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Kidney exchange transplantation current status, an update and future perspectives

World Journal of Transplantation 2018年第3期8卷 52-60页

作者： vivek b kute Narayan Prasad Pankaj R Shah Pranjal R Modi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research Centre Dr Trivedi Institute of Transplantation Sciences Department of Nephrology and Clinical Transplantation SGPGI Department of Urology and transplantation Institute of Kidney Diseases and Research Centre Dr Trivedi Institute of Transplantation Sciences

Kidney exchange transplantation is well established modality to increase living donor kidney transplantation. Reasons for joining kidney exchange programs are AbO blood group incompatibility, immunological inco-mpatibility(positive cross match or donor specific antibody), human leukocyte antigen(HLA) incompa-tibility(poor HLA matching), chronological incompa-tibility and financial incompatibility. Kidney exchange transplantation has evolved from the traditional si-multaneous anonymous 2-way kidney exchange to more complex ways such as 3-way exchange, 4-way exchange, n -way exchange,compatible pair, non-simult-aneous kidney exchange,non-simultaneous extended altruistic donor, never ending altruistic donor, kidney exchange combined with desensitization, kidney ex-change combined with AbO incompatible kidney tr-ansplantation, acceptable mismatch transplant, use of A2 donor to O patients, living donor-deceased donor list exchange, domino chain, non-anonymous kidney exchange, single center, multicenter, regional, National, International and Global kidney exchange. Here we discuss recent advances in kidney exchanges such as International kidney exchange transplantation in a gl-obal environment, three categories of advanced dona-tion program, deceased donors as a source of chain initiating kidneys, donor renege myth or reality, pros and cons of anonymity in developed world and(non-) anonymity in developing world, pros and cons of donor travel vs kidney transport, algorithm for management of incompatible donor-recipient pairs and pros and cons of Global kidney exchange. The participating transplant teams and donor-recipient pairs should make the decision by consensus about kidney donor travel vskidney transport and anonymity vs non-anonymity in allocation as per local resources and logistics. Future of organ transplantation in resource-limited setting will be liver vs kidney exchange, a legitimate hope or utopia?

关键词： Kidney transplantation Kidney exchange AbO incompatible Desensitization

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Increasing access to kidney transplantation for sensitized recipient through three-way kidney paired donation with desensitization: The first Indian report

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World Journal of Clinical Cases 2016年第10期4卷 351-355页

作者： vivek b kute Himanshu V Patel Pankaj R Shah Pranjal R Modi Veena R Shah Sayyed J Rizvi bipin C Pal Manisha P Modi Priya S Shah Umesh T Varyani Pavan S Wakhare Saiprasad G Shinde Viajay A Ghodela Minaxi H Patel Varsha b Trivedi Hargovind L Trivedi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research CenterDr.HL Trivedi Institute of Transplantation Sciences(IKDRC-ITS) Department of Urology and Transplantation IKDRC-ITS Department of Anesthesia IKDRC-ITS Department of Pathology Laboratory MedicineTransfusion Services and ImmunohematologyIKDRC-ITS

The combination of kidney paired donation(KPD) with desensitization represents a promising method of increasing the rate of living donor kidney transplantation(LDKT) in immunologically challenging patients. Patients who are difficult to match and desensitize due to strong donor specific antibody are may be transplanted by a combination of desensitization and KPD protocol with more immunologically favorable donor. We present our experience of combination of desensitization protocol with three-way KPD which contributed to successful LDKT in highly sensitized end stage renal disease patient. All recipients were discharged with normal and stable allograft function at 24 mo follow up. We believe that this is first report from India where three-way KPD exchange was performed with the combination of KPD and desensitization. The combination of desensitization protocol with KPD improves access and outcomes of LDKT.

