Angiomyolipoma are commonly found in Kidney but extrarenal sites are also mentioned. It arising in adrenal is very rare entity, usually asymptomatic, diagnosed incidentally on radiological investigation of abdomen for other conditions. We report our experience with a 37-year-old man who presented with sudden feeling of jerking discomfort and generalized weakness. An USS showed adrenal mass, computerised tomography (CT) scan confirmed and outlined the adrenal mass.Adrenalectomy was performed and the histopathological features confirmed the diagnosis of adrenal angiomyolipoma. The patient recovered without any complications following surgery.

In Bangladesh, the first living donor kidney transplantation was performed in 1982. Since then above 2,300 kidney transplantations were performed. Liver transplantation was started in 2010, but only six were performed. Cornea transplantation was started in 1984 and over 5,500 were done. Bone marrow transplantation was started in 2014 and 25 were transplanted. About 10 centers are performing kidney and three centers performing liver transplantation. In 2018, ABO-incompatible kidney transplantation was started and seven cases performed. Each year, nearly 40,000 patients reach end-stage renal disease (ESRD) but only 250-300 get transplanted. The graft survival at 1-, 5-, and 10-year is 96%, 85%, 50% respectively. Challenges in living donor transplantation include (a) scarcity of donors due to lack of awareness and fear of donation; (b) high cost of investigations, surgery and immunosuppressive drugs with meagre Government subsidy makes transplantation unaffordable for many patients; (c) lack of trained transplant physicians, surgeons, nurses, (d) lack of necessary laboratory facilities. Hurdles for deceased donor transplantation are (a) lack of ICU infrastructure for identification, declaration and management of brain death donors; (b) lack of awareness among general people and health care professionals; (c) certain socio-cultural and religious beliefs; (d) lack of trained transplant physicians, surgeons, nurses, transplant coordinators and grief counselors. In Bangladesh, only living donor transplants were performed so far. Efforts as now being made to start deceased donor transplantation. To increase awareness, different programs and conferences involving healthcare professionals, public, Islamic scholars and international advisers were organized. Leaflets, posters, donor cards were made. Brain Death Committee and Organ Procurement Committee are established and training programs for transplant coordinators and grief counsellors have been organized. It is expected that in future deceased donor transplantation will take place and facility for living donor transplantation will expand.

Background: Kidney transplantation is the best treatment modality for end-stage renal disease (ESRD) patients. In Bangladesh, kidney transplantation was started in 1982. Till date living kidney donation is the only source of kidney transplantation. In this study we evaluated the demographic and clinical characteristics of kidney donors. Methods: This retrospective study was conducted at Kidney Foundation Hospital and Research Institute, Bangladesh. Data of kidney donors from 2006 to 2020 was collected and analyzed with SPSS software. Results: A total of 503 donors were studied. The mean age of donors was 41.9 years (range, 21-67). Nearly two thirds of donors were female (63%) while only one third of donors were male (37%). Mothers comprised 37.2% of total donor pool followed by sisters (16.7%), brothers (16.3%), fathers (9.5%), and wives (5.4%). Majority donors were Muslims (94%). The commonest blood group was O (41%). The average weight was 55.4 kg; mean systolic and diastolic blood pressure was 114 mmHg and 76 mmHg respectively. About 10.2% donors were hypertensive according to JNC8 classification. Investigations showed mean hemoglobin 12.8 mg/dL, serum creatinine 75.5 mol/L, eGFR 86.4, PCR 0.17, calcium 2.2 mmol/L, phosphate 1.2 mmol/L, uric acid 260 mol/ L; fasting and 2hABF blood sugar 5.9 mmol/L and 7.7 mmol/L respectively. About 12.6% donors had impaired glucose tolerance according to ADA criteria. Ultrasonography showed that average size of right kidney 9.4 cm, left kidney 9.6 cm. CT angiogram demonstrated that 4.6% donor kidneys had cyst, 1.4% had stone and 25.2% had accessory renal arteries. Split renal function assessed using Tc-99m DTPA found that mean GFR of right kidney 48.7 mL/min, left kidney 49.6 mL/min and mean total GFR 98.8 mL/min. In 0.5% donors eGFR was less than 60%. Conclusions: This is the baseline profile of kidney donors of Bangladesh. This knowledge will be useful during selection of both living and deceased organ donors.

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