Objective To explore the long-term clinical effect and safety of tacrolimus (FK506) in renal transplant recipients. Methods There were 126 recipients received FK506 based immunosuppressive therapy and 109 recipients received Cyclosporine A (CsA) based immunosuppressive therapy enrolled into our study according to the criterion and were followed up for 3 years. The dose and trough blood concentrations of FK506, incidence of rejection and side-effect, survival of patients and grafts were recorded in detail. Results The 1-, 3-year patients/grafts survival of FK06 group and CsA group were 98.4?% / 96.8?% , 95.2?% / 90.5?% and 97.2?% / 96.3?% , 94.4?% / 89.0?% , respectively. The incidence of acute rejection was 13.5?% and 19.3?% ( P

Objective To establish a simple,reliable and high successful model of simultaneous liver-kidney transplantation(SLKT). Methods SLKT were performed with some self-made instruments in healthy male SD rats as the recipients,and other SD rats as the donors.The donor liver and kidney were resected simultaneously.The anastomosis of inferior vein cava(IVC) and kidney artery was modified. Results The operation time of donors was (38?5) min;no liver period of recipients was (20?3) min,the operation time of recipients was (81?13)min,the hot ischemic time was less than 4 s,cold ischemic time was less than 83 min,the successful rate is 87.1%(183/210) and postoperation complication was 12.9%(27/210). Conclusions The new model of simultaneous liver-kidney transplantation in the rat was simple,high successful,easily repeated and the complications rate was low.It might be a good model of fundamental research on simultaneous liver-kidney transplantation in the rat.

OBJECTIVETo observe the effects of acupuncture-moxibustion on chronic allograft nephropathy (CAN) and explore the methods of acupoint selection along meridian for transplanted-kidney-related diseases.

METHODSA total of 180 patients of CAN were randomized into a syndrome differentiation group, a spleen-meridian group, a kidney-meridian group and a control group, 45 cases in each one. A total of 33 cases dropped out before the end of the study, including 8 cases in the syndrome differentiation group, 12 cases in the spleen-meridian group, 13 cases in the kidney-meridian group and no case in the control group. Patients in the control group were treated with conventional western medicine; based on this, patients in other three groups were treated with acupuncture-moxibustion. In the syndrome differentiation group, Qihai (CV 6), Hegu (LI 4), Guanyuan (CV 4), Feishu (BL 13), Shenshu (BL 23), etc. were selected for qi deficiency of lung and kidney; Qihai (CV 6), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), Yinlingquan (SP 9), etc. were selected for deficiency of qi and yin; Ganshu (BL 18), Shenshu (BL 23), Sanyinjiao (SP 6), Taixi (KI 3), Yinlingquan (SP 9), Ququan (LR 8), etc. were selected for yin deficiency of liver and kidney; Zhongji (CV 3), Guanyuan (CV 4), Mingmen (GV 4), Guanyuanshu (BL 26), etc. were selected for yang deficiency of spleen and kidney. In addition, Sanyinjiao (SP 6), Diji (SP 8), Yinlingquan (SP 9), Xuehai (SP 10), etc. were added in the spleen-meridian group; Taixi (KI 3), Zhaohai (KI 6), Fuliu (KI 7), Ciliao (BL 32), etc: were added in the kidney-meridian group. Serum creatinine (Scr), creatinine clearance (Ccr) and 24-hour urinary protein before and after the treatment were com- pared among the four groups.

RESULTSAfter treatment, 24-hour urinary protein in the acupuncture-moxibustion groups and control group were all reduced (all P < 0.05); compared before treatment, the Scr in the spleen-meridian group was significantly reduced (P < 0.05); the difference of Ccr before and after treatment was insignificant in all the groups (all P > 0.05). Compared with the control group, 24-hour urinary protein in spleen-meridian group could relieve or recover the damage of transplant kidney induced by CAN. A new interlink may be established between the transplanted kidneys and the spleen meridians, indicating that transplanted kidney-related diseases can be treated by selecting acupoints of spleen meridian.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Allografts ; physiopathology ; Female ; Graft Rejection ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Meridians ; Middle Aged ; Moxibustion ; Renal Insufficiency, Chronic ; etiology ; therapy ; Transplantation, Homologous ; adverse effects

Objective To analyze the common causes leading to lung infection following renal transplantation and provide targeted preventive measures to reduce the incidence of lung infection.Methods The clinical data of 561 recipients who underwent renal transplantation from January 2006 to February 2011 were retrospectively analyzed.The recipients were divided into two groups:group Ⅰ,from January 2006 to December 2009 (n =416) ; group Ⅱ,from January 2010 to February 2011 (n =145).The causes possibly leading to lung infection which took place 3 days before the appearance of the clinical symptoms were offered by the patients who suffered lung infection of group Ⅰ.And then the causes were summarized and analyzed to formulate the specific and comprehensive measures to prevent the infection.Finally the measures were applied to recipients in group Ⅱ from January 2010.After applying the measures for 14 months,the incidence of lung infection in group Ⅱ was counted and compared with that in group Ⅰ to see the preventive effect.Results There were 58 cases of lung infection in group Ⅰ (58/416,13.9％) and 12 cases in group Ⅱ (12/145,8.3％). There was significant difference in the incidence of lung infection between two groups (x2 =4.0361,P＜0.05).All of the recipients with lung infection were hospitalized in six months after the transplantation.The causes leading to lung infection of 58 cases in group Ⅰ were as follows:6 cases due to being excessively tired,3 cases due to guest visiting,12 cases due to abrupt change of weather,9 cases due to exposure to public place,8 cases due to returning to hospital,6 cases due to close contact with children,5 cases due to close contact with animals,and the other 9 cases without specific causes found.Conclusion The incidence of lung infection following renal transplantation can be notably reduced by the application of targeted and concrete health propaganda education and preventive measures based on analysis on the specific causes of infection.

