- Email: [email protected]
Cadaver renal transplantation: Emphasis on urological aspects
634
INTERNATIONAL
similar to those found in resolving acute glomerulonephritis were seen. None of the patients had abnormal renal function within 7 years of the onset of hematuria and it is possible that they may be in a latent phase preceding chronic glomerulonephritis. It can be concluded that idiopathic hematuria may not always be idiopathic or benign-B. M. Henderson.
TRANSVERSE UPPER A~WMINAL “CHEVRON" INCISIONIN UROLOGICAL &RGERY. R. Chute, J. A. Baron, 528, 1968.
Jr.,
and
C. A. Olsson.
J.
Urol.
99:
This incision is recommended when bilateral operative exposure of structures in upper retroperitoneal areas is required. These may include bilateral nephrectomy, simultaneous operations on both renal pelves, retroperitoneal node dissections, bilateral renal artery procedures, and adrenal operations for pheochromocytoma or other hormone producing tumors. Among the 9 cases in which this incision was used there were no pulmonary complications or incisional hernias.-B. M. Henderson.
INGESTED FOREIGN BODIES MIGRATING TO THE KIDNEY FROM GA~TFIOINTESTINAL TRACT. J, M. Baird, 1968.
and
H.
M.
Spence.
J.
Urol.
99:675,
ABS’JXACXS OF PEDIATRIC SUFtCEElY
that renal transplantation with intermittent hemodialysis can be considered a promising form of therapy for terminal renal insufficiency, but better results must depend on improving technic in tissue preservation, and methods of immunosuppression. -B. M. Henderson.
CADAVER RENAL TRANSPLANTATION: EMPHASIS ON UROLOGICAL Asp~crs. K. 1. MacKintwn, J.A. Oliver, D. D. Morehouse, and Y. Taguchi. J. Urol. 99:486,
1968.
In a group of 59 transplants using cadaver donor kidneys 20 major urological complications occurred with a fatal outcome in 9 instances. There were 6 major vascular complications all of which resulted in the loss of the kidney. Severe, early rejection occurred in 6 patients and complications related to cadaver renal transplants occurred in 12, which included prolonged ischemia due to the lingering death of the donor, transmission of generalized cystoplasmosis to the recipient, excessive cooling or ischemia of the transplanted kidney, and poor preparation of the recipient. The technic of obtaining the donor kidney and placing it in the recipient is described. In discussing the management of complications, the paucity of symptoms and signs related to extravasation of urine in these patients is stressed.
the pelvis of the right kidney and caused hematuria. On reviewing the literature, a total of 23 similar cases were collected. Most presented with either pyuria or hematuria. The mechanism by which these foreign bodies reached the kidney was discussed.-B. M. Henderson.
Only low-grade fever may be present and it is now the custom of the authors to obtain cystograms when this occurs. The use of ureteral and urethral catheters is recommended so as to permit prompt exclusion of postrenal obstruction in the presence of postoperative oliguria. Urinary tract infection occurred in 18 of these patients within 6 months of transplantation and in the majority of this group other urological complications had developed.-B. M. Henderson.
FOUR
BACTERIAL ELIMINATION.F. Hinmun,
Three cases are presented including that 16year-old boy who occasionally chewed swallowed straw which had then migrated
of a and into
YEARS' CLINICAL EXPERIENCE WITH 138 KIDNEY TRANSPLANTS. R. A. Straflon, W. S.
Kiser, B. H. Stewart, C. V. Hewitt, R. W. Gifford, Jr., and S. Nukamoto. J. Urol. 99:479, 1968. This is a report of the authors’ experience with renal transplantation using cadaver donor kidneys. Of the 138 transplanted kidneys only 37 were from living donors and the remaining 101 were from cadaver donors. The one-year survival rate for patients receiving kidneys from living donors was 70 per cent (18 patients) and for those receiving cadaver kidneys it was 48 per cent (36 cases). In 20 patients a second renal transplantation was required and in one a third. The authors review their postoperative complications and conclude
99:811,
Jr. J. Urol.
1968.
The principal methods by which the urinary tract prevents bacterial invasion are described. The most important factor appears to be the balance between the doubling time of the bacteria and the rate at which they are washed out. Local factors such as mucosal defense are of less importance as they can be overwhelmed by the presence of poor drainage resulting in a rapid increase of bacterial concentration. Ureteral reflux allows bacteria to reach the renal pelvis and if its volume is unusually large or if the mixing function of the calices is reduced, then infection can become established. This process may be followed by renal
INTERNATIONAL
similar to those found in resolving acute glomerulonephritis were seen. None of the patients had abnormal renal function within 7 years of the onset of hematuria and it is possible that they may be in a latent phase preceding chronic glomerulonephritis. It can be concluded that idiopathic hematuria may not always be idiopathic or benign-B. M. Henderson.
