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Background Stroke volume variation (SVV) is known to be a simple and less invasive hemodynamic parameter for evaluating fluid responsiveness and preload status. Central venous pressure (CVP) has been targeted to achieve an adequate level for improving the graft perfusion and long-term graft function in kidney transplantation (KT) recipients, despite the various potential complications. The aim of this study was to investigate whether SVV could substitute for CVP in guiding intravascular volume management during KT. Methods This retrospective study evaluated 635 patients who underwent KT because of end-stage renal disease. Hemodynamic variables including CVP and SVV were obtained before skin incision (T 1 ), 5 minutes after iliac vein clamping (T 2 ), and 10 minutes after renal graft reperfusion (T 3 ). The ability of SVV to predict CVP level was investigated with receiver operating characteristic (ROC) curve analysis. Results CVPs were 6.0 ± 2.6, 8.6 ± 2.7, and 9.3 ± 2.5 mm Hg, and SVVs were 6.9 ± 3.0, 5.0 ± 2.1, and 4.3 ± 2.1% at T 1 , T 2 , and T 3 , respectively. ROC analysis showed that the discriminative power of SVV was fairly good with an area under the ROC curve of 0.70 (95% confidence interval, 0.67–0.72) for a CVP of 8 mm Hg, and that an optimal cutoff value of SVV was 6% as an alternative to CVP of 8 mm Hg during KT. Conclusions SVV may replace CVP in the volume management of patients who have undergone KT. Our results suggest that SVV can guide volume management to improve graft perfusion at critical time points during KT.

Background Although both Acute Kidney Injury Network (AKIN) and risk, injury, failure, loss, and end-stage (RIFLE) kidney disease criteria are frequently used to diagnose acute kidney injury (AKI), they have rarely been compared in the diagnosis of AKI in patients undergoing surgery for infrarenal abdominal aortic aneurysm (AAA). This study investigated the incidence of, and risk factors for, AKI, defined by AKIN and RIFLE criteria, and compared their ability to predict mortality after infrarenal AAA surgery. Methods This study examined 444 patients who underwent infrarenal AAA surgery between January 1999 and December 2011. Risk factors for AKI were assessed by multivariable analyses, and the impact of AKI on overall mortality was assessed by a Cox's proportional hazard model with inverse probability of treatment weighting (IPTW). Net reclassification improvement (NRI) was used to assess the performance of AKIN and RIFLE criteria in predicting overall mortality. Results AKI based on AKIN and RIFLE criteria occurred in 82 (18.5%) and 55 (12.4%) patients, respectively. The independent risk factors for AKI were intraoperative red blood cell (RBC) transfusion and chronic kidney disease (CKD) by AKIN criteria, and age, intraoperative RBC transfusion, preoperative atrial fibrillation, and CKD by RIFLE criteria. After IPTW adjustment, AKI was related to 30 day mortality and overall mortality. NRI was 15.2% greater (P=0.04) for AKIN than for RIFLE criteria in assessing the risk of overall mortality. Conclusions Although AKI defined by either AKIN or RIFLE criteria was associated with overall mortality, AKIN criteria showed better prediction of mortality in patients undergoing infrarenal AAA surgery.

A 3-dimensional alumina (Al 2 0 3 ) implant consisting of a continuous porous structure was fabricated using a fibrous monolithic process and its biocompatibility was evaluated through in vitro procedures and in vivo angiogenesis. In vitro experiments were carried out using human osteoblast like cells, MG-63 and osteoclast-like cells, Raw-264.7. Cellular proliferation and growth behavior were examined on the specimen surfaces by SEM. Highly condensed, circular cells with three-dimensional network like growth pattern was observed inside the pore surfaces using MG-63 cells. In contrast, the osteoclast-like Raw 264.7 cells had a multi-layered pebblestone appearance with interconnections. Moreover, the crystalline-like nodules generated by osteoblasts cultured on an Al 2 O 3 porous body were shown to have resulted from the in vitro mineralization of calcium-phosphate deposits. To investigate the in vivo angiogenesis, 3-dimensional Al 2 O 3 porous bodies were implanted into the subcutaneous tissues of rats. The porous bodies were completely filled with fibroblasts at 4 weeks and the formation of new blood vessels inside the porous body was observed at 6 weeks.