Effect of Angiotensin II Receptor Type 1 Antibodies on Kidney Allograft Function.

Introduction: Non-human leukocyte antigen antibodies are an independent risk factor for acute rejection in kidney transplant recipients. Among them, angiotensin II receptor type 1 (ART1) antibodies can induce various effects, but their clinical importance in kidney transplant recipients has not been properly explained. This study aimed to evaluate the effect of ART1 antibodies on allograft function and hypertension in stable kidney transplant recipients.

Current status of organ transplant in Islamic countries.

Objectives: The Organization of Islamic Cooperation consists of 57 member states whose people are mainly followers of the Islamic religion. During the past several decades, organ transplants have been increasingly used for the treatment of end-stage organ failures worldwide. This study is to investigate the current status of organ transplant in Islamic countries.

The history of organ donation and transplantation in Iran.

The first kidney transplant in Iran was performed in 1967, and this was the first organ transplant in countries that are current members of the Middle East Society for Organ Transplantation. In 1988, in response to the long waiting list at the Iranian Ministry of Health for kidney transplant, a state-regulated living-unrelated donor kidney transplant program was adopted. By 1999, the kidney transplant waiting list in Iran was eliminated.

Experimental and clinical transplantation: a commitment to integrity, accountability, and ethics in publication.

For the past few years, the social, economic, and political issues surrounding the field of organ transplantation have entered into many ethical discussions. Transplant tourism, and organ trade in particular, have finally received the attention they deserve and many commendable developments have ensued. The "Declaration of Istanbul on Organ Trafficking and Transplant Tourism," the result of a collective effort by hundreds of transplant professionals the world over, is one such example and is now considered the universal charter for ethical conduct in the field of transplantation.

Multifocal cranial plasmablastic lymphoma as a rare manifestation of posttransplant lymphoproliferative disorder.

We present an unusual case of a young woman who developed multiple cranial masses and unilateral facial palsy 10 years after a successful living-unrelated kidney transplant. She was diagnosed with diffuse large B-cell plasmablastic differentiated lymphoma, a rare form of posttransplant lymphoproliferative disorder. She responded to 5 cycles of cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy with resolution of all cranial masses.

Risk factors profile and cardiovascular events in solid organ transplant recipients.

By advances in surgical techniques, success in prevention and treatment of transplant-related infections, and introduction of new immunosuppressive drugs, the patient and graft survival rates in solid organ transplant recipients has steadily and remarkably improved. It has been shown that the longer the transplant patients survival rate, the more saturation with cardiovascular risk factors and the greater risk of cardiovascular mortality. Currently, cardiovascular disease is the primary cause of death after kidney transplantation and is among the three most common causes of death after heart and liver transplantation.

Incentives for organ donation: proposed standards for an internationally acceptable system.

Incentives for organ donation, currently prohibited in most countries, may increase donation and save lives. Discussion of incentives has focused on two areas: (1) whether or not there are ethical principles that justify the current prohibition and (2) whether incentives would do more good than harm. We herein address the second concern and propose for discussion standards and guidelines for an acceptable system of incentives for donation.

The deleterious effect of metabolic acidosis on nutritional status of hemodialysis patients.

One of the main causes of protein-energy malnutrition in patients on maintenance hemodialysis (MHD) is metabolic acidosis. The aim of this study was to evaluate the effect of metabolic acidosis on nutritional status in a group of MHD patients with adequately delivered dialysis treatment. Of 165 eligible anuric MHD outpatients with Kt/V ≥ 1 and no underlying inflammatory diseases, 47 subjects were enrolled.

Recurrence of primary hyperoxaluria after kidney transplantation.

Primary hyperoxaluria is a genetic disorder in glyoxylate metabolism that leads to systemic overproduction of oxalate. Functional deficiency of alanine-glyoxylate aminotransferase in this disease leads to recurrent nephrolithiasis, nephrocalcinosis, systemic oxalosis, and kidney failure. We present a young woman with end-stage renal disease who received a kidney allograft and experienced early graft failure presumed to be an acute rejection.

Measurement of serum levels of mannose-binding lectin in hemodialysis patients: a comparison with healthy individuals.

Introduction: Mannose-binding lectin (MBL) is a part of the innate immune system. Many studies showed an association of low serum MBL levels with decreased host defense against various infectious agents. Considering paradoxical reports about the serum level of MBL in hemodialysis patients, this study aimed to measure and compare serum MBL levels in hemodialysis patients and healthy individuals.

Renal biopsy findings in Iran: case series report from a referral kidney center.

Background: Several registries and single centers have reported the results of their renal biopsies from different parts of the world. As there are only few data regarding the epidemiology of glomerulonephritides in Iran, this study was conducted to determine the results of renal biopsy findings during the last 10 years in our center.

Methods: Data from 1,436 patients who had undergone a renal biopsy in our center between 1998 and 2007 were collected retrospectively for the first 989 patients and prospectively for the rest of them, including demographic data, renal syndrome at presentation and laboratory findings.

Estimation of glomerular filtration rate with creatinine-based versus cystatin C-based equations in kidney transplant recipients.

Introduction: Serum cystatin C is more sensitive for glomerular filtration rate (GFR) measurement, but it is not available for clinical use in all laboratories. Regarding the importance of accurate estimation of GFR in kidney transplant recipients, we compared cystatin C-based equations with creatinine-based formulas to estimate GFR as precisely and simply as possible in kidney transplant recipients.

