Early surgical complications after allograft kidney transplantation: incidence and management

Kidney transplantation has been established as the most efficient treatment of end stage renal disease with the advantage for the patient to live a nearly healthy life. Surgical complications are common in both the immediate postoperative period and later after kidney transplantation. But these complications when managed accordingly had no effect on the graft survival. We studied the incidence and management of early surgical complications; that occurred within the first month after transplantation, in 213 kidney transplanted patients. A cross sectional descriptive study including 213 patients with renal failure underwent allograft kidney transplantation from October 2003 to October 2010, in the renal transplant center, medical city teaching hospital, Baghdad. Focusing on the incidence and management of early surgical complications; that occurred within the first month after kidney transplantation. 213 patients, 144[67.6%] were males, 69[32.4%] were females. The age range of the donors was 18y-55years [mean 30.39 +/- 9.32], While the age range of the recipients was 7y-66y [mean 31.40 +/- 11.35]. 121[56.9%] were unrelated donors, 92 [43.2%] were related donors. The reported surgical complications were, urinary tract infection in 80[37.5%] patients, Urine leak 8[3.8%], Lymphocele 2[0.9%], Wound seroma 2[0.9%], Wound hematoma 1[0.5%], Wound infection 1[0.5%], Small bowel injury 1[0.5%], Acute pancreatitis 1 [0.5%], acute gastric erosion 1 [0.5%], Postoperative bleeding 1 [0.5%], Deep venous thromboses 3[1.4%], Intemal dissection of the renal artery with the formation of intemal flap 1 [0.5%], Arterial thromboses 1[0.5%] per-operatively, Venous thromboses 1[0.5%] per-operatively, No mortality, or graft loss happened because of these surgical complications. The one-month patient survival was 98%, and graft survival was 97%. Surgical complications occur in both the immediate postoperative period and later after kidney transplantation. But these complications had no effect on the graft survival, when managed accordingly

How to decrease the prevalence of hepatitis C in Iraqi hemodialysis patients

Hepatitis C virus infection has been recognized as an emerging problem in dialysis patients, its prevalence varies considerably among different areas of the world. The prevalence of HCV infection in hemodialysis patients and its associated risk factors is not well documented in our country. We performed this study aiming to discuss prevention of further transmission of HCV infection among our patients. We performed this study aiming to discuss prevention of further transmission of HCV infection among our patients. A cross sectional study done between September 2003 - December 2008 in the Renal Transplant Center, Medical City Teaching Hospital, Baghdad. Including 244 patients with end stage renal failure and had been on hemodialysis for more than 3 months, focusing on the prevalence of anti-HCV positive patients, and the associated risk factors. 153[62.7%] were males, and 91[37.3%] were females, with age range 14-67 years. The prevalence of anti-HCV positive patients was 12[4.9%], dialysis in different centers, female sex, > 60 years age, < 6 months on dialysis, blood transfusion, and < 9 hours per week haemodialysis were significant predictors of anti-HCV positivity. We conclude that adherence to universal infection precautions; HCV screening of transfusions and of patients on hemodialysis; and the use of separate machines in separate rooms for those who are anti-HCV positive, was important factors, To further reduce the prevalence in our patients, erythropoietin should replace blood transfusions, also to test for HCV RNA using polymerase chain reaction before starting hemodialysis

Hydatid disease of the vermiform appendix

A 50-year old woman came with a six-month history of a right iliac fossa painful palpable mass. Abdominal ultrasonography and computerized tomography revealed a calcified cystic mass. At laparotomy, the cystic mass was an enlarged appendix, containing a hydatid cyst without any other organ involvement. This is a rare manifestation of this disease