Vitamin E and selenium co-supplementation attenuates oxidative stress in haemodialysis patients receiving intra-dialysis iron infusion.

erative endarteritis were found in the kidney tissue, suggesting intravenous drug addiction in the kidney donor (Figure 1D). Follow-up quantitative Polymerase chain reaction (PCR) for cytomegalovirus (CMV) revealed 65.000 copies/ml. Liposomal amphotericin B, therapy for nontuberculous mycobacteriosis and ganciclovir were added to the therapeutic regime. The patient’s condition did not improve and despite all efforts, he died 102 days after the transplantation. This case demonstrates an unfortunate combination of bacterial, fungal and parasitic infections (CMV was reactivation) following kidney transplantation from a living unrelated donor in India. To the authors’ knowledge, 43 cases of post-transplant malaria have been reported [2–4]. During his stay in India, our patient remained in New Delhi and was therefore not exposed to malaria-bearing mosquitoes, so the most likely source of malaria was the allograft. It is highly likely that deep mycosis (A. tereus, Mucor spp.) and M. fortuitum were transmitted by the renal allograft as well. Renal mucormycosis, sharing similarities with our case, has previously been reported in a patient actively using intravenous drugs [5]. Over half of all the renal transplant recipients in tropical countries develop a serious infection at some point in the post-transplant period and 20–40% of them succumb to these infections [1,6,7]. A multitude of factors (unhygienic conditions, hot and humid climate, scanty diagnostic techniques, etc.) contribute to this dismal outcome. In commercial transplantations, the primary objective of the medical team is often profit, and not necessarily the well-being of either donors or recipients.