Hasil Pencarian  ::  Simpan CSV :: Kembali

"Though kidney transplantation is considered a routine procedure, there are still significant challenges in post-transplant management. Core Concepts in Renal Transplantation is a clinically focused authoritative guide to the management of kidney transplantation. This comprehensive, state-of-the-art reference summarizes the recent changes in the field of transplantation, offering the complete range of up-to-date information on all the various aspects of basic immunobiology and the medical care of the transplant recipient. "

"Latar Belakang: Transplantasi ginjal telah menjadi pilihan utama terapi bagi pasien dengan penyakit ginjal tahap akhir, baik yang berasal dari donor hidup maupun donor jenazah. Transplantasi ginjal memiliki risiko yang lebih rendah baik untuk mortalitas maupun kejadian kardiovaskular, serta memiliki kualitas hidup yang lebih baik dibandingkan pasien yang menjalani dialisis kronis, baik hemodialisis maupun dialisis peritoneal. Penelitian ini bertujuan mengetahui faktor-faktor yang mempengaruhi kesintasan transplantasi ginjal di RSUPN Ciptomangunkusumo tahun 2010-2017. Metode: Penelitian Desain penelitian ini adalah kohort retrospekstif menggunakan data rekam medis pasien transplantasi ginjal. Sampel penelitian adalah resipien transplantasi ginjal ≥ 18 tahun di di RSUPN Ciptomangunkusumo tahun 2010-2017, yaitu sebanyak 548 pasien. Hasil: penelitian probabilitas kesintasan resipien transplantasi ginjal selama pengamatan 5 tahun adalah 84,1% Hasil analisis dengan regresi cox menunjukkan bahwa resipien dengan donor yang berusia ≥ 40 tahun lebih cepat 1,487 kali untuk meninggal dibandingkan resipien dengan donor yang berusia < 40 tahun, resipien yang berusia ≥ 45 tahun lebih cepat 2,356 kali untuk meninggal dibandingkan pasien yang berusia <45 tahun, lama hemodialisis ≥ 24 bulan lebih cepat 2,356 kali untuk meninggal dibandingkan pasien yang lama hemodialisisnya < 24 bulan, skor charlson > 1 lebih cepat 2,861 kali untuk meninggal dibandingkan pasien yang skor charlson ≤ 1, resipien yang memiliki DM lebih cepat 2,947 kali untuk meninggal dibandingkan dengan yang tidak DM. Simpulan: Kesintasan lima tahun di Indonesia cukup baik. Insiden kematian relatif tinggi, menyebabkan penurunan kelangsungan hidup pasien lima tahun. Namun, hasil keseluruhan masih sebanding dengan negara-negara berkembang lainnya.

---

Background: Kidney transplantation has become the main choice of therapy for patients with end-stage kidney disease, both from living donors and donor bodies. Kidney transplantation has a lower risk for both mortality and cardiovascular events, and has a better quality of life than patients who undergo chronic dialysis, both hemodialysis and peritoneal dialysis. This study aims to determine the factors that influence the survival of kidney transplants in Ciptomangunkusumo Hospital in 2010-2017.

Methods: A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from March 2019 until May 2019. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or december 2018, whichever comes first. Five-year death and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study and analysis with Cox regression.

Result: which was as many as 548 patients. The results of this study indicate the probability of survival of kidney transplant recommendations during the 5-year observation was 84.1%. The results of the analysis with Cox regression showed that donors aged ≥ 40 years were 1,487 faster to die than recipients with donor aged <40 years, prescriptions aged ≥ 40 years 2,356 times faster to die than patients aged <40 years, duration of hemodialysis ≥ 24 months faster 2,356 times to die compared to patients with long hemodialysis <24 months, Charles score> 1 faster 2,861 times to die than patients who score charlson ≤ 1, the recipients who have DM are 2.97 times faster to die compared to those without DM.

Conclusions: The outcome of five-year death in Indonesia is very satisfactory. The incidence of death is relatively high, causing a decline in five-year patient survival. However, the overall results are still comparable to other developing countries."

