Objective:To investigate the effects of serum sICAM-1 and sVCAM-1 in renal allograft recipients with infection, acute rejection and CsA-induced nephrotoxicity for the clinical significance of early diagnosis and differential diagnosis.Methods:The sequential monitoring of serum sICAM-1 and sVCAM-1 were conducted by ELISA technique in 86 patients before and after renal transplantation.Results:The levels of serum sICAM-1 and sVCAM-1 increased in the first three day posttransplantation, decreased and stabilized after one to two weeks,increased one to three days prior to the clinical diagnosis in acute rejection and decreased with effective treatment,increased in infection and had no significant difference in CsA-induced nephrotoxicity.Conclusion:Sequential monitoring of serum sICAM-1 and sVCAM-1 of renal allograft recipients can be used to estimate the function of graft,as markers of the early diagnosis and differential diagnosis of acute rejection.

Objective:To investigate the effect of anti-CD25 monoclonal antibody in preventing acute rejection after renal transplantation.Methods:71 patients were randomly divided into two groups;treatment gourp( n =26)and control group( n =45).The treatment group received anti-CD25 monoclonal antibody twice before and after renal transplantation.The occurrence of rejection postoperation and renal function and T lymphocyte subtypes were sequentially monitored.Results:The occurrence of aute rejection in treatment group in 1,3,6 and 12 months after renal transplantation was 7.7% ,19.2%,23.1% and 30.8%,while it was 15.6%,28.9%,35.6% and 46.7% in control group.There was significant difference between the two groups( P0.05 ).Conclusion:It suggests that anti-CD25 monoclonal antibody reduce the occurrence of acute rejection and have no influence on T lymphocyte subtypes.

Objective:To examine whether the existence of the donor-and-recipient-derived DNA chimerism in recipient’s plasma can be a predictive marker for the status of transplanted organ.Methods:One hundred and twenty-six female patients who had been transplanted with male kidney were enrolled in the present study.In these female recipients,the SRY1,DYZ11st and DYZ12nd genes on the Y chromosome from the plasma were prospectively examined using reverse transcription polymerase chain reaction (RT-PCR).Results:SRY1,DYZ11st and DYZ12nd sequences were detected in the cell-free blood (plasma) of 97 (77%) of 126 female patients with male kidney.The average time-span when the transplanted kidneys functioned was 8.7 years and 5.4 years among microchimerism-positive and microchimerism-negative recipients,respectively.The frequency of the patients who had acute rejection after renal transplantation was approximately 10% and 28%in microchimerism-positive and microchimerism-negative recipients,respectively.Serum creatinine levels in microchimerism-positive patients were significantly lower than those in microchimerism-negative patients.Conclusion:These results suggest that plasma DNA microchimerism is present in certain patients following renal transplantation and measurement of plasma DNA microchimerism using quantitative RT-PCR might be a useful predictor for the acceptance of transplanted kidneys.

Objective To study the effect of renal ischemic reperfusion injury on intracellular ionized calcium level and apoptosis. Methods The model of rat's acute renal ischemic reperfusion injury was established.A total of 30 Wistar rats were divided into 5 groups:control, 1 h ischemia and 1 h,2 h,24 h reperfusion groups (n=6 for each group).Renal intracellular [Ca 2+]i level was determined by Fura-2/AM fluorescence assay,and renal cell apoptosis rates were measured by flow cytometry. Results The renal intracellular [Ca 2+]i levels at 1h,2h and 24h timepoint of reperfusion were 156.2 nmol/L,181.6 nmol/L and 260.6 nmol/L,respectively,which were significantly higher (P

Objective:To study the levels of TNF ? in serum and in urine and IL 6 in serum of renal allograft recipients with acute rejection, infection and CsA induced nephrotoxicity.Methods:The sequential monitoring of TNF ? and IL 6 was conducted by ELISA technique in 106 patients before and after renal transplantation.Results:The levels of IL 6 and TNF ? increased in the first day posttransplant, decreased and stabilized after 1 to 2 weeks, and increased 1 to 3 days prior to the clinical diagnosis in acute rejection, then decreased with effective treatment. IL 6 and TNF ? increased in serum in infection and had no difference in urine. TNF ? in serum and in urine and IL 6 in serum had no significant difference in CsA induced nephrotoxicity.Conclusion:It suggests that the sequential monitoring of IL 6 and TNF ? of renal allograft recipients can be used to estimate the function of graft, as markers of the early diagnosis of acute rejection.

Objective To investigate the relationship between the appearance of donor cells in urine and acute rejection and the clinical implication. Methods Eighty renal transplantation patients were observed, in which the donors were male and the recipients were female, or HLA DR antigen were mismatched (30 cases were at perioperative period, 20 cases were subjected to acute rejection, 30 cases had stable renal function). Urine samples were collected regularly. PCR and PCR SSP were applied to detect DYZ 1 (special gene fragment of Y chromosome) and DRB 1of HLA DR antigen respectively after DNA were obtained.Results Perioperative period group: donor cells in urine were detected in all the patients 24?h after operation. With the development of disease, the intensity of donor DNA expression in urine was decreased generally. 30 days later, donor cells in urine disappeared only in 3 cases of 30 cases, and acute rejection happened in 8 cases of the rest 27 cases. Acute rejection group: donor cells in urine were detected in 18 cases (90%); 2 weeks following anti rejection therapy, donor cells in urine were negative only in 3 cases, still positive in the other 15 cases, and the intensity of donor DNA expression in urine was decreased generally during the treatment. Donor cells in urine were negative in 16 cases ( 88.9% ) after treatment for 3 months. Stable renal function group: DYZ 1 or HLA DRB1 was positive in 2 cases ( 6.7% ), negative in 28 cases ( 93.3% ). Conclusion PCR and PCR SSP were used to detect DNA of donor cells in urine, which would be a new method to diagnose acute rejection of renal transplantation, but would not exactly fit for those happened in early stage. The intensity change of donor DNA expression in urine represented the recovery of renal transplantation, which provided the possibility to evaluate renal allograft rejection quantitatively at the same time.

