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Summary.-The effect of testosterone, dihydrotestosterone, 3p-androstanediol and oestradiol-17p on the morphology and RNA synthesis in human benign prostatic hyperplasia (BPH) in organ culture has been investigated. In hormone treated and untreated explants alike, the epithelium multiplied to form several layers. This effect was most marked after exposure to dihydrotestosterone. In explants grown in non-supplemented medium the epithelium showed some squamous changes; testosterone or dihydrotestosterone preserved the secretory character of the epithelium while oestradiol-17p caused cellular degeneration. IThe incorporation of 3H-uridine into RNA was studied by autoradiography. In the epithelium, testosterone or dihydrotestosterone raised the uptake significantly over that measured in the control explants, oestradiol-17p reduced itwhile3p-androstanediol produced similar values to those found in the control explants. The incorporation of 3H-uridine in the smooth muscle cells was increased by testosterone and decreased by oestradiol-17p. A comparison with normal rat prostatic epithelium in organ culture showed that in the absence of androgens the incorporation of 3H-uridine was lower than in BPH and the effect of testosterone correspondingly greater.The results suggest that although the growth of human BPH in organ culture appears to be androgen dependent, it still remains hormone sensitive and can be influenced by steroid hormones in a similar manner to that in rat prostate gland. They further show that the smooth muscle of the stroma is also hormone sensitive, a point which should be considered in the hormonal management of benign prostatic hyperplasia.THE USE of organ culture for the evaluation of hormonal effects on human benign prostatic hyperplasia (BPH) has obvious advantages. In this system, the various components, their anatomical relationship and function are, under suitable conditions, preserved in vitro and the action of hormones can be assessed on several parameters such as proliferation as well as cell differentiation and the effects on epithelium and stroma studied separately. Schrodt and Foreman (1971) explanted human BPH in organ culture and found that the prostatic * Sir Halley Stewart Fellow. epithelium and its fine structure were well preserved in the absence of androgens but showed somne evidence of squamous metaplasia; the addition of testosterone caused much epithelial necrosis. MacMahon and Thomas (1973), using the same system also obtained good maintenance in androgen-free medium and showed that neither testosterone nor stilboestrol diphosphate altered the morphology of the epithelium. McRae et al. (1973) used DNA synthesis as a criterion of hormonal action and reported a slight increase in DNA synthesis in

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Early experience with cadaveric renal transplantation was disappointing. In a series of 20 cases only three patients were able to leave hospital and return to their normal occupations (Calne et al., 1966 Donor SelectionIn view of the severe difficulties experienced in obtaining donor kidneys, donors less than ideal were often utilized, resulting in a high incidence of postoperative tubular necrosis in the transplants. Postoperative haemodialysis was required in all but eight of the recipients of cadaver kidneys, but not in the recipients of live donor kidneys. With the exception of primary intracerebral tumours, no donor suffered from malignant disease. The other criteria of donor selection were deaths uncomplicated by renal tract infection, hypertension, or septicaemia. Though kidneys from young donors were preferred, the ages of nine donors were between 60 and 72 years. TechniqueThe technique has been described in detail elsewhere (Calne, 1965).Cadaver Donors.-As soon after death as possible the kidneys were removed under full sterile precautions, and blood was taken for tissue typing and red cell grouping. The interval between death of the donor and revascularization of the transplant varied between 45 and 395 minutes, with an average of 166 minutes. The periods during which the kidneys were not adequately protected by cold-that is, warm ischaemia time made up of the interval between death and cooling plus the time for the anastomoses-ranged from 26 to 133 minutes, with an average of 83 minutes. The times for the anastomoses ranged from 13 to 38 minutes, with an average of 20 minutes.Live Donors.-The patients were assessed medically and intravenous pyelography and arteriography were performed to ensure that both kidneys were normal and to determine the anatomy of the arterial supply of the kidneys. The most suit-MEDCAL JOURNAL