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Varyani UT, Shah NM, Shah PR, Kute VB, Balwani MR, Trivedi HL. C1q Nephropathy in a Patient of Neurofibromatosis Type 1: A Rare Case Report. Indian J Nephrol 2019; 29:125-127. [PMID: 30983754 PMCID: PMC6440327 DOI: 10.4103/ijn.ijn_353_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
C1q nephropathy is a rare glomerular disease defined by the presence of characteristic mesangial dominant or codominant C1q deposition on immunofluorescence microscopy. Neurofibromatosis type 1 (NF-1) is an autosomal dominant syndrome caused by a mutation of a gene located on chromosomal segment 17q11.2. Nephrotic syndrome has rarely been reported in patients of NF-1, and the relation of NF-1 with nephrotic syndrome is unclear. Here, we present a rare case of C1q nephropathy in a patient of NF-1.
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Affiliation(s)
- U T Varyani
- Department of Nephrology and Transplantation Medicine, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre - Dr. H.L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - N M Shah
- Department of Nephrology and Transplantation Medicine, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre - Dr. H.L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Shah
- Department of Nephrology and Transplantation Medicine, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre - Dr. H.L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - V B Kute
- Department of Nephrology and Transplantation Medicine, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre - Dr. H.L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M R Balwani
- Department of Nephrology, Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra, India
| | - H L Trivedi
- Department of Nephrology and Transplantation Medicine, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre - Dr. H.L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Kasat GS, Patel JC, Patil MV, Kumar DP, Kute VB, Shah PR, Patel HV, Modi PR, Shah VR, Trivedi VB, Trivedi HL. Successful renal transplantation in a patient with perinuclear antineutrophil cytoplasmic antibody-associated vasculitis with chronic kidney disease with complement-dependent cytotoxicity crossmatch positivity (autoantibody induced) and donor-specific antibodies and flow cytometry crossmatch negative. Indian J Transplant 2019. [DOI: 10.4103/ijot.ijot_32_17] [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: 11/04/2022] Open
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Kanodia KV, Vanikar AV, Nigam LK, Patel RD, Suthar KS, Patel HV, Trivedi HL. Collapsing Glomerulopathy- A Troublemaker for the Renal Allograft: Lessons Learnt. Indian J Nephrol 2017; 27:342-346. [PMID: 28904428 PMCID: PMC5590409 DOI: 10.4103/ijn.ijn_287_16] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Collapsing glomerulopathy (CG) is a well-recognized distinct morphological pattern of proliferative parenchymal injury leading to rapid graft failure. We conducted a single-center retrospective study to evaluate the prevalence, clinicopathological features, and prognosis of CG in renal transplant recepient. We analyzed 2518 renal allograft biopsies performed from 2007 to 2015 and correlated their clinicopathological features. The prevalence of CG was 0.83% (21 out of 2518) of allograft biopsies with a higher prevalence of 1.4% during the period from 2012 to 2015. Out of 21 patients, 18 (85.71%) patients had undergone live donor and 3 (14.28%) patients had undergone deceased donor renal transplant. Hypertension was observed in 3 (14.28%) patients. The mean duration of diagnosis for CG was 1.85 ± 1.91 years. Urinalysis revealed microhematuria in 5 (23.8%) patients. The mean 24 h urinary protein excretion was 4.77 ± 5.3 g and serum creatinine was 2.12 ± 1.5 mg/dl. The predominant native kidney diseases in recipients were chronic glomerulonephritis of unknown etiology in 12 (57.14%) patients and hypertensive nephropathy in 3 (14.28%) patients. CG was associated with rejection in 9 (42.85%), calcineurin-inhibitor toxicity in 2 (9.5%), and BK virus nephropathy in 1 patient. All patients received standard triple immunosuppression. Eleven (52.38%) patients developed graft failure over a mean period of 2.2 ± 1.7 years and 6 (28.57%) patients recovered with stable graft function. CG can coexist with viral infection, drug toxicity, rejection, microvascular injury, etc. CG usually presents with moderate to severe proteinuria and may lead to rapid graft dysfunction and subsequent graft failure in most of the patients.
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Affiliation(s)
- K V Kanodia
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - A V Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.,Department of Regenerative Medicine and Cell Therapy, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - L K Nigam
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - R D Patel
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - K S Suthar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - H V Patel
- Department of Nephrology and Transplantation Medicine, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Regenerative Medicine and Cell Therapy, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India.,Department of Nephrology and Transplantation Medicine, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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Gera DN, Shah MK, Ghodela VA, Kute VB, Trivedi HL. De Novo Collapsing Glomerulopathy in Renal Allograft in Association with BK Virus Nephropathy in a Child and Stabilization of Renal Function by Elimination of Viremia. Indian J Nephrol 2017; 27:228-230. [PMID: 28553047 PMCID: PMC5434693 DOI: 10.4103/0971-4065.200516] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Well-recognized association between HIV 1 infection and collapsing glomerulopathy (CG) raises the possibility that intrarenal infection by other viruses may also contribute to the development of this lesion in native or post-transplant kidneys. There is evidence in literature about association of these lesions with cytomegalovirus, Epstein–Barr virus, hepatitis C virus, and parvovirus B19 infections. Here, we present a case report of post-transplant BK virus nephropathy in a male child who was found to have CG in subsequent biopsy 2 months later. His renal function and proteinuria were stabilized on elimination of viremia.
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Affiliation(s)
- D N Gera
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M K Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - V A Ghodela
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Pal BC, Modi PR, Rizvi SJ, Chauhan R, Kumar S, Nagarajan R, Kaushal D, Kute VB, Trivedi HL. The Learning Curve of Pure Retroperitoneoscopic Donor Nephrectomy. Int J Organ Transplant Med 2017; 8:180-185. [PMID: 29321833 PMCID: PMC5756899] [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: 11/24/2022] Open
Abstract
BACKGROUND Retroperitoneoscopic donor nephrectomy (RDN) is a well-established modality for the procurement of kidneys for renal transplantation. However the learning curve of pure RDN is not yet defined. Defining the learning curve will help in proper mentorship of the new donor surgeons besides providing safety to the donors. OBJECTIVE To define the learning curve of pure RDN. METHODS We analyzed the prospectively collected data of 102 voluntary kidney donors who underwent RDN by a single surgeon between August 2012 and April 2015 at our center. The donors were classified into group A (1-34), group B (35-68), and group C (69-102) according to the chronological order of their surgery. Left RDN was performed in 28 (82%), 25 (74%), and 28 (82%) donors of group A, B, and C, respectively. Right RDN was performed in 6 (18%), 9 (26%), and 6 (18%) donors of group A, B, and C, respectively. The clinical data were analyzed for each group. RESULTS Statistically significant difference was observed for the mean operative time (p<0.01) and warm ischemia time (p<0.04). The operative time remained around 200 minutes after the initial 35 cases. CONCLUSION The learning curve of pure RDN was 35 cases, although the mastery requires more number of cases to be performed.
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Affiliation(s)
- B. C. Pal
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India,Correspondence: Bipin Chandra Pal, MS, M Ch, DNB, Professor of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre - Institute of Transplantation Sciences, Ahmadabad, Gujarat, India, 380016, Tel: +91-989-830-5890, E-mail:
| | - P. R. Modi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - S. J. Rizvi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - R. Chauhan
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - S. Kumar
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - R. Nagarajan
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - D. Kaushal
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad – 380016, Gujarat, India
| | - V. B. Kute
- Department of Nephrology and Transplantation Medicine, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad - 380016. Gujarat, India
| | - H. L. Trivedi
- Department of Nephrology and Transplantation Medicine, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad - 380016. Gujarat, India
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Gera DN, Ghodela VA, Patel KN, Kute VB, Trivedi HL. Spontaneous callosal hemorrhage in a child on continuous ambulatory peritoneal dialysis. Indian J Nephrol 2016; 26:472-473. [PMID: 27942186 PMCID: PMC5131393 DOI: 10.4103/0971-4065.183602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- D N Gera
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - V A Ghodela
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - K N Patel
- Department of Radiology, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Kute VB, Patel HV, Shah PR, Modi PR, Shah VR, Trivedi HL. A Potential Solution to Make the Best Use of a Living Donor-Deceased Donor List Exchange. Am J Transplant 2016; 16:3580. [PMID: 27454322 DOI: 10.1111/ajt.13974] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H.L. Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
| | - H V Patel
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H.L. Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
| | - P R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H.L. Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
| | - P R Modi
- Department of Urology and Transplantation, IKDRC-ITS, Ahmedabad, India
| | - V R Shah
- Department of Anesthesia, IKDRC-ITS, Ahmedabad, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H.L. Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
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Pal BC, Modi PR, Modi JD, Nagarajan R, Kumar S, Patel K, Saifee Y, Sarmah A, Trivedi HL. Buccal Mucosal Graft Urethroplasty in Patients Awaiting Renal Transplantation. Transplant Proc 2016; 48:21-5. [PMID: 26915837 DOI: 10.1016/j.transproceed.2015.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/13/2015] [Accepted: 12/07/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the perioperative morbidity and early outcome of buccal mucosal graft (BMG) urethroplasty in patients with urethral stricture awaiting renal transplantation. METHODS Thirteen patients awaiting renal transplantation underwent BMG urethroplasty for long anterior urethral stricture between June 2011 and March 2013. The management issues, complications, and outcome of the BMG urethroplasty in this cohort of patients were studied. RESULTS Mean age of the patient was 38.7 ± 12.7 years. History of urethral manipulation was present in 8 patients. Mean stricture length was 6.92 ± 2.90 cm. Mean serum creatinine of the patient was 8.1 ± 3.6 mg%. Three patients required oral exploration for bleeding. Two patients had urinary extravasation, 3 patients had infected hematoma, and 1 patient developed dry gangrene of the glans. One patient had sepsis due to pyonephrosis in the postoperative period and succumbed to it. Mean follow-up of the patients was 34.54 ± 6.46 months. Three patients underwent VIU for recurrence of the stricture in the follow-up. At 3-month follow-up mean Qmax was 23.8 mL/sec, whereas at 6-month and 1-year follow-up, Qmax was 23.6 and 23.4 mL/sec, respectively. CONCLUSION This study shows a relatively higher complication rate of urethroplasty in prerenal transplant patients. Although the number of cases is too small to arrive at any definite conclusion, this study does gives an insight into the management issues, complications, and success of urethroplasty in this group of patients.
