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  1. Article ; Online: Anantharaman Vathsala, BS, MD, FRCP, FAMS: Yong Loo Lin School of Medicine, National University of Singapore, National University Centre for Organ Transplantation, National University Hospital, Singapore.

    Vathsala, Anantharaman

    Transplantation

    2018  Volume 102, Issue 8, Page(s) 1200–1202

    MeSH term(s) Cultural Characteristics ; Hospitals, University ; Humans ; International Cooperation ; Kidney Failure, Chronic/ethnology ; Kidney Failure, Chronic/surgery ; Kidney Transplantation/methods ; Kidney Transplantation/trends ; Physicians ; Schools, Medical ; Singapore
    Language English
    Publishing date 2018-07-24
    Publishing country United States
    Document type Interview
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000002233
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  2. Article: Healthy aging and chronic kidney disease.

    Merchant, Reshma Aziz / Vathsala, Anantharaman

    Kidney research and clinical practice

    2022  Volume 41, Issue 6, Page(s) 644–656

    Abstract: The world population is aging and the prevalence of noncommunicable diseases such as diabetes, hypertension, and chronic kidney disease (CKD) will increase significantly. With advances in medical treatment and public health, the human lifespan continues ... ...

    Abstract The world population is aging and the prevalence of noncommunicable diseases such as diabetes, hypertension, and chronic kidney disease (CKD) will increase significantly. With advances in medical treatment and public health, the human lifespan continues to outpace the health span in such a way that the last decade of life is generally spent in poor health. In 2015, the World Health Organization defined healthy aging as 'the process of developing and maintaining the functional ability that enables wellbeing in older age.' CKD is increasingly being recognized as a model of accelerated aging and is associated with physical performance decline, cognitive decline, falls and fractures, poor quality of life, loss of appetite, and inflammation. Frailty and dementia are the final pathways and key determinants of disability and mortality independent of underlying disease. CKD, dementia, and frailty share a triangular relationship with synergistic actions and have common risk factors wherein CKD accelerates frailty and dementia through mechanisms such as uremic toxicity, metabolic acidosis and derangements, anorexia and malnutrition, dialysis-related hemodynamic instability, and sleep disturbance. Frailty accelerates glomerular filtration decline as well as dialysis induction in CKD and more than doubles the mortality risk. Anorexia is one of the major causes of protein-energy malnutrition, which is also prevalent in the aging population and warrants screening. Healthcare systems across the world need to have a system in place for the prevention of CKD amongst high-risk older adults, focusing on screening for poor prognostic factors amongst patients with CKD such as frailty, poor appetite, and cognitive impairment and providing necessary person-centered interventions to reverse underlying factors that may contribute to poor outcomes.
    Language English
    Publishing date 2022-10-25
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2656420-8
    ISSN 2211-9132
    ISSN 2211-9132
    DOI 10.23876/j.krcp.22.112
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Invasive fungal infection by Volvariella volvacea: First reported case following solid organ transplantation and a unique therapeutic approach.

    Da, Yi / Vathsala, Anantharaman / Teo, Rachel Zui Chih

    Transplant infectious disease : an official journal of the Transplantation Society

    2021  Volume 23, Issue 4, Page(s) e13690

    MeSH term(s) Agaricales ; Fungal Proteins ; Humans ; Invasive Fungal Infections/diagnosis ; Invasive Fungal Infections/drug therapy ; Organ Transplantation ; Volvariella
    Chemical Substances Fungal Proteins
    Language English
    Publishing date 2021-07-29
    Publishing country Denmark
    Document type Letter
    ZDB-ID 1476094-0
    ISSN 1399-3062 ; 1398-2273
    ISSN (online) 1399-3062
    ISSN 1398-2273
    DOI 10.1111/tid.13690
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  4. Article ; Online: Preface.

    Danguilan, Romina A / Vathsala, Anantharaman

    Transplantation proceedings

    2018  Volume 50, Issue 8, Page(s) 2248

    Language English
    Publishing date 2018-10-13
    Publishing country United States
    Document type Introductory Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2018.08.012
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  5. Article ; Online: Preface.

    Danguilan, Romina A / Vathsala, Anantharaman

    Transplantation proceedings

    2018  Volume 50, Issue 9, Page(s) 2587

    Language English
    Publishing date 2018-11-06
    Publishing country United States
    Document type Editorial ; Introductory Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/S0041-1345(18)31353-8
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  6. Article: Outcomes for kidney transplants at the National University Health System: comparison with overseas transplants.

