Usefulness of 1H magnetic resonance spectroscopy in human testes: preliminary study.

AIM: To identify and quantify the metabolites detected on proton magnetic resonance spectroscopy ((1)H-MRS) in human testes. MATERIALS AND METHODS: The institutional review board approved the study, and all patients provided informed consent. A total of 27 patients consulting the Urology Department underwent single-voxel (1)H-MRS (4000 ms repetition time [RT], 31 ms echo time [TE], 128 averages for each TE) at 1.5 T. Spectroscopy was not evaluable in one patient, and four patients had only one testis; thus, 48 testes were studied. Choline-containing compounds (Cho) and methylene lipid (Lip) values were measured and the Cho/Lip ratio was calculated. Testes were classified as normal or abnormal based on conventional magnetic resonance imaging (MRI) findings. The Mann-Whitney U-test was used for correlated data and bootstrapping to compare mean Cho/Lip ratios between normal and abnormal testes, and the area under the receiver operating characteristic curve (AUC) was calculated. RESULTS: Thirty testes were classified as normal and 18 as abnormal. The mean Cho/Lip ratio was 1.02±0.46 in normal testes and 0.45±0.36 in abnormal testes (Mann-Whitney U, p=0.001; bootstrapping mean difference, 0.57; 95% confidence interval (CI) 0.32-0.82; AUC=0.833). CONCLUSION: (1)H-MRS could be useful in routine clinical practice to identify the major metabolites in the testes and help discriminate between normal and abnormal testes.

[Renal xenotransplant. Acute vascular rejection]. / Xenotrasplante renal. El rechazo vascular agudo.

INTRODUCTION AND OBJECTIVES: Organ transplant is nowadays a usual and succesful practice, although with limited application due to the lack of organs. Yearly thousands of patients get access to the waiting list and finally will death while they are waiting for an organ. In the U.S.A., 2005 waiting list for kidneys, heart, liver lung and pancreas was around 94.419. Number of transplants performed was 27.966 and died patients while waiting for an organ, 41.392 (1). Pig xenotransplant is one of the possibilities to ameliorate the lack of organs for transplant. Arrangement of pigs with different genetic modifications generated great expectatives on the use of these organs in clinics. Although preclinical experimental studies with kidneys reached prolonged survivals, these are really insufficient to go on with the clinical appliance. Hyperacute rejection produces destruction of the organ immediately. This problem could be pharmacologically precluded in xeno-transplant. However, acute rejection or vascular rejection usually produces the lost of the implant. New inmunosuppresive schedules delay significantly rejection, but not definitively. Xenotransplant as a therapeutic option introduces important scientific problems, as well as ethical and social. This paper reports a summary of our experience in renal xenotransplant and the management of acute rejection. MATERIAL AND METHODS: Twenty xenotransplants from transgenic pig (hDAF) as donor to babuine as receptor. Average weight of the animals ranged 11.4-75 kgrs and babuines 10-26 kg. Xenograft average weight ranged 39-160 grs. Implant was performed to aorta and cava. Four inmunosupressive schedules were used. RESULTS: Average survival was 7-9 days. Final Histological findings are described. Changes observed were secondary to acute tubular necrosis mixed with changes due to acute rejection. Three grafts were lost due to technical major problems. CONCLUSIONS: Although we have observed some promising results, xenotransplant is a very difficult problem to solve in the long-term. A lot of research is still needed-.

[Renal xenotransplantation from hDAF pig to baboon. Experience and review]. / Xenotrasplante renal cerdo hDAF-babuino. Experiencia y revisión.

UNLABELLED: The renal xenotransplant could be the solution on the demand of organs for transplantation. We present here our experience and review the actual status of the xenotransplant. METHODS: We have done 20 xenotransplants from transgenic pig h DAF to baboons, with four protocols of immunosuppression. All the hosts were treated with GAS 914. Group A: Cyclophosphamide, Cyclosporine, Mycophenolate, and Steroids (n = 10). Group B: Cyclophosphamide, Cyclosporine, FTY 720, and Steroids (n = 3). Group C: Basiliximab, Cyclosporine, Mycophenolate, and Steroids (n = 3). Group D: Basiliximab, FTY 720, Everolymus, and Steroids (n = 4). RESULTS: The duration of the xenografts ranged between 1 and 31 days. The function of the xenografts in relation to the type of immunosuppression were not significantly different: A) 7 days, B) 8 days, C) 8 days, and D) 9 days. CONCLUSIONS: 1. The cold ischemic time of the graft, has influence in the initial function of the kidneys but not in the evolution and duration of the graft. 2. The hyperacute rejection has been overcome with the utilization of transgenic pigs. The graft failure was due to acute humoral rejection that was not aborted by the actual inmunosupressors. 3. It is necessary to develop new immunosuppression protocols, through new knowledge of their pharmacology and the physiology of the xenografts, and at the same time it is important to avoid the potential risk of transmission of animal infections.