Browsing by Author "Ashish Sharma"

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A comparative study between rubber band ligation and local application of herbal caustic compound (pratisaraneeya kshara) in management of internal haemorrhoids
(National Taiwan University, 2020) Ashish Sharma; M. Sahu; S.J. Gupta
[No abstract available]
A prospective study on tubercular fistula in ano and its management; [Estudo prospectivo sobre a fístula anal tuberculosa e seu tratamento]
(Sociedade Brasileira de Coloproctologia, 2017) Manoranjan Sahu; Jai Krishna Mishra; Ashish Sharma; Uzma Fatmi
Objective: Tuberculosis fistula in ano, though less encountered, is an important clinical entity in developing countries like India. Diagnosis of TB fistula is a challenge despite of advances in diagnostic modalities and it depends upon both local and systemic clinical presentation. This prospective study aimed at to substantiate the importance of clinical diagnosis as well as medical management of tubercular fistula by antitubercular drugs. Methods and results: 25 patients of fistula in ano suspected to be of tubercular origin under-went histopathology of fistulous tracks and an 8 week therapeutic trial of antituberculartreatment after getting an informed consent. Though biopsy showed positive evidence of tubercular pathology only in 52% cases, therapeutic trial showed improvement in local and systemic features in 23 (92%) cases. Of these 23 cases, 3 were cured after 18 months of anti tubercular treatment and 18 showed cure after 24 months of anti tubercular treatment while 2 cases withdrew from the study at 12 and 14 months respectively due to adverse drug reactions though their fistulous symptoms were relieved. Conclusion: Meticulous clinical evaluation plays a vital role in diagnosis of tubercular fistula in addition to other diagnostic methods. Anti tubercular treatment is the mainstay of treatment in tubercular fistula with a minimum duration of 18–24 months owing to the recurrent and relapsing nature of disease. © 2017 Sociedade Brasileira de Coloproctologia.
An integrative approach for management of post-traumatic dorsal foot wounds - A case report
(Elsevier B.V., 2024) Rahul Sherkhane; Shruti Singh; Aadithyaraj K T; Anil Kumar; Ashish Sharma; Shiv Ji Gupta
Crush injuries to the foot have become increasingly prevalent in contemporary settings, primarily arising from incidents such as the impact of large objects falling onto the foot or involvement in traffic accidents. The complexity of treating these injuries is compounded by the intricate anatomy of the foot. In specific scenarios, the implementation of an integrated management approach could prove advantageous. In this report, we depict the case of a 23-year-old male who visited the Shalya OPD with a wound on his left foot caused by trauma. The wound covered the medial portion of the foot, involving the dorsal area, and measured roughly 20 cm by 9 cm and was unable to walk. We successfully managed the case by adopting an integrative approach. The Ayurvedic treatment included Panchavalkala kashaya for wound irrigation, as well as oral administration of Amalaki rasayana, Triphala guggulu, Shatavari churna and Ashwagandha churna. Jatyadi taila was topically applied. For the first seven days, in addition to these ayurvedic medications, we also employed analgesics and antibiotics to treat infection and pain. To accomplish early closure, we employed a split-thickness skin graft after sufficient granulation tissue had appeared. The wound was completely healed within three months and the patient was able to walk freely without any support. The combined approach yielded a promising result in this case. © 2024 The Authors
Clinical profile of hospitalized COVID-19 patients in first & second wave of the pandemic: Insights from an Indian registry based observational study
