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.

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). Conclusions The kidney transplantation without prior dialysis offered comparable patient/graft survival to kidney transplantation with prior dialysis and avoided the dialysis complications and sensitization of transfusion, while reduced the risk of acute rejection. Therefore, uremic patients may be considered to receive the kidney transplantation without prior dialysis in clinic.

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

Objective To evaluate the efficacy and safety of piperacillin/tazobactam in the treatment of moderate and severe pulmonary infection (MSPI). Methods The clinical data of 35 patients with MSPI following kidney transplantation were retrospectively analyzed.Results Thirty-five cases out of the 35 MSPI patients ( 97.14 % ) was rescued successfully. The overall clinical efficacy rate of piperacillin/tazobactam was 91.43 % (32/35). The bacterial clearance rate was 92.59 % . The incidence of adverse reaction was 8.57 % (3/35).Conclusions Intensive care and active measures should be given to the MSPI patients after kidney transplantation. The key points of successful treatment involve the in time application of effective antibiotics,the adjustment of immunosuppressant and the correction of hypoproteinemia.

Objective To investigate the relation of sexual hormones, trace elements and erectile function in male uremia patients subject to the therapy of hemodialysis or after renal transplantation.Methods Data of 136 cases from March 1999 to December 2002 were retrospectively analyzed.Results The differences in sexual hormones, trace elements and erectile function between male uremia patients receiving hemodialysis and control groups were respectively significant (P