Ahmed Halawa

Ahmed Halawa
Sheffield Teaching Hospitals NHS Foundation Trust | STH · Department of Nephrology and Transplantation (Northern General Hospital)

MBBCh MSc FRCS MD PGCEd MEd FRCS (Gen)

About

162
Publications
60,868
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Citations
Introduction
Ahmed Halawa currently works at the Department of Nephrology and Transplantation, Sheffield Teaching Hospitals NHS Foundation Trust. He is also Associate Professor, School of Medicine, University of Liverpool. Ahmed does research in Renal Transplantation with special interests in immunosuppression, post-transplant infection, post-transplant malignancy, immunology of transplantation and CKD-MBD
Additional affiliations
March 2000 - September 2015
Sheffield Teaching Hospitals NHS Foundation Trust
Position
  • Consultant
March 2000 - February 2021
Sheffield Kidney Institute - University of Liverpool
Position
  • Consultant
Description
  • I'm consultant Transplant Surgeon who is interested in medically and surgically challenging cases. I'm also the programme director of Diploma/Master degree in Transplantation (University of Liverpool). https://www.liverpool.ac.uk/medicine/cpd/courses/

Publications

Publications (162)
Article
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Background: Post-transplant nephrotic syndrome (PTNS) in a renal allograft carries a 48% to 77% risk of graft failure at 5 years if proteinuria persists. PTNS can be due to either recurrence of native renal disease or de novo glomerular disease. Its prognosis depends upon the underlying pathophysiology. We describe a case of post-transplant membra...
Article
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Kidney allograft failure is a significant complication in kidney transplant recipients, and the surgical decision to perform allograft nephrectomy poses a strong dilemma because it is associated with significant morbidity and mortality. There is a debate over the effect of allograft nephrectomy on the development of allosensitization and the impact...
Article
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The kidneys are the most transplanted organs, and the number of failed kidney transplants that require reinstitution of renal replacement therapy in patients is on the increase. Increased mortality has been noted in patients with failed grafts compared with transplant- naïve patients with chronic kidney disease who are treated with dialysis. Issues...
Article
The increased awareness of systemic sclerosis (SS) and its pathogenetic background made the management of this disease more amenable than previously thought. However, scleroderma renal crisis (SRC) is a rarely seen as an associated disorder that may involve 2%-15% of SS patients. Patients presented with earlier, rapidly progressing, diffuse cutaneo...
Article
Objectives: In many countries of sub-Saharan Africa, the most common causes of end-stage kidney disease are hypertension, chronic glomerulonephritis, and diabetes mellitus. So far, literature on recurrent focal segmental glomerulosclerosis in sub-Saharan African populations is limited. With the intention of providing guidance for best practices in...
Article
Background and Aims Interleukin-2 (IL-2) antagonist has been used as an induction therapy in many centres in calcineurin inhibitor-sparing regimens. Tacrolimus has overwhelmingly replaced cyclosporine in the maintenance immunosuppressive protocols in many transplant centres. The aim of our study and meta-analysis is to explore the effect of IL-2 in...
Article
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Background: Antibodies directed against donor mismatched Human Leucocyte Antigens (HLA) are known to cause antibody-mediated rejection and affect the graft survival of transplanted organs. The influence of donor-directed antibodies against the products of HLA class I and II genes in renal transplantation are well described for class I (HLA-A, B and...
Article
Introduction: The additive benefit of interleukin-2 receptor antagonist (IL2-RA) induction in standard-risk kidney transplant recipients, while maintained on tacrolimus-based immunosuppressive therapy, is uncertain. Methods: We divided the studies included in this meta-analysis into 2 groups: group A (included studies that used same dose of tacr...
Article
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Article
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Renal transplant is considered the best therapeutic option for suitable patients with end-stage kidney failure. Hematological complications that occur after kidney transplant include posttransplant anemia, leukopenia, neutropenia, and thrombocytopenia. Severely persistent leukopenia and neutropenia events predispose patients to infection, including...
Article
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Objectives: Organ trafficking has emerged worldwide as an important medical and ethical concern. In this study, we reviewed the literature presented on this matter to evaluate the global practices, ethical standards, and legal aspects of organ transplantation. Materials and methods: We adopted a qualitative study design to perform this study, wh...
Article
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Background: The T-cell costimulation blocking agent belatacept has been identified as a possible substitute for cal-cineurin inhibitors, however, no consensus has been established against its use over the standard care agent Tacroli-mus. The aim of systemic review and meta-analysis was to evaluate the effectiveness of belatacept based mainte-nance...
Article
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Transplant clinicians need to be watchful of several potential surgical complications in the early post-transplant period, including haemorrhage, extraperitoneal urine leak, and lymphocele. While haemorrhage and extraperitoneal urine leak usually present in the early post kidney transplant period, lymphoceles usually present 2–6 weeks after transpl...
Article
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Transplant renal artery stenosis (TRAS) remains a dreaded complication of renal transplant surgery with potentially devastating sequelae. TRAS occurring early in the posttransplant period is mainly due to technical faults related to the graft implantation process. Late TRAS, in contrast, is more the result of either progressive atherosclerotic dise...
