Publications by authors named "Hargovind Trivedi"

Background: Catheter-associated urinary tract infections (CAUTI) are among the most frequent healthcare-associated infections in the world. They are associated with increased mortality, prolonged hospital stay and increased healthcare costs. The objective of this study was to evaluate the efficacy of the noble metal alloy (NMA) coated BIP Foley Catheter in preventing the incidence of symptomatic CAUTI in a large cohort of patients in India.

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Background: Stem cells, including neural stem cells (NSCs), are endowed with self-renewal capability and hence hold great opportunity for the institution of replacement/protective therapy. We propose a method for in vitro generation of stromal cells from human adipose tissue and their differentiation into neural cells.

Materials And Methods: Ten grams of donor adipose tissue was surgically resected from the abdominal wall of the human donor after the participants' informed consents.

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Article Synopsis
  • The study focuses on the challenges faced by surgeons during retroperitoneoscopic living donor nephrectomy due to a rare vascular condition called duplication of the inferior vena cava.
  • Between 2005 and 2016, four out of 1460 donor surgeries in a single unit involved this complication, and the study analyzes the surgical techniques used to manage it.
  • Results show that the procedure can be performed safely, with specific recommendations for preoperative imaging and surgical expertise to navigate the anatomical complexities.
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  • The study evaluated kidney paired donations (KPDs) as a viable method to boost living donor kidney transplants in a program where traditional methods are limited by costs and complications.
  • Conducted at a single center, the research involved 77 KPD transplants, noting various reasons for KPD use including ABO incompatibility and sensitization, and highlighted an overall 25% increase in living donor transplants over one year.
  • The findings showed high success rates with excellent graft and patient survival, and shorter waiting times for KPD compared to deceased donor transplants, emphasizing the importance of a well-organized KPD registry and counseling efforts.
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  • This study presents the first successful 4-way kidney exchange transplant combined with desensitization in India, aimed at improving access for sensitized patients needing living-donor transplants.
  • The procedures were ethically approved and conducted without any medical or surgical complications, providing stable health outcomes for all recipients over an 11-month follow-up.
  • The research highlights the potential of this method to help disadvantaged groups in developing countries by pairing kidney exchange with desensitization techniques, paralleling successes seen in developed nations.
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We present 5-year experience of renal transplantation (RT) with tissue eosinophilia (TE) in renal allograft biopsy (RAB) and its repercussions on the outcome. In total, 1217 recipients underwent RT from 2011 to 2015, and they were evaluated for the presence of ≥4% TE. Group 1 consisted of RT with RAB showing TE, Group 2 consisted of RT with RAB with rejections without TE, and Group 3 consisted of RT without rejections.

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Tolerance induction (TI) has been attempted with chimerism/clonal deletion. We report results of TI protocol (TIP) using stem cell therapy (SCT) included adipose derived mesenchymal stem cells (AD-MSC) and hematopoietic stem cells (HSC) in 10 living-donor related renal transplantation (LDRT) patients under non-myeloablative conditioning with Bortezomib, Methylprednisone, rabbit-anti-thymoglobulin and Rituximab, without using conventional immunosuppression. Transplantation was performed following acceptable lymphocyte cross-match, flow cross-match, single antigen assay and negative mixed lymphocyte reaction (MLR).

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Stem cell based strategies are therapeutically potent for treating type-1 diabetes mellitus owing to their intrinsic regenerative capacity and immunomodulatory properties to arrest autoimmune β-cell destruction, preserve residual β-cell mass, facilitate endogenous regeneration, ameliorate innate/ alloimmune graft rejection, restore β-cell-specific unresponsiveness in absence of chronic immunosuppression and to reverse hyperglycemia.

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Article Synopsis
  • - One-third of living kidney donors are rejected due to ABO blood type incompatibility and donor-specific antibodies, which leads to longer wait times and increased health risks for patients in need of a kidney transplant.
  • - Kidney paired donation has become a prominent way to boost the number of living kidney transplants, particularly in regions with limited resources where incompatible transplants are not feasible.
  • - Strategies to enhance kidney paired donation include compatible pairs, altruistic donor chains, and leveraging social media for awareness, along with the establishment of dedicated teams or a national program to improve access and efficiency in matching donors and recipients.
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Background: Interleukin-10 secreting B-cells are a major subset of B-regulatory cells (B-regs), commonly recognized as CD19/38/24/IL10. They carry out immunomodulation by release of specific cytokines and/or cell-to-cell contact. We have generated B-regs in-vitro from donor adipose tissue derived mesenchymal stem cells (AD-MSC) and renal allograft recipient (RAR) peripheral blood mononuclear cells (PBMC) for potential cell therapy.

