International Journal of Organ Transplantation Medicine
Volume:14 Issue: 1, Winter 2023

The gold standard method of diagnosis of hepatic graft versus host disease (GVHD) is liver biopsy. However, liver biopsy is an invasive procedure with risk of complications especially bleeding.

Therefore, in the current study, we used acoustic radiation force impulse (ARFI) imaging that is a non-invasive, sensitive, and accurate tool for the assessment of liver fibrosis during routine conventional ultrasonography (US) evaluations.

The study was conducted prospectively on 30 adult patients undergoing allogeneic Hematopoietic stem cell transplantation (HSCT). Point shear wave Acoustic radiation force impulse (pSW-ARFI) elastography (stiffness and score) was performed for all patients: pre-transplant, within 3- and 6-months post-transplant.

Overall, ARFI score and stiffness were higher in patients who developed acute hepatic GVHD in comparison to those who did not develop acute GVHD (P=0.028 and P=0.03, respectively). Furthermore, the mean ARFI stiffness during the first 3 months post-transplant was directly correlated to the grade of acute hepatic GVHD (P=0.012). Moreover; ARFI score and stiffness within 6 months post-transplant were higher in patients who developed chronic hepatic GVHD in comparison to those who did not develop (P=0.020 and P=0.018, respectively).

pSW-ARFI is a reliable non-invasive tool for the early diagnosis of acute and chronic hepatic GVHD, especially if a liver biopsy is not feasible. It can also be used in the grading of acute hepatic GVHD.

Renal transplantation is the most effective therapeutic strategy in ESRD patients. One of the renal transplantation complications is gastrointestinal bleeding due to peptic ulcers beside other upper gastrointestinal diseases that have a great impact on patients’ morbidity and mortality.

The present study is designed for endoscopic assessment of the prevalence of upper gastrointestinal lesions and also Helicobacter pylori infection in ESRD patients waiting for renal transplantation who have no GI symptoms.

Our cross-sectional research was performed on 85 renal transplant candidates referred to organ transplantation center within 2016 to 2018. Patients who met inclusion criteria and didn’t have exclusion criteria underwent upper endoscopy. We performed biopsies in each case and data were classified according to endoscopic results, Helicobacter pylori infection and pathologic findings.

In 53 patients (62%) there were significant endoscopic findings. Erosive gastroduodenitis (32.5%) was the most prevalent finding. Abnormal histopathologic findings were found in 73% of patients and Helicobacter pylori infection was detected in 48.2%. We found significant correlation between H. Pylori infection and abnormal pathology (p=0.04).

Our results showed that asymptomatic gastrointestinal lesions and Helicobacter pylori infection were significantly prevalent in kidney transplant candidates thus routine upper endoscopy is recommended in them. This can result in early detection and treatment of gastric lesions before transplantation to prevent serious long-term complications.

The efficacy of phosphodiesterase-5 inhibitors (PDE5Is) on the improvement of erectile dysfunction (ED) in second kidney transplant (KT) recipients has not been well investigated previously.

We aimed to compare the efficacy of tadalafil in three groups: hemodialysis (HD) patients, first KT recipients (KT1), and second KT recipients (KT2) with bilaterally ligated internal iliac arteries.

Age-matched men with erectile dysfunction were included in the study. Patients were divided into three groups: HD, KT1, and KT2. The International Index of Erectile Function 15 (IIEF-15) was used to assess baseline erectile function. Tadalafil was administered in a dose-escalation method for three months. Patients were reevaluated by the questionnaire at three months. The mean score evolution was compared between the study groups by one-way ANOVA.

The final analysis included 106 patients in three groups. There was no significant difference between the study groups regarding age, body mass index (BMI), blood pressure, and frequency of smoking, opium, or alcohol use. Tadalafil was safe and effective in all three groups. The mean IIEF score evolution in HD, KT1, and KT2 groups was 16.4 (58.7% increase from baseline), 19.3 (45.0% increase), and 20.4 (52.7% increase), respectively (P= 0.66).

Tadalafil is effective and safe in managing ED after the second kidney transplantation, where the internal iliac arteries are cut bilaterally. The response rate is similar to first kidney transplant recipients and hemodialysis patients.

Background:

 Partial liver transplantation is one of the standard methods for liver transplantation. This surgical procedure is performed from a living person to a sick person, which can lead to physical and mental challenges affecting the quality of life of donors. Objective: To compare the level of health anxiety and quality of life of liver donors before and after liver transplant surgery.

Methods:

 This descriptive cross-sectional study was performed on 45 liver donors referred to Shiraz Organ Transplant Hospital between 2019 and 2020. Standard questionnaires of demographic information, health anxiety and quality of life were used to collect data by convenience sampling. Descriptive and inferential statistics tests were used to analyses the data. A significance level was considered P<0.05.

Results: 

Patients' quality of life score (in comparison with the overall score and with the subgroups) decreased significantly (P= 0.001) after liver donation. Also, patients' health anxiety scores (in comparison with the overall score and with the subgroups) increased significantly after surgery (P= 0.001).

Conclusion: 

The implementation of awareness programs before and after surgery and purposeful and long-term follow-up, as well as the use of empowerment programs to increase the level of health and quality of life of these people can be a comprehensive and appropriate approach for hospital officials in order to improve health and quality of life after organ donation.

Persistent infections caused by either hepatitis B virus (HBV) and/or hepatitis C virus (HCV) are the principal etiologies of cirrhosis on a global scale, with the potential to progress to the development of hepatocellular carcinoma (HCC). Typically, for HCC detected in its early stages, liver transplantation (LT) represents the optimal therapeutic intervention, as it addresses both the malignancy and the associated liver ailment in a concurrent manner. MicroRNAs (miRNAs) are 18-25 nucleotide RNA molecules that are known for their regulating ability during various developing processes of each cell and tissue especially in multicellular organisms. Considering the regulatory potential of miRNAs, any alterations in their expression pattern such as mutations that produce single-nucleotide polymorphisms (SNPs), might cause anomalies like tumors. In this review manuscript a systematic approach was used to investigate the studies performed to evaluate the role of Host miRNA SNPs in the outcome of viral based (HBV and HCV) HCC. The search was directed in PubMed, Web of Science, and Scopus databases that resulted in 33 related original articles and 8 reviews that used for finding any missing reports. Therefore, in this review it is tried to discuss the importance and relation of SNPs in host miRNAs during viral induced HCC complications.

Post-transplant lymphoproliferative disorder (PTLD) is a malignancy that occurs in 2-20% of solid organ transplant recipients. Isolated, primary central nervous system (PCNS) PTLD is exceedingly rare, with existing data limited to case reports and case series. The diagnosis of PCNS PTLD is difficult to diagnose given 1) non-specific clinical presentation and 2) burden of immunosuppression broadens diagnostic possibilities, often requiring extensive testing to reach a definitive diagnosis. We present the first known case of isolated PCNS PTLD after liver transplantation safely treated with methotrexate. Our case highlights the complex diagnostic and treatment considerations in the setting of immunosuppression and maintenance of adequate graft function.