Addressing Kidney Transplant Shortage: The Potential of Kidney Paired Exchanges in Jordan.

Jordan performed the Middle East's first living-donor kidney transplant in 1972. In 1977, the country became one of the first Arab countries to regulate organ donation and transplantation. Despite these early advances in living donor transplantation, Jordan's organ donation after brain death program remains inactive, making it challenging to meet organ demand and placing many patients on long transplant waiting lists. As of 2020, only 14.2% of the patients with end-stage kidney disease have access to a living donor. The scarcity of compatible living donors exacerbates Jordan's organ shortage, leaving patients with extended waits and uncertain transplant prospects. Due to the lack of living donors and the inactive brain death donation program, additional options are needed to meet organ demand. Kidney paired exchange (KPE), emerges as a potential solution to the problem of donor shortage and donor-recipient incompatibility. By allowing living donors to direct their donated organs to different compatible recipients, KPE offers the promise of expanding transplant opportunities for patients without suitable living donors. However, the current Jordanian law restricting living kidney donation to fifth-degree relatives further limits the pool of potential donors, aggravating the organ shortage situation. This article explores the feasibility of implementing KPE in Jordan and proposes an approach to implementing KPE in Jordan, considering ethical and legal aspects to substantially increase kidney transplants.

Budd-Chiari Syndrome following COVID-19 infection: a case report.

Introduction and importance: Budd-Chiari Syndrome (BCS) is a rare disorder that affects the liver and is caused by blockage of the hepatic veins. Coronavirus disease 2019 (COVID-19) has been linked to an increased risk of developing BCS due to its ability to cause inflammation in the body, which can lead to clotting disorders. Case presentation: A 43-year-old female presented to the emergency department complaining of severe epigastric and right upper quadrant pain and progressive abdominal distention. Upon examination, investigation, and triphasic liver computed tomography with contrast, the patient was diagnosed with BCS. Clinical discussion: The patient was started on anticoagulant therapy with low-molecular-weight heparin and supportive treatment. She was hospitalized for 3 weeks and discharged on oral warfarin 5 mg/day after showing clinical improvement. Conclusion: Hepatosplenomegaly and abdominal distention after COVID-19 infection raise suspicion for BCS. Therefore, early detection of these signs is essential for immediate management.

Bilateral Deep Vein Thrombosis (DVT) as a Harbinger of Lung Adenocarcinoma: A Rare Presentation.

Oncologic disorders, such as lung adenocarcinoma, can intricately interplay with the coagulation cascade, often leading to thromboembolic events, of which deep vein thrombosis (DVT) stands out prominently. In this report, we present a unique case of a 50-year-old non-smoking Jordanian male who exhibited bilateral DVT as an unexpected preliminary manifestation of an aggressive lung adenocarcinoma. Although the patient did not possess common risk factors for DVT, the bilateral presentation drew attention to the possibility of an underlying malignancy. Subsequent investigations revealed a stage 4 primary lung adenocarcinoma. This case underscores the imperative of maintaining a broad differential in cases of DVT, especially when presenting bilaterally and without evident etiology. Such early detection and intervention, accompanied by collaborative medical strategies and specialized care, can play a pivotal role in enhancing patient prognosis and survival rates. This case exemplifies the potential of DVT, particularly when bilateral, as a harbinger of a more sinister underlying pathology like lung adenocarcinoma.

COVID-19 Vaccine: A Possible Trigger for Pyoderma Gangrenosum.

Pyoderma gangrenosum is an uncommon ulcerative auto-inflammatory dermatosis. Numerous studies suggest cutaneous side effects of the COVID-19 vaccine. Pyoderma gangrenosum has been reported as one of the rare side effects of the COVID-19 vaccine. In this report, a 36-year-old male was admitted to a hospital due to a progression of pyoderma gangrenosum on the lateral aspect of his upper arm which had developed eight months ago, following the first dose of Sinopharm BBIBP COVID-19 vaccine. The reported symptoms included headache, blurred vision, palpitation, fatigue on exertion, documented fever, chills and productive cough with yellow sputum, possibly due to the inflammatory effect of pyoderma gangrenosum. In the past, the patient's face had several abnormal skin lesions similar to the newly developed lesion. In addition, the newly developed lesion did not regress despite using medication. COVID-19 vaccinations could potentially trigger pyoderma gangrenosum, especially in patients with a past medical history of similar lesions in different body parts. Therefore, we recommend inquiring about the past medical history of pyoderma gangrenosum or abnormal skin lesions prior to vaccination.

Filler-Induced Interstitial Nephritis in a Male-to-Female Transgender Person: A Case Report.

Transgender individuals experience lower overall health outcomes than cisgender individuals due to a higher burden of chronic illnesses in this demographic. An early loss in renal function is frequently seen in acute interstitial nephritis (AIN), which is defined by the presence of inflammatory infiltrates and edema inside the interstitium. Infections or medication use can cause interstitial nephritis. In two-thirds of cases, interstitial nephritis caused by drugs is detected. Few people are affected by it, thus, it's thought to be immune-mediated rather than dose-dependent. In this report, a 32-year-old transgender female was admitted to a hospital due to generalized swelling following filler injections in the buttocks region. It is important for doctors and patients to be informed about these procedures' potential risks. Additionally, more study has to be done on the negative effects of filler injections.