Heart transplantation in Iran; a comprehensive single-center review of 15-year performance

Heart transplantation in Iran was first performed in July 1993. Since then, Shariati Hospital, affiliated to Tehran University of Medical Sciences, has been representing the most active center of cardiac transplantation in Iran and one of the major sites in the Middle East. This is a comprehensive review of our 15-year practice registry to make a scheme of our record and achievements. Clinical data on all consecutive transplanted patients from the Department of Cardiac Surgery, Shariati Hospital, Tehran, Iran over the last 15 years were reviewed. Descriptive and analytical statistics were extracted in regard to recipients, donors, surgical characteristics, and current status of the patients on follow-up. Totally, 90 patients were transplanted since 1993; 11, 32, and 47 in three five-year periods, respectively. The mean age of the recipients was 29.30 +/- 13.17 years. Motor-vehicle accident was the main cause of brain death of donors [48.8%]. The most common indication for surgery was idiopathic dilated cardiomyopathy [75.5%].The mean survival rate has been 6.66 +/- 0.87 years. One-year and five-year survivals had a rising trend through the five-year periods. Acute allograft rejection and infection were the two major events complicating our transplants. This study shows that despite a vast variety of obstacles, we have passed the primitive milestones. The number of transplants is increasing at a higher rate in recent years, and patients' survival rates and outcomes seem to be improving

Pleuropulmonary manifestations in juvenile systemic lupus erythematosus; a review and descriptive study in 64 cases

Juvenile systemic lupus erythematosus [JSLE] is a multisystemic autoimmune disease that can involve multiple organs such as: skin, kidney, musculoskeletal system, brain, and others as well as lung. Pulmonary manifestations may be an initial and/or life-threatening complication of SLE in children. The aim of this report is to describe the first pleuropulmonary manifestation of childhood lupus erythematosus. We studied retrospectively 64 children with JSLE, diagnosed as JSLE at the Children's Medical Center Hospital between 1995 and 2005. All met the American College of Rheumatology [formerly American Rheumatism Association, ARA] revised criteria for SLE. They were evaluated for evidence of pleuro-pulmonary involvement. During the 10-yr study period, 64 patients were diagnosed as childhood-onset JSLE, who had the disease at or before the age of 16 [3-16 years]. Fifty five patients [86%] were females and 9 patients [14%] were males [female: male ratio=6/1]. Mean age of this group at the onset of the disease was 10 years [range 3-16]. Eighteen cases [28%] had pulmonary involvement. Pulmonary complications include: infectious pneumonia in 38%, pleuritis in 33%, pulmonary vasculitis in 11%, and acute lupus pneumonitis, chronic interstitial pneumonitis and pulmonary embolism [so-called lupus anticoagulant] each one in 5.5%. The prevalence of pulmonary involvement in patients with JSLE varies according to the method used, but clinically significant pulmonary involvement in our series occurs in approximately 28%. There is few data regarding the treatment for most of the immune mediated pulmonary manifestations of JSLE