    Vathsala, Anantharaman

    Clinical transplants

    2010  , Page(s) 149–160

    Abstract: The 5-year and 10-year graft survivals for 186 deceased donor (DD) transplants performed at National University Health System (NUHS) were 79.9% and 58.4% respectively. 5-year and 10-year patient survivals for DD transplants performed at NUHS were 94.2% ... ...

    Abstract The 5-year and 10-year graft survivals for 186 deceased donor (DD) transplants performed at National University Health System (NUHS) were 79.9% and 58.4% respectively. 5-year and 10-year patient survivals for DD transplants performed at NUHS were 94.2% and 83.4%. The 5-year and 10-year graft survivals for 128 living donor (LD) transplants performed at NUHS were 90.2% and 72% respectively. 5-year and 10-year patient survivals for DD transplants performed at NUHS were 98.6% and 95.1%. The projected graft half lives were 14.6 and 20.6 years for DD and LD transplants respectively. These results compare favorably with the 10-year survival rates of 40% and 58% for DD and LD grafts reported by the United States Renal Data System (USRDS) in 2010. The younger age and the lower prevalence of diabetes and HLAmismatch in the DD and LD transplant study populations, in comparison to the USRDS population and perhaps better access and compliance to maintenance immunosuppression, could have contributed to these excellent outcomes. The 5-year and 10-year graft survivals for 162 transplants receiving what were likely deceased donor kidneys from China were 89.2% and 69.2% respectively. Although these survivals were apparently better than that for DD performed at NUHS, the advantage for China Tx disappeared when DD with primary non function or vascular thrombosis were excluded from analysis. The 5-year and 10-year patient survivals for 30 transplants receiving live non-related transplants from India were 82.3% and 60.1%. Both groups were considered to have received commercial transplants based on various aspects of history from the patients. Among those receiving China_Tx or India Tx, there were a disproportionate number of males and Chinese; and a significant proportion underwent pre-emptive transplant or transplant after only a short period of dialysis. Prevalence of post-transplant hepatitis B was significantly higher among China_Tx than their DD counterparts (7.7% vs. 1.2%, P = 0.005); likewise, post transplant hepatitis C was significantly higher for India_Tx than their LD counterparts (23.1% vs. 3.4%, P = 0.003). These results suggest that commercialization in transplant, results in inequities to access to transplantation and is associated with compromise in screening for infections among potential donors or in observing safety precautions during dialysis.
    MeSH term(s) Adult ; Female ; Graft Rejection/immunology ; Graft Rejection/prevention & control ; Graft Survival ; Hospitals, Private/statistics & numerical data ; Hospitals, Public/statistics & numerical data ; Humans ; Immunosuppressive Agents/therapeutic use ; Kaplan-Meier Estimate ; Kidney Transplantation/immunology ; Kidney Transplantation/mortality ; Male ; Medical Tourism/statistics & numerical data ; Middle Aged ; National Health Programs/statistics & numerical data ; Outcome and Process Assessment (Health Care)/statistics & numerical data ; Program Development ; Program Evaluation ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Singapore ; Time Factors ; Tissue Donors/supply & distribution ; Tissue and Organ Procurement/statistics & numerical data ; Treatment Outcome ; Waiting Lists
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2010
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 607631-2
    ISSN 0890-9016
    ISSN 0890-9016
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  7. Article ; Online: Disparities in ethnicity and metabolic disease burden in referrals to nephrology.

    Chua, Yan Ting / Leo, Cheang Han / Chua, Horng Ruey / Wong, Weng Kin / Chan, Gek Cher / Vathsala, Anantharaman / Gan, Ye Lu Mavis / Teo, Boon Wee

    Singapore medical journal

    2023  

    Abstract: Introduction: The profile of patients referred from primary to tertiary nephrology care is unclear. Ethnic Malay patients have the highest incidence and prevalence of kidney failure in Singapore. We hypothesised that there is a Malay predominance among ... ...

    Abstract Introduction: The profile of patients referred from primary to tertiary nephrology care is unclear. Ethnic Malay patients have the highest incidence and prevalence of kidney failure in Singapore. We hypothesised that there is a Malay predominance among patients referred to nephrology due to a higher burden of metabolic disease in this ethnic group.
    Methods: This is a retrospective observational cohort study. From 2014 to 2018, a coordinator and physician triaged patients referred from primary care, and determined co-management and assignment to nephrology clinics. Key disease parameters were collated on triage and analysed.
    Results: A total of 6,017 patients were studied. The mean age of patients was 64 ± 16 years. They comprised 57% men; 67% were Chinese and 22% were Malay. The proportion of Malay patients is higher than the proportion of Malays in the general population (13.4%) and they were more likely than other ethnicities to have ≥3 comorbidities, including diabetes mellitus, hypertension, hyperlipidaemia, coronary artery disease and stroke (70% vs. 57%, P < 0.001). Malay and Indian patients had poorer control of diabetes mellitus compared to other ethnicities (glycated haemoglobin 7.8% vs. 7.4%, P < 0.001). Higher proportion of Malay patients compared to other ethnicities had worse kidney function with estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m
    Conclusion: A disproportionately large number of Malay patients are referred for kidney disease. These patients have higher metabolic disease burden, tend to miss appointments and are referred at lower eGFR. Reasons underpinning these associations should be identified to facilitate efforts for targeting this at-risk population, ensuring kidney health for all.
    Language English
    Publishing date 2023-08-14
    Publishing country India
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 2737-5935 ; 0037-5675
    ISSN (online) 2737-5935
    ISSN 0037-5675
    DOI 10.4103/singaporemedj.SMJ-2022-193
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  8. Article ; Online: Hospital-at-home as a first-line strategy for kidney transplant recipients with coronavirus disease 2019 infection.

    Chang, Zi Yun / Sran, Hersharan Kaur / Somani, Jyoti / Wong, Emmett / D'Costa, Matthew Ross / Lum, Lionel / Ko, Stephanie Q / Vathsala, Anantharaman

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2023  Volume 23, Issue 8, Page(s) 1278–1280

    MeSH term(s) Humans ; COVID-19 ; Kidney Transplantation ; SARS-CoV-2 ; Immunocompromised Host ; Hospitals ; Transplant Recipients ; Organ Transplantation
    Language English
    Publishing date 2023-05-03
    Publishing country United States
    Document type Letter
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1016/j.ajt.2023.04.030
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  9. Article: Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients.

    Lai, Yousheng Lester / Neo, Hui Ling Michelle / Vathsala, Anantharaman / Griva, Konstadina

    Transplantation direct

    2020  Volume 6, Issue 2, Page(s) e529

    Abstract: Kidney transplantation is regarded as the best treatment option for patients with end-stage renal disease. However, living-donor recipients (LDRs) and deceased-donor recipients (DDRs) still face challenges in transplant-specific emotional adjustment post- ...

    Abstract Kidney transplantation is regarded as the best treatment option for patients with end-stage renal disease. However, living-donor recipients (LDRs) and deceased-donor recipients (DDRs) still face challenges in transplant-specific emotional adjustment post-transplantation. Research distinguishing emotional adjustment between transplant groups has been limited to Western settings, with little attention given to Asian populations. As such, documenting and comparing the emotional adjustment of LDRs and DDRs in an ethnically diverse Asian setting in Singapore and identifying factors associated with emotional adjustment are of interest.
    Methods: One hundred eighty-two kidney transplant patients (106 LDRs and 76 DDRs) completed measures of generic distress (Depression, Anxiety, Stress Scale-21) and transplantation-specific emotional and behavioral outcomes (Transplant Effects Questionnaire).
    Results: LDRs were significantly younger (
    Conclusions: Clinicians should be vigilant of younger kidney transplant patients who have greater risk of poorer emotional adjustment. Future interventions should target alleviating anxiety and transplant-specific worry.
    Language English
    Publishing date 2020-01-24
    Publishing country United States
    Document type Journal Article
    ISSN 2373-8731
    ISSN 2373-8731
    DOI 10.1097/TXD.0000000000000956
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  10. Article ; Online: Tailoring management and immunosuppression regimen in kidney transplant recipients with COVID-19 infection: lessons from Singapore.

    Chang, Zi Yun / Tambyah, Paul Anantharajah / Lum, Lionel Hon Wai / Vathsala, Anantharaman / Teo, Rachel Zui Chih

    Singapore medical journal

    2021  Volume 63, Issue 12, Page(s) 759–762

    MeSH term(s) Humans ; COVID-19 ; Kidney Transplantation ; Singapore ; Immunosuppression Therapy ; SARS-CoV-2 ; Transplant Recipients ; Immunosuppressive Agents/therapeutic use
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2021-06-18
    Publishing country India
    Document type Journal Article
    ZDB-ID 604319-7
    ISSN 2737-5935 ; 0037-5675
    ISSN (online) 2737-5935
    ISSN 0037-5675
    DOI 10.11622/smedj.2021082
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