Clinical efficacy of extracorporeal membrane oxygenation on severe acute respiratory distress syndrome caused by Pneumocystis jersima pneumonia after renal transplantation / 中华器官移植杂志

Objective:To explore the clinical efficacy of venovenous extracorporeal membrane oxygenation(V-V ECMO)in patients with severe acute respiratory distress syndrome(ARDS)caused by Pneumocystis pneumonitis(PJP)after kidney transplantation(KT).Methods:Cal data of 9 KT recipients on V-V ECMO were retrospectively analyzed. Timing of V-V ECMO support, complications during treatment and V-V ECMO performance were summarized.Results:All 9 patients with confirmed PJP adopted V-V ECMO with oxygenation index of 25~92 prior to V-V ECMO and average time from admission to initiating V-V ECMO was 5.56(1~17)days. Except for one death from hemorrhagic shock due to abdominal hemorrhage, the remainders were successfully weaned. Another recipient died from sepsis after weaning and there were 7 survivors. V-V ECMO support time was 215.5 h among 8 successfully weaned recipients. Among 7 survivors, 1 had premorbid deterioration of graft function and no fatal complications occurred.Conclusions:V-V ECMO is an effective treatment for severe ARDS caused by P. pneumoniae post-KT. And its early application is recommended for reducing complications and improving patient prognosis.

The role of M2-type macrophages in interstitial fibrosis of kidney allograft / 中华器官移植杂志

Objective To investigate the role of M2-type macrophages in interstitial fibrosis of kidney allograft.Methods The degree of interstitial fibrosis in renal biopsy tissues was assessed by Masson staining.By immunohistochemical double staining method and image analysis system,the levels of CD163 and SMA expression were detected in the renal biopsy tissues of 30 cases of CAI and 10 cases of normal kidney.The soluble CD163 was determined in urine by double antibody sandwich enzyme-linked immunosorbent assay.Results There were statistically significant differences in the expression of CD163 and SMA between kidney allograft and normal kidney tissue (P＜0.05).With the increase in renal fibrosis severity,the levels of serum Cr,BUN and the expression of CD163 and SMA were increased (P＜0.05).There was a positive correlation between the CD163 expression and the levels of serum Cr (r =0.937,P =0.000),and between the expression of CD63 and the level of sCD163 in urine.Conclusion The abnormal high expression of M2 macrophages in chronic renal allograft injury was associated with the degree of interstitial fibrosis and renal insufficiency in patients.

Effect of the ratio of living related donor renal volume to recipient body surface area on early function of transplanted kidney / 器官移植

Objective To investigate the relationship between the ratio of living related donor renal volume (RV) to recipient body surface area (BSA) (RV/BSA) and early postoperative function of transplanted kidney. Methods Clinical data of 120 pairs of donors and recipients undergoing living related renal transplantation were retrospectively analyzed. According to the RV/BSA ratio, the recipients were divided into group A (RV/BSA<65.33 mL/m2), group B (RV/BSA 65.33~76.49 mL/m2), group C (RV/BSA 76.50~96.96 mL/m2) and group D (RV/BSA > 96.96 mL/m2). The postoperative estimated glomerular filtration rate (eGFR) of recipients was compared among 4 groups. The correlation between the RV/BSA and eGFR of recipients at postoperative 6 and 12 months was analyzed. Results The eGFR at postoperative 6 month in group A was significantly lower than that in groups B, C and D (t=2.313, 2.947, 5.903; all P<0.05). The eGFR at postoperative 12 month in group A was also significantly lower than that in groups B, C and D (t=2.189, 2.433, 2.909;all P<0.05). The RV/BSA was significantly correlated with the eGFR of recipients at postoperative 6 and 12 months (all P<0.05).Conclusions RV/BSA is intimately correlated with the early function of transplanted kidney after living related renal transplantation.

Prospective study of methylprednisolone and prednisone therapy for patients with pulmonary infection after renal transplantation / 实用医学杂志

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.

