Publications by authors named "Pranjal Modi"
Article Synopsis
- * Methods: The paper discusses the results of a single-center program that managed 539 KET cases to increase living donor kidney transplants between January 2000 and March 2024.
- * Results: Out of 5346 living donor kidney transplants, 539 were through KET, mainly involving ABO incompatible pairs, with successful outcomes after an average follow-up of 8.2 years, demonstrating effective strategies for KET implementation.
Laparoscopic Approach for Reconstructive and Ablative Procedures in Ectopic Pelvic Kidneys: A Challenge in 8 Cases.
J Laparoendosc Adv Surg Tech A
September 2023
Article Synopsis
- Laparoscopy is a common surgical method for kidney surgeries, and this study evaluates its effectiveness and safety specifically for pelvic ectopic kidneys.
- Eight patients underwent various laparoscopic procedures, with a success rate of 75% for completing the surgeries laparoscopically and only one experiencing a minor complication.
- The median operative time was 180 minutes, with minimal blood loss and an average hospital stay of 4 days, indicating that laparoscopic surgery for pelvic ectopic kidneys can lead to good outcomes and faster recovery.
Article Synopsis
- Machine perfusion for solid human organs has been known since 1855, but it’s still not commonly used in hospitals despite its benefits, particularly in kidney transplants.
- The article examines the challenges to implementing this technology, focusing on the roles of clinicians, hospitals, regulatory bodies, and industry, while noting the variations in adoption across different regions.
- Emphasis is placed on the need for collaboration among stakeholders, improved regulatory frameworks, and adaptable reimbursement strategies to enhance the use of organ perfusion technology in clinical settings.
Article Synopsis
- * A national task force of 19 liver transplantation clinicians from across India created a consensus document using a modified Delphi method to address liver allocation issues.
- * The resulting National Liver Allocation Policy outlines 46 statements covering various areas of DDLT, including criteria for patient listing, management of wait-lists, and prioritization for organ allocation, aiming to establish a consistent national policy for liver transplants.
Article Synopsis
- The study assesses the safety and effectiveness of the electrothermal bipolar vessel sealer (EBVS) compared to traditional sutures for managing lymphatic vessels in kidney transplant surgeries.
- In the trial involving 52 kidney transplant recipients, EBVS significantly reduced the preparation time for recipient vessels (8.3 minutes vs. 14.5 minutes), while anastomosis times were similar between both groups.
- The findings indicate that EBVS is a quick and reliable method for sealing lymphatic vessels, potentially reducing complications after transplantation.
Article Synopsis
- * A total of 27 patients were treated, with procedures including vesicovaginal fistula repairs and ureteral reimplants, showing no need for conversion to open surgery and successful outcomes.
- * The results indicate that this robotic approach is not only effective but also successful in cases that had previously experienced repair failures, with a positive follow-up report on complications.
Article Synopsis
- * Conducted in Ahmedabad, India, patients received two doses of convalescent plasma along with standard treatments, and the effectiveness was measured by improvements in symptoms and lab results within 1 to 7 days.
- * Results showed that 9 out of 10 patients fully recovered, with a significant reduction in inflammatory markers, indicating that convalescent plasma therapy is both safe and potentially reduces mortality in this patient group, warranting further research.
Article Synopsis
- * The study aimed to assess the rate of bridge-donor reneging in non-simultaneous kidney exchange cycles through a detailed protocol involving 67 donor-recipient pairs to reduce the likelihood of reneging and protect recipients.
- * Results showed 17 successful non-simultaneous exchanges with 67 kidney transplants using 23 bridge-donors, confirming that this method can safely facilitate kidney donations, especially for hard-to-match patients in resource-limited settings.
Article Synopsis
- There is limited data on the impact of COVID-19 on kidney transplant recipients (KTRs) in emerging countries, specifically in India, where a study involved 250 patients confirmed positive for the virus.
- The study found that KTRs presented with high comorbidity rates, especially hypertension and diabetes, and exhibited a range of COVID-19 symptoms, with 14% experiencing severe disease and a mortality rate of 11.6%.
