Expanded criteria donors, histological scoring, and prolonged cold ischemia: impact on renal graft survival.

The use of expanded donors or kidneys with preexistent chronic damage remains controversial, but they offer the opportunity to expand the donor pool. We investigated the impact of these conditions as predictors of graft survival among a cohort of recipients with prolonged cold ischemia times and a high incidence of delayed graft function. We included 70 consecutive cadaveric kidney allografts implanted between 2001 and 2005, which had undergone an early graft biopsy. Delayed graft function was present in 84% of cases with moderate or severe preexistent chronic damage in 63% and 27% of biopsies, respectively, and acute rejection was diagnosed in 14.3% of overall cases. The graft survival was 73.3% at 48 months. Primary nonfunctioning kidneys were more frequent using kidneys from expanded compared with standard donors (20.0% vs 0.0%, P < .002). Multivariate analysis showed that only the donor condition (standard vs expanded) was independently associated with graft survival (hazard ratio: 0.12; 95% confidence interval: 0.01-0.87; P < .03). Our results suggested that the donor characteristics prevail over other variables to predict graft outcomes.

[Breast carcinoma metastasis in ileum-colon and gallbladder simulating inflammatory diseases]. / Metástasis de carcinoma de mama en ileon-colon y vesicula biliar simulando enfermedades inflamatorias.

The metastasis in the extrahepatic digestive system are not very frequent and their characteristic is appearing after a long latent period, which takes 3 to 20 years, their symptoms are unspecific and appear to be inflammatory diseases or a second tumor. The most common histological subtype is the lobular carcinoma. Here we show you two cases of breast carcinoma metastasis, one in the ileum-colon and the other in the gallbladder. Both patient started showing symptoms, which led to the diagnosis was done in the surgical specimens where lobular carcinoma cells which infiltrated from the serosa to the mucosa were observed. The immunophenotype resulted to be BCA225, estrogen and progesterone positive. The treatment with radiotherapy, chemotherapy or hormonal therapy provides better life quality but the average chance of survival after the diagnosis is of a year.

Metástasis de carcinoma de mama en ileon-colon y vesicula biliar simulando enfermedades inflamatorias. / [Breast carcinoma metastasis in ileum-colon and gallbladder simulating inflammatory diseases]

The metastasis in the extrahepatic digestive system are not very frequent and their characteristic is appearing after a long latent period, which takes 3 to 20 years, their symptoms are unspecific and appear to be inflammatory diseases or a second tumor. The most common histological subtype is the lobular carcinoma. Here we show you two cases of breast carcinoma metastasis, one in the ileum-colon and the other in the gallbladder. Both patient started showing symptoms, which led to the diagnosis was done in the surgical specimens where lobular carcinoma cells which infiltrated from the serosa to the mucosa were observed. The immunophenotype resulted to be BCA225, estrogen and progesterone positive. The treatment with radiotherapy, chemotherapy or hormonal therapy provides better life quality but the average chance of survival after the diagnosis is of a year.