Background: Anaemia is not uncommon after renal transplantation and is associated with significant morbidity. Aim: To analyse the incidence and risk factors associated with early Post Transplant Anaemia (PTA). Material and Methods: Patients who underwent renal transplantation from August 1997 to March 2007 were included. Patient data included basic disease, age, sex, donor source, HLA matching, immunosuppression, acute rejections, infection. They were followed at monthly intervals. Laboratory parameters included haemogram, renal functions and urine examination. Early PTA was defined as Haemoglobin <13 gm% for male and <12 gm% for females at 6 months. Comparison was done between patients with and without anaemia. Results: Of 65 patients, 47 were males. Donors included related in 45, unrelated in 18 & cadavers in 2. Induction with IL 2 receptor antibody was given in 6 patients. cyclosporine was used in 56, tacrolimus in 9, azoran in 53, MMF in 12 and sirolimus in 1 patient. Rejection was seen in 15 patients of which cellular rejection was seen in 14& Humoral rejection in 1 patient. Infections were seen in 14 patients. No patients had malignancy. None were treated with erythropoietin.: 16(24%) patients had anaemia (9 females : 7 males). Mean age of patients with and without anaemia was 42 ± 18.26 yr & 40 ± 28.28 yr respectively. Mean haemoglobin levels were 10.2 ± 3.4 g% & 11.4 ± 4.2 g% and the mean creatinine was 2.2 ±1.4 mg% & 0.9 ± 0.3 mg% respectively. Female sex, Unrelated donor (P<0. 05), azathioprine(P<0. 05), acute rejection episode(P<0. 05) and infections (P<0. 05) were significant risk factors. Conclusions: 24% of post transplant patients have anaemia. Female sex, unrelated donor, azathioprine, acute rejection episodes and infections are significant risk factors for anaemia.

The isolated noncompaction of the left ventricle (IVNC) or “spongy myocardium” is a rare disease. IVNC is characterized by an excessively prominent trabecular meshwork of myocardium and deep intertrabecular recesses due to the arrest in the compaction process of the myocardial fibers in the absence of other structural heart diseases. IVNC can occur in sporadic and in familial patterns. The clinical symptoms depend on the extent of noncompacted cardiac segment. IVNC can lead to decompensated heart failure and may be successfully treated with heart transplantation. The morphological criteria for the diagnosis of this entity remain the subject of debate and are usually based on the findings of the imaging studies. Due to rarity of the disease, we are reporting a pathological finding in a recipient heart. This 9-year-old girl had undergone transcoronary stem cell implantation previously, before undergoing successful orthotropic heart transplantation.

Apical Hypertrophic cardiomyopathy (HCM) is a relatively rare morphological expression of the disease (<5% of patients), in which left ventricular wall thickening is confined to the most distal portion of the ventricles, below the papillary muscle level. Crypts may be an early sign of maladaptive myocardial alterations that ultimately lead to the development of the characteristic hypertrophy in HCM patients. Distinguishing this entity with noncompaction cardiomyopathy clinically is difficult proposition. The very recent discovery of the crypts in HCM carriers probably means that HCM carriers have been misdiagnosed in the past as having some form of noncompaction cardiomyopathy. However, distinguishing between these 2 cariomyopathies has important clinical therapeutic implications because HCM carriers may remain asymptomatic for decades and patients with noncompaction cardiomyopathy are at increased risk of thromboembolic events and supraventricular arrhythmia when heart failure is present.