ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06468.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06469.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06470.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Twenty‐two living related renal transplant operations have been performed at Prince Henry's Hospital over the last seven years. Donors have been accepted for nephrectomy only after exhaustive examination of their health and search for renal disease. The one and three year graft survival rates have been 85% and 64% respectively. Only two recipients have died, and recipient morbidity has been low. Donors have not suffered any serious complication from nephrectomy. It is concluded that living related renal transplantation has many advantages over cadaveric renal transplantation and is a relatively safe procedure for the donor, provided that rigid criteria are used in donor selectio

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06471.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Renal artery stenosis occurred in 13.5% of 229 consecutive cadaver renal transplants performed at the Royal Melbourne Hospital over an eight and a half year period. Clinical and laboratory indices which suggested the diagnosis were examined. The presence and severity of hypertension were of little predictive value, while deterioration of renal function for which other causes had been excluded and the histological appearance of renal biopsy specimens were valuable in suggesting the diagnosis. A selective approach in both investigation and attempted surgical repair is recommended.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06472.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Ninety‐nine (21 %) of 471 patients who survived with functioning grafts for at least six months following renal transplantation developed cancer. Of these 76 (77%) had skin malignancy, 29 (29%) had malignancy affecting other organs, and six had cancer of boti. ‐skin and other organs. In patients with skin cancer squamous cell carcinoma (SCC) was three times as frequent as basal cell carcinoma (BCC). SCC tended to be multiple, recurrent and aggressive. Seven (12%) patients with SCC developed metastases of whom five died. Cancers other than skin included reticulum cell sarcoma (9), acute leukaemia (2) and cancers involving the gastrointestinal (5), genitourinary (11) and respiratory (2) systems. Incidence of cancer in patients surviving beyond one, five and nine years after operation was 98/428 (23%), 70/179 (39%) and 20/45 (44%) respectively. In 31 patients who died more than five years after transplantation cancer was the major cause in eight (26%). For the types of cancers recorded estimates show allograft recipients to be at increased risk when compared with the age‐matched Australian population by factors which varied from 300 times for reticulum cell sarcoma to 1.8 times for invasive carcinoma of the cervix. The full extent of the threat of cancer in immune suppressed transplant recipients remains to be deter

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06473.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Gastrointestinal complications occur'red in 19 of 290 recipients (6.6%) of the 325 cadaveric renal allografts undertaken between September 1969 and December 1978. The mortality was 42.1%. Upper gastrointestinal complications, principally haemorrhage, occurred in 12 patients (4.1%), 11 of whom were males, usually within four months of transplantation, and often associated with acute rejection and its treatment. Surgery was required in five patients. The overall mortality was 16.7%. Colonic complications occurred in five patients (1.7%), four of whom died, the absence of specific signs having led to a significant delay in diagnosis. One patient died from abdominal vascular disease, and one from carcinoma of the gallbladder.To decrease the high morbidity and mortality, both medical and appropriate surgical prophylaxis for peptic ulceration and diverticular disease are necessary, as is an awareness of the transplant recipient's propensity to develop a gastrointestinal complication at any time, up to years after transplantation. Early recognition and treatment of such complications are essential.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06474.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Lymphoceles occurred in 25 of 115 patients after renal transplantation in the Oxford Unit. Signs of obstruction or pressure were produced in 16 of these 25 patients (15%), while nine were detected on a routine ultrasound scan. The 16 symptomatic lymphoceles were treated successfully by aspiration or surgical fenestration into the peritoneal cavity. Of the possible causes examined, diathermy and division of iliac lymphatics seemed to be the most likely reason for this high incidence. Since a technique of ligating or clipping the iliac lymphatics has been adopted, no lymphoceles have occurred in the subsequent 70 transplants.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06475.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Review of the results of the use of an external ureterovesical anastomosis in 266 renal transplantations showed that urinary fistulae occurred in 34 patients (12.8%), and ureteric obstruction in six (2.3%). The fistulae were due to technical failure of the anastomosis in 13 patients, to distal ureteric necrosis in 13, to total ureteric necrosis in six, and to other causes in two. Fistula management was successful in 26 cases (76.5%), but multiple operations were often necessary and wound complications frequent (41.2%). The continuing high incidence of urological complications following ureterovesical anastomosis has resulted in increasing use of ureteroneocystosfomy as the primary form of urinary reconstruction after transplantation in this unit.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06476.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

The blood vessels and blood supply are of first importance in organ transplantation, and the use of established vascular surgical principles and techniques can simplify renal grafting and reduce its risks and complications. This paper describes a vascular surgeon's approach to the problems of donor nephrectomy, kidney insertion, and the avoidance and management of complications, based on the surgical experience in the Royal Melbourne Hospital ofsome 350 transplants.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1979.tb06477.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY