Ali Jafarian
Tehran University of Medical Sciences, General Surgery, Faculty Member
Patients experience a new life with different challenges after liver transplantation (LT). Identifying these challenges can facilitate the improvement of their quality of life. This study aimed to explore patients’ experiences of post-LT... more
Patients experience a new life with different challenges after liver transplantation (LT). Identifying these challenges can facilitate the improvement of their quality of life. This study aimed to explore patients’ experiences of post-LT life challenges. This qualitative study was performed in 2019 through the content analysis approach. Participants were liver transplant recipients purposively recruited from a LT clinic. Semistructured interviews were conducted for data collection. Data were analyzed through Graneheim and Lundman’s conventional content analysis approach. Meaning units were identified and coded, and the codes were grouped into subcategories and categories according to their similarities. In total, 18 transplant recipients were interviewed. Their age mean was 51 years and their transplant age ranged from 4 months to 12 years. Their post-LT life challenges were categorized into 4 main categories, that is, self-care deficit, the need for seeking information, fears and c...
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Background Patients with liver cirrhosis experience a hyperdynamic circulation. Objective To investigate the association between early hemodynamic changes and graft function after liver transplant. Methods Those patients who underwent... more
Background Patients with liver cirrhosis experience a hyperdynamic circulation. Objective To investigate the association between early hemodynamic changes and graft function after liver transplant. Methods Those patients who underwent liver transplantation in 2016 were enrolled in the study. Liver function indices measured in postoperative days (POD) 1, 3, 5, 7, 9, and 11 along with hemodynamic indices including pulse rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and central venous pressure (CVP) measured q6h in the first 3 days after transplantation were recorded. Results 57 deceased-donor liver recipients with a mean±SD age of 41.4±11.8 years including 33 (58%) males were enrolled in the study. The mean±SD aspartate and alanine aminotransferases, alkaline phosphatase, and lactate dehydrogenase were significantly decreased from 1879±670.5, 369.2±40.5, 174.9±18.8, and 1907.6±323.1 U/L in POD 1 to 37.2±10.7, 243.4±37.3, 207.5±19.5, and 382.4±59.8 U/L in POD 3, ...
Background: Peripheral arterial disease is a source of morbidity and mortality. Surgical vascular reconstruction is a treatment option but probability of failure and complications are important concerns. In this study, we evaluated... more
Background: Peripheral arterial disease is a source of morbidity and mortality. Surgical vascular reconstruction is a treatment option but probability of failure and complications are important concerns. In this study, we evaluated outcome of surgical infrainguinal reconstruction and factors affecting graft patency for a period of one year. Methods: In this cohort study, 85 consecutive patients with chronic ischemia who underwent lower extremity surgical vascular reconstruction (including 52 femoropopliteal and 25 femorofemoral bypass) from March 2007 to Feb 2009 were recruited. Graft patency was evaluated before discharge from hospital and one year after the surgical operation using duplex ultrasonography. Association between possible risk factors and graft patency were evaluated. Results: In general, 71% (37 patients) of femoropopliteal and 52% (13 patients) of femorofemoral reconstructions were patent during the follow up period. Diabetes mellitus, hypertension, smoking, opium us...
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Background: We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran. Methods: COVID-19 patients were recruited... more
Background: We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran. Methods: COVID-19 patients were recruited based on clinical symptoms and patterns of computed tomography (CT) imaging between February 20 and March 19. All patients were tested for the presence of COVID-19 RNA. The Poisson regression model estimated the incidence rate ratio (IRR) for different parameters. Results: The average age (± standard deviation) was 56.9 (±15.7) years and 61.77% were male. The most common symptoms were fever (93.59%), dry cough (79.78%), and dyspnea (75.69%). Only 43.76% of patients were positive for the RT-PCR COVID-19 test. Prevalence of lymphopenia was 42.9% and more than 90% had elevated lactate dehydrogenase (LDH) or C-reactive protein (CRP). About 11% were severe cases, and 13.7% died in the hospital. The median length of stay (LOS) was 3 days. We found higher r...
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Research Interests: Psychology and Medicine
The coronavirus associated disease 2019 (COVID-19) caused by the SARS-CoV-2 virus has rapidly spread all around the world and became pandemic in March 2020. Data on liver transplantation and chronic liver disease during the pandemic has... more
The coronavirus associated disease 2019 (COVID-19) caused by the SARS-CoV-2 virus has rapidly spread all around the world and became pandemic in March 2020. Data on liver transplantation and chronic liver disease during the pandemic has remained scarce, and there is little information on whether immunosuppressed patients are at higher risk of developing severe COVID-19 infection. This review provides information for health care providers who care for patients with liver transplantation and chronic liver diseases.
