Purpose: Dual kidney transplantation (DKT) offers a way to extend the use of kidneys from expanded criteria donors (ECDs). Here, we compared the outcomes of DKT with those of single kidney transplantation from standard criteria donors (SCDs) and ECDs. Methods: In 2014, we began performing DKT using both kidneys from deceased donors greater than 70 years of age with one of two risk factors: serum creatinine (sCr) level over 3.0 mg/dl or eGFR under 30 ml/min. By 2017, we had performed 15 DKTs. We compared the outcomes of the 15 DKT recipients with those of 124 patients who received a kidney from an SCD and 80 patients who received a kidney from an ECD. Results: Compared with ECDs and SCDs, DKT donors were older, had a higher diabetes burden, and a higher sCr level (p < 0.01, < 0.01, and 0.03, respectively). DKT recipients were also older and had a higher diabetes burden than recipients of kidneys from ECDs and SCDs (p < 0.01, both). DKT recipients had a lower nadir sCr and shorter duration to nadir sCr than single ECD KT recipients (p < 0.01and 0.04, respectively). Conclusions: The survival rates of DKT grafts were compatible with those of single KT grafts. Therefore, DKT may be considered a suitable an option to expand the donor pool.

BackgroundThe apnea test (AT) is essential to confirming the diagnosis of brain death, but critical complications can occur if the AT is maintained over a long period. To minimize the AT period, we used end-tidal carbon dioxide (ETCO2) monitoring because ETCO2 is closely correlated with partial pressure of arterial carbon dioxide (PaCO2). The aim of the present study is to evaluate the usefulness of ETCO2 monitoring during apnea testing.MethodsWe reviewed 61 patients who were pronounced brain dead at our hospital from July 2009 to December 2012. The subjects were divided into two groups: the N-group, in which capnography was not used, and the C-group, in which capnography was used to monitor ETCO2. In the C-group, whenever arterial blood was sampled, the PaCO2 - ETCO2 gradients were calculated and the ventilator setting adjusted to maintain normocapnia prior to apnea testing.ResultsTwenty-eight subjects in the N-group and twenty-nine subjects in the C-group were included. The gender ratio, age, and cause of brain death were not different between the two groups. Prior to the AT, the normocapnia ratio was higher in the C-group than in the N-group. During the AT, the total test period was shorter in the C-group. Moreover, systolic blood pressure increased in the C-group and decreased in the N-group during apnea testing.ConclusionsETCO2 monitoring during AT allows the PaCO2 level to be predicted, which reduces the duration of the test and stabilizes systolic blood pressure. Thus, with ETCO2 monitoring, the AT can be fast and safe.

This study is to evaluate the snowmelt impact on dam inflow for the Chungju Dam watershed 6,642.0 km 2 using Terra MODIS (Moderate-Resolution Imaging Spectroradiometer) and Soil and Water Assessment Tool (SWAT). To determine the SWAT snowmelt parameter; snow cover depletion curve (SCDC) the snow depth distribution (SDD) using Terra MODIS was used, the snow depth was spatially interpolated using snowfall data of ground meteorological stations. For 10 sets (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) data during snowmelt period (November-April), the sno50cov parameter, that is, the 50% coverage at a fraction of SCDC which determines the shape of snow depletion process, showed the values of 0.4 to 0.7. The SWAT model was calibrated with average R 2 of 0.54 using the sno50cov of each year. The 10 years average streamflow during snowmelt period was 104.3 mm which covers 12.0% of the annual streamflow.