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Fungal infections in renal transplant recipients in a tertiary care centre – Single centre experience
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indian journal of transplantation 9 (2015) 73–81
variables. Pearson's correlation coefficient was used to see the relationship between the tools used in the study. Results: There was a significant (p = .025) difference in the levels of depression and the type of dialysis. Depression score is positively correlated with denial and blame, r = 0.363 (p = .004) and negatively correlated for problem-solving r = .442 (p = .000); positive distraction r = .489 (p = .000); acceptance and redefinition r = .496 (p = .000) and religion and faith r = .391 (p = .002). The duration of illness was positively correlated with the duration on waiting list r = .530 (p = .000) and duration of dialysis r = .726 (p = .000). There was a positive correlation between duration on the waiting list and duration of dialysis r = .751 (p = .000). Anxiety score was positively correlated with negative distraction r = .331 (p = .008) and denial and blame r = .323 (p = .010). Stress score was negatively correlated with problem solving r = .334 (p = .007); positive distraction r = .386 (p = .002) and acceptance redefinition r = .394 (p = .001). Stress score was positively correlated with denial and blame r = .303 (p = .016). Conclusions: Results indicate that persons with ESRD have depression, anxiety and stress and psychosocial interventions are required to help them cope better. http://dx.doi.org/10.1016/j.ijt.2015.09.083 Abstract #: ISOT2015-37 Fungal infections in renal transplant recipients in a tertiary care centre – Single centre experience S. Ananth, K. Praveen Kumar, K. Varaprasada Rao Narayana Medical College, Nellore, Andhra Pradesh, India Background: Infections are major source of morbidity and mortality in renal transplants. Invasive fungal infections cause lethal problems. The opportunistic pathogens such as Candida, Aspergillus, and Mucor mycosi are known to infect. Recipients of solid organ transplants have 24–40% incidence of opportunistic fungal infections with a mortality of 70–100%. This is related to the environmental exposure and net state of immunosuppression. Aims: To report the spectrum of fungal infections in renal transplant recipients from Narayana Medical College, Nellore. Methodology: All the 50 patients who underwent renal transplant in Narayana Medical College were reviewed. All were live related donors. All were on triple immunosuppresion with tacrolimus, MMF, steroids. Patients who were diagnosed having fungal infections were included in our study. 6 cases (12%) were found to have fungal infections. Results: All the patients were males. Out of 6 patients, 4 were found to have aspergillosis. 1 was in the form of cutaneous nodules. 3 were invasive fungal infections (brain, bone, lung). 1 has co-infection with mucormycosis. Two patients were infected with Candida sp. One patient presented with mycotic aneurysm of renal artery. Four patients were treated with i.v. liposomal amphotericin. One patient was treated with oral voriconazole. Three patients died due to severe fungal infection. Conclusions: Systemic fungal infections are an important cause of mortality and morbidity in renal transplant recipients. Infections with aspergillus and mucor are associated with increased mortality. http://dx.doi.org/10.1016/j.ijt.2015.09.084 Abstract #: ISOT2015-64 Software system for management of organ transplant centers Anita Kulkarni Puranik Metamagics Computing Pvt Ltd, Pune, India
Background: We are a software product company. We provide solutions to manage and analyse patient data. Aims: To talk about our software and show how it can relieve the doctors at the organ transplant centers from routine chores of managing patient data manually in paper format. Methodology: Organ transplants are complicated and high risk procedures. The transplant center doctors are working at the cutting edge of medical knowledge and technology. Why should they be struggling with paper-based systems when it comes to patient data? Waiting lists at the transplant centers are long and patients suffering from many complications need to be managed and stabilized until the organ comes their way. We provide software solution manage the complete transplantation care life cycle from pre-assessment, assessment, transplantation and follow-up protocol. Our solution follows the progress of complex patient populations, tracks care activities, and coordinates communication within the clinical care