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Kazuma Tsujimura,1 Morihito Ota,1 Kiyoshi Chinen,1 Kiyomitsu Nagayama,2 Masato Oroku,2 Morikuni Nishihira,2 Yoshiki Shiohira,2 Kunitoshi Iseki,3 Hideki Ishida,4 Kazunari Tanabe4 1Department of Surgery, 2Department of Nephrology, 3Clinical Research Support Center, Tomishiro Central Hospital, Okinawa, Japan; 4Department of Urology, Tokyo Women’s Medical University, Tokyo, Japan Background: There are limited reports on the use of everolimus for maintaining immunosuppression in ABO-incompatible (ABOi) kidney transplantation (KT). As everolimus (EVR) is effective for preventing calcineurin inhibitor (CNI) nephrotoxicity without increasing the risk of chronic rejection and viral infection, we aimed to assess the efficacy of EVR in ABOi KT.Patients and methods: We retrospectively studied 22 patients who underwent KT and received EVR. Patients in the ABOi KT group (n=7) were compared with those in the ABO-compatible kidney transplantation group (ABOc KT; n=15). We recorded the frequency of CNI nephrotoxicity, chronic rejection, and viral infection in the 2 groups.Results: CNI nephrotoxicity, chronic rejection, and viral infection occurred in the ABOi KT and ANOc KT groups at rates of 28.3% (2/7 patients) and 13.3% (2/15 patients) (P=0.388), 28.3% (2/7 patients) and 26.7% (4/15 patients) (P=0.926), and 14.3% (1/7 patients) and 26.7% (4/15 patients) (P=0.517), respectively.Conclusion: Administration of EVR is effective in preventing CNI nephrotoxicity after KT. The rate of CNI nephrotoxicity was lower in the ABOc KT group than in the ABOi KT group. The rate of chronic rejection and viral infection was comparable between the groups. This study was conducted in a small cohort of patients. Hence, further evaluation with large sample sizes is necessary in the future to confirm the outcomes. Keywords: blood group incompatibility, immunosuppression, kidney transplantation

The dimensionless material parameter R introduced by Wu and Jing into the Rice-Walsh equation of state (EOS) has been deduced from the LASL shock Hugoniot data for porous Al and Cu. It was found that the parameter R/p decays smoothly with shock pressure p and displays small experimental scatter in the high pressure region. This finding led to the conclusion that the parameter has only a weak temperature dependence and is well approximated by a function of pressure alone, and the Grüneisen parameter should be temperature dependent under compression. The thermodynamic formulation of the Rice-Walsh EOS for Al and Cu was realized using the empirically determined function R(p) for each material and their known shock Hugoniot. It was then possible to reproduce porous shock Hugoniot for these metals. For most degrees of porosity, agreement between the porous data and the calculated Hugoniots using the empirical function described was very good. However, slight discrepancies were seen for Hugoniots with very high porosity. Two new thermal variables were introduced after further analysis, which enabled the calculation of the cold compression curve for these metals. The Gruneisen parameters along full-density and porous Hugoniot curve were calculated using a thermodynamic identity connecting R and the Grüneisen parameter. It was shown that the Grüneisen parameter is strongly temperature dependent. The present analysis suggested that the Rice-Walsh type EOS is a preferable choice for the analysis with its simple form, pressure-dependent empirical Wu-Jing parameter, and its compatibility with porous shock data. [ABSTRACT FROM AUTHOR]