Reductive dechlorination of DNAPL mixtures with Fe(II/III)-L and Fe(II)-C: Evaluation using a kinetic model for the competitions.

A kinetic model for the competitions was applied to understand the reductive dechlorination of tertiary DNAPL mixtures containing PCE, TCE, and 1,1,1-TCA. The model assumed that the mass transfer rates were sufficiently rapid that the target compounds in the solution and the DNAPL mixture were in phase equilibrium. Dechlorination was achieved using either a mixture of Fe(II), Fe(III), and Ca(OH)2 (Fe(II/III)-L) or a mixture of Fe(II) and Portland cement (Fe(II)-C). PCE in the DNAPL mixtures was gradually reduced and it was reduced more rapidly using Fe(II)-C than Fe(II/III)-L. A constant total TCE concentration in the DNAPL mixtures was observed, which implied that the rate of loss of TCE by dechlorination and possibly other processes was equal to the rate of production of TCE by PCE dechlorination. On the other hand, 1,1,1-TCA in the DNAPL mixtures was removed rapidly and its degradation rate by Fe(II/III)-L was faster than by Fe(II)-C. The coefficients in the kinetic model (ki, Ki) were observed to decrease in the order 1,1,1-TCA>PCE>TCE, for both Fe(II/III)-L and Fe(II)-C. The concentrations of target compounds in solution were the effective solubilities, because of the assumption of phase equilibrium and were calculated with Rault's Law. The concentration changes observed were an increase and then a decrease for PCE, a sharp and then gradual increase for TCE, and a dramatic decrease for 1,1,1-TCA. The fraction of initial and theoretical reductive capacity revealed that Fe(II)-C had ability to degrade target compounds.

Desensitization Using Bortezomib and High-dose Immunoglobulin Increases Rate of Deceased Donor Kidney Transplantation.

Combination therapy of intravenous immunoglobulin (IVIG) and rituximab showed a good transplant rate in highly sensitized wait-listed patients for deceased donor kidney transplantation (DDKT), but carried the risk of antibody-mediated rejection. The authors investigated the impact of a new combination therapy of bortezomib, IVIG, and rituximab on transplantation rate.This study was a prospective, open-labeled clinical trial. The desensitization regimen consisted of 2 doses of IVIG (2  g/kg), a single dose of rituximab (375  mg/m), and 4 doses of bortezomib (1.3  mg/m). The transplant rate was analyzed. Anti-Human leukocyte antigen (HLA) DRB antibodies were determined by a Luminex solid-phase bead assay at baseline and after 2, 3, and 6 months in the desensitized patients.There were 19 highly sensitized patients who received desensitization and 17 patients in the control group. Baseline values of class I and II panel reactive antibody (%, peak mean fluorescence intensity) were 83  ±â€Š 16.0 (14952  ±  5820) and 63  ±  36.0 (10321  ±  7421), respectively. Deceased donor kidney transplantation was successfully performed in 8 patients (42.1%) in the desensitization group versus 4 (23.5%) in the control group. Multivariate time-varying covariate Cox regression analysis showed that desensitization increased the probability of DDKT (hazard ratio, 46.895; 95% confidence interval, 3.468-634.132; P = 0.004). Desensitization decreased mean fluorescence intensity values of class I panel reactive antibody by 15.5% (20.8%) at 2 months. In addition, a liberal mismatch strategy in post hoc analysis increased the benefit of desensitization in donor-specific antibody reduction. Desensitization was well tolerated, and acute rejection occurred only in the control group.In conclusion, a desensitization protocol using bortezomib, high-dose IVIG, and rituximab increased the DDKT rate in highly sensitized, wait-listed patients.