Renal transplantation with kidneys procured from cardiac deceased post-liver transplantation donor: 2 cases report and literature review / 中南大学学报(医学版)

OBJECTIVE@#To better understand the pre-operation evaluation of donor kidneys from extended criteria donation after cardiac death and to improve the management during and after renal transplantation.@*METHODS@#Both of the donor kidneys were from the donor who underwent liver transplantation 5 years ago in the Center of Organ Transplantation of Central South University. The donor was admitted because of liver function deterioration which led to hepatic coma, brain death, hepatorenal syndrome and cardiac death sequentially. Deceased donor score (DDS) and "zero point" kidney biopsy were applied to evaluate the donor kidney. After thorough examination of the donor and the renal function, renal transplantation was performed on 2 recipients.@*RESULTS@#The recipients were followed up by 6 months, both of whom developed pulmonary infection and relieved after treatments. The kidney grafts functioned well and no surgical complication and no acute rejection occurred during the follow-up.@*CONCLUSION@#Proper evaluation of the donor organs ensures the safety of renal transplantation with kidneys from cardiac death donors who underwent liver transplantation, which is an important way to increase the number of organs for transplantation, yet the long-term effects need further observation.

Effect of extracorporeal shock-wave lithotripsy on residual stones after different methods of surgery / 中南大学学报(医学版)

Objective To observe the effect of extraeorporeal shock wave lithotripsy (ESWL) on residual stones after different methods of surgery. Methods Clinical resources of 100 patients with residual stones after different methods of surgery treated with extracorporeal shock wave lithotripsy from May 2006 to May 2008 were retrospeetively studied. Of the 100 patients, ureteroscopic laser lithotripsy was used for 15 patients (Group Ⅰ) , ureteroscopic pneumatic lithotripsy was used for 25 (Group Ⅱ), mini-percutaneous nephrolithotomy (MPCNL) with holmium laser for 11 (Group Ⅲ), mini-percutaneous nephrolithotomy (MPCNL) with airpressure path lithotripterfor 12 (Group Ⅳ) , open surgery for the other 37 (Group Ⅴ). Results About 94% of the residual stones were shattered, and 86 % of the residual stones were cleared successfully. The clearance rate of residual stones from Group Ⅰ to Ⅴ was 100% , 100% , 81.8% , 83.3% , and 73.0% , respectively. The clearance rate of residual stones in Group Ⅰ + Ⅱ was higher than that of Group Ⅲ + Ⅳ and Group V (P<0.05). Conclusion Extracorporeal shock wave lithotripsy is good for the treatmentof residual stones after different methods of surgery, especially the management of residual stones after trans-urethral ureteroscope technique.