Kidney paired donation (KPD) programs offer the opportunity to enable living kidney donation when immunological and other barriers prevent safe directed donation. Children are likely to require multiple transplants during their lifetime; therefore, high-level histocompatibility and organ quality matching are key priorities. Details are given for a cohort of seven pediatric renal transplantations performed through the Australian Kidney Exchange (AKX), including barriers to alternative transplantation and outcomes after KPD. Reasons for entering the KPD program were preformed donor-specific antibodies to their registered donor in five cases, ABO mismatch, and avoidance of the risk of exposure to hepatitis B virus. Four recipients were highly sensitized. All patients received transplants with organs of lower immunological risk compared with their registered donors. HLA eplet mismatch scores were calculated for donor-recipient pairs; three patients had improved eplet mismatch load with AKX donor compared with their registered donor. All grafts are functioning, with a mean estimated glomerular filtration rate of 77 mL/min/1.73 m (range 46-94 mL) and a follow-up range of 8-54 months, and no patient experienced clinical or histological rejection. KPD is a viable strategy to overcome many barriers to living donation for pediatric patients who have an otherwise suitable donor and provides an opportunity to minimize immunological risks.

Summary Experiments were carried out on foetal lambs in utero from 103 to 133 days' gestation, to measure the daily flow and solute composition of liquid from the foetal lung. The mean daily flow from foetuses with a tracheal fistula was 231 ml/day (9·6 ml/h), while the mean hourly flow in foetuses with a tracheal loop was 5·1 ml/h. The pattern of flow of lung liquid was intermittent and irregular, with short periods of rapid flow interspersed with longer periods of slow and no How. The Na+, Ca2+, Mg2+, Cl− and urea concentrations showed no significant change with increasing gestational age, but the K+ concentration showed a significant rise. It is concluded that the lung of the foetal lamb behaves as an exocrine gland, secreting a substantial volume of liquid of a relatively constant composition.

AIM: To determine whether working dogs in New Zealand with carpal injuries and treated with unilateral pancarpal arthrodesis (PCA), using a dorsal hybrid-plating method, are able to return to satisfactory working ability. METHODS:Fourteen working dogs presented to the Veterinary Specialist Group (VSG) and the Massey University Veterinary Teaching Hospital (MUVTH) with carpal injuries were prospectively treated using dorsal hybrid plating. Dogs were eligible if actively involved in farm, hunting or police work. Dogs had a standardised PCA surgical procedure performed, and similar instructions for post-operative care were provided. Dogs were re-evaluated clinically and radiographically at 6 weeks, 6 months, and 12 months after surgery. A questionnaire was completed by 12 owners, to assess each dog's working ability. RESULTS:Twelve months following arthrodesis, 10/12 (83%) dogs could perform most or all duties normally. Eleven owners (92%) reported that the result of the surgery met their expectations, and nine owners (75%) were very satisfi ed with the outcome of the surgery. No owners were disappointed or very disappointed with the surgical outcome. Post-operative complications requiring surgical removal of the implant occurred in three (25%) dogs. CONCLUSIONS:Unilateral PCA using a standardised surgical procedure and dorsal hybrid plating of carpal injuries has a good prognosis for working dogs in New Zealand to return to work. CLINICAL RELEVANCE:These results may allow veterinarians to provide a more accurate prognosis to owners of working dogs that have debilitating carpal injury