Effect of recipients' peri-operative parameters on the outcome of kidney transplantation.

In this prospectively collected data base multifactorial study, the influence of the peri-operative recipients' parameters on the transplanted kidney function were examined. One hundred and twenty-one patients who underwent first cadaver kidney transplantation in our unit were involved and were followed up for another 2 yr. The recipients were divided into three groups. Group I, patients with non-functioning grafts, group II, with delayed graft function, and group III, with good graft function. All routinely measured parameters were involved in the examination. The pre-operative haematocrit level differed significantly among the three groups. Significant intra-operative differences were found among the three groups in mean arterial pressure, (group I: 81 +/- 31 mmHg, group II: 90 +/- 24 mmHg, vs. group III: 108 +/- 26 mmHg, p < 0.01) at 5 min before revascularisation. The patients who had better post-operative kidney function, had lower pre-operative haematocrit level, and higher blood pressure in the different phase of operation, than those who had post-operative kidney function problems. The second warm ischaemic time in Group III was significantly shorter than in group I. (Group I: 51.5 min vs. group II: 47 min, vs. group III: 46.3 min, p < 0.001). Rejection rate was higher during the first 5 post-operative days in patients with non-functioning grafts. (Group I: 53% and group II: 24% vs. group III: 12% p < 0.001). The other examined parameters had not differed significantly among the three groups. The kidney function differences observed in the early (first 5 d) post-operative period, remained similar at the end of the next 2 yr. According to our results the peri-operative fluid-balance is one of the most important factors which may influence the success of the kidney transplantation.

[Bronchoscopic evaluation of pulmonary complications following kidney transplantation]. / Vesetranszplantáción átesett betegek késöi tüdöszövödményeinek bronchoscopos vizsgálata.

The authors evaluated the efficiency of bronchoscopy in kidney transplanted patients with late pulmonary complications (mean 370 days after transplantation). The bronchoscopy was made meanly 9.5 days after recognizing pulmonary diseases, in that time 7 patients were mechanically ventilated. In 15 cases therapy guided by the cytological, histological and microbiological results has been hoped to improve outcome. This study suggest that bronchoscopy might be important in the diagnosis of the late pulmonary complications of kidney transplanted patients.