F Akhtar

Publications (31)66.98 Total impact

• Article: Outcome of pregnancy in renal allograft recipients: SIUT experience.

  R Naqvi, H Noor, S Ambareen, H Khan, A Haider, N Jafri, A Alam, R Aziz, K Manzoor, T Aziz, E Ahmed, F Akhtar, A Naqvi, A Rizvi
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  ABSTRACT: The course of pregnancy and its outcome was studied in renal allograft recipients. Between November 1985 and November 2005, a total of 1481 renal transplants were carried out at the Sindh Institute of Urology and Transplantation (SIUT); among them were 348 females, with 73 potential females for pregnancy. All patients received cyclosporine and prednisolone, with 82% also receiving azathioprine and 4 patients mycophenolate mofetil as a third immunosuppressant drug. We evaluated incidence of hypertension, diabetes, pre-eclampsia, urinary tract infection (UTI), rejection during pregnancy and during 3 months' postdelivery as well as outcomes of pregnancy. Among 73 potential candidates, 31 had 47 pregnancies, after an average of 31 months (8-86 months). Of 31 subjects, 21 subjects were hypertensive on one or two drugs prior to conception. A rise in blood pressure during pregnancy was noticed in 7 patients. Albuminuria from trace to 3+ appeared in 13 patients and glycosuria in one other. Blood sugar levels remained within normal range in all subjects. UTIs occurred during pregnancy in 7 patients. Among 47 pregnancies, 9 had abortions (7 spontaneous, 2 therapeutic) and 6 had preterm deliveries. The others were full-term deliveries: 12 via a lower segment caesarean section and 20 were normal vaginal deliveries. Average birth weight was 4.8 lbs. At an average follow-up of 38 months the serum creatinine values ranged from 0.94 to 2.3 mg %. One patient developed acute irreversible graft dysfunction soon after delivery. Our study demonstrated that pregnancy did not reduce renal graft survival, but newborns are at greater risk of premature birth and low birth weight.
  Transplantation Proceedings 10/2006; 38(7):2001-2. · 1.00 Impact Factor
• Article: Efficacy of isoniazid prophylaxis in renal allograft recipients.

  R Naqvi, S Akhtar, H Noor, T Saeed, S Bhatti, R Sheikh, E Ahmed, F Akhtar, A Naqvi, A Rizvi
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  ABSTRACT: The efficacy of isoniazid (INH) prophylaxis in renal allograft recipients who are on long-term immunosuppression in a region highly prevalent for tuberculosis (TB) was studied. INH (300 mg/d in patients weighing more than 35 kg and 5 mg/kg/d in patients with <35 kg body weight) together with Pyridoxine 50 mg/d for 1 year was started in randomly assigned renal allograft recipients. Occurrence of clinical tuberculosis during the initial 2 years posttransplantation was observed in the risk group and patients at no risk. Risks were defined as acute rejection episodes and exposure to antirejection therapy, past history of TB completely or incompletely treated, radiological evidence of past tuberculosis, history of tuberculosis in close contacts. Among 480 patients registered in the study, INH prophylaxis was given to 219 randomly assigned renal allograft recipients. Results were compared among patients developing TB during the initial 2 years posttransplantation in both the groups. Risk factors were analyzed for comparison in both groups. No significant difference was observed in terms of past history of TB, TB in close contacts, episodes of acute rejection during the initial 3 months, and comorbidities such as cytomegalovirus infection, hepatitis C virus infection, and posttransplant diabetes. One patient from the INH group and 10 patients from the non-INH group developed TB during the initial 2 years posttransplantation (P < .0001). None of patients required discontinuation of INH. INH was observed to be safe and effective as a chemoprophylactic agent in renal allograft recipients.
  Transplantation Proceedings 10/2006; 38(7):2057-8. · 1.00 Impact Factor
• Article: Improving kidney and live donation rates in Asia: living donation.

  S A H Rizvi, S A A Naqvi, A Hashmi, F Akhtar, M Hussain, E Ahmed, M N Zafar, Z Abbas, F Jawad, S Sultan, S M Hasan
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  ABSTRACT: Organ transplantation started with organs donated by living subjects. Increasing demands brought cadaveric organ donation. The brain-death law, mandatory for this procedure, is prevalent in all countries involved in organ transplantation except Pakistan. Spain is the leading country in cadaveric organ donation (32.5 pmp). Despite the sources of living and cadaveric organs, both heart-beating and non-heart-beating, the gap between the demand and supply has widened. An example is the United States, where the numbers of patients on the waiting list for kidney transplantation have risen from 30,000 in 1988 to more than 116,000 in 2001. This has caused a resurgence in living donors all over the world. These can be related, unrelated, spousal, marginal, or ABO-incompatible donors. Family apprehensions, medical care costs, and nonexistent social security can be barriers to this form of organ donation. Unrelated organ donation can open the doors to commercialism. To make this process more successful, transplantation should be made reachable by all sectors of the population. This is possible when transplantation is taken to the public sector institutions and financed jointly by the government and community. To increase living organ donation especially in Asian countries, which face barriers of low literacy rates, ignorance, and cultural and religious beliefs, more efforts are needed. Public awareness and education play an important role. Appreciation and supporting the donors is necessary and justified. It is a noble act and should be recognized by offering job security, health insurance, and free education for the donor's children.
  Transplantation Proceedings 10/2004; 36(7):1894-5. · 1.00 Impact Factor
• Article: Acute graft dysfunction due to pyelonephritis: value and safety of graft biopsy.

