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Objective To evaluate the safety and efficacy of robot-assisted laparoscopic living donor nephrectomy. Methods Clinical data of 31 donors and recipients undergoing robot-assisted laparoscopic living donor nephrectomy in Xijing Hospital of the Fourth Military Medical University from November 2013 to August 2015 were retrospectively analyzed. Results Donor nephrectomy was successfully performed in 31 cases. The operation time ranged from 110 to 190 min. Intraoperative hemorrhage volume was measured as 20-100 ml. The warm ischemia time of the donor kidney was 100 to 160 s. The retained length of renal vein was between 1.8 and 3.0 cm and the length of renal artery was 1.4 to 2.3 cm. In 2 cases, spleen injury occurred during the kidney extraction and was treated with splenorrhaphy. One donor had postoperative hemorrhage, which was treated with hemostasis and anemia correction. Thirty one donors received postoperative follow﹣up for over 6 months. No long-term complications were observed. Among 31 recipients,one patient had delayed recovery of renal graft function and the serum creatinine level returned to normal range after treatment at postoperative 1 month.The survival rate of kidney grafts was up to 100%. Conclusions Robot﹣assisted laparoscopic living donor nephrectomy is a safe and efficacious surgical procedure for kidney resection, which possesses the advantages of small trauma, rapid recovery and no influence upon renal function. [ABSTRACT FROM AUTHOR]

Objective To compare the performance of PSI, CURB-65 and SMART-COP systems in evaluating the severity and predicting the prognosis of pulmonary infection after renal transplantation. Methods Clinical data of 71 patients with pulmonary infection after renal transplantation in Xijing Hospital from January 2009 to June 2015 were retrospectively analyzed. All patients were divided into the severe (n = 27) and mild infection groups (n = 44). According to the risk-stratification criteria of three scoring systems, all patients were assigned into the low-risk group and moderate-high risk group. The fatality rate, utilization rate of respirator, occupancy rate of intensive care unit (ICU) and length of hospital stay were statistically compared among different risk groups of three scoring systems. The differences among the scores of three systems were compared between the severe and mild infection groups. The efficacy of three scoring systems in predicting the fatality rate of pulmonary infection patients was assessed by receiver operating characteristic (ROC) curve. Results By using three scoring systems, the fatality rate,utilization rate of respirator and occupancy rate of ICU in the moderate-high risk groups were significantly higher than those in the low-risk group (all P < 0. 05). The length of hospital stay in the moderate-high risk group was significantly longer than that in the low-risk group (P < 0. 05). The scores of PSI, CURB-65 and SMART-COP systems in the severe infection group were considerably higher than those in the mild infection group (all P <0. 05). The optimal cut-off scores of PSI, CURB-65 and SMART-COP systems were 75,1. 5 and 3. 5, respectively. The sensitivity, specificity and AUC of PSI, CURB-65 and SMART-COP systems in predicting the fatality rate were calculated as 0. 929, 0. 890, 0. 909; 0. 857, 0. 772, 0. 844; 0. 929, 0. 860, 0. 941, respectively. Conclusions PSI, CURB-65 and SMART-COP systems can assess the severity of pulmonary infection and predict the fatality rate after renal transplantation. SMART-COP possesses the highest accuracy in predicting the fatality rate. PSI is most sensitive but difficult to implement. CURB-65 is simple and convenient to apply in clinical practice. [ABSTRACT FROM AUTHOR]

Objective To discuss the safety of Rh-positive patients receiving kidney grafts from Rh-negative cadaver donor. Methods On November 29th 2013, two Rh-positive patients received renal transplantation with kidney grafts from Rh-negative cadaver donor at the Department of Urinary Surgery of Xijing Hospital, the Fourth Military Medical University. The clinical data of the two patients were analyzed retrospectively and the relevant literatures were reviewed. Results The two patients underwent renal transplantation successfully and no hyperacute rejection or acute rejection occured after the surgery. The two patients were followed up for 12 months. The kidney grafts survived well and the patients had no obvious discomfort. Conclusions Through enhanced immunosuppression before operation, sufficient perfusion and close postoperative monitoring, it is safe for Rh-positive patients receiving kidney grafts from Rh-negative cadaver donor. [ABSTRACT FROM AUTHOR]

Objective To investigate the diagnosis and treatment regimen for patients with chronic diarrhea after renal transplantation. Methods The clinical data of 353 patients with chronic diarrhea who underwent renal allograft transplantation at Department of Urology of Xijing Hospital from January 2007 to June 2014 with regular follow-up were analyzed retrospectively. The occurrence of chronic diarrhea after renal transplantation was observed, including incidence, time of occurrence, course of disease and complications. The changes in general conditions and auxiliary examination indexes (body mass index, anemia and other auxiliary examination indexes), treatment and prognosis of the patients with chronic diarrhea were recorded. Results Fifteen cases (4.2%) of 353 renal transplant recipients had chronic diarrhea. The time of symptomatic and etiological treatment was (15 ±7 ) d. Two patients died during diarrhea (died from gastrointestinal hemorrhage and sudden death caused by severe hypokalemia respectively) and other patients were recovered. Among the 13 patients, 5 cases had good prognosis, 2 cases died (both died from pulmonary infection), 5 cases suffered from renal allograft dysfunction and 1 case suffered from renal allograft insufficiency during the follow-up. Conclusions The etiology of chronic diarrhea after renal transplantation is complex and the patients should receive symptomatic and etiological treatment. The patients with chronic diarrhea after renal transplantation combined with severe complications have poor prognosis. [ABSTRACT FROM AUTHOR]

报道国内首例肾移植联合脾窝异位辅助性肝移植术治疗高致敏性肾移植受者的手术配合。充分的术前准备、密切的手术配合和周密的术中护理是提高手术成功率的重要保证。 [ABSTRACT FROM AUTHOR]