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ABSTRACT

Background and Aim:

after Kidney transplantation. However, in such pregnancies, potential risks of

immunosuppressive agents on pregnancy status and fetus should be taken into

consideration. There are some reports indicating fetal malformations, preterm labour,

abortion and intrauterine growth retardation in such pregnancies. The present study

was designed to evaluate the status of pregnancy in women with kidney

transplantation in Renal Transplantation Center of the 4

Kermanshah.

Women with chronic renal failure can resume normal fertilityth Shahid Mehrab Hospital in

Materials and Methods:

records of women who had pregnancy after renal transplantation during 1368-1378

were reviewed. Necessary data concerning the serum creatinine level, blood pressure

during pregnancy, age at the time of pregnancy, interval between transplantation and

child-birth and occurrence of acute allograft rejection during pregnancy were

collected. The newborns were examined twice in a 6 month interval for physical

growth, developmental status and major malformations.

This was a descriptive-analytic study and the medical

Results:

case led to abortion (9%). Immunosuppressive therapy consisted of cyclosporin A

and steroid in 3 cases (30%), and cyclosporin A, steroid and azathioprine in 7 cases

(70%). The time interval between transplantation and childbirth was 24.6±15.67

months, and the mean age of mothers during pregnancy was 27.22±5.74 years. There

was no significant difference between mean systolic and diastolic blood pressures and

serum creatinine level before and during pregnancy. There was no acute allograft

rejection or any other remarkable problems during pregnancy. Only four newborns, 3

boys and one girl were brought for follow up. 3 cases of pregnancies were unwanted

and only one case was intentional. The mean weight of the newborns was 2.62±0.47

Kg, and one of them was underweight (25%). Physical growth and development of

these newborns were normal and there was no obvious congenital malformation.

11 pregnancies occurred in 9 women with kidney transplantation, , but one

Conclusion:

expose mother and fetus to potential risks, this study like other recent studies revealed

that supportive measures before pregnancy and close monitoring of the pregnant

women by an experienced and multidisciplinary team, may lead to the birth of a

healthy baby, without any adverse effect on the function of the allograft

Although immunosuppressive agents can cross placental barrier and

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  ABSTRACT

 Background and Aim: Acute rejection is one of the most important complications after renal transplantation which influences transplant prognosis and survival. This study was conducted to determine the prognostic value of Th1/ Th2 cytokines in acute renal rejection (AR).

 Material and Methods: This was a cross-sectional study and included 60 kidney transplant recipients (40 male, mean age 38.82), who had received their transplants from live donors. Serum levels of Th-1 dependent cytokines [interleukin- (IL) 2 and interferon-gamma] and Th-2 dependent cytokines (IL-4, IL-10) were measured on the day before, 7th and 14th days post transplantation using ELISA. All the patients received Immunosupressive agents including cyclosporine, mychofenolate mofetile and prednisolon. Acute rejection was defined as a more than 50 percent rise in serum creatinin in the first 20 days after transplantation. Data were introduced into SPSS soft ware and analyzed by means of independent T-test.

 Results: Among 60 patients, 40 were male. The mean age of the patients were 38.82 years. In our study we diagnosed twelve cases of AR (20% of the cases). There was no significant relation between the serum levels of IL2, IL4, IL10 and IFN_δ in the patients with acute rejection of the transplant and those without.

Conclusion: These data showed that there is no correlation between Th1/ Th2 serum cytokines profile and early AR episodes in kidney transplantation and these cytokines can not be used as prognostic factors in acute renal rejection

