Successful kidney transplant from methanol-intoxicated donors.

The well-described disparity between the need for and the supply of organs suitable for transplant is growing. Because of this disparity, mortality of patients listed for transplant is increasing. Donors who die of intoxication (including victims of methanol poisoning) represent less than 1% of suitable donors and might be used to increase the supply of organs.

[Kidney transplantation from donors dying of methanol intoxication].

Introduction: Intoxicated patients represent only a minimum of the total number of cadaveric donors; however, their significance within the transplant program in the Czech Republic has recently been emphasized in connection with the so-called methanol affair.

Material And Methods: A retrospective analysis of methanol-poisoned patients who were declared brain-dead and subsequently underwent organ removal for transplantation purposes in the University Hospital Ostrava was performed. In cooperation with other transplant centres (Institute for Clinical and Experimental Medicine, Transplant Centre of the University Hospital Hradec Kráilové, Centre for Cardiovascular and Transplantation Surgery in Brno) the graft function, postoperative morbidity and mortality was evaluated.

[An overview of the results of renal transplantation in the Czech Republic].

Renal (kidney) transplantation is now a routine and the most successful form of renal replacement therapy. There is a long tradition of renal transplantation in the Czech Republic, The first was performed as early as 1961 in Hradec Kralove, and the programme as such was launched in 1966 with the first successful transplantation at the Institute of Experimental Surgery (later Institute for Clinical and Experimental Medicine, Prague). At present, transplantations are being performed at 7 transplantation centres (IKEM Prague, Centre for Cardiovascular and Transplantation Surgery Brno, Faculty Hospitals Hradec Kralove, Plzen, Olomouc and Ostrava and Faculty Hospital Motol for children).

["Low volume" laparoscopic nephrectomy for relative-to-relative transplantation].

Aim: Worldwide, the number of suitable cadaverous donors is limited. Therefore, as a solution for patients with chronic renal failure appears to extend the group of living donors of healthy individuals who voluntarily donate kidney to relatives or emotionally related recipients. Given the altruistic circumstances of these operations, the main monitored parameters are security for donors and excellent graft function for recipients.

Comparable Renal Function at 6 Months with Tacrolimus Combined with Fixed-Dose Sirolimus or MMF: Results of a Randomized Multicenter Trial in Renal Transplantation.

In a multicenter trial, renal transplant recipients were randomized to tacrolimus with fixed-dose sirolimus (Tac/SRL, N = 318) or tacrolimus with MMF (Tac/MMF, N = 316). Targeted tacrolimus trough levels were lower in the Tac/SRL group after day 14. The primary endpoint was renal function at 6 months using creatinine clearance (Cockcroft-Gault) and was comparable at 66.

[Preoperative preparation and examinations before scheduled cardiosurgical intervention].

In our article we inform about complete preoperative preparation and about required examinations before the scheduled cardiosurgical procedure. Important part of the preoperative preparation is also detailed instruction about the character of the operation, a way of its realization and about the operation risks. In the end of this article we discus the instruction of the patient about the types of the valvular prosthesis.

[Atrial transport function after surgical ablation of atrial fibrillation using cryoenergy].

Background: Surgical ablation is one of the most effective techniques for treatment of atrial fibrillation. Stable sinus rhythm is achieved and effective atrial contractions are restored in the majority of patients. The aim of the prospective study is to assess the presence of atrial transport function after surgical ablation of atrial fibrillation using cryoenergy and to evaluate predictors of the procedural success.

The diagnosis of brain death--own experience.

Background: The aim of this paper is a description of our experience with scintigraphic detection of brain death.

Material And Methods: Thirty-four patients were studied from February 2003 to June 2006. We performed brain scintigraphic examination utilising (99m)Tc-HMPAO and a two-headed SPECT camera E.

Discontinuation of mycophenolate mofetil from a tacrolimus-based triple regimen 2 months after renal transplantation: a comparative randomized, multicentre study.

Previous clinical data suggested that with a tacrolimus-based regimen adjunctive immunosuppressives may be withdrawn after an initial treatment period. This study investigated the early discontinuation of mycophenolate mofetil (MMF) from a standard triple regimen. Patients were randomized either to receive a continued tacrolimus/MMF/steroids triple regimen (control group) or to reduce and then stop the MMF dose (MMF stop group).

[The results of kidney transplantation from very young paediatric cadaveric donors to adult recipients in Czech Republic in the years 1994-2001 (retrospective study of the Czech transplant centres)].

The results of kidney transplantation from very young paediatric cadaveric donors up to five years, which were transplanted to adult recipients, are evaluated in the first retrospective study of all Czech transplantcentres. In general, 42 of these transplantations were carried out during 1994-2001. In 28 cases single kidney was transplanted, in 14 cases en bloc graft of both children kidneys was transplanted.

[Manually-assisted laparoscopic nephrectomy in a living donor].

Manually assisted laparoscopic nephrectomy from a live donor combines the advantage of a mini-invasive approach with the advantage of the assisting hand in the abdominal cavity to which the surgeon is used from classical operations. The authors performed the first nephrectomy from a live donor by this method on May 13, 2002. Our initial experience with five nephrectomies by this method indicate that every subsequent operation was shorter and the period of warm ischemia was also shorter.

[Major vascular injuries in laparoscopic operations].

The authors present three case-histories of major vascular injuries during laparoscopic operations. Subsequently they discuss causes and possible prevention of these rare but serious complications.

[Metastatic choriocarcinoma as a cause of hemorrhage in the digestive tract and abdominal cavity].

Authors present a case report of an young woman with metastatic choriocarcinoma. Clinical presentation of the disease was intracerebral bleeding concurring with intestinal bleeding and bleeding from ruptured spleen according to metastatic spread. Physicians firstly didn't think of choriocarcinoma because of small incidence of the disease and long period after the patient's latest pregnancy.

[Ureteroureteral end-to-side anastomosis in kidney transplantation--personal experience].

The most widely used way of reconstruction of the urinary pathways in transplantations of the kidney is at present a ureteroneocysto anastomosis. In some patients this type of reconstruction is difficult, if not impossible (adhesions in the lesser pelvis of the recipient, atrophic urinary bladder, short ureter of the graft, transplantation of child kidneys). In these instances the authors indicated a uretero-uretero end-to-side anastomosis.