Browsing by Author "Sandeep Guleria"

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Clinical perspectives towards improving risk stratification strategy for renal transplantation outcomes in Indian patients
(Wolters Kluwer Medknow Publications, 2022) Vijay Kher; Vivek B. Kute; Sarbeswar Sahariah; Deepak S. Ray; Dinesh Khullar; Sandeep Guleria; Shyam Bansal; Sishir Gang; Anil Kumar Bhalla; Jai Prakash; Abi Abraham; Sunil Shroff; Madan M. Bahadur; Pratik Das; Urmila Anandh; Arpita Ray Chaudhury; Manoj Singhal; Jatin Kothari; Sree Bhushan Raju; Dilip Kumar Pahari; G. Vishwanath Siddini; G. Sudhakar; Santosh Varughese; Tarun K. Saha
Graft loss and rejections (acute/chronic) continue to remain important concerns in long-term outcomes in kidney transplant despite newer immunosuppressive regimens and increased use of induction agents. Global guidelines identify the risk factors and suggest a framework for management of patients at different risk levels for rejection; however, these are better applicable to deceased donor transplants. Their applicability in Indian scenario (predominantly live donor program) could be a matter of debate. Therefore, a panel of experts discussed the current clinical practice and adaptability of global recommendations to Indian settings. They also took a survey to define risk factors in kidney transplants and provide direction toward evidence- and clinical experience-based risk stratification for donor/recipient and transplant-related characteristics, with a focus on living donor transplantations. Several recipient related factors (dialysis, comorbidities, and age, donor-specific antibodies [DSAs]), donor-related factors (age, body mass index, type - living or deceased) and transplantation related factors (cold ischemia time [CIT], number of transplantations) were assessed. The experts suggested that immunological conflict should be avoided by performing cytotoxic cross match, flow cross match in all patients and DSA-(single antigen bead) whenever considered clinically relevant. HLA mismatches, presence of DSA, along with donor/recipient age, CIT, etc., were associated with increased risk of rejection. Furthermore, the panel agreed that the risk of rejection in living donor transplant is not dissimilar to deceased donor recipients. The experts also suggested that induction immunosuppression could be individualized based on the risk stratification. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Deceased-donor organ transplantation in india: Current status, challenges, and solutions
(Baskent University, 2020) Vivek Kute; Vasanthi Ramesh; Sunil Shroff; Sandeep Guleria; Jai Prakash
Tamil Nadu, Gujarat, Telangana, Maharashtra, Kerala, Chandigarh, Karnataka, National Capital Territory of Delhi, and Rajasthan are states and union territories having active deceased-donor organ transplant programs in India. Transplant data (2013-2018) have been collected by the National Organ and Tissue Transplant Organization from all states and union territories of India and submitted to the Global Observatory on Donation and Transplantation. From 2013 to 2018, 49 155 transplants were reported in India, including 39 000 living-donor organ recipients and 10 155 deceased-donor organ recipients. These transplants were for kidney (living donor = 32 584, deceased donor = 5748), liver (living donor = 6416, deceased donor = 2967), heart (deceased donor = 895), lung (deceased donor = 459), pancreas (deceased donor = 78), and small bowel (deceased donor = 8). According to 2018 data, India was the second largest transplanting country in the world in terms of the absolute number of transplants. Here, we discuss the status, progress, challenges, and solutions for deceased-donor organ transplantation. The plan to increase rates of organ donation in India include the following points: teamwork and focus by intensive care unit doctors; public education on organ donation using social media; professional education and family donation conversation programs for brain death declaration and donor management; organ procurement organizations; international collaboration and regular meetings and updates for organizations working in the field of organ transplantation; grief counseling and reporting of potential donation for families of recently deceased people; nonfinancial incentivization to families of potential organ donors; expert committees and standard operating protocols for use of marginal donor organs, donation after circulatory death programs, and machine perfusion; maintenance of transparency and ethics in organ donation, allocation, and transplantation as directed by governmental, nongovernmental, and intergovernmental entities; and regular audit of progress and registry data. © 2020, Baskent University. 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]
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]