Objective To analyze the impact of allograft category on the result of living related donor kidney transplantation (LRKT)and to evaluate the predominant donors. Methods A retrospective analysis of 104 recipients receiving LRKT from Apr. 2004 to Mar. 2008 was performed. Based on donor resource, all the recipient-donor pairs were divided into four groups: spousal donation group,parental donation group, sibling donation group and cousinly donation group. The observational parameters were selected for analysis, such as average post-transplant hospitalization dates, time for serum creatinine (Scr) back to normal level, Scr levels of every observational time point, incidence of major complications (infection, rejection, DGF) and recipient/graft survival rate. Results Recipient/graft survival rate of sibling donation group seemed higher. Recipients of sibling donation group seemed to have fewer post-transplant hospitalization dates, but higher rates of infection, while those of parental donation group seemed to have higher rates of rejection. Rates of rejection and infection of spousal donation group were lower than supposed. There was no statistically significant difference in time for Scr back to normal level and Set levels of every observational time point among these four groups. Conclusions The result of sibling donor renal transplantation is better, while short-term outcome of spouse donor renal transplantation is ideal, which is similar with parent or cousin donor renal transplantation. Except for human leukocyte antigen, aspects such as quality of donor kidney, predominance during operation and self-administration post-transplant are also the guarantee for the success.

Objective To evaluate the efficacy and safety of tranexamic acid in blood protection in liver transplantation.Methods We searched the Cochrane library,MEDLINE,CNKI,VIP,CBM (from inception to May 2017),to collect all the randomized controlled trials of tranexamic acid for liver transplantation.the quality of the included studies was evaluated,and meta-analyses were performed with Cochrane Collaboration's RevMan 5.3 software.Results 1) A total of 8 studies involving 1107 patients were included.the results of meta-analyses showed:Compared with placebo,tranexamic acid was effective in reducing postoperative blood loss [SMD =-1.95,95％ CI (-3.21,-0.69)],P＜0.05],there were statistical heterogeneity between the studies (I2=94％,P＜0.05),2)Tranexamic acid was effective in reducing postoperative transfusion rates of RBC during the operation [SMD=-0.43,95％ CI (-0.74,-0.11)],P＜0.05];however,less effective than the placebo in terms of reducing postoperative FFP and PLT transfusion.Compared with placebo and other antifibrinolitic drugs the bleeding,renal insufficiency,thrombosis,infection,death and the incidence of other adverse events were not increased in tranexamic acid group after surgery.Conclusion Tranexamic acid was a safe and effective antifibrinolitic drug in liver transplantation,for it can reduce the amount of bleeding and red blood cell transfusion,However,due to the limited quality of the included studies,further verification with more high quality trials was needed.

Objective To analyze the relationship between the genetic polymorphisms of organic anion transporting polypeptide (SLCO1B1 and SLCO1B3) and mycophenolic acid ( MPA)pharmacokinetics in Chinese kidney transplant recipients. Methods Gene mutations (SLCO1B3T334G, SLCO1B1 A338G) were detected in 68 recipients by PCR-LDR. The plasma samples were collected and blood concentration of MPA was measured on the 28 th day after transplantation. The area under the curve (AUC)0-12 of MPA in different genotype recipients was compared to analyze the correlation between single nucleotide polymorphisms (SNPs) and MPA pharmacokinetics. Results MPA AUC0-12 was higher in SLCO1B3 T334G GG carriers group than in TT carriers [(54. 54 ±14.40)vs(37.30±12.88)mg·h·L-1,(P=0.052)].However,there was no difference in MPA AUC0-12 among each genotype of SLCO1B1 A338G (P>0. 05). Conclusion Genetic polymorphisms of SLCO1B3 affect interindividual variety in plasma MPA concentration in Chinese kidney transplantation recipients.

Objective To investigate the change and implication of plasma osteopontin (OPN) levels in renal allograft rejection.Methods The clinical data and biological samples of 46 renal transplant recipients were analyzed rerrospecnvely,including 16 patiens with stable allograft function and no evidence of biopsy-proved rejection (Non-R),22 patients with biopsy-proved acute cellular rejection (ACR),and 8 paients with biopsy-proved chronic allograft nephropathy (CAN).Six living related donors served as healthy controls (HC).Plasma OPN level was determined by using the human OPN ELISA kit.Type and grade of ACR were diagnosed based on Banff 03 classification criteria of renal allograft pathology.The plasma OPN levels were compared among different groups.The assistant diagnostic value of plasma OPN levels in differentiating rejection patients were also evaloated.Results The plasma OPN level in HC,Non-R,CAN and ACR groups was ( 12.23 ±5.95),(19.38±8.23),(27.77± 12.27) and (41.84± 18.51) μg/L,respectively.There was no significant difference in plasma OPN levels among HC,Non-R and CAN groups (P＞0.05),but the OPN levels in ACR group were decreased significantly as compared with Non-R and CAN groups (P＜0.05 ).OPN levels were positively correlated with Banff grading of ACR (P＜0.05).OPN levels were significantly different between grade Ia and grade IIb (P＜0.05).Conclusion The change in plasma OPN level has a relationship with acute rejection.Besides,the plasma OPN levels were also positively correlated with the severity of ACR.Monitoring plasma OPN levels should be useful in predicting and evaluating the severity of ACR in renal transplant recipients.

