RESUMEN
We have performed 115 "zero-hour" biopsies of transplanted kidneys since 1994. Donor kidneys were divided into five groups, based on the morphological findings of "zero-hour" biopsies. No morphological abnormalities were found in 38.26% of the cases (group 1). Arteriolosclerosis was present in 22.61% of donor kidneys (group 2). Specific morphological alterations, i.e. acute tubular necrosis (24.35%), tubulointerstitial nephritis (5.22%) or glomerulonephritis (9.56%) were detectable in the remaining cases (groups 3-5). During an average of 644 days after transplantation clinical and histological follow-up were performed. According to our observations: 1. Higher creatinine was found in patients with grafts with arteriolosclerosis (group 2). 2. There were more non-viable grafts and longer periods of delayed graft function in patients with acute tubular necrosis (group 3). 3. Higher serum creatinine, more frequent rejections with the need of secondary hemodialysis were observed in patients who received a kidney with "zero-hour" biopsy of tubulointerstitial nephritis (group 4). 4. The only complication observed in patients with glomerulonephritis donor kidneys was delayed functioning of the graft (group 5). Biopsies did not cause complication in any of our patients. In conclusion, "zero-hour" biopsies can be useful and safe tools to predict early graft function. Besides, "zero-hour" biopsies help histological interpretation of consecutive graft re-biopsies.
Asunto(s)
Biopsia/métodos , Enfermedades Renales/diagnóstico , Trasplante de Riñón , Riñón/patología , Arteriosclerosis/diagnóstico , Cadáver , Creatinina/sangre , Glomerulonefritis/diagnóstico , Rechazo de Injerto/etiología , Humanos , Riñón/fisiopatología , Enfermedades Renales/sangre , Enfermedades Renales/patología , Enfermedades Renales/fisiopatología , Necrosis Tubular Aguda/diagnóstico , Donadores Vivos , Nefritis Intersticial/diagnóstico , Valor Predictivo de las Pruebas , Pronóstico , Resultado del TratamientoRESUMEN
In the last ten years 62 patients were operated on by the authors because of liver echinococcosis. Each of the infections caused by echinococcus granulosus. In the course of the examination ultrasonography, abdominal X-ray, Casoni test and ELISA were used. Angiography and ERCP were applied only to answer special questions. The echinococcus cysts were removed in 15 cases by atypical liver resection, in 42 cases by pericystectomy and in 5 cases by partial cystectomy using the Pringle's manoeuvre in all of them. Operative mortality was 3.22%. Jaundice was observed in three cases, fever in five cases, wound infection in two cases. Reoperations had to be performed in two cases. All of the patients were treated postoperatively with mebendasol (Vermox). Recurrence of the infection could not be observed.
Asunto(s)
Equinococosis Hepática/cirugía , Adulto , Equinococosis Hepática/diagnóstico por imagen , Equinococosis Hepática/enzimología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Ictericia/etiología , Masculino , Mebendazol/uso terapéutico , Persona de Mediana Edad , Cuidados Posoperatorios , Radiografía , Infección de la Herida Quirúrgica/tratamiento farmacológico , UltrasonografíaRESUMEN
The roles of planar and SPECT 99mTc labeled red blood cell (RBC) scintigraphy in the diagnosis of hepatic cavernous hemangioma were evaluated. Out of the 29 patients with various focal intrahepatic lesions 13 were diagnosed as having hemangiomas: 6 proven by surgery, and 7 proven by maintaining stable clinical course ranging from 6 to 12 month with no change in the size or appearance of the lesion on US. In the 13 patients a total of 16 hemangiomas were found. 12 of these detected by planar imaging, 2 detected by SPECT only. The sensitivity of planar RBC scintigraphy was 75%, the specificity was 100%. Although planar imaging is probably sufficient for all large or superficial hemangioma, delayed SPECT should be used with small (2-3 cm) or deeply seated lesions.