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Objective To investigate the clinical efficacy of renal transplantation from donors of donation after brain and cardiac death(DBCD) complicated with acute kidney injury (AKI),and summarize the clinical experience of evaluation and application.Methods The clinical data of the 45 DBCD donors and 80 recipients in the First People's Hospital of Foshan from September 2011 to September 2015 were retrospectively analyzed.DBCD donors were classified into the AKI group (n=26) and non-AKI group (n=19) according to the serum creatinine level and urine output when the donors were admitted to the intensive care unit (ICU) in this hospital.A total of 80 recipients were divided into the AKI group (n=46) and non-AKI group (n=34) correspondingly.The condition of the donors before organ procurement between the two groups was compared,and the incidence of various complications,the 1 years survival rates of recipients and graft after renal transplantation were compared between the two groups.Results Among 45 donors,26 cases(57.8％) suffered from AKI.The serum creatinine of donors was significantly higher in the AKI group than that in the non-AKI group (P ＜ 0.01).The incidence of delayed graft function (DGF) in AKI group and non-AKI group was 21.7％ and 8.8％ respectively (P ＞ 0.05).After 1 years,the serum creatinine of the recipients in AKI group was significantly higher than that in non-AKI group [(134.9±63.4) μmol/L vs (106.6±28.2) μmol/L,P＜ 0.05],but the survival rates of recipients and grafts did no differ between the two groups (both P ＞ 0.05).Conclusions The donors combined with AKI do nothave a worse effect on the incidence of DGF,the 1-year survival rates of recipients and grafts after transplantation.So,the donors with AKI for transplantation can widen the origin of kidney grafts.
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Objective To observe the short?term clinical outcomes of kidney transplantation from brain and cardiac death donors (DBCD) and assess its feasibility to expand organ donor pool. Methods A retrospective analysis was performed on 48 cases of kidney transplantation from DBCD. The transplant recipients had finished 12?month follow?up in the First People's Hospital of Foshan from September 2011 to February 2015, with their renal function, rejection reaction and complications at 1 week, 1 month, 3 months, 6 months and 12 months after renal transplantation being collected. Survival rates of transplant recipients and transplant kidneys, incidence of delayed graft function (DGF) and its influence for recipients and graft survival were analyzed by statistics. Results In the 48 cases, the survival rates of recipients at 1, 3, 6 and 12 months after transplantation were 100.0%, 100.0%, 97.9%, 95.8%, and the survival rates of transplanted kidneys were 95.8%, 95.8%, 93.8%, 91.7%, respectively. DGF occurred in 8 of 48 (17.0%), but the occurrence of DGF did not adversely influence patient's survival (P=0.524) or graft survival (P=0.362). Conclusions The short?term clinical outcomes of kidney transplantation from DBCD are ideal. As the legislation of donation after brain death (DBD) has not been ratified in China, the kidney transplantation from DBCD could be an important way to solve the shortage of organs, and increase the number of kidneys available for transplantation.
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OBJECTIVE: To investigate the effect of Losartan and Amlodipine on serum and urine transforming growth factor -β_1 in patients undergoing kidney transplantation. METHODS: A total of 40 patients with mild or moderate hypertension (systolic pressure 140-170 mm Hg, and diastolic pressure 85-100 mm Hg, 1 mm Hg=0.133 kPa) following primary kidney transplantation were selected from First People's Hospital of Foshan, including 23 males and 17 females aged (38.6±19.2) years. They were randomly divided into two groups (n=20): Losartan group (oral administration 50 mg per day) and Amlodipine group (oral administration 5 mg per day). The blood pressure of patients should be controlled below 130/80 mm Hg. The blood pressure, renal function, 24 h-proteinuria, serum and urine transforming growth factor-β_1 6 months after medication were observed. RESULTS: A total of 40 patients were included in the final analysis. The systolic pressure and diastolic pressure of patients were decreased after administration (P < 0.05) and decreased to normal levels 6 months after administration (P < 0.01). During treatment, there were significant differences in blood pressure decrease and mean arterial pressure between two groups (P > 0.05). No difference was found in total efficacy between two groups (P > 0.05). In addition, blood urea nitrogen, creatinine, and blood uric acid did not significantly alter after treatment in two groups (P > 0.05). After 6 months of treatment, 24 h-proteinuria, serum and urine transforming growth factor -β_1 in Losartan group were significantly decreased compared with before treatment (P < 0.05), while no obvious changes were found in Amlodipine group (P > 0.05). The 24 h-proteinuria, serum and urine transforming growth factor-β_1 in Iosartan group were significantly less than Amlodipine group (P < 0.05).CONCLUSION: Both Losartan and Amlodipine effectively controlled hypertension of patients following kidney transplantation, but Losartan significantly decreased 24 h-proteinuria, serum and urine transforming growth factor-β_1 compared with Amlodipine.
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This paper retrospectively analyzed the clinical manifestation,diagnostic method,as well as the clinical treatment of 8 cases,who suffered complicated tuberculosis infection following renal transplantation.Of the 8 cases,2 cases showed blood Tb-Ab positive,1 case was positive to antiacid bacillus of sputum,the rest cases with negative TBAb.3 patients with 2 showed organs infection,6 patients passed the tissue biopsy diagnose,body temperature of 6 cases fall to normal after 3-7 days of antituberculotic treatment,mild liver dysfunction appeared in 2 patients,hyperuricemia occurred in 7 patients,in addition,1 patient developed reject reaction.Among all the cases,7 cases healed,1 died of pulmonary fungal infection.The result showed that minimal invasive tissue biopsy offers reliable basis for early diagnosis and treatment of disease.