关键词： Kidney failure Chronic Desensitization Immunologic Kidney transplantation blood group incompatibility Living donors Tissue and organ procurement

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International kidney paired donation transplantations to increase kidney transplant of O group and highly sensitized patient: First report from India

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World Journal of Transplantation 2017年第1期7卷 64-69页

作者： vivek b kute Himanshu V Patel Pankaj R Shah Pranjal R Modi Veena R Shah Sayyed J Rizvi bipin C Pal Priya S Shah Pavan S Wakhare Saiprasad G Shinde Vijay A Ghodela Umesh T Varyani Minaxi H Patel Varsha b Trivedi Hargovind L Trivedi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research Center Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) Department of Urology and transplantation IKDRC-ITS Department of Anesthesia IKDRC-ITS Department of Pathology Laboratory Medicine Transfusion Services and Immunohematology IKDRC-ITS

AIM To report the first international living related two way kidney paired donation(KPD) transplantation from India which occurred on 17 th February 2015 after legal per-mission from authorization committee. METHODS Donor recipient pairs were from Portugal and India who were highly sensitized and AbO incompatible with their spouse respectively. The two donor recipient pairs had negative lymphocyte cross-matching, flow cross-matchand donor specific antibody in two way kidney exchange with the intended KPD donor. Local KPD options were fully explored for Indian patient prior to embarking on international KPD. RESULTS both pairs underwent simultaneous uneventful kidney transplant surgeries and creatinine was 1 mg/d L on tacrolimus based immunosuppression at 11 mo follow up. The uniqueness of these transplantations was that they are first international KPD transplantations in our *** International KPD will increases quality and quantity of living donor kidney transplantation. This could be an important step to solving the kidney shortage with additional benefit of reduced costs, improved quality and increased access for difficult to match incompatible pairs like O blood group patient with non-O donor and sensitized patient. To the best of our knowledge this is first international KPD transplantation from India.

关键词： Kidney paired donation International kidney paired donation Living donor kidney transplantation

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Six end-stage renal disease patients benefited from first non-simultaneous single center 6-way kidney exchange transplantation in India

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World Journal of Nephrology 2016年第6期5卷 531-537页

作者： vivek b kute Himanshu V Patel Umesh T Varyani Pankaj R Shah Pranjal R Modi Veena R Shah Sayyed J Rizvi bipin C Pal Priya S Shah Pavan S Wakhare Vijay A Ghodela Saiprasad G Shinde Varsha b Trivedi Minaxi H Patel Hargovind L Trivedi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research Center Dr HL Trivedi Institute of Trans-plantation Sciences Department of Urology and Transplantation Dr HL Trivedi Institute of Trans-plantation Sciences Department of Anesthesia Dr HL Trivedi Institute of Transplantation Sciences Department of Pathology and laboratory medicine Dr HL Trivedi Institute of Transplantation Sciences

AIM To avoid desensitization protocols and AbO incompatible kidney transplantation(KT) due to high costs and increased risk of infections from intense *** We present institutional ethical review board- approved study of single center 6-way kidney exchange transplantation. The participants comprised AbO incompatibility(n = 1); positive cross-match and/or presence of donor specific antibody(n = 5). The average time required from registration in kidney paired donation(KPD) registry to find suitable donors was 45 d and time required to perform transplants after legal permission was 2 mo. RESULTS Graft and patient survival were 100%, and 100%, respectively. One patient had biopsy-proven acute borderline T cell rejection(banff update 2013, type 3). Mean serum creatinine was 0.8 mg/dL at 9 mo followup. The waiting time in KPD was short as compared to deceased donor KT. CONCLUSION We report first non-simultaneous, single center, 6-way kidney exchange transplantation from India. Our experience will encourage other centers in India to undertake this practice.

关键词： Kidney transplantation/methods Kidney paired donation Living donors/supply and distribution Donor selection/methods

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Past, present and future of kidney paired donation transplantation in India

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World Journal of Transplantation 2017年第2期7卷 134-143页

作者： vivek b kute Himanshu V Patel Pankaj R Shah Pranjal R Modi Veena R Shah Sayyed J Rizvi bipin C Pal Manisha P Modi Priya S Shah Umesh T Varyani Pavan S Wakhare Saiprasad G Shinde Vijay A Ghodela Minaxi H Patel Varsha b Trivedi Hargovind L Trivedi Department of Nephrology and Clinical Transplantation Institute of Kidney Diseases and Research CentreDr HL Trivedi Institute of Transplantation Sciences(IKDRC-ITS) Department of Urology and transplantation Department of Anaesthesia IKDRC-ITS Department of Pathology Laboratory MedicineTransfusion Services and Immunohematology

