Day 2 :
Beijing Chaoyang Hospital, China
Keynote: Title: Short- and long-term outcomes of kidney transplants with kidneys lavaged by retrograde perfusion technique
Time : 10:00-10:40
Xiu-Wu Han has completed his PhD from Capital Medical University, Beijing, China. He is the Director of Department of Urology, Beijing Chaoyang Hospital Affiliated to Capital Medical University (western campus) Beijing 100020, China. He has more than 20 years of experience in kidney transplantation and published more than 40 papers in Chinese and English.
Objective: The objective of the study is to evaluate the clinical safety and efficacy of the retrograde perfusion technique in kidney transplantation. Methods: Between January 2001 and June 2011, 24 cases of kidney transplantation with kidneys perfused using the retrograde perfusion technique due to renal artery variations or injury were selected as the observation group (retrograde perfusion group, RP group). 22 cases of kidney transplantation via a conventional perfusion were chosen as the control group (ante grade perfusion group, AP group). There were no statistically significant differences in donor data between the two groups. Cold ischemia time, warm ischemia time, renal perfusion time, amount of perfusion fluid, acute renal tubular necrosis, wound infection, urinary fistula, graft kidney function, and the 1-year, 3-year, and 5-year survival rates for the grafted kidney in both groups were served and recorded.
Results: The kidney perfusion time was shorter in the RP group than that in the AP group (3.14±1.00 vs. 5.02±1.15 min, P ¼ 0.030). There were 10 cases of acute renal tubule necrosis in the RP group and 5 in the AP group. The length of hospital stay was 40±14 d in the RP group and 25±12 d in the AP group. The follow-up time was 3.5-8.5 years (mean 6.25 years). The 1-, 3-, and 5-year survival rates for the grafted kidney were 95.8%, 75.5%, and 65.5% in the RP group and 97.1%, 82.5%, and 68.4% in the AP group, respectively (P>0.05).
Conclusions: This study indicates that retrograde perfusion is safe and practicable for cadaveric kidney harvesting and can be regarded as a better alternative or remedial measure for a poorly perfused kidney due to vascular deformity or injury.
Post Graduate Institute of Medical Education and Research, India
Keynote: Comparison of various techniques for extracellular fluid status assessment in hemodialysis patients
Time : 11:00-11:40
Himansu Sekhar Mahapatra has completed his DM (Nephrology) from AIIMS, New Delhi and at present working as Head of the Department of Nephrology at PGIMER, Dr. RML Hospital, New Delhi, India. He trained many of the post-graduate students of Nephrology and published more than 22 papers in reputed journals and has been serving as an Editorial Board Member of repute. He is the DM (Nephrology) Post-graduate student in Nephrology at PGIMER, Dr. R M L Hospital, New Delhi, India.
In the past multiple attempts have been made to develop an ideal method to assess the fluid status in hemodialysis (HD) patients. The aim of this study was to compare body bioimpedance spectroscopy (BIS) with ultrasound (US) lung comet score (ULCs), B-type natriuretic peptide (BNP) and inferior vena cava diameter (IVCD) by US for the estimation of extracellular fluid (ECF) status in HD patients. Methods: ECF was evaluated by BIS, ULCs, IVCD during inspiration (min) and expiration (max), the inferior vena cava collapsibility index (IVCCI) as well as serum BNP levels in 50 patients. The change in ECF after HD was also evaluated by all the methods. There was a significant correlation between the results of ECF measurement by BIS and ULCs (0.49), IVCD max (0.69), IVCD min (0.61), IVCC (-0.44). While BIS and BNP did not show correlation (0.03).
Conclusion: All methods were able to detect ECF to near ideal method like BIS except BNP.