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Biomedical subjects

A C Novick

Publications and source records attributed to A C Novick.

At least 379 records · Page 21Linked to original sources
PubMed1980

Vascular complications of renal transplantation.

From January, 1963, to May, 1979, 600 renal transplants were performed at the Cleveland Clinic. There were 21 vascular complications in this series (3.5%). Arterial complications included renal artery thrombosis in 5 patients, renal artery stenosis in 9 patients, and anastomotic hemorrhage in 2 patients. Venous complications included renal vein thrombosis in 2 patients and hemorrhage in 3 patients. Although vascular complications led directly to graft loss in 10 patients, only 1 resulted in patient death.

Hemorrhage↗
PubMed1980

Anatrophic nephrolithotomy for removal of staghorn or branched renal calculi.

Forty anatrophic nephrolithotomies were performed in 38 patients between November, 1965, and December, 1977, to remove staghorn or branched renal calculi. Thirty-six (95 per cent) of the patients' preoperative urine cultures were infected, and postoperatively 35 of the cultures (88 per cent) were sterile. Magnesium ammonium phosphate calculi were present in the majority of patients (67 per cent). In 6 patients (15 per cent) transient nephrocutaneous fistulas developed. Thirty-six of the 40 renal units (90 per cent) had improved or stable intravenous pyelograms postoperatively. The patients had been followed for an average of twenty months (four to one hundred and twelve months). In 6 patients (15 per cent) recurrent renal calculi developed, and 3 patients (8 per cent) had residual calculi during this period.

Adult↗
PubMed1980

Renal revascularization in patients with total occlusion of the renal artery.

A total of 15 patients with renovascular hypertension underwent revascularization of totally occluded renal arteries. Preoperative clinical assessments suggesting renal salvageability include urographic visualization of the involved kidney, renal length greater than 9 cm., filling of the distal renal arterial tree on angiography and elevated renal vein renin levels. Postoperatively, hypertension was cured or improved in 14 patients and there was 1 failure. Over-all renal function improved in 9 of 10 patients with preoperative azotemia and stabilized in the remaining 5 patients. Revascularization can be done successfully in properly selected patients with complete renal artery occlusion, with control of hypertension and reversal of renal failure.

Adult↗
PubMed1980

Posterior surgical approach to the kidney and ureter.

The posterior surgical approach allows certain operations on the upper urinary tract to be performed more rapidly, with optimum exposure and with diminished morbidity. In particular, the lumbotomy incision is excellent for bilateral nephrectomy, open renal biopsy, simple nephrectomy for benign disease, pyelolithotomy, pyeloplasty and upper third ureterolithotomy. The operative technique is reviewed, and the advantages and limitations of this approach are discussed.

Biopsy↗
PubMed1980

The older living renal donor: prognosis for the donor and recipient.

Results after 46 renal transplants from living donors more than 50 years old are presented. There were no complications after transperitoneal nephrectomy and renal function remained stable in all donors. The mean followup for transplant recipients was 6.2 years. The 2-year patient and graft survival rates were 76.1 and 60.9 per cent, respectively, while the corresponding 5-year rates were 60.5 and 46.5 per cent, respectively. These results suggest that age per se should not eliminate living related kidney donation.

Age Factors↗
PubMed1980

Results of renal transplantation in children.

From 1968 to 1978, 66 renal transplants were performed on 58 pediatric patients with end stage renal failure. With a mean followup of 6 years 46 patients (79.3 per cent) are alive and 35 (60.3 per cent) currently have a functioning renal allograft. Live donor allografts yielded fewer surgical complications and better long-term functional survival rates than cadaver allografts. Patient rehabilitation following a successful renal transplant was excellent. However, despite resumption of growth in most cases normal linear growth was achieved rarely. Renal transplantation provides the best long-term solution to the problem of end stage renal disease in children.

Adolescent↗
PubMed1980

Aortorenal bypass with autogenous renal artery for coexisting renal carcinoma and renal artery stenosis.

A case of renal artery stenosis and a large contralateral renal carcinoma is reported. After radical nephrectomy of the tumor-bearing kidney revascularization of the solitary remaining kidney was performed with an aortorenal bypass graft of autogenous renal artery. When renal artery stenosis coexists with contralateral intrinsic renal disease preservation of functioning renal parenchyma is an important goal of therapy.

Aorta, Abdominal↗
PubMed1980

Surgical management of branch renal artery disease: in situ versus extracorporeal methods of repair.

Herein are presented the techniques and their respective indications that have been found most effective in replacing the renal artery and its branches. Aortorenal bypass and, occasionally, splenorenal bypass can be tailored to achieve in situ repair of most branch renal artery lesions. Extracorporeal renal revascularization and autotransplantation have been done on onar disease. Revascularization with preservation of renal parenchyma can now be achieved in almost all patients with branch renal artery disease.