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Affiliation(s)
- B C Pal
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.
| | - P R Modi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - J D Modi
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - R Nagarajan
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - S Kumar
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - K Patel
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - Y Saifee
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - A Sarmah
- Department of Urology and Transplantation Surgery, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Nephrology and Transplantation Medicine, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Kanodia KV, Vanikar AV, Patel RD, Suthar KS, Trivedi HL. Crescentic Glomerulonephritis Associated with Pulmonary Tuberculosis. J Clin Diagn Res 2016; 10:ED01-2. [PMID: 26894074 DOI: 10.7860/jcdr/2016/14191.6970] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 09/03/2015] [Indexed: 11/24/2022]
Abstract
Tuberculosis of kidney and urinary tract is caused by members of the Mycobacterium tuberculosis complex. Kidney is usually infected by haematogenous spread of bacilli from focus of infection in the lungs. Glomerular involvement in tuberculosis presenting as a rapidly progressive glomerulonephritis is a rare entity. We report a rare case of crescentic glomerulonephritis associated with pulmonary tuberculosis in a 26-year-old man. Patient was treated with corticosteroids, haemodialysis, intravenous immunoglobulin and four cycles of plasmapheresis. He did not respond to 4-drug anti-tuberculosis treatment for renal pathology and was switched over to maintenance haemodialysis. However, he responded to pulmonary TB.
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Affiliation(s)
- K V Kanodia
- Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - A V Vanikar
- Professor and Head, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - R D Patel
- Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - K S Suthar
- Assistant Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - H L Trivedi
- Professor, Department of Nephrology and Transplantation Medicine and Director, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
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Kanodia KV, Vanikar AV, Modi PR, Patel RD, Suthar KS, Nigam LK, Trivedi HL. Histological and Clinicopathological Evaluation of Liver Allograft Biopsy: An Initial Experience of Fifty Six Biopsies. J Clin Diagn Res 2015; 9:EC17-20. [PMID: 26673862 DOI: 10.7860/jcdr/2015/13664.6812] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/03/2015] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Liver biopsy is gold standard for diagnosis of allograft dysfunction. AIM The aim of study was to evaluate liver allograft biopsies performed for graft dysfunction, study the pattern of injury and intensity, and timeline of occurrence of graft dysfunction. MATERIALS AND METHODS Retrospective study was carried out of 56 liver allograft biopsies and their histological findings with clinical presentation were correlated. Totally 56 needle liver allograft biopsies from January 1210 to July 2014, obtained from 35 patients were studied for histological and clinicopathological evaluation. RESULTS The mean age was 53.2±5.48 years. The most common original disease was alcoholic cirrhosis. The most common histological lesion was acute cellular rejection (ACR) in 31 (55.36%) biopsies followed by preservation-reperfusion injury (PRI) in 10 (17.86%) biopsies and drug toxicity in 8 (14.29%) biopsies. Chronic rejection was reported in 2 (3.57%) and recurrence of HCV in 3 (5.36%). Ischemic coagulative necrosis and acute cholangitis were seen in 1 (1.79 %) case each. CONCLUSION Alcoholic cirrhosis was the most common etiology for end stage liver disease. ACR and PRI were the major complications in liver allograft biopsies at our centre.
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Affiliation(s)
- K V Kanodia
- Professor, Department of Pathology, Lab Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - A V Vanikar
- Professor and Head, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - P R Modi
- Professor, Department of Transplantation Surgery and Urology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - R D Patel
- Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - K S Suthar
- Assistant Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - L K Nigam
- Junior Lecturer, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - H L Trivedi
- Professor, Department of Nephrology and Transplantation Medicine and Director, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
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Kanodia KV, Vanikar AV, Patel RD, Nigam LK, Trivedi HL. Rare Co-existence of Squamous Cell Carcinoma with Infiltration of Renal Vein and Xanthogranulomatous Pyelonephritis. J Clin Diagn Res 2015; 9:ED15-6. [PMID: 26816904 DOI: 10.7860/jcdr/2015/14908.6924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 09/10/2015] [Indexed: 11/24/2022]
Abstract
Primary renal squamous cell carcinoma is a very rare malignancy of the upper urinary tract. Most patients have history of chronic urolithiasis, analgesics abuse, radiotherapy or infection. Co-existence of SCC with xanthogranulomatous pyelonephritis is exceedingly rare with only few reports in the literature. We report a case of a 60-year-old male presented with right flank pain and mild tenderness of abdomen. Computed tomography of the abdomen revealed gross hydronephrosis with parenchymal thinning and irregular thick enhancing wall of pelvicalyceal system with multiple calculi in right kidney. Right renal vein appeared distended, filled with hypo dense material. Right nephrectomy was performed and sent for pathological examination. Histological evaluation revealed keratinizing squamous cell carcinoma with infiltration of renal vein and xanthogranulomatous pyelonephritis.
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Affiliation(s)
- K V Kanodia
- Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - A V Vanikar
- Professor and Head, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - R D Patel
- Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - L K Nigam
- Junior Lecturer, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
| | - H L Trivedi
- Professor, Department of Nephrology and Transplantation Medicine and Director, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences , Civil Hospital Campus, Asarwa, Ahmedabad, India
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Patel RD, Vanikar AV, Trivedi HL. Non-Functional Adrenal Gland Ganglioneuroma Masquerading as Chronic Calculus Cholecystitis. J Assoc Physicians India 2015; 63:80-81. [PMID: 27608876] [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: 06/06/2023]
Abstract
Adrenal ganglioneuromas in young adults are rare and ill-understood. We report an incidentally detected adrenal gland tumor diagnosed as ganglioneuroma (mature type) in 33 years old man who presented with vomiting and epigastric pain for 2 months. Histopathology examination revealed a well-encapsulated benign tumor of mature ganglion cells and Schwann-like cells arranged in fascicles, staining strongly with NSE and s-100 proteins, with adjacent unremarkable adrenal cortex and medulla.
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Affiliation(s)
- Rashmi D Patel
- Department of Pathology, Laboratory Medicine and Transfusion Services and Immunohematology
| | - Aruna V Vanikar
- Department of Pathology, Laboratory Medicine and Transfusion Services and Immunohematology
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre (IKDRC), Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS) Civil Hospital Campus, Ahmedabad, Gujarat
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Thakkar UG, Trivedi HL, Vanikar AV, Dave SD. Co-infusion of insulin-secreting adipose tissue-derived mesenchymal stem cells and hematopoietic stem cells: novel approach to management of type 1 diabetes mellitus. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0409-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kanodia KV, Vanikar AV, Patel RD, Suthar KS, Patel HV, Gumber MA, Shah PR, Trivedi HL. C1q nephropathy in India: a single-center study. Saudi J Kidney Dis Transpl 2015; 26:398-403. [PMID: 25758901 DOI: 10.4103/1319-2442.152562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
C1q nephropathy (C1qN) is defined by conspicuous C1q deposits in the glomerular mesangial regions of patients who do not have any evidence of systemic lupus erythematosus (SLE). We present our experience with C1qN over the last three years. In total, 1775 native renal biopsies were reviewed and dominant/co-dominant C1q mesangial deposits in patients with absence of clinical and/or serological evidence of SLE were considered as C1qN. Their clinical profile and renal function status were studied and correlated. C1qN was observed in 11 patients (0.61%), and included eight males and three females; the mean age was 36.6 years. The most common presentation was nephrotic syndrome. Hematuria was noted in eight patients (72%). The mean serum creatinine was 2.78 mg/dL. Hypertension was seen in two patients (18%). Mesangial proliferative glomerulonephritis (MePGN) was the most common histological pattern, followed by focal and segmental glomerulosclerosis and other lesions. The common codeposits along with C1q were IgM, followed by C3 and others. MePGN had better prognosis than others. To conclude, C1qN was noted in 0.61% of all renal biopsies with bimodal age distribution and may present as podocytopathy or non-podocytopathy. The prognosis depends on the morphological pattern and C1q deposits per se are not prognostic indicators.
