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Zahmatkeshan M.,Shiraz University of Medical Sciences | Geramizadeh B.,Shiraz University of Medical Sciences | Eshraghian A.,Shiraz University of Medical Sciences | Eshraghian A.,Shiraz Transplant Research Center | And 4 more authors.
Transplantation Proceedings | Year: 2011

Introduction: The incidence, risk factors, and natural history of de novo nonalcoholic fatty liver disease (NAFLD) after liver transplantation have not been well described. In this report we examined the risk factors and demographic characteristics of 3 patients. Materials and Methods: During a 16-year period, we performed 900 liver transplantations. We reviewed donor and recipient liver biopsies to identify patients who developed de novo fatty liver following liver transplantation, recording the pretransplantation and posttransplantation blood sugar values and lipid profiles as well as body mass indices (BMI) of affected patients. Results: Three patients developed de novo fatty liver after transplantation. The primary liver diseases among these patients were as follows: Crigler-Najjar syndrome, biliary atresia, and tyrosinemia. All of the patients who developed NAFLD were children. None of them had obesity; all had normal blood sugar values and lipid profiles (triglyceride cholesterol) at the time of and after the operation. Two patients received liver allografts from living related donors and 1 from a deceased donor. The BMI, lipid profile, and blood sugars of all donors were normal. Preoperative donor liver biopsy specimens showed normal histological findings with no evidence of a fatty liver, but the postoperative liver biopsy in recipients specimens revealed steatosis and fatty liver (20%40% fat). Portal vein thrombosis and hepatic artery thrombosis were observed in the patients using color Doppler sonography. Conclusion: De novo NAFLD after liver transplantation occurred less frequently than noted in previous reports. All 3 patients experienced complicated courses. Portal vein thrombosis and hepatic artery thrombosis seemed to be important factors for development of de novo fatty liver after transplantation. © 2011 by Elsevier Inc. All rights reserved.


Ebadi M.,Islamic Azad University at Science and Research of Fars | Yaghobi R.,Shiraz Transplant Research Center | Geramizadeh B.,Shiraz Transplant Research Center | Bahmani M.K.,Shiraz University of Medical Sciences | And 2 more authors.
Transplantation Proceedings | Year: 2011

Background: Infections with hepatitis C virus (HCV) and the familially related hepatitis G virus (HGV) threaten survival of liver transplant recipients. The prevalence and pathogenic effects of these hepatitis virus infections, in particular HGV, on clinical outcome and the need for surveillance are controversial. The present study examined the prevalence of HCV and HGV infections using polymerase chain reaction-based molecular methods in Iranian patients who had undergone orthotopic liver transplantation (oLT). Materials and Methods: Between 2007 and 2010, 202 EDTA-treated blood samples were obtained before and after liver transplantation in 106 patients. An optimized qualitative in-house multiplex reverse transcription polymerase chain reaction protocol was used for simultaneous diagnosis of HCV and HGV infections. Results: Hepatitis C virus molecular infection was diagnosed in 13 of 202 plasma samples (6.4%) in 10 of 106 patients (9.4%) before and after oLT. Eleven of 202 plasma samples (5.4%) from 10 of 106 patients (9.4%) demonstrated HGV genome infection before and after oLT. Conclusion: Detection of moderate prevalence of HCV and especially HGV infection in liver transplant recipients suggests potential importance of HCV infection in liver dysfunction and supports the hypothesis that HGV infection has a pathogenic role in liver-related clinical complications. © 2011 by Elsevier Inc. All rights reserved.


Pooranfar S.,Shiraz University | Shakoor E.,Shiraz University | Shafahi M.J.,Shiraz University | Salesi M.,Shiraz University | And 3 more authors.
International Journal of Organ Transplantation Medicine | Year: 2014

Background: Patients undergoing renal transplantation consume immunosuppressive drugs to prevent graft rejection. Cardiovascular complications and reduced quality of sleep are among the side effects of these drugs. Studies have indicated that the use of non-therapeutic methods such as exercise is important to reduce these complications. Objective: To evaluate the effect of a period of exercise training, as a non-therapeutic method, on quality and quantity of sleep and lipid profile in renal transplant patients. Methods: 44 renal transplant recipients were selected to participate in the study and randomized into exercise (n=29) and control (n=15) groups. The exercise group participated in a cumulative exercise program 3 days a week for 10 weeks in 60-90-minute exercise sessions. Control group subjects did not participate in any regular exercise activity during this period. Sleep quality of the subjects was evaluated using Pittsburgh Sleep Quality Index (PSQI) questionnaire; the sleep quantity was assessed by recording the duration of convenient nocturnal sleep of the subjects. Physiological sleep-related variables (serum triglyceride [TG], and total, high-density lipoprotein [HDL], and low-density lipoprotein [LDL] cholesterol) were measured before and after 10 weeks of exercise training. Results: In exercise training group, sleep quality of the subjects was improved by 27%; the sleep quantity was increased by 30 minutes (p<0.05). TG, cholesterol and LDL values were significantly (p<0.05) decreased after 10 weeks of exercise training in the exercise group compared to the control group, however, no change was observed in serum HDL level in exercise group compared to the control. There was also a significant (p=0.05) difference in sleep quality and quantity between control and exercise groups. However, there was no correlation between changing quality and quantity of sleep with sleep-related physiological factors. Conclusion: 10 weeks of exercise activity improved the quality and quantity of sleep as well as a numberof sleep-related physiological parameters in renal transplant recipients, and would be an effective approach to treat sleep-related disorders in renal transplant recipients.


Dehghani S.M.,Shiraz University of Medical Sciences | Gholami S.,Shiraz University of Medical Sciences | Bahador A.,Shiraz University of Medical Sciences | Nikeghbalian S.,Shiraz University of Medical Sciences | And 6 more authors.
Transplantation Proceedings | Year: 2011

Background: Family refusal is an important factor that limits the number of organ donations. Some studies from different centers have reported various reasons for family decisions of organ donation refusal. This study evaluated the reasons for organ donation refusal by family members covered in our organ procurement organization. Methods: This cross-sectional study was performed among families of potential organ donors who satisfied brain death criteria as identified between March 2009 and March 2010. Results: Among 125 potential donors 73 (58.4%) families refused donation. Their main reasons were as follows: lack of acceptance of brain death n = 26 (35.6%), belief in miracle and patient recovery (n = 22; 30.1), fear of gossip regarding sale rather than autonomous organ donation (n = 11; 15.1%), and fear about deformation of the donor's body (n = 9; 12.3%). Conclusion: Family members play an important role in the final decision for organ donation. The general public should be encouraged to register their donation preferences in the case of brain death. © 2011 by Elsevier Inc. All rights reserved.

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