raffinose and Acute-Disease

Topics: Acute Disease; Adenosine; Allopurinol; Animals; Chronic Disease; Glutathione; Graft Rejection; Humans; Insulin; Intestine, Small; Organ Preservation; Organ Preservation Solutions; Raffinose; Reperfusion Injury; Transplantation, Homologous

The purpose of this study was to compare the Belzer vs Custodiol solutions for cadaveric kidney perfusion in relation to delayed graft function, renal function, acute rejection episodes, and patient and graft survivals.. This randomized prospective study included 42 kidneys and 9 simultaneous kidney and pancreas recipients from December 2002 to February 2004, namely 24 in the Custodiol arm and 27 in the Belzer arm. We analyzed delayed graft function frequency, acute rejection episodes (biopsy proven), renal function (creatinine at 1, 6, and 12 months), as well as graft and patient survivals. Categorical and continuous variables were evaluated as appropriate.. We failed to observe a difference in the immunosuppressant drug protocol, cold ischemia time, or mean recipient or donor age. The prevalence of delayed graft function was 63% among the Belzer arm, and 50% among the Custodiol arm (P = NS). The renal function was the same in both arms at 1, 6, and 12 months. The graft survival after 3 months was 94% among the Belzer group (death from sepsis), and 95% among the Custodiol group (nonfunctioning graft). At 1 year, the results were 78% among the Belzer group (4 deaths from cardiovascular or infectious complications and 2 graft losses), and 79% among the Custodiol group (3 deaths, 1 primary nonfunctioning graft, and 1 graft loss; P = NS). After 12 months follow-up, patient survival was 84% among the Belzer group, and 86% among the Custodiol group. In the first year, the incidences of biopsy-proven acute rejection episodes were 37% among the Belzer group, and 33% among the Custodiol group.. Custodiol solution achieved similar results compared with Belzer solution.

Topics: Acute Disease; Adenosine; Allopurinol; Female; Glucose; Glutathione; Graft Rejection; Humans; Immunosuppressive Agents; Insulin; Kidney Transplantation; Length of Stay; Male; Mannitol; Organ Preservation Solutions; Pancreas Transplantation; Postoperative Complications; Potassium Chloride; Procaine; Prospective Studies; Raffinose; Survival Analysis

We evaluated whether IGL-1, a graft preservation solution containing polyethylene glycol, improves the outcome of small bowel grafts in comparison to the University of Wisconsin (UW) solution in a pig allotransplantation model.. Seventeen pigs were randomly allocated to group 1 (n = 10; intestinal allotransplantation with IGL-1) and group 2 (n = 7; allotransplantation with UW). Pigs received no immunosuppression and were sacrificed on postoperative d (POD) 8. Intestinal specimens were obtained from the animal immediately before cold flushing (T0), 2 h after graft reperfusion (T1), and at sacrifice (T2).. Survival rate to POD 8 was 50% in group 1 compared with 16% in group 2 (P < 0.05); 62% of pigs in group 1 did not present any acute cellular rejection (ACR) compared to 16% in group 2 (P < 0.05). Severe ACR rate was 25% in group 1 and 66% in group 2 (P < 0.05). iNOS activity and intestinal caspase 3 levels increased significantly between T0 and T1 in group 1 compared to group 2 (P < 0.05). Cell necrosis increased significantly between TO and T1 in group 2 compared with group 1 (P < 0.05) whereas cell apoptosis was significantly higher at T1 compared with T0 in group 1 in comparison to group 2.. Our results show that IGL-1 improves intestinal graft viability as compared to UW solution, possibly by reducing graft immunogenicity and by favoring intestinal epithelial repair.

Topics: Acute Disease; Adenosine; Allopurinol; Animals; Apoptosis; Caspase 3; Female; Glutathione; Graft Rejection; Graft Survival; Immunosuppression Therapy; Insulin; Intestinal Mucosa; Intestine, Small; Organ Preservation Solutions; Polyethylene Glycols; Raffinose; Reperfusion Injury; Sus scrofa; Transplantation, Homologous

