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Objective To analyze the prediction efficiency of scoring models at home and abroad on delayed graft function (DGF) after renal transplantation in China. Methods The clinical data of 112 donors and 220 recipients undergoing renal transplantation were prospectively analyzed. The DGF predicted by KDRI model, Jeldres model, and model of our center was compared with actual DGF incidence of renal transplant recipients. The prediction efficiency of each model was analyzed. The predictive accuracy was compared by the area under curve (AUC) of receiver operating characteristic (ROC) curve. Results The DGF incidence of 220 renal transplant recipients was 14.1% (31/220). DGF prediction using KDRI model showed that 41 cases were high risk donors, the AUC was 0.57, the sensitivity was 0.37, the specificity was 0.66, and the positive predictive value was 22%. DGF prediction using Jedres model showed that 22 cases were high risk recipients, the AUC was 0.56, the sensitivity was 0.13, the specificity was 0.92 and the positive predictive value was 20%. DGF prediction using the model of our center showed that 25 cases were high risk donors, the AUC was 0.80, the sensitivity was 0.53, the specificity was 0.84, the positive predictive value was 40%. Conclusions Compared with the KDRI and Jedres models, the prediction model of our center has higher AUC and sensitivity with a better prediction efficiency on DGF. Therefore, it is a suitable evaluation system of donors from donation after citizen s death in Chinese. [ABSTRACT FROM AUTHOR]

为了进一步规范尸体供肾体外机械灌注冷保存技术的临床应用，中华医学会器官移植学分会组织 器官移植学专家在《中国公民逝世后器官捐献供肾体外低温机械灌注保存应用专家共识（2016 版）》的基础上， 从 LifePort 的材料准备和应用流程、LifePort 的参数设置、改善 LifePort 转运供肾灌注参数的方法、LifePort 在供 肾质量评估中的应用、LifePort 应用注意事项等方面，制订本规范。 [ABSTRACT FROM AUTHOR]

Objective To evaluate short-term clinical efficacy of renal transplantation from the donation of pediatric donors. Methods Clinical data of 15 pediatric donors and 28 recipients (including 2 cases of bilateral renal transplantation) undergoing renal transplantation in the Department of Renal Transplantation of the First Affiliated Hospital of Xi'an Jiaotong University from November 2013 to December 2015 were retrospectively analyzed. Results Renal transplantation was successfully performed in 28 recipients. The median warm ischemia time of transplant kidney was 1 2.5 min (range:0-1 7.0 min) and 4.3 h (range:1 .5-7.7 h) for the median cold ischemia time. After operation, 4 cases developed with delayed graft function (DGF), 1 required dialysis, 2 died from pulmonary infection, 2 underwent renal resection due to renal anastomosis stenosis and renal thrombosis. Postoperative follow-up lasted for 1 -24 months. Twenty-six (93%) recipients survived after renal transplantation and 24 (86%) recipients survived with restored normal renal function. Conclusions Unilateral and bilateral renal transplantation from pediatric donors has relatively favorable short-term clinical efficacy. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical efficacy of different T lymphocyte polyclonal antibodies in renal transplantation from donor kidney of organ donation after citizen's death. Methods Clinical data of 691 donors and recipients undergoing renal transplantation from donor kidney of organ donation after citizen's death were retrospectively analyzed. According to different T lymphocyte polyclonal antibodies used for induction, all recipients were divided into the rabbit anti human T lymphocyte immunoglobulin (rALG) group (n=414) and rabbit anti human thymocyte immunoglobulin (rATG) group (n=277). The recovery of renal graft function in recipients of the two groups were collected, including the incidence of delayed graft function (DGF) and acute rejection (AR), and the changes of serum creatinine level after renal transplantation. The 1-year survival rate of the recipients and renal grafts was collected. The incidence of adverse effects within 1 year after operation was calculated. According to the DGF risk score of donors, all recipients were divided into 5 groups. The use proportion of rALG and rATG in the recipients of each group was calculated. Results The incidence of DGF in the recipients of rALG and rATG groups was 14.5% (60/414) and 11.9% (33/277), respectively. The duration of DGF in the recipients of rALG and rATG groups was (7±4) d and (12±7) d respectively, with no statistically significant difference between two groups (P>0.05). The incidence of AR in the rALG group was 7.5% (31/414), significantly higher than 4.0% (11/277) in the rATG group (P<0.05). The serum creatinine levels of recipients within 6 months after renal transplantation tended to gradually decline in both groups. In renal transplantation for donor kidney with a DGF risk score of 0-15, the use proportion of rALG was significantly higher than that of rATG. However, the use proportion of rATG was significantly higher than that of rALG in renal transplantation for donor kidney with a DGF risk score over 16 (P<0.05). The 1-year survival rates of the recipients and renal grafts in the rALG and rATG groups were 99.8% and 99.6%, 98.1% and 98.2%, respectively. There was no significant difference between two groups (both P>0.05). The incidence of acute pulmonary edema and leukopenia in the recipients of rATG group was significantly higher than that in the rALG group (both P<0.05). Conclusions Both rALG and rATG can effectively reduce the incidence of DGF and AR and achieve good clinical efficacy after renal transplantation from donor kidney of organ donation after citizen's death. The incidence of leukopenia and acute pulmonary edema induced by rATG is higher than that by rALG in the renal transplant recipients. