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Journey of a patient with scleroderma from renal failure up to kidney transplantation

World Journal of Transplantation 2021年第9期11卷 372-387页

作者： Fedaey Abbas mohsen el kossi Ihab Sakr Shaheen Ajay Sharma Ahmed Halawa Department of Nephrology Faculty of Health and ScienceUniversity of LiverpoolInstitute of Learning and TeachingSchool of MedicineLiverpool L693GBUnited Kingdom Doncaster Renal Unit Doncaster Royal InfirmaryDoncaster DN25LTUnited Kingdom Department of Paediatric Nephrology St James’s University HospitalGlasgow G514TFUnited Kingdom Department of Transplant Surgery Royal Liverpool University HospitalLiverpool L78XPUnited Kingdom Department of Transplant Surgery Sheffield Teaching HospitalSheffield S57AUUnited Kingdom

The increased awareness of systemic sclerosis(SS)and its pathogenetic background made the management of this disease more amenable than previously ***,scleroderma renal crisis(SRC)is a rarely seen as an associated disorder that may involve 2%-15%of SS *** presented with earlier,rapidly progressing,diffuse cutaneous SS disease,mostly in the first 3-5 years after non-Raynaud clinical manifestations,are more vulnerable to develop *** comprises a collection of acute,mostly symptomatic rise in blood pressure,elevation in serum creatinine concentrations,oliguria and thrombotic microangiopathy in almost 50%of *** advent of the antihypertensive angiotensin converting enzyme inhibitors in 1980 was associated with significant improvement in SRC *** a scleroderma patient maintained on regular dialysis;every effort should be exerted to declare any possible evidence of renal recovery.A given period of almost two years has been suggested prior to proceeding in a kidney transplant(KTx).Of note,SS patients on dialysis have the highest opportunity of renal recovery and withdrawal from dialysis as compared to other causes of end-stage renal disease(ESRD).KTx that is the best well-known therapeutic option for ESRD patients can also be offered to SS *** to other primary renal diseases,SS-related ESRD was considered for a long period of poor patient and allograft *** involvement in an SS patient is considered a strong post-transplant independent risk factor of *** of SRC after transplantation has been observed in some ***,an excellent post-transplant patient and graft outcome have been recently ***,the absence of extrarenal manifestations in an SS-induced ESRD patient can be accepted as a robust indicator for a successful KTx.

关键词： Systemic sclerosis Scleroderma renal crisis Risk factors Renal failure Hemodialysis Kidney transplant

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Post-transplantation lymphoproliferative disorders:Current concepts and future therapeutic approaches

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World Journal of Transplantation 2020年第2期10卷 29-46页

作者： Fedaey Abbas mohsen el kossi Ihab Sakr Shaheen Ajay Sharma Ahmed Halawa Nephrology Department Jaber El Ahmed Military HospitalSafat 13005Kuwait Faculty of Health and Science University of LiverpoolInstitute of Learning and TeachingSchool of MedicineLiverpool L693GBUnited Kingdom Doncaster Royal Infirmary Doncaster DN25LTUnited Kingdom Department of Paediatric Nephrology Royal Hospital for ChildrenGlasgow G514TFUnited Kingdom Department of Transplant Surgery Royal Liverpool University HospitalsLiverpool L78XPUnited Kingdom Department of Transplantation Sheffield Teaching HospitalsSheffield S57AUUnited Kingdom

Transplant recipients are vulnerable to a higher risk of malignancy after solid organ transplantation and allogeneic hematopoietic stem-cell *** lymphoproliferative disorders(PTLD)include a wide spectrum of diseases ranging from benign proliferation of lymphoid tissues to frank malignancy with aggressive *** main risk factors of PTLD are:Firstly,the cumulative immunosuppressive burden,and secondly,the oncogenic impact of the Epstein-Barr *** latter is a key pathognomonic driver of PTLD *** the last two decades,a considerable progress has been made in diagnosis and therapy of *** treatment of PTLD includes reduction of immunosuppression,rituximab therapy,either isolated or in combination with other chemotherapeutic agents,adoptive therapy,surgical intervention,antiviral therapy and *** this review we shall discuss the prevalence,clinical clues,prophylactic measures as well as the current and future therapeutic strategies of this devastating disorder.

