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- Fehrman-Ekholm, Ingela, 1947, et al.
(author)
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Incidence of end-stage renal disease among live kidney donors.
- 2006
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In: Transplantation. - : Ovid Technologies (Wolters Kluwer Health). - 0041-1337. ; 82:12, s. 1646-8
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Journal article (peer-reviewed)abstract
- BACKGROUND: The increasing use of living kidney donors requires knowledge about long-term effects, especially number and causes of donors with end-stage renal disease (ESRD). METHODS: A retrospective data analysis of 1,112 consecutive living kidney donors who underwent nephrectomy from 1965 until 2005 at Sahlgrenska University Hospital. Case reports were sought with help from nephrologists in the region and data from Swedish Registry of Active Uremic Treatment (SRAU). RESULTS: The number of cases with end stage kidney failure among living kidney donors was 6/1112, that is 0.5%. The donors had reached ESRD during the years 2001-2006, that means 36-41 years after start of the living donor program. The donors were 45-89 years old, median 77 years, and five of six were males. Time since donation was 14-27 years, median 20 years, for the donors developing ESRD. The diagnoses were nephrosclerosis (4 cases), postrenal failure (1 case), and renal carcinoma (1 case). The expected incidence for development of ESRD according to incidence in the general population would have been two donors but we found six. However, considering the high age of the donors in this follow up, the age-matched incidence is calculated to be closer to six donors due to higher incidence in the aged. CONCLUSION: In all 0.5% of the donors developed ESRD. Due to high age of the uremic donors, there seems to be no increased incidence.
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2. |
- Lyckeskog, Huyen, 1985, et al.
(author)
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Catalytic depolymerisation and conversion of Kraft lignin into liquid products using near-critical water
- 2014
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In: Journal of Supercritical Fluids. - : Elsevier BV. - 0896-8446. ; 86, s. 67-75
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Journal article (peer-reviewed)abstract
- A high-pressure pilot plant was developed to study the conversion of LignoBoost Kraft lignin into bio-oil and chemicals in near-critical water (350◦C, 25 MPa). The conversion takes place in a continuous fixed-bed catalytic reactor (500 cm3) filled with ZrO2 pellets. Lignin (mass fraction of approximately 5.5%) is dispersed in an aqueous solution containing K2CO3(from 0.4% to 2.2%) and phenol (approximately 4.1%).The feed flow rate is 1 kg/h (reactor residence time 11 min) and the reaction mixture is recirculated internally at a rate of approximately 10 kg/h. The products consist of an aqueous phase, containing phenolic chemicals, and a bio-oil, showing an increased heat value (32 MJ/kg) with respect to the lignin feed. The 1-ring aromatic compounds produced in the process are mainly anisoles, alkylphenols, guaiacols and catechols: their overall yield increases from 17% to 27% (dry lignin basis) as K2CO3 is increased.
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3. |
- Lyckeskog, Huyen, 1985, et al.
(author)
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Storage Stability of Bio-oils Derived from the Catalytic Conversion of Softwood Kraft Lignin in Subcritical Water
- 2016
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In: Energy & Fuels. - : American Chemical Society (ACS). - 1520-5029 .- 0887-0624. ; 30:4, s. 3097-3106
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Journal article (peer-reviewed)abstract
- The stability of lignin-derived bio-oil obtained from a continuous process [base (K2CO3)-catalyzed, using phenol as a capping agent] under subcritical conditions of water (25 MPa, 290-370 degrees C) was investigated. The lignin-derived bio-oil obtained was stored at ambient temperature for 2 years. Our results show that the base concentration in the feed solution affects the stability of this lignin-derived bio-oil during its long-term storage. It was found that, at low base concentrations (i.e., 0.4%-1.0%), the yields of all lignin-derived bio-oil fractions were relatively stable. At high base concentrations (i.e., 1.6%-2.2%), however, the yield of high-molecular-weight (high-Mw) structures increased and that of low-molecular-weight (low-Mw) structures decreased after storage. This indicated that the low-Mw materials had been polymerized to form high-Mw materials. In addition, it was found that the yield of gas chromatography-mass spectrometry (GC-MS)-identified compounds (excluding phenol) in this lignin-derived bio-oil decreased from 15% to 11%. This is probably due to the presence of solids in these lignin derived bio-oils, which promotes the catalytic polymerization reactions, suggesting that it is beneficial to remove the solids from this lignin-derived bio-oil in order to enhance its stability. Compared to the results obtained from bio-oil derived from biomass pyrolysis, our results show that bio-oil derived from the conversion of lignin in subcritical water has better chemical stability during long-term storage.
