Technique of Renal Homotransplantation: Experience With 42 Cases

Purely technical considerations play asignificant role in successful renal homotransplantation. Minimization of homograftischemia is critical. If blood supply to thecooled homograft can be restored within 40minutes, prompt urinary excretion can beexpected to follow. Longer periods of devascularizationresult in inconsistent earlyfunction. Even with ischemie intervals ofless than 40 minutes, there is an inverse correlation between the times necessary for vascular reconstruction and the quality of earlyrenal function.Additional important technical factors involve the site of placement of the homograft,provision for unkinked vascular channels,selection of a method of ureteroneocystostomywhich permits early removal of theurethral catheter, avoidance of all drains,and use of a one-stage operation incorporathemorrhage, diabetes mellitus, pancreatitis,thromboembolism, and neurologic disorders.The high incidence of such appears to be due to the high dose immunosuppressive therapy necessary to maintainviability of the homograft during the rejection crisis, to the terminal uremia which all patients are suffering at the timeof operation, and to specific elements of thetotal operative care such as splenectomy andinstrumentation of the pelvic veins. © 1964 IEEE All rights reserved

UV microbeam irradiations of the mitotic spindle. II. Spindle fiber dynamics and force production.

Metaphase and anaphase spindles in cultured newt and PtK1 cells were irradiated with a UV microbeam (285 nM), creating areas of reduced birefringence (ARBs) in 3 s that selectively either severed a few fibers or cut across the half spindle. In either case, the birefringence at the polewards edge of the ARB rapidly faded polewards, while it remained fairly constant at the other, kinetochore edge. Shorter astral fibers, however, remained present in the enlarged ARB; presumably these had not been cut by the irradiation. After this enlargement of the ARB, metaphase spindles recovered rapidly as the detached pole moved back towards the chromosomes, reestablishing spindle fibers as the ARB closed; this happened when the ARB cut a few fibers or across the entire half spindle. We never detected elongation of the cut kinetochore fibers. Rather, astral fibers growing from the pole appeared to bridge and then close the ARB, just before the movement of the pole toward the chromosomes. When a second irradiation was directed into the closing ARB, the polewards movement again stopped before it restarted. In all metaphase cells, once the pole had reestablished connection with the chromosomes, the unirradiated half spindle then also shortened to create a smaller symmetrical spindle capable of normal anaphase later. Anaphase cells did not recover this way; the severed pole remained detached but the chromosomes continued a modified form of movement, clumping into a telophase-like group. The results are discussed in terms of controls operating on spindle microtubule stability and mechanisms of mitotic force generation