关键词： Lymphoproliferative disorders Epstein-Barr virus Solid organ transplant Hematopoietic stem cell transplant Post-transplant lymphoproliferative disorder prevention Future therapies

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Thrombotic microangiopathy after renal transplantation: Current insights in de novo and recurrent disease

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World Journal of Transplantation 2018年第5期8卷 122-141页

作者： Fedaey Abbas mohsen el kossi Jon Jin Kim Ajay Sharma Ahmed Halawa Nephrology Department Jaber El Ahmed Military Hospital Faculty of Health and Science University of Liverpool Institute of Learning and Teaching School of Medicine Doncaster Renal Unit Doncaster Royal Infirmary Nottingham Children Hospital Transplant Surgery Royal Liverpool University Hospitals Department of Transplantation Surgery Sheffield Teaching Hospitals

Thrombotic microangiopathy(TMA) is one of the most devastating sequalae of kidney transplantation. A number of published articles have covered either de novo or recurrent TMA in an isolated manner. We have, hereby, in this article endeavored to address both types of TMA in a comparative mode. We appreciate that de novo TMA is more common and its prognosis is poorer than recurrent TMA; the latter has a genetic background, with mutations that impact disease behavior and, consequently, allograft and patient survival. Post-transplant TMA can occur as a recurrence of the disease involving the native kidney or as de novo disease with no evidence of previous involvement before transplant. While atypical hemolytic uremic syndrome is a rare disease that results from complement dysregulation with alternative pathway overactivity, de novo TMA is a heterogenous set of various etiologies and constitutes the vast majority of post-transplant TMA cases. Management of both diseases varies from simple maneuvers, e.g., plasmapheresis, drug withdrawal or dose modification, to lifelong complement blockade, which is rather costly. Careful donor selection and proper recipient preparation, including complete genetic screening, would be a pragmatic approach. Novel therapies, e.g., purified products of the deficient genes, though promising in theory, are not yet of proven value.

关键词： Kidney transplantation De novo thrombotic microangiopathy Thrombotic microangiopathy Recurrent thrombotic microangiopathy Atypical hemolytic uremic syndrome

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De novo glomerular diseases after renal transplantation:How is it different from recurrent glomerular diseases?

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World Journal of Transplantation 2017年第6期7卷 285-300页

作者： Fedaey Abbas mohsen el kossi Jon Kim Jin Ajay Sharma Ahmed Halawa Department of Nephrology Jaber El Ahmed Military Hospital Faculty of Health and Science University of LiverpoolInstitute of Learning and TeachingSchool of Medicine Doncaster Royal Infirmary Nottingham Children Hospital Royal Liverpool University Hospitals Department of Transplantation Surgery Sheffield Teaching Hospitals

The glomerular diseases after renal transplantation can occur de novo,i.e.,with no relation to the native kidney disease,or more frequently occur as a recurrence of the original disease in the native *** may not be any difference in clinical features and histological pattern between de novo glomerular disease and recurrence of original glomerular ***,structural alterations in transplanted kidney add to dilemma in *** changes in architecture of histopathology can happen due to:(1) exposure to the immunosuppression specifically the calcineurin inhibitors(CNI);(2) in vascular and tubulointerstitial alterations as a result of antibody mediated or cellmediated immunological onslaught;(3) post-transplant viral infections;(4) ischemia-reperfusion injury; and(5) hyperfiltration *** pathogenesis of the de novo glomerular diseases differs with each *** of B-cell clones with subsequent production of the monoclonal Ig G,particularly Ig G3 subtype that has higher affinity to the negatively charged glomerular tissue,is suggested to be included in PGNMID *** novo membranous nephropathy canbe seen after exposure to the cryptogenic podocyte *** role of the toxic effects of CNI including tissue fibrosis and the hemodynamic alterations may be involved in the de novo FSGS *** well-known deleterious effects of HCV infection and its relation to MPGN disease are frequently *** new concepts have emerged that demonstrate the role of dysregulation of alternative complement pathway in evolution of MPGN that led to classifying into two subgroups,immune complex mediated MPGN and complement-mediated *** latter comprises of the dense deposit disease and the C3 GN *** novo C3 disease is rather *** of de novo diseases varies with each type and their management continues to be empirical to a large extent.

关键词： De novo glomerulonephritis Renal transplantation New concepts of therapy

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Recurrence of primary glomerulonephritis:Review of the current evidence

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World Journal of Transplantation 2017年第6期7卷 301-316页

In view of the availability of new immunosuppression strategies,the recurrence of allograft glomerulonephritis(GN) are reported to be increasing with time post *** advances in understanding the pathogenesis of the GN recurrent disease provided a better chance to develop new strategies to deal with the GN *** GN diseases manifest with a variable course,stubborn behavior,and poor response to *** types of GN lead to rapid decline of kidney function resulting in a frustrating return to maintenance *** subgroup of aggressive diseases actually requires intensive efforts to ascertain their pathogenesis so that strategy could be implemented for better allograft *** of native glomerulonephritis as the cause of end-stage renal failure and subsequent recurrence of individual glomerulonephritis after renal transplantation was evaluated using data from various registries,and pathogenesis of individual glomerulonephritis is *** following review is aimed to define current protocols of the recurrent primary glomerulonephritis therapy.

