Browsing by Author "Hari Shankar Meshram"

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COVID-19 in Kidney Transplant Recipient With Concomitant Burn Injury: A Challenge to Balance Immunosuppression
(Başkent Üniversitesi, 2021-09) Hari Shankar Meshram; Vivek B. Kute,; Sanshriti Chauhan; Ruchir Dave
The COVID-19 pandemic has grossly affected the transplant communities with no exception to any geographic area. Burn injury remains an important public health problem, even during the pandemic. The management of concomitant burn in an organ transplant recipient has been rarely described. Here, we report a kidney transplant recipient who was admitted for moderate COVID-19 symptoms and then sustained a second-degree inhalational burn injury at home on day 2 after discharge from COVID-19. The patient was shown to be COVID-19 positive and was isolated initially in the burn unit. After a second negative report on day 3 of hospital admission, the patient was shifted to the general ward. He required a hemodialysis session and modification of immunosuppression, which was done through telemedicine from our center. The wound was complicated by a rejection episode, which was treated by regrafting. He recovered on day 45 after injury with baseline immunosuppression restored. His serum creatinine reached a nadir of 3.2 mg/dL, and he has continued on regular follow-up. In summary, our case highlights the difficulty in managing burn cases during the pandemic. The added problem of balancing immunosuppression in organ transplant recipients with burn injuries is a daunting task for transplant physicians.
Development of Tissue Banks in Developing Nations: A Journey From Past to Future
(Başkent Üniversitesi, 2021-03) Hari Shankar Meshram; Sanshriti Chauhan; Vivek B. Kute
Tissue banks are a relatively new concept in the emerging world. This review aims to comprehensively analyze the challenges and solutions for establishing tissue banks in developing nations. The burden of burns and road traffic accidents in the developing nations is disproportionately higher than in developed countries and so are the mortality rates associated with them. There is an unmet need for more tissue banks to counteract these problems. This was obvious from the historical aspect, with the era of tissue transplant emerging 3 decades later in developing nations versus developed nations and with many regions that have still not yet initiated tissue transplantation. The challenges ahead involve a lack of infrastructure, a lack of awareness, and many legal and ethical issues. A multidisciplinary team effort, even despite a lack of resources, is the mainstay of progress in tissue banks in resource-limited regions. The potential solutions to overcome this problem include simplified and applicable legislations, the development of continuous and long-term awareness programs, and integrated and harmonious efforts from all regions of the world. We hope that this review will help transplant authorities throughout the world to understand this problem statement and the need for timely action for concerting the path to successful tissue banking in emerging nations.