Immunoreactive relaxin in seminal plasma of fertile boars and its correlation with sperm motility characteristics determined by computer-assisted digital image analysis

Ejaculates from 10 mature fertile large white Yorkshire boars were used to examine the correlation between immunoreactive relaxin levels in seminal plasma and sperm motility characteristics. Seminal plasma levels of immunoreactive relaxin were measured by a time-resolved fluoroimmunoassay (TR-FIA). Motility characteristics were assessed using a CellSoft computer-assisted digital image analysis system. The mean +/- SD level of immunoreactive relaxin in seminal plasma was 2.61 +/- 0.62 ng/mL. When the correlation between seminal plasma levels of immunoreactive relaxin and parameters of sperm movement was examined, it was found that relaxin levels were significantly correlated with the percentage of motile spermatozoa (r=0.687, p < 0.05), curvilinear velocity (r=0.745, p < 0.05), straight line velocity (r=0.651, p < 0.05), mean amplitude of lateral head displacement (mean ALH) (r=0.844, p < 0.01) and the maximum amplitude of lateral head displacement (max ALH) (r=0.830, p < 0.01), but not with linearity, beat-cross frequency, or percentage of circular cells. Among these parameters, seminal plasma levels of immunoreactive relaxin showed the strongest correlation with the ALH parameter related to fertilizing ability. These results indicate that immunoreactive relaxin in boar semen may be necessary not only for normal sperm motility but also for normal fertility, suggesting that determination of the profile of immunoreactive relaxin in ejaculates may have value as a potential marker for predicting sperm fertilizing ability of boars.     

Small-for-size grafts in living-related liver transplantation

BACKGROUND: The problems associated with small-for-size grafts in living-related liver transplantation are not fully understood. STUDY DESIGN: A consecutive series of 79 patients underwent 80 living-related liver transplantation procedures, including one retransplant, at the University of Tokyo from January 1996 to January 2000. They were divided into two groups by graft size: graft weight/recipient standard liver volume ratios of 40% or less (n = 24), and more than 40% (n = 56). Preoperative status, mortality, morbidity, duration of hospital stay, and postoperative graft function were examined and compared between the groups. RESULTS: The rate of patients who were restricted to the intensive care unit preoperatively was comparable between the groups (33% versus 21%, p = 0.27). The mean standard liver volume ratios were 37% in the small graft group and 84% in the large group. Survival rates were 80% (5 of 24) for the small graft group, which was significantly lower than that for the large group (96%, 54 of 56, p = 0.02). The rate of acute rejection was comparable between the groups (33% versus 43%, p = 0.47). Vascular complication was observed in 17% of the small graft group patients and 23% of the large group (p = 0.77). No difference was observed in the frequency of bile leakage or bile duct stenosis (25% versus 21%, p=0.77). Hyper-bilirubinemia and elongation of prothrombin time persisted longer in the small graft group than in the large group (p < 0.0001 for both). CONCLUSIONS: Our surgical results may suggest that a graft weight ratio of 40% or less provides a lower chance of survival after living-related liver transplantation.     

Liver transplantation using a right lateral sector graft from a living donor to her granddaughter

One of the major concerns regarding living-related liver transplantation is graft-size disparity. The left liver graft is too small while the right is too large in some recipients. To overcome this problem, the right lateral sector (Segments VI and VII) was transplanted from a living donor (55 kg) to her granddaughter (17 kg). The common hepatic trunk had to be anastomosed end-to-end to the graft hepatic vein without being compressed by the graft overriding the vena cava and without unfavorable tension of the anastomosis. The anterior wall of the hepatic vein of the donor was resected as much as possible. The superficial left, left, middle and right hepatic veins of the recipient were made confluent by incision of the intervening venous walls, and the nicks were sutured to form a wide and long common venous trunk. The recipient received a graft corresponding to 75% of her standard liver volume. She was complicated with gastric dilation and acute rejection, but recovered with no signs of anastomotic stricture. Right lateral sector graft obtained by this innovative procedure may be useful for overcoming borderline graft-recipient size and shape differences.     

Effect of Add‐on Aliskiren to Type 1 Angiotensin Receptor Blocker Therapy on Endothelial Function and Autonomic Nervous System in Hypertensive Patients With Ischemic Heart Disease

The aim of this study was to evaluate the add‐on effect of aliskiren to valsartan on endothelial‐dependent vasodilation in hypertensive patients with ischemic heart disease (IHD). After 4 weeks of treatment with 80 mg of valsartan, 28 patients were allocated to either continued treatment with valsartan or an add‐on treatment with valsartan plus 150 mg of aliskiren. Aliskiren significantly decreased plasma renin activity, whereas endothelium‐dependent vasodilation measured by flow‐mediated dilation (FMD) did not change. In contrast, heart rate significantly decreased (73.1 ± 9.8 to 66.3 ± 7.0 beats per minute at baseline and 24 weeks, respectively [P = .009]) and the standard deviation of the R‐R intervals (SDNN) significantly increased in the aliskiren group. The add‐on aliskiren to valsartan therapy may not improve endothelial functions, although it significantly reduced resting heart rate via regulation of the autonomic nervous system in hypertensive patients with IHD.     