(Wolters Kluwer Medknow Publications, 2021) Gunjan Kumar; Aparna Mukherjee; Ravendra K. Sharma; Geetha R. Menon; Damodar Sahu; Naveet Wig; Samiran Panda; Vishnu Vardhan Rao; Sujeet Singh; Randeep Guleria; Balram Bhargava; Abhijit Pakhare; Rajnish Joshi; Sourin Bhuniya; Manoj Kumar Panigrahi; Pankaj Bhardwaj; Sanjeev Misra; Manoj Gupta; Akhil D. Goel; Netto George Mundadan; Adil Rashid Khan; Manish Soneja; Tridip Dutta Baruah; Pankaj Kumar Kannauje; Ajit Kumar; Kala M.L. Yadhav; Manoj Kumar; Mary John; Sangeetha Mohan; Amit Patel; Surabhi Madan; Subhasis Mukherjee; Amitava Pal; Saikat Banerjee; Arti D. Shah; Yash Rana; Arun Madharia; Ankit Madharia; Rajiv Kumar Bandaru; Archana Mavoori; Simmi Dube; Nitin Nahar; Thrilok Chander Bingi; Rajarao Mesipogu; Vinaya Sekhar Aedula; Manisha Panchal; Mansuri Amirsohil Mohammedrafiq; Rashmi Upadhyay; Saurabh Srivastava; Veeresh B. Salgar; Rizwan Desai; Nyanthung Kikon; Rhondemo Kikon; Lisa Sarangi; Mahesh Rath; Anup Agarwal; Alka Turuk; Lokesh Kumar Sharma; Tanu Anand; Tarun Bhatnagar; Saumitra Ghosh; Avijit Hazra; Yogiraj Ray; Rammohan Ray; Lipilekha Patnaik; Jagdish Prasad Sahoo; Jaya Chakravarty; Sangeeta Kansal; Mohammad Shameem; Nazish Fatima; M. Pavan Kumar; Bikshapathi Rao; D. Himanshu; Amit Kumar; Naveen Dulhani; Amar Deepak Toppo; Nikita Sharma; Rajat Vohra; Sushila Kataria; Pooja Sharma; Arunansu Talukdar; Gargi Dasgupta; Anita Desai; S.N. Nityasri; Yashmin Panchal; K. Manohar; Y.S. Raju; Star Pala; Md. Jamil; V.K. Katyal; Sandeep Goyal; U.K. Ojha; Ravi Ranjan Jha; Ashish Bhalla; G.D. Puri; S. Samita; Vikas Suri; Ritin Mohindra; Ashish Pathak; Ashish Sharma; Janakkumar R. Khambholja; Nehal M. Shah; Paltial N. Palat; Kruti Rajvansh; Sudhir Bhandari; Abhishek Agrawal; Bal Kishan Gupta; Jigyasa Gupta; Ratnamala Choudhury; Mangala Rao; Soumyadip Chatterji; Sudipta Mukherjee
Background & objectives: India witnessed a massive second surge of COVID-19 cases since March 2021 after a period of decline from September 2020. Data collected under the National Clinical Registry for COVID-19 (NCRC) were analysed to describe the differences in demographic and clinical features of COVID-19 patients recruited during these two successive waves. Methods: The NCRC, launched in September 2020, is an ongoing multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized, confirmed COVID-19 patients were captured in an electronic data portal from 41 hospitals across India. Patients enrolled during September 1, 2020 to January 31, 2021 and February 1 to May 11, 2021 constituted participants of the two successive waves, respectively. Results: As on May 11, 2021, 18961 individuals were recruited in the registry, 12059 and 6903 reflecting in-patients from the first and second waves, respectively. Mean age of the patients was significantly lower in the second wave [48.7 (18.1) yr vs. 50.7 (18.0) yr, P<0.001] with higher proportion of patients in the younger age group intervals of <20, and 20-39 yr. Approximately 70 per cent of the admitted patients were ≥ 40 yr of age in both waves of the pandemic. The proportion of males were slightly lower in second wave as compared to the first [4400 (63.7%) vs. 7886 (65.4%), P=0.02]. Commonest presenting symptom was fever in both waves. In the second wave, a significantly higher proportion [2625 (48.6%) vs. 4420 (42.8%), P<0.003] complained of shortness of breath, developed ARDS [422(13%) vs. 880 (7.9%), P<0.001], required supplemental oxygen [1637 (50.3%) vs. 4771 (42.7%), P<0.001], and mechanical ventilation [260 (15.9%) vs. 530 (11.1%), P<0.001]. Mortality also significantly increased in the second wave [OR: 1.35 (95% CI: 1.19, 1.52)] in all age groups except in <20 yr. Interpretation & conclusions: The second wave of COVID-19 in India was slightly different in presentation than the first wave, with a younger demography, lesser comorbidities, and presentation with breathlessness in greater frequency. © 2021 BioMed Central Ltd.. All rights reserved.
