En Bloc Kidney Transplantation from Pediatric Cadaveric Donors to Adult Recipients

The shortage of cadaveric donors for kidney transplantation has led to the expansion of the criteria used for donor selection, such as the use of pediatric cadaveric donors. In this study we reviewed our results of en bloc kidney transplantation of pediatric cadaveric donors to adults. From May 2001 to May 2005, 245 cadaveric kidney transplants have been performed in our hospitals. Seven of these were en bloc kidney transplantations in adult recipients from marginal pediatric donors [age < 5 years, donor weight < 15 kg, high creatinine clearance, or kidney length < 8 cm]. We reviewed their records. Follow-up [range, 3 to 24 months] included ultrasonography, dimercaptosuccinic acid renal scintigraphy, and magnetic resonance imaging. Serum levels of creatinine ranged between 0.8 m/dL to 1.9 mg/dL during the follow-up period. One patient died of myocardial infarction 3 months postoperatively. One-year graft and patient survivals were both 85.7%. Complications included acute tubular necrosis in 1 patient [managed by conservative therapy and dialysis for 2 weeks], renal vein thrombosis in 1 [treated by anticoagulation], and subcutaneous hematoma in 1. There were no urologic complications. Median size of the grafts was 7.2 cm preoperatively that reached 9.6 cm, 3 months postoperatively [P =.018]. Twelve months following operation, the median size of the grafts reached 11 cm [P =.045]. En bloc pediatric kidney transplantation is a safe and suitable alternative for adult recipients. One-year graft and patient survivals are acceptable and complication rate is low

p53 protein in serum and urine samples of patients with bladder transitional cell carcinoma and its overexpression in tumoral tissue

The aim of this study was to evaluate the levels of p53 protein in serum and urine samples of patients with bladder transitional cell carcinoma [TCC] and their relation with the overexpression of p53 in the tumoral tissue. A total of 39 patients with bladder TCC were evaluated for p53 protein in their serum and urine samples and the overexpression of this marker in their tumoral tissue. Of 39 patients with bladder TCC, 29 [74.4%] had tissue specimens positive for p53 protein overexpression, 20 [51.3%] had p53 protein in their serum samples, and 27 [69.2%] had this protein in their urine samples. A positive immunohistochemical finding was more common in higher grades of the bladder tumor [P = .03], but not in higher stages [P = .07]. Eighteen of 20 patients [90%] with a positive serum for p53 showed protein overexpression in the tumoral tissue of the bladder [P = .03]. Of 27 patients with a positive urine sample, 25 [92.6%] had p53 overexpression in their bladder tissue, and of the remainder 12 patients with a negative p53 protein in their urine samples, 8 [66.7%] had no evidence of p53 protein overexpression in their tumoral tissue [P < .001]. The grade and stage of tumor had no correlation with serum or urinary p53. According to our findings, a positive serum or urine sample for p53 protein is highly associated with the overexpression of p53 protein in the tumoral tissue of patients with bladder TCC