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The purpose of this study was to utilize the Context, Input, Process and Product (CIPP) evaluation model as a comprehensive framework to guide initiating, planning, implementing and evaluating a revised undergraduate medical education... more
The purpose of this study was to utilize the Context, Input, Process and Product (CIPP) evaluation model as a comprehensive framework to guide initiating, planning, implementing and evaluating a revised undergraduate medical education programme. The eight-year longitudinal evaluation study consisted of four phases compatible with the four components of the CIPP model. In the first phase, we explored the strengths and weaknesses of the traditional programme as well as contextual needs, assets, and resources. For the second phase, we proposed a model for the programme considering contextual features. During the process phase, we provided formative information for revisions and adjustments. Finally, in the fourth phase, we evaluated the outcomes of the new undergraduate medical education programme in the basic sciences phase. Information was collected from different sources such as medical students, faculty members, administrators, and graduates, using various qualitative and quantitat...
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Objectives. The study was aimed at providing a psychosocial profile for Iranian liver transplant candidates referred to an established liver transplantation program.Material and Methods. Patients assessed for liver transplant candidacy in... more
Objectives. The study was aimed at providing a psychosocial profile for Iranian liver transplant candidates referred to an established liver transplantation program.Material and Methods. Patients assessed for liver transplant candidacy in Imam Khomeini Hospital (Tehran, Iran) between March 2013 and September 2014 were included. The following battery of tests were administered: Psychosocial Assessment of Candidates for Transplant (PACT), the Short-Form health survey (SF-36), and Hospital Anxiety and Depression Scale (HADS).Results. Psychosocial assessment in 205 liver transplant candidates revealed significant impairments in several SF-36 domains; social functioning was the least and physical functioning was the most impaired domains. The prevalence of cases with probable anxiety and depressive disorders, according to HADS, was 13.8% and 5.6%, respectively. According to PACT, 24.3% of the assessed individuals were considered good or excellent candidates. In 11.2%, transplantation see...
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Abstract: The imaging diagnosis of Hepatocellular Carcinoma (HCC) is challenging and plays a crucial role in the diagnosis and staging of the disease. A variety of imaging modalities, such as ultrasound, computed tomography (CT), magnetic... more
Abstract: The imaging diagnosis of Hepatocellular Carcinoma (HCC) is challenging and plays a crucial role in the diagnosis and staging of the disease. A variety of imaging modalities, such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine are currently used in evaluating patients with HCC. Although the best option for the treatment of these cases is hepatic resection or transplantation, only 20% of HCCs are surgically treatable.
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Background Although liver transplantation is the last resort for treating end stage liver diseases, this medical procedure is not available for all needful patients because of inadequate organ supply. Therefore, guidelines have been... more
Background Although liver transplantation is the last resort for treating end stage liver diseases, this medical procedure is not available for all needful patients because of inadequate organ supply. Therefore, guidelines have been developed by medical experts to regulate the process. Some professionals believe that medical criteria are inadequate for organ allocation in all situations and may not secure fairness of organ allocation. Objectives The current study has been designed to identify decision criteria about allocation of ...
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BACKGROUND: Intussusception is a rare cause of intestinal obstruction in adult patients. The etiology of malignant nature has been reported to be more frequent in this group and the diagnosis is usually made at operation. Few reports are... more
BACKGROUND: Intussusception is a rare cause of intestinal obstruction in adult patients. The etiology of malignant nature has been reported to be more frequent in this group and the diagnosis is usually made at operation. Few reports are published for this clinical entity from Middle East. METHODS: The medical records of all adult patients admitted with the diagnosis of intussusception in a tertiary care center between 1989 and 2009 were reviewed. RESULTS: There were 15 cases of intussusception in this 20 years period. The ...
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BACKGROUND Iran's experience with liver transplantation (LT) began more than two decades ago. The purpose of this article is to present the status of LT in Iran, review specific characteristics of the programs, their outcomes, and... more
BACKGROUND Iran's experience with liver transplantation (LT) began more than two decades ago. The purpose of this article is to present the status of LT in Iran, review specific characteristics of the programs, their outcomes, and their growth to become one of the largest LT programs in the world. METHODS A questionnaire, asking for data on the number of transplants performed and specifics of the recipients and type of donors with focus on indications and outcomes was sent to LT programs. RESULTS During a period of 23 years, 4,485 LTs were performed at 6 centers in the country. Of these, 4106 were from deceased donors and 379 were from living donors. There were 3553 adults and 932 pediatric recipients. Hepatitis B and biliary atresia were the most common etiologies in adult and pediatric patients, respectively. Overall survival rates at 1, 5, and 10 years were 85%, 77%, and 71% for adults and 76%, 67% and 56% for pediatric patients, respectively. CONCLUSION Approval of the brain...