Brain death is associated with hemodynamic disturbances in systemic circulation and metabolic storm, and, thus, free radical-mediated injury to donor tissues was hypothesized. An assessment of oxidative stress in the donor and its effect on posttransplant kidney graft function comprised the scope of the study.. A prospective study was performed in 27 donors and 50 kidney transplant recipients. Sera from 27 brain-dead organ donors and preservation media were tested for malondialdehyde (MDA) and for total antioxidant status (TAS). Kidneys were preserved in University of Wisconsin-gluconate solution with machine perfusion. Mean ischemia time was 36.7+/-8 hours. Organs were transplanted to recipients on the Polish National Waiting List and posttransplant kidney function was monitored periodically. Posttransplant delayed graft function (DF) was diagnosed when a patient required at least one dialysis within first week after transplantation. Acute rejection was diagnosed clinically and confirmed with fine-needle biopsy if necessary.. Thirty-two recipients had immediate graft function (IF), and 18 suffered from DF. MDA level in preservation solution at the end of machine perfusion was significantly higher in the DF group (52.6+/-31 vs. 25.3+/-19 micromol/L) whereas donor TAS activity was lower (1.14+/-0.2 vs. 0.97+/-0.3 mmol/mL). Patients who suffered from acute rejection received kidneys from donors with significantly higher serum MDA (66+/-73 micromol/ml vs. 23+/-49 for patients without rejection). Serum creatinine 12 to 48 months after transplantation correlated to donor- and preservation-solution MDA (P<0.006).. Free-radical mediated injury occurring in the donor and during preservation is strictly correlated with immediate and long-term kidney function. It may also cause grafts to be prone to acute rejection.

Topics: Acute Disease; Adenosine; Adolescent; Adult; Aged; Allopurinol; Antioxidants; Brain Death; Creatinine; Female; Free Radicals; Glutathione; Graft Rejection; Humans; Insulin; Kidney; Kidney Diseases; Kidney Transplantation; Male; Malondialdehyde; Middle Aged; Organ Preservation Solutions; Prognosis; Prospective Studies; Raffinose; Time Factors; Tissue Donors

Protection of the failing right ventricle (RV) in the surgical treatment of massive pulmonary embolism is a keystone for myocardial recovery. This study evaluated whether cardioplegia should be used or avoided. In a modified Langendorff rat heart model pulmonary embolism was simulated by afterload elevation (20 cm H2O) for 30 min. Hearts were arrested with cardioplegic solutions [St. Thomas Hospital (ST); University of Wisconsin (UW); oxygenated Krebs-Henseleit-Potassium (KHP)] and stored for 10 min or were allowed to beat empty (NoCP) for 15 min. After reestablishing of baseline conditions groups were measured for 60 min. Cardiac index (CI) decreased in all groups to 20% during afterload elevation. Group NoCP showed 68 and Group ST 65% recovery after 10 min and deteriorated after 30 min. After 60 min CI was 37 (ST) and 39% (NoCP). UW and KHP showed a significantly better recovery (KHP 100%; UW 88%). At 60 min CI decreased to 60 (KHP) and 64% (UW), but was still significantly higher than corresponding values of NoCP and ST. Following increased pulmonary afterload cardioplegia with UW or KHP solution is beneficial for RV recovery. The composition of the cardioplegia is obviously important and needs further study.

Topics: Acute Disease; Adenosine; Allopurinol; Animals; Cardioplegic Solutions; Disease Models, Animal; Embolectomy; Evaluation Studies as Topic; Extracorporeal Circulation; Glucose; Glutathione; Heart Arrest, Induced; Heart Failure; Hypertension, Pulmonary; Insulin; Male; Myocardial Reperfusion Injury; Organ Preservation Solutions; Pulmonary Embolism; Raffinose; Rats; Rats, Inbred Lew; Tromethamine; Ventricular Function, Right

Enteritis caused by Yersinia enterocolitica appears to be an uncommon occurrence in the United States. Most of the reported cases have been caused by biochemically typical Y. enterocolitica serotype O:8, the most frequently encountered serotype in the United States. The present report describes the isolation of two biochemically and serologically unusual Y. enterocolitica isolates from a patient with acute enteritis. One strain was distinguished by the rapid fermentation of rhamnose and raffinose and by citrate utilization at 22 degrees C but not at 37 degrees C. The other isolate was sucrose negative, and at either temperature it lacked both the fermentative capability for rhamnose and raffinose and the ability to utilize sodium citrate. Neither strain was agglutinable with known Y. enterocolitica antisera. The rhamnose-positive isolate showed an increased resistance to ampicillin, cephalothin, colymycin, and penicillin when tested at 22 degrees C as compared to results obtained at 37 degrees C. The demonstration that one patient's serum contained agglutinins (1:64) against the sucrose-negative strain supports its etiological significance. The role of the rhamnose-positive strain in the patient's illness is speculative. It conceivably could have potentiated the pathogenicity of the sucrose-negative isolate.

Topics: Acute Disease; Adult; Citrates; Drug Resistance, Microbial; Enteritis; Female; Fermentation; Humans; Raffinose; Rhamnose; Species Specificity; Sucrose; Temperature; Yersinia; Yersinia Infections