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Affiliation(s)
- K V Kanodia
- Department of Pathology, Laboratory Medicine and Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, India
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Kute VB, Vanikar AV, Patel HV, Gumber MR, Shah PR, Modi PR, Trivedi HL. Successful renal transplantation from a deceased donor who died of bacterial meningitis. Indian J Nephrol 2014; 24:334-5. [PMID: 25249733 PMCID: PMC4165068 DOI: 10.4103/0971-4065.133049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - A V Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H V Patel
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M R Gumber
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Modi
- Department of Urology and Transplantation, Institute of Kidney Diseases and Research Center, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Kute V, Shah PR, Vanikar AV, Trivedi HL. Methyl alcohol poisoning (Hooch Tragedy in Ahmedabad). J Assoc Physicians India 2014; 62:654. [PMID: 25672055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Schachtner T, Reinke P, Dorje C, Mjoen G, Midtvedt K, Strom EH, Oyen O, Jenssen T, Reisaeter AV, Smedbraaten YV, Sagedal S, Mjoen G, Fagerland MW, Hartmann A, Thiel S, Zulkarnaev A, Vatazin A, Vincenti F, Harel E, Kantor A, Thurison T, Hoyer-Hansen G, Craik C, Kute VB, Shah PS, Vanikar AV, Modi PR, Shah PR, Gumber MR, Patel HV, Engineer DP, Shah VR, Rizvi J, Trivedi HL, Malheiro J, Dias L, Martins LS, Fonseca I, Pedroso S, Almeida M, Castro-Henriques A, Cabrita A, Costa C, Ritta M, Sinesi F, Sidoti F, Mantovani S, Di Nauta A, Messina M, Cavallo R, Verflova A, Svobodova E, Slatinska J, Slavcev A, Pokorna E, Viklicky O, Yagan J, Chandraker A, Messina M, Diena D, Tognarelli G, Ranghino A, Bussolino S, Fop F, Segoloni GP, Biancone L, Leone F, Mauro MV, Gigliotti P, Lofaro D, Greco F, Perugini D, Papalia T, Perri A, Vizza D, Giraldi C, Bonofilgio R, Luis-Lima S, Marrero D, Gonzalez-Rinne A, Torres A, Salido E, Jimenez-Sosa A, Aldea-Perona A, Gonzalez-Posada JM, Perez-Tamajon L, Rodriguez-Hernandez A, Negrin-Mena N, Porrini E, Mjoen G, Pihlstrom H, Dahle DO, Holdaas H, Von Der Lippe N, Waldum B, Brekke F, Amro A, Reisaeter AV, Os I, Klin P, Sanabria H, Bridoux P, De Francesco J, Fortunato RM, Raffaele P, Kong J, Son SH, Kwon HY, Whang EJ, Choi WY, Yoon CS, Thanaraj V, Theakstone A, Stopper K, Ferraro A, Bhattacharjya S, Devonald M, Williams A, Mella A, Messina M, Gallo E, Fop F, Di Vico MC, Diena D, Pagani F, Gai M, Ranghino A, Segoloni GP, Biancone L, Cho HJ, Nho KW, Park SK, Kim SB, Yoshida K, Ishii D, Ohyama T, Kohguchi D, Takeuchi Y, Varga A, Sandor B, Kalmar-Nagy K, Toth A, Toth K, Szakaly P, Zulkarnaev A, Vatazin A, Kildushevsky A, Fedulkina V, Kantaria R, Staeck O, Halleck F, Rissling O, Naik M, Neumayer HH, Budde K, Khadzhynov D, Bhadauria D, Kaul A, Prasad N, Sharma RK, Sezer S, Bal Z, Erkmen Uyar M, Guliyev O, Erdemir B, Colak T, Ozdemir N, Haberal M, Caliskan Y, Yazici H, Artan AS, Oto OA, Aysuna N, Bozfakioglu S, Turkmen A, Yildiz A, Sever MS, Yagisawa T, Nukui A, Kimura T, Nannmoku K, Kurosawa A, Sakuma Y, Miki A, Damiano F, Ligabue G, De Biasi S, Granito M, Cossarizza A, Cappelli G, Martins LS, Fonseca I, Malheiro J, Henriques AC, Pedroso S, Almeida M, Dias L, Davide J, Cabrita A, Von During ME, Jenssen TG, Bollerslev J, Godang K, Asberg A, Hartmann A, Bachelet T, Martinez C, Bello A, Kejji S, Couzi L, Guidicelli G, Lepreux S, Visentin J, Congy-Jolivet N, Rostaing L, Taupin JL, Kamar N, Merville P, Sezer S, Bal Z, Erkmen Uyar M, Ozdemir H, Guliyev O, Yildirim S, Tutal E, Ozdemir N, Haberal M, Sezer S, Erkmen Uyar M, Bal Z, Guliyev O, Sayin B, Colak T, Ozdemir Acar N, Haberal M, Banasik M, Boratynska M, Koscielska-Kasprzak K, Kaminska D, Bartoszek D, Mazanowska O, Krajewska M, Zmonarski S, Chudoba P, Dawiskiba T, Protasiewicz M, Halon A, Sas A, Kaminska M, Klinger M, Stefanovic N, Cvetkovic T, Velickovic - Radovanovic R, Jevtovic - Stoimenov T, Vlahovic P, Rungta R, Das P, Ray DS, Gupta S, Kolonko A, Szotowska M, Kuczera P, Chudek J, Wiecek A, Sikora-Grabka E, Adamczak M, Szotowska M, Kuczera P, Madej P, Wiecek A, Amanova A, Kendi Celebi Z, Bakar F, Caglayan MG, Keven K, Massimetti C, Imperato G, Zampi G, De Vincenzi A, Fabbri GDD, Brescia F, Feriozzi S, Filipov JJ, Zlatkov BK, Dimitrov EP, Svinarov DA, Poesen R, De Vusser K, Evenepoel P, Kuypers D, Naesens M, Meijers B, Kocak H, Yilmaz VT, Yilmaz F, Uslu HB, Aliosmanoglu I, Ermis H, Dinckan A, Cetinkaya R, Ersoy FF, Suleymanlar G, Fonseca I, Oliveira JC, Santos J, Martins LS, Almeida M, Dias L, Pedroso S, Lobato L, Castro-Henriques A, Mendonca D, Watarai Y, Yamamoto T, Tsujita M, Hiramitsu T, Goto N, Narumi S, Kobayashi T, Dahle DO, Holdaas H, Reisaeter AV, Dorje C, Mjoen G, Line PD, Hartmann A, Housawi A, House A, Ng C, Denesyk K, Rehman F, Moist L, Musetti C, Battista M, Izzo C, Guglielmetti G, Airoldi A, Stratta P, Musetti C, Cena T, Quaglia M, Fenoglio R, Cagna D, Airoldi A, Amoroso A, Stratta P, Palmisano A, Degli Antoni AM, Vaglio A, Piotti G, Cremaschi E, Buzio C, Maggiore U, Lee MC, Hsu BG, Zalamea Jarrin F, Sanchez Sobrino B, Lafuente Covarrubias O, Karsten Alvarez S, Dominguez Apinaniz P, Llopez Carratala R, Portoles Perez J, Yildirim T, Yilmaz R, Turkmen E, Altindal M, Arici M, Altun B, Erdem Y, Dounousi E, Mitsis M, Naka K, Pappas H, Lakkas L, Harisis H, Pappas K, Koutlas V, Tzalavra I, Spanos G, Michalis L, Siamopoulos K, Iwabuchi T, Yagisawa T, Kimura T, Nanmoku K, Kurosawa A, Yasunaru S, Lee MC, Hsu BG, Yoshikawa M, Kitamura K, Fuji H, Fujisawa M, Nishi S, Carta P, Zanazzi M, Buti E, Larti A, Caroti L, Di Maria L, Minetti EE, Shi Y, Luo L, Cai B, Wang T, Zou Y, Wang L, Kim Y, Kim HS, Choi BS, Park CW, Yang CW, Kim YS, Chung BH, Baek CH, Kim M, Kim JS, Yang WS, Han DJ, Park SK, Mikolasevic I, Racki S, Lukenda V, Persic MP, Colic M, Devcic B, Orlic L, Sezer S, Gurlek Demirci B, Guliyev O, Colak T, Say N CB, Ozdemir Acar FN, Haberal M, Vali S, Ismal K, Sahay M, Civiletti F, Cantaluppi V, Medica D, Mazzeo AT, Assenzio B, Mastromauro I, Deambrosis I, Giaretta F, Fanelli V, Mascia L, Musetti C, Airoldi A, Quaglia M, Guglielmetti G, Battista M, Izzo C, Stratta P, Lakkas L, Naka K, Dounousi E, Koutlas V, Gkirdis I, Bechlioulis A, Evangelou D, Zarzoulas F, Kotsia A, Balafa O, Tzeltzes G, Nakas G, Pappas K, Kalaitzidis R, Katsouras C, Michalis L, Siamopoulos K, Tutal E, Erkmen Uyar M, Uyanik S, Bal Z, Guliyev O, Toprak SK, Ilhan O, Sezer S, Bal Z, Ekmen Uyar M, Guliyev O, Sayin B, Colak T, Sezer S, Haberal M, Hernandez Vargas H, Artamendi Larranaga M, Ramalle Gomara E, Gil Catalinas F, Bello Ovalle A, Pimentel Guzman G, Coloma Lopez A, Sierra Carpio M, Gil Paraiso A, Dall Anesse C, Beired Val I, Huarte Loza E, Choy BY, Kwan L, Mok M, Chan TM, Yamakawa T, Kobayashi A, Yamamoto I, Mafune A, Nakada Y, Tannno Y, Tsuboi N, Yamamoto H, Yokoyama K, Ohkido I, Yokoo T, Luque Y, Anglicheau D, Rabant M, Clement R, Kreis H, Sartorius A, Noel LH, Timsit MO, Legendre C, Rancic N, Vavic N, Dragojevic-Simic V, Katic J, Jacimovic N, Kovacevic A, Mikov M, Veldhuijzen NMH, Rookmaaker MB, Van Zuilen AD, Nquyen TQ, Boer WH, Mjoen G, Pihlstrom H, Dahle DO, Holdaas H, Sahtout W, Ghezaiel H, Azzebi A, Ben Abdelkrim S, Guedri Y, Mrabet S, Nouira S, Ferdaws S, Amor S, Belarbia A, Zellama D, Mokni M, Achour A, Viklicky O, Parikova A, Slatinska J, Hanzal V, Fronek J, Orandi BJ, James NT, Montgomery RA, Desai NM, Segev DL, Fontana F, Ballestri M, Magistroni R, Damiano F, Cappelli G. TRANSPLANTATION CLINICAL 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu160] [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: 11/13/2022] Open
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Orandi BJ, Kraus ES, Bagnasco SM, Van Arendonk KJ, Garonzik-Wang JM, Wickliffe C, Montgomery RA, Segev DL, Trivedi HL, Vanikar AV, Dave SD, Patel HV, Kute VB, Gumber MR, Rawal MN, Modi PR, Rizvi SJ, Sicard A, Ducreux S, Rabeyrin M, McGregor B, Badet L, Scoazec JY, Fremeau-Bacchi V, Morelon E, Dubois V, Thaunat O, Kiki E, Kainz A, Kozakowski N, Oberbauer R, Regele H, Bartel G, Boehmig GA, Mallamaci F, Tripepi R, Leonardis D, Mafrica A, Versace MC, Provenzano F, Tripepi G, Zoccali C. TRANSPLANTATION 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu136] [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: 11/12/2022] Open
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Dave SD, Vanikar AV, Trivedi HL, Bertram A, Shushakova N, Park JK, Kirsch T, Agustian PA, Menne J, Hermann H, Gellai R, Hodrea J, Lenart L, Koszegi S, Ver A, Banki NF, Wagner L, Fulop N, Molnar A, Vannay A, Szabo AJ, Fekete A, Silva KAS, Santos RA, Arlotti MR, Jorge L, Luiz RS, Rampaso RR, Cunha TS, Schor N, Parodi EL, Ansaldo F, Veziano E, Villaggio B, Mij M, Gianiorio F, Viazzi F, Verzola D, Garibotto G, Menne J, Ritz E, Ruilope LM, Chatzikyrkou C, Viberti G, Haller H. DIABETES. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu132] [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: 11/14/2022] Open