- Key risk factors for higher mortality included older age, severe disease, prior allograft dysfunction, and the need for intensive care, with significant mortality rates, particularly in ventilated patients.
Two Decades of Deceased Donor Kidney Transplantation at Ahmedabad, India.
Exp Clin Transplant
October 2020
Article Synopsis
- The study at the Institute of Kidney Diseases and Research Center in Ahmedabad, India, analyzes two decades of outcomes from 943 deceased donor kidney transplants conducted between 1997 and 2020.
- Among the 831 recipients, the study reports a 70% patient survival rate and an 84% graft survival rate over an average follow-up of 8 years, highlighting effective strategies that broaden the donor pool.
- The research emphasizes the potential for deceased donor transplants, including those from expanded criteria donors and innovative organ procurement methods, to enhance kidney availability and patient outcomes.
Article Synopsis
- The main strategies for preventing the spread of COVID-19 include social distancing, handwashing, mask usage, travel restrictions, lockdowns, and testing, but implementing these in resource-limited developing countries is challenging.
- Key considerations for deceased-donor organ transplants in these settings involve limited medical resources, healthcare worker availability, and the evolving nature of the pandemic, which complicates efforts to provide care.
- The text advocates for prioritizing pandemic resolution over organ transplants, suggesting that transplant decisions should be made on a case-by-case basis, weighing the necessity against the available resources.
Article Synopsis
- The study demonstrates the successful technique of dual kidney transplantation using the da Vinci Si robotic platform in six recipients, employing a minimally invasive approach.
- The surgeries were performed without conversion to open operations, with average surgical times for venous and arterial connections being 16.4 and 17.5 minutes, respectively.
- Despite minor complications, including delayed graft function in two patients and one postoperative death from pneumonia, the results indicate that dual kidney transplantation through a 7 cm Pfannenstiel incision is technically feasible.
Article Synopsis
- The study evaluates the safety and effectiveness of retroperitoneal laparoscopic donor nephrectomy (RLDN) in obese versus nonobese kidney donors.
- It compares various preoperative and operative parameters, complications, and post-operative outcomes for both groups, with a total of 200 donors analyzed.
- Results show no significant differences in operative times, complications, or recipient serum creatinine levels, indicating RLDN is safe for obese donors.
Article Synopsis
- Retroperitoneoscopy offers a quicker and safer access to the kidney compared to traditional laparoscopic methods for early stage renal cancer, focusing on the outcomes of laparoscopic partial nephrectomy via this approach.
- A study analyzing 24 patients from 2008 to 2014 found that the average age was 49.16 years, with minimal complications observed, including bleeding and urinary leakage, during a follow-up period averaging 33 months.
- The results indicate that the outcomes of laparoscopic partial nephrectomy using the retroperitoneal approach are comparable in safety and effectiveness to both open surgeries and other laparoscopic techniques, regardless of whether the kidney lesion is on the right or left side.
Article Synopsis
- - Kidney exchange transplantation helps increase living donor kidney transplants by addressing issues like blood type and immunological matching, allowing for more complex arrangements beyond simple two-way exchanges.
- - Recent advancements include international kidney exchange programs and various donation schemes that address the challenges of incompatible donor-recipient pairs, while weighing the pros and cons of anonymity and donor travel.
- - Future prospects for kidney and organ transplantation in resource-limited settings focus on the possibility of developing an effective kidney exchange system, raising questions about practicality and feasibility.
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.
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- Most renal trauma cases can be treated without surgery, but severe cases (grade 4 and 5) may need the kidney removed, typically through laparotomy.
- This report highlights a successful laparoscopic nephrectomy in a patient with severe renal trauma that included significant bleeding and urine leakage.
- The authors argue that the transperitoneal method for laparoscopic nephrectomy is more effective and closely mirrors open surgery techniques, while also discussing potential challenges during these procedures in trauma situations.
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.
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.
Article Synopsis
- 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.