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ABSTRACT Background and Aim: This study was conducted to compare the sonographic (gray scale) findings with those of Doppler sonography in patients with rejection of kidney transplant. Material and Methods: This was a cross-sectional study performed in Hasheminejhad Educational and Therapeutic Center in Tehran. Sonography and then Doppler sonography were performed and primary creatinin level and if needed sequential creatinin levels, were checked. We used a scanner (AU4 mod) with 3.5 and 7.5 MHz probes. Results: The most common morphologic signs in sonography were increased antro-posterior diameter of allografts in 19 cases (31.4%). Other common morphologic signs consisted of increased cortical echogenicity in 18cases (30%), increased prominanance of the renal pyramid or hypoechogenicity of pyramid in 12 cases (20%), decreased echogenicity of rejected kidney sinus in 7cases (11/7%). The rarest morphologic sign was focal cortical hypoechogenicity in 2cases (3/4%). Thirty one patients (51.7%) had positive sonographic findings, 47 patients (78/3%) had Resistive Index (RI) ≥0.8 and 13 patients (21/7%) had Resistive Index≥0.9. Those with age range of 51-65 years had the highest frequency among all the patients and revealed positive findings in both methods of sonography. In 23.4% of the patients creatinin level was normal. 46 patients (76.6%) had early and fourteen other patients had late onset rejection of the transplant. Conclusions: Doppler sonography (RI) is the best and most sensitive non invasive method for precise and early diagnosis of renal allograft rejection. RI≥.0.8 has eliminated need of taking biopsy. Findings of sonography were less sensitive than those of Doppler sonography. Key words: gray scale ultrasound, Reanal allograft rejection, Resistive index, Doppler ultrasound, renal transplantation. Conflict of Interest: Nill Received: June 20, 2009 Accepted: November 16, 2009

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Background and Aim: Hair transplantation is the main therapeutic method for androgenic alopecia. Improvement of the hair transplant techniques with more acceptable appearance of the transplanted hair has made this method more popular. Nowadays, for more acceptable appearance of transplanted hair, every follicle is transplanted separately or in small groups which is a time consuming procedure and exposes the follicles to environmental stressors. The new device that we introduce here can be time saving and decreases the exposure time to stressors. Case report: This device was named Micro-implant and we used it for hair transplantation in a 45 years old man with androgenic alopecia. After informed consent and adequate explanations, necessary laboratory tests were performed which their results were normal. Three 10×2 cm grafts were resected from occipital area. The grafts were placed into sterile physiologic buffer rapidly and then divided by a scalpel into small pieces, each containing 1-4 follicles. These graft units were transplanted into the frontal bald area by means of the Micro-implant. Conclusion: Use of this device will reduce transplantation time notably and maintain the viability of the transplanted follicles which ensure success of transplantation.

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Background and Aim: Mesenchymal stem cells are adult, non-hematopoietic, mulipotent and self-renewal cells. These cells were first isolated from bone marrow and considered as the most important cells in cell therapy. These cells have been used in clinical trials (animal models) about more than a decade. Regarding immunomodulatory properties through immunosuppressive factors and their repair potency, these cells have been widely used in the treatment of immunological (chronic and autoimmune diseases) and non-immunological diseases (tissue engineering, tissue repair, degenerative and malignant diseases.( This review aimed to study the therapeutic roles, immunobiology and challenges ahead of mesenchymal stem cells. Material and Methods: At first articles related to mesenchymal stem cells were searched from valid databases such as Wily Online Library, ISI web of science, Springer Link, Sciencedirect, Pubmed, google scholar, SID, and ISC. Then, the related articles studied from 2002 to 2014 were searched. They were about the modulatory role, therapeutic effects (in immunologic and non-immunologic diseases) and clinical applications of mesenchymal stem cells. Results: The obtained results showed a high potential of mesenchymal stem cells, isolated from different sources in clinical trials (preclinical and clinical). Mesenchymal stem cells have a key role in immunomodulation through secreted factors and cell-cell contact in inflammatory diseases, as well as tissue restoration by homing via adhesion molecules and chemokines in cells that has been destructed due to physiologic or pathologic causes (non-inflammatory and destructive diseases). In addition, it has anticancer features for nanoparticle delivery to tumors and consequently angiogenesis prevention. Despite mentioned points, use of mesenchymal stem cells has some risks such as tumor induction, infection transmission, and ectopic tissue formation in receiving individual. Conclusion: The therapeutic role of mesenchymal stem cells in destructive and autoimmune diseases has been proved. Given challenges in using mesenchymal stem cells in cell therapy and the standards (according to protocols), these cells can be used widely in the future. Keywords: Mesenchymal stem cell transplantation, Immunomodulation, Cell therapy, Regenerative medicine, Tissue engineering, Cell-cell contact, Soluble factor Received: Dec 7, 2014 Accepted: Mar 3, 2015

