Long-term Results of Living Donors in Simultaneous Kidney and Liver Transplantations.

INTRODUCTION: Because of the shortage of organs available for transplantation, living related sequential transplantation with the use of liver and a kidney from the same donor has emerged as a reasonable therapeutic alternative. However, there is insufficient literature about the complications that living donors experience after simultaneous kidney and liver transplantations. METHODS: From December 2001 to October 2009, 5 living donors provided simultaneous donation of livers and kidneys and 1 living donor donated first her kidney and then her liver. Demographic data of the donors and information concerning the surgery and postoperative observation were collected prospectively. RESULTS: All of the donors were female. The median age was 27.5 (range, 19-36) years. Indications requiring the simultaneous transplantation of livers and kidneys were primary hyperoxaluria type 1 (PH1) in 5 potential recipients and cirrhosis due to chronic hepatitis B infection and idiopathic chronic renal insufficiency in 1 potential recipient. Four recipients underwent right hepatectomy (segments 5-8) and right nephrectomy; 1 recipient underwent left hepatectomy (segments 2-4) and right nephrectomy; and 1 recipient underwent left lobectomy (segments 2-3) and right nephrectomy. There were no complications except in 1 donor (postoperative ileus). No donor developed hypertension or microalbuminuria. CONCLUSIONS: With the right indications, appropriate preoperative evaluation, meticulous surgical technique, proper postoperative care, and long-term close monitoring to minimize morbidity and mortality risks, liver and kidney donation from the same donor can be considered for simultaneous kidney and liver transplantation.

Evaluation of telomerase activity in gingival fibroblasts of cyclosporine-treated patients.

Gingival overgrowth (GO) is a common side effect following administration of cyclosporin A (CsA). Various case reports have shown that squamous cell carcinomas could arise in GO induced by CsA and phenytoin. It is also known that human telomerase activated in about 90% of cancers is mainly composed of hTR, hTERT, and TPI. The aim of this study was to investigate the potential role of telomerase activity in the pathogenesis of CsA-induced GO. Included in the study were 9 patients on CsA: 4 with and 5 without GO. Gingival tissues were obtained during gingivectomy or flap procedures; gingival fibroblasts were cultured in Dulbecco's modified Eagle's medium (DMEM) supplemented with 10,000 U/mL penicillin, 10 mg/mL streptomycin, 2 mmol/L l-glutamine, and 10% heat-inactivated fetal bovine serum at 37 degrees C under a humidified 95% air virgule 5% CO(2) atmosphere. Quantitative detection of hTERT mRNA was performed with the commercially available LightCycler Telo TAGGG hTERT Quantification Kit using real-time online PCR. The hTERT mRNA expression was positive in one patient, while hTERT mRNA expression was negative in the others. Because results indicated that there may be a relationship between CsA-induced GO and positive telomerase activity, detailed studies should be performed to confirm the present findings.