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Ride sharing service known as carpooling service allows passengers to share rides with other passengers and for drivers, to utilize empty seats when serving passengers' orders. With the system provided by smart passenger transportation companies like Didi, Uber has made it flexible for people unable to operate a personal vehicle in large urban places to find a ride at a lower price. This system can offer more flexible service with shorter waiting times and higher travel convenience in urban areas, especially in rush hours when regular taxicab services become insufficient. Passenger dispatch and mileage saving are the key problems in the ride-sharing system. This research proposes a novel framework called 'Optimal Passenger Dispatch Approach (OPDA)' in ride-sharing systems based on real time (a) constraints and (b) parameters. This study formulated four real-time constraints and also seven parameters. This approach dispatched a set of new passengers generated in a time epoch and a set of vehicles that are near to the new passenger's origin and satisfy all constraints without violating the constraints of the involved parties. This study conducted a matching-based vehicle recommendation approach (OPDA), which considers multiple objectives of drivers, passengers, and the platform. Passengers and vehicles treated as nodes of a bi-graph, and a maximum weighted matching leads to dispatch the orders. The objectives have been set to overcome the constraints and improve the system by considering highest number of parameters that have valuable impacts. We demonstrated the significance of ride-sharing compared to regular non-shared vehicle service and nearest vehicle recommendation based on a simulation model of both systems.

Background Induction therapy with IL-2 receptor antagonist (IL2-RA) is recommended as a first-line agent in low immunological risk kidney transplant recipients. However, the role of IL2-RA in the setting of tacrolimus-based immunosuppression has not been fully investigated. Aims To compare different induction therapeutic strategies with 2 doses of basiliximab vs. no induction in low immunologic risk kidney transplant recipients as per KFSHRC protocol. Methods Prospective, randomized, double blind, non-inferiority, controlled clinical trial Expected outcomes 1. Primary outcomes: Biopsy-proven acute rejection within first year following transplant 2. Secondary outcomes: a. Patient and graft survival at 1 year b. eGFR at 6 months and at 12 months c. Emergence of de novo donor-specific antibodies (DSAs) Trial registration The study has been prospectively registered at clinicaltrials.gov (NTC: 04404127). Registered on 27 May 2020.

Primary focal segmental glomerulosclerosis recurrence occurs in 10% to 50% of recipients after kidney transplant and may affect both children and adults. Treatment after recurrence with plasma exchange and immunosuppression is quite variable and challenging, and those who do not respond usually progress to allograft failure. Podocyte injury and B7-1 expression and subsequently its blockade (abatacept) have been reported to be associated with complete remission of proteinuria in 4 patients with focal segmental glomerulosclerosis recurrence after kidney transplantation and in 1 patient with focal segmental glomerulosclerosis in native kidney. Here, we report our experience of successfully treating 3 consecutive patients with focal segmental glomerulosclerosis recurrence after kidney transplant with abatacept, which induced proteinuria remission.

Although the outcomes of ABO-incompatible (ABOi) kidney transplant recipients are quite favorable, these patients are at increased risk of early antibody-mediated rejection (AMR) and graft loss. Some studies have also shown high mortality in the ABOi group mainly due to increased risk of infections. The AMR rates have been reported anywhere from 50% in the literature. The outcomes of the ABOi kidney transplants in the Saudi population are not known. In this study, we aimed to determine the graft and patient survival in ABOi kidney transplant recipients in the Saudi population. We included all adult patients who underwent ABOi transplantation between 2007 and 2016. All patients received rituximab, therapeutic plasma exchange, thymoglobulin, intravenous antibiotics, and intravenous immunoglobulin. The maintenance immunosuppression was prednisone, mycophenolate mofetil, and tacrolimus. The data were collected from a prospectively maintained database. A total of 77 patients were included in the study. The most common blood group mismatch was A to O (44.2%), followed by B to O (26.0%) and A to B (16.9%). In the 1st year, 17% of patients developed acute cellular rejection and AMR occurred in 7.8% of patients. Two patients were diagnosed with BK nephropathy. In the 1st year, urinary tract infection occurred in 25 (32.5%) patients. No patient was diagnosed severe viral or fungal infection. In the 1st year, four grafts were lost (graft survival of 94.8%); all grafts were lost within two weeks, three due to AMR and one due to technical reason. One year patient survival was 100%. In this study of ABOi kidney transplant recipients, we observed low risks of infectious complications with excellent patient and graft survival. Our immunosuppressive protocol can be considered safe.

Background: Significant numbers of kidneys are discarded due to raised terminal creatinine of the donor. Aim: To determine long-term outcomes of kidneys utilized from donors with severe acute kidney injury (AKI). Methods: In this retrospective study, we included all patients who received kidneys from deceased donors between years 2000 and 2012. AKI was defined according to the acute kidney injury network (AKIN) classification. The primary outcomes were patient and graft survival and secondary outcomes were renal function at different time points, delayed graft function, acute rejection and length of hospital stay. Results: Two hundred and eighty-four recipients received kidneys from 261 deceased donors. One hundred and fourteen patients (40%) received kidneys from the donors with AKI. Forty-two patients received kidneys from the donors with severe AKI (AKIN-3 category). Mean age of the donor and recipient was 36 and 37 years, respectively. Main cause of death in donors was road traffic accident (34%) followed by cerebrovascular accident (33%). Terminal creatinine was 85 and 262 μmol/l in non-AKI and AKI groups, respectively ( P < 0.001) . Significantly more patients in the AKI group had delayed graft function ( P = 0.006), prolonged hospital stay ( P < 0.001) and high creatinine at discharge ( P = 0.002). However, acute rejection rates ( P = 0.25), 1-, 5- and 10-year graft survival ( P = 0.57) and patient survival ( P = 0.77) were not different between AKI and non-AKI groups. The outcomes in the AKIN-3 category were comparable with the non-AKI group. Conclusions: This study has shown favorable long-term outcomes of kidneys utilized from donors with severe AKI. This study may encourage healthcare professionals to consider accepting such kidneys.