Tehran University Medical Journal

Background: While excellent organ quality and ideal transplant conditions eliminate many of the known factors that compromise initial graft function (IGF), slow graft function (SGF), still occurs after living donor kidney transplantation (LDKT). The aim of our current study is determination SGF frequency and its risk factors in LDKT 

Methods: In this prospective study, between April 2004 and March 2006, data were collected on 340 LDKT, in Baghiyattallah Hospital, Tehran. Recipients were analyzed in two groups based on initial graft function (IGF): Creatinine <3 mg/dl 5 day after transplantation, SGF: Creatinine ≥ 3 mg/dl 5 day after transplantation with out dialysis in the first week. Donors' and recipients' characteristics and recipient lab. data were compared in two groups by chi-square, Mann-whitney & independent samples T-test.

Results: The incidence of SGF was 22 (6.2%) and IGF 318 (89.8%), Recipients' BMI in IGF were 22.1±3.9 and in SGF were 25.3±3.8 (P=0.001 95% Cl 1.097-1.401 OR= 1.24). SGF relative frequency in female donors is more than male donors. A multivariate analysis model confirms this significant difference. (P=0.044 95% Cl 1.028-7.971 OR= 2.862). SGF relative frequency in PRA (Panel Reactive Antibody) positive recipients are more than negative ones. A multivariate analysis model confirms this significant difference. (P=0.007 95%Cl 1.755-35.280 OR= 7.849). Recipients' age and donors' BMI are significant in univariate analysis (P=0.002 & P=0.029 respectively) but multivariate analysis model dose not confirm those significance. Serum ca & P & PTH levels don't have significant difference between IGF & SGF. Using calcium channels blockers have not a protective effect.

Conclusions: We conclude that negative PRA and lower recipient BMI have protective effects on SGF. Recipients with female donors have higher chance to develop SGF. We recommend recipients reduce their BMI before transplantation. The male donors are preferred to female ones.

Background: The effects of growth hormone (GH) on bone density in healthy adults is controversial. This study was performed to evaluate the effects of GH administration on bone density under controlled conditions in healthy adult rabbits.

Methods: Twenty healthy adult New Zealand white rabbits of both sexes were included in the study. The rabbits were divided into two groups. The experiment group received human GH and the controls placebo for three months. The density of femur and humerus were measured at proximal epiphysis, mid shaft and distal epiphysis by radiography, aluminum step-wedge and appropriate software. Measurements were performed in five stages, once before and four times after the administration of GH or placebo, with 3-week intervals.

Results: The mean concentration of serum insulin-like growth factor I (IGF-I) increased significantly after GH administration (P<0.05) in the experiment group. Bone density generally increased in all regions except the distal epiphysis of femur in the test group, but significant difference were only seen in the midshaft of femur in comparison to the controls (P<0.05). In the second stage, bone density decreased slightly in all regions except distal epiphysis of femur, but it increased in the next stages.

Conclusion: GH can increase bone density (mostly cortical bone) in adult rabbits. According to the similarities seen between growth hormone effects in rabbit and humans, this study suggests rabbits as a model for studying GH effects on bone density in acromegaly, growth hormone deficiency and even in healthy adult humans.