[Who may place the first donor heart? Conflict surrounding the first heart transplant in the Netherlands]. / De strijd rond het primaat van de eerste harttransplantatie in Nederland.

On Friday 22 June 1984 a patient was waiting in Rotterdam to be moved to Brussels for a heart transplant. The Dutch heart surgery centres tried to mutually agree on the place where the first heart transplant should be performed. When this proved impossible, the decision was made by the cardiac surgeons from Rotterdam and Leiden. In this article we will reconstruct the events that took place at that time, partly on the basis of a recent 'witness seminar'.

Earthquakes and crush syndrome casualties: lessons learned from the Kashmir disaster.

Major earthquakes may provoke a substantial number of crush casualties complicated by acute kidney injury (AKI). After the 1988 Armenian earthquake, the International Society of Nephrology (ISN) established the Renal Disaster Relief Task Force (RDRTF) to organize renal care in large disasters; this approach proved to be useful in several recent disasters. This paper depicts the organizational aspects of the rescue intervention during the Kashmir earthquake, in 2005. Specific problems were fierce geographic circumstances, lack of pre-registered local keymen, transportation problems, and inexperience of local teams to cope with problems related to mass disasters. Once treatment was installed, global outcomes were favorable. It is concluded that well-organized international help in renal disasters can be effective in saving many lives, but still necessitates conceptual adaptations owing to specific local circumstances.

Evaluation of the peritoneal membrane function by three letter word acronyms: PET, PDC, SPA, PD-Adequest, POL: what to do?

This paper describes and reviews different methods to evaluate the peritoneal transport capacity. This evaluation is important because it will influence the preferred treatment regimen, and will also be a tool for longitudinal follow up both in the individual patient as in patient groups.

Resection of abdominal aortic aneurysm in a patient with left-sided inferior vena cava and horseshoe kidney.

The presence of vascular and renal anatomical anomalies can create technical problems during abdominal aortic surgery and may give rise to serious intraoperative complications. We present a case of an abdominal aortic aneurysm resected in a patient with the extremely rare coexistence of a left-sided inferior vena cava and horseshoe kidney. The diagnosis of the anomalies was made prior to aortic surgery. CT-scan of the abdomen was the most accurate preoperative investigation. Aortic surgery was performed through a transperitoneal approach which allowed easy access to the aneurysm despite the presence of the left-sided inferior vena cava and horseshoe kidney. Recognition of vascular and renal anomalies on preoperative imaging studies is important in the surgical treatment of abdominal aortic aneurysms. If possible anomalies are recognized in time and treated correctly, the morbidity and mortality of aneurysm repair should not be influenced.