A Rare Cause of Diarrhea in a Kidney Transplant Recipient: Dipylidium caninum.

We report the first case of dipylidiasis in a kidney transplant recipient. Watery diarrhea due to Dipylidium caninum was observed in a male patient who had been undergone kidney transplantation 2 years before. The patient was successfully treated with niclosamide. D. caninum should be considered as an agent of diarrhea in transplant patients.

A kidney transplant center's initial experiences in eastern Turkey.

OBJECTIVES: Kidney transplantation is the best treatment method associated with improved quality of life and better survival for patients with end-stage renal disease. We started performing kidney transplantations in November 2010. We have performed 19 kidney transplantations so far. Fourteen of these were from living donors and five from deceased donors. Here, we present our initial experiences with 14 kidney transplant recipients from living donor kidney transplantations. MATERIALS AND METHODS: All recipients and their donors underwent detailed clinical history and examination. Recipients and their donors were followed in the transplant clinic during hospitalization. RESULTS: The male-to-female ratio was 11:3 in recipients. The mean age of recipients was 27.8 years (range 4-58 years). The number of the related, emotionally related, and unrelated transplantations were 9, 3, 2, respectively. The mean warm ischemic time was 95.7 seconds (range 52-168 seconds). Urine output started immediately after vascular anastomosis in all. The mean time of discharge from hospital was postoperative day 8 (range 4-18 days). The mean flow up was 125 days (range 18-210 days). Graft survival was 100% in this period, but one patient died from sepsis after 56 days. No kidney was lost from rejection, technical causes, infection, or recurrent disease. CONCLUSION: If transplant centers are as equipped and experienced as ours, kidney transplant programs should be started immediately so that they can reduce the number of the patients in waiting list for kidney transplantation.

En bloc and dual kidney transplantation: two initial cases from a new kidney transplantation center.

AIM: The aim of this study was to share our initial successful experiences with en bloc dual kidney transplantation. CASES: En bloc kidney were obtained, for case 1 from a 3-year-old deceased pediatric donor who had undergone cadaveric liver transplantation due to fulminant hepatitis A virus infection 1 week prior. The donor length was 97 cm and weight 13 kg. According to the age and weight of the donor, we selected a 50-year-old respectively. For case 2, a kidney was retrieved from a 20-month-old pediatric donor after development of hypoxic brain injury secondary to status epilepticus. The donor length and weight were 75 cm and 13 kg respectively. A 30-year-old female patient was of 162 cm and 59 kg. The suprarenal aorta, suprarenal vena cava, and caval and aortic lumbar branches were closed with running sutures during the backtable procedures. After the classic Gibson incision, the donor aorta was anastomosed to the recipient right common iliac artery, and the donor inferior vena cava to the recipient right common iliac vein in end-to-side fashion. The ureters were implanted with mucosa-to-mucosa ureteroneocystostomies separately according to the Lich-Gregoir technique. After the vascular anastomoses the kidneys had immediate good perfusion in both cases. Postoperative recovery was rapid, the recipients were discharged uneventfullly. CONCLUSION: En bloc dual kidney transplantation from young pediatric patients to adult recipients can be performed with low mortality and morbidity even by new centers.

Melatonin prevents oxidative stress and inhibits reactive gliosis induced by hyperhomocysteinemia in rats.

Homocysteine (Hcy), an independent risk factor for atherosclerosis, undergoes auto-oxidation and generates reactive oxygen species, which are thought to be main cause of Hcy neurotoxicity. However, the mechanisms leading to neurodegenerative disorders are poorly understood because studies that have investigated the potential neurotoxicity of hyperhomocysteinemia in vivo are scarce. The purpose of this study was to test whether daily administration of methionine, which induces hyperhomocysteinemia, causes glial hyperactivity, and also to investigate the protective effects of melatonin on the brain tissue against oxidative stress of Hcy in rats. There was a significant development of oxidative stress as indicated by an increase in malondialdehyde + 4-hydroxyalkenals in hippocampus and cortex of hyperhomocysteinemic rats, whereas significant reduction was found in the activity of glutathione peroxidase (GSH-Px). Co-treatment with melatonin inhibited the elevation of lipid peroxidation and significantly increased GSH-Px activity in the brain regions studied. Western blot analysis revealed an increase in glial fibrillary acidic protein (GFAP) contents both in hippocampus and frontal cortex (p < 0.001) of hyperhomocysteinemic rats compared to the controls. Administration of melatonin significantly decreased GFAP contents in hippocampus and cortex (p < 0.05). S100B contents increased only in frontal cortex in hyperhomocysteinemic rats compared to the control (p < 0.01) and was inhibited by melatonin treatment (p < 0.01). The present findings show that Hcy can sensitize glial cells, a mechanism which might contribute to the pathogenesis of neurodegenerative disorders, and further suggest that melatonin can be involved in protecting against the toxicity of Hcy by inhibiting free radical generation and stabilizing glial cell activity.