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- 저자 : Tasnuva Sarah Kashem (검색결과 2 건)
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Experiences of performing ABO-incompatible kidney transplantation in Bangladesh
Nura Afza Salma Begum,Tasnuva Sarah Kashem,Farnaz Nobi,Shakib Uz-Zaman Arefin,Harun Ur Rashid 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.2
Background: The number of end-stage renal disease (ESRD) patients is increasing in Bangladesh. Currently, living kidney donation is the only viable option for transplan- tation in Bangladesh, and it is further restricted by ABO compatibility issues. We have performed ABO-incompatible kidney transplantations (ABOi KTs) in Bangladesh since 2018. This study examines our experiences with seven cases of ABOi KT. Methods: The desensitization protocol included low-dose rituximab (100 mg/body) fol- lowed by plasma exchange (PEX), which was followed by a 5-g dose of intravenous im- munoglobulin. Immunosuppression was undertaken using tacrolimus (0.1 mg/kg/day), mycophenolate mofetil (1,500 mg/day), and prednisolone (0.5 mg/kg/day). All patients received basiliximab for induction therapy. Results: The median baseline anti-ABO antibody titer was 1:64 (range, 1:32–1:128). Transplantation was performed at a titer of ≤1:8. Our patients attended three to five PEX sessions before transplantation. Graft survival was 100% in the seven cases over a mean period of 22 months. The mean creatinine level was 204.6±47.4 μmol/L. Two patients were suspected of having developed acute rejection and received intravenous methylprednisolone, resulting in improved kidney function. One patient required post- transplant hemodialysis due to delayed graft function and subsequently improved. In- fection was the most common complication experienced by ABOi KT patients. Two pa- tients developed severe cytomegalovirus pneumonia and died with functioning grafts. Conclusions: ABOi KT in Bangladesh will substantially expand the living kidney donor pool and bring hope to a large number of ESRD patients without ABO-compatible do- nors. However, the high cost and risk of acute rejection and infection remain major con- cerns.
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Mycobacterial infections in solid organ transplant recipients
Harun Ur Rashid,Nura Afza Salma Begum,Tasnuva Sarah Kashem 대한이식학회 2021 Korean Journal of Transplantation Vol.35 No.4
Mycobacterium tuberculosis (MTB) infection in solid organ transplant (SOT) recipients remains a major challenge for physicians and surgeons. Active tuberculosis (TB) is associated with increased morbidity and mortality in SOT recipients. MTB usually develops after transplantation in a recipient with latent TB infection (LTBI) before transplantation and may also be transmitted from the donor or acquired from the community. Therefore, screening for LTBI in donors and recipients before transplantation is very important in preventing active disease after transplantation. This review article is based on recently published data, case series, and expert recommendations. We reviewed updated information about the epidemiology, diagnosis, and treatment of latent and active TB before and after transplantation. We also reviewed recent treatments for multidrug-resistant TB.
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