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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Transplant international 1 (1988), S. 95-98 
    ISSN: 1432-2277
    Keywords: Pediatric transplant patients ; Recipient and donor age
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The influnece of recipient and donor age on the outcome of first cadaver kidney transplants was analyzed in a series of 1325 pediatric recipients and in 4230 transplants from pediatric kidney donors. Graft survival improved significantly with increasing recipient age (P〈0.0001) and donor age (P〈0.0001). Combined analysis of recipient and donor age groups revealed an overriding effect of donor age on graft outcome. Kidneys from donors younger than 3 years old consistently yielded poor results regardless of recipient age. Kidneys from adult donors gave the best results even in young recipients 0–5 years of age. With adult donor kidneys in cyclosporin-treated patients, high 1-year graft survival rates of 86±9% (SE) in 15 0-to 5-year-old recipients, 85±3% in 137 6-to 12-year-old recipients, and 83±1% in 6027 13-to 40-year-old recipients were observed.
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  • 2
    ISSN: 1432-2277
    Keywords: Heart ; Graft survival ; Cyclosporine ; Sulfasalazine ; Rats
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sulfasalazine (SASP) has been used for many years as a disease-modifying agent in inflammatory bowel disease and in rheumatoid arthritis. However, its mode of action is not entirely clear. Evidence has been accumulated which indicates that its efficacy is due to an immunomodulatory effect. In the present communication, we report that SASP has an immunomodulatory capacity in an experimental rat cardiac allograft model. A combination of 100 mg/kg per day of SASP given orally until rejection and 10 mg/kg per day of cyclosporine A (CyA) given orally for 10 days resulted in a significantly increased graft survival time as compared to that in animals given CyA alone.
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  • 3
    ISSN: 1432-2277
    Keywords: Transplantation tolerance ; Intraportal injection ; Allogeneic bone-marrow transplantation ; Chimeras
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intraportal inoculation of C57BL/6 marrow cells into sublethally (400 rad) irradiated BALB/c recipients resulted in durable chimerism and the permanent acceptance of C57BL/6 skin allografts. Sublethally irradiated recipients of a similar number of marrow cells inoculated systemically did not develop chimerism or any significant prolongation of the survival of C57BL/6 skin allografts. Consequently, lethal graft-versus-host disease developed only in recipients of intraportal marrow allografts (80%). The intraportal injection of allogeneic C57BL/6 marrow cells into nonirradiated recipients resulted in significant, although not permanent, prolongation of skin allograft survival without durable chimerism, suggesting that the introduction of alloantigens intraportally may favor the induction of nonresponsiveness to alloantigens even across strong major histocompatibility barriers. The relevance of these findings is discussed regarding the intraportal inoculation of allogeneic bone marrow cells for the treatment of genetic disorders in utero through the induction of neonatal tolerance.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Transplant international 1 (1988), S. 118-118 
    ISSN: 1432-2277
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2277
    Keywords: Human orthotopic liver transplantation ; Complications ; Biliary tract ; Primary sclerosing cholangitis ; Recurrent disease ; Rejection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract One of 55 patients transplanted for sclerosing cholangitis during the cyclosporin-steroid era (March 1980–June 1986) developed intrahepatic biliary strictures in the absence of allograft rejection within the 1st year posttransplantation. Although many causes underlie biliary pathology in the postoperative period (i.e., arterial injury, ischemia, chronic rejection, cholangitis), recurrent disease remains a possibility.
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  • 6
    ISSN: 1432-2277
    Keywords: Elderly patients ; Renal transplantation ; Renal replacement therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of renal replacement therapy (RRT) in elderly patients in Norway were evaluated. During the 5-year period between 1981 and 1985, 368 patients at least 60 years of age (mean, 66.7 years) at the start of RRT were included and followed until 15 February 1987. Transplantation was planned for 249 patients; of these 127 were not grafted. The actuarial survival in this group was 64%, 44%, and 7% at 6, 12, and 48 months, respectively. Survival in 122 grafted patients was 93%, 87%, and 62%, respectively, and the corresponding graft survival was 70%, 67%, and 48%. The remaining 119 patients were allocated to long-term dialysis, with a survival of 63%, 48%, and 13%, respectively. Our results describe the outcome of a treatment program available to the entire elderly population accepted for RRT. In two-thirds of the patients transplantation was planned, and one-third of all patients were actually grafted, with good patient and graft survival. The results suggest that transplantation is the treatment of choice for most elderly patients.
