Browsing by Author "Chewaproug, Daranee"

Now showing 1 - 3 of 3

Cutaneous Metastasis of Pancreatic Adenocarcinoma After Kidney Transplant: A Case Report and Review of the Literature
(Başkent Üniversitesi, 2010-12) Pontinen, Thomas; Ortiz, Jorge; Zaki, Radi; Kung, Shiang Cheng; Chewaproug, Daranee; Khanmoradi, Kamran; Varadi, Gabor; Melin, Alyson
Objectives: Pancreatic cancer is one of the most lethal human cancers. Each year in the United States, about 42 470 individuals are diagnosed with this condition, and 35 240 die, despite advances in imaging, medical treatment, and surgical intervention. Often, 80% to 90% of pancreatic cancers are diagnosed at the locally advanced or metastatic stage. However, cutaneous metastases originating from pancreatic cancer are rare. If cutaneous metastases do indeed occur, it is often near the umbilicus, known as the Sister Mary Joseph’s nodule. Nonumblical cutaneous metastases are rare, with only several cases reported, but none regarding lesions after organ transplant. We introduce the first reported case of a cutaneous metastatic lesion of pancreatic adenocarcinoma after the transplant of an organ. We also performed a literature review and an analysis of reported cases of nonumblical cutaneous metastases of pancreatic adenocarcinoma. Materials and Methods: We performed a MEDLINE and PubMed search of reported nonumblical cutaneous metastases of pancreatic adenocarcinoma since 1980 after a literature review and analysis. Results: Our case involved a 76-year-old woman who developed cutaneous pancreatic adenocarcinoma metastases in her surgical wound 2 years after a bilateral kidney transplant. This is the first case of pancreatic adenocarcinoma cutaneous metastases after an organ transplant. Conclusions: The death rate from cancer has increased as the population has aged. This also holds true for transplant recipients. Some believe that cancer will soon surpass cardiovascular disease as the major cause of mortality after transplant. Therefore, it is incumbent upon us to appropriately screen patients with age-appropriate evidence-based examinations. Additionally, those patients with suspicious presentations should be judiciously evaluated to discover a cure for cancer as quickly as possible.
Early Allograft Biopsies Performed During Delayed Graft Function May Not Be Necessary Under Thymoglobulin Induction
(Başkent Üniversitesi, 2012-06) Ortiz, Jorge; Chewaproug, Daranee; Balasubramanian, Manju; Zaki, Radi; Campos, Stalin; Feyssa, Eyob; Khanmoradi, Kamran; Mumtaz, Khurram; Parsikia, Afshin
Objectives: Delayed graft function affects up to 50% of kidney transplant recipients. Some guidelines recommend surveillance biopsies beginning 7 days after engraftment. This may be unnecessary with anti-thymocyte globulin induction. Materials and Methods: We conducted a retrospective study of deceased-donor renal transplant recipients with delayed graft function. Results: One hundred eleven patients met the inclusion criteria. The incidence of rejections during delayed graft function was 2.7%. They were diagnosed between 9 and 11 days after transplant. The subsequent incidence of rejection at 12-month follow-up was 13.5% (n=15). The median time to rejection after transplant was 10 weeks. Fourteen of 15 patients had subtherapeutic immunosuppression. The only risk factor associated with later rejection after delayed graft function was use of donors after cardiac death. Conclusions: Early rejection during delayed graft function with anti-thymocyte globulin induction and maintenance immunosuppression with tacrolimus, mycophenolate mofetil, and steroids is rare. When later rejection occurs, it is at a median of 10 weeks after a transplant. Two of the 3 early rejections were antibody mediated. Later rejections were associated with subtherapeutic immunosuppression and donors after cardiac death. Biopsies need not be performed during the early postoperative period when anti-thymocyte globulin is used with tacrolimus, mycophenolate mofetil, and steroids.
Horseshoe Kidneys: An Underutilized Resource in Kidney Transplant
(Başkent Üniversitesi, 2010-03) Zaki, Radi; Ortiz, Jorge; Pontinen, Thomas; Khanmoradi, Kamran; Kumar, Anil; Kudsi, Hussam; Kung, Shiang Cheng; Chewaproug, Daranee
Objectives: Although the number of patients awaiting renal transplant is rapidly increasing, the donor pool has remained relatively stable. Horseshoe kidneys, a common renal fusion anomaly, can provide a useful solution to the ever-increasing gap between supply and demand. Materials and Methods: These kidneys can be transplanted, en bloc, into a single recipient or divided and transplanted into 2 recipients. Results: We report 2 cases of successful kidney transplants. Conclusions: The first is a split horseshoe kidney, transplanted into a single recipient, and the second, a horseshoe kidney from a donor after cardiac death split and transplanted into a single recipient. The second case is the first reported case of a horseshoe kidney transplant from a donor after cardiac death. We also performed a review of the literature of horseshoe kidneys with the hope of raising awareness of the necessity and promise of such transplants.