Efficacy and safety of single high-dose versus multiple low-dose ATG-Fresenius induction in de novo renal transplantation / 中华器官移植杂志

Objective To evaluate the efficacy and safety of single bolus high dose (SD group) ATG-Fresenius induction therapy in kidney transplantation vs.multiple low dose (MD group) administration.Methods A multiple center,prospective,randomized and controlled clinical study was performed on 280 de novo renal transplant recipients from 19 centers.Patients were randomized into 2 groups as follows:SD group,a single high dose (7-9 mg/kg) of ATG-F infused as an induction agent before the vessel anastomoses;MD group,2 mg/kg of ATG-F daily administrated in postoperative 4 days.All the patients accepted maintenance immunosuppressive protocol including tacrolimus,mycophenolate and prednisone.Patients were assessed and data were collected at regular schedule clinic visits on the day 1,3,7,14,30,90,180,270 and 365.The primary end point of efficacy was therapeutic failure rate [the number of death,grafts loss and acute rejection (AR)].The event first occurred should be used in the classification of patients.The non-inferiority evaluation of the two treatment regimens was done based on treatment failure rate.The secondary end points of efficacy were the incidence of AR,delayed graft function (DGF),1-year survival rate of patients and grafts,and serum creatinine at each visiting point.The indicators for safety evaluation included hemotologic variation and incidence of adverse events.Results The therapeutic failure rate in SD group was non-inferior to the MD group (17.24％ vs.23.08％).AR was the major cause of therapeutic failure and there was similar incidence of AR between SD gronp and MD group (12.07％ vs.21.37％).There was no significant difference in the incidence of DGF between SD group and MD group (12.07％ vs.6.84％,P =0.1721).The 1-year patient's survival rate and 1-year graft survival rate in SD group and MD group showed no significant difference (96.55％ vs.98.29％,P =0.6714;94.83％ vs 98.29％,P =0.2750).The serum creatinine level showed no significant differences between two groups at each visit point.There was also no significant difference in total incidence of adverse events between the two groups.In addition,there was also no statistically significant difference in the incidence of concerned and drug-related adverse events between the two groups,including infection,hemotologic abnormality,liver or renal dysfunction,gastrointestinal disorder,etc.After ATG--F administration,peripheral blood lymphocytes in the SD and the MD group immediately decreased but nearly restored to the normal level on the postoperative day 30 and 90 respectively.No severe granulocytopenia,erythropenia or thrombocytopenia occurred in both two groups.Conclusion The efficacy and safety of single high dose of ATG-F induction are non-inferior to multiple low dose ATG-F induction,moreover,single high dose of ATG-F induction is administered more conveniently and economically.

Experience of clinical efficacy of renal transplantation from donors of donation after brain death complicated with acute kidney injury / 器官移植

Objective To summarize the clinical efficacy of renal transplantation from donors of donation after brain death (DBD) complicated with acute kidney injury (AKI). Methods Fifty-nine DBD donors successfully undergoing renal transplantation were recruited in this investigation. According to the Scr level upon admission of intensive care unit (ICU), DBD donors were divided into the AKI group (n=14) and control group (n=45). A total of 101 recipients were assigned into the AKI group (n=23) and control group (n=78) correspondingly. The organ donation conditions of 59 donors were summarized. Main parameters of the donors before organ procurement were statistically compared between two groups. Postoperative kidney function, hospitalization condition and clinical outcomes of the recipients were statistically compared between two groups. Results Among 59 donors, 14 cases (24%) suffered from AKI. Two donors received continuous renal replacement therapy during organ maintenance. Compared with the donors in the control group, the APACHE Ⅱ score of the donors was significantly higher (P<0.05), the incidence of central diabetes insipidus was considerably higher (P<0.01), the Scr levels at admission of ICU and before organ procurement were significantly higher (both P<0.01) and the amount of urine at 24 h before organ procurement was dramatically less in the AKI group (P<0.01).Compared with the recipients in the control group, the Scr levels at postoperative 2 and 3 d were significantly higher (both P<0.05), the length of hospital stay was considerably longer (P<0.01) and the hospitalization expanse was significantly higher in the AKI group (P<0.05). No statistical significance was observed in the postoperative delayed recovery of renal graft function, incidence of acute rejection, infection and rehabilitation dialysis in the recipients between two groups (all P>0.05). At 3 months after transplantation, the recipients in two groups were discharged and the graft survival rate was 100%. Conclusions For renal transplantation from DBD donors complicated with AKI, active measures should be taken to maintain the organ and relieve the AKI, which yields similar clinical efficacy to renal transplantation from non-AKI donors and widens the origin of kidney graft.

