Influence of the management of asystolic donors on kidney transplantation outcome.

Two methods of donor management were analysed, namely, with and without in situ cooling perfusion of the kidney in an attempt to determine the optimal management and preservation methods for asystolic kidney donors. The group of recipients of in situ cooling perfusion kidneys showed more days of oliguria (P <.05), needed more dialysis sessions (P <.05), and showed no transplant function during the first week after surgery. This group also had a greater probability of acute rejection (P =.071) and a higher rate of nonfunctioning grafts (P =.09). We conclude that in situ cooling perfusion of asystolic kidney donors impairs graft function.

Adenoma metanéfrico renal típico. Cirugía conservadora / Tipical metanephric renal adenoma. Conservative surgery

El Adenoma Metanéfrico es un infrecuente tumor renal clasificado dentro del grupo complejo de los tumores embrionarios renales o nefroblásticos. Afecta generalmente a mujeres jóvenes y tiene un buen pronóstico en la mayoría de los casos. Debe diferenciarse fundamentalmente de variantes de carácter maligno como el carcinoma papilar de células renales, del adenosarcoma metanéfrico y del tumor de Wilms del adulto. La sospecha del mismo junto con un análisis intraoperatorio del tumor puede facilitar el empleo de cirugía renal conservadora como tratamiento evitando una cirugía radical agresiva e innecesaria. Existen casos de Adenoma Metanéfrico metastásico, con lo que el carácter totalmente benigno de esta patología y su potencial maligno no se encuentran aún totalmente esclarecidos. (AU)

[Typical renal metanephric adenoma. Conservative surgery]. / Adenoma metanéfrico renal típico. Cirugía conservadora.

Metanephric Adenoma is uncommon renal tumor included in the complex group of the embryologics or nefroblastics renal tumors. Generally occurs in young females and usually has excellent prognosis. It's important to differentiate of malignant variants, particularly renal cell papillary carcinoma, metanephric adenosarcoma and adult Wilms tumor. The suspicion and intraoperative analysis of the tumor can to facilitate the use of conservative renal surgery in order to avoid unnecessary radical and aggressive surgery. To exist cases of metastatic metanephric adenoma, and the totally benign characteristic of the metanephric adenoma and the malignant potential isn't totally clarify.

Nephrotic syndrome due to thrombotic microangiopathy (TMA) as the first manifestation of human immunodeficiency virus infection: recovery before antiretroviral therapy without specific treatment against TMA.

BACKGROUND: Among the possible renal complications that can develop a human immunodeficiency virus- (HIV) infected patient, thrombotic microangiopathy (TMA) is one of them. This is a type of vascular lesion more common in HIV patients than in normal population, and sometimes it can be the first manifestation of the HIV infection. METHODS: We present a patient with TMA in whom the subsequent investigation to find the cause of TMA revealed HIV infection and Giardia Lamblia in stool. RESULTS: Before antiretroviral therapy was started the patient began to show recovery of the hemolytic anemia, recovery of the nephrotic syndrome and partial remission of the proteinuria, so that he did not receive specific therapy for TMA. CONCLUSIONS: HIV infection should be suspected in patients presenting with TMA, and a HIV test should be routinely performed as part of the initial clinical evaluation of TMA. If the patients have not developed acquired immunodeficiency syndrome, the prognosis of TMA is equal to non-infected ones.

[Cardiac myxoma. Anatomo-clinical and immunohistochemical study of 13 cases]. / Mixomas cardíacos. Estudio anatomoclínico e inmunohistoquímico de 13 casos.

INTRODUCTION: Cardiac myxomas are the most frequent benign heart tumors, and have an uncertain histogenesis. An endothelial, subendocardial and an undifferentiated mesenchymal cell origin with vasoformative characteristics has been suggested. The aim of this study was to make a review the cardiac myxomas at our institution paying special attention to its histogenesis. MATERIAL AND METHODS: We reviewed the clinico-pathological features of the 13 cardiac myxomas studied at our hospital, and we stained them with immunohistochemical stains. RESULTS: The average age on presentation was 62.8 years. 12 cases were left atrial, one of them with cerebral metastasis. The average size was 6.3 cm. Microscopically all of them were composed of a myxoid-matrix with spindled cells and small neoformed vessels. The tumors were completely positive for Vimentin and randomly positive with Actin and VIII-RA. CAM 5.2 was strictly negative. CONCLUSION: These results show that these kinds of tumors are neoplasms arising from mesenchymal pluripotential cells which are capable of many types of differentiation (endothelium, etc).

[Segmental portal hypertension and cystic tumor of the pancreas]. / Hipertensión portal segmentaria y tumor quístico de páncreas.

Isolated obstruction of the splenic vein constitute 5-10% of all patients with portal hypertension. The evaluation of splenic vein patency is important in assessing inflammatory or neoplastic diseases of the pancreas. Accurate preoperative diagnosis is therefore essential to allow the correct choice of operative procedure. A case of isolated splenic vein obstruction with left-sided portal hypertension secondary to cystadenocarcinoma of the pancreas is reported in order to discuss criteria of preoperative diagnosis between benign and malignant cystic lesions of the pancreas.

[Malignant pancreatic oncocytoma]. / Oncocitoma pancreático maligno.

A pancreatic oncocytoma in a 77 year old man is described. A CT scan showed liver metastases three years earlier. The patient died from complications after surgery for a perforated duodenal ulcer, and at autopsy a primary tumor in the tail of the pancreas and several liver metastases were found. The morphologic and biologic features of this unusual tumor are discussed.