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1. RENAL PRE-TRANSPLANT MEET
Dr. Manoj Aryal/ Dr. Ishwor Poudel
DM Nephrology Resident/ MCh Urology Resident
NAMS, Bir Hospital
(2082-04-16)

2. DESCRIPTIONS
DESCRIPTION RECIPIENT DONOR
NAME Ranjana Thapa Ram Chandra Magar
AGE 36 yrs. 61 yrs.
SEX Female Male
RELATION Daughter Father
BLOOD GR/TYP A Positive O Positive
ADDRESS Panchthar,Pthidim Municipality-4 Panchthar,Pthidim
Municipality-13
Height 155cm 152cm
Weight 56kg 69kg
BMI 23.3kg/m2 29.7kg/m2

3. VIRAL MARKER
DESCRIPTION RECIPIENT DONOR
HIV I / II (2082/04/12)
Non-Reactive Non-Reactive
HBs Ag Non-Reactive Non-Reactive
Anti HCV Non-Reactive Non-Reactive
CMV IgG(2025/06/28) Positive Positive
CMV IgM Negative Negative

4. RECIPIENT CLINICAL DETAILS
PRIMARY DISEASE: CKD-CGN HD WITH CKD-MBD SINCE 4 YEARS.
 DIALYSIS STATUS : RIGHT IJV PERM CATH 2 MONTHS.
HD EVERY (MONDAY/THRUSDAY)
NO H/O BT
VACCINATION:DONE

5. RECIPIENT INVESTIGATION
HEMATOLOGY(2082/04/12)
HB 11.3
TLC 9,620
DC Neutrophils 71%
Lymphocytes 18%
Eosinophils 07%
PLT 2,14,000
PT/INR 12.7/0.84
BT 4
CT 8
aPTT 32

6. RECIPIENT INVESTIGATION
BIOCHEMISTRY
RBS(2082/04/12) 86 Total Bilirubin 0.4
FBS 97 Direct Bilirubin 0.2
HBA1C 4.9% SGPT 9
UREA 178 SGOT 26
CREATININE 9.9 ALK.PHOS 60
NA + 142 T. PROTEIN 7.6
K + 6.1 S. ALBUMIN 4.0
CALCIUM 9.8 IPTH 703.3
PHOSPHORUS 5.2 ANA Negative

7. RECIPIENT INVESTIGATION
ANA
Negative
TFT(2082/04/08) FT3/FT4 4.73/1.33
TSH 2.17

8. RECIPIENT INVESTIGATION(2082/04/12)
URINE ANALYSIS ALBUMIN 3+
SUGAR NIL
RBC 1-2
WBC 2-4
CAST Nil
URINE CULTURE (2082/04/12) Urine Culture Negative

9. RECIPIENT INVESTIGATION
 ECG :NSR
 USG: Bilateral Echogenic kidneys with loss of CMD.
 ECHO: (2082/02/16) LVEF 35-40%,Global LV
Hypokinesia,Moderate MR, Mild TR with TRPG
17mmHg.
 CXR –PA: (2082/04/11): Normal Findings.

10. Stress ECG
•Stress ECG Test Patient Exercised for 5’57’’ with
workload of 7.1 METS on Bruce Protocol. Exercise
terminated due to 100% THR achieved. Good effort
tolerance.
•No significant ST-T changes during exercise and
recovery as compared to Baseline ECG.

11. Stress Echo
•Stress Echo revealed Baseline LVEF 45% and Peak
LVEF 65%.Good Contractile reserve.NO RWMA.
•Test is Negative for Exercise Induced Reversible
Myocardial Ischemia.

12. TREATMENT CARDEX
S.N MEDICATION DOSE ROUTE DIRECTIONS
1 TAB MYLOD 5MG PO BD
2
3
4
6
7
8
9
TAB PANTOCID
TAB METLOC-XL
TAB CITRAPHOS
CAP BIOD3-PLUS
TAB REXTER
INJ EPOFIT
TAB NITROCONTIN
40MG
50MG
2TAB
1 CAP
50MG
4,000U
2.6MG
PO
PO
PO
PO
PO
S/C
PO
OD
OD
TDS
OD
BD
ONCE A WEEK
BD

13. Recipient Systemic Evaluation Clearance
Chest Evaluation: Done and Cleared
Cardiac Evaluation: Done and Cleared
ENT Evaluation : Done and Cleared
Dental Evaluation : Done and Cleared
Urology: Done and Cleared
PSYCHIATRY : Done and Cleared
PAC : Done and Cleared
CTVS : Done and Cleared
OB/GYNE : Done and Cleared

14. DONOR EVALUATION
• K/C/O Hypertension since 1 month
• Taking Losartan-H OD
• Taking Febuxostat For Hyperuricemia.

15. DONOR INVESTIGATION
HEMATOLOGY(2082/04/12)
HB 14.2gm%
TLC 9,500
DC Neutrophils 52%
Lymphocytes 39%
Monocytes 02%
Eosinophils 07%
PLT 3,61,000
PT/INR 12.6/0.90
APTT 26.6 sec
BT 1 mins
CT 6 mins

16. DONOR INVESTIGATION
BIOCHEMISTRY(2082/04/12)
RBS 94 HbA1C 5.0%
UREA 23 Total Bilirubin 0.3
CREATININE 0.8 Direct Bilirubin 0.1
NA + 141 SGPT 23
K + 4.17 SGOT 22
CALCIUM 9.4 ALK.PHOS 106
PHOSPHORUS 3.0 T. PROTEIN 7.1
URIC ACID 9.0 S. ALBUMIN 4.1

17. DONOR INVESTIGATION
ANA
Neg
TFT(2082/02/08) FT3/FT4 3.98/0.86
TSH 2.663

18. DONOR INVESTIGATION(2082/04/12)
URINE ANALYSIS ALBUMIN Nil
SUGAR Nil
RBC Nil
WBC Nil
CAST Nil
URINE C/S(2082/04/12) NEGATIVE

19. DONOR INVESTIGATION
 ECG: NSR
 USG(2081/1/26) Both kidneys are normal in size Rt
9.8cm,Lt 9.6cm, outline and echotexture. CMD is
maintained.
 ECHO(2082/01/31): LVEF:60%.
 CXR –PA: Grossly normal.

20. DONOR Systemic Evaluation Clearance
Chest Evaluation: Done and Cleared
Cardiac Evaluation: Done and cleared
ENT Evaluation : Done and cleared
Dental Evaluation : Done and Cleared
UROLOGY: Done and Cleared
PSYCHIATRY Done and Cleared
PAC Done and Cleared
CTVS Done and Cleared

21. DSA(28/07/2025)
ANTI HLA IgG antibodies MFI Result
CLASS I <500 NEGATIVE
CLASS II <500 NEGATIVE
CDC Cross Match
Auto:- IgM NEGATIVE
DTT cross match:- T & B cell
cross match
NEGATIVE

22. HLA REPORTS
• Matching Ratio with Patient :08/12

23. LEGAL CLEARANCE
ONGOING

24. THANK YOU