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Biomedical subjects

A M Paton

Publications and source records attributed to A M Paton.

At least 19 recordsLinked to original sources
PubMed1978

Influence of HLA matching and blood transfusion on renal allograft survival.

One hundred and seven consecutive cadaver kidney transplants have been followed for up to 6 years. The beneficial effect of HLA matching, shown in previous studies, has been confirmed. The 2-year failure rate from rejection was 29% for grafts with less than two incompatibilities, in comparison with a figure of 52% where there were two or more incompatibilities. In contrast to some reports, the presence of HLA antibodies did not have an adverse effect on the survival of first grafts. Patients not transfused prior to transplantation had a much higher 1-year graft failure rate (72%) than those given either frozen-thawed red cells (29%) or whole blood (23%). This apparently beneficial effect of blood transfusion was no greater in patients transfused with more than five units compared with those given less than five units. We believe that blood transfusion has an important influence on the outcome of renal transplantation.

Adolescent↗
PubMed1976

Bilateral nephrectomy prior to renal transplantation.

Bilateral nephrectomy was performed in 53 patients on regular haemodialysis. The indications were pyelonephritis in 30, polycystic kidneys in 6, glomerulnephritis in 7, uncontrollable hypertension in 9 and horseshoe kidney in 1. In 87 per cent of cases the operation was carried out as a separate procedure prior to transplantation. The mortality was 9 per cent and the postoperative complications included hypotension, clotting of arteriovenous shunts, pneumonia and subphrenic abscess. As a result of our experience we have revised our indications for bilateral nephrectomy which now are pyelonephritis only when associated with persistent bacteriuria or ureteric reflux, polycystic kidneys and uncontrollable hypertension.

Adolescent↗
PubMed1975

Ultrasound in the diagnosis of fluid collections following renal transplantation.

Ultrasound examinations of the pelvis and kidney have been carried out following 68 renal transplants. In 16 patients moderate sized or large perirenal or pelvic fluid collections were demonstrated. The composition of the fluid was lymph in seven cases, pus in four, blood in three and urine in two. Ten of these 16 patients had clinical features compatible with a pelvic fulid collection while six had no such localising features. We have found ultrasound to be extremely valuable in the diagnosis and precise localisation of pelvic fulid collections following transplantation, often at a stage before pressure effects and symptoms have appeared. It also provides a rapid and reliable means of excluding a pelvic or perirenal abscess in the pyrexial patient.

Abscess↗
PubMed1975

Plasma angiotensin II, renin, renin-substrate and aldosterone concentrations in acute renal failure in man.

Plasma concentrations of angiotensin II, renin, renin-substrate and aldosterone were measured in cases of acute renal failure. Angiotensin II, and renin levels were abnormally high on at least one occasion in nearly all patients. Mean angiotensin II and renin levels were highest in the first ten days of the disease. There was a highly significant positive correlation between concurrent estimations of renin and angiotensin II. Renin-substrate was also frequently elevated, but the correlations with renin and angiotensin II were not statistically significant. Despite the frequently marked elevation of plasma angiotensin II, only 2 of 17 measurements of plasma aldosterone were abnormally high. There was no significant relationship between aldosterone and plasma concentrations of angiotensin II, renin, sodium or potassium. The data are discussed in relation to current hypotheses implicating renin and angiotensin in the pathogenesis of acute circulatory renal failure.

Acute Kidney Injury↗
PubMed1972

Changes of blood pressure, renin, and angiotensin after bilateral nephrectomy in patients with chronic renal failure.

Circulating levels of renin, angiotensin I, and angiotensin II were increased in six patients with chronic renal failure and hypertension uncontrolled by dialysis and hypotensive drugs. Lower and often normal levels were found in 10 patients whose blood pressure was controlled by dialysis treatment. For a variety of reasons all patients were subjected to bilateral nephrectomy. The logarithm of the decrease in plasma concentrations of renin and angiotensin II was significantly related to the fall of blood pressure after operation. Plasma renin concentration correlated significantly with blood angiotensin I concentration and with plasma angiotensin II in samples taken before and after nephrectomy. Renin, angiotensin I, and angiotensin II were measurable in samples of blood taken 48 hours or more after the operation.

Adolescent↗
PubMed1972

Viral infection and renal transplant rejection.

The occurrence of an outbreak of influenza in a renal transplant unit is described. Five patients had a proved episode of infection, confirmed by a rise in the complement fixation titre to influenza virus A, and this coincided in three of the patients with episodes of acute rejection. It seems likely that the virus infection was responsible for the rejection, possibly through a stimulating effect of the virus on the host's immune response.

Adult↗
PubMed1972

Renal transplantation: an analysis of 33 cases.

Thirty-three patients with end-stage renal failure have had transplants over a three-year period, four patients receiving kidneys from siblings and the remainder cadaver organs. Twenty-seven kidneys survived with stable function for periods of six months to three years. Graft survival at one year was 85% and at two years 82%. One patient died and five were returned to dialysis. Complications included rejection episodes, technical problems, respiratory and wound infections, gastrointestinal disorders, and side effects of steroids.

Acute Kidney Injury↗