413with an anterior repair which, in turn, will reduce the risk of a direct recurrence.It is now 80 years since Bassini (1888) first described his operation and founded a principle of repair which, but for its ease of execution and the adaptability of nature, would have been abandoned years ago. If the problem of inguinal hernia is to be solved, we must seek a new principle of repair rather than yet another variant of the posterior repair operation. The operation I propose takes no longer to perform than the standard Bassini and gives uniformly good results with no complications-a finding by no means unique in the annals of the inguinal hernia. It is therefore my sincerest wish that the operation will be given as wide a trial as possible in the hope that it may one day be submitted to the acid test of impersonal statistical review, for no operation can be considered of value which cannot achieve success in the hands of all who wish to use it.

No abstract

Early experience with cadaveric renal transplantation was disappointing. In a series of 20 cases only three patients were able to leave hospital and return to their normal occupations (Calne et al., 1966 Donor SelectionIn view of the severe difficulties experienced in obtaining donor kidneys, donors less than ideal were often utilized, resulting in a high incidence of postoperative tubular necrosis in the transplants. Postoperative haemodialysis was required in all but eight of the recipients of cadaver kidneys, but not in the recipients of live donor kidneys. With the exception of primary intracerebral tumours, no donor suffered from malignant disease. The other criteria of donor selection were deaths uncomplicated by renal tract infection, hypertension, or septicaemia. Though kidneys from young donors were preferred, the ages of nine donors were between 60 and 72 years. TechniqueThe technique has been described in detail elsewhere (Calne, 1965).Cadaver Donors.-As soon after death as possible the kidneys were removed under full sterile precautions, and blood was taken for tissue typing and red cell grouping. The interval between death of the donor and revascularization of the transplant varied between 45 and 395 minutes, with an average of 166 minutes. The periods during which the kidneys were not adequately protected by cold-that is, warm ischaemia time made up of the interval between death and cooling plus the time for the anastomoses-ranged from 26 to 133 minutes, with an average of 83 minutes. The times for the anastomoses ranged from 13 to 38 minutes, with an average of 20 minutes.Live Donors.-The patients were assessed medically and intravenous pyelography and arteriography were performed to ensure that both kidneys were normal and to determine the anatomy of the arterial supply of the kidneys. The most suit-MEDCAL JOURNAL

No abstract

Experiments in dogs were performed to determine the effects of 40 additional minutes of pre‐cooling warm ischaemic time on kidneys cooled for 5 hours in ice and then retransplanted. A comparison was made with control kidneys in the same animals cooled for 5 hours with minimal warm ischaemia. The 40 minutes of warm ischaemia caused severe and partly irreversible damage in most experiments.