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Objective:To explore the microbiological characteristics of donor blood culture and donor liver perfusion culture and summarize the clinical experiences to provide basic rationales for preventing donor-derived infections.Methods:From August 1, 2018 to November 26, 2018 and November 27, 2018 to December 31, 2020 at First Affiliated Hospital, Zhengzhou University, culture results of donor blood and donor liver perfusate were retrospectively reviewed.According to whether or not donor liver was obtained without breaking diaphragm, removing gallbladder intraoperatively and flushing bile through cystic duct, two stages were assigned: before and after improvement measures of liver donor, i.e.August 1, 2018 to November 26, 2018 and November 27, 2018 to December 31, 2020.The culture results of donor blood samples and donor liver perfusion fluid samples in two stages of liver transplantation were statistically analyzed and infection preventing measures during donor liver maintenance and obtaining donor liver examined.Results:A total of 486 cases of blood culture from potential donors and 478 cases of liver perfusion culture were analyzed.The results showed that the incidence of blood culture infection was 4.5% and 4.3% before and after improvement measures( χ2=0.008; P=0.927)while the incidence of perfusion fluid infection was 56.8% and 46.2%( χ2=4.569; P=0.031); Klebsiella pneumoniae was a major pathogen cultured in perfusion solution before improvement measures and Staphylococcus epidermidis after improvement measures. Conclusions:Before organ donation, infection screening and prevention of potential donors and corresponding measures during donor liver acquisition can reduce donor source infection and effectively lower the mortality of recipients.
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OBJECTIVE@#To analyze the expression of microRNA-106a(miR-106a) in renal cell carcinoma (RCC) and its correlation with clinicopathological characteristics and prognosis of patients.@*METHODS@#Serum samples of 64 patients with newly diagnosed RCC were collected as the study group, and serum samples of 40 healthy individuals were used as the control group. Real-time fluorescence quantitative PCR was used to determine the expression level of miR-106a in each group. The correlation between miR-106a expression and clinicopathological characteristics of the patients was studied with single factor analysis and multiple Logistic regression model. Kaplan-Meier survival curve was used to analyze its correlation with the prognosis of patients.@*RESULTS@#Before surgery, compared with the control group (1.17± 0.58), RCC patients with high- (9.15± 0.96) and low-expression(3.45± 0.37) had increased expression of miR-106a. Postoperatively, the expression level of miR-106a in both groups of patients decreased to 1.53± 0.18 and 1.75± 0.21, respectively. The area under the curve (AUC) of the diagnostic value of serum miR-106a for RCC was 0.782 (95% CI: 0.661-0.902). With an optimal cutoff value of 0.531, the sensitivity was 78.10% and the specificity was 75.00%. Serum miR-106a level of RCC patients with TNM stage T3 or T4, clinical stage II or III, lymph node metastasis, and recurrence were significantly increased. The high expression of serum miR-106a in RCC patients has an independent relationship with the tumor TNM stage and lymph node metastasis. Of the 64 follow-up patients, 4 were lost and 30 had died. Among them, the median survival time of patients in the miR-106a high expression group was 30 months, which was significantly shorter than that of the low expression group (52 months).@*CONCLUSION@#The serum level of miR-106a is elevated in RCC patients, and may be used as a molecular marker for the diagnosis of RCC. High serum expression of miR-106a is an independent predictor for tumor TNM stage and lymph node metastasis, as well as an independent predictor for poor prognosis of RCC patients.
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Humans , Biomarkers, Tumor/genetics , Carcinoma, Renal Cell/genetics , Gene Expression Regulation, Neoplastic , Kidney Neoplasms/genetics , MicroRNAs/genetics , Neoplasm Recurrence, Local , PrognosisABSTRACT
Objective To compare the difference of all-cause mortality between diabetic and non-diabetic transplant recipients.Methods This population cohort study included all primary kidneyonly transplant recipients with data integrity between Jan.2000 and May 2017,the deadline date of follow-up was May 2018,and median follow-up period was 5.9 (range 1.1 to 17.1) years.According to whether the recipients had diabetes,they were divided into type 2 diabetes group (DM group),and no diabetes group (non-DM group).The clinical data of the two groups including recipients and donors were collected.The all-cause mortality and difference in dead causes were analyzed.Results Mortality was higher in DM group than in non-DM group.Compared with non-DM group,the relative risk(RR) for all-cause mortality in DM group was 2.25 (95％ CI:1.23-4.12).The cumulative survival rate in non-DM group was significantly higher than that in DM group(Log Rank P =0.035).The DM group aged younger than 40 years had the highest risk (RR 4.50),but there was no significant difference between the two groups at the age of ≥40 years.Compared with living donor and cadaveric donor renal transplantation,the relative mortality risk in DM group in DCD donor renal transplantation was highest (RR 2.68).The transplantation time did not change the multiple risk of death in both groups (adjusted RR 2.13).The first cause of death in two groups was infection (50％ in DM group vs.53.3％ in non-DM group).The difference was not statistically significant.Conclusion Kidney transplant recipients with type 2 diabetes had higher all-cause mortality than in those without diabetes.Compared with non-diabetic recipients,the age ＜40 years and receiving DCD for kidneys had a greater impact on the all-cause mortality of diabetic recipients.Infection was the leading cause of death in both groups.
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Objective To evaluate the effect of pediatric renal transplantation using donation after cardiac death (DCD).Methods The male DCD meeting Chinese standard Ⅲ (C-Ⅲ) was 49 years old,and the recipient with chronic renal failure was 14 years old.The right kidney of the donor was transplanted to the recipient.The renal artery and renal vein of the donor were end-to-side anastomoscd to the common iliac artery and common iliac vein of the recipient,respectively.The graft was transplanted into the fight iliac fosse.Warm ischemia time was 12 min,and cold ischemia time was 2 h.Immunity induction therapy was performed with basiliximab.Tacrolimus + mycophnolate mofetil + Pred were used as immunosuppressive regimen.Results The transplantation was done successfully.One day after operation,ALT was increased dramatically.The recipient was diagnosed as acute drug-induced liver injury.There was no occurrence of acute rejection and delayed graft function.The recipient was discharged one month after the operation,and followed up for 6 months with normal graft function.Conclusion Pediatric renal transplantation using DCD is effective and safe,even though the long-term effect still needs to be further observed.