Objective To investigate the diagnosis and treatment of pulmonary tuberculosis in renal transplantation recipients.Method The clinical data of 8 renal transplantation recipients suffering from pulmonary tuberculosis infection were retrospectively analyzed.Result Fever,cough and expectoration were the most common symptoms,however,lacking typicality.Images of chest Xray and CT scan were various and couldn't verify TB infection from pneumonia.Seven of 8 cases were diagnosed through invasive methods,either bronchofibroscope or fiberthoracoscopy.Immunosuppressants were decreased in all cases.Three-drug regimens,including isoniazide,rifampicin and ethambutol or pyrazinarnide,were administrated as anti-tuberculosis chemotherapy.All the cases were cured,without episodes like acute rejection and liver function impairment.Conclusion Routine examinations are not sufficient to diagnose pulmonary tuberculosis in kidney transplantation recipients.While,invasive methods like bronchofibroscope and fiberthoracoscope are helpful.When diagnosed,patients should receive normative anti-tuberculosis treatment and immunosuppressive agents adjustment,which can benefit the prognosis of pulmonary tuberculosis in renal transplantation recipients.

Objective To evaluate the hematological adverse events of sunitinib in treatment of advanced renal cell carcinoma.Methods Forty-four male patients and 18 female patients were included in this study.They were all with metastatic renal cell carcinoma and received sunitinib treatment at the dose of 50 mg daily in repeated 6 weeks cycle (4 weeks on and 2 weeks off).Toxicity was assessed every cycle with tumor assessments every 2 cycles via CT or PET-CT.Results Fifty patients (80.6％) had experienced treatment-related hematotoxicity,including leucocytopenia,anemia and thrombocytopenia.Severe hematological adverse events ( grade 3 -4 ) occured in 18 patients ( 29.0％ ) and slight events ( grade 1 - 2 ) in others (51.6％).Most of the hematological adverse events were manageable and reversible and treatment-changes (dose reduction,interruption) were necessary in severe cases.Almost half of the dose reduction (9/21,42.9％ ) were owing to hematotoxicity.Conclusions Sunitinib of 50 mg dose on schedule 4/2 is effective and well-tolerated in advanced renal carcinoma patients.Hematological adverse events are frequent in Chinese patients and can be controlled well.

Objective To observe the protection and distribution of bone marrow mesenchymal stem cells (MSCs) by distinct intravenous infusion time on renal ischemia reperfusion injury (IRI) in rats.Methods We used unilateral nephrectomy and contralateral vascular occlusion method to establish renal IRI model in rats.The experimental groups which received 2 × 106 MSCs infusion through the tail vein,were subsequently divided into 3 subgroups:2 h pre-reperfusion (PreOp,n =16),immediately after reperfusion (Op,n =16),6 h post-reperfusion (PostOp,n - 16).The control groups included sham operation group (n =16) and ischemia group (n =16).Chemotaxis of DAPI-labeled MSCs was detected 6 h after administration in the IR kidney.Renal function was detected at 6,24,and 48 h respectively after operation. Forty eight h after operation,the renal tissues were harvested to observe the pathological changes by HE staining and the tubular epithelial cell apoptosis via TUNEL assay.Results MSCs were found in the experimental groups after IR in the kidney,most in PostOp group.Twenty-four and 48 h after reperfusion,there was no significant difference in Cr and BUN between the experimental groups and sham operation group (P＞0.05),but the levels of Cr and BUN in the experimental groups were significantly lower than in the IR group (P＜ 0.05). As compared with IR group,the renal pathological injury was alleviated,the number of apoptotic cells was decreased in the experimental group,most significantly in PostOp group (P＜0.05).Conclusion MSCs can reduce the inflammatory response and inhibit renal tubular cell apoptosis in rat renal IRI.Post-reperfusion administration of MSCs leads to the best chemotaxis efficiency and protection.