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Vanikar AV, Trivedi HL, Dave SD, Kute VB, Rawal MN, Patel HV, Gumber MR, Afghahi H, Pirouzifard M, Svensson AM, Eliasson B, Svensson MK, Dumann K, Horrmann B, Lammert A, Rheinberger M, Gorski M, Kramer BK, Heid IM, Boger CA, Demirtas L, Akbas EM, Timuroglu A, Ozcicek F, Turkmen K, Fernandez-Fernandez B, Sanchez-Nino MD, Martin-Cleary C, Izquierdo MC, Elewa U, Ortiz A, Petrica L, Vlad A, Gluhovschi G, Gadalean F, Dumitrascu V, Gluhovschi C, Velciov S, Bob F, Vlad D, Popescu R, Petrica M, Jianu DC, Milas O, Izvernari O, Ursoniu S, Makino Y, Konoshita T, Nyumura I, Babazono T, Yoshida N, Uchigata Y, Handisurya A, Kerscher C, Tura A, Werzowa J, Heinzl H, Ristl R, Kautzky-Willer A, Pacini G, Saemann M, Schmidt A, Halbesma N, Metcalfe W, Bulum T, Prka in I, Blaslov K, Zibar K, Duvnjak L, Idorn T, Knop FK, Jorgensen MB, Christensen M, Holst JJ, Hornum M, Feldt-Rasmussen B, Naess H, Hartmann A, Jenssen TG, Holdaas H, Horneland R, Grzyb K, Bitter J, Midtvedt K, Yoshida N, Babazono T, Uchigata Y, Timar R, Gluhovschi G, Gadalean F, Velciov S, Petrica L, Timar B, Gluhovschi C, Soro-Paavonen A, Fleming T, Forsblom C, Gordin D, Tolonen N, Harjutsalo V, Nawroth PP, Groop PH, Tsuda A, Ishimura E, Uedono H, Yasumoto M, Nakatani S, Ichii M, Ohno Y, Ochi A, Mori K, Fukumoto S, Emoto M, Inaba M, Rheinberger M, Hormann B, Lammert A, Dumann K, Gorski M, Heid IM, Kramer BK, Boger CA, Siddaramaiah NH, Tez DK, Linker NJ, Bilous M, Winship S, Marshall SM, Bilous RW, Lampropoulou IT, Papagianni A, Stangou M, Didangelos T, Iliadis F, Efstratiadis G, Esposito P, Debarbieri G, Mereu R, Ditoro A, Montagna F, Groop PH, Bernardi L, Dal Canton A, Garland JS, Holden R, Morton R, Ross R, Adams M, Pruss C, Akbas EM, Demirtas L, Timuroglu A, Ozcicek F, Turkmen K, Bulum T, Prka in I, Blaslov K, Zibar K, Duvnjak L, Theodoridis M, Panagoutsos S, Bounta T, Roumeliotis S, Kantartzi K, Pouloutidis G, Passadakis P, Polaina Rusillo M, Borrego Utiel FJ, Ortega Anguiano S, Liebana Canada A, Gaber EW, Abdel Rehim WM, Ibrahim NA, Mahmoud BF, Silva AP, Fragoso A, Tavares N, Silva C, Santos N, Camacho A, Neves P, Rodriguez R, Porrini E, Gonzalez-Rinne A, De Vries A, Torres A, Salido E, Kato S, Makino H, Uzu T, Koya D, Nishiyama A, Imai E, Ando M, Jorgensen MB, Knop FK, Idorn T, Holst JJ, Hornum M, Feldt-Rasmussen B, Vaduva C, Popa S, Mitrea A, Mota M, Mota E, Theodoridis M, Panagoutsos S, Roumeliotis S, Bounta T, Kriki P, Roumeliotis A, Passadakis P, Ogawa T, Okazaki S, Hatano M, Hara H, Inamura M, Kiba T, Iwashita T, Shimizu T, Tayama Y, Kanozawa K, Kato H, Matsuda A, Hasegawa H, Elewa U, Fernandez B, Egido J, Ortiz A, Rottembourg J, Guerin A, Diaconita M, Dansaert A, Chakraborty J, Prabhu R, Nagaraju SP, Bairy M, Satyamoorthy K, Kosuru S, Parthasarathy R, Tomilina N, Zhilinskaya T, Stolyarevich E, Silva AP, Fragoso A, Guilherme P, Silva C, Santos N, Rato F, Camacho A, Neves P, Pasko N, Strakosha A, Toti F, Dedej T, Marku N, Petrela E, Zekollari E, Kacorri V, Thereska N, Roumeliotis SK, Roumeliotis AK, Theodoridis M, Tavridou A, Panagoutsos S, Passadakis P, Vargemezis V, Kim IY, Lee SB, Lee DW, Kim MJ, Shin MJ, Rhee H, Yang BY, Song SH, Seong EY, Kwak IS, Celebi K, Sengul E, Cekmen MB, Yilmaz A, Sonikian M, Dona A, Skarakis J, Miha T, Trompouki S, Karaitianou A, Spiliopoulou C, Dimas GG, Iliadis FS, Tegos TJ, Spiroglou SG, Kanellos IE, Fotiadis SD, Didaggelos TP, Savopoulos CG, Hatzitolios AI, Grekas DM, Hsu YH, Huang MC, Chang HY, Shin SJ, Wahlqvist ML, Chang YL, Hsu KC, Hsu CC, Miarka P, Grabowska-Polanowska B, Faber J, Skowron M, Pietrzycka A, Walus-Miarka M, Sliwka I, Sulowicz W. DIABETES CLINICAL. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu169] [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: 11/13/2022] Open
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Berthelot L, Robert T, Tabary T, Vuiblet V, Drame M, Toupance O, Rieu P, Monteiro RC, Toure F, Ferrario S, Cantaluppi V, De Lena M, Dellepiane S, Beltramo S, Rossetti M, Manzione AM, Messina M, Gai M, Dolla C, Biancone L, Camussi G, Pontrelli P, Oranger AR, Accetturo M, Rascio F, Gigante M, Castellano G, Schena A, Fiorentino M, Zito A, Zaza G, Stallone G, Gesualdo L, Grandaliano G, Pattonieri EF, Gregorini M, Corradetti V, Rocca C, Milanesi S, Peloso A, Ferrario J, Cannone M, Bosio F, Maggi N, Avanzini MA, Minutillo P, Paulli M, Maestri M, Rampino T, Dal Canton A, Wu KST, Coxall O, Luque Y, Candon S, Rabant M, Noel LH, Thervet E, Chatenoud L, Snanoudj R, Anglicheau D, Legendre C, Zuber J, Hruba P, Brabcova I, Krepsova E, Slatinska J, Sekerkova A, Striz I, Zachoval R, Viklicky O, Scholbach TM, Wang HK, Loong CC, Yang AH, Wu TH, Hruba P, Brabcova I, Krepsova E, Slatinska J, Sekerkova A, Striz I, Zachoval R, Viklicky O, Guberina H, Rebmann V, Dziallas P, Dolff S, Wohlschlaeger J, Heinemann FM, Witzke O, Zoet YM, Claas FHJ, Horn PA, Kribben A, Doxiadis IIN, Prasad N, Yadav B, Agarwal V, Jaiswal A, Rai M, Hope CM, Coates PT, Heeger PS, Carroll R, Zaza G, Masola V, Secchi MF, Onisto M, Gambaro G, Lupo A, Matsuyama M, Kobayashi T, Yoneda Y, Chargui J, Touraine JL, Yoshimura R, Vizza D, Perri A, Lupinacci S, Toteda G, Lofaro D, Leone F, Gigliotti P, La Russa A, Papalia T, Bonofilgio R, Sentis Fuster A, Kers J, Yapici U, Claessen N, Bemelman FJ, Ten Berge IJM, Florquin S, Glotz D, Rostaing L, Squifflet JP, Merville P, Belmokhtar C, Le Ny G, Lebranchu Y, Papazova DA, Friederich-Persson M, Koeners MP, Joles JA, Verhaar MC, Trivedi HL, Vanikar AV, Dave SD, Suarez Alvarez B, Garcia Melendreras S, Carvajal Palao R, Diaz Corte C, Ruiz Ortega M, Lopez-Larrea C, Yadav AK, Bansal D, Kumar V, Kumar V, Minz M, Jha V, Kaminska D, Koscielska-Kasprzak K, Chudoba P, Mazanowska O, Banasik M, Zabinska M, Boratynska M, Lepiesza A, Korta K, Klinger M, Csohany R, Prokai A, Pap D, Balicza-Himer N, Vannay A, Fekete A, Kis-Petik K, Peti-Peterdi J, Szabo A, Masajtis-Zagajewska A, Muras K, Niewodniczy M, Nowicki M, Pascual J, Srinivas TR, Chadban S, Citterio F, Henry M, Legendre C, Oppenheimer F, Lee PC, Tedesco-Silva H, Zeier M, Watarai Y, Dong G, Hexham M, Bernhardt P, Vincenti F, Rocchetti MT, Pontrelli P, Rascio F, Fiorentino M, Zito A, Stallone G, Gesualdo L, Grandaliano G, Su owicz J, Wojas-Pelc A, Ignacak E, Janda K, Krzanowski M, Su owicz W, Dellepiane S, Cantaluppi V, Mitsuhashi M, Murakami T, Benso A, Biancone L, Camussi G, Scholbach TM, Wang HK, Loong CC, Wu TH, Leuning D, Reinders M, Lievers E, Duijs J, Van Zonneveld AJ, Van Kooten C, Engelse M, Rabelink T, Assounga A, Omarjee S, Ngema Z, Ersoy A, Gultepe A, Isiktas Sayilar E, Akalin H, Coskun F, Oner Torlak M, Ayar Y, Riegersperger M, Plischke M, Steinhauser C, Jallitsch-Halper A, Sengoelge G, Winkelmayer WC, Sunder-Plassmann G, Foedinger M, Kaziuk M, Kuz'Niewski M, Ignacak E, B Tkowska- Prokop A, Pa Ka K, Dumnicka P, Kolber W, Su Owicz W. TRANSPLANTATION BASIC SCIENCE, ALLOGENIC AND XENOGENIC TOLERANCE. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu179] [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: 11/14/2022] Open
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Vanikar AV, Trivedi HL, Dave SD, Vanikar AV, Trivedi HL, Kolonko A, Chudek J, Wiecek A. TRANSPLANTATION 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu123] [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: 11/14/2022] Open
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Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Trivedi HL. Mesangial proliferative glomerulonephritis with acute tubule interstitial nephritis leading to acute kidney injury in influenza A (H1N1) infection. Indian J Nephrol 2014; 24:114-6. [PMID: 24701045 PMCID: PMC3968599 DOI: 10.4103/0971-4065.127902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Respiratory complications and renal failure are the leading causes for morbidity and mortality due to influenza (H1N1) virus infection. There has been limited information on histopathology of H1N1 influenza-related acute kidney injury (AKI). We describe AKI with H1N1 infection in a 52-year-old female. Renal biopsy showed mesangial proliferative glomerulonephritis with acute tubule interstitial nephritis. Her condition improved rapidly with oseltamivir, fluid replacement, steroid and dialysis. Our case suggests that H1N1 infection may have a causative link to the development of mesangial proliferative glomerulonephritis with acute tubulointerstitial nephritis.