Complex Anal fistula treated with IFTAK (Interception of fistulous track with application of ksharsutra) technique- A case report
(Elsevier B.V., 2023) Anil Kumar; Ashish Sharma; S.J. Gupta; Ashish Verma
Background: An anal fistula is a common benign anorectal disease that tends to reoccur simple or low-type fistulas can be treated without affecting the sphincter mechanism; however, repairing a complex ano fistula without compromising anal continence can be difficult for a surgeon. Case presentation: Here, we present an anal fistula of complex clinical appearance managed successfully by the IFTAK (Interception of fistulous track with application of ksharsutra) technique practiced at Banaras Hindu University, Varanasi, India. The diagnosis was made via visual and bi-manual digital rectal examination then confirmed by Endoanal ultrasonography (EAUS). The patient showed remarkable improvement and the fistula healed completely in due course of time without impairing the anal continence status of the patient. At four months of follow-up the patient was healthy and no recurrence was found. Conclusion: IFTAK is a minimally invasive technique and very effective in managing complex fistula in ano of cryptoglandular origin. The main cause of recurrence in complex anal fistula is non-identification of an infected anal crypt, secondary extensions, associated sepsis, or abscess at the time of examination or surgery. So, precise diagnosis and appropriate surgical measures play an equal role in the successful outcome of anal fistula treatment, failure to either will result in non-healing or recurrence. © 2023 The Authors
Current imaging techniques for evaluation of fistula in ano: a review
(Springer Science and Business Media Deutschland GmbH, 2020) Ashish Sharma; Priyanka Yadav; Manoranjan Sahu; Ashish Verma
Background: Fistula in ano is one of the common anorectal disorders which have a tendency to recur specially in complex cases usually due to missed or undetected sepsis at the time of examination or surgery. A correct identification of the primary source of crypt infection along with a complete understanding of the anatomical course of primary and secondary tracks and abscesses is a prerequisite for the successful management of fistula. Preoperative evaluation of fistula in ano using radio-imaging techniques provides a handy insight of fistula anatomy and helps in planning the appropriate treatment strategy. The objective of this article is to review the role of different radio-imaging techniques in the diagnosis and evaluation of fistula in ano along with their advantages and disadvantages over one another. Main text: A comprehensive literature review was performed searching through the electronic databases as well as the standard textbooks of colorectal surgery. X-rays (plain radiographs and contrast fistulography), computed tomography (CT) scanning, anal endosonography, and magnetic resonance (MR) imaging are the modalities used for preoperative imaging of fistula in ano. Due to low accuracy, X-ray fistulography is not used now for fistula imaging. CT fistulography can be more accurate in cases associated with acute inflammations and abscesses and the fistulas related with inflammatory bowel disease. Anal endosonography and MRI are two of the mostly used and reliable imaging techniques for fistula in ano. Though the use of a 3D technology has improved the accuracy of anal endosonography, MRI is the preferred choice by many. However, various reports have depicted comparable accuracies for both MRI and anal endosonography showing both to be equally sensitive but MRI to be more specific. 3D endoanal ultrasound, on the other hand, is more rapid and can also be used intraoperatively to provide live imaging during surgical exploration. Conclusion: Complex and recurrent fistula cases should undergo a preoperative imaging to reduce the chances of recurrence. MRI is recommended as the imaging modality of choice for such cases. 3D anal endosonography may however be a good option over MRI owing to its rapidity, availability, and potential of intraoperative assistance during surgery. © 2020, The Author(s).