Clinical analysis of mechanical perfusion in donor after cardiac death kidney transplantation / 中华器官移植杂志

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.

The guidance of urine concentration of chemokine IP-10 in clinical use of rabbit anti-human T-lymphocyte immunoglobulin / 实用医学杂志

Objective To investigate evaluation role of IP-10 level in urine of kidney transplant recipients when using rabbit anti-human T-lymphocyte immunoglobulin to treat acute cellular rejection.Methods A total of 40 patients who underwent renal transplantation and had been diagnosed as acute cellular rejection according to the results of histopathological examination were randomly divided them into IP-10 group (n =20) and serum creatinine group (Scr group,n =20).Urinary IP-10 and Scr levels were measured in time and patients then were treated with ATG,of which the doses and duration were adjusted according to IP-10 or Scr levels.We compared the total and daily ATG dosages,ATG administration period,side effects of ATG such as incidence of severe platelet and neutropenia,acute rejection during first 3 months and infection rates during first 1 year.Result The number of ATG duration is 5.35 ± 1.93 for IP-10 group versus 6.70 ± 1.75 for Scr group.We used a daily dose of 2.50 ± 0.57 mg/(kg·d) for IP-10 group and 2.77 ± 0.74 mg/(kg· d) for Scr group,a total dose of 13.40 ± 6.59 mg/kg for IP-10 group and 18.25 ± 7.35 mg/kg for Scr group.There was significance between the two group in above three outcomes (P ＜ 0.05).There was no significance in incidences of severe thrombocytopenia and neutropenia,incidences of acute rejection during first 3 months,incidences of infection during first 1 year between the two group (P ＞ 0.05).Conclusion Urine IP-10 test is effective and reliable indicators which can guide ATG usage in patients with acute rejection and reduce the ATG cost.

Effect of living-related donor renal transplantation with mild renal arterial stenosis on early renal function and postoperative complication in recipients / 器官移植

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.

Clinical effect of treating renal transplant recipients with percutaneous coronary intervention and its safety

Objective: To explore clinical effect of treating acute coronary syndrome [ACS] of renal transplant recipients with percutaneous coronary intervention and its safety

Methods: Forty two renal transplant recipients who were diagnosed with acute coronary syndrome and received percutaneous coronary intervention [PCI] in our hospital were selected. Serum creatinine [Cr] and glomerular filtration rate [GFR] were compared before surgery, 48 [tilde] 72 hour after surgery and one year after surgery. All patients were followed up

Results: All patients successfully completed PCI. Contrast-induced nephropathy was not found after surgery. Cr and GFR 48 [tilde] 72 hour after surgery and one year after surgery had no significant differences with that before surgery [P>0.05]. The follow up lasted for [61.2 +/- 32.2] months averagely. Of 42 cases, 4 cases died, 6 cases were found with nonfatal myocardial infarction, 4 cases were observed with repeat revascularization and 12 cases had accumulative major adverse cardiovascular events [MACE]

Conclusion: PCI is proved to be effective in treating renal transplant recipients; no severe complications are found and renal function recovers well after treatment

Clinical significance of quantitative and qualitative detection of BK and JC virus in blood and urine of renal transplantation recipients

Objective: To evaluate value of quantitative and qualitative detection of BK virus [BKV] and JC virus [JCV] in timely diagnosing polyomavirus-associated nephropathy [PVAN] occurring inrenal transplantation recipients

Methods: We collected 306 cases of urine specimen and 310 cases of blood specimen from 306 patients who underwent renal transplant. Levels of BKV and JCV in blood and urine were detected using real-time quantitative polymerase chain reaction [PCR]

Results: Detection rate of BKV DNA was 33.3% [102/306] in urine and 34.8% [108/310]; while that of JCV DNA was 30.7% [94/306] and 33.5% [104/310] respectively. The lowest detectable limit of BCK and JCV detection for patients who underwent renal transplant was 2×10[3] copies/ml, suggesting high specificity and sensitivity

Conclusion: Real-time quantitative PCR is able to monitor BCV and JCV in renal transplant recipients in a convenient and rapid way, thus it is beneficial for early discovery, diagnosis and treatment of PVAN