Article
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By April 26, 2020, infections related to coronavirus disease 2019 (COVID-19) affected people from 210 countries and caused 203,818 reported deaths worldwide. A few studies discussed the outcome of COVID-19 in kidney transplant recipients. This short series demonstrates our experience in managing COVID-19 disease in renal transplant patients in the...
Poster
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BODY: Background: Despite a large body of literature describing survival's outcome after renal transplantation, little
Article
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Introduction: The aim of our study is to explore the relationship of rabbit anti-thymocyte globulin (R-ATG) on development of post-transplant lymphoproliferative disease (PTLD) and its aggressive forms (monomorphic PTLD and Hodgkin lymphoma) in renal transplant recipients. Methodology: All patients diagnosed with PTLD post-renal transplant in the U...
Article
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Background: Since the discovery of BK Virus (BKV) in 1971, it became a growing challenge in the renal transplant field. Many hypotheses over the latest years have been made to justify the increased risk of acquiring BKV infection post-renal transplantation. Excessive immunosuppression remains the primary risk factor. Risk factors such as older reci...
Article
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The BK polyomavirus was isolated in 1971; it has been a significant risk factor for both graft dysfunction and failure in renal transplant recipients. So far, no specific treatment option has been available for effective treatment or prophylaxis for BK virus infections. Although the use of heavy immunosuppression has been the main risk factor for B...
Article
Background and Aims Antibody mediated rejection (AMR) remains accountable for the majority of death-censored graft failure following the first year of kidney transplantation. Despite significant advances in transplant immunology and immunosuppressive agents, long-term graft survival has not improved significantly. The objective of this systematic r...
Article
Background and Aims The role of polyomaviruses (PyV) in malignancy is controversial, this can be demonstrated in three ways; Firstly, hit and run mechanism where polyomaviruses contribute to the early phases of oncogenic progression. The second way, where PyV act as a passenger as polyomaviruses neither necessary nor contribute to the oncogenic pro...
Article
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Background: This study aims to assess outcomes of interleukin-2 (IL-2) receptor blocker induction therapy on allograft and patients' outcomes in standard risk recipients in the tacrolimus era, analysing data form the British Renal Transplant Registry. Methods: The study population involved all standard-risk renal transplant patients from 2000 ti...
Article
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Background The aim of this meta-analysis is to explore the effect of IL-2RA vs rATG on the rate of acute rejection, post-transplant infections, and graft as well as patient’s survival in standard- and high-risk renal transplant patients receiving tacrolimus-based maintenance immunotherapy.Methods Random effects model was the method used for identif...
Article
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Kidney transplantation offers the best modality of renal replacement therapy; however, requires overcoming the challenging task of maintaining long-term graft survival. Chronic allograft dysfunction (CAD) is a continuum of a process that eventually leads to graft loss. CAD has been previously viewed as a dilemma; however, it has now been found to b...
Article
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Graft dysfunction can result from ischemic damage or immunological injury that lead to serious consequences in both the short and the long term. There is a need for biomarkers of graft injury secondary to both immune and non-immune injuries at distinct time periods of the transplantation process. This is relevant in the initial phase of renal trans...
Article
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Transplant recipients are vulnerable to a higher risk of malignancy after solid organ transplantation and allogeneic hematopoietic stem-cell transplant. Post-transplant lymphoproliferative disorders (PTLD) include a wide spectrum of diseases ranging from benign proliferation of lymphoid tissues to frank malignancy with aggressive behavior. Two main...
Article
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Kidney transplantation is the treatment of choice for management of end-stage renal disease. However, in diabetic patients, the underlying metabolic disturbance will persist and even may get worse after isolated kidney transplantation. Pancreatic transplantation in humans was first introduced in 1966. The initial outcome was disappointing. However,...
Article
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The real effect of parasitic infection on transplant recipients is not known. Interestingly, only 5% of human parasitic infections can affect functioning of transplanted organs. Parasitic infections manifest in two different ways: first, systemic illness, including anemia and constitutional symptoms, and second, local syndromes, which are usually c...
Article
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Introduction of cyclosporine, over thirty years ago, led to a notable improvement in renal allograft survival rates especially in the first-year following transplantation. Unfortunately, this success has still not translated into similar gains in the long-term. The pathogenesis of chronic allograft dysfunction is often multifactorial. Donor factors...
Article
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Organ transplantation is widely undertaken to improve the quality of life of end-stage organ failure patients. The incidence of acute rejection of allografts has dramatically reduced due to the adoption of ever-evolving newer immunosuppressive drug therapies. Although these drug therapies have allowed the rise of organ transplantation and the reduc...
Article
