Although most female kidney transplant recipients were sexually active both before and after transplantation, many were not counseled about the need for contraception and did not use any form of birth control. Health professionals involved in the management of these patients need to include contraceptive counseling as part of their routine care.
The prevalence and recurrence of LAR are considerable and associated with increased incidence of graft loss. Patients who need dialysis during LAR should be carefully evaluated owing to the high prevalence of graft failure.
Tridimensional Rotational Angiography (3D-RA) as a Diagnostic Tool for Patients with Transplant Renal Artery Stenosis Background: Transplant renal artery stenosis (TRAS) is the major vascular complication associated to adverse events in patients with kidney grafts, whose incidence ranges from 1% to 23%. Angiography is the gold-standard for diagnosis, enabling immediate treatment; however, due to the variable anatomy and location of anastomosis, additional projections are often required, leading to greater exposure to contrast medium and radiation. Tridimensional rotational angiography (3D-RA) appears as a tool for diagnosis and treatment of TRAS. The aim of this paper was to evaluate the accuracy of measurements obtained by 3D-RA in comparison to conventional angiography. Methods: From April, 2010 to January, 2011, 41 3D-RAs were performed in patients with clinical suspicion of TRAS. Images were analyzed by independent observers; conventional angiography measurements were obtained online and 3D-RA measurements were obtained offline with the Philips Allure 3D-RA software. Results: Thirty-five 3D-RAs (84%) were considered adequate for angiographic measurements, and 20% provided additional and relevant information for the therapeutic strategy. There was no statistically significant difference between measurements obtained from the reference diameter and minimal luminal diameter of the artery using 3D-RA and conventional angiography. In addition, there was a strong correlation between them. Conclusions: 3D-RA comes up as a useful tool for TRAS
We observed a case of recombinant human erythropoietin resistance caused by Gastric Antral Vascular Ectasia in a 40-year-old female with ESRD on hemodialysis. Some associated factors such as autoimmune disease, hemolysis, heart and liver disease were discarded on physical examination and complementary tests. The diagnosis is based on the clinical history and endoscopic appearance of watermelon stomach. The histologic findings are fibromuscular proliferation and capillary ectasia with microvascular thrombosis of the lamina propria. However, these histologic findings are not necessary to confirm the diagnosis. Gastric Antral Vascular Ectasia is a serious condition and should be considered in ESRD patients on hemodialysis with anemia and resistance to recombinant human erythropoietin because GAVE is potentially curable with specific endoscopic treatment method or through surgical procedure.
Active HHV-6 infection occurs early after renal transplantation and is mostly asymptomatic. Donor or recipient infection may occur at the time of transplantation and are related to higher rates of posttransplantation infections.
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