关键词： Recurrent glomerulonephritis Renal transplantation Primary glomerulonephritis

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Complement-mediated renal diseases after kidney transplantation-current diagnostic and therapeutic options in de novo and recurrent diseases

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World Journal of Transplantation 2018年第6期8卷 203-219页

作者： Fedaey Abbas mohsen el kossi Jon Jin Kim Ihab Sakr Shaheen Ajay Sharma Ahmed Halawa Nephrology Department Jaber El Ahmed Military Hospital Faculty of Health and Science University of Liverpool Institute of Learning and Teaching School of Medicine Doncaster Royal Infirmary Nottingham Children Hospital Royal Hospital for Children Glasgow G51 4TF United Kingdom Royal Liverpool University Hospitals Sheffield Teaching Hospitals

For decades, kidney diseases related to inappropriate complement activity, such as atypical hemolytic uremic syndrome and C3 glomerulopathy(a subtype of membranoproliferative glomerulonephritis), have mostly been complicated by worsened prognoses and rapid progression to end-stage renal failure. Alternative complement pathway dysregulation, whether congenital or acquired, is well-recognized as the main driver of the disease process in these patients. The list of triggers include: surgery, infection, immunologic factors, pregnancy and medications. The advent of complement activation blockade, however, revolutionized the clinical course and outcome of these diseases, rendering transplantation a viable option for patients who were previously considered as non-transplantable *** less-costly therapeutic lines and likely better efficacy and safety profiles are currently underway. In view of the challenging nature of diagnosing these diseases and the long-term cost implications, a multidisciplinary approach including the nephrologist, renal pathologist and the genetic laboratory is required to help improve overall care of these patients and draw the optimum therapeutic plan.

关键词： Complement-related diseases Kidney transplantation De novo Recurrent diseases

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Human leukocyte antigen typing and crossmatch:A comprehensive review

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World Journal of Transplantation 2017年第6期7卷 339-348页

作者： Mohammed Mahdi Althaf mohsen el kossi Jon Kim Jin Ajay Sharma Ahmed Mostafa Halawa Jack Pryor Renal Unit Norfolk and Norwich University Hospital-NHS Foundation Trust Faculty of Health and Science University of LiverpoolInstitute of Learning and TeachingSchool of Medicine Doncaster Royal Infirmary Nottingham Children Hospital Royal Liverpool University Hospitals Department of Transplantation Surgery Sheffield Teaching Hospitals

Renal transplantation remains the best option for patients suffering from end stage renal disease(ESRD).Given the worldwide shortage of organs and growing population of patients with ESRD,those waitlisted for a transplant is ever *** crossmatch methods and human leukocyte antigen(HLA) typing play a pivotal role in improving organ allocation and afford better matches to *** crossmatch as well as HLA typing for renal transplantation and applying it in clinical practice is the key step to achieve a successful *** of crossmatch results can be quite challenging where clinicians have not had formal training in applied transplant *** review aims to provide a worked example using a clinical ***,each technique is discussed in detail with its pros and *** index case is that of a young male with ESRD secondary to Lupus *** is offered a deceased donor kidney with a 1-0-0 *** complement dependent cytotoxicity(CDC) crossmatch reported positive for B lymphocyte,but flow cytometry crossmatch(FCXM) was reported negative for both B and T ***-SAB(single antigen bead) did not identify any donor specific antibodies(DSA).He never had a blood *** positive CDCcrossmatch result is not concordant with DSA *** implausible results are due to underlying lupus erythematosus,leading to false-positive B-lymphocyte crossmatch as a result of binding immune complexes to *** positive report of CDC crossmatch can be caused by the underlying autoimmune diseases such as lupus erythematosus,that may lead to inadvertent refusal of adequate kidney *** study of DSA by molecular technique would prevent wrong exclusion of such *** on these investigations this patient is deemed to have "standard immunological risk" for renal transplantation.

