Patient perception of pre-pregnancy care and family planning among reproductive-age female diabetes mellitus patients in a primary care clinic in Penang, Malaysia.

Introduction: Pre-pregnancy care (PPC) is an important part of diabetic care among females in the reproductive age group, as it improves feto-maternal outcomes.

Objective: We aimed to assess female diabetic patients' perception of PPC and family planning prior to PPC care.

Methods: This was an observational, cross-sectional survey performed from June 2019 to September 2019, using universal sampling of registered female diabetic patients who fit the inclusion criteria prior to integrated PPC care.

Rabbit anti-thymocyte globulin (rATG) versus IL-2 receptor antagonist induction therapies in tacrolimus-based immunosuppression era: a meta-analysis.

Background: The aim of this meta-analysis is to explore the effect of IL-2RA vs rATG on the rate of acute rejection, post-transplant infections, and graft as well as patient's survival in standard- and high-risk renal transplant patients receiving tacrolimus-based maintenance immunotherapy.

Methods: Random effects model was the method used for identifying risk difference. Confidence interval including the value 1 was used as evidence for statistically significant risk difference.

Pancreatic transplantation: Brief review of the current evidence.

Kidney transplantation is the treatment of choice for management of end-stage renal disease. However, in diabetic patients, the underlying metabolic disturbance will persist and even may get worse after isolated kidney transplantation. Pancreatic transplantation in humans was first introduced in 1966.

Comparison of Ipsilateral and Contralateral Simultaneous Pancreas and Kidney Transplantation: A Single-Center Analysis with 5-Year Outcome.

BACKGROUND It is routine to implant the pancreas on the right and the renal graft on the left iliac fossa during a simultaneous kidney and pancreas transplant (cSPK). Ipsilateral placement of both organs on the same side raises concerns that the pancreas graft might compromise the distally placed kidney. However, ipsilateral SPK (iSPK) can be faster than the conventional contralateral graft placement and allows for preservation of the other side for future transplants.

Steroid regulation: An overlooked aspect of tolerance and chronic rejection in kidney transplantation.

Steroid conversion (HSD11B1, HSD11B2, H6PD) and receptor genes (NR3C1, NR3C2) were examined in kidney-transplant recipients with "operational tolerance" and chronic rejection (CR), independently and within the context of 88 tolerance-associated genes. Associations with cellular types were explored. Peripheral whole-blood gene-expression levels (RT-qPCR-based) and cell counts were adjusted for immunosuppressant drug intake.

Transperitoneal Enucleation of a Kidney Transplant Allograft Renal Cell Carcinoma.

Development of malignancy after solid-organ trans?lant is a well-known long-term complication of immunosuppressive therapy. Thus far, there are no specific oncologic recommendations regarding management of de novo tumors in transplanted kidneys. Here, we present the case of a 63-year-old male patient who developed a de novo renal cell carcinoma 6 years after the transplant procedure.

Biomarkers of Tolerance in Kidney Transplantation: Are We Predicting Tolerance or Response to Immunosuppressive Treatment?

We and others have previously described signatures of tolerance in kidney transplantation showing the differential expression of B cell-related genes and the relative expansions of B cell subsets. However, in all of these studies, the index group-namely, the tolerant recipients-were not receiving immunosuppression (IS) treatment, unlike the rest of the comparator groups. We aimed to assess the confounding effect of these regimens and develop a novel IS-independent signature of tolerance.

Incidence and Histologic Features of Transplant Graft Pancreatitis: A Single Center Experience.

Objectives: Pancreas transplant is an effective long-term treatment modality for complicated type 1 diabetes mellitus. However, allograft failure or severe concomitant rejection remain an obstacle to successful transplant outcome, occurring in approximately 21% of recipients within 1 year. Most histologic studies investigating the cause of pancreas transplant failure have concentrated on the presence and severity of acute and chronic cellular or vascular rejection.

A prospective cohort study of risk prediction in simultaneous pancreas and kidney transplantation.

Introduction: Current risk prediction scoring systems in pancreas transplantation are limited to organ factors and are specific to predicting graft outcome. They do not consider recipient factors or inform regarding recipient morbidity. The aim of this study was to assess the utility of commonly used general surgical risk prediction models (P-POSSUM [Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity], MODS [multiple organ dysfunction score], Charlson co-morbidity index, revised cardiac risk index, ASA [American Society of Anesthesiologists] grade and Waterlow score), and to correlate them with total length of hospital stay (LOS) and critical care unit (CCU) LOS, important surrogate markers of patient outcome.