Prediction of acute cellular rejection by peripheral blood eosinophilia in pediatric living donor liver transplantation

Background

Acute cellular rejection (ACR) is a common cause of morbidity following liver transplantation. Several reports have evaluated the predictive value of peripheral blood eosinophilia as a simple noninvasive diagnostic marker for ACR. This study examined whether the relative eosinophil counts (REC) predicted ACR in pediatric living donor liver transplantation (LDLT).

Methods

One hundred three patients underwent LDLT between May 2001 and December 2007. ACR were diagnosed based on the pathological findings.

Results

The incidence of ACR was 46.6% (48/103); ACR was diagnosed an average of 13.5 days after LDLT. The average REC at 4 and 2 days before the onset ACR (n = 39) within 30 postoperative day (POD) was 4.3% and 7.3%, respectively, and 9.0% at the onset. Patients with ACR showed significantly higher levels of REC compared with those free of ACR (P = .039). REC thresholds of 10% at POD 7 displayed a sensitivity and specificity of ACR detection of 80% and 75%, respectively. Moreover, the accumulated morbidity ratio of ACR within 30 POD was significantly higher with REC >10% at POD 7 (P = .007).

Conclusion

ACR within POD 30 should be considered when REC is >10% at POD 7 after LDLT.     

Islets from rats and pigs transgenic for photogenic proteins

Translational research is necessary for the development of efficient experimental animal models that can be used to develop innovative medical treatments, such as improvements in organ or tissue transplantation. We have developed animal models that produce photogenic proteins in their islet cells: rats models expressing the gene for luciferase or green fluorescent protein (GFP), and pig models expressing the gene for GFP or Kusabira-Orange. We also developed methods for preserving isolated islets in culture and showed that the fluorescence of the islets remains at usable levels for at least seven days. These models will enable transplanted islets to be visualized without the need for chemical reactions, and will be useful for research on the biology of islets as well as for the development of new transplantation methods.     

Role of Apheresis and Dialysis in Pediatric Living Donor Liver Transplantation: A Single Center Retrospective Study

In the field of pediatric living donor liver transplantation, the indications for apheresis and dialysis, and its efficacy and safety are still a matter of debate. In this study, we performed a retrospective investigation of these aspects, and considered its roles. Between January 2008 and December 2010, 73 living donor liver transplantations were performed in our department. Twenty seven courses of apheresis and dialysis were performed for 19 of those patients (19/73; 26.0%). The indications were ABO incompatible‐liver transplantation in 11 courses, fluid management in seven, acute liver failure in three, renal replacement therapy in two, endotoxin removal in two, cytokine removal in one, and liver allograft dysfunction in one. Sixteen courses of apheresis and dialysis were performed prior to liver transplantation for 14 patients. The median IgM antibody titers before and after apheresis for ABO blood type‐incompatible liver transplantation was 128 and eight, respectively (P < 0.05). Eleven courses of apheresis and dialysis were performed post liver transplantation for 10 patients. The median PaO2/FiO2 ratio before and after dialysis for fluid overload was 159 and 339, respectively (P < 0.05). No bleeding or technical complications attributable to apheresis and dialysis occurred. The 1‐year survival rate of the patients was 100%. Apheresis and dialysis in pediatric living donor liver transplantation are effective for antibody removal in ABO‐incompatible liver transplantation, and fluid management for acute respiratory failure.     

Pediatric living donor liver transplantation for biliary atresia with hepatopulmonary syndrome: the gift of a second wind

Purpose

Hepatopulmonary syndrome (HPS) is a progressive, deteriorating complication of end-stage liver disease (ESLD) that occurs in 13?C47% of liver transplant candidates. Although LT is the only therapeutic option for HPS, it has a high morbidity and mortality, especially in patients with severe hypoxemia before transplantation, but the course of HPS after living donor liver transplantation (LDLT), especially for biliary atresia (BA) patients is not well established.

Patients and methods

The present study evaluated 122 patients who received an LDLT for BA and of these, 3 patients had HPS at the time of LDLT in a single-center series.

Results

Two patients of the HPS patients them had biliary and/or vascular complications, but they recovered uneventfully with interventional treatment. None of the patients required supplemental oxygen and had no residual cardiopulmonary abnormalities at a follow-up of more than 24?months.

Conclusion

Although a series of three patients is too small for definitive conclusion and further investigations must be conducted, pediatric LDLT can be a favorable therapeutic option for HPS.