Renal Vascular and Ureteral Anatomic Variations in 1859 Potential Living Renal Donors

Background. Renal vascular and ureteral anomalies detected by preoperative computed tomography angiography (CTA) are important for determining the side of the donor nephrec-tomy and the optimal surgical technique. In the present study, we aimed to examine the renal vas-cular and ureteral variations in living kidney donor candidates

Effects of Ganoderma lucidum on Obstructive Jaundice-induced Oxidative Stress

WOS: 000288476100003PubMed ID: 21377103OBJECTIVE: Obstructive jaundice develops after occlusion of the common bile duct. Direct hyperbilirubinaemia, which occurs secondary to the condition, causes various life-threatening pathologies. Cytoprotective effects of Ganoderma lucidum (GL) have previously been shown. In this study, the effects of GL on oxidative stress and oxidant DNA damage in experimental obstructive jaundice were evaluated. METHODS: Sixty Wistar albino adult female rats were randomly divided into six weight-matched equal groups: sham group, bile duct ligated group (BDL); after sham operation 250 mg/kg/d of GL administered group, after sham operation 500 mg/kg/d of GL administered group, after bile duct ligation 250 mg/kg/d of GL administered (GL1BDL) group, and after bile duct ligation 500 mg/kg/d of GL administered (GL2BDL) group. GL polysaccharide was orally administered to the rats via gavage tube once a day for 14 days after bile duct ligation. RESULTS: The plasma malondialdehyde levels of the GL1BDL and GL2BDL groups were significantly lower than those of the BDL group (p < 0.01). The plasma 8-hydroxy-2'-deoxyguanosine levels of the GL1BDL and GL2BDL groups were significantly lower than those of the BDL group (p < 0.001). The liver tissue Cu-Zn superoxide dismutase level of the GL2BDL group was significantly higher than that of the BDL group (p < 0.05). CONCLUSION: GL protected against DNA and liver tissue damage by reducing oxidative stress in obstructive jaundice. [Asian J Surs; 2010;33(4):173-80

Influence of conversion from calcineurin inhibitors to everolimus on fibrosis, inflammation, tubular damage and vascular function in renal transplant patients

Conversion from calcineurin inhibitor (CNI) to mTOR inhibitors may reduce and even halt the progression of chronic allograft dysfunction (CAD) which is the most important cause of renal allograft loss. We aimed to investigate the effects of conversion from CNI to everolimus on parameters of fibrosis, inflammation, glomerulotubular damage and vascular functions in renal transplant recipients

Cardiovascular-Renal Changes After Kidney Donation: One-year Follow-up Study

Background. Long-termconsequences of kidney donation are not well known. Most of the studies published were focused on renal risk. In this prospective study, we investigated the changes in cardiovascular function after kidney donation. Methods. Thirty-eight living kidney donors were included. In addition to 24-hr ambulatory blood pressure monitoring, serum interleukin-6, vascular cell adhesion molecule (VCAM), and asymmetric dimethylarginine levels were measured. Endothelial function was examined bymeasuring ischemia-induced flow-mediated dilation (FMD) of the brachial artery. All studieswere repeated at 3 months and 12 months after kidney donation. Results. The mean serum interleukin-6 levels, both at 3 months and 12 months, were significantly increased as compared to the baseline (P = 0.007 and P < 0.001, respectively). The mean serum asymmetric dimethylarginine (P < 0.001) and VCAM levels (P < 0.001) at 12 months were significantly increased as compared to baseline. FMD values at 1 year (9.3% +/- 7.1%) were significantly decreased as compared to 3 months (13.0% +/- 6.0%, P = 0.001) and baseline (13.9% +/- 6.3%, P = 0.002). In multivariate analysis, serum uric acid (P = 0.001), estimated glomerular filtration rate (P = 0.027), and VCAM (P = 0.014) levels were the independent predictors of FMD 12 months after kidney donation. Conclusion. Our findings suggest that kidney donation might increase the cardiovascular risk in kidney donors

Diarrhoea following renal transplantation

In this study, we retrospectively evaluated all attacks of diarrhoea in our renal transplant recipients that came to our medical attention between 1985 and 2000. Also, the clinical features of patients with diarrhoea were compared with the features of recipients without diarrhoea. We diagnosed 41 attacks of diarrhoea in 39 (12.6%) of 308 renal transplant recipients during this time period. An aetiology was detected in 33 (80.5%) of all diarrhoeal episodes and in seven (17.1%) of those the specific agent was diagnosed with the help of stool microscopy. The most frequent causes of diarrhoeal attacks were infectious agents (41.5%) and drugs (34%). Six (14.6%) episodes of diarrhoea were chronic and six were nosocomial. About two-thirds of diarrhoea developed within the late post-transplant period (> 6 months). When recipients with diarrhoea were compared with those without diarrhoea, it was seen that diarrhoeal patients had significantly higher creatinine and significantly lower albumin levels when compared with the latter group (p < 0.05). Also, the frequency of antibiotic usage was significantly higher in diarrhoeal patients than in the control group (p < 0.05). Four (10.2%) patients with diarrhoea died despite institution of the appropriate therapy. Two of these deaths were primarily related to diarrhoea and the aetiological agent was Clostridium difficile in both these cases. During the 15-yr study period, 3.6% of all deaths and 5.1% of infection-related deaths in transplant recipients were secondary to diarrhoea. As a result, we observed that infections and drugs were the most frequent causes for diarrhoea in our series of renal transplant recipients. Also, diarrhoea was an important cause of mortality in this patient population