Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease

Background. Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder leading to end-stage renal failure. The objective of this study was to evaluate a longitudinal experience of kidney transplantation for ADPKD. Methods. A single center retrospective review of patients undergoing kidney transplantation was conducted, with comparisons across two time periods: early (02/2000–04/2007, n = 66) and late (04/2007–08/2012, n = 67). Results. Over the 13.5-year study period, 133 patients underwent transplantation for ADPKD. Overall, no significant difference between the early and late group with regard to intraoperative complications, need for reoperation, readmissions within 30 days, delayed graft function, and mortality was noted. There was a trend towards increase in one-year graft survival (early 93.1% versus late 100%, P = 0.05). In the early group, 67% of recipients had undergone aneurysm screening, compared to 91% of recipients in the late group (P < 0.001). Conclusions. This study demonstrates consistent clinical care with a trend towards improved rates of one-year graft survival. Interestingly, we also note a significantly higher use of cerebral imaging over time, with the majority that were detected requiring surgical intervention which may justify the current practice of nonselective radiological screening until improved screening criteria are developed

Study of non-thyroidal illness syndrome and its recovery in critically ill patients at a tertiary care centre in South India

Background and Objectives: Transient thyroid hormone alterations are common during critical illness and are termed non-thyroidal illness syndrome (NTIS). We studied the prevalence of NTIS in the ICU setting and its impact on predicting mortality and other outcomes and compared it to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Materials and Methods: The study included 119 consecutive patients admitted with a critical illness. APACHE II score was calculated. Total T3, total T4, TSH, free T3, and free T4 were measured at admission and after six weeks of discharge. NTIS and euthyroid groups were studied for ICU, hospital stays, mortality, readmission, and recovery. Predictors of mortality were compared between survivors and non-survivors. Results: The mean age was 60.15 ± 14.50 years with M:F = 84 (71%):35 (29%). NTIS was observed in 84 (71%), low T3 being the most common abnormality in 53 (63%). The occurrence of NTIS was significantly higher among non-survivors (28/30, 93%) versus survivors (56/89, 63%) (P = 0.002). Non-survivors showed significantly lower T3, TSH, and FT3/FT4 ratios and higher readmissions. NTIS group showed significantly greater ICU stay (P = 0.02) and had higher readmission rates (P = 0.032). Baseline T3 had the greatest power to predict mortality. APACHE II score also correlated significantly with mortality (19.60 ± 10.58 vs 11.99 ± 6.80, P < 0.001). The area under the curve (0.677) for the T3 level was lower than the APACHE II score (0.760). After six weeks, 61% had recovered from NTIS. Conclusions: NTIS was common amongst critically ill patients (71.5%), which reversed in 61% at six weeks. Low T3 was the most common abnormality and independently predicted mortality. Free T3/free T4 also significantly predicted mortality. The correlation between thyroid dysfunction and the severity of primary illness makes it an additional attractive low-cost marker of mortality

BiFeO₃-Black TiO₂ Composite as a Visible Light Active Photocatalyst for the Degradation of Methylene Blue.

The application of a novel BiFeO3 (BFO)-black TiO2 (BTO) composite (called BFOT) as a photocatalyst for the degradation of methylene blue is reported. The p-n heterojunction photocatalyst was synthesized for the first time through microwave-assisted co-precipitation synthesis to change the molar ratio of BTO in BiFeO3 to increase the photocatalytic efficiency of the BiFeO3 photocatalyst. The UV-visible properties of p-n heterostructures showed excellent absorption of visible light and reduced electron-hole recombination properties compared to the pure-phase BFO. Photocatalytic studies on BFOT10, BFOT20, and BFOT30 have shown that they decompose methylene blue (MB) in sunlight better than pure-phase BFO in 70 min. The BFOT30 photocatalyst was the most effective at reducing MB when exposed to visible light (97%). Magnetic studies have shown that BTO is diamagnetic, and the BFOT10 photocatalyst exhibits a very weak antiferromagnetic behavior, whereas BFOT20 and BFO30 show diamagnetic behavior. This study confirms that the catalyst has poor stability and weak magnetic recovery properties due to the non-magnetic phase BTO in the BFO

BiFeO3-Black TiO2 Composite as a Visible Light Active Photocatalyst for the Degradation of Methylene Blue.

The application of a novel BiFeO3 (BFO)-black TiO2 (BTO) composite (called BFOT) as a photocatalyst for the degradation of methylene blue is reported. The p-n heterojunction photocatalyst was synthesized for the first time through microwave-assisted co-precipitation synthesis to change the molar ratio of BTO in BiFeO3 to increase the photocatalytic efficiency of the BiFeO3 photocatalyst. The UV-visible properties of p-n heterostructures showed excellent absorption of visible light and reduced electron-hole recombination properties compared to the pure-phase BFO. Photocatalytic studies on BFOT10, BFOT20, and BFOT30 have shown that they decompose methylene blue (MB) in sunlight better than pure-phase BFO in 70 min. The BFOT30 photocatalyst was the most effective at reducing MB when exposed to visible light (97%). Magnetic studies have shown that BTO is diamagnetic, and the BFOT10 photocatalyst exhibits a very weak antiferromagnetic behavior, whereas BFOT20 and BFO30 show diamagnetic behavior. This study confirms that the catalyst has poor stability and weak magnetic recovery properties due to the non-magnetic phase BTO in the BFO

Donor-derived ehrlichiosis: two clusters following solid organ transplantation

Ehrlichiosis has been infrequently described as transmissible through organ transplantation. Two donor derived clusters of ehrlichiosis are described here. During the summer of 2020, two cases of ehrlichiosis were reported to the Organ Procurement and Transplantation Network (OPTN) and the Centers for Disease Control and Prevention (CDC) for investigation. Additional transplant centers were contacted to investigate similar illness in other recipients and samples were sent to CDC. Two kidney recipients from a common donor developed fatal ehrlichiosis-induced hemophagocytic lymphocytic histiocytosis (HLH). Two kidney recipients and a liver recipient from another common donor developed ehrlichiosis. All three were successfully treated. Clinicians should consider donor-derived ehrlichiosis when evaluating recipients with fever early after transplantation after more common causes are ruled out, especially if the donor has epidemiological risk factors for infection. Suspected cases should be reported to the organ procurement organization (OPO) and the OPTN for further investigation by public health authorities