Erythraemia in Renal Transplantation

Seven cases of erythraemia following successful renal transplantation are described. This complication was not necessarily associated with clinical evidence of rejection of the transplant, and the prognosis so far as rejection was concerned was excellent. Four patients, however, developed thromboembolic pulmonary complications, and two other patients had thrombotic episodes. Hence it is suggested that treatment either by anticoagulation or by venesection is indicated.     

Vesico-ureteric Reflux after Renal Transplantation

The uretero-vesical junction has been examined by micturating cystography in 20 patients after renal transplantation. Intravenous pyelograms were used to investigate the upper urinary tract in 13 of the patients. Persistent urinary infection did not occur in patients without vesico-ureteric reflux. However, both those with reflux of their own and the transplant ureters had persistent infection. When reflux affected the tunnelled transplanted ureter there was no infection, but two patients without a tunnel implant had a persistent urinary infection.     

Abdominal Bruit after Renal Transplantation

Forty-seven recipients of renal allografts have been studied at varying intervals of up to five years after transplantation. Renal artery bruit occurred in eight of 16 patients observed over the first two post-transplant months and disappeared spontaneously in four of these. The disappearance of the bruit was associated with poor renal function. Renal bruits were audible in 10 patients examined more than two months after transplantation; nine of these were hypertensive and of six in whom arteriography was performed five were shown to have stenosis of the allograft artery. By contrast only eight of 37 patients without abdominal bruit were hypertensive, and arteriography in 10 normotensive patients without bruit showed no stenosis. It is concluded that while a renal artery bruit during the first two months after transplantation may be a marker of good renal blood flow at the time, its presence suggests a poor long-term prognosis since persistence of the murmur indicates that significant stenosis of the allograft artery is likely, while its disappearance is associated with poor renal function.     

Ileocolonic Problems after Cadaveric Renal Transplantation

Fatal colonic complications in five patients after cadaveric renal transplantation were all due to ischaemia of the bowel wall, which in two cases had led to multiple perforation. In two the lesions involved the whole colon and in three they were segmental.     

Raised Serum IgG Levels in Hypertension

Serum IgG levels were significantly higher in 118 severely hypertensive patients compared with a group of 163 normotensive blood donors, matched for age and sex. Serum IgA and IgM were the same in both groups. Raised levels of serum IgG were found in patients who had never been treated for hypertension, as well as in those who were treated with methyldopa or other hypotensive drugs.It is suggested that the raised levels of serum IgG may be an index of vascular damage induced by hypertension.     

貉血清IgG纯化及抗血清的制备

目的 制备高纯度貉血清IgG和兔抗貉IgG抗血清,作为建立多种动物抗体检测技术的储备。方法 采用Hitrap Protein A亲和层析及盐析再沉淀法纯化貉血清IgG,通过PAGE电泳和Western-Blot免疫印迹法对IgG作纯度及免疫活性检测;常规免疫法制备兔抗貉IgG血清。结果 貉血清IgG与Protein G虽有较强的结合力,但同时也结合血清中其他杂蛋白;用二步纯化法可从5 mL貉血清中纯化IgG约7 mg,电泳和免疫印迹测定显示,IgG纯度大于95%,常规免疫法制备抗血清免疫双扩散效价达1∶32。结论 建立了可行的貉血清IgG的纯化方法和高效价的兔抗貉血清IgG抗血清,为貉血清IgG二级抗体酶联物的制备储备了资源。     

虎血清免疫球蛋白（IgG）的纯化及纯度、活性鉴定

目的 建立高纯度、高活性的虎血清IgG纯化方法。方法 用饱和硫酸铵沉淀虎血清得到IgG粗品;结合Hitrap Protein A亲和层析预装柱及阴离子交换层析法对粗品IgG进一步分离纯化,采用PAGE电泳和Western-Blot免疫印迹法鉴定IgG纯度和免疫活性。结果 80 mL虎血清亲和纯化得到84 mg IgG,阴离子交换层析纯化得到30 mg虎的IgG纯品。结论 建立了简便快速、纯度高、活性好的虎血清IgG的分离纯化方法,为虎血清IgG二级抗体的制备提供了高纯度、活性好的一级抗体免疫原。     

肾移植术后移植肾动脉破裂4 例及文献复习

目的:提高肾移植术后移植肾动脉破裂的诊治水平。方法:回顾性分析临床所见4例肾移植术后移植肾动脉破裂诊治并复习国内外病例文献资料。结果:移植肾动脉破裂口均不在吻合口,离吻合口距离为0.5~0.8cm;破裂原因:3例为霉菌感染,1例为细菌感染;经行移植肾切除和抗真菌、抗菌治疗后,2例受者恢复血透,1例因术中肺梗塞死亡,1例因失血性休克而死亡。结论:移植肾动脉破裂临床上较少见,后果严重,不仅会影响到移植肾功能,更可能危及病人生命,早期诊断、紧急手术探查和特异性治疗可改善预后,挽救患者生命。     

硫化氢在肾脏病中的保护作用

肾脏病发病率逐年增高,已经成为影响人类健康的重要疾病之一。硫化氢是继NO、CO之后的第三种气体信号分子,大剂量有毒害作用,但生理浓度的硫化氢起到舒张血管、抗氧化、抗炎、抗凋亡等重要作用。肾脏病尤其继发性肾脏病如梗阻性肾病、肾移植、糖尿病肾病及高血压性肾损害等与血管病变、氧化应激、炎症密切相关,那么硫化氢与肾脏疾病之间有怎样的关系,本文将就硫化氢在肾脏病中的保护作用做一综述。     

Leucopenia Associated with Trimethoprim-Sulphamethoxazole after Renal Transplantation

Four patients who had received cadaveric renal allografts developed a profound and sustained leucopenia in association with a trimethoprim-sulphamethoxazole preparation. Ten other cadaveric renal allograft recipients received identical chemotherapy with no adverse effects. Statistical analysis showed that the association of leucopenia and trimethoprim-sulphamethoxazole therapy was dependent on the time after the transplantation procedure and was not related to the dosage of immunosuppressive chemotherapy or renal function.     

Antigen-Specific versus Non-Antigen-Specific Immunoadsorption in ABO-Incompatible Renal Transplantation

Introduction

ABO-incompatible (ABOi) renal transplantation (RTx) from living donors is an established procedure to expand the donor pool for patients with end stage renal disease. Immunoadsorption (IA) is a standard procedure for the removal of preformed antibodies against the allograft. In this study, antigen-specific and non-antigen-specific IA in ABOi RTx were compared.

Patients and Methods

10 patients underwent antigen-specific IA (Glycosorb group) and 13 patients non-antigen-specific IA (Immunosorba group). The effects of both procedures regarding antibody reduction, number of treatments, complications, costs, as well as the allograft function and patient survival were compared between both groups.

Results

Although the IgG levels were reduced equally by both procedures (p=0.82), the reduction of the IgM level was more effective in the Glycosorb group (p=0.0172). Patients in both groups required a median number of 6 IA before ABOi RTx. Allograft function at one year after AB0i RTx was similar in both groups (estimated glomerular filtration rate: 66 vs. 64 ml/min/1.73m² respectively), with a death-censored graft survival of 90.0% and 92.3% respectively. Complication rates did not differ between procedures. Due to the reuse of non-antigen-specific Immunosorba columns, costs were considerably lower in this group; however, the use of the Immunosorba-based IA was less time-efficient.

Conclusion

Considering upcoming alternatives as simultaneous performance of dialysis and IA or a possible reuse of Glycosorb columns, this might become less relevant in the future.