Kidney transplantation is the gold-standard therapy for end-stage renal disease. However, in the early postoperative period following allograft kidney transplantation, insufficient graft function presents a diagnostic challenge to clinicians. Ischemic damage to the graft and/or an early autoimmune rejection may cause a decrease in function. Ischemic damage is a benign and transient condition, while acute immune rejection requires immediate therapy. A kidney graft ultrasound may produce a false negative result, and graft biopsy is invasive and slow to return results. Serum lactate dehydrogenase (LDH) is under examination as a possible tool for differential diagnosis between ischemic damage and immune rejection. Herein, we analyze the continuous lab results of four patients in the early post-transplantation period, showing patterns correlating with different clinical outcomes and prognoses. In our experience, a persistent elevated LDH accompanies ischemic damage. Immune rejection was, however, associated with a decrease in LDH. Hemodialysis was not a confounding factor, while packed red blood cell transfusion caused severe diagnostic problems.

Based on a prior university patent, the authors developed a novel type of bioimpedance-based test method to noninvasively detect nonalcoholic fatty liver disease (NAFLD). The development of a new potential NAFLD diagnostic procedure may help to understand the underlying mechanisms between NAFLD and severe liver diseases with a painless and easy-to-use paraclinical examination method, including the additional function to detect even the earlier stages of liver disease. The aim of this study is to present new results and the experiences gathered in relation to NAFLD progress during animal model and human clinical trials.

Fluid management after kidney transplantation requires balancing adequate graft perfusion against fluid overload. We compared central venous pressure (CVP)-guided and point-of-care ultrasound (POCUS)-guided postoperative management and explored whether longitudinal changes in inferior vena cava (IVC) diameter relative to an individual postoperative reference provided information beyond absolute IVC diameter. This single-center retrospective comparative study included 60 adult kidney transplant recipients (30 per group) with standardized assessments on postoperative days 1–5 and 10. POCUS-guided management was associated with more active therapeutic adjustments during days 1–5 (48.0% vs. 25.3%; OR 2.80, 95% CI 1.45–5.42; p = 0.002), without a significant difference in cumulative fluid balance. Reference IVC diameter ranged from 7 to 21 mm and showed substantial interindividual variability. Within-patient IVC variation was associated with daily fluid balance (p = 0.002) and weight change (p = 0.003). In a post hoc exploratory ROC analysis, peak baseline-referenced ΔIVC showed an AUC of 0.749 (95% CI 0.574–0.924) for >1 kg postoperative weight gain, compared with 0.518 (95% CI 0.300–0.737) for peak absolute IVC; the two AUCs were not formally compared. No statistically significant between-group differences in early graft outcomes were observed, although the study was not powered for these outcomes. POCUS-guided monitoring was associated with greater treatment actionability; whether this translates into clinical benefit requires prospective evaluation.