Interventional treatment of transplant renal artery rupture of donation after citizens death: report of 4 cases / 中华器官移植杂志

Objective To explore the characteristics and effects of interventional therapy of transplant renal artery rupture of donation after citizens death (DCD).Method Among 28 cases of DCD renal transplantations (from February 2012 to December 2013),the transplant renal artery rupture occurred in 4 cases.Vascular complications were treated with the guide wires to place stents in the pseudoaneurysms or bleeding period.Result Pseudoaneurysms occurred in 2 cases,and they were successfully discharged after interventional treatment.In the rest two patients,the artery residual ruptured and bled after the nephrectomy,and they recovered after interventional treatment to stop bleeding.Conclusion For kidney transplant recipients,the DCD postoperative infection is risky.Some transplant kidneys have local infection and erosion of renal artery,which causes arterial hemorrhage.The interventional treatment of transplant renal artery pseudoaneurysms and rupture bleeding has the advantages of small trauma and instant effect,and can be used as an alternative treatment of open surgery.

Mucoraceae infection lead to the pseudoaneurysms following renal transplantation: a report of 2 recipients with the same donor after cardiac death / 中华器官移植杂志

Objective To analyze the diagnosis and treatment of iliac pseudoaneurysms following renal transplantation.Method The data of two patients with pseudoaneurysm who underwent kidney transplantation were retrospective analysied.Result One case with pseudoaneurysm received transplant nephrectomy,and pathological examination diagnosed mucoraceae infection; the other patient received endovascular treatment and amphotericin B therapy,endly died of hemorrhagic shock.Conclusion The development of pseudoaneurysms at the kidney transplantation recipients with the same donor results in high rates of mucormycosis.They should take anti-fungus therapy and operation as early as possible.

Horsetail mixture on rheumatoid arthritis and its regulation on TNF- alpha and IL-10

Taking autoimmune inflammation of rheumatoid arthritis as entry point, this paper discussed the clinical effect of horsetail mixture on rheumatoid arthritis [RA] and its mechanism. A total of 60 cases of patients with RA were randomly divided into experimental group and control group using randomized controlled trial. We observed its biochemistry, TNF- alpha and IL-10 before and after treatment, and then systematically assessed the clinical effect of horsetail on RA. Results showed that the total effective rate of experimental group was 80%, while that of control group was 16.67%. After statistical treatment, the differences between two groups were significant [p>0.05]. Comparison of the difference value of TNF-alpha [p<0.05] and IL-0.05 in serum between groups before and after treatment, there were significant differences. Comparison of CRP within group before and after treatment was significant different [p<0.05], while comparison of CRP between groups was not significantly different [p<0.05]. Comparison of ESR and RF within group before and after treatment was significantly different [p<0.01], and comparison of them between groups was also significantly different [p<0.05]. Comparison of difference values within group before and after treatment were also significantly different [p<0.01]. It was concluded that horsetail mixture has remarkable curative effect on rheumatoid arthritis, and its clinical application is safe and reliable. It has obvious down regulatory effect on cell factor TNF- alpha related to RA, that is, it can down regulate the level of pre-inflammatory factor TNF- alpha as well as the level of anti-inflammatory factor IL-10. Therefore, it is considered that the regulating effect of horsetail mixture on TNF- alpha and IL-10 is one of the mechanisms of its treatment on RA

Alprostadil promotes the early recovery of transplanted renal function / 中国组织工程研究

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.

Correlation of tacrolimus blood concentration and the levels of blood lipid and fasting glucose after renal transplantation / 中华器官移植杂志

