The Modernization of the Autopsy: Application of Ultrastructural and Biochemical Methods to Human Disease

The autopsy has provided, and still provides, the stimulus for many attempts to reproduce disease in experimental animal models. This approach has become increasingly difficult, however, in the case of human disease, principally shock. The study of some pathological states in animal models requires testing in several species and final confirmation in man before this knowledge can be applied to living patients. In our studies the application of cell biology techniques at autopsy has permitted the generation of new hypotheses which are more amenable to further exploration in experimental models and can be more precisely related to human disease

The use of bilateral adult renal allografts - A method to optimize function from donor kidneys with suboptimal nephron mass

Alternatives to traditional organ donor usage has allowed expansion of the organ donor pool to help compensate for the increasing disparity between recipients and donors. The use of bilateral adult renal transplants is a novel idea to salvage older donor kidneys with suboptimal nephron mass that would otherwise be destined for discard. Ten renal transplants were performed utilizing both kidneys from adult cadaver donors with diminished nephron mass determined by calculated glomerular filtration rate or biopsy evidence of significant glomerulosclerosis (\u3e10%). Nine of ten (90%) recipients have satisfactory renal function at a mean follow-up of 7 months. The single case of graft failure was due to documented medical non-compliance. Mean serum creatinine at 6 months was 1.5 mg/dl. Mean measured creatinine clearance was 43.2±3.4. These preliminary findings suggest that the use of bilateral renal transplants provide satisfactory early function and allows salvage of older donor kidneys with suboptimal nephron mass