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Article Synopsis
  • In countries with limited resources for kidney transplants, kidney paired donation (KPD) can effectively increase living donor kidney transplants (LDKT), as shown by a study in India involving 300 KPD transplants from 2000 to 2016.
  • The most common reasons for patients joining KPD included ABO incompatibility, positive cross-match, and better matching, leading to a variety of exchange configurations that successfully facilitated these transplants.
  • The program demonstrated excellent patient outcomes, with high graft and patient survival rates, and highlights the importance of registry maintenance, patient counseling, and a strong teamwork approach to optimize transplant success.
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  • The study reports the first international living related two-way kidney paired donation (KPD) transplantation from India, which occurred on February 17, 2015, following legal approval.
  • The procedure involved donor-recipients from Portugal and India who were highly sensitized and ABO incompatible, with successful negative cross-matching confirming compatibility for the exchange.
  • The results demonstrated that both pairs had successful surgeries with good kidney function at 11 months post-transplant, highlighting international KPD as a promising solution to kidney shortages and improving outcomes for difficult-to-match patients.
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Renal involvement in hepatitis B-polyarteritis nodosa (HBV-PAN) usually occurs in the form of hypertension, microscopic hematuria, proteinuria but nephrotic range proteinuria or renal failure is very uncommon. A 60-year-old man had abdominal pain for 15 days which was followed by bilateral pedal edema in a day and in next three days he had sudden onset bilateral foot drop with numbness. He had weight loss of 10 kg in last 20 days.

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The kidney has been considered a highly terminally differentiated organ with low proliferative potential and thus unlikely to undergo regeneration. Glomerular disease progresses to end-stage renal disease (ESRD), which requires dialysis or renal transplantation for better quality of life for patients with ESRD. Because of the shortage of implantable kidneys and complications such as immune rejection, septicemia and toxicity of immunosuppression, kidney transplantation remains a challenge.

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Background: Timely diagnosis of invasive fungal infections (IFI) in renal transplant (RT) patients on immunosuppression is often difficult, jeopardizing their life and graft. We reported IFI and their causative fungal agents in post-RT patients.

Materials And Methods: This was a retrospective 6-year clinical study carried out from 2010 to 2015 on 1900 RT patients.

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Aim: To avoid desensitization protocols and ABO incompatible kidney transplantation (KT) due to high costs and increased risk of infections from intense immunosuppression.

Methods: We present institutional ethical review board - approved study of single center 6-way kidney exchange transplantation. The participants comprised ABO incompatibility ( = 1); positive cross-match and/or presence of donor specific antibody ( = 5).

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The combination of kidney paired donation (KPD) with desensitization represents a promising method of increasing the rate of living donor kidney transplantation (LDKT) in immunologically challenging patients. Patients who are difficult to match and desensitize due to strong donor specific antibody are may be transplanted by a combination of desensitization and KPD protocol with more immunologically favorable donor. We present our experience of combination of desensitization protocol with three-way KPD which contributed to successful LDKT in highly sensitized end stage renal disease patient.

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Renal transplant patients are at high risk of developing various infections causing morbidity and mortality. Invasive fungal infection has been recognized as a significant complication of organ transplantation. The major fungal infections in these patients are due to candida, aspergillus and mucormycosis.

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Type 1 diabetes mellitus (T1DM) is an autoimmune disease causing progressive destruction of pancreatic β cells, ultimately resulting in loss of insulin secretion producing hyperglycemia usually affecting children. Replacement of damaged β cells by cell therapy can treat it. Currently available strategies are insulin replacement and islet/pancreas transplantation.

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Background: Globally there is an increase in incidence of chronic kidney diseases (CKDs). Diabetes mellitus (DM), hypertension and stone diseases are the major risk factors for CKD. We organized kidney disease screening camps in a semi-urban population of Gujarat, India on the occasion of World Kidney Day (WKD).

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Introduction: Collapsing Glomerulopathy (CG) is recognized as distinct pattern of proliferative parenchymal injury with poor response to empirical therapy.

Aim: A single center retrospective study was carried out to find out clinicopathological features of idiopathic CG.

Materials And Methods: A total of 3335 native renal biopsies were analyzed retrospectively which were performed from 2008 to 2014 with emphasis on clinicopathological correlation and histopathological presentation.

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Objective: To evaluate the role of computed tomography (CT) angiography using 64 slice multidetector CT scan to establish relationships among tumor size, aneurysm formation, and spontaneous rupture of renal angiomyolipomas (AML).

Materials And Methods: Total 27 patients were diagnosed as having renal angiomyolipoma (AML) at institute of kidney disease and research center from June 2008 to June 2015. All patients with renal AML underwent contrast-enhanced CT (CECT) with CT angiography with 64 slice multidetector CT scan.

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Background: Spinal cord injury (SCI) is not likely to recover by current therapeutic modalities. Stem cell (SC) therapy (SCT) has promising results in regenerative medicine. We present our experience of co-infusion of autologous adipose tissue derived mesenchymal SC differentiated neuronal cells (N-Ad-MSC) and hematopoietic SCs (HSCs) in a set of patients with posttraumatic paraplegia.

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