  E Ahmed, F Akhtar, A Hashmi, S Imtiaz, Z Hussain, S Hafeez, A Naqvi, A Rizvi
  Renal Failure 06/2003; 25(3):509-12. · 0.82 Impact Factor
• Article: Emerging challenges in transplantation in developing countries.

  S A H Rizvi, S A A Naqvi, Z Hussain, A Hashmi, F Akhtar, M Hussain, E Ahmed, M N Zafar, R Muzaffar, S Hafiz
  Transplantation Proceedings 01/2003; 34(8):3146-9. · 1.00 Impact Factor
• Article: Recruiting the community for supporting end-stage renal disease management in the developing world.

  A Rizvi, R Aziz, E Ahmed, R Naqvi, F Akhtar, A Naqvi
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  ABSTRACT: Although the incidence of new end-stage renal disease (ESRD) patients in Pakistan is estimated at 100 patients per million (ppm), the prevalence of those alive on renal replacement therapy (RRT) is around 40 ppm, reflecting the severe shortage of facilities. A national program was launched in 1998 to provide free RRT, but the funds were extremely limited, leading to the flourishing of suboptimal treatment in private dialysis and transplant centers. The Sindh Institute of Urology and Transplantation (SIUT), started as a small unit in 1975, took the lead in recruiting nongovernmental funds for RRT. Through the devotion of several groups, it was possible to raise funds from individuals, pharmaceutical firms, and other organizations, which permitted the development of SIUT into an independent, large, and fully equipped institution that provides free RRT including dialysis and transplantation to many thousands of patients. This prompted the government to increase its contributions to encourage SIUT to pursue its unique path.
  Artificial Organs 10/2002; 26(9):782-4. · 2.00 Impact Factor
• Article: Study of a new generic cyclosporine, Consupren, in de novo renal transplant recipients.

  M N Zafar, E Ahmed, A Alam, F Akhtar, H Zafar, A Hashmi, A Naqvi, A Rizvi
  Transplantation Proceedings 10/2002; 34(6):2480-1. · 1.00 Impact Factor
• Article: Anemia characteristics after renal transplantation.

  S N Mahmud, R Aziz, E Ahmed, F Akhtar, M N Zafar, A Naqvi, A Rizvi
  Transplantation Proceedings 10/2002; 34(6):2428. · 1.00 Impact Factor
• Article: Living-related pediatric renal transplants: a single-center experience from a developing country.

  S A H Rizvi, S A A Naqvi, Z Hussain, A Hashmi, F Akhtar, M N Zafar, M Hussain, E Ahmed, J I Kazi, A S Hasan, R Khalid, S Aziz, S Sultan
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  ABSTRACT: We retrospectively analyzed the results of 75 living-related pediatric renal transplants performed at our center between January 1986 and December 1999. The major causes of end-stage renal disease (ESRD) were glomerulonephritis (26%) and nephrolithiasis (16%), while the etiology was unknown in 50%. The mean age of the recipients was 12 yr (range 6-17 yr) and that of the donors was 39 yr (range 20-65 yr). The majority (73%) of donors were parents. Eighty five per cent of donors were one-haplotype matched and the rest identical. Immunosuppression was based on a triple drug regimen. Thirty per cent of recipients were rapid metabolizers of cyclosporin A (CsA) (area under the curve [AUC]: < 6,000 ng/mL/h), while 16% were slow metabolizers (AUC: > 8,000 ng/mL/h). Forty three (57%) children encountered 59 rejection episodes, the majority of which (59%) were recorded in the first month post-transplant. Seventy-four per cent of the rejection episodes were steroid sensitive and the rest, except two, were resolved by therapy with antithymocyte globulin (ATG) or orthoclone thymocyte 3 (OKT3). After a mean follow-up of 37 months, 17 (22%) grafts had chronic rejection and 76% of these recipients had previously experienced acute rejection episodes. The overall infection rate was high, necessitating two hospital admissions/patient/year. The majority (53%) of the infections were bacterial. Urinary tract infections (UTIs) were seen in 17 (23%) recipients. Twelve of these had ESRD as a result of stone disease and eight grafts were lost because of UTIs. Eight per cent of recipients developed tuberculosis (TB), and extra-pulmonary lesions were seen in 50%. Surgical complications were encountered in eight patients. Free medication to all recipients and parental support ensured a compliance rate of 93%. Baseline growth deficit was seen in children of the two groups studied (the 6-12 yr and 13-17 yr age-groups), with Z-scores of - 2.39 and - 2.12, respectively. No growth catch-up was observed at 12 and 24 months in either group. Post-donation complications were seen most commonly in donors > 50 yr of age and included: proteinuria (> 300 mg/24 h, four patients), hypertension (three patients), and diabetes (one patient). Twenty-four grafts were lost, 54% as a result of immunological and the rest as a result of non-immunological causes, and 17 recipients died during the follow-up period. Infections were the main cause of patient and graft loss. Overall 1- and 5-yr graft and patient survival rates were 88% and 65%, and 90% and 75%, respectively.
  Pediatric Transplantation 05/2002; 6(2):101-10. · 1.48 Impact Factor
• Article: Pregnancy in renal allograft recipients.

