RESUMO
Overt proteinuria was detected in the urine of a potential kidney donor, ultimately leading to the refusal of the kidneys for transplantation purposes. Histological examination of the kidneys did not reveal any abnormalities. Searching for substances that could have interfered with the urinary total protein assay, the role of infused, modified gelatin plasma expanders was investigated. We therefore measured the concentration of protein before and after the addition of various artificial plasma expanders to urine. Only when Biuret reagent or Pyrogallol Red dye were used did we find elevated concentrations of protein. Other methods, including the turbidimetric assays, did not detect additional amounts of protein in the spiked urine. We conclude that the infusion of modified gelatin solutions may cause apparent proteinuria. This effect is not observed with starch-based plasma expanders. Clinical chemists and clinicians should be aware of this phenomenon and possibly repeat the analysis with a different technique.
Assuntos
Substitutos do Plasma/química , Proteínas/análise , Proteinúria/urina , Urina/química , Albuminas/análise , Reação de Biureto , Colorimetria , Corantes , Reações Falso-Positivas , Gelatina/química , Gelatina/metabolismo , Gelatina/urina , Humanos , Transplante de Rim , Nefelometria e Turbidimetria , Polímeros/química , Polímeros/metabolismo , Pirogalol/análogos & derivados , Amido/química , Amido/metabolismo , Succinatos/química , Succinatos/urina , Doadores de TecidosRESUMO
If organ donations concern not only the kidneys, but also the liver, pancreas and, sometimes, the heart and (or) lungs, several surgical removal teams, often from different (foreign) transplantation centres, may be involved. This has created organizatory problems resulting in loss of organs for transplantation. In the Nijmegen area since October 1994 a removal team has been active that in the regional donor hospital removes all abdominal organs from the donor on behalf of the various transplantation centres. This regional removal team performed 105 multi-organ explanations in the period from October 1994 to December 1997. The reports that came back from the transplantation centres that had received the organs showed that none of these organs had been lost for transplantation through organizatory problems or anatomical damage. Experiences of operating room staff involved were positive: it was especially the standard surgical techniques and the quiet in the operating room that were appreciated. Special removal teams may greatly improve the evolution of organ donation in the Netherlands.