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A 56 year old CKD 5 patient due to diabetic nephropathy (biopsy proved) presented to our hospital in transplant clinic for transplant assessment. She is not yet on dialysis and her current eGFR is 20 ml/min. She was diagnosed at the age of 29 to have diabetes. It is not clear from notes whether she is type 1 or type II DM. She is currently on insul...
Article
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Drug-induced gingival hyperplasia is an abnormal enlargement of the gingival tissues, which can occur as a side effect of Cyclosporine A, following renal transplantation. It is a debilitating condition, which can result in increased dental infection rates, tooth loss and subsequent reduced masticatory function. Although immunosuppressive agents suc...
Article
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Post-transplant lymphoproliferative disorder remains a rare but highly significant complication following both stem cell and solid organ transplantation. The highly variable clinical presentation may result in significant diagnostic delays requiring close supervision and vigilance of patients at high risk of developing the condition. Treatment of e...
Article
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The first successful kidney transplantation was performed between twins in 1954. That established kidney transplant as a key step in the treatment of end-stage kidney disease to improve the quality of life and prolong the life of patients who are fit for this procedure. However, the timely recognition, precise diagnosis, and well-timed treatment of...
Article
Renal transplant is the treatment of choice for end-stage renal disease. Perirenal fluid collections are a common surgical complication postrenal transplant that may lead to early graft loss, considerable morbidity, and excess financial loss, if not diagnosed and managed early. The causes of posttransplant fluid collections are urinary leak, lympho...
Article
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Post-transplant lymphocele has a reported incidence of 0.6-34%. While numerous surgical and non-surgical risk factors have been described, the incidence remains fairly constant among different transplant settings. The majorities of such lymphoceles are asymptomatic and are incidental findings on routine imaging of the allograft. Large volume lympho...
Article
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Renal transplant, undoubtedly, is the best available approach for selected patients with end-stage kidney disease. It enhances life quality and improves life expectancy when compared with dialysis therapy. It is very pertinent to carefully assess patients who are referred for transplantation to identify factors that may limit patient and graft surv...
Article
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Since first successful kidney transplantation by Murray and colleagues in 1954, our understanding of kidney transplantation has evolved considerably. However, the long-term graft survival remains an enigma. Current Immunosuppressive therapy is a double edge sword, preventing rejection but contributing to multiple side effects including chronic graf...
Article
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Post-transplant mineral bone disease (PT-MBD) is associated with increased morbidity and mortality in kidney transplant recipients. Bone abnormalities can range from adynamic bone disease to severe persistent hyperparathyroidism with associated hypercalcemia and hypophosphataemia. In addition, these patients can develop other complications such as...
Article
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p>Surgical complications are not uncommon after renal transplantation. They should always be in the differential diagnosis of renal graft dysfunction. While ruling out or confirming a surgical cause of graft dysfunction, a sequential approach should be undertaken starting from clinical examination and moving on to more invasive investigations as th...
Article
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The presence of pre-formed donor-specific antibodies (DSAs) in kidney transplantation is associated with worse overall outcomes compared with DSA-negative transplantation. A positive complement-dependant cytotoxic crossmatch presents a high immunological risk, while a negative flow cytometry crossmatch is at the lower end of the risk spectrum. Yet,...
Article
The presence of pre-formed donor specific antibodies (DSA) in kidney transplantation is associated with worse overall outcomes compared to DSA negative transplantation. A positive complement dependant cytotoxic crossmatch (CDCXM) presents a high immunological risk, whilst a negative flow cytometry crossmatch (FCXM) is at the lower end of the risk s...
Article
For decades, kidney diseases related to inappropriate complement activity, such as atypical hemolytic uremic syndrome and C3 glomerulopathy (a subtype of membranoproliferative glomerulonephritis), have mostly been complicated by worsened prognoses and rapid progression to end-stage renal failure. Alternative complement pathway dysregulation, whethe...
Article
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Nail-Patella syndrome is pleiotropic autosomal dominant disorder characterized by skeletal abnormalities and frequently renal disease. In this case report genetic analysis revealed a pathogenic heterozygous missense mutation of the LMX1B gene as c.[737G>A], p.([Arg246Gln)]. This variant is predicted to cause substitution of a basic arginine residue...
Article
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Solid organ transplantation has continued to evolve over past 60 years with invent of newer immunosuppressive medication and ever-advancing battery of tests for immune compatibility. The development of cardiovascular disease, malignancy and infection pose a significant threat to long-lasting graft and patient survival. The source of infection could...
Article
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Thrombotic microangiopathy (TMA) is one of the most devastating sequalae of kidney transplantation. A number of published articles have covered either de novo or recurrent TMA in an isolated manner. We have, hereby, in this article endeavored to address both types of TMA in a comparative mode. We appreciate that de novo TMA is more common and its p...