Evaluation of living related kidney donors in China: policies and practices in a transplant center.

BACKGROUND: Rigorous donor evaluation is essential for living related donor kidney transplantation (LRDKT). However, guidelines for living kidney donor evaluation are absent in China. The aim of this study is to describe the initial experience in the living kidney donor evaluation process in a single transplant center in China. METHODS: The evaluation process of our center is sequentially divided into five steps: outpatient consultation and information, preliminary evaluation, comprehensive evaluation, final informed consent, and ethics committee oversight. RESULTS: Between June 2007 and March 2009, 124 potential living donors were evaluated in our center, of whom 82 (66.1%) became effective donors and the remaining 42 (33.9%) were excluded. The exclusion reasons were related to clinical problems in 27 cases, psychosocial problems in seven cases, and suspected organ trading in eight cases. CONCLUSION: Although strongly forbidden by Chinese laws, organ trading remains a threat to the healthy development of LRDKT in China. To prohibit organ trading, the kinship between the donor and recipient should be carefully identified. Guidelines for living donor evaluation appropriate to the actual situation in China should be set up for the sake of safety and to protect the rights and interests of both donors and recipients.

Psychosocial evaluation of Chinese living related kidney donors.

BACKGROUND: Although living kidney transplantation has numerous advantages over cadaveric transplantation, donor apprehension remains a problem. This study investigated psychosocial features and quality of life in Chinese living kidney donors after transplantation procedures. METHODS: Participants were 84 donors interviewed during follow-up after donation. Sociodemographic characteristics were evaluated by a 22-item questionnaire. Social support, quality of life, depression, and anxiety were objectively measured with the Social Support Rating Scale for Chinese, the Short-Form 36 Health Survey, the modified Beck Depression Inventory, and the Self-Rating Anxiety Scale questionnaire, respectively. RESULTS: All donors volunteered without pressure from families or recipients. Altruistic motives were the main impetus for donation, and donors had good social support. Living transplantation affected donors' quality of life, with a slight negative effect on some physical aspects. There were no major depressive or anxiety disorders following donation. CONCLUSIONS: Living kidney donation was a generally positive experience without evidence of major psychological disturbance. However, considering the limited size and duration of our study, we recommend careful follow-up of all donors. We also recommend provision of social support services and removal of financial disincentives for donors.

Experimental study on inhibitory effects of histone deacetylase inhibitor MS-275 and TSA on bladder cancer cells.

OBJECTIVE: To investigate the inhibitory effect of histone deacetylase (HDAC) inhibitors (MS-275 and TSA) on T24 human bladder cancer cells in vitro, and explore the possible mechanism. METHODS: The MTT assay was employed to evaluate the inhibitory effect of MS-275 and TSA on T24 cell growth. FCM was used to analyze the variation of T24 cell cycle distribution and the apoptotic ratio after T24 cells were treated with MS-275 and TSA. Histone acetylation level was detected by Western blot. mRNA expression of p21 WAF1/CIP1, cyclin A, and cyclin E was measured by FQ-PCR. Dynamic changes of Bcl-2 and bax expression were detected by FCM. RESULTS: MS-275 and TSA inhibited T24 cell growth in a concentration and time-dependent manner. Treatment with 4 µmol/l MS-275 or 0.4 µmol/l TSA blocked cell cycling in the G0/G1 phase and induced a significant increase in cell apoptosis. MS-275 and TSA significantly increased the level of histone acetylation, induced p21CIP1WAF1 mRNA expression, and inhibited cyclin A mRNA expression, though no significant effect was observed on cyclin E. Bcl-2 expression was down-regulated, while bax expression was up-regulated. CONCLUSION: HDAC inhibitors can block bladder cancer cell cycle in vitro and induce apoptosis. The molecular mechanism may be associated with increased level of histone acetylation, down-regulation of p21WAF1/CIP1 expression, up-regulation of cyclin A expression, and dynamic change of bcl-2 and bax expression.

A comparison of prediction equations for estimating glomerular filtration rate in Chinese potential living kidney donors.

BACKGROUND: Accurate measurement of donor renal function has important long-term implications for both donors and recipients. In clinical practice, renal function may be estimated by using 24-h urinary creatinine clearance (urine-CrCl) and various specifically derived prediction equations. We assessed the suitability of urine-CrCl and prediction equations for evaluating Chinese kidney donors. METHODS: A total of 224 donors who had undergone (99m)Tc-diethylenetriaminepentaacetic acid glomerular filtration rate (GFR) estimation were enrolled. We evaluated the performance of the Cockcroft-Gault equation (CG-CrCl), the CG-CrCl equation corrected for GFR (CG-GFR), the isotope dilution mass spectrometry traceable modification of diet in renal disease (IDMS-MDRD) study equation, the new MDRD study equation for Chinese (C-MDRD 1), the modified MDRD study equation with a Chinese coefficient (C-MDRD 2), the modified IDMS-MDRD study equation with a Japanese coefficient (J-MDRD), and urine-CrCl in predicting GFR before donation. RESULTS: Of 224 donors selected, 68 were male and 156 were female. Of all the prediction equations, C-MDRD 1 was the least scattered and most precise. However, predictive performance was poor for all the equations. CONCLUSION: The performance of urine-CrCl and all the equations was disappointing, and even the best performing equation C-MDRD 1 was unacceptable. Considering the potential risk of living kidney donation, other more accurate methods of GFR measurement should be used in clinical practice.