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Objective To observe the clinical effect of mechanical perfusion preservation kidney transplantation in donor after cardiac death (DCD),and to explore the effect of mechanical perfusion preservation of DCD on renal function recovery.Methods The clinical data of 186 patients undergoing DCD kidney transplantation from January 2012 to December 2016 were retrospectively analyzed.Sixty-eight DCD donor's kidneys were preserved by LifePortpreservation (low temperature mechanical perfusion group),118 DCD donor's kidneys were preserved by static low temperature preservation (static low temperature preservation group).The renal function recovery,the incidence of primary non-function,delayed graft function and infection,and the survival rate of patients and renal grafts were analyzed.Results There was no significant difference between the two groups in gender,age,hemodialysis ratio,dialysis time,BMI,warm ischemia time and cold ischemia time (P＞0.05).There was significant difference in creatinine value between the two groups at 1st week (P＜0.05),but there was no significant difference in creatinine at 3rd,6th,12th,24th and 36th month (P＞0.05).There was significant difference in the incidence of DGF between two groups (P＜0.05),but no significant difference in the incidence rate of PNF,AR and infection,and the survival rate of patient and renal graft between two groups (P＞0.05).There was no significant difference in 1-and 3-year survival rate of the recipients and transplanted kidney between the two groups (P＞0.05).Conclusion LifePort can significantly reduce the incidence of DGF as compared with static cold preservation.The resistance index and perfusion flow of the LifePort have important significance to assess the renal quality.
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Objective To investigate the clinical efficacy of methylprednisolone intravenous infusion and to take oral prednisone for patients with pulmonary infection after renal transplantation. Methods One hundred and thirty?six patients with severe pulmonary infection after renal transplantation in our hospital from January 2013 to January 2016 were enrolled and randomly divided into 2 groups. All patients were treated with immunosuppressant adjustment based on the basis of routine treatment. Patients in the observation group were applied methylprednisolone, while patients in the control group were applied prednisone. The clinical efficacy between 2 groups were compared. The changes of body temperature, PaO2 during treatment in survivors of both 2 groups and the changes of ACR, Scr, urine β2?macroglobulin after treatment in survivors of both groups were compared. Results There were 2 cases died and 1 case of renal allograft dysfunction in the observation group. There were 2 cases died and 3 case of renal allograft dysfunction in the observation group. No significant difference in clinical efficacy was found between 2 groups (P > 0.05). For survivors, the recovery time of body temperature in the observation group was significantly shorter than that in the control group. From 16 hours until 4 days after treatment, the body temperature in the observation group was significantly lower than that in the control group (P 0.05). Conclusion Methylprednisolone can decrease body temperature and increase PaO2 in patients with pulmonary infection after renal transplantation rapidly, with no effects on reducing the mortality and renal allograft dysfunction, and the middle?time renal function.
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Objective To evaluate the effect of living-related donor renal transplantation with mild renal arterial stenosis upon the early renal function and postoperative complications of the recipients. Methods Clinical data of 1 4 donors and recipients undergoing living-related donor renal transplantation with mild renal arterial stenosis and 50 donors and recipients receiving standard living donor renal transplantation from healthy relatives were retrospectively analyzed. The levels of serum creatinine (Scr ) in the donors were statistically compared between two groups. The serum levels of Scr at postoperative 1 ,3 and 6 months in the recipients were statistically compared between two groups. The survival rate of kidney graft,and the incidences of delayed graft function (DGF),acute rejection and pulmonary infection were compared between two groups. Results Postoperative Scr levels of the donors did not significantly differ between two groups(all P>0. 05 ). The Scr levels of the recipients at postoperative 1 ,3 and 6 months did not significantly differ between two groups (all P>0. 05 ). The survival rate of kidney graft,and the incidences of DGF,acute rejection and pulmonary infection in the recipients did not significantly differ between two groups (all P >0. 05 ). Conclusions Living-related donor renal transplantation with mild renal arterial stenosis exerts no significant effect upon renal function and postoperative complication in the recipients,who are eligible for the donors for renal transplantation.
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BACKGROUND:Studies have found that alprostadil can inhibit platelet aggregation, relax vascular smooth muscle, diastole peripheral blood vessels and thereby improving peripheral circulation. OBJECTIVE:To further verify whether alprostadil can promote the early recovery of renal function of renal transplantation recipients. METHODS:Total y 125 patients in the alprostadil group received intravenous infusion of 20μg alprostadil daily, and then compared with the 115 patients in the unused alprostadil group in the same time. The urine volume, serum creatinine and the creatinine clearance were compared between two groups;blood flow resistance-indexes, as wel as the incidences of delay recovery of renal function and acute rejection were detected under color doppler ultrasound. RESULTS AND CONCLUSION:The urine volume and creatinine clearance in the alprostadil group were significantly higher than those in the unused alprostadil group;while the serum creatinine and the blood flow resistance-indexes were lower than the unused alprostadil group. The incidence of delay recovery of renal function in the alprostadil group was 7.2%which was significantly lower than that in the unused alprostadil group (P<0.01);there was no significant difference in the incidence of acute rejection between two groups. The findings suggest that the administration of alprostadil in renal transplantation recipients during the early stage of kidney transplantation can accelerate the recovery of the renal function and can promote the early rehabilitation after renal transplantation.
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[Objective]To investigate the effect of proximal femoral intramedullary nail with spiral blade for the treatment of femoral peritrochanteric fractures with femoral shaft fractures.[Method]From January 2002 to October 2006,21 patients of femoral peritrochanteric fractures with femoral shaft fractures were treated by minimal invasive technique with proximal femoral intramedullary nail and spiral blade.[Result]All 21 patients were followed up from 9 months to 5 years,with an average of 13 months,fractures healed in all patients.There was no nail and screw broken or loosening.The hip and knee joints of ingived limbs retained good function.[Conclusion]It is a good internal fixation operation for treatment of femoral peritrochanteric fractures with femoral shaft fractures(according to the patient's age,the type of fracture and the Singh index of the bone)by using minimal invasive technique with proximal femoral intramedullary nail and spiral blade,the key of treatment is the anatomic reduction of the fractures under minimal invasive surgery.