Is screening for Factor V Leiden and Prothrombin G20210A Mutations in Renal Transplantation worthwhile? Results of a large single-center U.K. study

This single center study is the largest series of renal transplant recipients and donors screened for the commonest prothrombotic genotypes. A total of 562 transplant recipients and 457 kidney donors were genotyped for the factor V Leiden and prothrombin G20210A mutations. The prevalence of heterozygous factor V Leiden was 3.4% and 2.6% and prothrombin G20210A was 2.0% and 1.1% in recipients and donors, respectively, similar frequencies to that of the general U.K. population. The 30-day and 1-year graft survival rates in recipients with thrombophilic mutations were 93% and 93%, compared with 88% and 82% in patients without these mutations (log-rank P =0.34). Thrombophilia in recipients (odds ratio 0.55; confidence interval 0.06-2.29; P =0.56) or in donors (odds ratio 1.53; confidence interval 0.27-5.74; P =0.46) did not correlate with graft loss at 30 days after transplantation. In contrast to recent reports, this study did not demonstrate an association between thrombophilia and renal allograft loss, and routine screening is not recommended.

Soil conditioning of sand for EPB applications:A laboratory research

EPB tunnelling requires the application of soil conditioning to increase its field of applicability particularly for cohesionless soils. Choosing the most suitable conditioning set for the various soils requires the use of a feasible laboratory test which can permit to define the characteristics of the conditioned soils and provide measurable data. A series of tests has been carried out using a laboratory screw conveyor device which was designed for this purpose and which simulates the extraction of the spoil from a pressure chamber in a similar way as in EPB tunnelling. The tested soils were medium-grain sands with varying amounts of silt and the tested conditioned mixtures were obtained with different water contents and amounts of foam. A simple slump test was also used to analyze the global characteristics of the conditioned soils. The test has shown that the proposed laboratory procedure permits a quantitative comparison to be made between different conditioning amounts and agents on the basis of measurable parameters. © 2007 Elsevier Ltd. All rights reserved.