Background. The impact of renal transplantation (RT) in the elderly with many comorbid conditions is a matter of concern. The aim of our study was to assess the impact of RT on the survival of patients older than 60 years compared with those remaining on the waiting list (WL) according to their comorbidities. Methods. In this multicentric observational retrospective cohort study, we included all patients older than 60 years old admitted on the WL from 01 January 2006 to 31 December 2016. The Charlson comorbidity index (CCI) score was calculated for each patient at inclusion on the WL. Kidney donor risk index was used to assess donor characteristics. Results. One thousand and thirty-six patients were included on the WL of which 371 (36%) received an RT during a median follow-up period of 2.5 (1.4–4.1) years. Patient survival was higher after RT compared to patients remaining on the WL, 87%, 80%, and 72% versus 87%, 55%, and 30% at 1, 3, and 5 years, respectively. After RT survival at 5 years was 37% higher for patients with CCI ≥ 3, and 46% higher in those with CCI < 3, compared with patients remaining on the WL. On univariate and multivariate analysis, patient survival was independently associated with a CCI of ≥3 (hazard ratio 1.62; confidence interval 1.09-2.41; P < 0.02) and the use of calcineurin-based therapy maintenance therapy (hazard ratio 0.53; confidence interval 0.34-0.82; P < 0.004). Conclusions. Our study showed that RT improved survival in patients older than 60 years even those with high comorbidities. The survival after transplantation was also affected by comorbidities.

Magnetic resonance imaging (MRI) was performed on 73 hips in 59 children aged 3 to 16 months after surgical reduction of developmental dislocation of the hip. Twenty-seven hips in 22 children had repeat MRI 6 weeks after reduction, and 20 hips in 16 patients had further MRI at least 1 year later. Only 38% of hips appeared concentrically reduced on the initial MRI scan, but this increased to 90% by 1 year later, without intervention. The authors measured coronal plane acetabular index and transverse plane anterior, posterior, and axial acetabular indices, as well as acetabular version and anteversion. Persistent difference could be shown in the coronal plane acetabular index between the dysplastic and normal sides for the cartilaginous anlage and the bony model of the acetabulum in scans performed at least 1 year after reduction. However, 40% of cartilaginous coronal plane acetabular indices fell within the "normal" range at 1 year. No other parameters could be shown to be persistently different.

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Objective: to assess the frequency of I/D polymorphism of ACE gene and AGT M235T genotype and its impact on glucose metabolism in patients after kidney transplantation. Patients and Methods: Medical records of 53 adult Caucasoid patients covering a period 4th month -4 years after Tx were included in a retrospective analysis. Immunosuppression consisted either of CsA (10 Ps) or Tac (39 Ps) or Rapa (4Ps). All Ps were treated with mycophenolate mofetil or sodium and 10 mg of prednisone. Evaluated groups did not differ in acute rejection episode incidence and methylprednisolon treatment. PCR-RFLP was used to detect gene polymorphisms. Results: Frequencies of ACE gene II: ID: DD genotypes were 34%: 36%: 30% and TT: TM: MM genotypes of AGT 26%: 47%: 27%. Highest fasting glucose level was signifi cantly different in TT homozygous individuals in comparison to MM genotype (mean ± SEM= 8.62 ± 0.78 vs 6.62 ± 0.31 mmol/l, p < 0.05). differences between I/I vs D/D were not statistically signifi cant (8.31 ± 0.65 vs 7.2 ± 0.43 mmol/l, p= 0.15). Highest HbA1c level was signifi cantly different in carriers of at least one T allele in comparison to MM genotype (7.67 ± 0.27 vs 6.94 ± 0.26%, p < 0.05). differences between I/I vs D/D were not signifi cant (7,4 ± 0,2 vs 7,3 ± 0,3%). Conclusions: Our results suggest infl uence of RAS polymorphisms on glucose metabolism after kidney transplantation. Carriage of at least one T allele (M235T) of AGT was linked to increased fasting glycaemia and HbA1c during the follow up. If proven in a larger study, prospective genotyping of RAS on the waiting list could help to further individualization of posttransplant immunosuppressive strategy, with a special regard to metabolic syndrome, e.g. steroid avoidance or minimalization.