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Biomedical subjects

A Flatmark

Publications and source records attributed to A Flatmark.

At least 109 records · Page 6Linked to original sources
PubMed1986

HLA-matching and pretransplant blood transfusions in cadaveric renal transplantation--a changing picture with cyclosporin.

613 patients were included in a study to assess the extent to which HLA-matching and pretransplant blood transfusions affect the outcome of cadaveric renal transplantation in patients treated with cyclosporin and low doses of prednisolone. Matching for the HLA-DR-antigens significantly reduced the frequency of rejection episodes, but neither HLA-matching nor pretransplant blood transfusions influenced the patient and graft survival rates.

Analysis of Variance↗
PubMed1986

Liver transplantation in a 23-year-old tyrosinaemia patient: effects on the renal tubular dysfunction.

Orthotopic liver transplantation was performed on a 23-year-old female with hereditary tyrosinaemia. The disorder was diagnosed at 7 years of age due to severe rickets, and the patient was treated with a diet restricted in phenylalanine and tyrosine. Nineteen months before the transplantation she had an acute episode of diffuse gastrointestinal bleeding due to portal hypertension. Three subsequent bleeding episodes with accompanying ascites and signs of encephalopathy were considered life-threatening. Nine months after the liver transplantation the patient is well, but serum transaminases are slightly elevated. Without dietary restrictions serum tyrosine and inorganic phosphate are normalized, no succinylacetone can be detected in serum, and urinary excretion of p-hydroxyphenyllactate and p-hydroxyphenylpyruvate is normal. Excretion of amino acids, glucose and beta 2-microglobulin decreased significantly after the transplantation but is still elevated. The succinylacetone concentration in urine is about 20% of the preoperative level. After an oral tyrosine load, succinylacetone excretion increased sevenfold but no deterioration of the renal tubular function was observed and no tyrosine metabolites were detectable in serum. The findings indicate that the defective tyrosine metabolism occurs in the kidneys, but does not produce tubular dysfunction. The residual tubular dysfunction of the patient is probably due to irreversible damage of the tubular epithelium.

Adult↗
PubMed1986

Long-term blood pressure and renal function in kidney donors.

We have reexamined 68 (92%) of 74 donors accepted at this center nine to 15 years ago. There was a moderate but significant increase in BP, and ten donors (15%) were hypertensive at the follow-up. Twenty-six donors (38%) had albumin excretion over 10 micrograms/min or excretion of total protein over 185 mg/24 hr. In four of 16 with increased excretion of total protein, this exceeded 400 mg/24 hr, and in three donors this could be due to an intercurrent disease. Ccr averaged 78.4% of preoperative values, and was less than 50% (range 32 to 49%) in eight donors. The compensatory increase (median 30.5 mliter/min/1.73m2) was inversely correlated with age and BP. Aspects of tubular function were assessed by the diluting capacity during water diuresis and by urinary excretion of beta 2-microglobulin and N-acetyl-beta-glucosaminidase. No consistent abnormalities were observed. A subgroup of donors (N = 32) was compared with a matched control group. Urinary albumin excretion among the donors was significantly higher compared to the controls, both in absolute terms (5.4 vs. 3.3 micrograms/min, P less than 0.002) and as percent of total protein excretion (7.6 vs. 5.7%, P less than 0.05). Otherwise no consistent differences were observed. The development of BP over time warrants further observations, but there is no evidence that uninephrectomy represents a long-term risk to the donors' health.

Acetylglucosaminidase↗
PubMed1986

HLA-matching in cyclosporine treated renal transplant recipients: a prospective Swedish-Norwegian multicenter study.

1. In this prospective study of 613 CD and 205 one haplotype mismatched LRD transplant recipients treated with CyA, there was no influence of HLA-matching (A, B, DR or combinations) on graft survival rate at one and two years. 2. Patients who successfully received HLA-DR-matched kidneys (CD or LRD) had fewer rejection episodes during the first six months after transplantation. 3. Three factors significantly reduced the cadaveric graft survival rate: (a) presence of panel reactive T-cell antibodies in a current recipient serum, (b) cold ischemia time beyond 27 hours, and (c) recipient age above 55 years. 4. The survival rate of one haplotype mismatched LRD kidneys was excellent and is considered to be the optimal treatment for uremia also in CyA-treated patients. 5. Based on this study, exchange of well HLA-matched CD kidneys to non-sensitized patients has been terminated provisionally in Scandia-transplant. Exchange of HLA-A, B-matched kidneys will be maintained, however, for sensitized patients inasmuch as this will increase the chance of obtaining a negative cross-match and possibly improve graft survival in this high-risk patient group.

Cyclosporins↗
PubMed1986

Renal transplants from HLA-haploidentical living-related donors. The influence of donor-specific transfusions and different immunosuppressive regimens.

A total of 151 potential recipients of kidney grafts from one-HLA-haplotype-mismatched MLC-positive (RR greater than 20%) donors treated during 1980-1984 was investigated. The recipients were divided retrospectively into four groups: (A) 42 patients who received pretransplant donor-specific transfusions (DST) and posttransplant azathioprine/prednisolone (DST-only); (B) 10 patients who received DST with azathioprine before and azathioprine/prednisolone after grafting (DST-aza); (C) 42 patients who received no pretreatment and azathiprione/prednisolone posttransplant (aza group) and (D) 57 patients who also received no pretreatment but cyclosporine/prednisolone posttransplant (CsA group). DST-only led to persistently positive crossmatch in nine (21%) and transient positive crossmatch in two patients, while no sensitization occurred in the DST-aza group. Posttransplant, early acute rejection episodes were frequent in the DST-only group, but no graft was lost to acute rejection during first year; one-year graft survival (GS) = 94%. Similar GS (93%) was obtained in the CsA group, while in the aza group poorer results were obtained; GS = 69%. In the DST-aza group clinical problems including serious infections were observed. As CsA treatment without DST gave as high graft survival as in the DST groups, but avoided the sensitization risk by DST alone and the bone marrow complications of DST-aza, such treatment has become our preferred therapy for haploidentical renal transplants.

Adolescent↗
PubMed1985

Prednisolone pharmacokinetics in cushingoid and non-cushingoid kidney transplant patients.

Prednisolone pharmacokinetics and protein binding have been compared in 16 cushingoid and 46 non-cushingoid long-term kidney transplant recipients. After oral administration of 10 mg prednisolone, the cushingoid patients had a significantly higher peak prednisolone serum concentration (P less than 0.03), a longer elimination half-time (P less than 0.03), and a larger area under the time-concentration curve of total (P less than 0.01) and free (P less than 0.03) prednisolone. The apparent total body clearance of total and free prednisolone was significantly lower in the cushingoid than in the non-cushingoid patients (P less than 0.02 and less than 0.05, respectively). There was no significant difference in time of peak concentration, apparent volume of distribution or serum protein binding of prednisolone. It is suggested that the development and persistency of some cushingoid features may be related to a decreased total body clearance of prednisolone, which, in turn, may be influenced by impaired renal function.

Adult↗