Objective To observe the early clinical effect of single kidney transplantation from cardiac death pediatric donors to adult recipients. Methods Clinical data of 6 single kidney transplantations from cardiac death pediatric donors in adult recipients in Department of Organ Transplantation ,Guangdong Province No.2 People′s hospital were retrospectively analyzed. the transplant operations were carried out between January 2010 to may 2016.The median age of 6 pediatric donors was 9 years (5 years to 15 years). All recipients had the same blood type. The median age of 12 recipients was 38 years (21 years to 65 years),with 4 man and 8 women. All recipients received kidney transplantation for the first time,and overall reactive antibodies(PRA) were negative,with HLA mismatch between 1to 4. All recipients received single kidney transplantation in right fossa iliaca. Results 12 kidney transplantations were successful. The renal allografts recovered successfully without acute renal rejection , delayed graft function or primary nonfunction. Renal function of 5 of recipients immediately recovered in 5 days,5 recovered in 10 days,and 2 recovered slowly. 1 recipient manifested urine leak and recovered after drainage. 1 case developed delayed incision healing and recovered after dressing at stage II. All patients and renal grafts functions were wellnormal during follow?up period between 1 month to 36 months. Conclusion The early clinical effect of single kidney transplantation from cardiac death pediatric donors to adult recipients is good and could be a promising pathway to expand the organ donor sources.

Objective To study the prognostic role of plasma neutrophil gelatinase-associated lipocalin (NGAL) early after renal transplantation.Methods A total of 37 kidney recipients were enrolled from Department of Organ Transplantation,Guangdong Second Provincial General Hospital within a 12-month period of time.Plasma NGAL was measured immediately before and at 6 and 12 h post-transplantation.Changes of serum creatinine were documented daily within the first week postoperation.Acute kidney injury (AKI)/graft rejection during the first week after transplantation was the outcome variable.Results The levels of serum NGAL in the 37 patients were (311.14 ± 102.69),(317.81 ± 107.28) and (312.16 ± 134.80) μg/L respectively immediately before and at 6 and 12 h post-transplantation.There was no significant difference in serum NGAL levels before and 6 h or 12 h after operation (P =0.70,and P =0.96).There were no significant differences in gender and age between the two groups (P =0.29,and P =0.20).There was significant difference in creatinine levels between the AKI group and the non-AKI group (P =0.002) and between pre-operation and 6 or 12 h postoperation.The preoperative levels of serum NGAL in AKI group and non-AKI group were (333.58 ± 116.30) and (300.36 ± 96.15) μg/L (P =0.36),and those were (383.3 ± 147.16) and (286.32 ± 65.97) μg/L (P＜0.01) at 6 h,and (437.33 ± 164.16) and (252.08 ± 57.53) μg/L (P＜ 0.001) at 12 h after operation.The sensitivity and specificity of serumNGAL (317μg/L at 12 h after operation as the cutoff value) predicting AKI was 100％ and 92％ respectively,which was much better than that of serum creatinine at the corresponding time point (sensitivity =66.7％,and specificity =61.9％).Conclusion Plasma NGAL,particularly at 12 h after transplantation,is a very sensitive and specific biomarker for predicting AKI.

Objective To explore the feasibility of serum Klotho level in the elderly donors to predict the renal graft function in the recipients. Methods Clinical data of 16 elderly donors and 27 recipients undergoing renal transplantation were collected. The general status of the recipients was observed. The levels of serum Klotho and serum creatinine (Scr) in the elderly donors were measured on the day of renal transplantation. The Scr levels in the recipients were measured at postoperative 1, 3 and 12 months respectively. The estimated glomerular filtration rate (eGFR) was calculated. The correlation between the serum Klotho level of the donors and postoperative graft function of the recipients was analyzed. Results The cold ischemia time during renal transplantation was (649±245) min. The incidence rate of delayed graft function (DGF) was 26%. The incidence rate of acute rejection was 7%. In the elderly donors, the serum Klotho level was 537 (245-793) pg/mL and the Scr level was (164±62) μmol/L. At postoperative 1, 3 and 12 months, the Scr levels in the recipients were (136±47), (132±43) and (133±46) μmol/L, respectively. The corresponding eGFR was (52±20), (52±19) and (53±21) mL/(min?1.73m²), respectively. The serum Klotho level in the elderly donors was negatively correlated with the renal graft function at postoperative 1 month in the recipients (P < 0.05). The sensitivity and specificity of serum Klotho level in predicting the renal graft insufficiency at postoperative 1 month were 0.909 and 0.769. Conclusions The preoperative serum Klotho level in the elderly donors have predictive value for renal graft function in the recipients at postoperative 1 month.

OBJECTIVE: To assess the potential of transient expression of recombinant human plasminogen activator (rhPA) in plants as a cost-effective approach for recombinant rhPA production. METHODS: Tobacco mosaic virus-based expression vector pTMV rhPA-NSK and plant binary expression vector pJ Zera-rhPA were constructed by sequence synthesis and subcloning. The two vectors were inoculated on either or leaves agroinfiltration. The expression of recombinant rhPA in leaves was examined using Western blotting and ELISA, and the fibrinolysis activity of plant-produced rhPA was assessed by fibrin agarose plate assay (FAPA). RESULTS: Five to nine days after infiltration with an inoculum containing pTMV rhPA-NSK, necrosis appeared in the infiltrated area on the leaves of both plants, but intact recombinant rhPA was still present in the necrotic leaf tissues. The accumulation level of recombinant rhPA in infiltrated leaves was significantly higher than that in leaves ( < 0.05). The yield of recombinant rhPA was up to 0.6% of the total soluble protein (or about 60.0 μg per gram) in the fresh leaf biomass at 7 days post-inoculation. The plant-derived rhPA was bioactive to convert inactive plasminogen to active plasmin. No necrosis occurred in pJ Zera-rhPA-infiltrated leaves. The Zera-rhPA protein was partially cleaved between the site of Zera tag and rhPA sequence in both leaves. We speculated that the formation of Zera tags-induced particles in the plant cells was a dynamic process of progressive aggregation in which some of the soluble polypeptides were encapsulated in these particles. CONCLUSIONS Enzymatically active recombinant rhPA can be rapidly expressed in tobacco plants using the plant viral ampliconbased system, which offers a promising alternative for cost-effective production of recombinant rhPA.
Humans ; Plant Leaves ; Plants, Genetically Modified ; Plasminogen ; Plasminogen Activators ; metabolism ; Recombinant Proteins ; Tobacco