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Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - A V Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Shah
- Department of Nephrology and Clinical Transplantation, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M R Gumber
- Department of Nephrology and Clinical Transplantation, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H V Patel
- Department of Nephrology and Clinical Transplantation, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Centre, Dr. H L Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Kute VB, Gumber MR, Shah PR, Patel HV, Vanikar AV, Modi PR, Shah VR, Trivedi HL. Successful three-way kidney paired donation transplantation: The first Indian report. Indian J Nephrol 2014; 24:45-7. [PMID: 24574632 PMCID: PMC3927192 DOI: 10.4103/0971-4065.125094] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Providing transplantation opportunities for patients with incompatible live donors through kidney paired donation (KPD) is an important strategy for easing the crisis in organ availability. KPD is can overcome the barriers when the only living potential donors are deemed unsuitable owing to an incompatibility of blood type, of human leukocyte antigen cross-match, or both. In KPD, the incompatibility problems with two donor recipient pairs can be solved by exchanging donors. In the absence of well-organized deceased donor program, or transplantation with desensitization protocol and ABO incompatible transplantation, living donor KPD promises hope to the growing number of patients suffering from end-stage renal disease in India. We report our first successful three-way KPD transplantation from India. In an era of organ shortage, this approach is relevant to encourage wider participation from KPD donors and transplant centers to prevent commercial transplantation.
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Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
| | - M R Gumber
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
| | - P R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
| | - H V Patel
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
| | - A V Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
| | - P R Modi
- Department of Urology and Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
| | - V R Shah
- Department of Anesthesia and Critical Care, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
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Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Modi PR, Rizvi SJ, Shah VR, Modi MP, Kanodia KV, Trivedi HL. Outcome of live and deceased donor renal transplantation in patients aged ≥55 years: A single-center experience. Indian J Nephrol 2014; 24:9-14. [PMID: 24574624 PMCID: PMC3927204 DOI: 10.4103/0971-4065.125049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Renal transplantation (RTx) has now become an accepted therapeutic modality of choice for elderly ESRD patients. This single-center study was undertaken to evaluate the outcome of RTx in ESRD patients ≥55 years. A total of 103 patients underwent RTx 79 living related living donors [LD], 24 deceased donors [DD]) at our center. Post-transplant immunosuppression consisted of calcineurin inhibitor-based regimen. The mean donor age was 58.3 years in the LD group and 59.5 years in the DD group. Male recipients constituted 92% in LD and 75% in DD group. In living donor renal transplantation, 1- and 5-year patient survival was 93% and 83.3% respectively and death-censored graft survival was 97.3% and 92.5% respectively. There were 12.6% biopsy proven acute rejection (BPAR) episodes and 12.6% patients were lost, mainly due to infections. In deceased donor renal transplantation, 1- and 5-year patient survival was 79.1% and 74.5% respectively and death-censored graft survival was 95.8% and 85.1% respectively. There were 12.5% BPAR episodes and 25% of patients were lost, mainly due to infections. RTx in ESRD (≥55 years) patients has acceptable patient and graft survival if found to have cardiac fitness and therefore should be encouraged.
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Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - A V Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M R Gumber
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H V Patel
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - P R Modi
- Department of Urology and Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - S J Rizvi
- Department of Urology and Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - V R Shah
- Department of Anesthesia and Critical Care, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - M P Modi
- Department of Anesthesia and Critical Care, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - K V Kanodia
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Gera DN, Patil SB, Iyer A, Kute VB, Gandhi S, Kumar D, Trivedi HL. Posterior reversible encephalopathy syndrome in children with kidney disease. Indian J Nephrol 2014; 24:28-34. [PMID: 24574628 PMCID: PMC3927187 DOI: 10.4103/0971-4065.125053] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinic-radiographic entity of heterogeneous etiologies that are grouped together because of similar findings on neuro-imaging and associated symptom complex of headache, vision loss, altered mentation, and seizures. Although usually considered benign and reversible, characteristics of this syndrome in pediatric patients remain obscure. This case series included 11 patients (8 males, 3 females, age 3-15 years) of PRES during September 2010 to February 2012 out of a total 660 renal pediatric patients (1.66%). We studied their clinical profile, contributory factors, and outcome. Presenting symptoms were headache in 73%, dimness of vision or cortical blindness in 36%, seizures in 91%, and altered mentation in 55%. The associated renal diseases were acute renal failure (55%), chronic renal failure (9%), and 36% had normal renal function. The contributory factors were uncontrolled hypertension (100%), severe hypoproteinemia (9%), persistent hypocalcemia (9%), hemolytic uremic syndrome (36%), cyclosporine toxicity (9%), lupus nephritis (9%), high hematocrit (9%), and pulse methylprednisolone (9%). Brain imaging showed involvement of occipito-parietal area (100%) and other brain areas (63%). All but one patient of hemolytic uremic syndrome had complete clinical neurological recovery in a week, and all had normal neurological imaging after 4-5 weeks. PRES is an underdiagnosed entity in pediatric renal disease patients. Associated hypertension, renal disease, and immunosuppressive treatment are important triggers. Early diagnosis and treatment of comorbid conditions is of prime importance for early reversal of syndrome.
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Affiliation(s)
- D N Gera
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
| | - S B Patil
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
| | - A Iyer
- Department of Radiology, IKDRC-ITS, Ahmedabad, India
| | - V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
| | - S Gandhi
- Department of Radiology, IKDRC-ITS, Ahmedabad, India
| | - D Kumar
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
| | - H L Trivedi
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India
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Mehta TR, Shah VR, Butala BP, Parikh GP, Parikh BK, Vora KS, Modi MP, Bhosale GP, Kadam PG, Shah PR, Gumber MR, Patel HV, Kute VB, Modi PR, Rizvi SJ, Vanikar AV, Trivedi HL. Intercity deceased donor renal transplantation: a single-center experience from a developing country. Saudi J Kidney Dis Transpl 2014; 24:1280-4. [PMID: 24231504 DOI: 10.4103/1319-2442.121283] [Citation(s) in RCA: 4] [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: 11/04/2022] Open
Abstract
In a developing country such as India, deceased donor renal transplantation (DDRTx) accounts for only about 1% of all renal transplants (RTx). Our institute initiated an intercity DDRTx in the year 2006, which significantly increased the number of RTx. We retrieved 74 kidneys from 37 deceased donors from various cities of Gujarat from January 2006 to December 2009. We transplanted the allografts in 66 recipients and a retrospective analysis of the donor profile and management and recipient outcome was performed. The mean age of the donors was 43.3 ± 18.8 years. The causes of death included road traffic accident in 51.35% of the donors and cerebrovascular stroke in 48.65% of the donors; 83.78% of the donors required ionotropes for hemodynamic stability in addition to vigorous intravenous fluid replacement. The average urine output of the donors was 350 ± 150 mL. The organs were perfused and stored in HTK solution. The mean cold ischemia time (CIT) was 9.12 ± 5.25 h. The mean anastomosis time in the recipient was 30.8 ± 8.7 min. 57.6% of the recipients established urine output on the operating table and 42.4% developed delayed graft function. At the end of 1 month after transplantation, the mean serum creatinine was comparable to the Ahmadabad city DDRTx, although the CIT was significantly longer in the intercity patients. Intercity organ harvesting is a viable option to increase the donor pool. Distance may not be an impediment, and good recipient outcome is possible in spite of prolonged CIT in case of proper harvesting and preservation.
