摘要:

SUMMARYForty-one dog livers were preserved with cold, lactated Ringer's, plasma, or intracellular (Collins) solutions. Consistent survival was obtained with all three solutions for 9 hr. After 18 hr, the plasma and Collins solutions permitted survival, with the Collins solution having a slight overall advantage. The method using Collins solution has been used to preserve seven human livers in Los Angeles, to transport the organs to Denver, and to transport them as orthotopic grafts from 6 hr, 45 min to 10 hr later.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYThe records of 192 cadaver renal allotransplants were reviewed in order to evaluate the role of the hepatitis B antigen (HB2Ag) carrier state on graft function, patient survival, and the incidence of severe hepatic dysfunction. Twenty-one allografts were placed into patients with hepatitis B antigenemia. After follow-up ranging from 1.5 to 8 years (mean 4.7), graft and patient survivals were not statistically different from antigen-negative patients. In addition, the acquisition of HB2Ag after grafting did not seem to affect the rate of graft failure or death. Neither cirrhosis nor fatal hepatic failure developed in the HB2Ag carrier group, whereas five HB2Ag-negative recipients died of hepatic disease. Among HB2Ag-positive recipients, nine with functioning renal allografts and five with graft failures, there was a low incidence of e antigen, suggesting low infectivity. This may explain the lack of correlation of the surface antigen with serious liver disease.Severe hepatic disease developing in renal graft recipients is most likely attributable to causes other than hepatitis B infection. The presence of hepatitis B antigenemia alone should not be a deterrent to renal transplantation.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYEstablished enhancement in rat cardiac allografts was challenged in a variety of ways in an attempt to provoke rejection. Incompatible skin grafts, injections of sensitised lymphocytes, and the administration of the macrophage-stimulating agentCorynebacterium parvumproved ineffective. However, levamisole, which stimulates both macrophages and sensitised lymphocytes, caused rejection in four of a group of six AS rats bearing enhanced (August x AS)F, hybrid heart allografts. A combination of C.parvumand levamisole provoked rejection in all four animals in which it was used. The results suggest that an increased activity of both lymphocytes and macrophages is required to break established enhancement.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYA randomized, double-blind study comparing horse antilymphoblast globulin (ALG) (25 patients) with human IgG (20 patients) in addition to standard antirejection therapy was performed in recipients of first kidney transplants having their first rejection episodes. Patients received ALG (20 mg/kg/day) for 10 days, and a control group was given human IgG (20 mg/kg/day) for 10 days in addition to standard therapy. The groups were comparable with respect to HLA matching, age, time to onset of first rejection episode, and number of diabetics. The number of patients requiring transplant nephrectomy and/or dialysis, having a second rejection episode, having good late function, or dying did not differ in recipients of related kidneys receiving either ALG or human IgG. Recipients of cadaver kidney grafts had fewer (0.05 < P < 0.06) second rejection episodes if they received ALG during their first rejection episode. However, the number of patients requiring transplant nephrectomy and/or dialysis, having late good function, and dying did not differ significantly for recipients of cadaver kidneys. We conclude that ALG does not add significantly to standard antirejection therapy for the treatment of first rejection episodes.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYSeventy-three patients with primary renal neoplasms underwent kidney transplantation. Three distinct groups were identified. Thirty-four patients (group 1), who underwent antineoplastic therapy 1 year or less before transplantation, developed metastases or recurrences in 53% of the cases. In contrast, none of 15 patients in group 2 had this problem. All of these patients had a waiting period of at least 15 months between nephrectomy and transplantation. These findings emphasize the value of a lengthy waiting period between treatment of the neoplasm and performance of transplantation with its associated immunosuppressive therapy. Group 3 also had a favorable outcome. All had incidentally discovered renal malignancies, in 18 patients during the work-up of chronic renal failure or after bilateral nephrectomy in preparation for renal transplantation, and in 6 several months after transplantation when the recipient's own kidneys were removed or autopsy examination was per-formed. None of these 24 patients developed recurrences or metastases.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYIn this study, the effects of a variety of immunosuppressive agents on T, B, and K lymphocyte levels and function were monitored in 92 renal and cardiac allograft recipients and correlated with rejection parameters. Maintenance prednisone (P) and Imuran (I) had little effect on the levels and reactivity of T cells and no selective T cell effects. Intravenous P (1 g) injections caused variable (0 to 64%) and transient falls in T cell levels and as well as variable (11 to 69%) falls in T cell reactivity, again without a selective T cell effect. P-I had similar effects on K cell cytotoxicity with significant falls occurring only after high doses of i.v. P. Antithymocyte globulin (ATG) in low doses caused a profound fall in T cell levels (mean of 3.2% of normal) and reactivity (11.2% of normal) within hr. This effect was persistent for 1 week or more after the last ATG administration. High potency ATG caused a more marked and more selective fall of T cells than moderate potency ATG. ATG administration was associated with rises in surface immunoglobulin-positive (B) cells (to 72 to 93% of mononuclear cells) and EAC receptor-positive cells (to 36 to 68% of mononuclear cells), indicating a selective effect of ATG on the circulating T cells. ATG also caused a marked fall in K cell cytotoxicity which was significantly greater (P < 0.05) than with P-I only. In vitro findings correlated with in vivo rejection parameters, with ATG-treated patients showing no accelerated rejection and only 1 graft lost to rejection in the first month in over 200 cadaver transplants treated with ATG.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYIn these studies, pretransplant testing of donor-recipient compatibility was per-formed in 10 related donor and 26 cadaveric renal transplants using a variety of cell-mediated immunity tests. Mixed lymphocyte culture results did not correlate with acute rejection (AR), acute irreversible rejection, or chronic rejection (CR). Lymphocyte-mediated cytolysis also did not correlate with AR, acute irreversible rejection, or CR. Cell-mediated lympholysis correlated with AR but not with acute irreversible rejection or CR. Antibody-dependent cell-mediated cytolysis (ADCMC) was positive pretransplant in 13 (36%) of the recipients. Of the positive patients, 4 had early severe AR and 9 developed typical CR. Of these 13 patients, 9 or 69% lost graft function to rejection whereas only 3 of 20 (15%) of ADCMC-negative patients lost graft function because of rejection (P < 0.05). In summary, cell-mediated lympholysis testing demonstrated a capability to predict AR episodes. The most useful pretransplant monitoring assay in this patient series was the ADCMC assay. A positive ADCMC against donor cells pretransplant indicates a relatively poor prognosis for long-term graft survival.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYIn patients that received transplants of cadaver kidneys, prior transfusion improves the prognosis for graft survival. Patients receiving frozen-thawed red cells have better 1-year survival rates than patients given other forms of red cells. The effect of prior transfusions is minimal in patients that received transplants of kidneys from living related donors.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYTo evaluate the extent of injury in short- and long-term renal allografts, the urinary excretion of IgG, IgA, and IgM was observed during acute rejection crisis. In reversible rejection, treatment resulted in prompt correction of immunoglobulinuria, whereas in irreversible crisis urinary immunoglobulin levels continuously increased in spite of the same antirejection treatment. A good prognosis in long-term allografts was shown by low levels of immunoglobulinuria; unstable graft function had higher levels. Immunoglobulinuria can be used as an additional test to evaluate the reversibility of acute rejection, and also has significance in the long-term situation.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

