All conventional immunosuppressive tree drugs-protocols are based on Cyclosporine; consisting of low doses of Cyclosporine (CsA), Azathioprine (AZA) or Mycophenolate Mofetil (MMF) and Prednisolone. AZA has been used in clinical transplantation for more than 30 years and was the first immunosuppressive agent to achieve widespread use in organ transplantation. MMF was introduced in clinical practice in 1995 after several clinical trials proved that it was more efficient than AZA for prevention of acute rejection episodes. Our aim was to evaluate influence of AZA and MMF on renal graft function in early post-transplant stage. Study recruited 74 patients who underwent kidney transplantation in University Clinical Centre Tuzla. All patients received CsA and corticosteroid-based immunosuppression, as a part of triple immunosuppressive regiment, 40 patients received AZA and 34 MMF. In order to assess renal graft function, following parameters were evaluated: glomerular filtration rate GFR (ml/min) creatinine clearance (CrCl) (ml/min), 24 h urine output (ml/day), and from the serum potassium, sodium, urea and creatinine (mmol/dm3). Significantly higher average values of 24 hour urine output were recorded during first seven postoperative days in patients receiving MMF compared to those treated with AZA. Serum creatinine values showed statistically significant decrease, starting with the second postoperative day, in MMF vs. AZA group (168,7+/-70,5 vs. 119,9+/-42,6; p<0,0007). GFR was significantly higher in MMF compared to the AZA group of patients. On the first post-transplant day CrCl was higher in AZA group (24,3+/-10 vs. 17,5+/-7,3; p=0,01), next six days situation is reversed CrCl is significantly higher in the MMF group (43,7+/-15 vs. 53, 4+/-22, 8 p=0,006). MMF vs. AZA therapy was associated with protective effect against worsening of renal function in first seven post-transplant days.

Background: Accurate estimations of hepatitis B virus transmission risk for any region in Bosnia and Herzegovina are not clearly established. We aimed to determine levels of risk associated with intrafamilial transmission of hepatitis B infection within families in our region. Patients and Methods: Family members of 81 chronic carriers of hepatitis B surface antigen (>6 months positive and considered as index case) were tested for hepatitis B markers. For family members, we recorded their age, sex, and family relationship to the index case, and vaccination status. Results: The proportion of HBsAg positive family members was 25/207 (12.1%), while the proportion of family members with evidence of exposure to HBV was 80/207 (38.6%). Only 17/207 (8.2%) family members had evi--dence of past HBV vaccination. Age was found to be a significant predictor of HBV exposure of family members (odds ratio 1.05, 95% CI 1.03-1.07, P< .001). In a multivariate analysis, HBsAg positivity was associated with a female index case (odds ratio 11.31, 95% CI 3.73-34.32, P< .001), HBeAg positivity in the index case (odds ratio 5.56, 95% CI 1.80-17.23, P< .005) and being a mother of the index case (odds ratio 9.82, 95% CI 2.43-39.68,P< .005). A female index case (odds ratio 4.87, 95% CI 2.21-10.72, P< .001), HBeAg positivity in the index case (odds ratio 3.22, 95% CI 1.15-9.00, P< .05) and being a mother of the index case (odds ratio 3.72, 95% CI 1.19-11.64, P< .05) were also risk factors for HBV exposure among family members. The combination of HBeAg positivity and female index case was a significant predictor for HBsAg positivity of family members (odds ratio 70.39, 95% CI 8.20-604.61, P< .001). Conclusions: Children of HBeAg positive mothers are at highest risk for becoming chronic carriers them--selves and generally, the combination of female sex and HBeAg positivity dramatically increases the chances of HBV transmission within the family.