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Affiliation(s)
- T R Mehta
- Department of Anesthesia and Critical Care, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Center (IKDRC) - Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS) Civil Hospital Campus, Asarwa, Ahmadabad, Gujarat, India
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Ghuge PP, Kute VB, Vanikar AV, Gumber MR, Gera DN, Patel HV, Shah PR, Modi PR, Shah VR, Trivedi HL. Successful renal transplantation from a brain-dead deceased donor with head injury, disseminated intravascular coagulation and deranged renal functions. Indian J Nephrol 2013; 23:448-51. [PMID: 24339525 PMCID: PMC3841515 DOI: 10.4103/0971-4065.120344] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Deceased donors (DDs) with the brain death due to head injury are the major source of organs for transplantation. The incidence of post-head injury disseminated intravascular coagulation (DIC) ranges from 24% to 50%. Many centers do not accept organs from donors with DIC due to increased risk of primary graft non-function and/or high chances of morbidity/mortality. We performed two successful renal transplants from a DD with head injury with DIC and deranged renal function. One of the recipients developed transient thrombocytopenia, but there was no evidence of DIC or delayed graft functions in either of the recipients. Over a follow-up of 1 month, both are doing well with stable graft function and hematological profile. Thus, a carefully selected DD with severe DIC even with deranged renal function is not a contraindication for organ donation if other risk factors for primary non-function are excluded. This approach will also help in overcoming organ shortage.
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Affiliation(s)
- P P Ghuge
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
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Dave SD, Vanikar AV, Trivedi HL, Thakkar UG, Gopal SC, Chandra T. Novel therapy for insulin-dependent diabetes mellitus: infusion of in vitro-generated insulin-secreting cells. Clin Exp Med 2013; 15:41-5. [PMID: 24317657 DOI: 10.1007/s10238-013-0266-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 11/20/2013] [Indexed: 12/20/2022]
Abstract
Insulin-dependent diabetes mellitus (IDDM) is a metabolic disease usually resulting from autoimmune-mediated β-cell destruction requiring lifetime exogenous insulin replacement. Mesenchymal stem cells (MSC) hold promising therapy. We present our experience of treating IDDM with co-infusion of in vitro autologous adipose tissue-derived MSC-differentiated insulin-secreting cells (ISC) with hematopoietic stem cells (HSC). This was an Institutional Review Board approved prospective non-randomized open-labeled clinical trial after informed consent from ten patients. ISC were differentiated from autologous adipose tissue-derived MSC and were infused with bone marrow-derived HSC in portal, thymic circulation by mini-laparotomy and in subcutaneous circulation. Patients were monitored for blood sugar levels, serum C-peptide levels, glycosylated hemoglobin (Hb1Ac) and glutamic acid decarboxylase (GAD) antibodies. Insulin administration was made on sliding scale with an objective of maintaining FBS < 150 mg/dL and PPBS around 200 mg/dL. Mean 3.34 mL cell inoculums with 5.25 × 10(4) cells/μL were infused. No untoward effects were observed. Over a mean follow-up of 31.71 months, mean serum C-peptide of 0.22 ng/mL before infusion had sustained rise of 0.92 ng/mL with decreased exogenous insulin requirement from 63.9 international units (IU)/day to 38.6 IU/day. Improvement in mean Hb1Ac was observed from 10.99 to 6.72%. Mean GAD antibodies were positive in all patients with mean of 331.10 IU/mL, which decreased to mean of 123 IU/mL. Co-infusion of autologous ISC with HSC represents a viable novel therapeutic option for IDDM.
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Affiliation(s)
- S D Dave
- Stem Cell Lab, Transplantation Biology Research Centre, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre (IKDRC)-Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad, 380016, Gujarat, India,
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Kute VB, Patel HV, Vanikar AV, Shah PR, Gumber MR, Balwani MR, Trivedi HL. Meningioma in long-term survivor after renal transplantation. Indian J Nephrol 2013; 23:393-4. [PMID: 24049287 PMCID: PMC3764725 DOI: 10.4103/0971-4065.116338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences (IKDRC ITS), Ahmedabad, India
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Abstract
Primary renal carcinoid tumor is extremely rare and, therefore, its pathogenesis and prognosis is not well known. We report a primary renal carcinoid in a 26-year-old man treated by radical nephrectomy.
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Affiliation(s)
- K V Kanodia
- Department of Pathology, Dr. H. L. Trivedi Institute of Transplantation Sciences, Gujarat, India.
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Kanodia KV, Vanikar AV, Shah PR, Trivedi HL. Renal transplantation in idiopathic thrombocytopenic purpura. Saudi J Kidney Dis Transpl 2013; 24:793-4. [PMID: 23816733 DOI: 10.4103/1319-2442.113890] [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: 11/04/2022] Open
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Marques IB, Silva RDM, Moraes CE, Azevedo LS, Nahas WC, David-Neto E, Furmanczyk-Zawiska A, Baczkowska T, Chmura A, Szmidt J, Durlik M, Joslin J, Blaker P, White B, Marinaki A, Sanderson J, Goldsmith DJ, Medani S, Traynor C, Mohan P, Little D, Conlon P, Molina M, Gonzalez E, Gutierrez E, Sevillano A, Polanco N, Morales E, Hernandez A, Praga M, Morales JM, Andres A, Park SJ, Kim TH, Kim YW, Kim YH, Kang SW, Kujawa-Szewieczek A, Szotowska M, Kuczera P, Chudek J, Wiecek A, Kolonko A, Mahrova A, Svagrova K, Bunc V, Stollova M, Teplan V, Hundt F, van Heteren P, Woitas R, Cavallo MC, Sepe V, Conte F, Albrizio P, Bottazzi A, Geraci PM, Alpay N, Gumber MR, Kute VB, Vanikar AV, Patel HV, Shah PR, Engineer DP, Trivedi HL, Golebiewska JE, Debska-Slizien A, Rutkowski B, Matias P, Martins AR, Raposo L, Jorge C, Weigert A, Birne R, Bruges M, Adragao T, Almeida M, Mendes M, Machado D, Masin-Spasovska J, Dohcev S, Stankov O, Stavridis S, Saidi S, Dejanova B, Rambabova-Busletic I, Dejanov P, Spasovski G, Nho KW, Kim YH, Han DJ, Park SK, Kim SB, Fenoglio R, Lazzarich EE, Cagna D, Cena T, Conti N, Quaglia M, Radin E, Izzo C, Stratta P, Oh IH, Park JS, Lee CH, Kang CM, Kim GH, Leone F, Lofaro D, Gigliotti P, Lupinacci S, Toteda P, Vizza D, Perri A, Papalia T, Bonofiglio R, di Loreto P, de Silvestro L, Montanaro D, Martino F, Sandrini S, Minetti E, Cabiddu G, Yildirim T, Yilmaz R, Turkmen E, Abudalal A, Altindal M, Ertoy-Baydar D, Erdem Y, Panuccio V, Tripepi R, Parlongo G, Versace MC, Politi R, Zoccali C, Mallamaci F, Porrini E, Silva I, Diaz J, Ibernon M, Moreso F, Benitez R, Delgado Mallen P, Osorio J, Lauzurica R, Torres A, Ersoy A, Koca N, Gullu Koca T, Kirhan E, Sarandol E, Ersoy C, Dirican M, Milne J, Suter V, Mikhail A, Akalin H, Dizdar O, Ersoy A, Pascual J, Torio A, Garcia C, Hernandez J, Perez-Saez MJ, Mir M, Anna F, Crespo M, Carta P, Zanazzi M, Antognoli G, Di Maria L, Caroti L, Minetti E, Dizdar O, Ersoy A, Akalin H, Ray DS, Mukherjee K, Bohidar NP, Pattanaik A, Das P, Thukral S, Kimura T, Yagisawa T, Ishikawa N, Sakuma Y, Fujiwara T, Nukui A, Gavela EE, Sancho AA, Kanter JJ, Avila AA, Beltran SS, Pallardo LL, Dawoud FG, Aithal V, Mikhail A, Majernikova M, Rosenberger J, Prihodova L, Nagyova I, Jarcuskova M, Roland R, Groothoff JW, van Dijk JP, van Agteren M, de Weerd A, van de Wetering J, IJzermans J, Betjes M, Weimar W, Popoola J, Reed A, Tavarro R, Chryssanthopoulou C, MacPhee I, Mayor M, Franco S, Jara P, Ayala R, Orue MG, Martinez A, Martinez M, Wasmouth N, Arik G, Yasar A, Turkmen E, Yildirim T, Altindal M, Abudalal A, Yilmaz S, Arici M, Bihari Bansal S, Pokhariyal S, Jain S, Sethi S, Ahlawat R, Kher V, Martins LS, Aguiar P, Dias L, Fonseca I, Henriques AC, Cabrita A, Davide J, Sparkes TM, Trofe-Clark J, Reese PP, Jakobowski D, Goral S, Doll SL, Abt PL, Sawinski D, MBloom RD, Knap B, Lukac J, Lukin M, Majcen I, Pavlovec F, Kandus A, Bren AF, Kong JM, Jeong JH, Ahn J, Lee DR, Son SH, Kim BC, Choi WY, Whang EJ, Czajka B, Malgorzewicz S, Debska-Slizien A, Rutkowski B, Panizo N, Rengel MA, Vega A, Abad S, Tana L, Arroyo D, Rodriguez-Ferrero M, Perez de Jose A, Lopez-Gomez JM, Koutroutsos K, Sackey J, Paolini L, Ramkhelawon R, Tavarro R, Chowrimootoo M, Whelan D, Popoola J, Szotowska M, Kuczera P, Chudek J, Wiecek A, Kolonko A, Slatinska J, Honsova E, Wohlfahrtova M, Slimackova E, Rajnochova SB, Viklicky O, Yankovoy A, Smith ISJ, Wylie E, Ruiz-Esteban P, Lopez V, Garcia-Frias P, Cabello M, Gonzalez-Molina M, Vozmediano C, Hernandez D, Pavlovic J, Radivojevic D, Lezaic V, Simic-Ogrizovic S, Lausevic M, Naumovic R, Ersoy A, Koca N, Kirhan E, Gullu Koca T, Ersoy C, Sarandol E, Dirican M, Sakhuja V, Gundlapalli S, Rathi M, Jha V, Kohli HS, Sharma A, Minz M, Nimgirova A, Esayan A, Kayukov I, Zuyeva E, Bilen Y, Cankaya E, Keles M, Gulcan E, Turkeli M, Albayrak B, Uyanik A, Yildirim R, Molitor N, Praktiknjo M, Woitas R, Abeygunaratne TN, Balasubramanian S, Baker R, Nicholson T, Toprak O, Sari Y, Keceli S, Kurt H, Rocha A, Malheiro J, Martins LS, Fonseca I, Dias L, Pedroso S, Almeida M, Henriques A, Nihei C, Bacelar Marques I, Seguro CA, David-Neto E, Mate G, Martin N, Colon L, Casellas L, Garangou D, de la Torre M, Torguet P, Garcia I, Calabia J, Valles M, Pruthi R, Calestani M, Leydon G, Ravanan R, Roderick P, Korkmaz S, Ersoy A, Gulten S, Koca N. Transplantation - clinical studies II. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft155] [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: 11/14/2022] Open
