The occurrence of closely related strains of maternally transmitted endosymbionts in distantly related insect species indicates that these infections can colonize new host species by lateral transfer, although the mechanisms by which this occurs are unknown. We investigated whether ectoparasitic mites, which feed on insect haemolymph, can serve as interspecific vectors of Spiroplasma poulsonii, a male-killing endosymbiont of Drosophila. Using Spiroplasma-specific primers for PCR, we found that mites can pick up Spiroplasma from infected Drosophila nebulosa females and subsequently transfer the infection to Drosophila willistoni. Some of the progeny of the recipient D. willistoni were infected, indicating successful maternal transmission of the Spiroplasma within the new host species. However, the transmission rate of the infection from recipient flies to their offspring was low, perhaps due to low Spiroplasma density in the recipient flies.

Purpose Continuous transversus abdominis plane (TAP) block using a catheter has proven its usefulness in reducing opioid requirements and pain scores after lower abdominal surgery. However, there are no reports of its successful use after renal transplant. We tested the hypothesis that continuous TAP block would retrospectively reduce opioid requirement, nausea score and hospital stay after renal transplant surgery. Methods In a retrospective study, we reviewed the data from 63 adult renal transplant recipients—31 with patient-controlled TAP analgesia with standing orders for intravenous as well as oral opioids as needed and 32 with intravenous patient-controlled analgesia. The TAP catheter was inserted preoperatively using an ultra-sound-guided technique. Infusion of ropivacaine 0.2 % at 8 ml basal, 12 ml bolus and a lockout interval of 60 min were maintained for 48 h postoperatively. The primary outcome was total morphine-equivalent dose during the 48-h postoperative period. Secondary outcomes were pain and nausea scores for the 48-h postoperative period. Results The mean 48-h postoperative morphine-equivalent doses [95 % confidence interval] for patient-controlled intravenous analgesia and TAP catheter were 197 [111, 349] and 50 [28, 90], respectively, which were significantly different (P = 0.002). The mean 48-h average verbal response pain scores were 2.94 [2.39, 3.50] and 2.49 [1.93, 3.06], respectively, which were not significantly different (P = 0.26). The mean nausea scores were 0.66 [0.46, 0.87] and 0.60 [0.40, 0.81], respectively, which were not significantly different (P = 0.69). There was no difference regarding hospital stay. Conclusion The use of continuous TAP analgesia for postoperative analgesia after renal transplant was effective in reducing the morphine-equivalent requirements.

No abstract

The concept that brief manipulation(s) could protect an organ or tissue from subsequent ischemic injury was first put forth by Bob Jennings of Duke University. In the ensuing 35 years, ischemic preconditioning has been shown in preclinical studies to protect all commonly transplanted organs from myriad pathophysiologic insults; however, the translation of this phenomenon into clinical practice has not been smooth. Nonetheless, under controlled scenarios where there is a high probability of an ischemic event, various human preconditioning trials have demonstrated benefit with respect to improved organ function and reduced morbidity and mortality. Volatile anesthetics (VAs) have been shown to directly precondition or indirectly enhance ischemic preconditioning of a variety of different organs. The importance of preconditioning and its implications during general anesthesia and specifically during surgery are still controversial.

Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). With recent advancements in the field of transplantation, especially with an expanded donor pool and postoperative care, kidney transplants are now viewed as relatively straightforward surgeries. More than 23,000 kidney transplants were done in the United States in 2019, yet there still remains major unmet need for more organs. As of June 20, 2020, there were more than 93,000 patients on the waiting list to receive a kidney transplant. Thus, optimum anesthetic management is an integral part of patient and graft survival. The majority of transplanted kidneys are procured from deceased donors following death by neurological criteria (DNC). Therefore, due to the unpredictable and emergent nature of the surgery, in addition to routine preoperative evaluation, unique considerations need to be addressed. This chapter reviews the major considerations for pre-, intra-, and postoperative care of kidney transplantation.