关键词： Human leukocyte antigen typing Cytotoxic crossmatch Flow cytometry crossmatch Virtual crossmatch Human leukocyte antigen null alleles

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The combined effects of farm yard manure and boron application on growth,and oil quality of Canola grown under newly reclaimed soils

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Oil Crop Science 2024年第1期9卷 53-59页

作者： Farid Hellal Saied el Sayed Amany Abdel mohsen Ramadan Doaa M.Abobasha Plant Nutrition Department National Research Centre33 El-Behouth St12622DokkiCairoEgypt Botany Department National Research Centre33 El-Behouth St12622DokkiCairoEgypt

Two field experiments were conducted during the main seasons of 2021/2022 at the Research and Production Station of National Research Centre in Egypt to investigate the effects of farmyard manure(FYM)and boron on Canola growth,yield,oil yield,and *** results unequivocally demonstrated that the combined application of FYM at a rate of 14.4 ton ha^(-1)with a foliar spray of boron at 100 ppm positively influenced plant characteristics,leading to enhanced growth rates and higher yields compared to the control ***,this integrated approach significantly improved nutrient content by enhancing levels of oil content,carbohydrates,proteins,phenolics,flavonoids,and total soluble *** findings provide compelling evidence that utilizing farm manure along with boron can effectively enhance Canola properties in newly reclaimed soils while promoting sustainable agricultural practices.

关键词： Oil quality Farmyard manure Phytochemical content Canola Yield production

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Post-transplant malignancy:Focusing on virus-associated etiologies,pathogenesis,evidence-based management algorithms,present status of adoptive immunotherapy and future directions

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World Journal of Meta-Analysis 2023年第7期11卷 317-339页

作者： Rahul Yadav mohsen el kossi Dawlat Belal Ajay Sharma Ahmed Halawa Department of Urology Kidney Transplant and Robotic Uro-oncologyTender Palm Super Speciality HospitalLucknow 226010Uttar PradeshIndia Department of Urology and Kidney Transplant Charak Hospital and Research CentreLucknow 226003Uttar PradeshIndia Department of Nephrology Doncaster Royal InfirmaryDoncaster DN25LTUnited Kingdom Department of Nephrology and Medicine Kasr El-Ainy School of MedicineCairo UniversityCairo 11562Egypt Department of Transplant Surgery Royal Liverpool University HospitalsLiverpool L78XPUnited Kingdom Department of Transplantation Sheffield Teaching HospitalsSheffield S57AUUnited Kingdom

Modern immunosuppression has led to a decrease in rejection rates and improved survival rates after solid organ *** the potency of immunosuppression promotes post-transplant viral infections and associated cancers by impairing immune response against viruses and cancer *** review reflects the magnitude,etiology and immunological characteristics of various virus-related post-transplant malignancies,emphasizing the need for future research.A multidisciplinary and strategic approach may serve best but overall literature evidence targeting it is ***,the authors attempted to provide a more detailed update of the literature consensus for the prevention,diagnosis,management and surveillance of post-transplant viral infections and associated malignancies,with a focus on the current role of adoptive immunotherapy and the way *** order to achieve long-term patient and graft survival as well as superior post-transplant outcomes,collaborative research on holistic care of organ recipients is imperative.

关键词： Post-transplant malignancy management Post-transplant virus-associated malignancy Cancer Kidney transplantation Solid organ transplantation Virus

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Childhood asthma biomarkers including zinc: An exploratory crosssectional study

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World Journal of Clinical Pediatrics 2024年第1期13卷 31-40页

作者： Hoda Atef Abdelsattar Ibrahim Mona mohsen Boles Salep Aziz Hanna Dina Mahmoud Khaled Mohamed Abdelhamid el-Khashab Pediatric Clinical Nutrition Unit Faculty of MedicineCairo UniversityCairo 12613Egypt Department of Pediatrics Faculty of MedicineCairo UniversityCairo 12613Egypt Department of Clinical Pathology Faculty of MedicineCairo UniversityCairo 12613Egypt

BACKGROUND Childhood bronchial asthma(BA)is a chronic inflammatory respiratory *** conditions,including zinc deficiency,can affect such allergic *** To outline the difference in serum zinc levels between asthmatic children and healthy *** A cross-sectional study was carried out at Children’s Hospital,Cairo University,investigating serum zinc levels in children with BA(n=40)and healthy children(n=21).Other markers included serum ferritin,iron,hemoglobin(Hb),and immunoglobulin E(IgE)*** t-tests and Mann-Whinny tests were used for *** Kruskal-Wallis test was applied to compare serum ferritin and IgE levels with regard to asthma ***'s rank correlation was performed to explore the relationship between serum ferritin levels and both iron and Hb levels in asthmatic *** Children with BA had higher levels of zinc,yet the difference was not significant(P=0.115).Serum ferritin and IgE levels were significantly higher in asthmatic children(P=0.006 and 0.001,respectively),yet their levels did not differ significantly by severity(P=0.623 and 0.126,respectively).There was a nonsignificant weak correlation between serum ferritin levels and both serum iron and Hb *** Serum zinc levels do not seem to differ between asthmatic children and healthy *** ferritin levels may be a marker of asthma *** IgE levels are not markers of asthma severity.

关键词： Children Asthma Zinc Ferritin

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