Objective:To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation ( ECMO) in the donation organ transplantation .Methods: Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results:In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion:ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .

0.05). Conclusions When SD rats serve as both donors and recipients,the rejection is mild because of their good tissue compatibility.The rejection of Wistar-SD rat kidney transplants is rapid and severe, which can serve as good animal model of acute rejection.

Objective To probe into the clinical features, ways of diagnosis and treatment measures of concurrent paratyphoid fever A after renal transplantation. Methods The 5 patients were all town or village people under the county level. After the operation, the immunosuppressive scheme of ciclosporin A (or Tacrolimus) + mycophenolate mofetil (MMF) + prednisone acetate was adopted. One case was caused by catching cold and the rest 4 had no any distinct inducement. Five patients fell ill respectively at the 5th, 7th, 7th, 9th and 14th month after the operation. On the admission, the 5 patients suffered from gastrointestinal symptoms such as vomiting and diarrhea to varying degrees; 3 from toxic symptoms such as fever, intolerance of cold, hypodynamia and headache; 3 from symptoms of the respiratory system such as stuffy nose and congestion of throat; 1 from elevation of blood pressure; 1 from relative slow pulse. In 3 patients with decrease of urine volume, 1 suffered from gross hematuria, swelling of transplanted area of the kidney, pain on pressure and rise of blood pressure. Only 1 patient's paratyphoid fever A antibody in the Widal's test gastroenteritis or untoward reaction of MMF and the curative effect was bad. After definite diagnoses,the combined treatment of the third-generation cephalosporin and FQNS were given to all of them.After treatment for 7-10 days, the symptoms in all patients all disappeared. During the treatment, 1 patient was diagnosed as acute rejection and given the methylprednisolone shock for 3 days. After that, the patient's graft function was improved; 3 patients suffered from relatively great fluctuation of blood concentration of immunosuppressive agent and toxic symptoms such as decrease of the graft function, etc. After adjustment of dosage, their indicators of renal function became normal. Conclusion Early symptoms and accessory examinations of paratyphoid fever A after renal transplantation lack specificities. Diagnosis of paratyphoid fever A after renal transplantation mainly depends on blood culture. Drugs of first choice include FQNS and the third-generation cephalosporin. During the treatment, the doctor should closely monitor blood concentration of the immunosuppressive agent.

Objective To provide references for enriching and innovating patterns of TCM syndrome differentiation by exploring the relationship between pathological changes and TCM syndrome differentiation of delayed graft function (DGF) after renal transplantation. Methods Totally 57 patients with DGF after renal transplantation who were diagnosed by pathological biopsy were also diagnosed by TCM doctors to obtain TCM syndromes. And the pathological diagnoses were compared with the distribution of TCM syndromes to discuss the relationship between them. Results All the patients were classified into four TCM syndromes:spleen-kidney qi deficiency, liver-kidney yin deficiency, qi-stagnation and blood stasis, and deficiency of both qi and yin. The results of pathological biopsy were as follows:acute tubular necrosis, calcineurin inhibitor toxicity and acute rejection. Quantitative corresponding relation was found between the pathological diagnoses and the TCM syndromes. Conclusion There are inner links between pathological diagnosis and TCM syndromes of DGF, which can be references for diagnosis and treatment of TCM syndrome differentiation.

Objective To quantitatively detect intragraft and peripheral blood monocyte cells (PBMCs) perforin mRNA,and analysis the relationship between acute rejection and perforin mRNA. Methods In the allograft group Wistar and male SD rats were used as donors and recipients.SD rats served as donors and recipients in the isograft group.The graft specimens were harvested 5 days postoperatively.They were examined histologically after sectioning and staining with hematoxylin and eosin,Masson’s trichrome, periodic acid-Schiff reagent and periodic acidsilver metheramine.And then the fluorescent quantitative PCR was employed to measure the intragraft and PBMCs expression level of perforin mRNA. Results The histological scores in allograft and isograft kidney samples were 2~5 (3.43?0.98) and 0~1 (0.71?0.49)(P

BACKGROUND: Security of organ donor attracts more attention, because donor complication and transplantation failure always occur following renal transplantation. Therefore, living-related kidney transplantation should be paid much attention in order to make sure life and quality of life. OBJECTIVE: To investigate the safety of living-related kidney transplantation. METHODS: A total of 38 cases of living relative donor kidney transplantation were retrospectively analyzed. Before transplantation, identify of patients should be determined, and all patients provided the informed consent. The general data of patients were sufficiently dialyzed before transplantation to improve the body status. TacroUmus or mixture of cyclosporine A, mycophenolate, and adrenal cortex hormone were administrated following transplantation to observe renal function, complication incidence, and acute rejection reaction. RESULTS AND CONCLUSION: Due to short waiting time, low price, and long-term survival rate, living-relative donor kidney transplantation has low risk factor, s for donor. However, the safety still needs to be sufficiently evaluated for donors and recipients.