Journey of a patient with scleroderma from renal failure up to kidney transplantation.
1] Abbas F, El Kossi M, Shaheen IS, Sharma A, Halawa A. Post-transplantation lymphoproliferative disorders: Current concepts and future therapeutic approaches. World J Transplant 2020; 10(2): 29-46. https://www.wjgnet.com/2220-3230/full/v10/i2/29.ht 10.5500/ wjt.v10.i2.29
Summary: One of the most serious complications after kidney transplantation is the development of malignancy of the lymphatic system. An augmented immunosuppressive load is usually the culprit agent. Moreover, re-transplantation can be- despite rare- associated with recurrence of this type of malignancy. The recent progress on genomic technology has its impact of this serious disease. An increased awareness of the manifestations of this complication is necessary for a timely diagnosis and proper management. Furthermore, close liaison between nephrology and hemato-oncology teams will be reflected on the better control of this type of cancer.
2] Journey of a patient with scleroderma from renal failure up
to kidney transplantation.
Abbas, Mohsen El Kossi, Ihab Sakr Shaheen, Ajay Sharma, Ahmed Halawa
World J Transplant 2021; 11(9): 372-387
10.5500/wjt.v11.i9.372]https://www.wjgnet.com/2220-3230/full/v11/i9/372.htm. DOI: 10.5500/wjt.
SS is a multisystem disorder that can be clinically encountered in several stages. In contrary to the reported poor survival of SS patients maintained on RRT in comparison to other groups, these patients may show the highest likelihood of renal recovery permitting their withdrawal from dialysis. Recent data in the literature are in favor of better outcome of SS patients receiving a KTx as compared to the previous results. Furthermore, these results were comparable to KTRs in other groups of patients. A particular insight, however, should be focused on the extrarenal manifestations of this disease, especially those related to the pulmonary involvement, an independent risk factor of death in this cohort. Furthermore, the post-transplant cardiac and GI involvement should be closely monitored as they may getting worse. In view of the comparable patients and allograft survival rates that have been observed in transplanted SS patients with other groups, further work-up should be tailored to identify which type of an SS patient may benefit more from an offered transplant.
Abbas F, El Kossi M, Shaheen IS, Sharma A, Halawa A. Journey of a patient with scleroderma from renal failure up to kidney transplantation. World J Transplant
2021; 11(9): 372-387 [DOI: 10.5500/wjt.v11.i9.372
Fedaei Abbas, Sara Fedaei Abbas.
De Novo and Recurrent Thrombotic Microangiopathy After Renal
Transplantation: Current Concepts in Management
http://www.ectrx.org/detail/epub/1/1/1/0/1126/ DOI: 10.6002/ect.2021.0069
Summary: The pathogenesis of TMA and its risk factors remain important topics of
interest among the transplant community. The proper preparation of
KTRs, particularly regarding genetic mutation abnormalities related to
the evolution of aHUS (complement-mediated HUS), is a fundamental step
before commencing with kidney transplant. This is particularly crucial
in patients with ESRD due to HUS disease. A careful evaluation of KTRs
can result in detection of a simple and avoidable etiology for HUS (eg,
medications, switching of which can result in a complete disease
reversal and avoidance of unnecessary costly medications). Therapeutic
agents are under robust investigation to reduce cost and to improve the
cost-effective balance (eg, through the therapy upon recurrence
strategy). However, more efforts are needed to simplify these
complicated therapeutic strategies of this serious disease and to
guarantee better patient and graft outcomes.