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.

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.

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.

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.

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.

0. 05) . The sensitivity and specificity of NMP-,2 in diagnosing transitional cell carcinoma of bladder were 85. 7% and 60% when the cut-off was set 10 u/ml, In contrast, the sensitivity and specificity of urinec cytology were 32. 1% and 100%. Conclusions: Urinary NMP22 can be used to screen and follow up transitional cell carcinomas of bladder with high sensitivity and high specificity.

Objective To testify the possibility that two-hour concentration (C_2) substituting for the target concentration (C_0) is used to be a monitoring tool for CsA. Method The whole blood concentrations of CsA having taken orally in 17 renal transplant patients were measured by FPIA. The data of concentration-time was processed by 3P87 pharmacokinetic program. Results The correlation between C_2 values and AUC_ 0-4 , or AUC_ 0-12 was both more excellent than C_0( P

Objective To investigate the association of prognosis with clinical features,tumor imaging,and pathological grading and staging in small renal cell carcinoma(SRCC). Methods The clinical data of 76 cases of SRCC (no more than 3 cm in diameter) were analyzed retrospectively.According to the clinical symptoms,they were divided into two groups,symptomatic (hematuria and lumbago) group (n=17,accounting for 22.4%) and asymptomatic group (n=59,77.6%).All the 76 cases underwent CT scan,with the diagnosis rate of 94.7%;69 cases underwent B-ultrasound examination with the diagnosis rate of 84.1%. Results All the 76 cases underwent radical nephrectomy through oblique incision in the lumbus.The excised tumors were pathologically confirmed to be clear cell carcinoma.The patients were followed up for 32 to 87 months(mean,62.7 months).The 1-,3-,and 5-year cancer-free survival rates of the symptomatic and asymptomatic groups were 100% and 53.3%,33.3% and 100%,90.6% and 77.4%,respectively.There were statistically significant differences between the two groups in the 3- and 5-year cancer-free survival rates (P

Objective To investigate the diagnosis and treatment of fungal infections of the lungs after renal transplantation. Methods A total of 43 cases (35 males and 8 females,mean age of 32 years) fungal infections of the lungs after renal transplantation from January 1999 to March 2002 were retrospectively analyzed.The mean time from post-operation to onset of the infection was 59 days. Results Among the 43 cases,16 were infected with candidiasis ,4 with candida Krusei ,2 with candida parapsilosis ,3 with mycormyccosis ,4 with aspergillosis ,1 with cryptococcosis neoformans and 2 with nocardiasis .14 cases out of 43 cases were coinfected with bacteria and CMV.The other 11 cases were negative for fungus-culturing test.23 cases were cured with fluconazole (100 mg,3 times per day for 10 days),17 with amphotericin B (50 mg,once a day for 10 days)and 3 died. Conclusions Fungal infection of the lungs is a severe complication after renal transplantation. Early diagnosis and timely treatment may achieve satisfactory effects.