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Objective To compare the Panel reactive antibody (PRA) producing incidence in living and cadaveric transplant for forecasting long term survival. Methods Retrospectively analyze post-transplant PRA of 48 living transplant patients ( December 2003-Sepdtember 2007 ), and 258 cadaveric transplant patients( Feburary 2003-June 2007 ), which in both groups were all PRA negative in pre-transplant. PRA was detected using LAT-1240 (OneLambda) and QUICKSCREE&BSCREEN (GTI). Serum creatine/urea nitrogen level was provided by clinical laboratory. Results Four recipients in 48 living transplant patients showed PRA positive(8.33% ), while 62 receipients in 258 cadaveric transplant patients showed PRA positive(24.03% ) ( P ＜0.05 ). Three recipients in 35 male living donor transplant patients showed PRA positive(8.57% ) ,while 23.03% PRA positive in male cadaveric transplant patients (P ＜0.05). In females, 1out of 13 living donor transplant patients showed HLA-Ⅱ positive, whereas 20 out of 106 in cadaveric transplant patients( 18.87% ) ( P ＜ 0. 05). Conclusion The incidence of HLA antibody production was much higher in cadaveric transplant patients than that in those of living donor transplant.
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OBJECTIVES: We describe the results of over one hundred nephrectomies performed using a subcostal mini incision. INTRODUCTION: A major effort has been undertaken to encourage living donor renal transplantation. New techniques that use minimally invasive approaches to perform donor nephrectomy have been progressively accepted. Among these new procedures is the mini-incision approach. METHODS: We prospectively analyzed one hundred and seventeen consecutive donors that were subjected to subcostal mini-incision nephrectomy at a single center. Surgical time, warm and cold ischemia time, intraoperative complications, time until hospital discharge, presence of infection, bleeding, the need for a second operation, and death were analyzed. Eventual loss of donor renal function was indicated by increases in serum creatinine and proteinuria. RESULTS: The mean time of surgery was 180.5 ± 26.2 minutes. The mean warm ischemia time was 93 ±8.3 seconds, while the mean cold ischemia time was 85.9 (±23.5) minutes. We had one case with an intraoperative complication, and only two patients required another operation. An intra-abdominal abscess occurred in one patient (0.85 percent), proteinuria occurred in one patient (0.85 percent), and a transitory increase of creatinine levels occurred in two patients (1.7 percent). DISCUSSION: Reducing the length of the abdominal incision did not influence surgical time or result in an increase in intraoperative complications relative to our historical data or literature reports. Organ preparation was accomplished successfully with a brief warm ischemia time. Additionally, the mean hospital stay was short, and few surgical complications occurred. CONCLUSION: The use of a subcostal mini incision is both safe and similar to conventional techniques previously described in the literature.