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2. En-bloc Transplantation: an Eligible Technique for Unilateral Dual Kidney Transplantation

Author

M Salehipour, A Bahador, S Nikeghbalian, K Kazemi, AR Shamsaeifar, S Ghaffaripour, MA Sahmeddini, H Salahi, A Bahreini, P Janghorban, S Gholami, and SA Malek-Hosseini

Subjects
K idne ytr ans p lantatio n, En-bloctransplantation, Dua lkidn eytra ns p lant ation, E xpandedcriteriadon, Medicine
Abstract

Background: Objective: To evaluate the en bloc anastomosis technique for unilateral dual kidney transplantation (DKT). Methods: From May to October 2011, 5 patients (4 women and 1 man) with mean age of 31.8 years underwent unilateral DKT with this technique in which distal end of the aorta and proximal end of inferior vena cava (IVC) were closed with running sutures. Then, proximal end of the aorta and distal end of the IVC were anastomosed to internal (or external) iliac artery and external iliac vein, respectively.Results: Post-operative course was uneventful. No vascular and urologic complications developed; all patient had acceptable serum creatinine at discharge time and up of 2–6 months of post-operation follow up.Conclusion: Unilateral DKT is a safe method for performing DKT. The proposed en bloc anastomosis can improve the outcome of the graft by reducing the cold ischemia and the operation time.

Published
2012

3. Effect of Web-Based Life Skills Education on Nurses' Job Burnout

Author

Yektatalab, Shahrzd, Honarmandnejad, Khadijeh, Janghorban, Roksana, and Zarifsanaiey, Nahid

Abstract

This study aimed to assess the effect of web-based life skills education on burnout in nurses. Participants were 104 nurses who had moderate to high burnout. The intervention group received web-based life skills education over 10 weeks. A week later intervention, burnout level was measured in control and intervention groups. Comparison of mean burnout score in the intervention group before and after the intervention showed a significant reduction in total burnout score, and in emotional exhaustion and depersonalization, and a significant increase in personal accomplishment. The study showed that web-based life skills education was able to reduce level of burnout.

Published
2020

15. Immuno-subtyping of breast cancer reveals distinct myeloid cell profiles and immunotherapy resistance mechanisms

Author

Kim, Ik Sun, Gao, Yang, Welte, Thomas, Wang, Hai, Liu, Jun, Janghorban, Mahnaz, Sheng, Kuanwei, Niu, Yichi, Goldstein, Amit, Zhao, Na, Bado, Igor, Lo, Hin-Ching, Toneff, Michael J., Nguyen, Tuan, Bu, Wen, Jiang, Weiyu, Arnold, James, Gu, Franklin, He, Jian, Jebakumar, Deborah, Walker, Kimberly, Li, Yi, Mo, Qianxing, Westbrook, Thomas F., Zong, Chenghang, Rao, Arundhati, Sreekumar, Arun, Rosen, Jeffrey M., and Zhang, Xiang H.-F.

Published
2019
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33. Outcome of Liver Transplant Patients With Intraoperative-Detected Portal Vein Thrombosis: A Retrospective Cohort Study in Shiraz, Iran

Author

P. Janghorban, Behnam Honarvar, Elaheh Foroutanifard, Sayed Ali Malek-Hosseini, Amir Anushiravani, Kamran Bagheri Lankarani, Mozhgan Seif, Maryam Akbari, Nasrin Motazedian, and Saman Nikeghbalian

Subjects
Adult, medicine.medical_specialty, Autoimmune hepatitis, Iran, Severity of Illness Index, Gastroenterology, Primary sclerosing cholangitis, End Stage Liver Disease, Liver disease, Model for End-Stage Liver Disease, Internal medicine, Humans, Medicine, Survival rate, Retrospective Studies, Prothrombin time, Transplantation, medicine.diagnostic_test, Portal Vein, business.industry, Proportional hazards model, Thrombosis, Middle Aged, medicine.disease, Liver Transplantation, Portal vein thrombosis, Treatment Outcome, business
Abstract

