No abstract available.
Allografts* ; Kidney Transplantation* ; Risk Factors*

The field of renal transplantation has undergone continual evolution to become the standard treatment for patients with end-stage renal diseases. The attempts to improve organ shortage, studies for clinical and basic science, empirical trial of new immunosuppressive drugs and technical challenges are very important for the development of renal transplantation medicine and improved patient outcome. This review will focus on the recent advancement and current hot issues of living donor renal transplantation worldwide.
Humans ; Kidney Transplantation* ; Living Donors*

No abstract available.
Aged* ; Humans ; Tissue Donors*

No abstract available.
Aged* ; Humans ; Tissue Donors*

Diagnostic ability of duplex Doppler ultrasonography reling on resistive index is limited when clinical symptoms and signs of rejection are subtle or renal dysfunction is caused by other conditions such as urinary tract infection. To investigate the significance in the changes of renal pelvis, a combined analysis of resistive index and ultrasonographic findings in cases of renal pelvis dilatation and mucosal thickening was undertaken. A mean resistive index was calculated from Doppler measurements of the main, segmental and interlobar arteries. The cause of mucosal thickening was retrospectively analysed using the clinical and laboratory findings. Twenty three cases of renal pelvis dilatation and 17 cases of mucosal thickening were found in a total of 159 renal transplantation cases. In 14 of the 23 cases with renal pelvis dilatation, renal function was normal and their mean resistive index was 0.64±0.04. Pelvis and ureter dilatation caused by ureteral stenosis or compression was demonstrated in 6 cases and their mean resistive index(0.72±0.05)was increased. Mucosal thickening of renal pelvis was found in 7 of 32 cases with acute rejection and in 2 of 13 cases with chronic rejection, but their mean resistive index was not different from that of the cases without pelvic mucosal changes Three cases of acute rejection associated with urinary tract infection and 2 cases of chronic rejection in whom resistive indices were indeterminate, but mucosal thickening of the renal pelvis was prominent at ultrasonography. In renal transplant patients having indeterminate resistive index and mucosal thickening of the renal pelvis, ultrasonographic features must be correlated with the clinical and laboratory findings for an accurate diagnosis and treatment of renal dysfunction.
Arteries ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Humans ; Kidney Pelvis ; Kidney Transplantation ; Kidney* ; Pelvis* ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Ureter ; Urinary Tract Infections

BACKGROUND: Toll like receptor (TLR), an element of innate immunity, is upregulated by Ischemia/reperfusion (IR) injury and may be involved in adaptive immune response. Immunosuppressive agents may increase or attenuate IR injury and TLR expression. To explore the involvement of TLRs in hypoxic tubular injury and modification by mycophenolic acid (MPA) rapamycin (RAP), this study examined TLR expression in hypoxia-induced human renal proximal tubular epithelial cells (HK-2). METHODS: HK-2 cells were cultured in keratinocyte-SFM media supplemented with epidermal growth factor and bovine pituitary extract. The Induction of hypoxia was achieved using GasPak pouch system. TLR 2, 3, and 4 mRNA expression was analyzed by real time RT-PCR using SYBR green and TLR 4 protein expression was evaluated by Western blot analysis. MPA at concentration of 100 nM and 1uM and RAP at concentration of 20, 50, and 100 nM were added to culture medium. RESULTS: TLR4 but noTLR2 or TLR3 mRNA expressions increased in hypoxic HK-2 cells at 24 and 48 hrs. TLR4 protein expression also increased in hypoxic HK-2 cells at 24 and 48 hrs. MPA (100 nM and 1uM) and RAP (20, 50, and 100 nM) decreased hypoxia-induced TLR4 mRNA expression in HK-2 cells compared to normoxia at 24 hrs. However, TLR4 protein expression was decreased only by RAP at 20 and 50 nM. CONCLUSIONS: The results suggest that RAP may modify hypoxic renal tubular damage by decreasing TLR4-mediated inflammatory and immune reactions.
Adaptive Immunity ; Anoxia ; Blotting, Western ; Epidermal Growth Factor ; Epithelial Cells ; Humans ; Immunity, Innate ; Immunosuppressive Agents ; Mycophenolic Acid ; RNA, Messenger ; Sirolimus ; Toll-Like Receptors

The vascular lesions in FK506 nephrotoxicity are similar to cyclosporine A, in which mediators related to vascular constriction and thickening such as endothelin, TGF-beta and PDGF may have some roles. Their expressions may be different in terms of degree and time sequence as well as overlapping ischemia, which made us to perform this experiment. Male Sprague Dawley rats received FK506 daily at a dosage of 2 mg/kg by intramuscular route for 4 weeks at maximum and were sacrificed 3 days, 1, 2 and 4 weeks after the initiation of the study, respectively. The control rats received saline. Renal ischemia was induced by occluding the left renal artery for 45 minutes and rats were sacrificed up to 2 weeks after reperfusion. Kidneys were processed for light microscopy and stained with PAS method and with antibodies against endothelin, TGF-beta and PDGF. The number of juxtaglomerular apparatus(JGA) and arterioles positive for each antibody was counted under light microscope and was expressed as mean +/- S.D per mm2 cortex. In FK506 treated rats, JGA and afferent arterioles were prominent with PAS positive granules, which was extended proximally to interlobular arteries with increased duration of FK506 treatment. With increasing duration, TGF-beta reactivity was increased in afferent arterioles. However, no such results were shown in cases of PDGF and endothelin. Renal ischemia itself increased vascular TGF-beta as well as endothelin and PDGF reactivities. Renal ischemia in FK506 treated rats further upregulated the expression of these markers in a similar distribution. However, the expression of endothelin was mostly found in endothelial cells of peritubular and glomerular capillaries. PAS staining was decreased in ischemic kidneys regardless of FK506 treatment. These results indicate that FK506 toxicity was comparable to CsA toxicity. Since expression levels of endothelin, TGF-beta and PDGF were increased in ischemic kidney, it might be helpful to prevent ischemic damage as well as to hinder secretion of these factors in order to reduce FK506 nephrotoxicity.
Animals ; Antibodies ; Arteries ; Arterioles ; Capillaries ; Constriction ; Cyclosporine ; Endothelial Cells ; Endothelins* ; Humans ; Ischemia ; Kidney ; Male ; Microscopy ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Reperfusion ; Tacrolimus* ; Transforming Growth Factor beta*

No abstract available.
Humans ; Microcomputers* ; Survival Analysis*

No abstract available.
Aneurysm, Infected ; Aorta, Abdominal

No abstract available.
Anemia, Hemolytic, Autoimmune* ; Kidney Transplantation*