فهرست مطالب

Organ Transplantation Medicine - Volume:14 Issue: 4, Autumn 2024

International Journal of Organ Transplantation Medicine
Volume:14 Issue: 4, Autumn 2024

  • تاریخ انتشار: 1403/09/21
  • تعداد عناوین: 5
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  • Somayeh Yazdanpanah, Ahmad Jabrodini, Mojtaba Shafiekhani *, Hamed Nikopour, Bita Geramizadeh, Mohammad Hossein Anbardar, Maryam Gashtasebi, Mohsen Moghadami, Keyvan Pakshir, Kamiar Zomorodian Pages 9-16
    Background

    Invasive candidiasis are the most prevalent fungal infections in solid organ transplant (SOT) recipients. In this regards, emerging pathogens and antifungal resistance are concerning issues in transplantation medicine.

    Objective

    Regarding universal prophylaxis in SOT recipients, particularly with fluconazole, and the emergence of azole-resistant species, the present study was conducted to species identification and antifungal susceptibility profiles of yeasts isolated from SOT recipients.

    Methods

    All adults undergone solid organ transplantations between 21 March -22 September 2022 in Abu-Ali Sina transplant center, Shiraz, Iran, were included with 6 months follow-up. Species identification of isolated yeasts from different clinical specimens was performed by ITS1-5.8S-ITS2 gene sequencing. Antifungal susceptibility testing was determined according to the microbroth dilution method documented by CLSI.

    Results

    During the study period, 28 of 383 (9.8%) adult SOT recipients developed at least one positive culture of yeasts isolated from different clinical specimens. Candiduria was the most prevalent type of involvement by Candida species. The incidence rate of invasive candidiasis was 2.6%. Of 54 isolated yeasts, C. albicans was the most frequent species (22/54, 40.7%), followed by C. glabrata (11/54, 20.3%), and C. parapsilosis (9/54, 16.7%). Resistance or decreased susceptibility to fluconazole was found in 55% of isolates, and also 13% of isolates were known crossresistant to different azole antifungal drugs.

    Conclusion

    Our results showed a high incidence of azole- resistant Candida strains causing candidiasis in SOT recipients. Indeed, the findings support the need to perform antifungal susceptibility testing of yeast isolates in immunocompromised patients to guide proper treatment.

    Keywords: Candida, Candidiasis, Antifungal Resistance, Organ Transplantation
  • Gholam Reza Sivandzadeh, Fardad Ejtehadi, Alireza Shamsaeefar, Maryam Beheshti * Pages 17-26
    Background

    Cryptogenic cirrhosis (CC) is defined as cirrhosis arising without an obvious etiology of chronic liver disease, making it a complex entity to describe and investigate. It is clear from prior epidemiologic and histologic studies that various conditions can lead to a state in which clinical and histologic diagnostic features of the original disease are not uniformly evident.

    Objective

    Studies on CC in post-liver transplantation (LT) clinical course are scarce. Hence, this study aimed to evaluate the clinical course of CC in LT subjects.

    Methods

    This prospective cohort study maintained a database with accrued information on all patients who underwent LT at Shiraz University of Medical Sciences, Abu Ali Sina organ transplant center, and was reviewed. All patients aged more than 18 years at the time of transplantation and with a presumptive pre-transplant diagnosis of CC were included in the study. All cases were followed prospectively for one year after LT. A total of 162 cases were entered into the study.

    Results

    During 1-year follow-up (mean of 308.4 ± 122.06 days), 28 (17.4%), 6 (3.7%), 5 (3.3%), and 35 (21.6%) subjects were rejected, their liver disease recurred, re-transplanted, and deceased, respectively. One year, the patient survival rate was 78.4%. The survival distributions for rejection were not statistically significantly different (χ2= 0.998, P= 0.318), but it was significant for corticosteroid dose (χ2= 40.446, P< 0.0001). Those who survived received lower doses of corticosteroids (P< 0.0001), had a higher proportion of receiving mycophenolic acid (P= 0.003), had lower serum levels of WBC (P= 0.006), and had a higher proportion of being positive for HBc Ab (P= 0.002). Subjects who developed rejection had lower serum levels of albumin (P= 0.001) and albumin/protein ratio (P= 0.026), a shorter diagnosis-LT interval (P= 0.028), a higher proportion in receiving MTP pulse (P= 0.019), and a higher proportion in receiving mycophenolic acid (P= 0.044). However, Cox regression multivariate analysis showed no independent variable predicting patients or graft survival.

    Conclusion

    The prevalence of rejection, recurrence, and survival during the first year of LT amongst CC recipients was near the in-line studies. In addition, owing to the presence of metabolic syndrome components in our cases, it would be plausible that a proportion of our cohort might have NAFLD and NASH. However, correlation with histopathologic and liver function biomarkers was not performed.

    Keywords: Cryptogenic Cirrhosis, Liver Transplantation, Metabolic Syndrome, Survival, Liver Cirrhosis
  • Ibrahim Agung *, Fitri Anestherita, Luh Karunia Wahyuni, Nelfidayani Nelfidayani, Nazamta Yusfiatuzzahra Pages 27-30

    Persons with End Stage Renal Disease (ESRD) experience poor quality of life due to poor physical function. After the transplant, his physical fitness did not improve, ultimately creating a vicious cycle of inactivity, increasing the risk of cardiovascular and other causes of death. A 39-year-old man was diagnosed with ESRD and underwent a renal transplant from a living donor. He underwent early post-operative rehabilitation from day one and continued until he was discharged. The study was conducted at Dr. Cipto Mangunkusumo National Hospital. Persons with ESRD showed significant improvement during the rehabilitation program. On the sixth day, he took a 4-meter walk test in 17.58 seconds and made a good impression. He was then discharged and continued remote rehabilitation until day 14. Physical inactivity leads to decreased survival, increased morbidity, and increased mortality. Early rehabilitation for post-renal transplantation may become a potential intervention to improve a person with ESRD's physical activity and quality of life, especially in Indonesia.

    Keywords: End Stage Renal Disease, Living Donor, Rehabilitation, Renal Transplantation, Quality Of Life
  • Sedigheh Esfandiarnezhad, Fatemeh Masjedi Pages 32-34
  • Seyed Ali Malek-Hosseini Pages 35-127