ABSTRACT
Renal transplantation is the best option for treatment of the end-stage renal diseases and has more advantages than dialysis. The objective of this study was to determine the ten-year graft survival rate of renal transplantation and its contributing factors among a group of Iranian patients aged 18 years or younger. In a retrospective cohort we aimed to study the ten-year graft survival rate of renal transplantation and its contributing factors among pediatric patients who have been transplanted from March 1999 to March 2009 in Shiraz Namazi Hospital Transplantation Center, southern Iran. Kaplan-Meier method was used to determine the survival rate, log rank test to compare survival curves, and Cox regression model to determine hazard ratios and to model variables affecting survival. The 1, 3, 5, 7 and 10 year-graft survival rates were 96.8, 88.8, 82.8, 78.1, 78.1 percent, respectively. Cox regression model revealed that the duration of hospitalization was one of the important factors in graft survival rate in renal transplantation. In this study, the 10 year-graft survival rate for pediatric renal transplantation was 78.1%. Graft survival was significantly related to hospital stay after the operation. Donor source, cold ischemia time, immunosuppressive drugs regimen, time to diuresis, and cause of ESRD did not influence the survival rate.
ABSTRACT
Squamous cell carcinoma of the gallbladder is rare and constitutes only 0.5-3% of all malignancies of this organ. Most of the reported cases have had a component of adenocarcinoma. We report a 70-year-old man who presented with acute onset right upper quadrant pain. He operated on based on a presumptive diagnosis of acute cholecystitis according to clinical and ultrasonographic findings. Histopathological examination of the infiltrating mass of the gallbladder revealed well differentiated keratinized squamous cell carcinoma invading full wall thickness. Thorough evaluations revealed no other primary site for the tumor. Pure primary squamous cell carcinoma of the gallbladder is rarely reported. Clinicians and pathologists must be aware of its vague clinical presentations
ABSTRACT
This study aimed to compare outcomes of kidney transplantation in patients with systemic lupus erythematosus [SLE] and a matched control group of non-SLE kidney recipients. In a case-control study, 33 patients with kidney transplantation due to end-stage renal disease caused by SLE were matched to a control group consisted of 33 non-SLE patients who had been transplanted during the same period of time in our center. The clinical characteristics, complications, and patient and graft survival were compared between the two groups. In each group, 12 patients [36.4%] received a kidney from a deceased donor, 15 [45.4%] from a living unrelated donor, and 6 [18.2%] from a living related donor. There was no significant difference between the outcome in SLE patients and duration of dialysis before transplantation. The mean duration of hospital stay was 23.4 +/- 18.1 days in the SLE group, while it was 13.0 +/- 7.3 days in the controls [P = .006]. One-year graft survival was 79.0% in patients with SLE and 90.9% in non-SLE patients [P = .17]. One-year patient survival was 93.9% in patients with SLE versus 81.8% in the controls [P = .26]. Nine patients in the SLE group versus 11 patients in the control group developed posttransplant complications [P = .59]. Although hospital stay after transplantation was longer in the SLE kidney recipients than controls, safety of kidney transplantation was comparable. Graft failure in the SLE patients was not significantly different between patients with different sources of kidneys
Subject(s)
Humans , Male , Female , Lupus Erythematosus, Systemic , Treatment Outcome , Case-Control Studies , Kidney Failure, ChronicABSTRACT
Although liver abscess is more prevalent in developing countries than in developed countries, there is scant data about the characteristics of pediatric liver abscess in our region. We aimed to analyze the characteristics of pediatric liver abscess in our region and compare these with those of developed countries. The clinical features, laboratory, imaging, microbiologic findings, management strategy, and final outcome were extracted from the patients' records retrospectively. There were 18 cases of liver abscess including 16 pyogenic liver abscess, one amebic liver abscess and one candida liver abscess. Fever and abdominal pain were the most common clinical findings and leukocytosis was the most common laboratory finding. The most predisposing factors of liver abscess were immune deficiency, minor thalassemia. Origin of liver abscess was appendicitis in two patients, the rest were considered as cryptogenic. While one patient was treated with antibiotics alone, five cases were taken for open drainage, and 12 cases were treated with percutaneous aspiration. Percutaneous aspiration failed in two patients who were later taken for open drainage, with an overall mortality rate of 5.5%. The overall characteristics of liver abscess in children in our society are not so different from developed countries. However, in contradiction to case reported in developed countries, most cases of liver abscess were seen in healthy patients in our centre. Moreover, liver abscess was reported in our patients at a younger age and was more commonly seen in male children. Mortality rate was similar to that of developed countries
ABSTRACT
Kidney transplantation is the treatment of choice for end stage renal disease that restores the patients' quality of life and reduces the morbidity and mortality rates induced by renal failure and its complications. The aim of this study is to determine the ten-year graft cumulative survival rate of renal transplantation in patients who have been transplanted from March 1999 to March 2009 in Shiraz Nemazi Hospital Transplantation Center, Iran. This is a retrospective cohort study designed to determine the organ survival rate after kidney transplantation and its relationship with age and gender of recipients and donors, during a period of 10 years [March 1999 to March 2009] in 1356 patients, Shiraz transplant center, Namazi hospital, Shiraz, Iran. Kaplan-Meier method was used to determine the graft cumulative survival rate and log-rank test was used to assessment difference between survival curves in subgroups. Mean follow-up period was 47.23 +/- 33.3 months. Ten years graft cumulative survival rate of kidney transplantation calculated by Kaplan-Meier method was 85.8% [95% CI=85.78 - 85.81]. Age of recipients and donors were showed significant relationship with survival rate of renal allograft. Renal transplantation is one of the important therapeutic strategies in end stage renal disease, and chosen the appropriate donor, can improve the graft cumulative survival rate. The based on this study results, we found no significant relationship between donor and recipients' sex with graft cumulative survival rate, but the relationship between age of donor and recipient and graft cumulative survival rate were significant
ABSTRACT
Recently there are a number of reports on the cardiotoxicity of tacrolimus in post-transplant patients. There is no protocol for cardiovascular evaluation in these patients. This study was performed to evaluate the cardiotoxicity of tacrolimus in liver transplant recipients. We evaluated 63 post-liver transplant patients who received tacrolimus. They were evaluated for cardiovascular complications by physical examination, electrocardiographic and echocardiographic examinations within three and six months following liver transplantation. Serum tacrolimus levels were checked by ELISA. For comparison, we selected 50 post-liver transplant patients who received no tacrolimus and evaluated them for cardiovascular function identically. Among 63 patients, 42 were male [66.7%] and 21 were female [33.3%] 70% of the patients were adults, and 19 [30%] were within the pediatric age group. The cardiovascular examinations, electrocardiogram and echocardiography of all patients three months post-transplantation were normal except for two children who developed tacrolimus related cardiac complications. Both had high serum tacrolimus levels. No adults developed cardiovascular complications. In the control group, the results of the cardiovascular evaluations were normal in all cases. The cardiovascular toxicity of tacrolimus, such as hypertrophic cardiomyopathy, may be observed in pediatric patients. Therefore, we recommend routine regular cardiovascular evaluation of children after liver transplantation