Materials And Methods: Seventy living donor kidney transplant recipients with stable kidney function were enrolled in our study.

Ethical issues and living unrelated donor kidney transplantation.

During the past decades, the number of altruistic living unrelated kidney donations has substantially increased in developed countries. However, the altruistic supply of transplantable kidneys has remained much less than the demand. As a result, severe kidney shortage has been associated with increasing number of patient deaths and increasing number of commercial transplants and transplant tourism.

High frequency of clinically significant infections and cytomegalovirus disease in kidney transplant recipients with serum mannose-binding lectin deficiency.

Introduction: Mannose-binding lectin (MBL) constitutes defense against infections when adaptive immune response is compromised. Elevation in serum MBL levels has been shown in patients with kidney failure. We compared serum MBL levels before and after kidney transplant and evaluated association of MBL deficiency with infectious complications in kidney transplant recipients.

Improvement of maximum corrected QT and corrected QT dispersion in electrocardiography after kidney transplantation.

Introduction: The electrocardiography (ECG) markers of corrected QT interval (QTc) and QTc dispersion are prolonged in patients on hemodialysis. This study was carried out to investigate if changes in these markers will reverse by successful kidney transplantation.

Materials And Methods: Twenty-six kidney allograft recipients with functioning grafts, 26 patients on maintenance hemodialysis, and 22 healthy individuals were underwent a 12-lead ECG and laboratory studies for electrolytes and arterial blood gas.

The Predictive Value of HLA-DR Matching and Cytokine Gene Polymorphisms in Renal Allograft Acute Rejection: a Living-unrelated Donor (LURD) Study.

Background: In addition to Human Leukocyte Antigens (HLA) compatibility, gene polymorphism in cytokines might be important in the quality of allogeneic immune response.

Objectives: In this study HLA-DR matching and a number of cytokine gene polymorphisms have been evaluated in occurrence of acute rejection after living-unrelated donor (LURD) kidney transplantation.

Methods: A total of 42 renal transplants that were performed at Hashemi Nejad Kidney Hospital (Tehran/Iran) and then followed up for 3 months post-transplantation were included in our study.

Posttransplant diabetes mellitus in kidney allograft recipients at Shaheed Hasheminejad Hospital.

Introduction: Our aim was to evaluate the frequency and risk factors of posttransplant diabetes mellitus (PTDM) at our kidney transplant center, and to compare graft and patient outcomes between the kidney recipients with and without PTDM.

Materials And Methods: We studied 203 kidney transplant recipients with a negative history of diabetes mellitus before transplantation. We examined them for PTDM and made diagnosis on the basis of the American Diabetes Association criteria.

Organ transplantation in Iran.

The first renal transplantation in Iran was carried out in 1967. Between 1967 to 1988 almost all renal transplants were from living-related donors and the number of renal transplants performed was much lower than the national demand. In 1988, a compensated and regulated living-unrelated donor renal transplantation program was adopted.

Prevalence and clinical findings of biopsy-proven glomerulonephritidis in Iran.

Epidemiological data of renal diseases is population-based and have great geographic variability. Due to the lack of a national renal data registry system, there is no information on the prevalence rate, and clinical and laboratory features of various glomerulo-nephritidis (GNs) in Iran. In a retrospective cross sectional study, we analyzed 462 adult renal biopsies in Tehran, Iran.

Iranian model of paid and regulated living-unrelated kidney donation.

Since the 1980s, many countries have passed legislation prohibiting monetary compensation for organ donation. Organ donation for transplantation has become altruistic worldwide. During the past two decades, advances in immunosuppressive therapy has led to greater success in transplantation and to increased numbers of patients on transplant waiting lists.

Catheter associated infections in hemodialysis patients.

Hemodialysis catheter related infections (HCRI) are one of the major causes of increasing mortality, morbidity and cost of therapy in hemodialysis patients. Prevention of HCRI requires the identification of predisposing risk factors. To determine the frequency of HCRI risk factors, we studied 116 patients (54% male, mean age of 49.

Transplant tourism and the Iranian model of renal transplantation program: ethical considerations.

Currently, the buying and selling of kidneys through "transplant tourism" is occurring at an increasing rate, both in developed and developing countries. Since 1988, Iran has adopted a compensated and regulated living-unrelated donor renal transplant program, and by providing financial incentives to volunteer living donors, has eliminated the renal transplant waiting list. In the Iranian model of renal transplantation program, regulations have been put in place to prevent transplant tourism.

Governed financial incentives as an alternative to altruistic organ donation.

In 1984, an offensive proposal for kidney sales by a US physician led the National Organ Transplant Act to become a law in the United States. Similar legislation passed in many other countries. An ethical consensus developed around the world that there should be no monetary compensation for transplantable organs, either from living or deceased persons.

Middle East Society for Organ Transplantation (MESOT) Transplant Registry.

During the seventies, sporadic renal transplants were performed in few MESOT-region countries, mainly Turkey, Iran, Egypt, and Lebanon. Since the introduction of cyclosporine in the early eighties, transplantation has become the preferred therapeutic modality for end-stage renal failure. In 1986, the Islamic theologians (Al Aloma) issued what became known as the Amman declaration, in which they accepted brain death and retrieval and transplantation of organs from living and cadaveric donors.