Objective:To explore the significance of coagulation and platelet function analysis (Sonoclot) in monitoring coagulation function, severity evaluation and blood transfusion indication of perioperative liver transplant (LT) recipients.Methods:A total of 95 perioperative LT recipients received Sonoclot, thromboelastography (TEG), routine coagulation panel, liver function panel, blood routine, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring and model for end-stage liver disease (MELD) scoring between January 2021 and October 2022.The correlation analysis of the above parameters was performed.According to the scores of APACHE Ⅱ and MELD, they were assigned into three groups of low-risk, medium-risk and high-risk.The levels of Sonoclot parameters in each group were compared.They were divided into two groups of transfusion (n=31) and non-transfusion (n=64) according to the necessity or non-necessity of transfusion..The risk factors for blood transfusion were examined by Logistic regression and receiver operating characteristic (ROC) curve.Results:Pearson's correlation analysis indicated that activated clotting time (ACT) value was correlated positively with the levels of prothrombin time (PT), prothrombin time ratio (PTR), international standard ratio (INR), R/K value, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactic dehydrogenase (LDH)( r=0.279 1, P=0.006 2; r=0.280 2, P=0.006 5; r=0.3, P=0.003 5; r=0.642 8, P<0.000 1; r=0.452 8, P<0.000 1; r=0.377 6, P=0.002; r=0.349 6, P=0.000 6; r=0.271 4, P=0.018 3) and yet negatively with the levels of platelet (PLT), MA, CI and α ( r=-0.339 1, P=0.000 8; r=-0.573 3, P<0.000 1; r=-0.656 3, P<0.000 1; r=-0.632 6, P<0.000 1); CR value was correlated positively with the levels of maximal amplitude (MA), coagulation index (CI), α and ALT ( r=0.466 8, P=0.000 6; r=0.482 7, P=0.000 4; r=0.514 8, P=0.000 1; r=0.229 2, P=0.027 1) and yet negatively with the level of R/K value ( r=-0.366 9, P=0.010 3; r=-0.356 9, P=0.011 0); platelet function (PF) value was correlated positively with the levels of PLT, MA, CI, α and alkaline phosphatase (ALP)( r=0.481 9, P<0.000 1; r=0.630 7, P<0.000 1; r=0.623 5, P<0.000 1; r=0.593 0, P<0.000 1; r=0.223 1, P=0.032 5) and yet negatively with the level of R/K value ( r=-0.421 5, P=0.002 8; r=-0.530 7, P<0.000 1). CR value was correlated negatively with APACHE Ⅱ score ( r=-0.212 3, P=0.038 9) while ACT value was correlated positively with MELD score ( r=0.244, P=0.04). ACT values spiked in low, middle and high-risk groups of APACHE Ⅱ and MELD scores while PF value declined gradually by grouping these recipients based upon scoring systems.CR values decreased merely in MELD score.Logistic regression analysis indicated that ACT was a risk factor for necessity of blood transfusion in perioperative LT recipients ( OR=1.010, 95% CI 1.000-1.019, P<0.05). The maximal area under the curve of ROC curve analysis plus ACT, hemoglobin (Hb) and hematocrit (Hct) was 0.896. Conclusions:Sonoclot parameters of perioperative LT recipients have some certain correlation with thromboelastographic and conventional coagulation parameters.Both may serve as a supplementary means.Associated with liver function parameters and liver scores, Sonoclot parameters are significant for early clinical evaluations.Sonoclot parameters plus Hb/Hct detection have some guiding significance for perioperative LT recipients with necessity for blood transfusion and blood products.

Objective:To explore the protective effect of thioether-cyclized helix B peptide (CHBP)on renal tubular epithelial cells and its mechanism by experiment in vitro.Methods:Human renal proximal tubular epithelial cell line HK-2 cells were cul-tured in vitro and divided into control group,H2 O2 group and CHBP group.Oxidative stress damage models were established by stimulation with 500 μmol/L H2 O2 for 4 h.In CHBP group,20 nmol/L CHBP was added to the culture medium 1 h prior to the establishment of oxidative stress model.After 4 h stimulation with 500 μmol/L H2 O2 ,cell viability,situation of apopto-sis,and severity of oxidative stress damage were measured.The expressions of Binding immunoglobulin protein(BiP),C/EBP homologous protein(CHOP),and the molecular in downstream NF-E2-related factor 2 (Nrf2)signaling pathway were detected by Western blotting and real-time PCR analysis,so as to evaluate the level of endoplasmic reticulum(ER)stress.Results:Oxi-dative stress induced cytotoxic injury could be alleviated by CHBP pretreatment.Kit-8 (CCK-8 )assay and TUNEL showed that,after CHBP pretreatment,cell viability increased,while cell apoptosis,oxidative stress and ER stress decreased.The levels of Nrf2 and heme oxygenase-1(HO-1)were significantly higher in CHBP group than those in H2 O2 group.Conclusions:CHBP pretreatment could alleviate oxidative stress damage of HK-2 cells,and the protective effect may be achieved by inhibi-ting ER stress and activating downstream Nrf2 signaling pathway.

Autophagy is a conservative biological process of maintaining internal balances through degrading damaged proteins, organelles and intracellular pathogens.It may promote cell survival and accelerate cell death.Ferroptosis is a newly discovered regulated form of cell death characterized by lipid peroxidation and membrane damage in 2012.In recent years, more and more studies have demonstrated complex interactions between autophagy and ferroptosis.Various forms of cell death are regulated during the progression of kidney diseases.And autophagy and ferroptosis play important roles.However, potential connections between autophagy and ferroptosis in renal injury disease has not been fully elucidated.This review focused upon on the regulatory role of autophagy in ferroptosis and its possible link to renal injury, providing new theoretical rationales for researches on acute or chronic kidney injury.