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  • Cadaver kidney transplantation  (1)
  • Membrane plasma separation  (1)
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  • 1
    ISSN: 1432-1440
    Keywords: MHC ; Cadaver kidney transplantation ; Graft survival rate ; Blood transfusions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The influence of prospective HLA-DR matching on the graft survival rate was investigated in a multicenter analysis of 85 transplants. Simultaneously in a retrospective analysis of graft outcome the importance of matching for MT-antigens MT1, MT2 and MT3 as a newly defined B-cell alloantigen system was evaluated. HLA-DR antigens and MT-specificities were determined on B-cells enriched by nylon-wool filtration using locally well characterised HLA-DR antisera and the antiserum set of the 8th International Histocompatibility Workshop (“discase set”) which allowed the definition of the HLA-DR specificities HLA-DR 1–9 and of the MT-antigens MT 1–3. HLA-DR matching showed a significantly improved graft outcome only in HLA-DR identical donor-recipient combinations. In 11 of 60 patients with one HLA-DR compatibility additional matching for two MT-antigens, however, improved the two year graft survival rate from 60% to 91%. Altogether 17 patients were matched for two MT-specificities with their kidney donor and showed a superior prognosis of 94% at two years compared to 53% or 17% of recipients with one or zero MT compatibility. Graft outcome in this patient group was also superior to that of HLA-DR identical or HLA-AB identical grafts. These data suggested that the MT-system rather than the HLA-DR antigens may be of critical importance in cadaver kidney transplantation. In addition a favorable influence of pretransplant blood transfusions on less HLA-DR matched grafts was confirmed.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1440
    Keywords: Kappa light chain nephropathy ; Plasma exchange therapy ; Membrane plasma separation ; Calcium-free dialysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Often the diagnosis “light chain nephropathy” is not made before renal failure has developed. In the past these patients had a poor prognosis. Special features of this disease and improvement of renal function by plasma exchange therapy are shown in a case report. A 51-year-old man admitted to hospital with renal failure, proteinuria and hypercalcaemia was treated by Ca-free dialysis and membrane plasma separation (MPS). Renal biopsy studied by light and electron microscopy showed mainly tubular protein casts. It is assumed that this nephropathy is caused by a direct toxic effect of the kappa light chains on function and structure of tubuli. Proteinuria was markedly lowered and renal failure was made partly reversible by prompt and effective MPS. Thus, MPS may improve the prognosis of this stage of disease.
    Type of Medium: Electronic Resource
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