Pre-emptive pediatric kidney transplantation or not?

Background: Kidney transplantation prior to dialysis (pre-emptive kidney transplantation, PKT) has been controversial because of the paucity of clinical evidence to clarify the risks and benefits of PKT. Several authors have confirmed a significant advantage of PKT in the treatment of patients with end-stage renal disease (ESRD). The aim of this study was to examine the characteristics of patients who received PKT or non-pre-emptive kidney transplant (NPKT).

Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: a randomized, double-blind clinical trial.

Periampullary neoplasms are rapidly progressive tumors with a poor prognosis and high morbidity and mortality rates, which have a negative influence on patient outcomes. Some probiotics and prebiotics have the ability to protect the intestinal barrier and prevent bacterial translocation, infection, and postoperative complications. We evaluated the use of synbiotics in a prospective, double-blind study of patients undergoing surgery for periampullary neoplasms (PNs) and assessed the effect of these agents on nutritional status, postoperative complications, antibiotic use, length of hospital stay, and mortality.

Kidney transplantation in children weighing less than 15 kg: extraperitoneal surgical access-experience with 62 cases.

Small children are a challenging group in whom to perform KT. This retrospective study analyzed the results of 62 KTs in children weighing <15 kg, performed between 1998 and 2010, using extraperitoneal access and anastomosis of the renal vessels of donors to the aorta and IVC or iliac vessels of the recipients. Thirty-two (51.

Late intestinal obstruction due to an intestinal volvulus in a pregnant patient with a previous Roux-en-Y gastric bypass.

This is a case of a 33 weeks pregnant woman, presented 2 years after laparoscopic Roux-en-Y gastric bypass, with abdominal pain for 2 days. A laparoscopic cholecystectomy was performed 1 day earlier in another hospital, without improving the pain. She presented at our hospital with acute abdominal pain and clinical signs of intestinal obstruction, undergoing an exploratory laparotomy that revealed a volvulus and necrosis of the jejunum from the gastroenteroanastomosis through the lateral enteroenterostomy, which was resected with the reconstruction of the Roux-en-Y limb performed at the same operation.

Educational program of organ donation and transplantation at medical school.

A favorable attitude of health professionals to organ donation can positively influence the decision of families of potential donors. By increasing health professionals knowledge about donation and transplantation and qualifying them to disseminate information, education has produced a positive response to increase the insufficient number of donors. Educating students early in their careers may become crucial in this setting.

Results of en bloc renal transplants of pediatric deceased donors into adult recipients.

Unlabelled: Various strategies have evolved to expand the donor pool due to the extreme shortage of organs. Herein we reviewed our experience with en bloc pediatric kidney transplantation since 1998.

Methods: From January 1998 to December 2004, nine adult patients underwent kidney transplantation using en bloc kidneys from donors <5 years old (range, 1 to 4).

Renal transplantation in children younger than 6 years old.

Herein we report our experience in renal transplantation in 38 children (40 transplants), ages 1 to 5 years, between 1989 and 2005. Demographics as well as patient and graft survivals are reported. Mean age at transplantation was 3.

300 pediatric renal transplantations: A single-center experience.

Unlabelled: Our objective was to relate the results of 300 consecutive kidney transplants performed in children at a single center.

Patients And Methods: An analysis of kidney transplants was performed on patients less than 18 years old engrafted from May 1977 to August 2005.

Results: Among 300 kidney transplants, 48% of the patients were female, 87% were Caucasian, and 13% were African-Brazilian.

Immunosuppression in pancreas transplantation: mycophenolate mofetil versus sirolimus.

The use of mycophenolate mofetil (MMF) in pancreas transplantation has increased graft survival and decreased the incidence of acute rejections episodes (ARE), regardless of the choice of calcineurin inhibitor. The combination of MMF with tacrolimus (TAC) is the most common protocol, it is considered the gold standard for new protocols. In the last few years, there have been reports of a small number of patients treated with sirolimus (RAPA), usually combined with TAC.

Substitution of basic amino acids in the basic region stabilizes DNA binding by E12 homodimers.

The E2A gene encodes two alternatively spliced products, E12 and E47. The two proteins differ in their basic helix-loop-helix motifs (bHLH), responsible for DNA binding and dimerization. Although both E12 and E47 can bind to DNA as heterodimers with tissue-specific bHLH proteins, E12 binds to DNA poorly as homodimers.

Duct-enterostomy as a treatment of pancreatic fistula in a bladder-drained pancreas transplant.

A case of combined pancreaticoduodeno-renal transplant with good graft function was complicated by recurrent episodes of graft pancreatitis treated by vesical catheter drainage. Four months after transplantation, a fistula from the pancreatic body associated with ascitis was identified. Anastomosis between pancreatic fistula and an individualized jejunal loop was performed.