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Biomedical subjects

B Charpentier

Publications and source records attributed to B Charpentier.

At least 235 records · Page 13Linked to original sources
PubMed1985

[Prospective study of a triple immunosuppressive combination in renal transplantation: cyclosporin A-corticoids-azathioprine].

Cyclosporin A significantly improves patient and graft survival as compared with the conventional corticosteroid-azathioprine treatment. However, the results are the same, or even worse, when the cyclosporin A-corticosteroid regimen is compared with the corticosteroid-azathioprine-antilymphocyte globulin regimen. The authors have investigated a prednisone-azathioprine-low dose cyclosporin A combination in 46 high risk patients from a series of 117 renal transplantations performed in 1983. The actuarial patient and graft survival rates were as good as, but not better than, those obtained in 1982 in 106 patients treated with the conventional regimen which includes antilymphocyte globulin; they were 96.5% vs 98% and 85.5% vs 84% respectively at 6 months; 96.5% vs 98% and 83.5% vs 84% respectively at 12 months. The low dosage utilized (8 mg/kg instead of the usual 14-17 mg/kg) avoided virtually all the extrarenal side-effects of cyclosporin A, but not its nephrotoxicity. The theoretical risk of excessive immunosuppression was not confirmed by our study. Since cyclosporin A is very expensive, other therapeutic methods for optimal usage of that drug should be investigated.

Azathioprine↗
PubMed1985

[Continuous ambulatory peritoneal dialysis before renal transplantation].

In order to evaluate precisely the place of continuous ambulatory peritoneal dialysis in the treatment of chronic renal failure, it is important to find out whether this method may produce complications, mostly infectious, after renal transplantation. From April, 1979 to December, 1983, 419 renal transplantations were performed in our centre; 17 of these patients had previously been treated with peritoneal dialysis over a mean 13.5 months period, with 3.2 peritonitis/patient. The peritoneal catheter was left in situ for 4 to 16 weeks post-graft, so that the patients could easily be dialysed if needed; it was removed during transplantation in the only 3 cases of recent peritonitis. The only complications noted after transplantation were an episode of spontaneously reversible ascites and a peritoneal breach following reintervention on the renal region. This homogeneous series confirms that continuous ambulatory peritoneal dialysis does not constitute a contra-indication, let alone an obstacle, to subsequent renal transplantation. Indeed, it may be regarded as the first-choice method for patients in whom early grafting is envisaged on account of their immune status.

Adult↗
PubMed1985

Synthesis of 7 alpha- and beta-carboxymethyl derivatives of cortisol, corticosterone, deoxycorticosterone and cortisone. Immunogenic properties of cortisol, corticosterone and deoxycorticosterone derivatives.

7 alpha- and 7 beta-Carboxymethylderivatives of cortisol, corticosterone and deoxycorticosterone have been synthetized. After coupling to bovine serum albumin, they were used to elicit antibodies in rabbits. Highly specific antisera were obtained which may possibly be used for a direct radioimmunoassay of these steroids in human and rodent plasma. In the case of the derivatives of cortisol and corticosterone and stereoisomery of the coupling had an effect on the affinity and the specificity of the antisera. In all immunized rabbits the antisera obtained with the 7 alpha-derivative had a higher affinity and a narrower specificity than the antiserum obtained with the 7 beta-derivative.

Antibody Affinity↗
PubMed1985

Need for hepatocellular carcinoma screening before renal transplantation in HBs +, HBe +, western African.

We report a case of fulminant hepatocellular carcinoma discovered 50 days after renal transplantation. The recipient was a young Senegalese, hepatitis B virus chronic carrier. The pre-transplant check-up was normal, and the tumor was latent until its dramatic expression. Progression of hepatitis B liver disease occurs in immuno-suppressed renal transplant recipients, which often leads to chronic active hepatitis, cirrhosis and hepatocellular carcinoma, with a high risk of death due to liver disease. The early discovery of the tumor in this patient emphasizes the necessity for complete hepatic screening before transplantation in african, hepatitis B virus chronic carrier recipients. Moreover, the accumulation of risk factors for hepatocellular carcinoma: hepatitis B virus, food mycotoxins (aflatoxin), parasitic infestation and immunosuppression with transplantation is stressed.

Adult↗
PubMed1985

[Renal transplantation and pregnancy].

The authors report four cases of pregnancy in a series of 174 women who had undergone renal transplantation. In one case the pregnancy was complicated by a pre-eclamptic attack and premature delivery. A review of the literature shows that the risks to the mother and the kidney are marginal. The risk to the child, however, is more serious. Pregnancy in transplant patients is therefore a high-risk pregnancy requiring advance precautions and careful surveillance.

Adult↗
PubMed1985

[Rejection reaction and use of rifampicin in the treatment of tuberculosis in kidney transplantation].

