N. Isbel

Neutrophil dysplasia characterised by a pseudo-Pelger-Huet anomaly occurring with the use of mycophenolate mofetil and ganciclovir following renal transplantation: a report of five cases

Aim: The pseudo‐Pelger‐Huet (PH) anomaly has been associated with a variety of primary haematological disorders, infections and drugs. Recently, the development of dysgranulopoiesis characterised by a pseudo‐PH anomaly has been reported in two patients with the use of mycophenolate mofetil (MMF) in the setting of heart and/or lung transplantation. We present a further five cases of MMF‐related dysgranulopoiesis characterised by a pseudo‐PH anomaly occurring after renal transplantation. Methods: All patients were receiving standard immunosuppression protocols for renal transplantation, including a combination of MMF, steroids and either cyclosporin or tacrolimus. Oral ganciclovir was also used for cytomegalovirus prophylaxis in each case. Results: Development of dysplastic granulopoiesis occurred a median of 96 days (range 66‐196 days) after transplantation. Moderate or severe neutropaenia (<1.0 2 10 9 /l) developed in three cases, and appeared to be directly correlated with the percentage of circulating neutrophils present with dysplastic morphology. Resolution of dysgranulopoiesis occurred in all cases only after dose reduction and/or cessation of both MMF and ganciclovir. Conclusions: In our series, the observed dysplastic granulopoiesis appeared related to the combination of MMF and ganciclovir, rather than MMF alone. Further study is required to determine the exact incidence and pathogenesis of this pattern of bone marrow toxicity.

Management of organ transplant recipients attending a high-throughput skin cancer surgery and surveillance clinic in Queensland.

The incidence of skin cancer in organ transplant recipients (OTRs) is very high, due mainly to long‐term immunosuppressive therapy. The problem is particularly severe for OTRs living in Queensland, Australia, and results in significant mortality.

A randomised, controlled trial of exit site application of medihoney for the prevention of catheter-associated infections in PD patients - Honeypot study

Aim: Patency after percutaneous balloon angioplasty (PTA) for haemodialysis fistula stenosis is highly variable. This study aimed to assess factors associated with patency following first episode of treatment with PTA. Background: Restenosis recurs commonly after PTA. Previous studies have shown that some intrinsic fistula and biochemical factors may influence patency after PTA. Methods: We retrospectively reviewed all endovascular procedures performed by nephrologists between 2007 and 2012 at a single centre. Anatomical, clinical, biochemical and medication information was subjected to cox regression analysis to identify factors influencing post-intervention patency. Results: 120 patients were identified as having first episode treatment with PTA. During a median follow-up period of 22.66 months (5.24–53 months), 171 follow-up procedures were performed. Post-intervention primary patency rates at 6, 12 and 18 months were 46%, 25% and 15% respectively. Cumulative (functional) patency rates at 6, 12 and 18 months were 97%, 94 and 92% respectively with 1.4 additional procedures per patient. In univariate cox regression analysis, the presence of multiple lesions (p = 0.037) was associated with early restenosis at 6 months, while upper arm fistulae were associated with early restenosis (p = 0.004) and shorter primary patency (p = 0.001). Other anatomical characteristics (fistula age, lesion length, pre-procedure stenosis), clinical history (diabetes, coronary and peripheral artery disease), medications, and biochemical parameters (HbA1c, CRP, albumin and lipids) did not influence patency. Conclusion: Multiple stenoses and upper arm fistulae may be associated with shorter patency after PTA. More large volume prospective studies are required to further assess factors associated with patency after PTA in haemodialysis fistulae, particularly the role of metabolic and inflammatory markers.

INTRAVENOUS VERSUS ORAL IRON FOR POST-TRANSPLANT ANAEMIA: A RANDOMISED CONTROLLED TRIAL: 149

D.W. Mudge1, K. Tan2, R. Miles3, D.W. Johnson2, S.B. Campbell4, C.M. Hawley2, N.M. Isbel4, C.L. Van Eps5, D.L. Nicol6 1Department Of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane/Queensland/AUSTRALIA, 2Department Of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane/AUSTRALIA, 3Department Of Renal Medicine, Greenslopes Private Hospital, Brisbane/QLD/AUSTRALIA, 4Nephrology, Princess Alexandra Hospital, Brisbane/AUSTRALIA, 5Department Of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane/QLD/AUSTRALIA, 6Department Of Urology, University of Queensland at Princess Alexandra Hospital, Brisbane/QLD/AUSTRALIA

Anaemia prevalence among new referrals to nephrology outpatients in South East Queensland

Disease Jeff S Coombes, Amanda Crawford, Robert G Fassett, 3 Dale A Kunde, Iain K Robertson, Madeleine J Ball, Dominic P Geraghty School of Human Movement Studies, University of Queensland, Brisbane, Queensland, AUSTRALIA School of Human Life Sciences, University of Tasmania, Launceston, Tasmania, AUSTRALIA 3 Royal Brisbane and Womens Hospital, Brisbane, Queensland, AUSTRALIA Project funded by the Clifford Craig Medical Research Trust (C Prosser Green Endowment)