"ASBTRACTPurpose: Airway complications (ACs) after living-donor lobar lung transplantation (LDLLT) could have different features from those after cadaveric lung transplantation (CLT). We conducted this study to compare the characteristics of ACs after LDLLT vs. those after CLT and investigate their impact on outcomes.Methods: We reviewed, retrospectively, data on 163 recipients of lung transplantation, including 83 recipients of LDLLT and 80 recipients of CLT.Results: The incidence of ACs did not differ between LDLLT and CLT. The initial type of AC after LDLLT was limited to stenosis in all eight patients, whereas that after CLT consisted of stenosis in three patients and necrosis in ten patients (p = 0.0034). ACs after LDLLT necessitated significantly earlier initiation of treatment than those after CLT (p = 0.032). The overall survival rate of LDLLT recipients with an AC was significantly lower than that of those without an AC (p = 0.030), whereas the overall survival rate was comparable between CLT recipients with and those without ACs (p = 0.25).Conclusion: ACs after LDLLT, limited to bronchial stenosis, require significantly earlier treatment and have a greater adverse impact on survival than ACs after CLT."

"ABSTRAKSalah satu cara penyembuhan dan pemulihan kesehatan yaitu dengan cara transplantasi (pencangkokan) organ dan atau jaringan. Pengertian transplantasi ialah pemindahan atau pencangkokan organ atau jaringan tubuh dari seorang individu ke tempat lain pada individu itu atau ke tubuh individu lain. Dalam proses tindakan transplantasi itu ada pihak yang menerima (resipien) organ dan atau jaringan tubuh dan ada pihak yang memberi (donor) organ dan atau jaringan tubuh.Pemberian resipien pelayanan medis dari dokter kepada pasien (resipien) demikian itu di samping mempunyai aspek medis juga mempunyai aspek yuridis yaitu timbulnya transaksi terapeutik antara dokter dengan pasien (resipien) dan antara dokter dengan donor; penting adanya informed consent dari pasien dan donor, dan tanggung jawab hukum dokter di bidang perdata dan hukum pidana apabila dalam melakukan tugasnya dokter itu melakukan medical malpractice. Oleh karena itu membicarakan transplantasi ditinjau dari segi hukum berarti membicarakan perlindungan hukum dari gangguan yang mengancam kepentingan pihak-pihak yang terlibat dalam tindakan transplantasi yaitu: (a) perlindungan hukum terhadap dokter (yang memberikan pelayanan medis kepada pasien dan donor} dari gugatan pihak ketiga(pasien), (b} perlindungan hukum terhadap pasien (resipien) dan (c} perlindungan hukum terhadap pemberi organ (donor} apabila pada waktu dilakukan transplantasi terjadi medical malpractice. Perlindungan hukum demikianitu mempunyai arti penting bagi pihak-pihak yangbersangkutan, karena Peraturan pelaksanaan transplantasi (Peraturan Pemerintah Nomor 18 Tahun 1981) perlu peninjauan kembali misalnya tentang ?batasan mati" yang disimpulkan ?mati jantung" padahal pusat regulasi terletak di batang otak.Dari segi kedokteran saat mati perlu ditetapkan, dalam hal transplantasi dari donor jenazah, dokter dihadapkan pada dua masalah yang harus diputuskan secara tepat melalui proses pengambilan keputusan yang relatif sangat singkat sehubungan dengan fungsi organ tersebut. Dokter (tim medis) harus memilih antara pertimbangan demi kesehatan penerima (resipien) yang akan ditransplantasi itu, atau pertimbangan akan harapan hidup donor yang mungkin masih diragukan kematiannya.Faktor sosio-kultural dalam pelaksanaan transplantasi sangat berpengaruh, karena tampaknya nilai-¬nilai sosial budaya masyarakat Indonesia belum seluruhnya menerima kalau salah satu organ tubuh seseorang diambil untuk dimanfaatkan bagi orang lain yang membutuhkannya.Pandangan hukum Islam terhadap hukum menyelenggarakan transplantasi merupakan hasil "ijtihad" para pakar agama Islam, dimasa yang akan datang sangat menunjang kemajuan ilmu kedokteran khususnya dan pelayanan medis pada umumnya di Indonesia.