Erratum: Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing? (J Korean Assoc Oral Maxillofac Surg(2019)45 (76-82)Doi: 10.5125/jkaoms.2019.45.2.76)
(Korean Association of Oral and Maxillofacial Surgeons, 2019) Sam Paul; Rupshikha Choudhury; Nandini Kumari; Sanjay Rastogi; Ashish Sharma; Vikas Singh; Shyamalendu Laskar; Tushar Dubey
This article has been retracted at the request of the Editorial Board. The Editorial Board consulted with the KAMJE (Korean Association of Medical Journal Editors) about 'Imalas' matter of the publication and concluded as following: The Paper A1 is an article on the study of pain, inflammation and formation of granulation tissue using platelet rich fibrin (PRF) for dry socket treatment after tooth extraction. This study was conducted on 100 patients at Teerthankar Mahaveer Dental College and Research Center, Moradabad, from September 2014 to March 2016. The Paper B2 is a research based on the same conditions as Paper A1. This study was conducted on 100 patients using PRF and 100 patients using zinc oxide eugenol, from August 2014 to December 2017. The study was held at the Kothiwal Dental College and Research Centre (KDCRC), Moradabad. The clinical factors studied in above two articles are the same, and the pain scale in Fig. 3 in Paper A1 is almost identical to the Fig. 2, Group A in Paper B2; and Fig. 5 in Paper A1 is also same as Fig. 4, Group A in Paper B2. Both papers are judged to have the overlapping publication in the similar period and the patient, and it is considered intentional not to cite Paper A1 in Paper B2. Therefore, Paper B2 is believed to be a significant double publication. For this reason, the Editorial Board decided to retracted this article and sincerely apologize for any inconvenience this may have caused. © 2019 The Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.
Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?
(Korean Association of Oral and Maxillofacial Surgeons, 2019) Sam Paul; Rupshikha Choudhury; Nandini Kumari; Sanjay Rastogi; Ashish Sharma; Vikas Singh; Shyamalendu Laskar; Tushar Dubey
Objectives: To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing. Materials and Methods: Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed. Results: Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05). Conclusion: PRF is a better alternative than ZOE for the effective management of alveolar osteitis. © 2019 The Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.
ISOT consensus statement for the kidney transplant recipient and living donor with a previous diagnosis of COVID-19
(Wolters Kluwer Medknow Publications, 2021) Vivek Kute; Sandeep Guleria; Anil Bhalla; Ashish Sharma; Sanjay Agarwal; Manisha Sahay; Santosh Varughese; Narayan Prasad; Prem Varma; Sunil Shroff; Harsh Vardhan; Manish Balwani; Shruti Dave; Dhamendra Bhadauria; Manish Rathi; Dhananjai Agrawal; Pankaj Shah; Jai Prakash
[No abstract available]
ISOT consensus statement for the kidney transplant recipient and living donor with a previous diagnosis of COVID-19
(Wolters Kluwer Medknow Publications, 2022) Vivek Kute; Sandeep Guleria; Anil Bhalla; Ashish Sharma; S. Agarwal; Manisha Sahay; Santosh Varughese; Narayan Prasad; P. Varma; Sunil Shroff; Harsh Vardhan; Manish Balwani; Shruti Dave; Dhamendra Bhadauria; Manish Rathi; Dhananjay Agarwal; Pankaj Shah; Jai Prakash
[No abstract available]
Log-Product-Type Estimator for Estimation of Population Variance Using Auxiliary Information
(Thai Statistical Association, 2024) Prabhakar Mishra; Ashish Sharma; Nitesh Kumar Adichwal; Sakshi Rai; Rajesh Singh
This paper proposed a log product type estimator for estimating population variance under simple random sampling without replacement (SRSWOR) using auxiliary information. We have calculated the mean square error (MSE) and bias expressions up to the first order of approximation. To substantiate the result, an empirical study has been performed using three real population data sets. The properties of the estimators also verified through simulation study. The result shows that the performance of the proposed estimator is better than the existing estimators. © 2024, Thai Statistical Association. All rights reserved.
