Browsing by Author "Malekhosseini, Seyed Ali"

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Clinical Experience in Organ Transplant From The Shiraz Transplant Center: 2011
(Başkent Üniversitesi, 2012-08) Nikeghbalian, Saman; Malekhosseini, Seyed Ali; Salehipour, Mahdi; Bahador, Ali; Salahi, Heshmatollah; Mehdi, Syed Heider; Bahreini, Amin; Far, Alireza Shamsaee; Kazemi, Kourosh; Aliakbarian, Mohsen
Objectives: The Shiraz Organ Transplant Center, the largest transplant center in Iran, has expanded its program of organ transplant during recent years. This article seeks to summarize organ transplantation over the last 2 decades and evaluate its status as of 2011. Materials and Methods: We retrospectively analyzed the clinical records of all organ transplants performed in our center in 2011. We reviewed the patients’ demographics, underlying disease, operation details as well as postoperative complications. Results: During this period, 655 organ transplants including 345 liver, 297 kidney, 29 pancreas, and 11 intestine and multivisceral transplants were done. Among 345 liver transplants, 291 patients received a deceased-donor graft including 18 cases of split liver transplants while 54 patients received living-donor liver transplants. The 1-year graft and patient survival rates were 90.1% and 91%. Conclusions: In recent years, our program in organ transplantation has expanded in number and variety of organs transplanted. This improvement is related to our multidisciplinary strategies to expand the donor pool and the experiences obtained during our transplant activities.
CTLA4 CT60 A/G Gene Polymorphism in Liver Transplant Recipients
(Başkent Üniversitesi, 2010-09) Azarpira, Negar; Daraie, Masumeh; Aghdaie, Mahdokht Hosein; Malekhosseini, Seyed Ali
Objectives: Cytotoxic T-lymphocyte antigen 4 (CTLA4) has a critical role in the down-regulation of the immune response. We retrospectively examined the association between acute rejection and the single nucleotide polymorphism A/G in the CTLA-4 CT60 gene in liver transplant recipients. Materials and Methods: Fifty-one liver transplant recipients with at least 3 months’ follow-up were selected and genotyped for CTLA-4 CT60 polymorphism (HpyCH4 IV). The association of each genotype with allograft acute rejection was evaluated. Results: The mean age of patients was 27.9 ± 15.17 years (minimum, 1 year, maximum, 55 years), with 39% male and 61% female. Overall, 17 recipients (33.3%) experienced acute rejection within the first 3 months after a liver transplant. In our study, 50% of the patients (n=26) have G/A , 31% (n=16) have A/A, and 17% have G/G genotypes (n=9). Distribution of alleles was not different according to underlying liver disease. There also was no difference in sex, age, and distributions of CTLA-4 CT60 alleles with acute rejection episodes. Conclusions: CT60 A/G dimorphism within the 3'-UTR of CTLA4 gene does not influence acute rejection development in liver transplant. However, organ rejection is determined by a combination of several genetic traits rather than a single gene. Therefore, more studies with larger patient numbers are necessary to investigate the effect of combinations of genetic phenotypes involved in this process.
Determining the Incidence of Aspergillosis After Liver Transplant
(Başkent Üniversitesi, 2010-09) Badiee, Parisa; Shakiba, Elaheh; Nikeghbalian, Saman; Malekhosseini, Seyed Ali; Alborzi, Abdolvahab
Objectives: Aspergillus has become an increasingly frequent cause of life-threatening opportunistic infections in liver transplant recipients. This study seeks to determine the incidence of invasive aspergillosis in liver transplant recipients using routine and molecular methods in a teaching hospital in Shiraz, the unique center for liver transplant in Iran. Materials and Methods: Four hundred eight recipients who underwent liver transplant were followed for Aspergillus infections by microscopic examination, culture, and nested polymerase chain reaction. Blood samples were cultured by bedside inoculation to BACTEC medium. Results: The female-to-male ratio was 151:257 (mean age, 29.6 years; mean hospitalization, 26 days). Sensitivity and specificity of the nested polymerase chain reaction was 92.8% and 94%. Aspergillosis was detected in 19 recipients (4.6%) by routine and molecular method (4 proven, 10 probable, and 5 possible) of whom 12 recipients died (63.2%). Conclusions: This study found the incidence rate of invasive aspergillosis as an uncommon complication of liver transplant recipient cases but associated with poor outcomes. The rate is consistent with those reported in previous studies, but molecular assay that is more-sensitive and specific was used in the present study.