One third of healthy willing living kidney donors are rejected due to AbO blood group incompatibility and donor specific antibody. This increases pre-transplant dialysis duration leading to increased morbidity and mortality on the kidney transplantation waiting list. Over the last decade kidney paired donation is most rapidly increased source of living kidney donors. In a kidney transplantation program dominated by living donor kidney transplantation, kidney paired donation is a legal and valid alternative strategy to increase living donor kidney transplantation. This is more useful in countries with limited resources where AbO incompatible kidney transplantation or desensitization protocol is not feasible because of costs/infectious complications and deceased donor kidney transplantation is in initial stages. The matching allocation, AbO blood type imbalance, reciprocity, simultaneity, geography were the limitation for the expansion of kidney paired donation. Here we describe different successful ways to increase living donor kidney transplantation through kidney paired donation. Compatible pairs, domino chain, combination of kidney paired donation with desensitization or AbO incompatible transplantation, international kidney paired donation, nonsimultaneous, extended, altruistic donor chain and list exchange are different ways to expand the donor *** absence of national kidney paired donation program,a dedicated kidney paired donation team will increase access to living donor kidney transplantation in individual centres with team work. Use of social networking sites to expand donor pool, HLA based national kidney paired donation program will increase quality and quantity of kidney paired donation transplantation. Transplant centres should remove the barriers to a broader implementation of multicentre, national kidney paired donation program to further optimize potential of kidney paired donation to increase transplantation of O group and sensitized patients. T

关键词： Living donor kidney transplantation Kidney paired donation Renal replacement therapy Developing country

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Determining the Checkpoint of Transition from Thin to Thick Periodontal Phenotypes in the Maxillary and Mandibular Anterior Regions of South Indian Population

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Journal of Forensic Science and Medicine 2024年第1期10卷 55-61页

作者： Mohan Kumar Pasupuleti Rasagna Chowdary G Gautami SPenmetsa vivek bypalli Ramesh S.V.Konathala Sruthima N.V.S.Gottumukkala Department of Periodontics and Implantology Vishnu Dental CollegeBhimavaramAndhra PradeshIndia2Vishnu Dental CollegeBhimavaramAndhra PradeshIndia

Aim:The aim of this study was to compare and investigate the tissue thickness at the maxillary and mandibular central incisors utilizing the probe visibility method and traditional way of measuring gingival thickness(GT)by endodontic ***:In 200 selected patients,the GT was measured at both the maxillary and mandibular anterior using an endodontic file after local infiltration at the mid-distance from the gingival margin to the mucogingival *** checkpoint of transition from thin to thick periodontal phenotype was determined by probe visibility method in the following age groups:Group A:21-30 years;Group b:31-40 years;Group C:41-50 years;and Group D:51-60 ***:GT varied from 0.3 to 1.9 *** translucency was observed up to the thickness of 0.7 *** 0.8 mm of GT,there was no probe ***:According to the present research,the gingiva appears transparent up to a thickness of around 0.7 *** checkpoint of transition between thin and thick periodontal phenotypes at both the maxillary and mandibular anterior was associated with a GT of 0.8 mm.

关键词： Gingiva periodontal phenotype probe visibility

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Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery bypass Grafting: Insights from a bangladesh-based Single Center Experience

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World Journal of Cardiovascular Diseases 2024年第4期14卷 252-267页

作者： vivek Kumar Jha Md Abir Tazim Chowdhury Munama Magdum Manoj Tiwari Md Abul bashar Maruf Md Saiful Islam Khan Priyanka Sinha Rajesh Naryan Kapar Md. Rezwanul Hoque Department of Cardiothoracic and Vascular Surgery BP Koirala Institute of Health Sciences Dharan Nepal Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Thoracic Surgery BP Koirala Memorial Cancer Hospital Bharatpur Nepal Department of Cardiac Surgery United Hospital Limited Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of Microbiology Kathmandu Medical College Kathmandu Nepal Department of Nephrology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

background: Following coronary artery bypass grafting (CAbG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CAbG. Methods: Conducted in the Department of Cardiac Surgery at bSMMU from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CAbG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group b (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-b had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group b (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group b patients, statistically significant compared to the 4.5% in Group A. However, patients in Group b who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group b, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period a

