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Objective To analyze the curative effect of simultaneous liver and kidney transplantation (SLKT) for patients with end-stage liver and kidney diseases and liver cirrhosis patients with hepatorenal syndrome.Methods All SLKTs (n=21) performed at our center from January 1999 to December 2010 were reviewed and SLKT outcomes were compared with those of kidney transplantation (KT) (n=609) and liver transplantation (LT) (n=133) performed during the same period.Results There were 3 deaths due to infection 2 weeks, 6 months and 5 years respectively after operation. One patient died due to multiple organ dysfunction syndrome 2 weeks after operation. One patient was dead 5 years after operation because of rejection. MELD level between SLKT and LT had no significant difference, but serum creatinine in SLKT group was significantly higher than in LT group (516.0±329.9 vs 111.4±138.1 mmol/L, P<0.01). The 1-year acute kidney rejection rate and rate of delayed graft function (DGF) of the kidney had no significant difference between SLKT group (0 vs 9.5 %) and KT group (6 % vs 17.3 %). There was no significant difference in one-, 3- and 5-year patient survival rate between SLKT group (87.7 %, 67.8 % and 67.8 %) and LT group (84.2 %, 73.5 % and 69.4 %).Conclusion SLKT is a safe and effective treatment for end-stage liver and kidney diseases.
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OBJECTIVES:To evaluate the efficacy of rapamycin(RPM)oral liquid plus cyclosporine(CsA)on the preven?tion of early acute rejection after renal allograft.METHODS:20patients undergoing primary renal allografting were randomly divided into RPM trial group and Azathioprine(Aza)control group,10cases in each group,who were respectively assigned to receive CsA and adrenocortial hormones-based immunosuppression for6months,indexes including survival rates of recipients/kidneys,incidences of acute rejection and adverse reactions between2groups were compared.RESULTS:For the17patients who had finished6-month treatment,the survival rates(recipients/kidneys)were100%.Only2episodes of acute rejection occurred in one case in Aza group.Both groups had2cases of severe adverse episodes.CONCLUSIONS:The combined therapy pf RPM plus CsA is effective in the prevention of acute renal allograft rejection,and it can maintain renal function at a good level.Nevertheless,it may increase the hepatotoxicity of CsA.
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Objectives: To investigate the effect of the addition of glutamine to WMO solution on the small bowel preservation. Methods:According to preservation solutions, the rats were divided randomly into three groups: University of Wisconsin solution(UW group), WMO solution (WMO group) and WMO solution with the addition of glutamine(WMO G group). And each group was redivided into two subgroups in terms of preservation time of 8 h or 12 h. The intestine was perfused by intubation via abdomial aorta, then the gut was flushed with metronidazole solution(4℃,5%). The proliferation of small intestine was observed through tissue culture. The histology, immunohistochemistry (TUNEL, PCNA) of intestinal mucosa and determination of ATP were used to evaluate the results. Results: Compared with UW group and WMO group, ATP contents of WMO G group were significantly higher, particularly in 12 h subgroup. Apoptosis in WMO G group was slighter than those in UW group and in WMO group. The difference in the two latter was not obviously, although pathological change in UW group was slighter than that in WMO group. The number of positive PCNA cells in WMO G group was more than that in other groups. Conclusions: The addition of glutamine to WMO solution could decrease injury of small bowel induced by cold ischemia, provide energy for the small bowel,and promote the proliferation of small bowel mocosal cell.
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Glutamine is a conditional essential amino acid. It has many biological functions. It can promote the proliferation of immunologic cell. The common factor is the NADPH which is produced during the metabolism of glutamine.