Outcome of kidney transplant with double ureter: a multicenter study.

Objectives: Renal transplant with double ureters is uncommon. However, with increasing numbers of en bloc and dual transplants from marginal donors, we frequently observe 2 ureters for implant. The current study reviewed our experience with 76 double-ureter renal transplants.

Anthropometrics Identify Wasting in Patients Undergoing Surgery for Encapsulating Peritoneal Sclerosis.

Unlabelled: ♦

Introduction: Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis in which gastrointestinal (GI) symptoms reduce appetite and dietary intake. Adequate nutrition is important, especially if surgery is required. Although the incidence of EPS is low, the present report is able to detail preoperative nutrition status and treatment in a large cohort of patients from a national EPS referral center.

Outcomes of methicillin-resistant Staphylococcus aureus infection after kidney and/or pancreas transplantation.

Background: The true extent of Methicillin-Resistant Staphylococcus aureus (MRSA) colonization and incidence of infection after solid organ transplantation in adults and children is not well-known. The aim of this study was to evaluate the incidence and the outcomes of MRSA infection following kidney and/or pancreas transplantation.

Material And Methods: We reviewed the case notes of all patients who developed MRSA colonization and infection within the first year of transplantation between September 2002 and December 2009.

Campath, calcineurin inhibitor reduction and chronic allograft nephropathy (3C) study: background, rationale, and study protocol.

Background: Kidney transplantation is the best treatment for patients with end-stage renal failure, but uncertainty remains about the best immunosuppression strategy. Long-term graft survival has not improved substantially, and one possible explanation is calcineurin inhibitor (CNI) nephrotoxicity. CNI exposure could be minimized by using more potent induction therapy or alternative maintenance therapy to remove CNIs completely.

Mortality in diabetes: pancreas transplantation is associated with significant survival benefit.

Background: Pancreas transplantation in complicated type 1 (insulin dependent) diabetes mellitus improves the quality of life, increases longevity and stabilizes diabetic complications. There may be clinician reticence due to perceived poor outcomes with published associated mortality rates of 5-8% due to significant co-morbidities, particularly cardiovascular impairment.

Methods: Retrospective analysis was performed on patients undergoing pancreas transplantation in a single centre since the programme's initiation [simultaneous pancreas kidney (SPK) = 148, pancreas after kidney (PAK) = 33 and pancreas transplant alone (PTA) = 11] compared with a control group accepted contemporaneously onto the waiting list.

Transplantation in adults with primary hyperoxaluria: single unit experience and treatment algorithm.

Background: Kidney transplantation alone in Primary Hyperoxaluria is associated with a high rate of recurrence and in many cases early graft loss. Liver transplantation offers the possibility of correcting the metabolic defect.

Material/methods: A retrospective review of five cases of Primary Hyperoxaluria managed at a major transplant unit was performed.

Successful en bloc renal transplant from a 19-month-old nonheart-beating donor into an adult recipient: case report.

Worldwide, there is a shortage of organs available for transplant into patients with end-stage renal failure. This has led to donor selection of the most-marginal donors. These strategies, so far, have failed to meet the requirements.

Native nephrectomy for autosomal dominant polycystic kidney disease: before or after kidney transplantation?

Unlabelled: Study Type - Therapy (case series).

Level Of Evidence: 4. What's known on the subject? and What does the study add? The indications and timing of native nephrectomy in patients with autosomal dominant polycystic kidney disease (ADPKD) is controversial, especially for those undergoing renal transplantation.

Outcomes of patients who develop symptomatic Clostridium difficile infection after solid organ transplantation.

Clostridium difficile-associated diarrhea is the most common cause of hospital-associated diarrhea in the UK. Infection can produce a spectrum of manifestations from mild diarrhea to toxic megacolon, colonic perforation, and death. The aim of this study was to evaluate the outcomes of patients who developed symptomatic Clostridium difficile infection (CDI) within the first year after solid organ transplantation.

Negative pressure wound therapy used to heal complex urinary fistula wounds following renal transplantation into an ileal conduit.

Transplantation into an ileal conduit is an established option for patients with end-stage renal failure and a nonfunctioning urinary tract. Urinary fistulae are more common following these complex transplants. Urinary fistula in this scenario can cause substantial morbidity and even result in graft loss.