فهرست مطالب

Organ Transplantation Medicine - Volume:6 Issue: 3, Summer 2015

International Journal of Organ Transplantation Medicine
Volume:6 Issue: 3, Summer 2015

  • تاریخ انتشار: 1394/05/12
  • تعداد عناوین: 7
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  • A. Heidary Rouchi, M. Mahdavi, Mazdeh Page 93
    Since the beginning of organ/tissue transplantation, the therapeutic modality of choice in endstage organ failure, organ shortage has been the main problem in transplantation medicine. Given the so far unsolved obstacle, all hope-raising procedures to possibly tackle this longlasting problem can draw attentions. In this context, “regenerative medicine” sounds to be more promising compared to other approaches. To consider the huge impact of hematopoietic stem cell transplantation on the treatment of some congenital or acquired hematological or metabolic disorders and some advances to produce tissue engineered materials on one hand, and to take all aspects of this emerging and costly interdisciplinary field of research into consideration, on the other hand, inevitably makes this reality unchanged, in particular in countries with low or middle income, that allograft (from deceased or living donors) will remain for years as the irreplaceable source of organ transplantation.
  • T. Foroutan, M. Najmi, N. Kazemi, M. Hasanlou, A. Pedram Page 99
    Background
    In regenerative medicine, use of each of the mesenchymal stem cells derived from bone marrow, cord blood, and adipose tissue, has several cons and pros. Mesenchymal stem cells derived from cord blood have been considered the best source for precursor transplantation. Direct reprogramming of a somatic cell into induced pluripotent stem cells by over-expression of 6 transcription factors Oct4, Sox2, Klf4, lin28, Nanog, and c-Myc has great potential for regenerative medicine, eliminating the ethical issues of embryonic stem cells and the rejection problems of using non-autologous cells.
    Objective
    To compare reprogramming and pluripotent markers OCT4, Sox-2, c-Myc, Klf4, Nanog, and lin28 in mesenchymal stem cells derived from cord blood and induced pluripotent stem cells.
    Methods
    We analyzed the expression level of OCT4, Sox-2, c-Myc, Klf4, Nanog and lin28 genes in human mesenchymal stem cells derived from cord blood and induced pluripotent stem cells by cell culture and RT-PCR.
    Results
    The expression level of pluripotent genes OCT4 and Sox-2, Nanog and lin28 in mesenchymal stem cells derived from cord blood were significantly higher than those in induced pluripotent stem cells. In contrast to OCT-4A and Sox-2, Nanog and lin28, the expression level of oncogenic factors c-Myc and Klf4 were significantly higher in induced pluripotent stem cells than in mesenchymal stem cells derived from cord blood.
    Conclusion
    It could be concluded that mesenchymal stem cells derived from human cord blood have lower oncogenic potential compared to induced pluripotent stem cells.
  • St Masoumian Hoseini, Z. Manzari, I. Khaleghi Page 105
    Background
    Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation.
    Objective
    To assess ICU nurses’ knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran.
    Methods
    In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process.
    Results
    90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses’ knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard.
    Conclusion
    Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process.
  • Ms Rezaee, Zavareh, R. Ajudani, M. Ramezani Binabaj, F. Heydari, B. Einollahi Page 114
    Background
    It is said that renal transplantation lithiasis is rare. However, literature has some different frequencies in this field and most of the studies related to this issue are case reports. Also the exact effect of this complication on the graft survival rate is not clear.
    Objectives
    To determine the prevalence of nephrolithiasis among kidney transplant recipients and evaluate its association with the graft survival.
    Methods
    We conducted a retrospective study to determine the prevalence of renal stone among 574 kidney transplant patients aged ≥18 years who had undergone renal transplantation in Baqiyatallah Transplant Center between 1990 and 2010. Cox regression analysis was used to determine the effect of renal stone on the graft survival.
    Results
    The mean±SD follow-up time was 55±53 months. Kidney stones were diagnosed in 31 (4.4%) of all 574 kidney transplants studied. Cox regression analysis revealed that nephrolithiasis after transplantation had no significant effects on the survival of the transplanted kidney (OR 1.04, CI: 0.708–1.54).
    Conclusion
    For the first time, we showed that nephrolithiasis in recipients does not have a significant effect on the transplant survival.
  • R. Adelian, J. Jamali, N. Zare, Smt Ayatollahi, Gr Pooladfar, N. Roustaei Page 119
    Background
    Identification of the prognostic factors for survival in patients with liver transplantation is challengeable. Various methods of survival analysis have provided different, sometimes contradictory, results from the same data.
    Objective
    To compare Cox’s regression model with parametric models for determining the independent factors for predicting adults’ and pediatrics’ survival after liver transplantation.
    Methods
    This study was conducted on 183 pediatric patients and 346 adults underwent liver transplantation in Namazi Hospital, Shiraz, southern Iran. The study population included all patients undergoing liver transplantation from 2000 to 2012. The prognostic factors sex, age, Child class, initial diagnosis of the liver disease, PELD/MELD score, and pre-operative laboratory markers were selected for survival analysis.
    Results
    Among 529 patients, 346 (64.5%) were adult and 183 (34.6%) were pediatric cases. Overall, the lognormal distribution was the best-fitting model for adult and pediatric patients. Age in adults (HR=1.16, p<0.05) and weight (HR=2.68, p<0.01) and Child class B (HR=2.12, p<0.05) in pediatric patients were the most important factors for prediction of survival after liver transplantation. Adult patients younger than the mean age and pediatric patients weighing above the mean and Child class A (compared to those with classes B or C) had better survival.
    Conclusion
    Parametric regression model is a good alternative for the Cox’s regression model.
  • F. Ozdemir, V. Ince, A. Baskiran, Z. Ozdemir, Y. Bayindir, B. Otlu, S. Yilmaz Page 126
    Progressive multifocal leukoencephalopathy (PML) is a lytic infection of the central nervous system caused by the reactivation of John Cunningham Virus (JCV) in severely immunosuppressed patients. Occurrence of PML after solid organ transplantations, especially after liver transplantation, is rare. If a patient has poor prognostic factors such as atypical radiological involvements or high viral load in cerebrospinal fluid (CSF), overall survival rates could be poor. Herein, we report on a patients who underwent liver transplantation three times and developed PML with unexpected radiological findings; he was also positive for JCV DNA with a high viral load. Although there are limited data about efficacy of cytarabine against JCV, it was given to the patient for five days. Despite the initiation of cytarabine and complete cessation of the immunosuppressive therapy, we lost the patient, unfortunately.
  • V. Kanubhai Sutariya, A. Tank, P. Ramanlal Modi Page 131
    Among various complications of end-stage liver disease, hepatorenal syndrome has the highest mortality. Patients with both end-stage liver disease and end-stage renal disease are candidates for combined liver-kidney transplantation. However, patients with cirrhosis with decompensation presenting in the form of hepatorenal syndrome, are also likely candidates for the procedure. Herein, we present a patient who underwent combined liver-kidney transplantation for hepatorenal syndrome.