Effect of transfusion of donor on allograft survival.

It has been reported by two European transplant centers that blood transfusion of cadaver donors with third-party blood prior to nephrectomy increases renal allograft survival rates by approximately 30% at 1 year. A retrospective analysis in our center was performed on 293 kidney recipients, 110 of whom received kidneys from untransfused donors. Actuarial analyses revealed no significant differences in graft survival rates between all nontransfused donor kidneys and all transfused donor kidneys. Considering only first transplant recipients, there was no difference in graft survival rates between nontransfused donor kidneys and transfused donor kidneys. In addition, when only preoperatively transfused recipients receiving first transplants were examined, there was no difference in graft survival rates between nontransfused donor kidneys and transfused donor kidneys. Animal studies were performed with (Lewis x Brown Norway)F1 (LBNF1) hybrid rat hearts transplanted heterotopically to the abdomens of Lewis rat recipients. Six LBNF1 heart grafts had a mean survival time of 8.0 +/- 1.1 days. Five LBNF1 rats received 2 ml of heparinized whole blood from Charles River (CD) rats 24 hr before heart transplantation to Lewis recipients. The transfused LBNF1 grafts had a mean survival time of 6.6 +/- 0.9 days. Therefore, donor blood transfusion does not appear to prolong graft survival in this retrospective human study or in the animal model.

Effect of duodenal cooling on small intestinal pacing.

The aim of this study was to determine whether mid-duodenal cooling would decrease the frequency of the pacesetter potentials in the distal duodenum and so facilitate pacing of the distal duodenum by electrical stimuli. Stepwise cooling of the mid duodenum of four awake dogs from 38 degrees to 4 degrees C decreased markedly the frequency of the distal duodenal pacesetter potentials (mean +/- SEM, 19.7 +/- 0.6 versus 13.6 +/- 0.4 cycles/min, P less than 0.05). Moreover, during cooling, electrical pacing near the ligament of Treitz increased the frequency of the pacesetter potentials in the distal duodenum and reversed their direction of travel from caudad to orad. The maximum driven frequency was progressively slowed as the mid duodenum was cooled from 38 degrees to 4 degrees C (20.9 +/- 0.5 versus 18.0 +/- 0.7 cycles/min, P less than 0.05). Because the unpaced frequency declined more rapidly than the maximum driven frequency as the mid duodenum was cooled, the spread between them, or the "pacing range," enlarged with decreasing temperature. We concluded that duodenal cooling decreased the frequency of the distal duodenal pacesetter potentials and expanded the range over which the pacesetter potentials could be paced.