title: [Effect of ulinastatin in promotion of graft recovery in early stage after kidney transplantation: a clinical study].
abstract: OBJECTIVE
  To investigate the effects of ulinastatin (UTI), a urinary trypsin inhibitor, on the promotion of the function recovery of transplanted kidney, especially for those with acute tubular necrosis (ATN).
  
  
  METHODS
  Thirty patients underwent general cadaver kidney transplantation were randomly allocated to 2 equal groups: Group A (UTI-treatment group) and Group B (control group). 40 patients whose allografts were presumed to be with acute tubular necrosis (ATN) were also divided into 2 equal groups: Group C (UTI-treatment group) and Group D (control group). Group A and C were given ulinastatin perioperatively. 1, 3, 7, and 10 days after the transplantation blood and urine samples were collected. The levels of urine and blood alpha1-microglobulin (MG) were detected by radioimmunoassay. Blood IL-8, IL-10, and serum creatine (sCr) were detected by ELISA.
  
  
  RESULTS
  Within 10 days after the transplantation the urine volume of Group A significantly increased, especially the urine volumes of days 2, 6, 7, 9, and 10 were significant greater than those of Group B (all P < 0.05). The levels of blood IL-8 of Group A in days 1 and 3 were (93.75 +/- 31.5) ng/L and (41.98 +/- 24.01) ng/L respectively, significantly lower than those of Group B [(135.0 +/- 31.2) ng/L and (78.34 +/- 76.39) ng/L respectively, both P < 0.05]. The levels of urine alpha1-MG in days 1 and 3 were (69.89 +/- 32.60) mg/L and (35.33 +/- 34.54) mg/L respectively, both significantly lower than those of Group B [(91.15 +/- 28.39) mg/L and (65.84 +/- 33.38) mg/L respectively, both P < 0.05]. In group C, the levels of blood alpha1-MG in days 7 and 10 of Group C were (118.26 +/- 41.23) mg/L and (99.49 +/- 68.63) mg/L respectively, both significantly lower than those of Group D [(187.15 +/- 55.23) mg/L and (151.27 +/- 87.42) mg/L respectively, both P < 0.05]. The urine alpha1-MG in days 7 and 10 were (39.89 +/- 22.32) mg/L and (38.21 +/- 20.36) mg/L respectively, both significantly lower than those of Group D [(67.34 +/- 21.56) mg/L and (62.26 +/- 29.24) mg/L respectively, both P < 0.05]. Compared to Group D, the increasing tendency of blood IL-8 was better suppressed in Group C, and the diuretic phases appeared earlier.
  
  
  CONCLUSIONS
  UTI significantly improves the microcirculation, protects the tubule of transplanted kidney, increases the volume of urine, inhibits the inflammatory response, and promotes the recovery of ATN during the perioperative period of kidney transplantation.
authors.affiliation: Department of Organ Transplantation, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Qiu
authors.forename: Chang-Xi
authors.initials: CX
authors.lastname: Wang
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Chen
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Fei
authors.forename: Jiong
authors.initials: J
authors.lastname: Bi
mesh_terms: D000510:Alpha-Globulins / Q000378:metabolism; D003401:Creatine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D006023:Glycoproteins / Q000627:therapeutic use*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D016030:Kidney Transplantation / Q000379:methods*; D011184:Postoperative Period; D020127:Recovery of Function / Q000187:drug effects*; D016896:Treatment Outcome; D014361:Trypsin Inhibitors / Q000627:therapeutic use
chemical_list: D000510:Alpha-Globulins; D006023:Glycoproteins; D016209:Interleukin-8; D014361:Trypsin Inhibitors; C016001:alpha-1-microglobulin; D016753:Interleukin-10; D003401:Creatine; C028665:urinastatin