SUMMARYBecause of the ubiquity of cytomegalovirus (CMV) infection among renal transplant patients, the correlation between CMV isolation and clinical events is often difficult. In this prospective study, clinical CMV disease was diagnosed in 26 of 68 patients (38%) that received transplants between 1974 and 1976 on the basis of viral isolation and/or >4-fold rise in complement-fixing antibody in patients with an unexplained febrile illness of >5 days' duration.All CMV syndromes began 1 to 4 months post-transplant, persisting up to 23 weeks thereafter (mean duration of symptoms was 19 days). Although CMV was observed in some instances to cause only prolonged fever (10 patients) or hepatitis (4 patients), its most important effects were pneumonia (9 patients) and profound leukopenia (8 patients). Three patterns of pneumonia were observed: bilateral interstitial pneumonia (3 patients), unilateral focal consolidation (1 patient) (both attributable to CMV alone), and diffuse bilateral pneumonia attributable to CMV and superinfecting microorganisms (5 patients). These last patients had CMV-induced leukopenia of >1 week's duration at onset of superinfection, and all died. The 4 patients without leukopenia did not develop superinfection, and all survived. Two other renal transplant recipients died of infection during this period, both with CMV, leukopenia, and Listeria monocytogenes sepsis. The major infectious disease importance of CMV appears to be its effects on the respiratory tract and systemic host defense in predisposing to fatal superinfection.

ISSN:0041-1337    

出版商:OVID    

年代:1977

数据来源: OVID