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Background and Aim: Various methods are used to analyze the data in survival studies. The aim of this study was to compare the analysis results of penalized splines in Cox model and Cox proportional hazards model in relation to the effects of prognostic factors related to the survival of renal transplant patients.
Material and Methods: This retrospective study included data of 876 renal transplant patients in Kermanshah, in Iran, from 2001 to 2015. Cox proportional hazards model and penalized splines in cox model were used. We used R version 3.3.2 for data analysis. The significance level was set at 0.05 and Akaike information criterion was used to compare the efficacy rates of these models.
Results: Using Cox proportional hazards model, one, three and five year survival rates of the patients were 94.9, 92.3 and 90.2 percent, respectively. But the corresponding figures for penalized spline model were 95.6, 93.3 and 91.4 percent. The recipient's age, postoperative creatinine, urea after surgery and underlying diabetes were significantly associated with the patients' survival rates (p < 0.05). Akaike's criteria for Cox proportional hazards model and penalized spline model were 1016.3 and 984.1, respectively.
Conclusion: Considering lower Akaike information criterion and suitability of penalized spline model for continuous variables affecting the survival of renal transplant patients, this model can be used instead of Cox proportional hazards model for more accurate estimate of survival rate of the renal transplant patients.
Key words: Survival, Renal transplantation, Cox proportional hazards model, Penalized spline model.
 
Received: May 6, 2017     Accepted: Jul 8, 2017

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Background and Aim: Microorganisms living in the human body play an important role in human health. Human microbiota is known as an essential agent and playing an important role in the biological processes of the human body. The role of the microbiota in the host metabolism, intestinal inflammatory responses and their treatment has been well recognized. In this study we investigated the relationship between intestinal microbiota and schizophrenia.
Materials and Methods: Using keywords of”Gut microbiota”، “Schizophrenia”، “Fecal transplantation” و “Mental disorders”, we searched data bases of  SCOPUS، PubMed و Web of Science in order to find studies on the effects and relationship of the gut microbiota with occurrence of some diseases, the gut-brain relationship, and the role of fecal transplantation in the treatment of inflammatory bowel diseases and mental illnesses, particularly schizophrenia.
Results: Recent studies have emphasized the importance of the microbial gut-brain axis. The intestinal microbiota has certain impacts in the process of development of mental disorders such as anxiety, stress, depression, and behavioral disorders.
Conclusion: Use of gut microbiota maybe helpful for the patients with schizophrenia for improvement of the cognitive changes. In addition, due to the low prevalence and high rate of complications of this disease, more studies on the role of fecal microbiota transplantation in the patients with schizophrenia are recommended.
 

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Background and Aim: Kidney transplantation is the most effective therapeutic option for improving the quality of life in the patients with end-stage renal disease. Due to the importance of preserving the transplanted organ function, transplant recipients should follow certain self-care practices after transplantation. Increasing use of electronic health (eHealth) can provide useful solutions in this field. The aim of this study was to review published articles on e-Health in kidney transplant recipients.
Materials and Methods: We searched Google Scholar for English articles, and, Scientific Information Database, and Magiran for Persian sources.
Results: After screening more than 434 articles, 14 were included in the study based on the predefined criteria. USA with 6 articles had the highest number of publications. Based on the methods, the papers were divided into three categories. The first group which was consisted of interventional studies (6 papers), used mobile applications, portals, televisit, educational programs, or a combination of them. In the second group, reports of one of the methods of e-Health were included (2 studies). The third group was consisted of cross-sectional or qualitative studies that aimed to investigate different people's perspectives about e-Health (6 studies).
Conclusion: Considering the positive findings of the interventional studies and the diversity of e-Health methods, there is still a long way to evaluate the sustainability, efficiency, and cost-effectiveness of these interventions.