Out of 321 cases of renal transplantation, 12 had hyperacute rejection(3.6%) after operation.Among them transplanted kidneys in 4 caseswere immediately remo-ved during operation, donor kidneys in 7 cases were removed 3-20d postoperation, and rejection in 1 case was controlled after suitable treatment,however donor kidney became atrophied gradually without being removed.Immunosuppressive drugs were discontinued and dialysis v/as restored in tjnv: in all the 12 patients.None of them died of rejection.Clinical diagnosis of hyperacute rejection was confirmed pathologically.Mechanisms, inducing factors, diagnosis and differential diagnosis, and treatment of hyperacute rejection are discussed.

Objective:To observe the influence of a self-designed multiple organ preservation solution,namely Shanghai multi-organ preservation solution(SMO),on the apoptosis of canine renal cortical cells during cold storage and the related mechanism.Methods: Canine kidneys were freshly perfused and separately stored with cold(0-4℃) SMO,hypertonic adenine citrate solution(HC-A),and University of Wisconsin solution(UW solution)(the latter 2 as control).At defined time points during storage,the morphologic changes of renal cortical samples were observed;apoptosis of renal cortical cell was determined by TUNEL;changes of malonldialdehyde(MDA) in cortex homogenate were measured by thiobarbituric acid method;and the activity of superoxide dismutase(SOD) was determined by xanthine oxidase method.Results: Pathologic assessments indicated that the kidney damage was similar in 3 groups within 24 h.The kidney tubular cell swelling and necrosis in SMO group and UW group were slighter than those in HC-A group after stored for 2 days.With the prolongation of storage time,apoptosis increased in all groups,with the apoptotic index of SMO group significantly lower than that of HC-A group(P

Objective To comprehensively summarize the recent development of organ transplantation specialty,and raise a suggestion for the future progress of the subject.Methods The info investigation method was employed to retrieve the literature concerning solid organ transplantation published in recent five years domestically and abroad,and the new progresses were analyzed on organ transplantation in both military and civil fields,and also fundamental and clinical researches.Results Researches on organ transplantation had progressed rapidly on foundation and clinical application in recent 5years in armed forces.The major achievements were in immune recognition and adjustment,transplant immune tolerance,the regulating effect of CTLA4Ig on NK cell function,preparation of the preservation fluid,and pathological diagnosis.Conclusions The professional level of organ transplantation in the armed forces had teken the foremost position in advance in the country.During the period of "12th Five-Year Plan" ,researches should be carried out on procurement,preservation and transplantation of the donated organs after cardiac death(DCD)organ.Meanwhile the foundational and clinical researches should be enhanced of immune tolerance,regulatory T lymphocyte,formulation of preservation fluid,and of animal experiment for closely bonding the foundational and clinical researches,and striving for greater research outcome.

UW solution has bean considered the gold standard for abdominal organ preservation. Celsior solution and HTK solution, with low potassium and low viscosity, are becoming more widely used in the preservation of the kidney, liver and pancreas, and are gradually accepted as an ideal alternative for UW solution. Recent studies have found that addition of trophic factors can attenuate hypothermic ischemic injury to the donor organ, thus improving the preservation outcome. This paper reviews the progress in laboratory research and looks foward to the clinical application of multi-organ preservation solution.

0.05).The acute rejection rates in non-dialysis group was significantly lower than that of dialysis group(19.53% vs 34.27%,P0.05).The 1 year survival rates of patient/graft were 98.44% in non-dialysis and(97.72%/)95.96% in dialysis group(no significance);the 3 year survival rates of patient/graft were 96.23% in nondialysis and(94.4%/88%) in dialysis group(no significance).Conclusion:Renal transplantation without dialysis can avoid the dialysis complications and transfusion-induced sensitization,and reduce the risk of hepatitis infection as well as the acute rejection rate;while its patient/graft survival rate is similar to that of dialysis renal transplantation,making it feasible for clinical application.