  R Naqvi, R Sheikh, E Ahmad, F Akhtar, A Hashmi, A Naqvi, A Rizvi
  Transplantation Proceedings 12/1999; 31(8):3148. · 1.00 Impact Factor
• Article: Donor selection in living donors: prospects and problems.

  F Akhtar, F Mazhar, R Ahmed, H Jamal, A Naqvi, A Rizvi
  Transplantation Proceedings 12/1999; 31(8):3385. · 1.00 Impact Factor
• Article: Problems of donor selection in a living related renal transplant program.

  F Jawad, Z Hussain, E Ahmed, F Akhtar, M Hussain, R Sheikh, T Aziz, S Ahmed, A Naqvi, A Rizvi
  Transplantation Proceedings 12/1998; 30(7):3643. · 1.00 Impact Factor
• Article: Correlation between biopsies and noninvasive assessment of acute graft dysfunction.

  F Akhtar, T A Rana, J Kazi, N Zafar, A Hashmi, S Bhatti, R Naqvi, R Mohsin, A Naqvi, A Rizvi
  Transplantation Proceedings 12/1998; 30(7):3069. · 1.00 Impact Factor
• Article: Factors influencing renal transplantation in a developing country.

  S A Rizvi, S A Naqvi, Z Hussain, S Hafiz, F Akhtar, N Zafar, H Altaf, E Ahmed, M Hussain
  Transplantation Proceedings 09/1998; 30(5):1810-1. · 1.00 Impact Factor
• Article: Acute renal failure developing after a scorpion sting.

  R Naqvi, A Naqvi, F Akhtar, A Rizvi
  British Journal of Urology 09/1998; 82(2):295.
• Article: Factors influencing graft survival in living-related donor kidney transplantation at a single center.

  A Rizvi, A Naqvi, Z Hussain, S Hafiz, A Hashmi, N Zafar, F Akhtar, E Ahmed, M Hussain, A Askari
  Transplantation Proceedings 06/1998; 30(3):712-6. · 1.00 Impact Factor
• Article: Outcome of living-related donor renal allografts in hepatitis C antibody-positive recipients.

  A Naqvi, T Aziz, M Hussain, N Zafar, R Muzaffar, J Kazi, F Akhtar, E Ahmad, A Hashmi, Z Hussain, A Rizvi
  Transplantation Proceedings 06/1998; 30(3):793. · 1.00 Impact Factor
• Article: Problems of diagnosis and treatment of tuberculosis following renal transplantation.

  A Naqvi, F Akhtar, R Naqvi, S Akhtar, H Askari, M Lal, S Bhatti, A Shahzad, S Soomro, A Rizvi
  Transplantation Proceedings 12/1997; 29(7):3051-2. · 1.00 Impact Factor
• Article: Acute renal failure due to traumatic rhabdomyolysis.

  R Naqvi, E Ahmed, F Akhtar, I Yazdani, S Bhatti, T Aziz, A Naqvi, A Rizvi
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  ABSTRACT: Between 1990 and 1993, we studied 14 cases of acute renal failure due to prolonged muscular exercise (e.g., squat jumping, sit-ups) and blunt trauma inflicted by law enforcement personnel using sticks or leather belts. None of the patients had a prior history of myopathy, neuropathy, or renal disease. All were critically ill and required renal support in the form of dialysis. Although the morbidity was high, 13 of the patients recovered normal renal function. One patient expired due to sepsis.
  Renal Failure 08/1996; 18(4):677-9. · 0.82 Impact Factor
• Article: Predictors of outcome in malarial renal failure.

  R Naqvi, E Ahmad, F Akhtar, I Yazdani, K Abbas, A Naqvi, A Rizvi
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  ABSTRACT: We studied 38 patients with acute renal failure (ARF) due to malaria over a 5-year period between 1990 and 1994 at the Institute of Urology and Transplantation. There were 30 males and 8 females who ranged in age from 13 to 75 years. Most were critically ill on presentation with blood urea levels between 116 and 587 mg% and serum creatinine concentrations between 3 and 30 mg%. Anemia accompanied by hyperbilirubinemia was a result of severe hemolysis. Antimalarial therapy consisted of quinine sulfate, chloroquine, or both. Of the 38 patients, 32 required hemodialysis and eventually recovered normal (n = 29) or near normal (n = 3) function. Six patients died.
  Renal Failure 08/1996; 18(4):685-8. · 0.82 Impact Factor