Rifampicin is considered as one of the most potent antituberculous agents and is often used in renal transplant recipients. However, acute cellular rejection episodes were observed when rifampicin was prescribed in 4 tolerant renal transplant recipients. Acute rejection occurred in 3 out of the 5 patients, despite doubled daily dose of steroids. First, rifampicin is an enzymatic inducer and accelerates steroid metabolism. Secondly, rifampicin per se is an immunosuppressive drug, as already proved in animals. Rifampicin interferes with the active mechanisms involved in specific transplantation tolerance. In conclusion, we recommend a very cautious use of rifampicin in kidney transplant recipients.

Adult↗
PubMed1985

[Urologic complication of renal transplantation. Importance of the length of the ureter].

The authors report a series of 430 renal transplantations performed over five years. During this period, the surgical technique was modified to ureterovesical anastomosis. The urological complications--fistulae and stenosis--are discussed as a function of the site of the implantation, the position of the kidney, the type of anastomosis and the length of the ureter. The results show that transplantation in the iliac position gives rise to more complications than transplantation in the pelvic position. They also show that inversion of the superior pole of the kidney leads to a greater number of urological complications. In the series reported, ureterovesical anastomosis gave 6.7% of complications, against 12% for uretero-ureteral anastomosis, which also gave rise to a significantly larger number of fistulae. More detailed study of the series reveals a complication rate of 4.7% for ureterovesical anastomosis (out of 224 patients) against 4% for uretero-ureteral anastomosis, when the ureter was short (in both series). The dominant factor is therefore the length of the ureter; the longer it is, the greater the number of urological complications.

Constriction, Pathologic↗
PubMed1984

[Mechanisms of allograft rejection].

Recent studies have considerably altered our understanding of allograft rejection mechanisms. The new approaches concern rejection targets, effector mechanisms, the triggering of the immune response and the genetic control of the immune response. Rejection targets now regarded as most important are antigenic epitopes such as "tissue specific" antigens, vascular endothelium antigen, skin Epa antigen and the minor histocompatibility antigen H-Y. Effector mechanisms seem to be restricted almost to the lymphocyte Th helper subset rather than to the Tc cytotoxic subset. The triggering of the immune response is mainly effected by certain cells, e.g. dendritic cells and Langerhans cells, or by lymphokines, such as interleukin 2. Finally, the genetic control of the response to alloantigens, previously demonstrated for less complex systems, is now known to exist in allograft rejection.

Animals↗
PubMed1984

[Brain-death unit and renal transplantation. Evaluation of 5 years' experience].

From 1977 to 1982, 170 potential organ donors were referred to "a brain-death unit". A vast majority of these patients were provided by intensive care units of district general hospitals from Ile-de-France. This fact confirms the dispersion of potential organ donors and the usefulness of an organ-procurement structure based in an University Hospital. Its effectiveness is demonstrated by an harvesting rate of 58%, largely over the already published reports in case of absence of such a center. It is concluded that the adoption of this system by other hospitals would significantly increase the number of cadaver kidney grafts available for transplantation whereas actually the number of kidney grafts remains dramatically low in France.

Adolescent↗
PubMed1984

Successful in situ treatment of a fungal peritonitis during CAPD.

A case of candida peritonitis during continuous ambulatory peritoneal dialysis (CAPD) which recovered with intraperitoneal 5-fluorocytosine alone is reported. This seems to be the first case of fungal peritonitis during CAPD without removing the catheter to be described in the literature.

Adult↗
PubMed1984

Deficient natural killer cell activity in alcoholic cirrhosis.

Natural killer (NK) cell activity against two types of target cells was found to be low in patients with inactive alcoholic cirrhosis (AC). This defect was significantly more pronounced in AC patients with severe malnutrition than in those with mild or moderate malnutrition. This was not due to modifications of the kinetics of NK activity. The sera from AC patients had no inhibitory effect on the NK activity of normal subjects. Lymphocytes and macrophages from AC patients did not exert major suppressive effect on the NK activity of normal subjects. Interferon boosted the NK activity of cells from AC patients, but to a lesser degree than cells from normal controls. The findings show that a deficit of NK activity is clearly associated with inactive AC. This seems to be another consequence of AC on cellular immunity, and might be related to the protein calorie malnutrition often present in AC.

Adult↗
PubMed1984

[What are the indications for nephrectomy in candidates for renal transplants].

The kidneys of a patient with renal insufficiency often retain an endocrine role which should not be overlooked, and they are sometimes capable of residual diuresis. A case history of acute pyelonephritis, the existence of infected stones, or problems of infected reflux, are all indications for nephrectomy. On the other hand, arterial hypertension or an uninfected reflux do not, in our view, constitute indications for this procedure. In cases of renal polycystosis, only those kidneys whose volume constitutes an obstacle to transplantation should be treated surgically.

Humans↗