Abrogation of antibodies improves outcome of renal transplantation.

Introduction: Antibodies are known to cause rejection and therefore are detrimental to graft survival. We describe two protocols of clonal stimulation deletion (CSD) pretransplant followed by grafting with no conventional immunosuppression (IS).

Methods: CSD was employed in 54 patients of mean age, 28.

IgM nephropathy in India: a single centre experience.

Objective: To find out the incidence and natural history of IgMN in India.

Methods: Renal biopsies of children ≤12 y age of last 6 y were retrospectively evaluated. Their clinical and biochemical presentation were correlated.

Successful treatment of Nocardia pneumonia with cytomegalovirus retinitis coinfection in a renal transplant recipient.

Nocardiosis is a rare opportunistic infection, especially seen in immunocompromised patients, including renal allograft recipients. Primary pulmonary infection is the most common clinical pattern and can easily result in disseminated Nocardia infection if treatment therapy is not adequate at the beginning. We report a case of pulmonary nocardiosis associated with cytomegalovirus retinitis in a renal transplant recipient, followed by chronic allograft dysfunction.

Unusual presentation of Plasmodium vivax: a neglected human malaria parasite.

Severe and complicated malaria is usually caused by Plasmodium falciparum malaria (PF) but it has been increasingly observed that Plasmodium vivax malaria (PV), which was otherwise considered to be benign malaria, with a low case-fatality ratio, can also occasionally result in severe disease as with PF malaria. There is an urgent need to re-examine the clinical spectrum and burden of PV so that adequate control measures can be implemented against this emerging but neglected disease. We report a case of severe PV malaria with multi-organ dysfunction.

The analgesic efficacy of peritubal infiltration of 0.25% bupivacaine in percutaneous nephrolithotomy - A prospective randomized study.

Background: Percutaneous nephrolithotomy is a routine endourologic procedure in patients with renal stones. Although it is less painful than open surgery, good postoperative analgesia is required to alleviate pain around nephrostomy tube.

Materials And Methods: Sixty ASA grade I patients, 18 to 60 years of age, of either sex were randomized to receive 20 ml of 0.

Acute hypoxaemia due to intraoperative lung collapse after repositioning the patient.

Desaturation after induction of anaesthesia and repositioning due to mucus plug causing atelectasis (lung collapse) is a rare event. We present a case of intraoperative right lung collapse due to mucus plug in a patient undergoing left laparoscopic nephrectomy. Hypoxaemia occurred after the induction of anaesthesia and repositioning.

Acute renal failure in the pediatric age group - single center prospective study of 180 cases.

Acute renal failure (ARF) is one of the common emergencies in pediatric practice. In the Indian subcontinent, its etiology, clinical features and outcome vary from other parts of the world. We decided to perform a prospective study of ARF in 180 pediatric patients admitted to our institute between August 2006 and March 2008.

Lupus nephritis associated with CD20+ B-cell NHL.

The combination of NHL and documented malignancy-associated glomerulonephritis is uncommon. Also, no single renal pathological entity is consistently found in patients with NHL. Epstein-Barr virus (EBV) infection may manifest as systemic lupus erythematosus (SLE) and/or diffuse large cell lymphoma (DLBCL) in a genetically/ immunologically susceptible individual with defective cytotoxic T-cell response against EBV.

Deceased donor organ transplantation: A single center experience.

Renal transplantation (RTx) is the best therapeutic modality for patient suffering from end-stage renal disease (ESRD). Deceased donor organ transplantation (DDOT) accounts for <4% of RTx in India. We report 4 years single centre experience on DDOT vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr), rejection episodes, and delayed graft function in 160 DDOT.

Outcome of deceased donor renal transplantation in diabetic nephropathy: a single-center experience from a developing country.

Background: Type 2 diabetes mellitus (DM) is the commonest cause of end-stage renal disease (ESRD) worldwide. Renal transplantation (RTx) is the best therapeutic modality for such patients. First-degree relatives of patients with type 2 DM have high risk of diabetes/pre-diabetes.

Post-exposure prophylaxis for H1N1 with oseltamivir in renal allograft recipient--safe and effective without any immunosuppresive drug interaction.

Kidney transplant recipients are at a high risk for H1N1 infection associated complications during the current pandemic. Prevention of infection by immunization, together with early recognition and prompt antiviral treatment are critical. Post-exposure prophylaxis of H1N1 with oseltamivir was safe, effective and well tolerated to prevent H1N1 influenza A virus infection in newly transplanted renal allograft recipient receiving triple immunosuppression without any interaction with tacrolimus level.

Breast carcinoma metastasizing to the urinary bladder and retroperitoneum presenting as acute renal failure.

Breast carcinoma is the most common nondermatologic cancer diagnosis in women. Common metastatic sites include lymph nodes, lung, liver, and bone. Breast carcinoma metastatic to the bladder has been reported only sporadically.

Hemodialysis through persistent left superior vena cava.

We report a case of end stage renal disease patient who displayed a persistent left superior vena cava (PLSVC) after placement of hemodialysis (HD) catheter through left internal jugular vein, as revealed by routine post-procedure X-ray chest. The diagnosis of PLSVC was confirmed by arterial blood gas, two-dimensional echocardiography, computed tomography thorax and angiographic examination. This anomaly is rather rare; few studies on safety of PLSVC for HD have been reported.

