A myriad of immunosuppressive agents is currently available for the management of graft recipients; however, a consensus on the optimum immunopharmacological plan is nonextant. Twenty kidney recipients on quadruple (mycophenolate mofetil, prednisone, cyclosporine A or tacrolimus, and sirolimus) therapy and 85 on triple therapy where sirolimus was excluded were analyzed for graft rejection or loss within a posttransplant surveillance period of 3 years. Only 1 of 20 recipients (5%) on quadruple therapy experienced a rejection episode. On the other hand, 13 of 85 recipients (15.3%) on triple therapy had a rejection episode or lost the graft. Overall, 14 of 105 recipients (13.3%) experienced a rejection episode or kidney loss. Our observations indicate that an immunosuppressive regimen including sirolimus is advantageous for the management of kidney allograft recipients in the short term.
The low rate of viral infections observed in our study population supports the utility of prophylactic administration of antiviral agents to transplant recipients. However, statins seem to have a protective effect on graft longevity (odds ratio [OR] = 0.361, 95% confidence interval [CI] = 0.044-2.957).
Kidney transplantation for end-stage renal disease remains the preferred solution due to its survival advantage, enhanced quality of life and cost-effectiveness. The main obstacle worldwide with this modality of treatment is the scarcity of organs. The demand has always exceeded the supply resulting in different types of donations. Kidney donation includes pure living related donors, deceased donors, living unrelated donors (altruistic), paired kidney donation and more recently compensated kidney donation. Ethical considerations in live donor kidney transplantation have always created a debate especially when rewarding unrelated donors. In this paper, we examine the problems of financially driven kidney transplantation, the ethical legitimacy of this practice, and propose some innovative methods and policies that could be adopted to ensure a better practice with accepted ethical guidelines.
Prostate cancer is a key health concern for men with its etiology still under investigation. Recently, the role of dietary supplements has been noted to have a major inhibitory effect on prostate cancer and numerous studies have been conducted in this regard. This review provides a summary on numerous recent studies conducted in this field. Some of the studies reviewed revealed a protective role for supplements, and others showed no correlation while some even had an adverse effect. The mechanism of how these supplements act on the prostate is still not clear. Further studies are warranted especially for supplements that have been shown to have a potential inhibitory role in prostate cancer.
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