关键词： Coronary Artery bypass Grafting (CAbG) Serum Cortisol Postoperative Delirium bangladesh

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THE CHARACTERIZATION OF EFFICIENCY AND SADDLE POINT CRITERIA FOR MULTIObJECTIVE OPTIMIZATION PRObLEM WITH VANISHING CONSTRAINTS

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Acta Mathematica Scientia 2019年第2期39卷 382-394页

作者： Anurag JAYSWAL vivek SINGH Department of Applied Mathematics Indian Institute of Technology (Indian School of Mines)

In this article, we focus to study about modified objective function approach for multiobjective optimization problem with vanishing constraints. An equivalent η-approximated multiobjective optimization problem is constructed by a modification of the objective function in the original considered optimization problem. Furthermore, we discuss saddle point criteria for the aforesaid problem. Moreover, we present some examples to verify the established results.

关键词： multiobjective optimization problem with vanishing constraints efficient solution invexity η-Lagrange function saddle point

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Polymer Modified banana Pseudo Stem-based Interfacial Solar-driven Evaporation System

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Journal of bionic Engineering 2022年第3期19卷 752-760页

作者： vivek Chandran Sujith Lal Sudip K.batabyal Department of Sciences Amrita School of EngineeringAmrita Vishwa VidyapeethamCoimbatoreTamil Nadu641112India Amrita Centre for Industrial Research and Innovation(ACIRI) Amrita School of EngineeringAmrita Vishwa VidyapeethamCoimbatoreTamil Nadu641112India

Interfacial solar-driven evaporation technique is an environmental friendly and cost-effective advanced approach for water purification using solar *** energy sources are effectively utilized using the structural design of evaporators and functional *** this work,we have fabricated a solar-driven interfacial evaporation device with banana Pseudo Stem(bPS)and a photothermal layer made up of PVA PDMS Carbon(PPC)is attached to *** evaporation rate of 2.03 kg m^(−2) h^(−1) is achieved by the system under 1 sun *** localization on interfacial surface,reflectance of photothermal layer,presence of micro-fluidic channels in bPS were studied using IR imaging,UV-DRS and SEM characterization techniques,*** localization of interfacial temperature around 53℃ and very low reflectance of photothermal layer substantiates high photothermal conversion efficiency of the *** complete purification of water containing high concentration of Rhodamine-b dye using bPS is a novel and simple approach for water *** is an eco-friendly,cost-efficient novel approach in fabrication of interfacial solar-driven evaporation system with high evaporation rate for purification of water containing high concentration of organic dye.

关键词： banana pseudo stem Polymers Interfacial evaporator biomaterial Water purification High efficiency

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Reconciliation of size-density bivariate distributions over a separating node

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Particuology 2008年第3期6卷 167-175页

作者： bidarahalli Venkoba Rao vivek Ganvir Sirigeri Jois Gopalakrishna Engineering and Industrial Services Tata Consultancy Services Limited 1Mangaldas RoadPune 411001India Tata Research Development and Design Centre Tata Consultancy Services Limited 54BHadapsar Industrial EstatePune 411013India Department of Mineral Processing Post Graduate CenterSandurKarnataka 583119India

Data reconciliation considers the restoration of mass balance among the noise prone measured data by way of component adjustments for the various particle size or particle density classes or assays over the separating node. In this paper, the method of Lagrange multipliers has been extended to balance bivariate feed and product size-density distributions of coal particles split from a settling column. The settling suspension in the column was split into two product fractions at 40% height from the bottom after a minute settling of homogenized suspension at start. Reconciliation of data assists to estimate solid flow split of particles to the settled stream as well as helps to calculate the profiles of partition curves of the marginal particle size or particle density distributions. In general, Lagrange multiplier method with uniform weighting of its components may not guarantee a smooth partition surface and thus the reconciled data needs further refinement to establish the nature of the surface. In order to overcome this difficulty, a simple alternative method of reconciling bivariate size-density data using partition surface concept is explored in this paper.

关键词： Data reconciliation Size-density partition surface Settling test

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