Renal allograft preservation: a comparison of University of Wisconsin solution and of hypothermic continuous pulsatile perfusion.

A study was performed to compare early allograft function in kidneys preserved with University of Wisconsin (UW) solution to kidneys preserved by hypothermic pulsatile perfusion. The study consisted of two sets of data. The first set was a donor-paired study (matched data) of 30 heart-beating, hemodynamically stable donors. After removal from the donor each cooled kidney was individually prepared for preservation. One kidney was flushed with +/- 500 ml of UW solution and stored in UW solution on slushed ice. The other kidney was continuously perfused with cooled (4-6 degrees C) cryoprecipitated plasma. The kidneys were transplanted into suitable recipients in a random sequence. Twelve donors were excluded from the study because one or both kidneys were transplanted into recipients who had previously been transplanted. The remaining 36 kidneys were implanted into two similar groups after a mean of 19 hours in the pulsatile perfusion group and 18 hours in the UW solution group. The second set of data consisted of all the kidneys preserved in UW solution (n = 62) at our institution and of 57 kidneys preserved by hypothermic continuous pulsatile perfusion during the same period (mixed data) and was used to evaluate the effect of prolonged preservation (longer than 24 hours) on delayed graft function. Both of these groups were also comparable. Acute tubular necrosis (ATN) was defined as the need for dialysis during the 1st week after transplantation, and delayed function as the delayed clearance of creatinine during the early post-operative phase.(ABSTRACT TRUNCATED AT 250 WORDS)

A review of carcinoma of the colon and rectum over a 3-year period at Hillbrow Hospital, Johannesburg.

Fifty-one patients with adenocarcinoma of the large bowel seen at Hillbrow Hospital over a 36-month period are reviewed. The mean age at diagnosis was 53 years. Advanced disease was present in at least 60%. Carcinoma of the rectum constituted 48% and colonic carcinoma 52%. Cancer and polyps of the large bowel in urban blacks are no longer a rarity in urban hospitals.

Spontaneous closure of a gastrocolic fistula. A case report.

A medically unit elderly man who had documented healing of a gastrocolic fistula with conservative measures only is described. Only 5 such cases have previously been reported. Closure without surgery is a rare event and, in this case, was most probably aided by withdrawal of non-steroidal anti-inflammatory agents.

Intrapericardial herniation. A report of 2 cases.

Traumatic intrapericardial rupture is an infrequent occurrence and often associated with other fatal injuries. Two cases of delayed presentations of central tendon defects and intrapericardial herniation after blunt trauma to the chest and abdomen are reported.

Subxiphoid pericardial windows--helpful in selected cases.

There is a small group of patients who sustain multiple penetrating injuries who present with haemodynamic changes, making it difficult to clinically exclude or prove the presence of penetrating cardiac injury. It is in this select group of patients that we found subxiphoid pericardial windows to be extremely useful to prove or disprove the existence of a cardiac injury and thereby prevent a delay in diagnosing these injuries.