Carotid-jugular arteriovenous fistula: a case report of an iatrogenic complication following internal jugular vein catheterization for hemodialysis access.

We report a case of diabetic end-stage renal disease patient who presented with a right common carotid artery jugular arteriovenous fistula as a complication of the insertion of a polyurethane double-lumen hemodialysis catheter into the right internal jugular vein .On physical examination of the neck, a pulsating mass with a palpable thrill and a bruit was noted in the right subclavicular region. The diagnosis was confirmed by color doppler ultrasonography of the neck and carotid angiography.

Laparoscopic excision of a congenital seminal vesicle cyst associated with ipsilateral renal agenesis.

Seminal vesicle cyst (SVC) with ipsilateral renal agenesis is a rare congenital anomaly. Surgical treatment is indicated for symptomatic patients. The open surgical approach, traditionally considered the definitive form of treatment, has been associated with a high rate of morbidity.

Laparoscopic kidney transplantation: an initial experience.

Laparoscopic donor nephrectomy has the advantages of less pain, early ambulation and shorter hospitalization compared to open donor nephrectomy. Kidney recipient surgery is, however, traditionally performed by open surgery. Our aim was to study feasibility and safety of laparoscopic kidney transplantation (LKT).

Living donor paired-kidney exchange transplantation: A single institution experience.

Introduction: Paired-kidney exchange (PKE) is used in western countries to increase donor pool. In India, there are not many centers involved in PKE program. We present 10 years of this experience and outcome of the recipients.

Cotransplantation of adipose tissue-derived insulin-secreting mesenchymal stem cells and hematopoietic stem cells: a novel therapy for insulin-dependent diabetes mellitus.

Aims. Insulin dependent diabetes mellitus (IDDM) is believed to be an autoimmune disorder with disturbed glucose/insulin metabolism, requiring life-long insulin replacement therapy (IRT), 30% of patients develop end-organ failure. We present our experience of cotransplantation of adipose tissue derived insulin-secreting mesenchymal stem cells (IS-AD-MSC) and cultured bone marrow (CBM) as IRT for these patients.

High mortality in critically ill patients infected with 2009 pandemic influenza A (H1N1) with pneumonia and acute kidney injury.

Patients infected with H1N1 virus may develop pneumonia and acute kidney injury (AKI). To determine the epidemiological characteristics, clinical features, management and out-comes of patients with confirmed H1N1 complicated by pneumonia and AKI and treatment with oseltamivir and to identify the prognostic indicators, we studied all the patients with a confirmed diagnosis of H1N1 infection with pneumonia and AKI, using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay, between October 2009 and March 2010. H1N1 infection was confirmed in 20 patients with pneumonia and AKI; the mean age was 42.

Treatment of polyglandular autoimmune syndrome type 3 using co-transplantation of insulin-secreting mesenchymal stem cells and haematopoietic stem cells.

The authors report a 17-year-female and a 19-year-male with uncontrolled insulin-dependent diabetes mellitus (IDDM) for ≥10 years, treated with insulin-secreting human adipose tissue derived mesenchymal stem cells (IS-h-ADMSC). Both had hypothyroidism and were diagnosed as polyglandular autoimmune syndrome type-3 (PGAS-3). PGAS are rare polyendocrinopathies with ≥2 endocrine disorders mediated by autoimmune mechanisms leading to hypo-function and organ failure.

Malaria induced acute renal failure: a single center experience.

Malaria has protean clinical manifestations and renal complications, particularly acute renal failure that could be life threatening. To evaluate the incidence, clinical profile, out-come and predictors of mortality in patients with malarial acute renal failure, we retrospectively studied the last two years records of malaria induced acute renal failure in patients with peripheral smear positive for malarial parasites. One hundred (10.

Successful renal transplantation after recovery from acute disseminated encephalomyelitis in a child with end-stage renal disease.

Acute disseminated encephalomyelitis (ADEM), seen mostly in children, is an acute demyelinating disease, affecting mainly the white matter of brain and spinal cord. We report an unusual case of ADEM in an 11-year old boy with endstage renal disease, who underwent hemopoietic stem cell transplantation prior to renal transplantation. He needed admission to the intensive care unit and required mechanical ventilation.

Successful en bloc transplantation of pediatric deceased donor kidneys with grade 1 injury.

Kidney transplantation from deceased donors is in its infancy in India. Marginal donors are now accepted by many centers for kidney transplantation. We report a case of procurement of en bloc kidneys from a pediatric deceased donor having grade 1 renal injury and transplanted to an adult recipient with a follow up of two years and five months.

Triad of bladder agenesis with solitary kidney and ectopic ureter.

The bladder agenesis is an extremely rare congenital genitourinary anomaly; only 60 cases have been reported in the English literature and only 19 of these were noted in viable neonates.[1] Our case represents the 20th live birth with bladder agenesis. The triad of bladder agenesis with solitary kidney and ectopic ureter is seldom compatible with life due to associated anomalies.