environment. It includes a comprehensive data management module to get all of patients' historical and assessment data. The intelligent listing management component consists of a dynamic scoring that visually indicates how far the assessment process is complete. Results: Our solution was implemented at one of the large corporate hospitals for their liver transplant unit. This has helped the unit to go paperless. In India harvested organs cannot cross the sate boundaries, but the number of expert transplant surgeons is rather limited. Hence, patients are listed at multiple locations and have no certainty of where they will get the organ. In such a scenario, having all the medical history and assessment results on a secure cloudbased system and accessible using even a smart phone makes the management of the entire life cycle easy. On the other hand, the surgeons are now able to analyse the patient population data for organ procurement, improvement and optimization. Conclusions: Efficient listing management. Improved remote post-transplant care. Accessibility of data from multi-location centers. http://dx.doi.org/10.1016/j.ijt.2015.09.085 Abstract #: ISOT2015-54 Case of Pauci immune glomerulonephritis in donor nephrectomy K. Jyothi Priyadarshini, Pradeep Deshpande, Manjusha Yadla, Ramesh Chada Gandhi Hospital, Hyderabad, India Background: The rate of living donor renal transplantations has increased. However, in view of the possible complications, the question as to whether the condition of the recipient justifies operation of the donor still remains unanswered. The present case enumerates an unusual presentation of vasculitis in woman with donor nephrectomy. Aims: Case of Pauci immune glomerulonephritis in a patient with donor nephrectomy. Methodology: 55-yr-old lady non-diabetic and non-hypertensive who underwent donor nephrectomy 4 yrs back, recipient being her son, admitted with complaints with bilateral pedal edema, oliguria and azotemia. On evaluation CUE showed 1+ protein and 15–20 RBC/hpf. 24 hr urine protein is 330 mg. Her serum creatinine is 1.5 mg/dl with eGFR of 37 ml/min. Her C3 and C4 were within normal limits. ANCA serology negative. In view of active urine sediment, patient underwent left renal biopsy, report s/o Pauci immune glomerulonephritis. Patient is counselled regarding AVF and vaccination. Patient is started on immunosuppression with steroids and cyclophosphamide.
indian journal of transplantation 9 (2015) 73–81
variables. Pearson's correlation coefficient was used to see the relationship between the tools used in the study. Results: There was a significant (p = .025) difference in the levels of depression and the type of dialysis. Depression score is positively correlated with denial and blame, r = 0.363 (p = .004) and negatively correlated for problem-solving r = .442 (p = .000); positive distraction r = .489 (p = .000); acceptance and redefinition r = .496 (p = .000) and religion and faith r = .391 (p = .002). The duration of illness was positively correlated with the duration on waiting list r = .530 (p = .000) and duration of dialysis r = .726 (p = .000). There was a positive correlation between duration on the waiting list and duration of dialysis r = .751 (p = .000). Anxiety score was positively correlated with negative distraction r = .331 (p = .008) and denial and blame r = .323 (p = .010). Stress score was negatively correlated with problem solving r = .334 (p = .007); positive distraction r = .386 (p = .002) and acceptance redefinition r = .394 (p = .001). Stress score was positively correlated with denial and blame r = .303 (p = .016). Conclusions: Results indicate that persons with ESRD have depression, anxiety and stress and psychosocial interventions are required to help them cope better. http://dx.doi.org/10.1016/j.ijt.2015.09.083 Abstract #: ISOT2015-37 Fungal infections in renal transplant recipients in a tertiary care centre – Single centre experience S. Ananth, K. Praveen Kumar, K. Varaprasada Rao Narayana Medical College, Nellore, Andhra Pradesh, India Background: Infections are major source of morbidity and mortality in renal transplants. Invasive fungal infections cause lethal problems. The opportunistic pathogens such as Candida, Aspergillus, and Mucor mycosi are known to infect. Recipients of solid organ transplants have 24–40% incidence of opportunistic fungal infections with a mortality of 70–100%. This is related to the environmental exposure and net state of immunosuppression. Aims: To report the spectrum of fungal infections in renal transplant recipients from Narayana Medical College, Nellore. Methodology: All the 50 patients who underwent renal transplant in Narayana Medical College were reviewed. All were live related donors. All were on triple immunosuppresion with tacrolimus, MMF, steroids. Patients who were diagnosed having fungal infections were included in our study. 