Objective To study the implact of tacrolimus blood concentration (Tac) after renal transplantation on blood lipid and fasting glucose (FBG) in recipients.Method The recipients who regularly given Tac + mycophenolate mofetil + prednisone after renal transplantation were chosen and those had normal preoperative levels of blood lipid and fasting glucose as subjects.The recipients were classied into high concentration group,normal concentration group and low concentration group by comparing Tac blood concentration of different postoperative periods with corresponding normal concentration range.The changes of biochemical indexes such as steady Tac valley blood concentration,blood lipid and FBG were monitored,and the differences in blood lipid and FBG levels at different periods among three concentration groups were compared.Result TG level was significantly higher (P＜0.05),and HDL-C level was significantly lower in high concentration group than in normal and low concentration groups one month after operation (P＜0.05).Three months after operation,TG and FBG levels were significantly higher in high concentration group than in normal and low concentration groups (P＜0.05 and 0.01,respectively).Six months after operation,TC,TG and FBG levels were significantly higher in high concentration group than in normal and low concentration groups (P＜0.05,0.01 and 0.05,respectively).There was no significant difference between normal and low concentration groups in various biochemical indexes at any time point (P＞0.05).Conclusion The higher blood concentration of Tac and the longer used after renal transplantation,the easier it might cause drug-induced hyperlipidemia and diabetes.

Application of HRRT in delayed graft function after kidney transplantation / 中华器官移植杂志

Objective To observe the effect of hybrid renal replacement therapy (sustained lowefficiency hemodiafiltration) in recipients with delayed graft function (DGF) after kidney transplantation.Methods In 33 kidney transplant patients with DGF,there were 15 cases subject to sustained low-efficiency hemodiafiltration (SLEDF group),18 cases subject to hemodialysis (HD group).The renal function was tested,and the expression levels of complements C3,C4,and CRP,IL-1β,IL-6,TNF-α were detected before and after therapy.Results In SLEDF group,the renal function recovered in (29 ± 13) days after therapy,and in (47 ± 21) days in HD group.After therapy,the BUN and Scr in both two groups were lower than before (P＜0.01).After therapy,the levels of IL-1β,IL-6 and TNF-α were also lower than before in two groups,and the levels were lower in SLEDF group than in HD group (P＜0.05).The levels of complements C3,C4,and CRP in two groups were decreased after therapy,but there was no statistically significant difference (P＞0.05).Conclusion SLEDF can decrease the level of SCr,BUN and some cytokines in recipients effectively,and It's helpful to recovery of the renal function.SLEDF can be used by DGF recipients in transit time.

Correlation of urine monocyte chemoattractant protein-1 and acute rejection after renal transplantation / 中国组织工程研究

BACKGROUND: Presently, acute rejection following renal transplantation remains a risk factor for chronic rejection and graft function injury, How to non-invasive, rapid and exact diagnosis and prompt treatment is important. OBJECTIVE: To investigate early diagnosis and post-treatment expression of urine monocyte chemoattractant protein-1 (MCP-1) in the acute rejection after renal transplantation, through detecting the association of the urine MCP-1 variation according to some cases of nephridial tissue biopsy. METHODS: We selected 62 chronic renal failure patients who received renal homotransplantations in the Department of Renal Transplantation of Zhengzhou People's Hospital from October 2008 to February 2009. The stable renal function group contained 42 patients with stable renal function following renal transplantation. Acute rejection group contained 20 patients with acute rejection following renal transplantation. We chose 10 patients who examined no abnormalities in the Medical Examination Center of Zhengzhou People's Hospital to detect their urine sample as control group. All patients following renal transplantation underwent conventional immunosuppression. In addition, patients in the acute rejection group were treated with antilymphocyte globulin or methylprednisolone reinforced impact therapy. MCP-1 mass concentration changes were measured by double antibodies sandwich enzyme linked immurosorbent assay. RESULTS AND CONCLUSION: Compared with control group, no significant change was determined in urine MCP-1 mass concentration in the stable renal function group (P > 0.05). The urine MCP-1 mass concentration was significantly increased in the acute rejection group (P< 0.01). Compared with pretreatment, urine MCP-1 mass concentration was significantly decreased following treatment in 20 patients from the acute rejection group (P < 0.01). Of them, 17 cases had relieved clinical symptom, and normal auxiliary examination, and their urine MCP-1 mass concentration was close to the control group; 3 cases were inefficient, whose urine MCP-1 mass concentration was greater than the control group. Eight cases received nephridial tissue biopsy, and kidney pathology demonstrated acute rejection of transplanted kidney, which was similar to urine MCP-1 mass concentration in the acute rejection group prior to treatment (P > 0.05). These indicated that the level of MCP-1 in urine can non-invasively diagnose acute rejection following renal transplantation in an early phase, and monitor therapeutic efficacy. This may be associated with renal pathological injury during acute rejection following renal transplantation.