Objective To investigate the relationship between microchimerism and immunologic tolerance in kidney transplantation recipients. Methods In samples of peripheral blood and urinary sediment from 176 females who received male donor's kidney,DNA and mRNA expression of specific fragment in Y chromosome were determined by PCR and RT PCR. Results The test results were positive for chimerism in 137 out of 176 recipients(77.84%),and negative in 39 cases (22.16%).The mean survival period in chimerism positive group was 8.9?3.7 years,and 5.2?3.9 years in chimerism negative group.The difference was statistically significant between the 2 groups ( P

Objective:To study the effect of anti CD3 monoclonal antibody on preventing acute rejection episodes after renal transplantation.Methods:42 patients undergoing renal transplantation were treated with anti CD3 monoclonal antibody (5 mg) daily for a mean of 10 days (treated group).122 patients who were not treated with anti CD3 monoclonal antibody (control group).Acute rejection episodes,graft loss,death and rate of CMV infection in patients were observed.Results:The treated group had a significantly reduced risk of acute rejection (18 6%),as compared with the control group (28 7%).The rate of graft loss were significantly reduced in the treated group 1 year,2 years,or 3 years after renal transplantation.There were no significant differences in mortality between treated group and control group 1 year,2 years,or 3 years after renal transplantation.The incidence rate of CMV infection were significantly increased in the treated group (33 3%),as compared with the control group (13 9%).The first acute rejection episode was postponed significantly in the treated group.There were more acute rejection episodes that could be reversed by MP in the treated group.Conclusion:Anti CD3 monoclonal antibody significantly reduced the risk of acute rejection and significantly reduced the rate of graft loss.Anti CD3 monoclonal antibody significantly increased the incidence rate of CMV infection,which should be paid attention. [

Objective To investigate the mechanism of chronic intermittent hypoxia (CIH)-induced renal injury and the protection of metallothionein (MT).Methods 8-10 weeks old male MT-1 transgenic (MT-TG) mice (n=12) and the wide type (WT) mice (n=12) were randomly divided into two groups respectively,Air mimic control(Ctrl) group (n=6) and CIH group (n=6).The period of chronic intermittent hypoxia was continued for 8 weeks.The CIH paradigm consisted of 20.9％ O2 and 8％ O2 fraction of inspiration O2 (FiO2) alternation cycles (30 episodes per hour) with 20 seconds at the nadir FiO2 for 12 hours/day during daylight.The nadir hemoglobin oxygen saturations mainly ranged from 60％ to 70％.Urine,blood,kidney were collected at the end of study respectively.Histopathology,Western blotting and colorimetric method for related target were performed respectively.Results In WT mice,renal fibrosis,the expression of connective tissue growth factor (CTGF),type-1 plasminogen activator inhibitor (PAI-1),hypoxia-inducible factor 1α (HIF-1α),transforming growth factor β1 (TGF-β1),phosphorylated Smad2 and the MDA content were significantly increased by CIH (P ＜ 0.01).In WT mice,the expression of MT detected by using Western blotting was significantly decreased by CIH (P ＜ 0.01).However,in MT-TG mice,above-mentioned indicators showed no significant difference between CIH and Ctrl group.Conclusions Oxidative stresses is the main mechanism of CIH-induced renal injury.The possible molecular mechanism of CIH-induced renal injury is that CIH increases the expression of HIF-1α in kidney tissue,then activate the TGF-β1-Smad2 signaling pathway and lead to the renal fibrosis.The protection of MT on CIH-induced renal injury may be via its antioxidant effect.

Objective To investigate the safety and clinical effect of renal hilum controlling during right retroperitoneal laparoscopic living donor nephrectomy (RPLDN).Methods From January 2009 to May 2012,62 cases of right RPLDN were performed in our department.The clinical data,including the general status of donors,operative time,blood loss,donor kidney warm ischemic time,hospital stays and complications,were analyzed retrospectively.Results Right RPLDN was performed successfully on all 62 cases without conversion to open procedure and apparent complications.The function of all the kidney grafts recovered well.Mean operative time was 73.5 ± 10.4 min,mean blood loss was 30.7 ± 10.4 ml,mean warm ischemic time was 107.2 ± 24.8 s,mean artery and vein lengths were 3.3 ± 0.5 cm and 2.0 ± 0.4 cm,vena cava incision suture time was 2.0 ± 0.5 min and mean hospital stay was 5.2 ± 1.6 days,respectively.Conclusion Right donor kidney with small part of vena cava can be harvested by using retroperitoneal laparoscopy plus open passage way.This technique of renal hilum controlling in RPLDN has good clinical effect and more advantages,including ensuring the safety of donors and kidney grafts,promoting the operation done smoothly,reducing the pain and financial burden of donors.