I am currently working as Director and Head of the Department of Nephrology at Medanta Hospital, Gurgaon, which is a multispeciality hospital of 1200 beds in the National capital region Delhi. Dr Bansal has been trained in Nephrology at SGPGIMS Lucknow, considered one of India's best institutes for Nephrology. I am also the coordinator of the DNB Nephrology teaching program in Nephrology and am actively involved in training new Nephrology doctors. Dr Bansal has been involved in the care of more than 3000 kidney transplant recipients till now. Dr Bansal is also an avid researcher and has published more than 100 original articles and many book chapters in the field of Nephrology and kidney transplantation. Some of his notable research work includes the first report of Kidney Transplantation in an HIV-positive patient in India, the First Report and subsequent series of ABO-incompatible kidney transplants in India, the first report of Steroid free kidney transplant in India, paired kidney transplantation in India etc. Recently he published a supplementation on Transplant Infectious disease guidelines for South Asia in the Indian Journal of Transplantation as guest editor and a summary of these guidelines has been published in `Transplantation`. I have published multiple articles in Infection in Transplant patients including HIV, Histoplasmosis, Mucormycosis, Dengue, Scrub Typhus etc.
I am also the current general secretary of the Indian Society of Nephrology. I have been the past secretary of the Delhi Nephrology Society and an executive member of the Indian Society of Organ Transplantation. I am also a member of the educational committee of transplantation, a member South Asia Regional Board International Society of Nephrology and have been appointed as Chair of the local organising team World Congress of Nephrology 2025 to be held in India.
Acute graft pyelonephritis in a kidney transplant recipient: A single centre experience in northern India
Ankur Mittal1, Shyam Bihari Bansal1, Abhyuday Singh Rana1, Pooja Lokur1, Neha Manhas1.
1Department of Nephrology, Medanta - The Medicity, Gurugram, Haryana, India
Background: Urinary tract infections (UTI) are the most common infections after kidney transplantation. Although clinical spectrum of pyelonephritis after kidney transplantation remains less clear. This study was conducted to evaluate the prevalence, clinical and microbiological profile with antibiogram of post-transplant pyelonephritis.
Methods: We retrospectively reviewed and analysed the charts of 1684 patients, who underwent kidney transplantation at Medanta – The Medicity between January 2015 and May 2023. Patients were screened for the diagnosis of pyelonephritis and their clinical characteristics and outcome were evaluated.
Results: 93/1684 (5.5%) patients with a mean age of 41 ± 13.57 years had developed at least one episode of Pyelonephritis. 68 were males and 25 were females. Older age, female gender, hyperglycaemia, use of induction immunosuppression were the risk factors for Pyelonephritis. Median time of occurrence was 44 days after transplantation. Most common symptoms were fever (n=64) followed by dysuria (n=40), and abdominal pain (n=11). Most common organism isolated was Escherichia coli (51.6%) followed by Klebsiella pneumonia (30.1%), and Pseudomonas aeruginosa (11.8%). This study showed a high percentage of resistance to commonly used antibiotics like Carbapenems (61.3%), third generation cephalosporin (49.5%). 41/93 (44%) patients had acute graft dysfunction at the time of presentation. Median duration of hospital stay was 7 days. 90/93 patients had graft recovery and one patient lost his graft after episode of UTI.
Conclusion: Pyelonephritis is a common cause of morbidity after kidney transplantation and occurs in an early post-transplant period. Gram negative bacilli are the major pathogens and carbapenems as an empirical therapy might be useful choice for management of Pyelonephritis and coverage of majority pathogens.