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Dave SD, Vanikar AV, Trivedi HL. Extrinsic factors promoting in vitro differentiation of insulin-secreting cells from human adipose tissue-derived mesenchymal stem cells. Appl Biochem Biotechnol 2013; 170:962-71. [PMID: 23633267 DOI: 10.1007/s12010-013-0250-y] [Citation(s) in RCA: 19] [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] [Received: 01/25/2012] [Accepted: 04/21/2013] [Indexed: 11/25/2022]
Abstract
Understanding of β cell regeneration is needed to develop new treatment modalities in diabetes mellitus. We present our experience of glucose-sensitive insulin-secreting mesenchymal stem cells (IS-MSC) generated and differentiated from human adipose tissue (h-AD) with application of specific differentiation media, sans xenogenic material. h-AD from donor abdominal wall was collected in proliferation medium composed of α-Minimum Essential Media, albumin, fibroblast-growth factor and antibiotics, minced, incubated in collagenase I at 37 °C with shaker and centrifuged. Supernatant and pellets were separately cultured in proliferation medium on cell + plates at 37 °C with 5 % CO(2) for 10 days. Cells were harvested, checked for viability, sterility, quantification, flow-cytometry (CD45(-)/90(+)/73(+)), and differentiated into insulin-expressing cells using medium composed of Dulbecco's modified eagle's medium, gene expressing upregulators and antibiotics for 3 days. They were studied for transcriptional factors paired box genes-6(Pax-6), islet 1 transcriptional factor (Isl-1), pancreatic and duodenal homobox-1(Pdx-1). C-peptide and insulin were measured by chemiluminescence. IS-MSC showed presence of all three transcriptional factors and showed rise in insulin and c-peptide level in presence of glucose stimuli. It can be concluded that the specific extrinsic factors used in the defined differentiation media effectively and safely promote differentiation of glucose-sensitive insulin-secreting cells from human adipose tissue, without any genetic modulation.
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Affiliation(s)
- S D Dave
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute Of Kidney Diseases & Research Centre (IKDRC)- Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad 380016 Gujarat, India.
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Patel MP, Kute VB, Gumber MR, Gera DN, Shah PR, Patel HV, Trivedi HL, Vanikar AV. Plasmodium vivax malaria presenting as hemolytic uremic syndrome. Indian J Nephrol 2013; 23:74-5. [PMID: 23580813 PMCID: PMC3621247 DOI: 10.4103/0971-4065.107217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- M P Patel
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Centre, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Shah PR, Kute VB, Gumber MR, Patel HV, Patel MP, Yadav DK, Vanikar AV, Trivedi HL. Benzene hexachloride poisoning with rhabdomyolysis and acute kidney injury. Indian J Nephrol 2013; 23:80-1. [PMID: 23580818 PMCID: PMC3621252 DOI: 10.4103/0971-4065.107222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- P R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences [IKDRC-ITS], Ahmedabad, Gujarat, India
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Kute VB, Shah PR, Shrimali JD, Gumber MR, Patel HV, Vanikar AV, Trivedi HL. Nephrotic syndrome after thymectomy for myasthenia gravis. Indian J Nephrol 2013; 23:75-6. [PMID: 23580814 PMCID: PMC3621248 DOI: 10.4103/0971-4065.107218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, India
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Vanikar AV, Kanodia KV, Patel RD, Suthar KS, Patel HV, Gumber MR, Trivedi HL. Authors' reply. Indian J Pediatr 2013; 80:358. [PMID: 23671923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
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Abstract
Nephrotic syndrome in infancy and childhood can be associated with thromboembolic complications. We describe two cases of nephrotic syndrome who presented with non-specific findings. Magnetic resonance imaging brain with magnetic resonance venography showed thrombosis of multiple venous sinuses. Patients were successfully treated with anticoagulants and there was complete resolution of thrombosis on repeat imaging.
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Affiliation(s)
- D N Gera
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Institute of Transplantation Sciences [IKDRC-ITS], Ahmedabad, Gujarat, India
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Kute VB, Patel HV, Vanikar AV, Patel MP, Shah PR, Gumber MR, Trivedi HL. Everolimus for the treatment of CD20+ diffuse large B-cell lymphoma in a renal allograft recipient. Indian J Nephrol 2013; 22:486-8. [PMID: 23436965 PMCID: PMC3573500 DOI: 10.4103/0971-4065.106052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India
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Vanikar AV, Suthar KS, Kute VB, Rizvi SJ, Trivedi HL. Incidentally detected lymphatic filariasis in a renal allograft recipient. Int J Organ Transplant Med 2013; 4:123-4. [PMID: 25013664 PMCID: PMC4089319] [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: 11/23/2022] Open
Abstract
Post-transplntation lymphocele is a well known complication, and lymphatic filariasis (LF) has occasionally been found to present as post-transplantation lymphocele. However, incidentally detected LF during transplantation surgery has not been reported. We present an incidentally detected LF presenting as enlarged lymph node in the right iliac fossa of a recipient during transplantation of donor kidney. He was subsequently treated after transplantation and had stable graft function without any complications after 8 months of follow-up.
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Affiliation(s)
- A. V. Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, ,Correspondence: Aruna V Vanikar, MD, Professor and Head, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R.Doshi and K.M. Mehta Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Civil hospital campus, Asarwa, Ahmedabad, India. Tel: +91-79-2268-7152/7153, Fax: +91-79-2268-5454, E-mail:
| | - K. S. Suthar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology,
| | - V. B. Kute
- Department of Nephrology and Clinical Transplantation,
| | - S. J. Rizvi
- Department of Urology and Transplantation, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS), Ahmedabad, India.
| | - H. L. Trivedi
- Department of Nephrology and Clinical Transplantation,
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Gera DN, Ghuge PP, Gandhi S, Vanikar AV, Shrimali JD, Kute VB, Trivedi HL. Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child. Indian J Nephrol 2013; 23:456-9. [PMID: 24339527 PMCID: PMC3841517 DOI: 10.4103/0971-4065.120346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated genetic or inherited risk factors.
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Trivedi HL, Vanikar AV, Kute VB, Patel HV, Gumber MR, Shah PR, Dave SD, Trivedi VB. The effect of stem cell transplantation on immunosuppression in living donor renal transplantation: a clinical trial. Int J Organ Transplant Med 2013; 4:155-62. [PMID: 25013669 PMCID: PMC4089327] [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: 11/24/2022] Open
Abstract
BACKGROUND/OBJECTIVE We designed a clinical trial on a group of live-donor renal transplantation (LDRT) patients subjected to pre-transplant stem cell transplantation (SCT) to minimize immunosuppression to low-dose steroid monotherapy. METHODS LDRT patients subjected to pretransplant SCT who had stable graft function for ≥2 years and serum creatinine (SCr) <2 mg/dL were recruited. Patients with diabetes, hepatitis C/B, rejections, or unwilling to participate, were excluded. They had been subjected to non-myeloablative conditioning of total lymphoid irradiation (TLI)/bortezomib and cyclophosphamide, rabbit-antithymocyte globulin (r-ATG) and rituximab with SCT. The maintenance immunosuppression consisted of calcineurin inhibitors (CNI) and/or anti-proliferative agents and prednisone. Donor-specific antibodies (DSA) and peripheral T-regulatory cells (CD127(low/-)/4(+)/25(high)) (p-Tregs) were studied before and after withdrawal of major immunosuppressants; graft biopsy was taken after 100 days of withdrawal in willing patients. Rejections were planned to be treated by anti-rejection therapy followed by rescue immunosuppression. RESULTS All immunosuppression but prednisone, 5-10 mg/day has been successfully withdrawn for a mean of 2.2 years in 76 patients with a mean age of 31.4 years and a mean donor-recipient HLA match of 2.9. The mean SCr of 1.4 mg/dL and p-Tregs of 3.5% was remained stable after withdrawal; DSA status was negative in 35.5% and positive in 47.4% patients. Protocol biopsies in all 10 patients who gave the consent were unremarkable. CONCLUSION Stable graft function in LDRT on low-dose steroid monotherapy using pre-transplant SCT under non-myeloablative conditioning with generation of p-Tregs can be achieved successfully and safely.