Objectives We aimed to determine outcomes and predictors of intraoperative-detected portal vein thrombosis in liver transplant recipients. Materials and methods We retrospectively analyzed 806 adult liver transplant recipients from Shiraz, Iran, to determine those with intraoperative-detected portal vein thrombosis. Patients with this complication were compared with age- and sex-matched patients without this complication. Background diseases, surgery parameters, hospital admission, reoperation, rethrombosis, acute rejection, and use of antico-agulants were assessed. Cox proportional hazards, logistic regression, and random classification forest and random survival forest plots were used for data analyses. Results Mean age of patients was 44.7 ± 13.2 years. Patients with intraoperative-detected portal vein thrombosis (n = 91; 11.3%) had mortality ratio of 2.9 (range, 1.0-8.6) and 2-year survival of 78% versus 2-year survival rate of 92% in patients without this disease. Median time of survival in patients with this complication who died was 2 weeks versus 10 months in patients who died and did not have this complication. Random classification forest plots showed that high fasting blood sugar, autoimmune hepatitis, low prothrombin time, and cryptogenic cirrhosis were (in order) the main predictors of this complication. Random survival forest plots revealed that low prothrombin time, having intraoperative-detected portal vein thrombosis, Model for End Stage Liver Disease score, primary sclerosing cholangitis, diabetes mellitus, and hepatocellular carcinoma were (in order) the main predictors of death in liver transplant recipients. Low body mass index was associated with mortality in patients with intraoperative-detected portal vein thrombosis (by Cox proportional hazards). Conclusions One of every 9 liver transplant patients had intraoperative-detected portal vein thrombosis. Hazard of death was 2.9, and death occurred far earlier in patients with this complication. Improvements in diabetes mellitus care, prothrombin time, Model for End-Stage Liver Disease score, and body mass index may improve outcomes of these patients.

Published
2021
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50. New Onset Diabetes and Impaired Fasting Glucose After Liver Transplant: Risk Analysis and the Impact of Tacrolimus Dose

Author

P. Janghorban, Kamran Bagheri Lankarani, Seyed Ali Malek-Hosseini, Saman Nikeghbalian, and Ahad Eshraghian

Subjects
Adult, Blood Glucose, Male, medicine.medical_specialty, Time Factors, Iran, Risk Assessment, Gastroenterology, Tacrolimus, New onset diabetes, Risk Factors, Internal medicine, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Cardiovascular mortality, Transplantation, business.industry, Incidence, Incidence (epidemiology), Fasting, Middle Aged, medicine.disease, Impaired fasting glucose, Liver Transplantation, Cross-Sectional Studies, Treatment Outcome, surgical procedures, operative, Endocrinology, Tacrolimus Dose, Female, Transplant patient, business, Biomarkers, Immunosuppressive Agents
Abstract

Obj ectives: New onset diabetes mellitus after transplant is one of the major metabolic complications after liver transplant. Development of impaired fasting glucose after liver transplant is thought to be associated with increased risk of cardiovascular mortality and has not been well studied before. The aim of this study was to evaluate incidence and risk factors of new onset diabetes mellitus after transplant and impaired fasting glucose in liver transplant patients. Materials and Methods: In a cross-sectional study, all adult patients (aged ≥ 18 years) who were transplanted because of chronic liver diseases from June 2002 to September 2010 at Shiraz Liver Transplant Center were evaluated for developing diabetes and impaired fasting glucose. Results: Totally, 86 patients (18.81%) were found to have diabetes after liver transplant. Forty patients (27 men and 13 women; 8.75%) developed new onset diabetes mellitus after transplant and 36 patients (7.87%) developed impaired fasting glucose after liver transplant. The mean age of patients with new onset diabetes mellitus after transplant was higher than that of nondiabetic patients ( P = .001). Mean fasting plasma glucose before liver transplant was significantly higher in diabetic patients compared with nondiabetic patients ( P = .002) (5.20 ± 0.93 mmol/L vs 4.44 ± 0.56 mmol/L) (93.86 ± 16.80 mg/dL vs 80 ± 10.14 mg/dL). Patients with new onset diabetes mellitus after transplant received higher doses of tacrolimus as immunosuppressive medication than nondiabetic patients ( P = .001). Conclusi ons: Fasting plasma glucose before transplant can predict development of new onset diabetes mellitus after transplant. Age and tacrolimus dosage are independent risk factors for new onset diabetes mellitus after transplant in our patients.

Published
2014
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