---

"

"ABSTRAK Severe gingival enlargement (GE) is one of the most commonly observed adverse effects in patients who have undergone renal transplants due to the use of cyclosporine A. Objectives: We aimed to gain more insight into the prevalence of GE in patients with renal transplants. Methods: We searched the PubMed and Web of Science databases for relevant studies from January 1990 to January 2018. Using random effects models, we calculated summary incidence rates and 95% confidence intervals (CIs). Results: A total of 595 patients from 10 studies were included. Patients using cyclosporine A with or without any other drugs had a 62.6% (95% CI, 41.9% until 79.5%) incidence of GE. Subgroup analysis according to diagnostic criteria showed that the incidence of GE was lower when using well defined diagnostic criteria or scoring system. The incidence of GE was 88.2% (95% CI, 80.9% until 93.0%) in patients using cyclosporine A with nifedipine. Cyclosporine A without nifedipine was associated with a significantly decreased risk of GE incidence when compared with the combination of cyclosporine A and nifedipine (odds ratio:0.198, 95% CI, 0.083 until 0.473, P < 0.001). Conclusions: It is important for all clinicians to know the effects of the aforementioned drugs and the treatment options. "

"Latar Belakang: Meningkatnya angka kejadian stroke dan beratnya disabilitas dari penderita stroke yang bertahan hidup, menjadikan diperlukannya terapi yang optimal untuk restorasi paska stroke. Neurorestorasi dengan transplantasi sel punca menjanjikan perbaikan luaran fungsional yang baik pada pasien stroke iskemik. Penelitian ini dibuat untuk mengamati efek transplantasi Stem Cell from Human Exfoliated Deciduous Teeth SHED pada luaran klinis dan rasio sel neuron mati pada model stroke iskemik, untuk mendapatkan terapi yang optimal untuk stroke iskemik.Metode: Pembuatan tikus model stroke iskemik dilakukan dengan oklusi arteri cerebri media (MCAO). Pada 48 jam setelah MCAO, dilakukan transplantasi sel mesenkimal asal SHED secara intravena, dengan dosis 2x106/kgBB. Dilakukan evaluasi fungsional tikus secara neurobehaviour dengan tes Y Maze, dan evaluasi sensorimotor tikus dengan tes silinder. Evaluasi rasio neuron mati dilakukan dengan pewarnaan Hematoksilin dan Eosin.Hasil: Terdapat perbaikan evaluasi neurobehaviour dengan Y Maze (p=0,04) dan evaluasi sensorimotor dengan tes silinder (p=0,04) pada 14 hari setelah transplantasi pada kelompok tikus yang ditransplantasi SHED dibandingkan kontrol. Terdapat pengurangan rasio sel neuron mati (p=0,0) pada tikus yang ditransplantasi SHED pada 21 hari setelah MCAO.Kesimpulan: Transplantasi SHED pada tikus model stroke iskemik pada fase akut stroke menunjukkan perbaikan klinis dan terdapat pengurangan rasio neuron mati pada otak tikus model stroke iskemik yang di transplantasi dengan sel mesenkimal asal SHED.

---

Background: The incidence of stroke reaches 15 million cases worldwide, and 5 million stroke survivors suffered permanent disability. Ischemic stroke causes a burden on health problems particularly in Indonesia. The prevalence of stroke in Indonesia in 2013 is 7 per 1000 population. The optimal stroke restoration therapy required, and neurorestoration with stem cell transplantation is a promising therapy that provides functional improvements for ischemic stroke. This research was conducted to observe the effects of Stem Cell from Human Exfoliated Deciduous Teeth (SHED) transplantation on the clinical improvement and neuron death ratio in the brain of rats models with ischemic stroke.Methods: One group of normal rats and two groups (n=5) of male wistar rats undergone permenents Middle Cerebral Artery Occlusion (MCAO). SHED transplantation performed 48 hours after MCAO, by intravenous injection with a dose of 2x106 cells/kg. Functional evaluation conducted in rats with Y Maze and cylinder Test. Evaluation of the death neurons ratio in brain cortex area done by Hematoksilin and Eosin staining.Results : The functional evaluation using Y Maze and Cylinder Test was significantly improved in the treatment group compared to the control stroke group p < 0,05 14 days after MCAO. There was a reduction in the neuron death ratio p = 0.0 in rats transplanted with SHED.Conclusion : SHED transplantation in acute stroke showed clinical improvement and reduction in the neuron death ratio in the brain of rat models with ischemic stroke. Keywords: Cell transplantation, Ischemic Stroke, MCAO, SHED"