TRANSVERSE UPPER A~WMINAL “CHEVRON" INCISIONIN UROLOGICAL &RGERY. R. Chute, J. A. Baron, 528, 1968.
Jr.,
and
C. A. Olsson.
J.
Urol.
99:
This incision is recommended when bilateral operative exposure of structures in upper retroperitoneal areas is required. These may include bilateral nephrectomy, simultaneous operations on both renal pelves, retroperitoneal node dissections, bilateral renal artery procedures, and adrenal operations for pheochromocytoma or other hormone producing tumors. Among the 9 cases in which this incision was used there were no pulmonary complications or incisional hernias.-B. M. Henderson.
INGESTED FOREIGN BODIES MIGRATING TO THE KIDNEY FROM GA~TFIOINTESTINAL TRACT. J, M. Baird, 1968.
and
H.
M.
Spence.
J.
Urol.
99:675,
ABS’JXACXS OF PEDIATRIC SUFtCEElY
that renal transplantation with intermittent hemodialysis can be considered a promising form of therapy for terminal renal insufficiency, but better results must depend on improving technic in tissue preservation, and methods of immunosuppression. -B. M. Henderson.
CADAVER RENAL TRANSPLANTATION: EMPHASIS ON UROLOGICAL Asp~crs. K. 1. MacKintwn, J.A. Oliver, D. D. Morehouse, and Y. Taguchi. J. Urol. 99:486,
1968.
In a group of 59 transplants using cadaver donor kidneys 20 major urological complications occurred with a fatal outcome in 9 instances. There were 6 major vascular complications all of which resulted in the loss of the kidney. Severe, early rejection occurred in 6 patients and complications related to cadaver renal transplants occurred in 12, which included prolonged ischemia due to the lingering death of the donor, transmission of generalized cystoplasmosis to the recipient, excessive cooling or ischemia of the transplanted kidney, and poor preparation of the recipient. The technic of obtaining the donor kidney and placing it in the recipient is described. In discussing the management of complications, the paucity of symptoms and signs related to extravasation of urine in these patients is stressed.
the pelvis of the right kidney and caused hematuria. On reviewing the literature, a total of 23 similar cases were collected. Most presented with either pyuria or hematuria. The mechanism by which these foreign bodies reached the kidney was discussed.-B. M. Henderson.
Only low-grade fever may be present and it is now the custom of the authors to obtain cystograms when this occurs. The use of ureteral and urethral catheters is recommended so as to permit prompt exclusion of postrenal obstruction in the presence of postoperative oliguria. Urinary tract infection occurred in 18 of these patients within 6 months of transplantation and in the majority of this group other urological complications had developed.-B. M. Henderson.
FOUR
BACTERIAL ELIMINATION.F. Hinmun,
Three cases are presented including that 16year-old boy who occasionally chewed swallowed straw which had then migrated
of a and into
YEARS' CLINICAL EXPERIENCE WITH 138 KIDNEY TRANSPLANTS. R. A. Straflon, W. S.
Kiser, B. H. Stewart, C. V. Hewitt, R. W. Gifford, Jr., and S. Nukamoto. J. Urol. 99:479, 1968. This is a report of the authors’ experience with renal transplantation using cadaver donor kidneys. Of the 138 transplanted kidneys only 37 were from living donors and the remaining 101 were from cadaver donors. The one-year survival rate for patients receiving kidneys from living donors was 70 per cent (18 patients) and for those receiving cadaver kidneys it was 48 per cent (36 cases). In 20 patients a second renal transplantation was required and in one a third. The authors review their postoperative complications and conclude
99:811,
Jr. J. Urol.
1968.
The principal methods by which the urinary tract prevents bacterial invasion are described. The most important factor appears to be the balance between the doubling time of the bacteria and the rate at which they are washed out. Local factors such as mucosal defense are of less importance as they can be overwhelmed by the presence of poor drainage resulting in a rapid increase of bacterial concentration. Ureteral reflux allows bacteria to reach the renal pelvis and if its volume is unusually large or if the mixing function of the calices is reduced, then infection can become established. This process may be followed by renal