1,721,163 research outputs found
Cardiac arrest following intravenous administration of Clindamycin phosphate [Arresto cardiaco indotto dalla somministrazione endovenosa di clindamicina fosfato. Descrizione di un caso clinico]
No full textsafe conversion of stable kidney transplant recipients from twice-daily tacrolimus (Prograf) to once-daily modified release tacrolimus (advagraf)
No full textEffect of cilastatin on cyclosporine-induced acute nephrotoxicity in kidney transplant recipient
No full textBackground. Cyclosporine (CsA)-induced acute nephrotoxicity could be reduced by prevention of parenchymal accumulation of the drug itself. The objective of this prospective study was to evaluate whether cilastatin, an inhibitor of active tubular resorption of CsA, reduces CsA-induced acute nephrotoxicity in kidney graft recipients.
Methods. Sixty-nine kidney recipients with immediate graft functional recovery were randomly assigned to either the treatment group (imipenem/cilastatin, n=33) or the control group (ceftazidime, n=36). All patients followed a standard immunosuppressive regimen based on CsA and low-dose prednisone. Craft function and CsA levels were evaluated 3, 5, 10, 15, and 30 days after transplantation.
Results. Compared with the control group, imipenem/cilastatin administration reduced the serum creatinine level in the first 2 weeks after transplantation, reaching a significant effect on postoperative day 10 (P<0.05). No significant differences were demonstrated between the two groups for CsA levels, patient and graft survival, and all the other examined parameters.
Conclusions. Our findings support the hypothesis that cilastatin administration can reduce CsA-induced acute nephrotoxicity after kidney transplantation
Bilateral renal cell carcinoma of the native kidneys after renal transplantation
No full textWe report the case of a 45-year-old man who received a cadaveric renal transplant and subsequently developed a bilateral neoplasm of the native kidneys. Two tumors per each kidney were detected and in the left kidney they were cytologically different, one granular and one clear cell type. Bilateral nephrectomy with radical lymphadenectomy was performed, immunosuppression was withdrawn and medrossiprogesterone was administered. A control CT scan 3 months after surgery demonstrated no evidence of neoplastic recurrence, while ultrasonography detected a liver metastasis. The patient subsequently developed a para-neoplastic syndrome and died 7 months after surgery. We believe that all long-term immunosuppressed transplant patients need close observation. Regular imaging of the native kidneys, by ultrasound or CT, should be carried out yearly. Prophylactic bilateral nephrectomy is not desirable because of the loss of the important mechanism of pressure control. mediated by the renine-angiotensin system
The contribution of Na+/H+ exchange to postreperfusion injury and recovery of transplanted kidney.
No full textAcute kidney injury soon after reperfusion seems to anticipate short- and long-term graft prognosis. Sodium-hydrogen exchanger (NHE) is involved in several steps of kidney graft function recovery, such as the restoration of intracellular pH, acute postreperfusion inflammation, and tubular epithelium repair and proliferation. We studied 20 first kidney transplantations by measuring the erythrocyte NHE of both recipient and donor as well as recipient serum and urine indices of renal structural and functional integrity every day since grafting. Heightened exchange activity in the donor-recipient couple resulted, which was associated to a prompt graft recovery together with a short stay for the donor in the intensive care unit, brief cold ischemia time, and a nonatherogenic lipoprotein profile for the recipient. Additional positive prognostic indices were time-zero diuresis and urinary excretion rates of N-acetyl-beta-D-glucosaminidase (NAG) and albumin. Over the one-year follow-up period, a long post-transplantation hospital stay was associated with a significantly increased risk of rejection, and the urinary alanine-aminopeptide (AAP) excretion rate was confirmed as a useful criterion for evaluating the clinical course of kidney graft
Laparoscopic nephrectomy for massive kidneys in polycystic kidney disease
Full text linkBackground and Objectives: Laparoscopic nephrec-tomy is now considered a feasible surgical approach, even for large kidneys. In the case of massive kidneys, laparoscopy can be problematic, so that some authors suggest an open approach. However, previous studies have shown that hand-assisted laparoscopic nephrectomy (HALN) may represent a useful compromise. We describe our hand-assisted laparoscopic technique for nephrectomy of large kidneys (> 2500 g) to encourage the use of laparoscopy for nephrectomy in autosomal dominant polycystic kidney disease. Methods: We retrospectively analyzed data from 26 nephrectomies in 17 patients who underwent HALN for ADPKD and compared them to a group of 22 nephrecto-mies in 18 patients with open surgical technique. Results: The duration of the procedure was significantly longer in the laparoscopic group, with a median of 180 minutes versus 90 minutes for the unilateral nephrec-tomies, and 240 minutes versus 122 minutes for the bilateral procedures. The median kidney weight in the open group was 2500 g (range 1300 – 4500 g), while the median weight in the HALN group was 2375 g (range 1000 – 4700 g). The median hospital stay was comparable. No significant differences were recorded in the intra-and postoperative complication rate. Conclusion: Hand-assisted laparoscopic nephrectomy can be considered a technique of choice for patients suf-fering from ADPKD requiring nephrectomy, also with massive kidneys weighing more than 3500 g. Compared to open nephrectomy, HALN can be performed safely, with reasonably longer operating times and without major complications, and offers a significant reduction in hospitalization time, pain and postoperative discomfort
Renal transplantation following reduction of ileocecocystoplasty performed 9 years earlier for undiversion
No full textA case of complex urinary tract reconstruction is reported. Reduction of ileocecocystoplasty, performed in a young boy for undiversion, was necessary together with native binephrectomy before renal transplantation 9 years later. Transplantation was successfully performed after cystoplasty volume reduction and decrease of outlet resistance obtained with unilateral TUIP. Enterocystoplasty is a reasonable option for bladder rehabilitation in patients requiring renal transplantation for end-stage renal disease caused by lower tract dysfunction. © 1997 S. Karger AG, Basel
Doppler ultrasonography of the lower limbs and arteriography. Correlation of the results at rest and after exertion [Dopplersonografia agli arti inferiori ed arteriografia. Correlazione dei risultati a riposo e dopo sforzo]
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