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  • 7
    ISSN: 1432-2277
    Keywords: Liver transplantation ; Aspiration cytology ; Rejection ; Fine needle aspiration ; Total corrected increment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The role of aspiration cytology (AC) and the total corrected increment (TCI) in the diagnosis of hepatic rejection was assessed in 30 patients following 36 liver transplants. A total of 174 AC specimens were “blindly” evaluated. Patients underwent protocol AC twice weekly and when biochemical or clinical parameters suggested rejection. Hepatic rejection was only confirmed when clinical and biochemical changes were accompanied by positive histological diagnosis. In all, 103 specimens were matched against histology, the remainder assessed against retrospective clinical and biochemical diagnoses. There were 80 cytological diagnoses of rejection, confirmed in 69 specimens, and 94 diagnoses of no rejection, confirmed in 73 specimens. These figures give a sensitivity of 76.7%, a specificity of 86.9% and a positive predictive value of 86.3%. Overall, 39.7% of specimens taken more than 2 months after grafting proved to be incorrectly diagnosed. However, the accuracy was higher in 145 specimens taken within 8 weeks of transplantation, with a sensitivity of 81.3%, a specificity of 90%, a positive predictive value of 89.7% and an accuracy of 85.5%. Although histology remains the gold standard in the diagnosis of acute rejection after hepatic grafting, AC using a TCI with a positive predictive value of 86.3% may prove to be of value in monitoring liver transplant patients in the first 2 months after grafting.
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  • 8
    ISSN: 1432-2277
    Keywords: Canine partial orthotopic liver transplantation ; Energy metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Liver transplantation is now proven therapy for various forms of end-stage liver disease in children; however, the problem of donor liver shortage remains. To investigate the feasibility of graft procurement from living, genetically related adult donors without injury to either donor or recipient, partial orthotopic liver transplantation (PLT) using a graft transected and warm perfused in situ was evaluated in beagles; the viability of the graft was assessed in terms of energy metabolism, including blood ketone body ratio (KBR), as well as of recipient survival. PLT was performed in two groups with venovenous bypass. The left half of the donor liver was transected in situ, flush perfused with 21 lactated Ringer's solution (4°C in group A, 20°C in group B), and immediately implanted into the recipient, who was totally hepatectomized, care having been taken to leave the inferior vena cava intact. Four of seven dogs survived for 5 days or longer (longest, 8 days) in group A and six of eight dogs (longest, 20 days) in group B. Causes of death were gastrointestinal bleeding, intussusception, or infection but not graft dysfunction. In both groups the KBR decreased significantly during the anhepatic period, recovered rapidly to the pre-anhepatic level after revascularization, and was maintained within a normal range thereafter. No significant differences in the time course of changes in KBR were seen between the two groups. These results suggest that a warm-perfused graft does not have a poorer viability than a cold-perfused one, that the concept of PLT with a graft transected and warm perfused in situ is feasible, and that it may be the solution to the problem of donor liver shortage.
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  • 9
    ISSN: 1432-2277
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 10
    ISSN: 1432-2277
    Keywords: Kidney transplantation ; Retransplantation ; Monitoring ; Donor-reactive antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twenty retransplant patients were serially screened for donor-reactive antibodies (DRA). DRA appeared exclusively in patients whose grafts permanently failed and these DRA shared some common features, namely early appearance (days 4–8 post-transplant), high titers (1:10 up to more than 1:400), and broad anti-HLA specificity. This preliminary data would suggest that regrafted patients with primary graft failure represent a distinct subgroup of particularly immune responsive individuals.
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