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Objective To evaluate short-term clinical efficacy of renal transplantation from the donation of pediatric donors.Methods Clinical data of 1 5 pediatric donors and 28 recipients (including 2 cases of bilateral renal transplantation)undergoing renal transplantation in the Department of Renal Transplantation of the First Affiliated Hospital of Xi'an Jiaotong University from November 201 3 to December 201 5 were retrospectively analyzed. Results Renal transplantation was successfully performed in 28 recipients.The median warm ischemia time of transplant kidney was 1 2.5 min (range:0-1 7.0 min)and 4.3 h (range:1 .5-7.7 h)for the median cold ischemia time.After operation,4 cases developed with delayed graft function (DGF),1 required dialysis,2 died from pulmonary infection,2 underwent renal resection due to renal anastomosis stenosis and renal thrombosis.Postoperative follow-up lasted for 1 -24 months.Twenty-six (93%)recipients survived after renal transplantation and 24 (86%)recipients survived with restored normal renal function.Conclusions Unilateral and bilateral renal transplantation from pediatric donors has relatively favorable short-term clinical efficacy.
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Objective To investigate the clinical value of color Doppler flow imaging (CDFI) for evaluating transplant renal artery stenosis (TRAS).Methods Clinical and ultrasonographic data of 216 kidney transplant recipients were collected by follow-up monitoring from September 2015 to July 2016.CDFI indexes included the peak systolic velocity (PSV) in the renal artery and resistant index (RI).Renal artery PSV and RI were measured.All suspected TRAS patients accepted transplant renal artery angiography (DSA).Results Fourteen patients with suspected TRAS accepted DSA,of which 12 patients were confirmed.The diagnostic accuracy of CDFI was 85.7％.When the POST-PSV ratio＞ 1 0,the sensitivity and specificity of diagnosis of TRAS were 91 ％ and 95 ％,respectively.CDFI indexes remarkably changed after the TRAS patients had undergone renal artery dilatation or stent implantation.PSV of the main renal artery and the POST-PSV ratio decreased significantly,and the PSV of interlobar arteries increased.Conclusions CDFI is a reliable first choice for screening transplant renal artery stenosis.The POST-PSV ratio has relatively higher sensitivity and specificity in the diagnosis of TRAS.
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Objective To investigate the correlation between immune cell function and the infection after renal transplantation through monitoring of immune function intracellular ATP by Cylex ImmuKnow assay,and explore its significance in individual immunosuppressive therapy of renal transplantion recipients.Method We collected 44 renal transplant patients suffered from pulmonary infection from January 2014 to March 2015.The patients were divided into two groups according to the clinical status,namely,ImmuKnow monitoring group (n =22) and empirical treatment group (n =22).Thirty-two non-infection recipients were collected as controls.All the kidney transplantation recipients received immunosuppressive therapy based on calcineurin inhibitors,mycophenolate mofetil and prednisone,and ATG for induction therapy after transplantatior.The immune cell function levels were measured by Cylex ImmuKnow assay.The whole blood samples were collected before infection onset,at the time of infection,and 1 week after infection resolution.Result When infection occurred,ATP concentrations in CD4+ T cells of the kidney transplant recipients were significantly lower than those in non-infection group [(151.30--71.35 ng/mL vs.(308.34 ± 141.29 ng/mL,P＜0.05).When the infection got controlled,the ATP concentrations in CD4+ T cells increased to those before infection occurred.The average hospitalization time in ImmuKnow monitoring group was 12.27 ± 0.74 days,which was significantly shorter than in empirical treatment group (16.64 ± 1.98 days,P＜ 0.05).The incidence of acute rejection was 4.5％ in ImmuKnow monitoring group,and 13.6％ in empirical treatment group (P＞0.05).Conclusion The examination of ATP in CD4+ T cells by Cylex Immuknow assay could reflect the status of cellular immunity,provide reliable and objective basis for the diagnosis and treatment of infection after renal transplantation,and guide the clinical individualized immunosuppressive therapy.
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Objective To explore the significance of serum CD30 in predicting acute rejection in kidney transplant recipients.Method A total of 106 kidney transplant recipients were recruited in this prospective six months follow-up study from December 2010 to October 2012.According to the clinical outcome,the subjects were devided into stable renal function group (72 cases) and acute rejection group (34 cases).Twenty healthy subjects were choosed as controls.Serum sCD30 levels were detected by ELISA.The whole peripheral blood samples were collected from all recipients before transplantation,at days 7,14,21 and 28 post-transplantation,and at months 2,3,4,5 and 6 posttransplantation.Additional blood samples were collected for on the days that acute rejection occurred and reversed.Result Preoperative serum sCD30 levels were 33.42 ± 11.49 and 26.5 1 ± 13.70μg/L in AR group and stable group respectively.When acute rejection occurred,serum sCD30 levels in AR group was 50.38 ± 12.10μg/L,which was significantly higher than stable group (20.03 ± 6.68μg/L,P＜0.05) and healthy control group (13.57 ± 5.56 ng/L,P＜0.05).After the anti-rejection therapy,serum sCD30 levels decreased to 15.31 ± 6.37μg/L,which was lower than that before the therapy started (50.38± 12.10 μg/L,P＜0.05).Elevated preoperative serum sCD30 levels suggested a higher risk of acute rejection in kidney transplant recipients,with Cutoff values of 24.96 μg/L,and the sensitivity and specificity were 91.30％ and 84.21％ respectively.Conclusion Serum sCD30 levels can predict and assess the risks of rejection episodes in kidney transplant recipients.