Başkent Üniversitesi Yayınları

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Type: search.filters.itemtype.Case ReportSubject: search.filters.subject.Renal transplant

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Now showing 1 - 10 of 11
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    Emergency Endovascular Repair in a Patient With Abdominal Aortic Aneurysm With Pelvic Transplant Kidneys: Case Report
    (Başkent Üniversitesi, 2012-12) Smedile, Gianluca; Tisone, Giuseppe; Leporelli, Paolo; Orlando, Giuseppe; Booth, Christopher; Luca, Linda De; Castrucci, Tommaso; Laria, Giuseppe; Bellini, Maria Irene
    Abdominal aortic aneurysms after a kidney transplant are becoming treated more frequently owing to the extension of renal transplant in severely arteriosclerotic older patients. Renal transplant recipients with autosomal dominant polycystic kidney disease are prone to develop abdominal aortic aneurysms. We present the case of a ruptured abdominal aortic aneurysm that occurred in a renal transplant patient with autosomal dominant polycystic kidney disease. The patient was treated with emergency endovascular repair because open surgery could not be performed successfully owing to the presence of massive polycystic native kidneys and a liver that was occupying the entire peritoneal cavity. His postoperative course was uneventful without complications. The important lessons to be learned from our case are 2-fold: (1) Autosomal dominant polycystic kidney disease renal transplant recipients should be screened annually for abdominal aortic aneurysms to prevent ruptures and (2), emergency endovascular repair may be a preferred treatment in renal transplant recipients owing to its low surgical risk and success.
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    Isolated Ocular Surface Squamous Neoplasia in a Renal Transplant Recipient
    (Başkent Üniversitesi, 2012-10) Aktas, Nimet; Aytac, Berna; Kilic, Nurten; Yazici, Bulent; Ersoy, Alparslan
    Ocular surface squamous neoplasia is a rare complication after a kidney transplant, related with increased risk and poor prognosis. Generally, ocular surface squamous neoplasia in kidney transplant patients is associated with skin lesions. We report a case of ocular surface squamous neoplasia without skin lesions in a kidney transplant recipient. Systematic periodic ophthalmic evaluation of recipients may help ensure the early diagnosis of subtle ocular surface squamous neoplasia.
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    Effective Therapy for Acute Antibody-Mediated Rejection With Mild Chronic Changes: Case Report and Review of the Literature
    (Başkent Üniversitesi, 2012-08) Osama Gheith,; Ibraheim, Mona; Saied, Tarek; Muzeirei, Ibraheem; Al-Waheeb, Salah; Nair, Prasad; Halim, Medhat; Nampoory, Narayanan; Al-Otaibi, Torki
    To reduce the long-term toxicities of immuno­suppressant drugs, corticosteroid-sparing and calcineurin-inhibitor–sparing immunosuppression protocols have become increasingly popular in managing kidney transplant recipients. The most vexing clinical condition caused by antibodies in organ transplants is antibody-mediated rejection. Limitations of the current antibody-mediated rejection therapies include (1) antibody-mediated rejection reversal tends to be gradual rather than prompt, (2) expense, (3) rejection reversal rates below 80%, (4) common appearance of chronic rejection after antibody-mediated rejection treatment, and (5) long-term persistence of donor specific antibodies after therapy. Because these limitations may be due to a lack of effects on mature plasma cells, the effects of bortezomib on mature plasma cells may represent a quantum advance in antihumoral therapy. Our experiences represent the first clinical use of bortezomib as an antihumoral agent in renal allograft recipients in Kuwait. We present 2 cases with resistant-acute antibody-mediated rejection to the standard therapies that were managed successfully with bortezomib.
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    "True"Mycotic Aneurysm of the Anastomotic Site of the Renal Allograft Artery
    (Başkent Üniversitesi, 2012-08) Reddy, Chilumula Ram; Murthy, PVLN; Dakshinamurty, Kaligotla Venkata; Prayaga, Aruna; Krishna, Lanka S. R.; Swarnalatha, Gudithi; Ram, Rapur
    The incidence of vascular complications after renal transplant as reported varies from 3.5% to 14%. Pseudoaneurysm formation at the site of the anastomosis is a rare complication, and only a few cases have been reported. There also were only a few reports of "true" mycotic aneurysms of the renal allograft artery. We present 2 patients with true mycotic aneurysmal formation of the renal allograft artery after a renal transplant. Both patients presented with fever and increasing serum creatinine levels. Cultures from aneurysm tissue samples have grown Aspergillus flavus. Both patients were subjected to an allograft nephrectomy, and amphotericin was given.
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    Surgical Correction of Nephrogenic Ascites in a Renal Transplant Recipient
    (Başkent Üniversitesi, 2012-08) Jaffers, Gregory J.; Fasola, Carlos G.; Narayanan, Mohanram
    The unusual development of massive ascites, 3 years after renal transplant, caused by undefined, innate renal allograft pathology is described. Challenges of surgical correction of this problem, allowing for salvage of the allograft, are reviewed.
