Flow cytometry: is it the ultimate crossmatch technique in living donors?
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Biomedical subjects
Publications and source records attributed to Z Shapira.
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Due to a shortage of suitable kidneys for transplantation there has been an increase in the use of kidneys taken from old and marginal donors, which has led to a high incidence of acute tubular necrosis. Several reports suggest that the administration of calcium channel blockers improves the initial function after renal transplantation. We conducted a randomized, double-blind placebo-controlled trial to study the effect of the calcium channel blocker gallopamil on the incidence and course of acute tubular necrosis following cadaveric renal transplantation. A trend developed showing a decrease in episodes of acute tubular necrosis in gallopamil versus placebo, and became statistically significant when the outcome of kidneys from donors older than 50 years was analyzed separately [gallopamil 6/14 (42%) vs. placebo 10/11 (91%), P <0.01 corrected chi2]. We conclude that pre-transplantation renal graft perfusion and post-transplantation recipient treatment with gallopamil reduces the incidence of post-transplantation acute tubular necrosis, particularly in kidney taken from older donors.
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Large-cell retroperitoneal lymphoma was partially resected including a long segment of ureter. The proximal end of the ureter was clipped during surgery. A percutaneous nephrostomy was inserted after 48 h. Adjuvant chemotherapy was then delivered and the kidney was autotransplanted to the contralateral iliac fossa. Salvage of a hydronephrotic functioning kidney by nephrostomy and delayed contralateral autotransplantation in a case of huge retroperitoneal tumor involving the ureter has not, to the best of our knowledge, been described previously. This might suggest a reasonable approach for young patients with large retroperitoneal tumors involving long segments of the ureter. Autotransplantation was performed only after a disease-free status was confirmed following chemotherapy.
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