Objective Hypothermic machine perfusion may improve the outcome after transplantation of kidney donated after citizen's death (DCD),but few powered prospective studies have been reported,especially in China.The aim is to compare hypothermic machine perfusion (HMP) with simple cold storage (SCS) in Chinese DCD kidney transplantation,which can offer an optimal method for graft storage with better graft function and survival.Methods 54 kidney pairs from DCD donors were included in this controlled trial in one single center from December 2015 to March 2017.Every two kidneys from each DCD donor wavs randomly assigned to HMP and SCS group.One-year recipient and graft survival rate and endpoints containing the incidence of DGF,the duration of DGF,creatinine reduction ratio (CRR),estimated glomerular filtration rate (Egfr),primary non-function (PNF),acute rejection (AR),toxicity of the immunosuppressive drugs,nosocomial infections and the length of hospital stay were compared between HMP and SCS group.Results One-year recipient survival rate was 98.15 ％ and 96.23％ after DCD transplant in HMP and SCS group,and one-year graft survival rate was 90.74％ and 88.68％,respectively.DGF incidence was 9.62％ in total DCD kidney transplant,8.00％ in HMP group and 11.11％ in SCS group,which was no difference in two groups.22 DCD was from expanded criteria donor (ECD) donation,DGF happened in 15.91％ ECD kidney transplant.However,HMP reduced the incidence of DGF from 27.27％ to 4.55％ after ECD kidney transplant,which was significantly different (x2 =4.247,P =0.039).HMP group acquired significantly lower creatinine level (130.95 ± 46.60) μmol/L than SCS group (181.64 ± 72.94) μmol/L on day 14 after ECD transplant (t =-2.686,P =0.011).Conclusion There was a higher recipient and graft survival rate after DCD and ECD kidney transplant,which would be an effective method to expand donor pool for kidney transplant.HMP was not associated with lower DGF rate in DCD kidney transplant and more rapid recovery in early graft function.However,HMP preservation not only made renal function recover more rapidly but reduced the risk of DGF after ECD kidney transplant.

Objective To study the effect of high mobility group box B1(HMGB1)gene knockout on alleviating a-cute lung injury and inhibiting toll-like receptor 4(TLR4)/nuclear factor-KB(NF-κB)pathway of sepsis mice.Methods Wild-type(WT)mice were divided into WT-Sham group and WT-model group,and HMGB1 knockout(KO)mice were divided into KO-sham group and KO-model group.Sepsis ALI model was established by cecal ligation and perforation in WT-model group and KO-model group.Sham operation was performed in WT-Sham group and KO-Sham group.24 h after modeling,the partial pressure of arterial oxygen(PaO2)was detected,oxy-genation index(OI)was calculated,pathological changes of lung tissue were detected and lung injury score was calculated,the concentrations of tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β),interleukin-6(IL-6),reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD),in serum and lung tissues and the expression of HMGB1,TLR4 and nuclear NF-κB in lung tissues were detected.Results The PaO2,OI and the concentration of SOD in serum and lung tissue of WT-model group were lower than those of WT-Sham group,the lung injury scores,the concentrations of TNF-α,IL-1 β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of HMGB1,TLR4 and nuclear NF-κB in lung tissue were higher than those in WT-Sham group(P＜0.05).HMGB1 was not expressed in lung tissue of KO-model group,and the concentrations of PaO2,OI and the concentration of SOD in serum and lung tissue of KO-model group were higher than those of WT-model group,the lung injury scores,the concentrations of TNF-α,IL-1β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of TLR4 and nuclear NF-κB in lung tissue were lower than those of the WT-model group(P＜0.05).Conclusion HMGB1 gene knockout alleviates acute lung injury of sepsis mice,the re-lated molecular mechanism may be the inhibition of TLR4/NF-κB pathway mediated inflammation and oxidative stress.