Management of Complex Fistula-in-ano by Interception of Fistula Track with Application of Ksharasutra (IFTAK): A Novel Technique
(Georg Thieme Verlag, 2022) Manoranjan Sahu; Ashish Sharma
Objective Despite all the technological advances, successful management of complex fistula-in-ano is still a challenge due to recurrence and incontinence. The present study evaluates the outcomes of a novel technique, Interception of Fistula Track with Application of Ksharasutra (IFTAK) in terms of success rate and degree of incontinence. Methods In the present prospective study, 300 patients with complex fistula-in-ano were treated by the IFTAK technique, whose surgical steps include: incision at the anterior or posterior midline perianal area, identification and interception of the fistulous track at the level of the external sphincter, rerouting the track (and extensions) at the site of interception, and application of a ksharasutra (medicated seton) in the proximal track (from the site of interception to the internal opening) that is laid open gradually, with the resulting wound healing with minimum scarring. The distal track is allowed to heal spontaneously. Results There were 227 trans-sphincteric and 73 intersphincteric varieties of fistula with supralevator extension in 23 cases, of which 130 were recurrent fistulas, 29 had horseshoe track, while 25 had blind fistula with no cutaneous opening. The mean duration of the ksharasutra application was 8.11 ± 3.86 weeks with an overall success rate of 93.33% at the 1-year follow-up. A total of 3.67% of the cases reported with a mild impairment of continence on the Wexner incontinence scoring system. Pre- and postoperative anal manometry evaluation showed minimal reduction in median basal and squeeze pressures. Conclusion The IFTAK technique is a minimally invasive, daycare surgical procedure for the management of complex fistula-in-ano with low recurrence and minimal sphincter damage. © 2022 Elsevier Editora Ltda. All rights reserved.
Notto covid-19 vaccine guidelines for transplant recipients
(Wolters Kluwer Medknow Publications, 2021) Vivek Kute; Sanjay Agarwal; Jai Prakash; Sandeep Guleria; Sunil Shroff; Ashish Sharma; Prem Varma; Narayan Prasad; Manisha Sahay; Subhash Gupta; S. Sudhindran; Kewal Krishan; Vasanthi Ramesh; Sunil Kumar
In December 2019, novel coronavirus (SARS-CoV-2) infection started in Wuhan and resulted in a pandemic within a few weeks' time. Organ transplant recipients being at a risk for more severe COVID-19 if they get SARS CoV-2 viral infection, COVID-19 vaccine has a significant role in these patients. The vaccine is a safer way to help build protection and would either prevent COVID-19 infection or at least diminish the severity of the disease. It would also reduce the risk of the continuing transmission and enhance herd immunity. Immuno-compromised patients should not receive live vaccines as they can cause vaccine-related disease and hence the guidelines suggest that all transplant recipients should receive age-appropriate 'inactivated vaccine' as recommended for general population. Though trials have not been undertaken on transplant recipients, efficacy and safety of COVID-19 vaccine have been scientifically documented for few vaccines among the general population. © 2021 Indian Journal of Nephrology.
NOTTO COVID-19 vaccine guidelines for transplant recipients
(Wolters Kluwer Medknow Publications, 2021) Vivek Kute; Sanjay K. Agarwal; Jai Prakash; Sandeep Guleria; Sunil Shroff; Ashish Sharma; Prem Varma; Narayan Prasad; Manisha Sahay; Subhash Gupta; S. Sudhindran; Kewal Krishan; Vasanthi Ramesh; Sunil Kumar
In December 2019 Novel corona virus (SARS-CoV-2) infection started in Wuhan and resulted in a pandemic within few weeks' time. Organ transplant recipients being at a risk for more severe COVID-19 if they get SARS CoV-2 viral infection, COVID 19 Vaccine has a significant role in these patients. The vaccine is a safer way to help build protection and would either prevent COVID -19 infection or atleast diminish the severity of the disease. It would also reduce the risk of the continuing transmission and enhance herd immunity. Immuno compromised patients should not receive live vaccines as they can cause vaccine related disease and hence the guidelines suggest that all transplant recipients should receive age appropriate 'inactivated vaccine' as recommended for general population. Though trials have not been undertaken on transplant recipients, efficacy and safety of COVID-19 vaccine have been scientifically documented for few vaccines among the general population. © 2021 Indian Journal of Transplantation | Published by Wolters Kluwer - Medknow.
