Recurrent glomerulonephritis after renal transplantation.

PURPOSE OF REVIEW: The current understanding of the incidence, predisposing factors, pathophysiology and effective treatment of recurrent glomerulonephritis (RGN) in renal transplants remains at best patchy and at worst, completely lacking. Current reports have been limited by inconsistencies in study design, sample populations and lengths of follow-up. Making sense of the available evidence will provide the tools to support transplant nephrologists in their management of allograft donors and recipients. RECENT FINDINGS: With better survival of renal allografts, RGN has become a dominant factor influencing allograft survival. Evidently, the risk of recurrence is proportional to the incremental time posttransplantation. The proposed risk factors for RGN include but are not limited to the severity of primary glomerulonephritis (PGN), younger recipient age, live-related donor allograft, minimal HLA mismatch, steroid avoidance and nonuse of induction therapy. Unfortunately, these findings are derived from retrospective cohort and registry studies; hence, true causality for RGN is hard to prove. SUMMARY: The management of RGN is improving, as we gain greater understanding of its pathophysiology, including the genetic, alloimmune and autoimmune contributions to recurrence. With better pretransplant risk stratification, posttransplant surveillance, novel biomarkers and new treatment strategies, we hope the transplant community will eventually have the tools to predict risk, prevent recurrence and personalise treatment of RGN.

Analysis of Arterial and Venous Blood Gases in Healthy Gyr Falcons ( Falco rusticolus ) Under Anesthesia.

Arterial and venous blood gas analysis is useful in the assessment of tissue oxygenation and ventilation and in diagnosis of metabolic and respiratory derangements. It can be performed with a relatively small volume of blood in avian patients under emergency situations. Arterial and venous blood gas analysis was performed in 30 healthy gyr falcons ( Falco rusticolus ) under anaesthesia to establish temperature-corrected reference intervals for arterial blood gas values and to compare them to temperature-corrected venous blood gas values with a portable point-of-care blood gas analyzer (i-STAT 1, Abbott Laboratories, Abbott Park, IL, USA). Statistically significant differences were observed between the temperature-corrected values of pH, partial pressure of carbon dioxide (Pco2), and partial pressure of oxygen (Po2) and the corresponding nontemperature-corrected values of these parameters in both arterial and venous blood. Values of temperature-corrected pH, temperature-corrected Pco2, bicarbonate concentrations, and base excess of extra cellular fluid did not differ significantly between arterial and venous blood, suggesting that, in anesthetized gyr falcons, venous blood gas analysis can be used in place of arterial blood gas analysis in clinical situations. Values for hematocrit, measured by the point-of-care analyzer, were significantly lower compared with those obtained by the microhematocrit method.