MyMedR

Grossly delayed graft function in a living related kidney transplant recipient: a case report

Thye YL, Lim SK, Wong CM, Keng TC, Chong YB, Tan SY

Transplant Proc, 2008 Sep;40(7):2435-6.

PMID: 18790259 DOI: 10.1016/j.transproceed.2008.07.051

Delayed graft function is a potentially challenging problem especially in cadaveric kidney transplant recipients. It adversely impacts long-term graft survival. It is rarely seen in living kidney transplants. Recovery of graft function usually occurs within a month. The chances of recovery of graft function diminish with further prolongation of delayed function. In fact, recovery of graft function after 3 months has rarely been described, we report herein recovery of graft function after 132 days of nonfunction in a living related kidney transplant.

Matched MeSH terms: Kidney Failure, Chronic/surgery

Fulltext Anaesthesia for a patient with long QT syndrome undergoing renal transplantation

Lim KY, Lim TA, Wong WH

Med J Malaysia, 2005 Dec;60(5):647-9.

PMID: 16515119

Anaesthetizing patients with Long QT Syndrome is a major challenge, as the potential for sudden catastrophic cardiovascular collapse is well known. We present a 15-year-old boy with Long QT Syndrome who presented for an elective renal transplant. All electrolyte concentration abnormalities were corrected preoperative and adequate beta-blockade was maintained. The patient was given a target controlled infusion of propofol, together with opioids and atracurium. Anaesthesia was uneventful and the patient was extubated at the end of the surgical procedure.

Matched MeSH terms: Kidney Failure, Chronic/surgery*

Cyclosporine-associated encephalopathy: a case report and literature review

Chang SH, Lim CS, Low TS, Chong HT, Tan SY

Transplant Proc, 2001 12 26;33(7-8):3700-1.

PMID: 11750577

Matched MeSH terms: Kidney Failure, Chronic/surgery

Fulltext A qualitative examination of barriers and solutions to renal transplantation in Malaysia: Key-informants' perspective

Gan Kim Soon P, Lim SK, Rampal S, Su TT

PLoS One, 2019;14(8):e0220411.

PMID: 31404075 DOI: 10.1371/journal.pone.0220411

INTRODUCTION: End-stage renal disease (ESRD) is increasing globally, and renal transplantation (RT) is the preferred renal replacement therapy to treat ESRD. Internationally, there are only a few countries with RT rates above 50 per million population (pmp), while most of the countries have RT rates between 30-40 pmp. The low- and middle-income countries (LMIC) makes up the majority for the RT rates below 20 pmp in which Malaysia belongs to despite its increasing ESRD rates. There is a need to explore the barriers to access RT with targeted solutions to improve the RT rates and service in LMIC. Thus, a qualitative study was undertaken in Malaysia to address this issue.

METHOD: A qualitative methodological approach was performed between March-May 2018. Semi-structured interviews were used to explore current RT policy and service availability. Key-informants were identified from a detailed stakeholder analysis of RT system in Malaysia. Interviews were digitally audio-recorded, transcribed verbatim, coded with ATLAS.ti software and underwent thematic analysis thoroughly.

RESULTS: Eight key-informants participated in the study. Barriers and related solutions were classified using the socio-ecological model (SEM). As reported, the barriers and solutions of RT in Malaysia are the results of a complex interplay of personal, cultural, and environmental factors. Key barriers are linked to public's attitude and perception towards RT and the unaccommodating practices in the healthcare fraternity for RT. Key-informants provided a systematic solution that shed light on how RT could be improved at each SEM level via effective communication, education and inter-agency collaboration.

CONCLUSION: The SEM provided a framework to foster a better understanding of current practice, barriers, and solutions to RT in Malaysia. This study is the first to explore the barriers and related solutions to RT comprehensively as a whole. Implications of these findings could prompt a policy change for a better RT service delivery model not just for Malaysia but also for other LMIC. Further stakeholder engagement and evaluation of the systems are required to provide insight into best practices that will help to improve the RT rates and service in Malaysia.

Matched MeSH terms: Kidney Failure, Chronic/surgery

The need for kidney transplantation in low- and middle-income countries in 2012: an epidemiological perspective

Muralidharan A, White S

Transplantation, 2015 Mar;99(3):476-81.

PMID: 25680089 DOI: 10.1097/TP.0000000000000657

Epidemiological and demographic transitions are shifting the burden of modifiable risk factors for chronic and end-stage kidney disease to low- and middle-income countries (LMIC). This shifting burden of disease--combined with economic transitions and health system reforms--has led to the rapid growth of dialysis populations in LMIC including Malaysia, Tunisia, Turkey, Chile, Mexico, and Uruguay. Yet, compared to 1.5 million on dialysis in LMIC, only approximately 33,000 kidney transplants were performed in 2012. Reasons include health system factors (personnel, infrastructure, system coordination, and financing) and cultural factors (public and professional attitudes and the legal environment). The size of the dialysis populations, however, is generally a poor indicator of the potential need for kidney transplantation in LMIC. Population needs for kidney transplantation should instead be assessed based on the epidemiology of the actual underlying burden of disease (both treated and untreated), and the costs and benefits of treatment as well as prevention strategies relative to existing service provision. Here, we review current data on the global burden of end-stage kidney disease and the distribution of major risk factors, and compare this to access to kidney transplantation in 2012.

Matched MeSH terms: Kidney Failure, Chronic/surgery*

Outcome of overseas kidney transplantation in Malaysia

Morad Z, Lim TO

Transplant Proc, 2000 Nov;32(7):1485-6.

PMID: 11119799

Matched MeSH terms: Kidney Failure, Chronic/surgery

FK506 "rescue" therapy complicated by renal tubular acidosis in renal allograft recipients

Goh BL, Tan SY

Transplant Proc, 1998 Nov;30(7):3594-5.

PMID: 9838575

Matched MeSH terms: Kidney Failure, Chronic/surgery

Fulltext Immune haemolysis after renal transplantation secondary to ABO minor-mismatch between donor and recipient

Jayaranee S, Ramesh P, Nadesan V

Singapore Med J, 2002 Aug;43(8):421-2.

PMID: 12507029

Immune haemolysis following renal transplantation has been reported and known causes include infection, medication and metabolic disturbances (1,2). Autoimmune haemolysis after renal transplantation secondary to ABO minor mismatch is an uncommon but important cause that should be considered in the differential diagnosis of post-transplantation haemolysis. A case of haemolytic anaemia caused by graft versus host antibody formation is presented. We suggest that direct Coomb's test should be done as a routine in all cases of ABO mismatch renal transplantation and red cells compatible with both donor and recipient or group "O" packed cells should be transfused if transfusion is indicated.

Matched MeSH terms: Kidney Failure, Chronic/surgery

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