La fantasma de Valencia y las comedias de Fiestas del jardín de Alonso de Castillo Solórzano: hipótesis de datación y circunstancias de representación.

Alonso de Castillo Solórzano, prolific cultivator of the novelistic genre, gathered and published his work in miscellaneous volumes or colectáneas all along the XVII century. In these volumes, mainly formed by novels assembled in a narrative framework, dramatic pieces appear from time to time. This is the case of Fiestas del Jardín (1634), which alternates four plays written in prose and three comedies. We know about the last ones that they were brought to the stage by renowned authors of the time. However, the date of their composition remains unknown as well as the circumstances in which they were staged. It is our goal to shed light on these questions following the study of La fantasma de Valencia, one of the three aforementioned comedies.

Strict selection criteria in uncontrolled donation after circulatory death provide excellent long-term kidney graft survival.

BACKGROUND: We aimed to report our experience in uncontrolled donation after circulatory death (uDCD) kidney transplantation applying a strict donor selection and preservation criteria. METHODS: All kidney recipients received a graft from a local uDCD. As controls, we included all renal transplants from local standard criteria donation after brain death (SDBD) donors. Normothermic regional perfusion was the preservation method in all cases. RESULTS: A total of 19 kidneys from uDCD donors were included and 67 controls. Delayed graft function (DGF) was higher in the uDCD group (42.1% vs 17.9%; P = .033), whereas no differences were observed in primary nonfunction (0% cases vs 3% controls; P = .605). The estimated glomerular filtration rate was identical in both groups. No differences were observed in graft survival censored for death between the uDCD and the SDBD groups at 1-year (100% vs 95%) or 5-year follow-up (92% vs 91%). uDCD kidney recipients did not have higher risk of graft loss in the multivariate analysis adjusted by recipient age, cold ischemic time, presence of DGF, and second kidney transplant (HR: 0.4; 95% CI 0.02-6; P = .509). CONCLUSIONS: Obtaining renal grafts from uDCD is feasible in a small city and provides similar outcomes compared to standard DBD donors.

[Experience with third, fourth and fifth kidney transplants and their complications.] / Experiencia en terceros, cuartos y quintos trasplantes renales y sus complicaciones.

OBJECTIVES: Kidney transplant may be a good choice to treat chronic renal failure even in patients with two or more previous renal grafts. However, there might be several surgical complications and other difficulties we have to deal with. The aim of this report is to analyze the third, fourth and fifth transplants performed in our center focusing on the surgical complications and graft and patient survivals. METHODS: We performed a retrospective analysis of the 73 third, fourth and fifth kidney transplants performed in our center between February 1975 and December 2015. Statistical analysis has been performed with IBM SPSS 23.0 software. RESULTS: 62 patients received a third graft, 10 received a fourth one and one patient received a fifth graft. The median age of the recipients was 48 years, while for donors it was 50. Median cold ischemia time was 21 hours. Transplantectomy was not necessary in 49.31% of the cases. In 59.7% of the cases the graft vessels were anastomosed to the external iliac vessels. There were 21 cases of relevant postoperative complications (27.4% of the total grafts). Vascular thrombosis appeared in 5.5%. After 49 months of follow-up, the 1-, 3-, and 5-year graft survival were 64.3%, 56.16% and 50.69%, respectively. CONCLUSIONS: A new renal transplant in patients with two or more previous grafts is feasible, being necessary to individualize the cases. In spite of being more complex operations than previous transplants with a higher complication rate, we can obtain both acceptable graft and patient survival outcomes with an appropriate approach.

Experiencia en terceros, cuartos y quintos trasplantes renales y sus complicaciones / Experience with third, fourth and fifth kidney transplants and their complications

Objetivos: El trasplante renal puede ser una buena opción terapéutica en la insuficiencia renal terminal, incluso en los pacientes con dos o más injertos previos. Sin embargo, pueden existir una serie de dificultades y complicaciones quirúrgicas a las cuales el equipo de trasplante debe enfrentarse. El objetivo de este artículo es revisar los terceros, cuartos y quintos trasplantes realizados en el Hospital Universitario Marqués de Valdecilla (HUMV) analizando las dificultades quirúrgicas, sus complicaciones y la supervivencia de injertos y pacientes. Método: Revisión retrospectiva desde Febrero de 1975 hasta Diciembre de 2015 que incluye 73 trasplantes (3º,4º y 5º) realizados en el HUMV. El estudio estadístico ha sido realizado con el programa informático IBM SPSS versión 23.0. Resultados: 62 pacientes han recibido un tercer trasplante, 10 de ellos posteriormente han recibido un cuarto y 1 única paciente ha recibido un quinto. La mediana de edad de los receptores fue 48 años y la de los donantes 50. La mediana de isquemia fría fue de 21 horas. No fue necesaria la trasplantectomía de los injertos previos en un 49,31 % de los casos. En un 59,7% de los casos se pudieron anastomosar los vasos del injerto a los vasos iliacos externos del receptor. Se registraron un 27,4% de complicaciones postquirúrgicas relevantes, con un 5,5% de trombosis en los vasos de los injertos. Tras una mediana de seguimiento global de 49 meses la supervivencia del injerto a 1, 3 y 5 años fue del 64,3%, 56,16% y 50,69% respectivamente. Conclusión: A pesar de ser necesario individualizar los casos, un nuevo trasplante en pacientes con dos o más injertos renales previos, sigue siendo una opción terapéutica a considerar. Aunque pueden ser cirugías complejas y de alto riesgo de complicaciones, con un manejo óptimo y cirujanos expertos se pueden obtener cifras de supervivencia de injerto aceptables (AU)

Objectives: Kidney transplant may be a good choice to treat chronic renal failure even in patients with two or more previous renal grafts. However, there might be several surgical complications and other difficulties we have to deal with. The aim of this report is to analyze the third, fourth and fifth transplants performed in our center focusing on the surgical complications and graft and patient survivals. Methods: We performed a retrospective analysis of the 73 third, fourth and fifth kidney transplants performed in our center between February 1975 and December 2015. Statistical analysis has been performed with IBM SPSS 23.0 software. Results: 62 patients received a third graft, 10 received a fourth one and one patient received a fifth graft. The median age of the recipients was 48 years, while for donors it was 50. Median cold ischemia time was 21 hours. Transplantectomy was not necessary in 49.31% of the cases. In 59.7% of the cases the graft vessels were anastomosed to the external iliac vessels. There were 21 cases of relevant postoperative complications (27.4% of the total grafts). Vascular thrombosis appea-red in 5.5%. After 49 months of follow-up, the 1-, 3-, and 5-year graft survival were 64.3%, 56.16% and 50.69%, respectively. Conclusions: A new renal transplant in patients with two or more previous grafts is feasible, being necessary to individualize the cases. In spite of being more complex operations than previous transplants with a higher complication rate, we can obtain both acceptable graft and patient survival outcomes with an appropriate approach (AU)