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Affiliation(s)
- H. L. Trivedi
- Department of Nephrology and Transplantation Medicine,
| | - A. V. Vanikar
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS), Asarwa, Ahmedabad-380016, Gujarat, India
| | - V. B. Kute
- Department of Nephrology and Transplantation Medicine,
| | - H. V. Patel
- Department of Nephrology and Transplantation Medicine,
| | - M. R. Gumber
- Department of Nephrology and Transplantation Medicine,
| | - P. R. Shah
- Department of Nephrology and Transplantation Medicine,
| | - S. D. Dave
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS), Asarwa, Ahmedabad-380016, Gujarat, India
| | - V. B. Trivedi
- Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS), Asarwa, Ahmedabad-380016, Gujarat, India
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Sainaresh VV, Jain SH, Engineer DP, Patel HV, Shah PR, Trivedi HL. Laproscopic salvage of omental wrapping of the continuous ambulatory peritoneal dialysis catheter. Indian J Nephrol 2012; 22:68-9. [PMID: 22279354 PMCID: PMC3263075 DOI: 10.4103/0971-4065.83031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- V V Sainaresh
- Department of Nephrology and Transplantation, Dr. H L Trivedi Institute of Transplantation Sciences (ITS)- Smt. Gulabben Rasiklal Doshi and Smt. Kamlaben Mafatlal Mehta Institute of Kidney Diseases & Research Centre (IKDRC), Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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Kute VB, Shah PR, Munjappa BC, Gumber MR, Patel HV, Jain SH, Engineer DP, Naresh VVS, Vanikar AV, Trivedi HL. Outcome and prognostic factors of malaria-associated acute kidney injury requiring hemodialysis: A single center experience. Indian J Nephrol 2012; 22:33-8. [PMID: 22279340 PMCID: PMC3263060 DOI: 10.4103/0971-4065.83737] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Acute kidney injury (AKI) is one of the most dreaded complications of severe malaria. We carried out prospective study in 2010, to describe clinical characteristics, laboratory parameters, prognostic factors, and outcome in 59 (44 males, 15 females) smear-positive malaria patients with AKI. The severity of illness was assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) score, Multiple Organ Dysfunction Score (MODS), and Glasgow Coma Scale (GCS) scores. All patients received artesunate and hemodialysis (HD). Mean age of patients was 33.63 ± 14 years. Plasmodium falciparum malaria was seen in 76.3% (n = 45), Plasmodium vivax in 16.9% (n = 10), and mixed infection in 6.8% (n = 4) patients. Presenting clinical features were fever (100%), nausea-vomiting (85%), oliguria (61%), abdominal pain/tenderness (50.8%), and jaundice (74.5%). Mean APACHE II, SOFA, MODS, and GCS scores were 18.1 ± 3, 10.16 ± 3.09, 9.71 ± 2.69, and 14.15 ± 1.67, respectively, all were higher among patients who died than among those who survived. APACHE II ≥20, SOFA and MODS scores ≥12 were associated with higher mortality (P < 0.05). 34% patients received blood component transfusion and exchange transfusion was done in 15%. Mean number of HD sessions required was 4.59 ± 3.03. Renal biopsies were performed in five patients (three with patchy cortical necrosis and two with acute tubular necrosis). 81.3% of patients had complete renal recovery and 11.8% succumbed to malaria. Prompt diagnosis, timely HD, and supportive therapy were associated with improved survival and recovery of kidney functions in malarial with AKI. Mortality was associated with higher APACHE II, SOFA, MODS, GCS scores, requirement of inotrope, and ventilator support.
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Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Institute of Transplantation Sciences, IKDRC-ITS, Ahmedabad, India
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Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Godara SM, Munjappa BC, Sainaresh VV, Engineer DP, Jain SH, Modi PR, Shah VR, Trivedi VB, Trivedi HL. Post-renal transplant cytomegalovirus infection: study of risk factors. Transplant Proc 2012; 44:706-9. [PMID: 22483473 DOI: 10.1016/j.transproceed.2011.12.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Cytomegalovirus (CMV) is a common opportunistic infection following renal transplantation (RTx). It responds promptly to antiviral treatment. The mortality rate reaches 90% if untreated. Identification of risk factors helps in the early diagnosis of CMV. We studied demographic features, risk factors, and outcomes associated with CMV infection in RTx recipients despite ganciclovir prophylaxis. MATERIALS AND METHODS We reviewed 720 RTx recipients between 2007 and 2009. We examined the serostatus of the donor and recipient before transplantation using an enzyme-linked immunosorbent assay, and diagnosed CMV infections in recipients by CMV DNA detection with a polymerase chain reaction. RESULTS A total of 42 of 750 (5.6%) patients were identified to display CMV infection (69.1%) or disease (30.9%). Their mean age was 34 ± 13.5 years, with 80.9% men. CMV serologic status was D+/R- in 21.4% and D+/R+ in 59.5% patients. Fever, malaise (76.2%), and leukopenia (52.3%) were the commonest presenting symptoms; diabetes (30.9%) and hepatitis C virus (28.6%) the commonest comorbid conditions. Risk factors were triple drug immunosuppression (47.6%), antithymocyte globulin ATG induction (54.8%), and a rejection episode (26.1%) and methylprednisolone (76.2%) which were more common in CMV disease than infection. Mean CMV DNA at diagnosis was 78,803; 71.2% patients developed CMV within 6 months posttransplantation, the majority occurring after 3 months. With a mean follow-up of 4 ± 1.9 years, patient and graft survival rates were 85.7% and 81% with a mean serum creatinine value of 1.83 ± 12 mg/dL. CONCLUSIONS Universal CMV prophylaxis was associated with a low incidence (5.6%) and mild form of CMV disease among our patients.
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Affiliation(s)
- V B Kute
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India.
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Shah PR, Modi PR, Kute VB, Vanikar AV, Patel HV, Gumber MR, Shah VR, Trivedi HL. World kidney day 2010: medical aspects of 10 live-donor renal transplantations in a single center from a developing country. Transplant Proc 2012; 44:47-8. [PMID: 22310575 DOI: 10.1016/j.transproceed.2011.11.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND World Kidney Day (WKD) has become the most widely celebrated event associated with kidney disease in the world and the most successful effort to raise awareness among both the general public and government health officials about the dangers of kidney disease. We celebrated WKD 2010 in a unique way by performing 10 live-donor renal transplantations (RTx) on March 11, 2010. PATIENTS AND METHODS We report a single-center experience on RTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr) level, and rejection episodes in 10 live-donor RTx performed on WKD. Recipient diseases leading to end-stage renal disease (ESRD) were chronic glomerulonephritis (60%), benign nephrosclerosis (20%), and chronic interstitial nephritis (20%). Mean recipient age was 35 ± 8.7 years. Nine recipients were males. Mean donor age was 37 ± 8.7 years, Nine donors were females. Donors were spouse (n = 6), mother (n = 2), sister (n = 1), and extended family member (n = 1), with mean HLA match 1.8 ± 1.48. All patients received steroids, calcinueurin inhibitors, and mycophenolate mofetil/azathioprime for maintenance immunosuppression. RESULTS During a mean follow-up time of 18 months, patient and graft survival rates were 90% and 90%, respectively, with a mean SCr level of 1.21 mg/dL; 20% had biopsy-proven acute rejection. One patient died due to infection after antirejection therapy. CONCLUSION RTx has acceptable graft and patient survival. RTx is the best cost-effective therapeutic modality for patients suffering from ESRD and should be encouraged in view of organ shortage on events such as WKD. To our knowledge, this is the first report from a developing country on 10 successful RTx on WKD.
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Affiliation(s)
- P R Shah
- Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center and the Institute of Transplantation Sciences, Ahmedabad, India
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Gumber MR, Kute VB, Goplani KR, Shah PR, Patel HV, Vanikar AV, Modi PR, Trivedi HL. Deceased donor organ transplantation: A single center experience. Indian J Nephrol 2011; 21:182-5. [PMID: 21886978 PMCID: PMC3161436 DOI: 10.4103/0971-4065.82636] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Renal transplantation (RTx) is the best therapeutic modality for patient suffering from end-stage renal disease (ESRD). Deceased donor organ transplantation (DDOT) accounts for <4% of RTx in India. We report 4 years single centre experience on DDOT vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr), rejection episodes, and delayed graft function in 160 DDOT. Between January 2006 to December 2009, 160 RTx from 89 donors were performed, of which 25.2% were expanded criteria donors. Majority of the donors were brain dead due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (49%), diabetes mellitus (10%), and benign nephrosclerosis (10%). Mean recipient/donor age was 35.6±14.68 and 44.03±18.19 years. Mean dialysis duration pretransplantation was 15.37±2.82 months. Mean cold ischemia time was 5.56±2.04 hours. All recipients received single dose rabbit-anti-thymocyte globulin induction and steroids, mycophenolate mofetil/calcinueurin inhibitor for maintenance of immunosuppression. Delayed graft function was observed in 30.6% patients and 14% had biopsy proven acute rejection. Over mean follow-up of 2.35±1.24 years, patient and graft survival rates were 77.5% and 89.3% with mean SCr of 1.40±0.36 mg/dl. DDOT has acceptable graft/patient survival over 4 years follow-up and should be encouraged in view of organ shortage.
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Affiliation(s)
- M R Gumber
- Department of Nephrology and Clinical Transplantation, Dr. H. L. Trivedi Institute of Transplantation Sciences (ITS), Institute of Kidney Diseases and Research Centre (IKDRC), Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India
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Kaswan KK, Vanikar AV, Feroz A, Patel HV, Gumber M, Trivedi HL. Nocardia infection in a renal transplant recipient. Saudi J Kidney Dis Transpl 2011; 22:1203-1204. [PMID: 22089782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Opportunistic infection occurs in up to 20% renal transplant patients and is associated with a high mortality. We report a 47-year-old diabetic female with 1-year-old deceased donor renal allograft on triple drug immunosuppression. She developed cytomegalovirus retinitis at ten months post-transplant followed by nocardiasis manifested by hemiparesis with comatose state due to lumbar epidural and multiple brain abscesses, in spite of immediately curtailing immunosuppression. She recovered with linezolid and cotrimoxazole and was discharged two weeks later. She is maintaining stable graft function with serum creatinine 1.4 mg/dL on cyclosporin 2.5 mg/kg/day and prednisone10 mg/day with maintenance therapy for nocardiasis.
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Affiliation(s)
- K K Kaswan
- Department of Nephrology and Transplantation Medicine, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases & Research Centre, Ahmedabad, Gujarat, India
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