First global forum on education on organ donation and transplantation for schools.

The Transplantation Society, in collaboration with the Canadian Society of Transplantation, organized a forum on education on ODT for schools. The forum included participants from around the world, school boards, and representatives from different religions. Participants presented on their countries' experience in the area of education on ODT.

Proteinuria >0.5 g/d, a prevalent prognostic factor for patient and graft survival in kidney transplantation.

Unlabelled: Proteinuria >0.5 g/d (HP) and serum creatinine (Scr) >120 micromol/L (HSC) at three months, two and five yr were compared as prognostic factors in kidney transplantation. We retrospectively analyzed 454 first transplants (follow-up: 100 +/- 3.

Pharmacologic approaches for volume excess in acute kidney injury (AKI).

Volume management is an integral component of the care of patients with acute kidney injury (AKI). Considerable controversy exists regarding the use of pharmacological agents for volume management. Although overt fluid overload is often seen in AKI and may prompt attention for the use of diuretics, often these agents are used in the absence of fluid retention.

An international opinion poll of well-educated people regarding awareness and feelings about organ donation for transplantation.

Despite repeated campaigns promoting transplantation, the high donation refusal rate remains unchanged. We targeted a well-educated population to assess the impact of our current transplantation promoting programs and personal feelings toward new approaches to organ donation. A questionnaire was proposed in five universities to students and university staffs that would have been likely to benefit from previous information campaigns in two South American and three European countries.

Public opinion and organ donation suggestions for overcoming barriers.

Getting organs for transplantation depends on people's decision; thus, public opinion is essential to finding a solution to this problem. Efforts to improve organ shortage focus on: 1) Living, unrelated donation, 2) increasing marginal donors and 3) proposing economic support for donors. Paradoxically, no initiative has been suggested to modify public opinion towards cadaver donors.

Influence of socioeconomic and ethical factors on people's behaviour regarding the use of cadaveric organs.

An organ donation is based on feelings of human solidarity and altruism. This approach, however, has not improved the organ shortage problem. The following suggestions might help to dismantle the persistent barrier linked to organ donation.

Organ shortage, are we doing our best?

Continuing organ shortage and ever-longer waiting lists have prompted the transplant community to adopt a broader than medical perspective in attempts at increasing the donor pool. Surveys conducted in various parts of the world reveal only a moderate acceptance of transplantation among medical professionals, a possible consequence of inadequate educational program at school/university level. General public awareness is low and efforts should be aimed at promoting a philosophy of sharing, reevaluating the traditional notion of the integrity of the human body, encouraging a readiness to fullfil an ever present social need through organ donation.

The role of education in increasing organ donation.

The influence of extensive educational programs in increasing organ donation is discussed. Improvements in organ donation rates can be expected by acceptance of the "suboptimal donor", economic assistance to those responsible for organ procurement and the information campaigns for the general public. Organ shortage can be considered as a "disease" that kills thousands of persons yearly.

High-dose furosemide for established ARF: a prospective, randomized, double-blind, placebo-controlled, multicenter trial.

Background: The effect of furosemide on the survival and renal recovery of patients presenting with acute renal failure (ARF) is still debated.

Methods: Three hundred thirty-eight patients with ARF requiring dialysis therapy were randomly assigned to the administration of either furosemide (25 mg/kg/d intravenously or 35 mg/kg/d orally) or matched placebo, with stratification according to severity at presentation. The primary end point was survival.

Therapeutic effects of angiotensin II inhibition or blockade on the progression of chronic renal disease.

Experimental and clinical research has supported the use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in diabetic, hypertensive and proteinuric nephropathies. This review will evaluate the role of angiotensin II in the progression of renal damage in kidney diseases; the diagnostic value of microalbuminuria as an early clinical sign of renal damage and the possibility of preventing its further progression; the clinical results obtained with ACE inhibitors and/or ARBs in diabetic and non-diabetic nephropathies; and the therapeutic possibilities of ACE inhibitors and ARBs in renal transplantation. Based on available clinical data, ACE inhibitors can be considered to be the gold standard in reducing and/or preventing albuminuria, and thereby decreasing the percentage of patients who will progress to end-stage renal disease and death.

Improvement in organ shortage through education.

Given the persisting shortage of organs for transplantation, it is time to consider whether the message that is sent to society to encourage donation is unsuitable. This message is mainly based on altruism and solidarity, and it has failed. Patients die because of the lack of cadaver organs that society refuses to offer; paradoxically, society is denying itself a chance of life.

Histologic features of chronic allograft nephropathy revealed by protocol biopsies in kidney transplant recipients.

Background: The aim of the present study was to describe the histologic features disclosed by protocol kidney transplant biopsies in patients who experienced neither acute rejection nor acute renal failure during the 2 years after transplantation.

Methods: We studied 10 recipients of HLA-identical kidneys from living-related donors and 31 recipients of cadaveric kidneys. They were selected because, during the 2 years after transplantation, they did not experience clinical acute or chronic rejection, their renal function was normal and stable, and they underwent a protocol kidney biopsy at 3 months and at 2 years after transplantation.

A simple prognostic index for patients with acute renal failure requiring dialysis. French Multicentric Prospective Study on Furosemide in Acute Renal Failure Requiring Dialysis.

The probability of death in patients with acute renal failure (ARF) remains high. A valid prognostic index available on patient admission and during follow-up could be helpful for decision making. In this study, 94 ARF patients requiring dialysis (not responding to a previous single dose of furosemide 15 mg/kg) were included.