"ABSTRACTPurpose: Gastrointestinal complications after lung transplantation (LTx) are an important postoperative morbidity associated with malnutrition and the malabsorption of drugs. We reviewed our experience of managing gastrointestinal complications after LTx.Methods: Between June, 2008 and April, 2017, 160 lung transplants were performed at our institution, as living-donor lobar lung transplants in 77 patients, and as deceased-donor lung transplants in 83. We reviewed, retrospectively, the incidence, type and management of gastrointestinal complications.Results: Among the 160 LTx recipients, 58 (36.3%) suffered a collective 70 gastrointestinal complications, the most frequent being gastroparesis, followed by gastroesophageal reflux disease. Two complications were managed surgically, by Nissen fundoplication for gastroesophageal reflux disease in one recipient and Hartmann's operation for sigmoid colon perforation in one. The other 68 complications were managed medically. Two patients died of complications: one, of aspiration pneumonia caused by gastroparesis; and one, of panperitonitis caused by a gastric ulcer. There were no significant differences in overall survival or chronic lung allograft dysfunction-free survival between the patients with and those without gastrointestinal complications.Conclusions: Gastrointestinal complications are not uncommon in LTx recipients and may be serious; therefore, early detection and appropriate treatment are imperative. Surgical management is required for some complications, but most can be managed medically."

"Latar belakang : Simblefaron merupakan suatu proses penempelan konjungtivatarsal dengan konjungtiva bulbi yang terjadi akibat inflamasi kronis. Transplantasimembran amnion merupakan tata laksana yang umum dilakukan pada kasussimblefaron. Terdapat 2 jenis membran amnion yaitu cryopreserved dan frezeedriedyang berbeda proses pengawetanya. Hingga saat ini belum ada penelitianyang membandingkan secara langsung efektivitas kedua amnion tersebut dalamproses epitelisasi konjungtiva.Tujuan: Mengetahui perbandingan efektivitas membrane amnion cryopreserveddan frezee-dried dalam epitelisasi konungtiva, dalam menurunkan inflamasi danmeningkatkan densitas sel goblet.Metode: Sebanyak 14 mata (10 subyek) simblefaron dilakukan randomisasikemudia dibagi kedalam 2 kelompok. 7 mata menjalani release simblefaron dantransplantasi membrane amnion cryopreserved, 7 mata lainnya dengan amnionfreeze-dried. Pasca bedah pada minggu 1,2,3 dan 4 dilakukan foto segmen anterioruntuk menilai waktu epitelisasi dan derajat inflamasi. Dan pada minggu ke-4pasien menjalani pemeriksaan sitologi impresi dan Ferning untuk dibandingkandengan hasil yang telah dilakukan pre operasi.Hasil: kelompok mata dengan amnion cryopreserved menunjukan rerata waktuepitelisasi 2,14 ± 1,07 minggu sedangkan amnion freeze-dried 3,29 ± 1,25 minggu.Derajat inflamasi berat lebih banyak ditemukan pada kelompok freeze-dried.Densitas sel goblet dan derajat Ferning lebih tinggi ditemukan pada kelompokcryopreserved.Kesimpulan: Secara klinis membran amnion cryopreserved memilikikecenderungan hasil yang lebih baik dibandingkan amnion freeze-dried dalamproses epitelisasi, menurunkan inflamasi dan meningkatkan densitas sel goblet.

---

Background : symblepharon is a attachment of conjunctival bulbi to conjunctival

tarsal due to chronic inflammation. Amnion membrane (AM) transplantation is a

surgical treatment for symblepharon. There are two types of amniotic membranes

namely cryopreserved and freeze-dried which have different preservative

processes.

Objective : Our aims was to compare AM cryopreserved and freeze-dried in

complete conjunctival epithelization, reduce the inflammation and restored goblet

cells.

Methods : In 14 eyes of symblepharon, symblepharon release with AM

transplantation were performed. 7 eyes with AM cryopreserved, 7 eyes with MA

freeze-dried. Post-operative evaluation was done weekly in all subjects until 4

weeks after surgery include photographic documentation to evaluate conjunctival

epithelization and grading inflammation. On the last week subjects underwent

cytology impression and Ferning test (mucin production) to be compared with

results that have been done pre-operatively.

Results : Eyes with AM cryopreserved showed epithelization in 2,14 ± 1,07 weeks,

while AM freeze-dried was 3,29 ± 1,25 weeks. Severe inflammation (4/7) was

found in eyes with freeze-dried, goblet cells and mucin production were higher in

eyes with AM cryopreserved.

Conclusion : Clinically AM cryopreserved showed better result in completing

conjunctival epithelization, reduce inflammation and restored goblet cells

compared with AM freeze-dried."