Combination effect of melatonin and dexamethasone on liver ischemia/reperfusion injury.

OBJECTIVE: Liver failure following ischemia-reperfusion (I/R) injury is a major concern in liver surgery. The purpose of this study was to evaluate combination pretreatment with melatonin (MEL) and dexamethasone (DEX) on liver I/R model. Male Wistar rats (n = 60) were assigned to 5 groups of 12 animals each: (1) Sham: laparotomy without I/R; (2) I/R: hepatic I/R; (3) I/R+MEL: hepatic I/R+melatonin injected intraperitoneally (20 mg/kg); (4) I/R+DEX: hepatic I/R+ dexamethasone injected intravenously (10 mg/kg); (5) I/R+MEL+DEX: hepatic I/R+ melatonin injected intraperitoneally+dexamethasone injected intravenously. The liver was subjected to ischemia by clamping the portal triad for 30 minutes and then reperfused for 6 hours after ischemia by removing the clamps. RESULTS: The levels of glutathione peroxidase (GPx) and superoxide dismutase (SOD) decreased after hepatic I/R in all groups. Levels of GPx and SOD were higher in I/R+MEL+DEX group compared to I/R, I/R+MEL and I/R+DEX groups and they were significantly higher in I/R+MEL group compared to I/R and I/R+DEX groups (p < 0.05). Levels of ALT, AST, TNF-α, hepatic tissue malondialdehyde (MDA), liver injury index, and apoptotic index increased after hepatic I/R. Levels of ALT, AST, tissue MDA, tissue injury index and apoptotic index were lower in I/R+MEL+DEX group compared to those in I/R, I/R+MEL and I/R+DEX groups, and in I/R+MEL they were significantly lower than in I/R+DEX group (p < 0.05). TNF-α level was lower in I/R+MEL+DEX group compared to other groups and it was significantly lower in I/R+DEX group than in I/R+MEL and I/R groups (p < 0.05). CONCLUSION: Combination therapy with melatonin and dexamethasone had better results in decreasing the liver injury compared to when each of them was administered alone (Tab. 3, Ref. 58).

BK polyoma virus nephropathy among Iranian renal transplant recipients.

BACKGROUND: BK virus nephropathy (BKVN) is recognized as a cause of graft loss in renal transplant patients. The disorder may be related to the introduction of new, potent immunosuppressive regimens. We sought to assess the prevalence, outcome, and clinical characteristics of BKVN. MATERIALS AND METHODS: We retrospectively analyzed 160 specimens from episode biopsies. BKVN was diagnosed by light microscopic examination and positive immunohistochemical staining. RESULTS: Among 160 patients, 21 (13.1%) were diagnosed as BKVN. The mean interval between biopsy and transplantation was 13.6 +/- 10.67 months. There were no significant differences between BKVN patients and non-BKVN patients with respect to age, sex, interval between diagnosis and transplantation, cyclosporine blood level, and azathioprine versus mycophenolate mofetil immunosuppression. Graft loss occurred in 57.1% of BKVN versus 12.2% of non-BKVN subjects (P = .005). There was a significant difference between antilymphocyte globulin (ALG)- and non-ALG-treated groups with respect to the incidence of BKVN (6.6% in non-ALG versus 19% in ALG groups; P < .01). BKVN was diagnosed by immunohistochemistry in 61% of specimens with acute rejection according to light microscopic evaluation. CONCLUSIONS: This is the first report of BKVN in Iranian renal allograft recipients. In our hospital, the prevalence of BKVN was higher than that previously reported for non-Iranian recipients. BKVN had a negative impact on graft survival.