NOTTO transplant specific guidelines with reference to COVID-19
(Wolters Kluwer Medknow Publications, 2020) Vivek Kute; Sandeep Guleria; Jai Prakash; Sunil Shroff; Narayan Prasad; Sanjay Agarwal; Santosh Varughese; Subhash Gupta; A. Gokhale; Manisha Sahay; Ashish Sharma; Prem Varma; Anil Bhalla; Harsh Vardhan; Manish Balwani; Shruti Dave; Dhamendra Bhadauria; Manish Rathi; Dhananjay Agarwal; Pankaj Shah; Vasanthi R; Rajiv Garg
[No abstract available]
NOTTO transplant specific guidelines with reference to COVID-19
(Wolters Kluwer Medknow Publications, 2020) Vivek Kute; Sandeep Guleria; Jai Prakash; Sunil Shroff; Narayan Prasad; Sanjay Agarwal; Santosh Varughese; Subhash Gupta; A. K Gokhale; Manisha Sahay; Ashish Sharma; Prem Varma; Anil Bhalla; Harsh Vardhan; Manish Balwani; Shruti Dave; Dhamendra Bhadauria; Manish Rathi; Dhananjay Agarwal; Pankaj Shah; Vasanthi Ramesh; Rajiv Garg
[No abstract available]
Retraction : Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing? (Korean oral and maxillofacial surgery (2019) 45 (76-82) DOI: 10.5125/jkaoms.2019.45.2.76)
(Korean Association of Oral and Maxillofacial Surgeons, 2019) Sam Paul; Rupshikha Choudhury; Nandini Kumari; Sanjay Rastogi; Ashish Sharma; Vikas Singh; Shyamalendu Laskar; Tushar Dubey
This article has been retracted at the request of the Editorial Board. The Editorial Board consulted with the KAMJE (Korean Association of Medical Journal Editors) about 'Imalas' matter of the publication and concluded as following: The Paper A1 is an article on the study of pain, inflammation and formation of granulation tissue using platelet rich fibrin (PRF) for dry socket treatment after tooth extraction. This study was conducted on 100 patients at Teerthankar Mahaveer Dental College and Research Center, Moradabad, from September 2014 to March 2016. The Paper B2 is a research based on the same conditions as Paper A1. This study was conducted on 100 patients using PRF and 100 patients using zinc oxide eugenol, from August 2014 to December 2017. The study was held at the Kothiwal Dental College and Research Centre (KDCRC), Moradabad. The clinical factors studied in above two articles are the same, and the pain scale in Fig. 3 in Paper A1 is almost identical to the Fig. 2, Group A in Paper B2; and Fig. 5 in Paper A1 is also same as Fig. 4, Group A in Paper B2. Both papers are judged to have the overlapping publication in the similar period and the patient, and it is considered intentional not to cite Paper A1 in Paper B2. Therefore, Paper B2 is believed to be a significant double publication. For this reason, the Editorial Board decided to retracted this article and sincerely apologize for any inconvenience this may have caused. © 2019 Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.
Update on Coronavirus 2019 Vaccine Guidelines for Transplant Recipients
(Elsevier Inc., 2022) Vivek Kute; Hari Shankar Meshram; Ashish Sharma; Arpita Ray Chaudhury; S. Sudhindran; AllaGopala Krishna Gokhale; Milind Hote; Randeep Guleria; Devinder Singh Rana; Jai Prakash; Vasanthi Ramesh
The coronavirus disease 2019 (COVID-19) vaccine and its utility in solid organ transplantation need to be timely revised and updated. These guidelines have been formalized by the experts—the apex technical committee members of the National Organ and Tissue Transplant Organization and the heads of transplant societies—for the guidance of transplant communities. We recommend that all personnel involved in organ transplantation should be vaccinated as early as possible and continue COVID-19–appropriate behavior despite a full course of vaccination. For specific guidelines of recipients, we suggest completing the full schedule before transplantation whenever the clinical condition permits. We also suggest a single dose, rather than proceeding unvaccinated for transplant, in case a complete course is not feasible. If vaccination is planned before surgery, we recommend a gap of at least 2 weeks between the last dose of vaccine and surgery. For those not vaccinated before transplant, we suggest waiting 4 to 12 weeks after transplant. For the potential living donors, we recommend the complete vaccination schedule before transplant. However, if this is not feasible, we suggest receiving at least a single dose of the vaccine 2 weeks before donation. We suggest that suitable transplant patients and those on the waiting list should accept a third dose of the vaccine when one is offered to them. We recommend that organs from a deceased donor with suspected/proven vaccine-induced thrombotic thrombocytopenia should be avoided and are justified only in cases of emergency situations with informed consent and counseling. © 2021 Elsevier Inc.