Profile of organ donors in Ceará, northeastern Brazil, from 1998 to 2012.

The use of cadaver donors for transplantation is often the only alternative in the treatment of patients with organ failure. The purpose of this study was to draw a comprehensive profile of solid organ donors in Ceará, northeastern Brazil, from 1998 to 2012. The study was retrospective and based on secondary data regarding sex, age, blood typing, and cause of brain death obtained from the solid organ donor database of the Ceará Transplantation Center covering the period November 1998 to December 2012. During the study period, 976 donors (69% male) were used. Donors were distributed in 4 age groups as follows: 12.9% <18 years, 50.9% 18-40 years, 28.5% 41-60 years, and 7.7% >60 years. The average age was 35 ± 16 years. On the average, female donors were older than male donors (38.4 ± 17 y vs 33.5 ± 16 y; P < .0001). Men were predominant in the age groups 18-40 y (75.3%; P < .0001) and 41-60 y (59.4%; P < .0001). The main causes of brain death were traumatic brain injury (TBI) (56.7%) and stroke (33.1%). The former was more common in men (P < .0001), the latter in women (P < .0001). TBI was caused by traffic accidents (51.4%), of which 50.7% were motorcycle accidents, and urban violence (22.6%), of which 71.2% were associated with firearms. The number of donations increased in the study period (11.2 donors per million population in 1998-2002 to 68.1 in 2008-2012). In Ceará, solid organ donation is on the rise. The predominant donor profile was young men aged 18-40 years with brain death due to TBI caused by traffic accidents and urban violence.

Polyomavirus-infected decoy cells in cytocentrifuged urine cytology specimens from renal transplant recipients.

OBJECTIVE: To evaluate the prevalence of BK virus (BKV) infection in renal transplant recipients based on the detection of urinary decoy cells. METHODS: Fifty transplantation patients (56% males) aged 39.9 ± 11 years were screened for urinary decoy cells. The majority (86%) had received grafts from living donors. The inclusion criteria were graft dysfunction, hematuria, and/or leukocyturia. Creatinine and urea serum levels were monitored for 6 months. RESULTS: Decoy cells were found in the urine of 12 (24%) patients 1-2 years after transplantation. The immunosuppression regimens most frequently adopted by BKV-positive patients were cyclosporine + azathiprine (50%) and FK + mycophenolate mofetyl + prednisone (25%). A renal biopsy revealed normal structures in 7 patients (58.4%), BKV nephropathy with lymphomononuclear infiltrate and fibrosis in 4 patients (33.3%), and acute cellular rejection with lymphomononuclear infiltrate without fibrosis in 1 patient (8.3%). In the latter patient, BKV-associated nephropathy was confirmed by immunohistochemistry. During the first month, creatinine and urea serum levels were higher among patients with urinary decoy cells. Creatinine levels decreased between the first and the sixth months. CONCLUSION: The finding of BKV-associated nephropathy in 33.3% of the patients with urinary decoy cells stresses the importance of screening for BKV with urinary cytology.

Rapamycin even when combined with cyclosporine attenuates tumor growth but does not induce regression of established walker sarcomas.

PURPOSE: To investigate the effect of rapamycin (Rapa) on growth or regression of Walker tumor used alone or in combination with CsA and MMF. METHODS AND RESULTS: Wistar rats received water (control) or Rapa or CsA 1 day before and daily after tumor inoculation. On day 10, tumor volume (TV) was smaller among Rapa (6.8 +/- 2.7 cm(3)) versus control (14.9 +/- 4.2 cm(3), P <.001) or CsA (13.9 +/- 3.0 cm(3), P <.0001) treatment groups. Tumor growth was greatly inhibited (TI) by Rapa (-49.3%). Tumor weight (TW) was significantly (P < or =.001) lower in Rapa (3.7 +/- 1.2 g) versus CsA (8.8 +/- 2.1 g) or control (7.3 +/- 2.0 g) animals. An additional set of rats received water or Rapa or CsA + Rapa, or MMF + Rapa 1 day before tumor inoculation. On day 10, TV and TW were lower among Rapa (3.8 +/- 1.5 cm(3)) and Rapa + CsA (3.1 +/- 1.2 cm(3)) and Rapa + MMF (4.6 +/- 2.7 cm(3)) groups compared with controls (10.9 +/- 3.8 cm(3), P <.0001). TI was -52.1% in Rapa, -68.5% in Rapa + CsA, and -63% in Rapa + MMF. A further set of rats received either water or Rapa on the day 4 after tumor inoculation. On day 10, tumor growth and TW among the Rapa and control groups were similar. CONCLUSION: Rapamycin greatly inhibited tumor growth when used alone or with CsA or MMF, but did not produce an effect on a well-established Walker sarcoma.

Mycophenolate mofetil attenuates Walker's tumor growth when used alone, but the effect is lost when associated with cyclosporine.

PURPOSE: To investigate the effect of mycophenolate mofetil on Walker's carcinosarcoma, without versus with the growth and regression of cyclosporine. METHODS AND RESULTS: Wistar rats received water (control), MMF, and/or CsA-N 1 day before tumor inoculation. On day 10, tumor volume (TV) was lower among MMF (10.3 +/- 2.8 cm(3)) than control rats (14.9 +/- 4.2 cm(3), P <.05), and similar to that in CsA-N (13.9 +/- 3.0 cm(3)). However, tumor weight (TW) was significantly lower in MMF (5.2 +/- 2.0 g) than CsA-N (8.8 +/- 2.1g) or control hosts (7.3 +/- 2.0 g, P < or =.01). Growth was inhibited by MMF (-28.2%). In experiment II, CsA-N, MMF + CsA-N, or water were introduced 1 day before tumor inoculation. On day 10, TV and TW were similar for MMF + CsA-N as compared to CsA-N and control animals. In experiment III, water or MMF was introduced on the day 4 after tumor inoculation. On day 10, tumor growth are TW in the MMF group was similar to, that in the controls. CONCLUSIONS: MMF produces an anti-tumoral effect against Walker's carcinosarcoma. However, this inhibitory effect was lost when MMF was used in combination with CsA-N or administered in the presence of a well- established tumor.