Pourmand G. Lipids and lipoproteins alteration after renal transplantation. Nephrol Dial Transplant 1997; 12:233-4. [PMID: 9027812 DOI: 10.1093/ndt/12.1.233b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
|
45
|
Pourmand G, Jazaeri SA, Mehrsai A, Kalhori S, Afshar K. Nocardiosis: report of four cases in renal transplant recipients. Transplant Proc 1995; 27:2731-3. [PMID: 7482893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- G Pourmand
- Renal Transplantation Unit, Sina Hospital, Tehran University of Medical Sciences, Iran
| | | | | | | | | |
Collapse
|