6 cases (12%) were found to have fungal infections. Results: All the patients were males. Out of 6 patients, 4 were found to have aspergillosis. 1 was in the form of cutaneous nodules. 3 were invasive fungal infections (brain, bone, lung). 1 has co-infection with mucormycosis. Two patients were infected with Candida sp. One patient presented with mycotic aneurysm of renal artery. Four patients were treated with i.v. liposomal amphotericin. One patient was treated with oral voriconazole. Three patients died due to severe fungal infection. Conclusions: Systemic fungal infections are an important cause of mortality and morbidity in renal transplant recipients. Infections with aspergillus and mucor are associated with increased mortality. http://dx.doi.org/10.1016/j.ijt.2015.09.084 Abstract #: ISOT2015-64 Software system for management of organ transplant centers Anita Kulkarni Puranik Metamagics Computing Pvt Ltd, Pune, India
Background: We are a software product company. We provide solutions to manage and analyse patient data. Aims: To talk about our software and show how it can relieve the doctors at the organ transplant centers from routine chores of managing patient data manually in paper format. Methodology: Organ transplants are complicated and high risk procedures. The transplant center doctors are working at the cutting edge of medical knowledge and technology. Why should they be struggling with paper-based systems when it comes to patient data? Waiting lists at the transplant centers are long and patients suffering from many complications need to be managed and stabilized until the organ comes their way. We provide software solution manage the complete transplantation care life cycle from pre-assessment, assessment, transplantation and follow-up protocol. Our solution follows the progress of complex patient populations, tracks care activities, and coordinates communication within the clinical care environment. It includes a comprehensive data management module to get all of patients' historical and assessment data. The intelligent listing management component consists of a dynamic scoring that visually indicates how far the assessment process is complete. Results: Our solution was implemented at one of the large corporate hospitals for their liver transplant unit. This has helped the unit to go paperless. In India harvested organs cannot cross the sate boundaries, but the number of expert transplant surgeons is rather limited. Hence, patients are listed at multiple locations and have no certainty of where they will get the organ. In such a scenario, having all the medical history and assessment results on a secure cloudbased system and accessible using even a smart phone makes the management of the entire life cycle easy. On the other hand, the surgeons are now able to analyse the patient population data for organ procurement, improvement and optimization. Conclusions: Efficient listing management. Improved remote post-transplant care. Accessibility of data from multi-location centers. http://dx.doi.org/10.1016/j.ijt.2015.09.085 Abstract #: ISOT2015-54 Case of Pauci immune glomerulonephritis in donor nephrectomy K. Jyothi Priyadarshini, Pradeep Deshpande, Manjusha Yadla, Ramesh Chada Gandhi Hospital, Hyderabad, India Background: The rate of living donor renal transplantations has increased. However, in view of the possible complications, the question as to whether the condition of the recipient justifies operation of the donor still remains unanswered. The present case enumerates an unusual presentation of vasculitis in woman with donor nephrectomy. Aims: Case of Pauci immune glomerulonephritis in a patient with donor nephrectomy. Methodology: 55-yr-old lady non-diabetic and non-hypertensive who underwent donor nephrectomy 4 yrs back, recipient being her son, admitted with complaints with bilateral pedal edema, oliguria and azotemia. On evaluation CUE showed 1+ protein and 15–20 RBC/hpf. 24 hr urine protein is 330 mg. Her serum creatinine is 1.5 mg/dl with eGFR of 37 ml/min. Her C3 and C4 were within normal limits. ANCA serology negative. In view of active urine sediment, patient underwent left renal biopsy, report s/o Pauci immune glomerulonephritis. Patient is counselled regarding AVF and vaccination. Patient is started on immunosuppression with steroids and cyclophosphamide.