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Impact of transplant nephrectomy on peak PRA levels and outcome after kidney re-transplantation

World Journal of Transplantation 2014年第2期4卷 141-147页

作者： Dietlind Tittelbach-Helmrich Przemyslaw Pisarski Gerd Offermann Marcel Geyer oliver thomusch Ulrich Theodor Hopt oliver Drognitz Department of General Surgery University of Freiburg79106 Freiburg i. Brsg.Germany Department of General Surgery University of Luebeck23538 LuebeckGermany Transplant Center Medical Department IVCampus Benjamin FranklinUniversity Charité of Berlin12200 BerlinGermany Department of Nephrology University of Freiburg79106 Freiburg i. Brsg.Germany

AIM: To determine the impact of transplant nephrectomy on peak panel reactive antibody(PRA) levels, patient and graft survival in kidney re-transplants. METHODS: From 1969 to 2006, a total of 609 kidney re-transplantations were performed at the University of Freiburg and the Campus Benjamin Franklin of the University of Berlin. Patients with PRA levels above(5%) before first kidney transplantation were excluded from further analysis(n = 304). Patients with graft nephrectomy(n = 245, NE+) were retrospectively compared to 60 kidney re-transplants without prior graft nephrectomy(NE-).RESULTS: Peak PRA levels between the first and the second transplantation were higher in patients undergoing graft nephrectomy(P = 0.098), whereas the last PRA levels before the second kidney transplantation did not differ between the groups. Age adjusted survival for the second kidney graft, censored for death with functioning graft, were comparable in both groups. Waiting time between first and second transplantation did not influence the graft survival significantly in the group that underwent nephrectomy. In contrast, patients without nephrectomy experienced better graft survival rates when re-transplantation was performed within one year after graft loss(P = 0.033). Age adjusted patient survival rates at 1 and 5 years were 94.1% and 86.3% vs 83.1% and 75.4% group NE+ and NE-, respectively(P < 0.01). CONCLUSION: Transplant nephrectomy leads to a temporary increase in PRA levels that normalize before kidney re-transplantation. In patients without nephrectomy of a non-viable kidney graft timing of re-transplantation significantly influences graft survival after a second transplantation. Most importantly, transplant nephrectomy is associated with a significantly longer patient survival.

关键词： Kidney re-transplantation Graft nephrectomy Panel reactive antibodies,Patient and graft survival

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甲状腺手术中运用神经监测仪的优越性

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Oncology and Translational Medicine 2001年第1期18卷 9-9页

作者： oliverthomusch,HenningDralle,吴亚群 Klinik fur Allgemeinchirurgie Martin-Luther-Universitat Halle-Wittenberg Ernst-Grube Klinik fur Allgemeinchirurgie Martin-Luther-Universitat Halle-Wittenberg Ernst-Grube 华中科技大学同济医学院附属同济医院 Str.40 D-06097 Halle/Saale Str.40 D-06097 Halle/Saale

甲状旁腺和甲状腺外科中危险的并发症是喉返神经损伤。文献报道,喉返神经麻痹发生率在结节性甲状腺肿首次手术后为0％,而在再次手术时发生高达20％。术后喉返神经麻痹可能是手术分离过程中牵拉、压迫、结扎神经和电凝的热损伤所致,基于... 详细信息

甲状旁腺和甲状腺外科中危险的并发症是喉返神经损伤。文献报道,喉返神经麻痹发生率在结节性甲状腺肿首次手术后为0％,而在再次手术时发生高达20％。术后喉返神经麻痹可能是手术分离过程中牵拉、压迫、结扎神经和电凝的热损伤所致,基于此,shedd

关键词：神经监测仪发生率甲状腺肿电生理甲状腺疾病术中神经监测喉返神经

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