Objective To summarize the experiences of kidney retransplantation from 1978 to Dec. 2002.Methods The clinical data of 86 cases subject to first renal transplantation and 86 cases to second renal transplantation were retrospectively analyzed. The main causes of failure of the first renal transplantation were CAN, while those of the second renal transplantation were HAR, and other complications such as AR, graft rupture and serious graft T.B. PRA or CDC in 31 cases was positive before retransplantation. The clinical data such as antibody-inducing therapy, the protocols of immunosuppression and the survival rates of patients and grafts in these patients were analyzed.Results Survival rates at 1, 3, 5 year of the patient/graft of retransplantation group were 84.8 %/61.6 %, 79.1 %/45.3 % and 58.1 %/41.9 % respectively, while those at 1, 3, 5 years of the patient/graft with the first renal transplantation were 89.5 %/79.1 %, 81.4 %/74.4 % and 67.4 %/58.1 % respectively. No significant difference in the patient survival rates and graft survival rates was observed (P

Objective To investigate the adjustment of immunosuppression and prevention of infections in lung after renal transplantation.Methods 253 cases of pulmonary infections after renal transplantation between January 1999 to March 2004 were analyzed. After 2003, postinduction period, the blood concentrations of CsA and FK506 were maintained at 0.125~0.166 ?mol/L and 5 ?g/L respectively. The oral dose of MMF was 1 g every day. Results The creatinine levels were stable 253 patients after treatment. Among 253 cases, 229 cases were cured (90.51 %) and 24 died (9.49 %). After adjustment of immunosuppressants, common pulmonary infections and severe pulmonary infections were decreased.Conclusions Infection in lung was a severe complication after renal transplantation. Timely treatment, nursing care and adequate adjustment of immunosuppression may achieve satisfactory effects in preventing lung infection.

Objective To investigate the risk factors for delayed graft function (DGF) under-(going) cadaver renal transplantation.Methods Twenty-four relative variables were analyzed by SPSS11.0 statistical software. Using chi-square analysis method, the influence of these variables on DGF was retrospectively studied. Logistic regression analysis was done to assess and rank the relative risk of potential variables.Results The overall incidence of DGF was 5.01 %. Chi-square analysis (revealed) that the risk factors for DGF were identified as: cold ischaemia time, warm ischaemia time, recipient hypovolaemia, number of previous transplants, allosensitisation of the recipient, ATN, (accelerated) rejection, cyclosporine nephrotoxicity, ureteral leakage obstruction. Logistic multivariate analysis showed that there were 8 risk factors contributing to DGF.Conclusion DGF is a common (allograft) complication in the immediate posttransplant. There are many risk factors contributing to this condition. The basic change is ischemia-reperfusion injury. It is very important to comprehend the risk (factors) thoroughly in order to prevent them effectively.

Objective To study the therapeutic effects and side effects of foscarnet in the treatment of active(IgG+,IgM+)and inactive(IgC+,IgM-)cytomegalovirus(CMV)infection after cadaver renal transplantation.Methods Forty-one cases of active cytomegalovirus infection and 22 of inactive cytomegalovirus were selected to receive foscarnet treatment.Besides,10 cases of inactive cytomegalovirus infection served as control group without receiving foscarnet.The usage of foscarnet was 40 mg/kg,iv.,2 ～3 weeks in the active stage,50 mg/kg,iv.,3～4 weeks in the inactive stage.Results Clinical symptoms of patients in the active stage were controlled,and serologic CMV IgG turned negative.Moreover,no positive infection was found after 3-month follow-up for those who received foscarnet.At the same time, 3 patients in the control group turned into active infection. Only one receiving foscarnet appeared urine volume cutting down temporarily,and the renal function had a reversible change;2 patients had skin red reaction.Conclusion Foscarnet could control CMV active infection quickly,markedly and firmly.and no recurrence was found during a 3-month follow-up.Foscarnet may protect the inactive patients from turning positive.And foscarnet had no obvious damage to the renal graft function and didn't interfere with the metabolism of blood calcium and cyclosporine A.Foscarnet is a safe and effective drug to treat CMV infection.

Retrospective analysis of 761 case-times successive color Doppler sonography for 518 renal transplant patients was carried out.six parameters of sonography were used to compare, the CsA-NT hemodynamic changes among the patients with normal function, rejected and hy-dronephrotic kidney.It revealed that during rejection of the rendl srafts, besides an elevation of resistance index(RI)and a decrease of D/S ratio, the velocity and volume of renal blood flow were also slowed down and decreased respectively.After combating rejection, the renal function recovered to normal gradually, and RI dropped below 0.75 subsequently.Otherwise R1 would be persistently elevated, which indicated an irreversible rejection.The diagnosis of acute rejection was given at RI≥0.83, with the sensitivity rate being 82.70%and specificity being 80.10%.It was suggested that RI is a relatively sensitive and relialble parameter for the diagnosis of rejection.In combination with the clinical manifestations RI is of great important clinical value for the early diagnosis and treatment of acute rejection.