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical effect of hypothermic machine perfusion (HMP) in the storage of renal grafts from deceased donor (DD) with high-risk delayed graft function (DGF). Methods Clinical data of 52 donors with high-risk DGF were collected in this prospective randomized controlled study. Two renal grafts from each donor were randomly divided into the HMP group («=52) and static cold storage (SCS) group (n=52). In the HMP group, the renal grafts were stored by LifePort under HMP, whereas the renal grafts in the SCS group were preserved in University of Wisconsin solution (UW solution). The incidence of DGF and primary nonfunction (PNF) after renal transplantation was statistically compared between two groups. The recovery of renal graft function, the survival rates of the recipients and renal grafts within postoperative 1 year were observed in two groups. Results The incidence of DGF in the HMP group was 4%(2/52), significantly lower than 17% (9/52) in the SCS group (.P<0.05). No PNF was reported in the I IMP groupand 1 case of PND was noted in the SCS group, the difference was not statistically significant (P>0.05). The recovery time of graft function of the recipients in the HMP and SCS groups were (7.2 ± 0.6) d and (7.7 ± 1.0) d with no statistical significance (/f>0.05). In the HMP group, the urine volume of the recipients on the day of operation, postoperative 1 and 2 d was significantly larger than that in the SCS group (all .P<0.05). In the HMP group, the levels of scrum creatinine at each time point after operation were significantly lower than those in the SCS group (all .P<0.05). The 1-ycar survival rates of the recipient and kidney were 98.1%, 92.3% and 100%, 96.2% in the IIMP and SCS groups with no statistical significance (all F^O.05). Conclusions IIMP can significantly reduce the incidence of DGF after renal transplantation from DD with high-risk DGF and promote the early recovery of graft function. [ABSTRACT FROM AUTHOR]

To establish an effective method for acquiring bone marrow-derived dendritic cells (DCs) from BALB/C mice in vitro and to establish a reservoir of DC precursor cells. Methods CD117+ hematopoietic stem cells (HSCs) were isolated and purified from bone marrow of BALB/C mice by immunomagnetic beads separation system (MACS), and then amplified in vitro with mouse stem cell factor (SCF) and interleukin-3 (IL-3). HSC was induced to differentiate into DCs by adding granulocyte-macrophage colony-stimulating factor (rmGM-CSF) and IL-4. Different cytokines (tumor necrosis factor-alpha or IL-10) were added to control the maturity of dendritic cells. Then the morphology (electron microscopy), surface molecular markers (FACS method) and cytokine secretion level (ELISA method) were identified. Results ① The purity of CD117 + HSC isolated and purified by MACS system was over 95%. ② SCF plus IL-3 could effectively stimulate HSC amplification. ③ The morphology of mature DC (mDC) and immature DC (imDC) was significantly different under light and scanning electron microscopy. ④ In the expressions of surface markers CD40, CD80, CD86, I-A/I-E, there were significant differences between imDC group and mDC group (P<0.01). ⑤ After LPS stimulation, the secretion of IL-12 in imDC group did not change significantly (P=0.064), while the secretion of IL-12 in mDC group increased significantly (P=0.009). LPS and TNF-α had a synergistic effect in stimulating DC maturation. Conclusion Specific combinations of cytokines can effectively induce the differentiation of bone marrow HSCs into DCs in BALB/C mice, and can control the maturity of DCs. This study makes it possible to use gene modified dendritic cells in GD immunotherapy. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is often associated with organ donation and renal transplantation, which leads to an increase of fatality rate, hospitalization time and hospitalization costs. In recent years, studies have shown that ferroptosis is closely related to AKI, but the exact molecular biological mechanism has not been clarified, which need more research. In this article, the role of ferroptosis in AKI was reviewed from the aspects of ferroptosis related biomarkers and biological reactions, in order to find a new possible direction for the prevention and treatment of AKI. