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Background and purpose: Tuberculosis (T.B) is an important cause of morbidity and mortality in renal transplant recipients. The incidence of mycobacterium tuberculosis in renal transplant patients compared with normal papulation is high specially in developing countries.
Materials and methods : This study is a retospective review of the records of 700 renal transplant recipients 10 of whom developed post-transplant T.B. . Demographic information, interval between transplantation and T.B diagnosis, T.B site, graft survival and patient outcome were analysed.
Results : From 700 renal transplant recipient we found 10 documented cases of T:B (1.4%). Mean age was 37.9 years and mean time for diagnosis of post-transplantation T.B was 15.7 months. The most common forms were pleuro-pulmonary T.B. (60%) followed by milliary pattern (20%) and bone and joint involvement (20%). Two patients (20%) died and rejection occurred in 3 patients (30%).
Çonclusion: The incidence of T.B in renal transplant recipients is relatively high and its presentation usually atypic, thus a high index of suspicion should be retained in the long term follow-up of these patients, given the importance of early diagnosis and specific treatment to the chance of graft and patient survival.

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Background and purpose:We evaluated outcome of transplantation in donors MRAs that underwent multiple anastomosis in recipient, according to graft function, survey of graft and recipient, hypertension before and after transplantation, and surgical complications, comparable with single renal artery and MRA that was converted to a single artery before transplantation.
Materials and methods:In this case series study, from March 2003 to March 2009 in our kidney transplantation center, 7 renal grafts with MRAs underwent multiple anastomosis between renal arteries and recipient internal and external iliac and inferior epigasteric arteries. Single renal artery and multiple renal arteries that were converted to a single artery before transplantation, were excluded.
Results:Excellent perfusion was observed in renal graft after removal of vascular clamps in all cases. Convenient diuresis with average of 13444 cc in first day after transplantation was instituted. Post transplantation hypertension did not occur. All of recipients had a normal serum creatinin level with mean range 1.3 mg%. We observed perinephric collections in 2 recipients. One of collections was lymphocele and second one reported degenerated hematoma. Both collections were treated with aspiration. Isotopic scan and grafts ultrasonography indicated good survey and function of allografts.
Conclusion:We observed graft function, graft and recipient survival, intra and post operative complication, preoperative and post transplantation hypertension in our procedure similar to renal transplantation with single renal artery and MRA that was converted to single artery, because total ischemic time (TIT) was decreased in our option. We believe our procedure is a good alternative for bench surgery in MRA.

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Background and purpose: Kidney transplant is the most cost-effective strategy in treatment of patients with kidney failure. But allograft dysfunction is still discussed as one of the main problems in these patients. The aim of this study was to identify the factors associated with the development of complications after kidney transplant. Materials and methods: This correlation- descriptive study was performed in kidney transplant recipients (2002-2006) in Mashhad Imam Reza Hospital. Data was recorded in a researcher-made check list including type of dialysis, history of dialysis, cause of kidney disorder, donor kidney anatomy, parathormone hormone level, and complications after kidney transplant including length of hospitalization, urinary infection, and post-renal transplant diuresis. Results: The results showed relationships between age of recipients and wound infection, donor kidney anatomy with lynfocel, deceased or live donor with length of hospitalization, and post-renal transplant diuresis with acute tubular necrosis. We found relationships between history of transplant with length of hospitalization, lynfocel, and acute tubular necrosis. Also, a significant correlation was found between history of dialysis with length of hospitalization (B=0.153, P=0.002) and acute tubular necrosis (B=-0.137, P=0.002). Moreover, there was a significant association between parathormone hormone level with length of hospitalization and post-renal transplant diuresis (B=0.473, P= 0.004 and B=0.398, P=0.011, respectively). Conclusion: Old age recipients, high frequency of dialysis, low level of parathormone hormone, deceased or live donor, and donation of right kidney were amongst the main factors in development of post-transplant complications.

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Background and purpose: Cytomegalovirus (CMV) is one of the most important pathogens in immunocompromised patients, those who need regular blood transfusion, and renal failure patients undergoing hemodialysis. The aim of this investigation was to study the epidemiology of cytomegalovirus in hemodialysis patients in Sari, Iran.
Materials and methods: This cross-sectional study was performed in 180 hemodialysis patients attending two referral centers in Sari, 2017-2018. To include the patients we considered sociodemographic characteristics, blood transfusion history and period, and duration and frequency/week of hemodialysis. Blood samples were collected from all patients and after centrifuge, serum samples were examined for CMV-specific immunoglobulin G (IgG) using enzyme-linked immunosorbent assay (ELISA). Statistical tests including Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis, and descriptive analysis including proportion for qualitative data and median (quartile range 25-75) for quantitative data were used.
Results: The participants were 180 patients, including 93 (51.7%) females and 87 (48.3%) males (mean age: 61.5±14.4). All patients (100%) were positive for anti-CMV IgG antibody. There were no significant relationships between antibody titer and sex, age, dialysis period, dialysis duration, dialysis frequency per week, transfusion, transplantation, or HBV and HCV status (P >0.05).
Conclusion: Our findings showed high frequency of CMV-IgG positive in hemodialysis patients. Due to the possibility of CMV infection progression in immunocompromised patients, especially those who undergo hemodialysis, screening programs should be performed to prevent adverse consequences.