Publications by authors named "Hari Shankar Meshram"

Gender disparity refers to the unequal treatment or a perception of individuals based on their gender and arises from differences in socially constructed gender roles. In the field of transplantation, gender inequality arises at different stages, affecting access to medical care, donation practices, and posttransplant followup care. Gender disparity in transplantation is not limited to any geographic region but is thought to be more prevalent in developing nations.

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Introduction Kidney transplant recipients (KTRs) are prone to coronavirus disease 2019 (COVID-19) disease secondary to chronic immunosuppressive therapy. There have been differences in mortality and morbidity amongst the general population with different COVID-19 waves. This study is done to understand the effects of different COVID-19 waves amongst KTRs.

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Objectives: Chikungunya is an arboviral illness, with patients presenting with fever, arthralgias, and myalgias. Outbreaks have occurred in tropical regions, and the virus is now endemic to many tropics, including South Asia, with India contributing a large part of the global burden. The presentation and long-term effects on transplant recipients are largely unknown.

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Purpose Of Review: We review the key principles of kidney paired donation (KPD) and discuss the status and unique considerations for KPD in developing countries.

Recent Findings: Despite the advantages of KPD programs, they remain rare among developing nations, and the programs that exist have many differences with those of in developed countries. There is a paucity of literature and lack of published data on KPD from most of the developing nations.

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Background: There is no robust evidence-based data for ABO-incompatible kidney transplantation (ABOiKT) from emerging countries.

Methods: Data from 1759 living donor ABOiKT and 33 157 ABO-compatible kidney transplantations (ABOcKT) performed in India between March 5, 2011, and July 2, 2022, were included in this retrospective, multicenter (n = 25) study. The primary outcomes included management protocols, mortality, graft loss, and biopsy-proven acute rejection (BPAR).

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Objectives: There are scarce data on the incidence and resistance pattern of rifampicin-resistant Mycobacterium tuberculosis among kidney transplant recipients.

Materials And Methods: This is a retrospective, single- center study of kidney transplantrecipients suspected of M. tuberculosis infection.

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Article Synopsis
  • The study aimed to provide a systematic review and meta-analysis of pediatric solid-organ transplants in India, as there was no previous comprehensive review available on this topic.
  • The analysis included data from 31 studies among over 50,000 initial searches, focusing on pediatric kidney, liver, and heart transplants.
  • The findings indicated that survival rates for kidney and liver transplants in Indian children are comparable to Western standards, but infections were identified as a major cause of graft loss and patient death, highlighting the need for better registries to support future transplants.
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Outcomes of severe acute respiratory syndrome coronavirus 2 in kidney transplant recipients (KTR) compared with matched cohort are certainly lacking for different pandemic waves and geographic regions. In this single-center retrospective study of coronavirus disease-2019 (COVID-19) cases admitted during March 26, 2021 to June 7, 2021, a propensity-matched analysis in a 1:1 ratio was performed to compare the clinical profile and outcomes between KTR and non-KTR. A Cox proportional hazard model from the whole study population to analyze risk factors for severe disease and mortality was calculated.

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Objectives: Evidence on living donor kidney transplant procedures when both the donor and recipient have had a history of COVID-19 infection is scarce.

Materials And Methods: We retrospectively explored the protocol, outcomes, and follow-up of 64 donors and recipients of living donor kidney transplant who had recovered from COVID-19. This was a multicenter (n = 12) study from India that included transplants between October 29, 2020, and December 1, 2021.

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Objectives: India ranks third globally in organ procurement and transplant and has the second highest COVID-19 incidence rate, but data regarding COVID-19 vaccination in solid-organ transplant patients are scarce.

Materials And Methods: We created a cross-sectional, anonymous, online questionnaire and sentinvitations to several transplant centers in India. We surveyed vaccine mandates, immunization coverage and side effects, administration timing, infection severity among solid-organ transplant recipients, and booster dosage recommendations.

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Article Synopsis
  • India ranks second and third globally for COVID-19 burden and organ transplants, showing a 40-50% decline in solid-organ transplants during the pandemic.
  • Mortality rates for COVID-19-positive kidney transplant recipients were lower in India compared to other countries, but significantly higher than the general population, indicating a need for improved safety guidelines.
  • Research on treatments like remdesivir and convalescent plasma showed promising results, but COVID-19 vaccines had lower efficacy in transplant patients, underlining the importance of ongoing studies on vaccine response and donor safety.
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Background: There is a dearth of data regarding the consequences of ABO-incompatible kidney transplant (ABOiKTx) among post-COVID-19 candidates.

Methods: The study was designed as a retrospective, multicentric cohort study across 11 sites in India, from August 2020 to December 2021. The data for ABOiKTx conducted for post-COVID-19 candidates were investigated.

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Background: We aimed to analyze the humoral and cellular response to standard and booster (additional doses) COVID-19 vaccination in solid organ transplantation (SOT) and the risk factors involved for an impaired response.

Methods: We did a systematic review and meta-analysis of studies published up until January 11, 2022, that reported immunogenicity of COVID-19 vaccine among SOT. The study is registered with PROSPERO, number CRD42022300547.

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Coronavirus disease (COVID-19) has engulfed the whole world, and India has been the second worst-hit nation. Organ transplant services were halted in both the public and private care sectors of India, with public care sectors more adversely affected. Deceased donations were disproportionately more affected, with unfavorable rates at the peak of the pandemic.

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Background: There is an enormous knowledge gap on management strategies, clinical outcomes, and follow-up after kidney transplantation (KT) in recipients that have recovered from coronavirus disease (COVID-19).

Methods: We conducted a multi-center, retrospective analysis in 23 Indian transplant centres between June 26, 2020 to December 1, 2021 on KT recipients who recovered after COVID-19 infections. We analyzed clinical and biopsy-confirmed acute rejection (AR) incidence and used cox-proportional modeling to estimate multivariate-adjusted hazard ratios (HR) for predictors of AR.

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Background: COVID-19 has drastically affected transplant services, but there is limited understanding of the discrepancy of COVID-19 effects on various regions of the world.

Methods: We have explored the Global Observatory for Organ Donation and Transplantation data for assessing the transplant number changes between the calendar year 2019 (n = 157,301) and 2020 (129,681).

Results: There was a disproportionate impact of COVID-19 on different areas of the world.

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Purpose Of Review: As the coronavirus disease 2019 (COVID-19) pandemic continues to surge, determining the safety and timing of proceeding with solid organ transplantation (SOT) in transplant candidates who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and who are otherwise transplant eligible is an important concern. We reviewed the current status of protocols and the outcomes of SOT in SARS-CoV-2 recovered patients.

Recent Findings: We identified 44 published reports up through 7 September 2021, comprising 183 SOT [kidney = 115; lung = 27; liver = 36; heart = 3; simultaneous pancreas-kidney (SPK) = 1, small bowel = 1] transplants in SARS-CoV-2 recovered patients.

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There is a scarcity of data regarding the impact of cytomegalovirus (CMV) infection complicating the coronavirus disease-2019 (COVID-19) course. The objective of the study was to explore the clinical profile and outcome of CMV co-infection with COVID-19. This is a single-center retrospective study of COVID-19 cases with concomitant CMV infection.

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Objectives: Comparisons of COVID-19 incidence between kidney transplant recipients and patients who did not receive kidney transplant are underexplored in various geographic regions.

Materials And Methods: This Indian, single-center, retrospective study analyzed COVID-19 data of patients hospitalized between May 12, 2020, and January 11, 2021. A propensity matching score was used to compare outcomes between the 2 groups.

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