High Intrapatient Tacrolimus Variability Is Associated With Worse Outcomes in Renal Transplantation Using a Low-Dose Tacrolimus Immunosuppressive Regime.

Background: High intrapatient tacrolimus variability has been associated with worse clinical outcomes postrenal transplantation. Theoretically, tacrolimus levels consistently outside the target therapeutic window may result in allograft dysfunction as subtherapeutic tacrolimus levels predispose to episodes of acute rejection, whereas supratherapeutic levels may cause nephrotoxicity.

Methods: We investigated the effect of tacrolimus variability in a "Symphony" style low-dose tacrolimus based regime, by collecting data from 432 patients over a 4-year period.

A novel rodent model of severe renal ischemia reperfusion injury.

Renal ischemia reperfusion injury (IRI) is a major problem, currently without treatments in clinical use. This reflects the failure of animal models to mimic the severity of IRI observed in clinical practice. Most described models lack both the ability to inflict a permanent reduction in renal function and the sensitivity to demonstrate the protective efficacy of different therapies in vivo.

Identification of Molecular Markers of Delayed Graft Function Based on the Regulation of Biological Ageing.

Introduction: Delayed graft function is a prevalent clinical problem in renal transplantation for which there is no objective system to predict occurrence in advance. It can result in a significant increase in the necessity for hospitalisation post-transplant and is a significant risk factor for other post-transplant complications.

Methodology: The importance of microRNAs (miRNAs), a specific subclass of small RNA, have been clearly demonstrated to influence many pathways in health and disease.

Endo-biliary stents for benign disease: not always benign after all!

This case report describes the presentation, management and treatment of a patient who suffered small bowel perforation due to the migration of his biliary stent which had been inserted for benign disease.

Impaired gluconeogenesis in a porcine model of paracetamol induced acute liver failure.

Aim: To investigate glucose homeostasis and in particular gluconeogenesis in a large animal model of acute liver failure (ALF).

Methods: Six pigs with paracetamol induced ALF under general anaesthesia were studied over 25 h. Plasma samples were withdrawn every five hours from a central vein.

Aortic valve replacement following coronary artery bypass grafting using bilateral internal mammary arteries.

Aortic valve replacement in patients with a patent internal mammary artery grafts poses two main challenges: Sternal reentry and myocardial protection. Beating heart procedures have been well described in coronary and valve surgery. Herein, we describe a simple reproducible technique of aortic valve replacement that circumvents the main issues highlighted above.