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5. |
- Olausson, Michael, 1956, et al.
(author)
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Successful combined partial auxiliary liver and kidney transplantation in highly sensitized cross-match positive recipients
- 2007
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In: American journal of transplantation. - 1600-6135. ; 7:1, s. 130-6
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Journal article (peer-reviewed)abstract
- Combined liver and renal transplantations can be performed against a positive cross-match, indicating that the liver protects the kidney from the harmful HLA antibodies. This led us to the hypothesis that a partial auxiliary liver graft may have a similar protective effect when performed together with the kidney in highly sensitized patients. Seven patients, with broadly reacting HLA antibodies and positive crossmatches, were transplanted with a partial liver and a kidney from the same donor. In one of the cases a living donor was used. We performed lymphocytotoxic and flow cross-matches before and after the transplantation. Cross-matches turned negative after grafting in five of seven cases. The kidney function was excellent, without rejections, during the follow-up (24-60 months) in these patients. In two cases the cross-match remained positive after transplantation, one with a never-functioning renal graft and the other with an early graft failure, probably due to humoral rejection. A simultaneous transplantation of a partial auxiliary liver graft from the same donor, with the sole purpose of protecting the kidney from harmful lymphocytotoxic antibodies, can be performed successfully despite a positive cross-match and may thus be a new option of treatment for highly sensitized patients waiting for a kidney transplant.
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6. |
- Friman, Styrbjörn, 1948, et al.
(author)
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Kidney transplantation--a 46-year experience from the Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden.
- 2011
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In: Clinical transplants. - 0890-9016. ; , s. 119-25
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Journal article (peer-reviewed)abstract
- The limiting factor in organ transplantation is the availability of organs. Ongoing work to improve donation rates both at the public and the organizational level in donating hospitals is essential. We also think that encouragement of live donation is important, and the possibility of ABO incompatible transplantation has increased the number of LD transplantations. The one-year graft survival rate is excellent and focus has shifted towards achieving long-term results to reduce the attrition rate. There is also an increasing interest in studying and working to reduce comorbidities on a long-term basis and thus, improve survival rates and recipient quality of life.
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7. |
- Gourdon, Mathias, 1980, et al.
(author)
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Fouling Layer Growth in Black Liquor Falling Film Evaporation
- 2007
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In: Proceedings of the International Chemical Recovery Conference 2007, May 29-June 1, 2007, Quebec City, Canada , s. 473-477.
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Conference paper (peer-reviewed)abstract
- The fouling behaviour (both local and overall) for black liquor evaporation in a falling film evaporator has been investigated. The experimental results showed that, in the interval of the studied dry solids content, the fouling rates were independent of dry solids content as long as it exceeded a critical limit. The fouling rates were seen to have a strong dependence on circulation flow rate; doubling the circulation flow rate resulted in about halved fouling rates. The local heat flux measurements showed great differences between fouling rates vertically along the heat transfer surface. The fouling was seen to start from the bottom and then expanded upwards.
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8. |
- Gourdon, Mathias, 1980, et al.
(author)
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Scale formation and growth when evaporating black liquor with high carbonate to sulphate ratio
- 2008
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In: Nordic Pulp and Paper Research Journal. - 2000-0669 .- 0283-2631. ; 23:2, s. 231-239
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Journal article (peer-reviewed)abstract
- Scaling in black liquor evaporators has for longbeen recognised as a problem. Most problems are connected tothe precipitation of sodium salts. In the black liquor evaporation,as the black liquor gets concentrated, sodium carbonateand sodium sulphate will saturate and precipitate from the solution.When precipitation occurs the salts may crystallise on theheat transfer surface or adhere to the surface as well as they cancrystallise in the bulk. If crystals remain on the heat transfersurface an insulating layer of scales can quickly build up causingthe heat flux to drop and eventually forcing the evaporatorto be shut down for cleaning. The research in this paper focused primarily on scaling forblack liquors with high ratio of carbonate to sulphate, a conditionshown to be important in industrial black liquor evaporators(Frederick et al. 2004). The scaling behaviour was investigatedexperimentally in a falling film evaporator. The aim wasto find favourable operating conditions decreasing or eliminatingscaling. The examined parameters were different heat flux,circulation flow rate, internal residence time and black liquorfeed concentration. For the investigated operating conditions themain parameters affecting scaling were the circulation flow rateand heat flux whereas the scaling rate was seen independent ofthe internal residence time.
