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Objective: Ringer's lactate (RL) was one of the perfusion fluid used in renal transplants, which were replaced by perfusion fluid with an intracellular composition like histidine-tryptophan-ketoglutarate (HTK) solution. These are preferred in cadaveric renal transplants. However, there are no guidelines for live-related donor renal transplant. We study whether HTK solution is better than RL solution, an extracellular composition fluid in preserving allograft in live-related donor renal transplantation. Materials and Methods: A single-blinded randomized trial comparing HTK solution and RL solution in 80 patients undergoing live-related donor renal transplantation from July 2017 to June 2018. The outcome was measured in serum cystatin C and plasma malondialdehyde (MDA) and serum creatinine for 30 days. Results: In 19 cases, surgeons preferred HTK solution as perfusion fluid due to the presence of multiple arteries; hence, these cases are removed from analysis due to deviation from the study protocol. Four patients in the HTK group and five patients in the RL group were excluded due to loss to follow-up. Recipient age, sex, and donor age, sex, and basic disease were comparable in both groups. The higher warm ischemia in the HTK group (5.58 min [standard deviation (SD) 1.44 min]) as compared to the RL group (5.00 min [SD 1.12 min]) with P 0.096. Similarly, the longer cold ischemia in the HTK group (82.00 min [SD 21.31 min]) as compared to the RL group (70.32 min [SD 24.56 min]) with P 0.783. 8.3% rejection in the HTK group and 17.9% rejection in the RL group. Serum cystatin C, marker of glomerular filtration was comparable, HTK group ((3.75 ± 1.98 mg/l) and RL (3.94 ± 1.68 mg/l) with P 0.714. The plasma MDA marker of ischemia-reperfusion injury was also comparable HTK group (80.16 ± 80.08 ng/ml) and RL group (61.50 ± 92.23 ng/ml) with a P 0.446. Fall in serum creatinine was significantly more in the HTK group than RL. At the end of 30 days, both groups had similar levels of serum creatinine level. Conclusion: Graft perfused by HTK solution and RL solution at our center had comparable 30-day outcomes. Although none of the differences was statistically significant, the HTK group had consistently better metrics in terms of fall in creatinine and serum cystatin C despite a trend to longer ischemia times and higher plasma MDA levels. [ABSTRACT FROM AUTHOR]

The prophylactic use of neonicotinoids in paddy fields has raised concern due to its toxicity to ecological systems and human health. The present study evaluated the concentrations of neonicotinoids such as clothianidin, imidacloprid, thiamethoxam, acetamiprid, and thiacloprid in the water-soil systems of the paddy fields, and their potential discharge into the groundwater along the Cauvery delta region, South India. Though neonicotinoids are extensively sprayed in the paddy fields, the concentration of residues analyzed by QuEChERS, combined with LC-MS/MS found no detectable residues at concentrations above LOD. The LOD and the LOQ values for water and soil were 0.001 ppm and 0.0025 ppm and 0.025 ppm and 0.05 ppm respectively. The results of the study found that neonicotinoids are less persistent in the water-soil systems of the delta region as they are readily exposed to photolysis and undergo rapid microbial degradation. Further, the hydropedological characteristics of the highly saturated delta soil facilitate ready leaching followed by vertical migration and infiltration into the soil aquifers.