ABSTRACT
INTRODUCTION: The aim of this study was to evaluate the plasma levels of hypoxanthine (HX) and xanthine in the renal vein blood samples for prediction of delayed graft function (DGF). MATERIALS AND METHODS: Two blood samples were taken from 47 kidney recipients, intraoperatively. The first sample was obtained from a peripheral vein before vascular anastomosis and the second from the allograft renal vein, 15 minutes after the anastomosis. Purine metabolites including xanthine and HX were measured and their associations with operative time, anastomosis time, frequency of clamping, urine output, and DGF were evaluated. RESULTS: The mean levels of xanthine and HX were 0.12 +/- 0.10 mg/L and 0.37 +/- 0.17 mg/L in the first plasma samples, respectively. Thirty patients (63%) had no significant changes in neither of their purine metabolite levels and 17 (37%) had higher levels of HX, but not xanthine, in their second samples. Only anastomosis time had a significant relation with the level of the metabolites (P = .04). Three patients (10%) with no changes in the metabolites and 5 (29.4%) with higher HX levels had DGF (P = .12). The anastomosis time and frequency of vascular clamping were higher and the urine output after the anastomosis was lower in the patients with DGF. CONCLUSION: Cold ischemia in kidney transplantation causes a mild increase in the HX concentration indicative of short-term ischemia effects on the cell metabolism. But it cannot predict DGF. Anastomosis time, frequency of clamping, and urine output after the anastomosis are more sensitive indices.
ABSTRACT
INTRODUCTION: Our aim was to evaluate the overexpression of p53 protein, product of mutated TP53 gene, in histologic sections of the kidneys with renal cell carcinoma (RCC) and its association with tumor grade and subtype. MATERIALS AND METHODS: A total of 66 histologic sections of the kidneys of patients with the diagnosis of RCC were re-evaluated and tumor grade, tumor subtype, and p53 expression were determined. RESULTS: Of the total 66 histologic sections with the diagnosis of RCC, 34 (51.5%), 27 (41%), and 5 (7.5%) were conventional, papillary, and chromophobe subtypes, respectively. Fifty-one (77.3%), 14 (21.2%), and 1 (1.5%) of tumors were grade 2, 3, and 4, respectively. Thirty (45.4%) sections were positive for p53 immunohistochemical staining. In 7 cases (20.6%) of the conventional tumors, p53 staining was positive, while 18 papillary (66.6%) and 5 chromophobe tumors (100%) had a positive staining for p53 (P < .001). Seventeen out of 51 grade 2 tumors (33.4%) and 12 out of 14 grade 3 tumors (85.7%) were positive for p53. The single case of grade 4 tumor was positive for p53 protein, too (P = .001). CONCLUSION: Increased expression of p53 protein is rather prevalent in RCC. This factor is associated with tumor grade and subtype. According to our findings, it is generally accompanied by nonconventional subtypes and higher tumor grades.
