A laparoscopic approach to allograft nephrectomy and bilateral native nephrectomy: a case report.

INTRODUCTION: Laparoscopic surgery is rapidly emerging as the standard of care for a variety of urological conditions, even among patients who have undergone prior renal transplantation. We describe the technique of bilateral native nephrectomy and allograft nephrectomy by laparoscopy. CASE REPORT: A 32-year-old man with end-stage renal disease who had undergone a cadaveric renal transplant presented with chronic graft dysfunction. He had received a living donor kidney transplant with a postoperative course complicated by persistent proteinuria and refractory hypertension. Our nephrology service indicated the need for bilateral native nephrectomy and allograft nephrectomy for better blood pressure control following a second transplant. Bilateral native nephrectomy was performed following the previous reported techniques for pure laparoscopic nephrectomy. Allograft nephrectomy started by dissection of the iliac vessels to identify the vascular anastomosis. The hilum of the transplanted kidney was accessed. The renal vessels were clipped and transected. The ureter was identified and clipped. All three kidneys were removed from the abdominal cavity through a 3-cm skin incision. RESULTS: The left nephrectomy took 25 minutes and the right nephrectomy, 40 minutes. The estimated blood loss was 300 mL and the total operative time was 210 minutes. The patient had an uneventful postoperative course and was discharged on the third postoperative day. CONCLUSIONS: We demonstrate the feasibility of laparoscopic allograft nephrectomy and bilateral native nephrectomy in a transplant recipient.

Coeficient of parentage and breeding of Brazilian soybean germplasm

Foram estimados 2346 coeficientes de parentesco (f) entre 69 cultivares de soja (Glycine max (L) Merrill). Os valores de f variaram de 0 a 1. Apenas oito pares de cultivares mostraram f = 1; um número de 106 pares de cultivares tiveram f = 0; o restante 2232 pares de cultivares apresentaram valores de f maiores que zero e menores que a unidade. Foram calculadas a média e o desvio padräo das 68 estimativas de coeficientes de parentesco obtidas para cada cultivar. A menor média de coeficiente de parentesco ocorreu no cultivo Ivorá (f = 0,0443) e a maior média no cultivar Haree (f = 0,2272). Com base na média geral dos 2346 coeficientes de parentesco (f = 0,1641), verificou-se que o programa de melhoramento de soja no Brasil seria considerado como uma populaçäo com tamanho efetivo relativamente baixo (N = 11 a 15), mudando do segundo para o terceiro ciclo de seleçäo recorrente. Foram feitas comparaçöes entre o germoplasma de soja americano, argentino e brasileiro. Discutiu-se o emprego dos coeficientes de parentesco na seleçäo de parentais para melhoramento de caracteres quantitativos e para ampliaçäo da base genética do germoplasma cultivado