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9. |
- Gourdon, Mathias, 1980, et al.
(author)
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Sodium Salt Scaling in Black Liquor Evaporators – Pilot Plant Results and Industrial Significance
- 2010
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In: Proceedings of International Chemical Recovery Conference, Williamsburg, Virginia, USA, March 29 – April 1 2010, s. 298-312. - 9781595101983 ; 2, s. 298-311
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Conference paper (peer-reviewed)abstract
- In industrial black liquor evaporation plants large amounts of sodium crystals are produced every day which all has the potential to scale the evaporator surfaces. In this project, research on the crystallization during evaporation of softwood black liquor has been performed. The results are based on measurements in a research black liquor evaporator.The distribution of scales vertically along the heat transfer surface has been investigated as well as the influence of different operating conditions, such as the circulating flow rate of black liquor, the residence time for the black liquor in the evaporator and the temperature difference between the liquor and the heating steam.The sodium scales formed during evaporation are mainly in the form of double salts of sodium carbonate and sodium sulfate. The ratio between the two salts is one important parameter affecting the crystallization and scaling. The effect of the carbonate-to-sulfate ratio has been investigated for aqueous sodium carbonate – sodium sulfate solutions. In this paper, the results of these investigations are presented and a number of industrial significances are illustrated.
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10. |
- Herlenius, Gustaf, 1961, et al.
(author)
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Conversion From Calcineurin Inhibitor to Either Mycophenolate Mofetil or Sirolimus Improves Renal Function in Liver Transplant Recipients With Chronic Kidney Disease : Results of a Prospective Randomized Trial
- 2010
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In: Transplantation Proceedings. - : Elsevier BV. - 0041-1345 .- 1873-2623. ; 42:10, s. 4441-4448
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Journal article (peer-reviewed)abstract
- Background. Chronic kidney disease (CKD) has emerged as a significant cause of morbidity and a risk factor for mortality after orthotopic liver transplantation (OLT). The use of calcineurin inhibitor (CNI)-based immunosuppression is an important etiologic factor for developing CKD. CNI discontinuation or minimization protocols with replacement of the CNI with non-nephrotoxic drugs, such as mycophenolate mofetil (MMF) or sirolimus (SRL), may have the potential to preserve or recover renal function. Patients and Methods. In this prospective, randomized, single-center study with CNI discontinuation, OLT recipients with CKD (measured glomerular filtration rate [GFRm] 15-45 mL/min/1.73 m(2)) were randomized to either SRL or MMF-based immunosuppression. The main objective was to study the effect of CNI discontinuation on renal function. Secondary aims were to assess the frequency of biopsy-proven acute rejection episodes (BPAR) and adverse events (AE). Renal function was followed with GFRm using 51-Chromium EDTA clearance at baseline, 3 months, and 1 year. Patients were stratified according to baseline GFRm > versus <30 mL/min/1.73 m(2). The 25 patients were enrolled for MMF (n = 13) or SRL (n = 12). The median age at inclusion was 59 years (range, 25-66) and the median number of years after OLT was 4.4 (range, 1-13). Twenty-two patients were followed up for a year; MMF (n = 12) and SRL (n = 10). Results. Mean GFRm for the whole cohort (n = 25) was 31+/-8 mL/min/1.73 m(2) at baseline. After 3 months the GFRm (n = 23) increased to 40+/-10 mL/min/1.73 m(2) (P = .0001) and at 1 year 42 +/- 11 mL/min/1.73 m(2) (n = 22). There was not significant difference between the MMF and the SRL study arms. The cohort (n = 8) with baseline GFRm <30 mL showed a 63% (P = .003) increased filtration after 1 year. There was no significant difference in the frequency or severity of AE between the study arms with the exception of oral ulcerations and persistent hypertriglyceridemia in the SRL group. Two deaths occurred, 1 in each study arm, both probably unrelated to the change in immunosuppression. There were no BPAR episodes. Conclusion. CNI discontinuation and replacement with either MMF or SRL resulted in a significant improvement in renal function even in those patients with severe CKD. The protocol was effective with no acute rejection episodes. The SRL arm showed a higher frequency of oral apthous ulcerations and hypertriglyceridemia. Future studies addressing long-term renal function after CNI discontinuation are needed.
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