Abstract: Recent advances in organ transplantation have promised certain benefits to humankind. Consequently, it is neces¬ sary to take into consideration all aspects of these new approaches and provide specific ethical guidelines for re¬... more
Abstract: Recent advances in organ transplantation have promised certain benefits to humankind. Consequently, it is neces¬ sary to take into consideration all aspects of these new approaches and provide specific ethical guidelines for re¬ search in this field.
Background: Chronic venous stasis ulcers of the leg are still a challenge in vascular surgery. Innovation of new surgical techniques using endoscopic instruments have ushered in a new era with less complications and better results. This... more
Background: Chronic venous stasis ulcers of the leg are still a challenge in vascular surgery. Innovation of new surgical techniques using endoscopic instruments have ushered in a new era with less complications and better results. This study was designed to evaluate the safety and long-term outcomes of this technique for the first time in Iran. Methods: Subfascial endoscopic perforator vein surgery was performed on 10 legs in 8 patients who had signs of chronic venous insufficiency (between September 2001 and September 2003).
Background Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and... more
Background Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran.
Background: Kidney transplantation is one of the major progresses of medical science with many ethical debates. The shortage of organs and the increases in waiting list for cadaver transplantation has leaded to transplantation from living... more
Background: Kidney transplantation is one of the major progresses of medical science with many ethical debates. The shortage of organs and the increases in waiting list for cadaver transplantation has leaded to transplantation from living donors. In this article, we discuss the ethics of transplantation from living kidney donors. Methods: For compiling this article, we searched in Pubmed and Ovid by the keywords of kidney transplantation, living donor, ethics.
Background/Objective: The accurate anatomic mapping and determination of the severity of arterial disease an important health problem of the elderly is of great significance. We aimed to determine the diagnostic value of 64-multislice CT... more
Background/Objective: The accurate anatomic mapping and determination of the severity of arterial disease an important health problem of the elderly is of great significance. We aimed to determine the diagnostic value of 64-multislice CT angiography (MSCTA) in arterial disease in run-off and cut-off sites, taking into consideration the results of surgical findings of our study as a standard of reference.
Background: Gall stone is an important health problem in the world for which different risk factors have been characterized. Gall stone and cardiovascular disease have common risk factors. Homocysteine is accepted as one of the risk... more
Background: Gall stone is an important health problem in the world for which different risk factors have been characterized. Gall stone and cardiovascular disease have common risk factors. Homocysteine is accepted as one of the risk factors for cardiovascular disease. We aimed to study the effect of homocysteine level on gall stone formation. Methods: 54 patients with gall stone-related diseases and 54 patients without stone (control group) were studied from January 2007 to December 2008.
Abstract: We report on a 12 year-old female with criggler-najjar syndrome type I. She showed signs of kernicterus like relative decrease in IQ and speech disturbance. Total bilirubin was 29 and direct bilirubin 1 mg/dl. The first child of... more
Abstract: We report on a 12 year-old female with criggler-najjar syndrome type I. She showed signs of kernicterus like relative decrease in IQ and speech disturbance. Total bilirubin was 29 and direct bilirubin 1 mg/dl. The first child of the parents, a male newborn, died because of high hyperbilirubinemia. One 10 year-old son is normal, and a 3 year-old daughter is also congenitally icteric. The liver of a 16-year old boy who died in automobile accident was transplanted to her soon after his brain death.
BACKGROUND: Cadaveric organ shortage is the most important obstacle to more widespread provision of transplants. Many factors influence the donation rate: social factors, religion, familial relations, and especially knowledge and... more
BACKGROUND: Cadaveric organ shortage is the most important obstacle to more widespread provision of transplants. Many factors influence the donation rate: social factors, religion, familial relations, and especially knowledge and attitudes toward organ and tissue donation and transplantation. Increasing public awareness can reform the incorrect beliefs and myths about donation and transplantation.
Abstract: Oral feeding is the best means of nutrition in surgical patients. There arc many reports on early oral feeding after lower gastrointestinal {(il) operations but data regarding upper Gl procedures is rather scant. This limited... more
Abstract: Oral feeding is the best means of nutrition in surgical patients. There arc many reports on early oral feeding after lower gastrointestinal {(il) operations but data regarding upper Gl procedures is rather scant. This limited study rocuses 011 early removal of nasogastric tube and start of oral diet after transhiatal csophagcctomy. We prospectively evaluated 13 consecutive patients (8 males. 5 females) with esophageal cancer who had undergone rranshiatal csophngcctomy from March 100 I to September: lOrn.