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    Successful Management of Critical Illness Polyneuropathy and Myopathy in Renal Transplant Recipients
    (Başkent Üniversitesi, 2012-02) Gheith, Osama; Nampoory, M.R. Narayanan; Balaha, Mohamed; Hosni, Waleed; Zakareya, Zakareya; Abd-el-Tawab, Khalid; Nair, Prasad; Said, Tarek; Halim, Medhat; Otaibi, Torki Al
    Critical illness polyneuropathy and myopathy commonly occur in patients with multiorgan failure and sepsis. Distal muscle weakness and loss of deep tendon reflexes are usually found, with sparing of the cranial nerve musculature. Many risk factors have been identified, specifically hypoxia, hypotension, hyperpyrexia, and age. Other independent risk factors include female sex, severity of illness, duration of organ dysfunction, renal failure and renal replacement therapy, hyperosmolality, parenteral nutrition, low serum albumin level, duration of intensive care unit stay, vasopressor and catecholamine support, and central neurologic failure. Hyperglycemia also has been identified as an independent risk factor, with important potential affect in terms of prevention. Herein, we report the development of critical illness polyneuropathy and myopathy in 7 of 22 renal transplant recipients who underwent successful ventilator weaning during treatment for bronchopneumonia. This is the first report of critical illness polyneuropathy and myopathy among renal transplant recipients. Clinical suspicion and electrophysiologic studies are tools for early diagnosis. Proper management, including correction of risk factors (especially diabetes) and long-term rehabilitation measures might be beneficial.
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    Posttransplant Lymphoproliferative Disorder With Lung Involvement in a Renal Transplant Recipient
    (Başkent Üniversitesi, 2011-12) Mirza, Emel Isiktas; Akyurek, Nalan; Arinsoy, Turgay; Derici, Ulver; Aki, Sahika Zeynep; Okyay, Gulay Ulusal; Suyani, Elif; Mutluay, Ruya
    Posttransplant lymphoproliferative disorder is one of the most important complications of solid-organ transplant in terms of malignancy. Here, we report a case of Epstein-Barr-virus–negative posttransplant lymphoproliferative disorder of T-cell type, involving the lung, in a renal transplant recipient. A 23-year-old woman received a living-related renal transplant in 2002. She presented with a 6-month history of weight loss, malaise, night sweats, and lymphadenopathy 6 years after the transplant. Chest radiograph showed miliary opacities. We performed a biopsy of the submandibular mass and computed-tomography–guided transthoracic needle biopsy of the lung. Pathological investigation of lymphadenopathy and lung were inconsistent with posttransplant lymphoproliferative disorder of T-cell type. After the diagnosis of posttransplant lymphoproliferative disorder, her immunosuppressive regimen was modified, and she was treated with cyclophosphamide, doxorubicin, vincristine, prednisolone, ifosfamide, carboplatin, and etoposide chemotherapies, which resulted in partial remission. Posttransplant lymphoproliferative disorders may be seen as an atypical presentation; the differential diagnosis should be thought of pulmonary infiltrates in renal transplant recipients.
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    Ramsay Hunt Syndrome With Atypical Progress in a Renal Transplant Recipient: A Case Report
    (Başkent Üniversitesi, 2011-12) Ozel, Leyla; Canbakan, Mustafa; Titiz, Izzet; Kucuk, Mustafa; Ata Eren, Pinar; Kara, Melih; Unal, Ethem; Toros, Sema Zer
    Ramsay Hunt syndrome is a rare complication of herpes zoster disease in which reactivation of latent varicella zoster virus infection occurs in the geniculate ganglion causing otalgia, unilateral vesicular eruption in a restricted dermatomal distribution, and peripheral facial paralysis. Dermal infections caused by human pathogenic herpes viruses are common in organ transplant recipients. For a transplant surgeon, it is imperative to remember that viral prophylaxis is essential in the follow-up of the transplant patients. Here, we presented a case of renal transplant and Ramsay Hunt syndrome with multiple cranial nerve involvement, with an atypical course. Management and differential diagnosis of this particular case are discussed with a review of the literature.
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    Chronic Myeloid Leukemia Within a Year of Kidney Transplant With Elevated Alkaline Phosphatase Correlated With Imatinib Therapy
    (Başkent Üniversitesi, 2011-10) Sayar, Hamid; Mehta, Rakesh; Taber, Tim E.; Sharfuddin, Asif A.
    The incidence of certain malignancies is significantly higher after organ transplant. However, there are rare reports of chronic myeloid leukemia in the posttransplant setting. The average reported interval between a transplant and the diagnosis of chronic myeloid leukemia is 44 months (range, 10-96 mo). We report 2 patients with chronic myeloid leukemia within 1 year of a kidney transplant, which is significantly shorter than those previously reported. Both patients were receiving mycophenolate mofetil and tacrolimus for immunosuppression. They were treated with imatinib for chronic myeloid leukemia, and both patients demonstrated an isolated elevation of serum alkaline phosphatase that was directly correlated with imatinib. Despite a potential interaction between the 2 drugs, blood levels of tacrolimus and imatinib were not elevated during the course of treatment. Isolated elevation of alkaline phosphatase in this particular setting has not been reported previously.
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    Aspergillus Fumigatus Spondylodiskitis in Renal Transplant Patient: Voriconazole Experience
    (Başkent Üniversitesi, 2011-08) Ersoy, Alparslan; Ener, Beyza; Akalin, Halis; Oruc Koc, Aysegul; Dizdar, Oguzhan Sitki
    The incidence of invasive aspergillosis has increased after solid organ transplant. However, aspergillus osteomyelitis in vertebrae is rare. We report a case of aspergillus spondylodiskitis after pulmonary aspergillosis in a renal transplant recipient. He was treated by antifungal therapy and surgical intervention. The transplantist should be alert for a diagnosis of aspergillus spondylodiskitis in recipients who developed back pain after aspergillosis infection in other sites.