Aorta, Abdominal↗
PubMed1980

Extracorporeal renal surgery and autotransplantation: indications, techniques and results.

Renal autotransplantation and/or an extracorporeal renal operation has been done 67 times in 65 patients. The indications for operation were severe ureteral injury in 8 patients, urinary undiversion in 2, renovascular hypertension in 10, carcinoma in a solitary kidney in 3, recurrent renal colic in 1 and donor arterial reconstruction before renal transplantation in 43. Methods of renal preservation and operative repair are described. Sixty-five operations were successful and 2 operations failed because of severe perirenal fibrosis in patients undergoing urinary undiversion. Renal autotransplantation and extracorporeal reconstruction can provide the best solution for selected urologic problems not correctable by conventional methods.

Extracorporeal Circulation↗
PubMed1980

Transperitoneal live donor nephrectomy.

We review 171 anterior transperitoneal live donor nephrectomies. The transperitoneal approach provides optimum exposure for atraumatic dissection of the kidney and renal vessels. The total and major postoperative complication rates were 30.4 and 3.5 per cent, respectively. These results compare favorably to reported series of extraperitoneal live donor nephrectomies. Transperitoneal live donor nephrectomy is a safe and effective operation with low risk to the donor.

Nephrectomy↗
PubMed1980

Preservation of ischemically damaged canine kidneys. Cold storage versus perfusion.

Dog kidneys subjected to a period of warm ischemia followed by either simple cold storage or hypothermic pulsatile perfusion were autotransplanted 24 hr after harvesting, and a contralateral nephrectomy was performed at the same time. Renal function was comparable with both techniques, and all dogs survived. When kidneys were subjected to 30 min of warm ischemia followed by one of the two preservation methods, renal function was again comparable and 50 per cent of the animals in each group survived. We conclude, therefore, that for 24 hr of canine renal preservation, cold storage is as effective as pulsatile perfusion even when the kidney has been initially subjected to 30 min of warm ischemia.

Animals↗
PubMed1980

Effect of immunologic donor pretreatment on survival of perfused canine renal allografts.

We evaluated the effect of immunologic donor pretreatment followed by perfusion preservation on canine renal allograft survival. Donor-recipient pairs were selected on the basis of dog erythrocyte identity, a negative white blood-cell crossmatch, equivalent dog leukocyte matching, and significant mixed lymphocyte culture stimulation. Four hours before nephrectomy, all donors were pretreated with either normal saline or cyclophosphamide and methylprednisolone. After donor nephrectomy, all grafts were preserved by pulsatile perfusion for 24 hr. Transplantation into the matched recipient was performed with simultaneous bilateral nephrectomy. No significant difference was found in the postoperative serum creatinine levels or median allograft survival between the two groups. This controlled study showed no beneficial effect of donor pretreatment on survival of perfused canine renal allografts.

Animals↗
PubMed1980

Reduced morbidity with posterior surgical approach for pretransplant bilateral nephrectomy.

Bilateral nephrectomy is indicated prior to transplantation for selected patients with endstage renal disease. Bilateral posterior surgical incisions have been used to perform this operation upon 45 patients. Postoperatively, there were no deaths, and a single minor complication occurred. These results were compared with 331 transperitoneal bilateral nephrectomies performed at this institution. The posterior surgical approach has proved superior in permitting bilateral nephrectomy to be performed with a more rapid recovery period for the patient and with diminished morbidity.

Adolescent↗
PubMed1979

Endarterectomy and patchgraft angioplasty in treatment of atherosclerotic renovascular hypertension.

From 1962 to 1978, 56 patients underwent transrenal endarterectomy as surgical treatment for renovascular hypertension. Over-all results were 39 per cent cured, 36 per cent improved, and 25 per cent failed. Criteria for selecting patients with atherosclerotic renal artery disease for surgical treatment are reviewed. Transrenal endarterectomy is a simple operation and should continue to be applied in the management of properly selected patients.

Adult↗
PubMed1979

Aortorenal reimplantation in treatment of renovascular hypertension.

From 1964 to 1977, 33 patients underwent aortorenal reimplantation as surgical treatment for renovascular hypertension. Over-all results were 13 patients cured (39 per cent), 15 patients improved (46 per cent), and there were 5 failures (15 per cent). The results were equally satisfactory in patients with atherosclerotic or fibrous renal artery disease. Postoperative arterial stenosis or occlusion occurred in 5 patients (15 per cent). Aortorenal reimplantation is an effective method of renal revascularization in properly selected patients, and long-term results are comparable with those of aortorenal bypass.

Adolescent↗