Search

Renal-sparing treatment of spontaneous renal allograft rupture remains a surgical challenge, since profuse hemorrhage may result from these friable kidneys during surgical repair. A technique is proposed to achieve control of local bleeding with a synthetic glue (gelatin, resorcin and formaldehyde) and external compression with a polyglactin 910 absorbable mesh. We report 4 cases of spontaneous allograft rupture associated with rejection and bleeding was controlled in all 4. Three grafts were preserved with more than 1 year of followup. The other graft had to be removed for uncontrolled vascular rejection despite satisfactory control of renal fractures. Renal wrapping with external compression is proposed to improve results of conservative management of renal allograft rupture.

The advent of hybridoma technology has proved a major breakthrough in the field of tumor immunology and enables analysis at the molecular level of tumor heterogeneity. This approach seems particularly promising in urothelial tumors of the bladder and carries implications for diagnosis, prognosis and therapy of this disease. Two murine monoclonal antibodies (G4 and E7), obtained by xenogenic immunization of Balb/c mice with a human transitional carcinoma cell line (TCC) (647V) have proved especially useful. Use of a panel of monoclonal antibodies covering the entire spectrum of TCCs, most of which are already available, can be expected to result in significant modifications in the management of urothelial tumors. Advances in the field of monoclonal antibody technology may provide specific tools applicable to humans in vivo.