Pseudohyperkalemia with Myelofibrosis after Splenectomy

SEUDOHYPERKALEMIA refers the serum potassiumlevel is higher than plasma potassium due tovarious reasons in vitro monitoring, but actualpotassium level in vivo is at the normal range. Aseries of inappropriate clinical interventions due to initialfailure to recognize it may actually decrease potassiumlevel，which could cause life-threatening condition. Here wereport a patient with myelofibrosis who occurred spurioushyperkalemia after splenectomy, aiming at emphasizingthe importance of recognizing pseudodyperkalemia.

Short-and long-term outcomes of kidney transplants with kidneys lavaged by retrograde perfusion technique

Objective: To evaluate the clinical safety and efficacy of the retrograde perfusion technique in kidney transplantation.Methods: Between January 2001 and June 2011, 24 cases of kidney transplantation with kidneys perfused using the retrograde perfusion technique due to renal artery variations or injury were selected as the observation group (retrograde perfussion roup, RP group).Twenty-two cases of kidney transplantation via conventional perfusion were chosen as the control group (antegrade perfussion group, AP group).There were no statistically significant differences in donor data between the two groups.Cold ischemia time, warm ischemia time, renal perfusion time, amount of perfusion fluid, acute renal tubular necrosis, wound infection, urinary fistula, graft kidney function, and the 1-year, 3-year, and 5-year survival rates for the grafted kidney in both groups were observed and recorded.Results: The kidney perfusion time was shorter in the RP group than that in the AP group (3.14 ± 1.00 vs.5.02 ± 1.15 min, P =0.030).There were 10 cases of acute renal tubule necrosis in the RP group and 5 in the AP group.The length of hospital stay was 40 ± 14 d in the RP group and 25 ± 12 d in the AP group.The follow-up time was 3.5-8.5 years (mean 6.25 years).The 1-, 3-, and 5-year survival rates for the grafted kidney were 95.8％, 75.5％, and 65.5％ in the RP group and 97.1％, 82.5％, and 68.4％ in the AP group, respectively (P＞0.05).Conclusions: This study indicates that retrograde perfusion is safe and practicable for cadaveric kidney harvesting and can be regarded as a better alternative or remedial measure for a poorly perfused kidney due to vascular deformity or injury.Copyright 2015, Chinese Medical Association Production.Production and hosting by Elsevier B.V.on behalf of KeAi Communications Co., Ltd.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

Transplantation tolerance mediated by regulatory T cells in mice

Background With potent suppressive effect on responder T cells, CD 4 +CD 25 + regulatory T (Treg) cells have become the focus of attention only recently and they may play an important role in transplantation tolerance However, the mechanism of action is not clear This study was designed to assess the possibility of using CD 4 +CD 25 + Treg cells to induce transplantation tolerance and to investigate their mechanism of action KH*2/5DMethods CD 4 +CD 25 + Treg cells were isolated using magnetic cell separation techniques Mixed lymphocyte reactions were used to assess the ability of Treg cells to suppress effector T cells Before skin transplantation, various numbers of CD 4 +CD 25 +Treg cells, which have been induced using complex skin antigens from the donor, were injected into the host mice either intraperitoneally (0 5×10 5, 1×10 5, 2×10 5, 3×10 5, 4×10 5, or 5×10 5) or by injection through the tail vein (5×10 3, 1×10 4, 2×10 4, 5×10 4, 1×10 5, 2×10 5) Skin grafts from two different donor types were used to assess whether the induced Treg cells were antigen-specific The survival time of the allografts were observed Single photon emission computed tomography was also used to determine the distribution of Treg cells before and after transplantation Results Treg cells have suppressive effect on mixed lymphocyte reactions Grafts survived longer in mice receiving CD 4 +CD 25 + Treg cell injections than in control mice There was a significant difference between groups receiving intraperitoneal injection of either 2×10 5 or 3×10 5 CD 4 +CD 25 +Treg cells and the control group ( P <0 05, respectively) Better results were achieved when Treg cells were injected via the tail vein than when injected intraperitoneally The transplantation tolerance induced by CD 4 +CD 25 + Treg cells was donor-specific Analysis of the localization of Treg cells revealed that Treg cells mainly migrated from the liver to the allografts and the spleen KH*2/5DConclusions CD 4 +CD 25 +Treg cells can induce donor-specific transplantation tolerance Cell-to-cell contact may be the primary mechanism by which Treg cells act on effector T cells