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of renal ischemia-reperfusion injury (RIRI) on the TLR2 signaling pathway and the role of TLR2 in RIRI. Methods: Twenty-one Wistar rats were randomly divided into sham operation group (Sham), renal ischemia reperfusion model group (I/R) and T2.5 treatment group (T2.5). After 24 hours of ischemia-reperfusion, heart blood and left kidney tissue were collected. Pathological analysis of renal tissue was observed, and serum creatinine (Cr) and blood urea nitrogen (BUN) were detected by kit. Inflammation and oxidative stress of renal tissue were detected by enzyme-linked immunosorbent assay (ELISA) and Western blot analysis. Results: Compared with the sham group, the renal tissue of the model group showed obvious damage, and the renal structure of the T2.5 group performed well, the difference was statistically significant (P<0.05). Compared with the sham group, the Serum Cr and BUN levels significantly increased in the I/R group, while T2.5 inhibited that increase of serum Cr and BUN and reduced renal damage of I/R rats (P<0.05). Compared with the sham group, the relative expression of TLR2 and TLR4 significantly increased in the renal tissue of the I/R group, while T2.5 regulated TLR signaling pathway by inhibiting that increase of TLR2, TLR4 in injured renal tissue (P<0.05). Compared with the sham group, the expression of NF-kB and its phosphorylation both significantly increased in the I/R group (P<0.05). T2.5 significantly down-regulated the phosphorylation of NF-kB in I/R rats (P<0.05), while had no significant effect on NF-kB expression (P>0.05). Compared with the sham group, the concentrations of pro-inflammatory factors IL-6, IL-1β and TNF-α significantly increased in the renal tissue of I/R group(P<0.05). T2.5 can promote the inflammation of I/R rats by down-regulating IL-6 and IL-β levels (P<0.05), while had no significant effect on TNF-α level (P>0.05). Compared with the sham group, the SOD activity significantly de- Creased in the I/R group, T2.5 significantly reversed this decreasing by up regulating SOD activity(P<0.05). MDA activity in the I/R group was significantly increased than sham group (P<0.05), while T2.5 had no significant effect on MDA activity in I/R rats (P>0.05). Conclusion: TLR2 promotes inflammatory response and oxidative stress in ischemia-re perfusion injury by activating TLR signaling pathway, up-regulating the phosphorylation of NF-kB, further regulating the release of pro-inflammatory factor and activity of antioxidant enzymes. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effect of the preservation of the donor kidneys from donation after cardiac death (DCD) and expanded criteria donor (ECD) by donor kidney pulse perfusion storage transporter (LifePort) on the postoperative recovery of renal function in recipients undergoing renal transplantation. Methods Perioperative clinical data of 466 donors (DCD+ECD) and 882 recipients undergoing renal transplantation were retrospectively analyzed. According to different approaches of kidney preservation, bilateral kidneys of 309 DCD donors were randomly divided into the LifePort group (DCD-LP, n=309) and DCD cold storage group (n=309). All the bilateral kidneys of 132 ECD donors were stored and transported by LifePort and assigned into the ECD-LP group (n=264). The postoperative overall condition, early postoperative renal function indexes and postoperative complications of the recipients were observed among three groups. The pathological findings of renal puncture before renal transplantation were observed in donor kidneys. The LifePort perfusion parameters of the donor kidney were compared between the recipients with and without delayed graft function (DGF) after renal transplantation. Results Compared with the DCD cold storage group, the length of hospital stay was significantly shorter in the DCD-LP and ECD-LP groups (both P<0.05). The survival rate of the recipients was 100% in three groups. The survival rate of the donor kidney was 99.7%, 100% and 99.2% in the DCD cold storage, DCD-LP and ECD-LP groups, respectively. No statistical difference was observed among three groups (all P>0.05). Compared with the DCD cold storage group, the incidence of DGF was significantly lower in the DCD-LP and ECD-LP groups (both P<0.05). Early postoperative renal function, the incidence of acute rejection, infection and surgical complications did not significantly differ among three groups (all P>0.05). Pathological examination demonstrated that usage of LifePort perfusion could significantly mitigate the edema, degeneration and necrosis of renal tubules. In the recipients with DGF, the LifePort perfusion resistance index of donor kidney was significantly higher, whereas the LifePort perfusion volume of donor kidney was considerably lower than those without DGF (both P<0.05). Conclusions LifePort can effectively improve the quality of the donor kidney from DCD and ECD in vitro, reduce the incidence of postoperative DGF, promote the recovery of transplanted kidney function and predict the postoperative recovery during the maintenance and evaluation of the isolated kidney. [ABSTRACT FROM AUTHOR]