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Biomedical subjects

C B Anderson

Publications and source records attributed to C B Anderson.

At least 127 records · Page 7Linked to original sources
PubMed1979

Delayed renal function and long-term cadaver renal allograft survival.

This study indicates that (1) ATN adversely affects long-term allograft survival but not patient survival, (2) in patients with delayed function the duration of ATN does not influence allograft survival, (3) ATN kidneys with good recovery (SCR less than 3.0) do as well as immediate-function kidneys, (4) poor recovery from ATN (SCR greater than 3.0) is associated with poor long-term allograft survival and may be the result of allograft rejection during ATN, since analysis of multiple characteristics at the time of transplantation failed to discern any difference between the good- and poor-recovery groups, and (5) there are no reliable pretransplant indicators of those kidneys that will never function or be in the poorly recovered group.

Acute Kidney Injury↗
PubMed1979

A pilot program of multiple cadaver organ and tissue retrieval.

A one year pilot project conducted at a 2,000 bed medical center involved a unique approach to the retrieval from cadavers of multiple viable organs and tissues. Aspects of the program included a special unit for sterile evaluation and storage of tissue, a computerized registry of potential donors, a nurse to coordinate and expedite retrieval, and a retrospective chart review to define the incidence and location of potential cadaver donors. There were requests for 121 tissues by 39 investigators. Eleven different tissues were needed within 4 hours of death. Forty-two percent of individuals contacted directly enlisted in the donor registry, three of whom were identified on the computer at the time of death. A five-fold increase in cadaver donor evaluation referrals occurred, and one third of referrals resulted in viable tissue retrieval. A review of 728 deaths indicated that 45% could have been potential eye donors, 27% pancreas donors and 2.5% kidney donors. A coordinated program to retrieve multiple viable organs and tissues for transplantation and research appeared to be effective in this initial pilot study.

Cadaver↗
PubMed1978

Significance of microbial contamination of stored cadaver kidneys.

The importance of microbial contamination of cadaver kidneys was assessed in 83 consecutively stored and transplanted kidneys. Fourteen kidneys had a single positive culture during storage and five had multiple positive cultures. Only one postoperative infection could be traced to kidney contamination during storage (Candida wound infection). In three of 64 patients who received noncontaminated kidneys, posttransplant wound infections developed. No wound infections occurred in 35 patients who received prophylactic antibiotics, whereas four wound infections occurred in 48 patients without antibiotic coverage. It is concluded that, although microbial contamination of stored cadaver kidneys occurs commonly, it is not an important source of infection in renal transplant recipients.

Candidiasis↗
PubMed1978

Venous angiography and the surgical management of subcutaneous hemodialysis fistulas.

Venous angiography of subcutaneous arteriovenous (A-V)) hemodialysis fistulas involves venous injection of radiographic contrast material which spreads throughout the venous system and into the arteries via the A-V anastomosis when blood flow to the extremity is temporarily occluded. Direct arterial cannulation is avoided. Subsequent restoration of blood flow with rapid sequential roentgenograms differentiates arteries from veins and identifies direction of fistula blood flow. A 44 month experience with 125 consecutive studies in 82 patients was performed with a 0.8% complication rate. Indications for fistulography included insufficient blood flow during dialysis (67%), cardiac failure (10%), aneurysms (6%), sepsis of undertermined site (6%) and other (77%). Roentgenographic findings identified vascular stenoses or occlusions (45%), malpositioned dialysis needles (11%), aneurysms (9%), unsuitable veins for dialysis (6%), absence of septic origin (5%), abnormal flow rates or patterns (5%), technically unsuitable studies (2%) and normal or baseline studies (17%). Information useful in planning clinical management of the patient was obtained in 88% of studies and fistular operations were performed in 65 patients (52%). Venous fistulography can be an effective and safe method of evaluating and planning correction of A-V dialysis fistula complications.

Adolescent↗
PubMed1978

Intravenous phenytoin: clinical and pharmacokinetic aspects.

Phenytoin was administered intravenously in large doses (mean = 16.6 mg per kilogram) for prevention and treatment of seizures on 159 occasions to 139 patients aged 17 to 94 years (mean = 52 years) and weighing 37 to 113 kg (mean = 65 kg). Hypotension was more frequent among older patients. No deaths were attributable to phenytoin. Volumes of distribution were relatively constant (mean = 0.78 +/- 0.11 liters per kilogram), but half-lives varied considerably and were prolonged (mean = 51 +/- 32 hours) because of the large doses administered. A dose of 18 mg per kilogram was effective in maintaining phenytoin serum levels above 10 microgram per milliliter for 24 hours.

Adolescent↗
PubMed1978

Serum autoleukocytotoxic activity and the positive cross-match in potential allograft recipients.

To evaluate possible causes of the false-positive cross-match test for clinical renal transplantation, the incidence of serum autoleukocytotoxic activity and its relationship to allogeneic sensitization to HLA antigens (the positive cross-match) were determined in 234 sera from 28 sensitized and eight nonsensitized chronic renal failure patients. Seven sera from four patients had autoleukocytotoxic activity. The autoleukocytotoxic activity was detected only in patients who showed transient allogeneic sensitization at some point. This activity could be adsorbed either by autologous or allogeneic platelets, but adsorption with autologous platelets did not remove the synchronous allogeneic leukocytotoxicity. This autoleukocytotoxic activity appears to coexist with alloreactive antibody, and in such a setting the positive alloreactive cross-match should contraindicate the proposed transplant until adsorption studies prove the false-positiveness of the test.

Adsorption↗
PubMed1978

Renal injury by companion kidney during hypothermic pulsatile perfusion.

To study possible deleterious effects of traumatized kidneys on well harvested ones during hypothermic pulsatile perfusion, paired dog kidneys were monitored on two separate MOX-100 machines connected to pool a common perfusate. First kidneys were optimally harvested and baseline renal vascular resistance (RVR) calculated from pressure divided by flow (mm Hg/ml minute). After 1 hour second kidneys were added and observation was continued for an additional 3 hours. RVR in first kidneys increased immediately and doubled by 3 hours when ischemic traumatized second kidneys were added, 0.70 +/- 0.07 to 1.37 +/- 0.15 (p less than 0.001). No change in RVR was noted when second kidneys were optimally retrieved or if the dogs were heparinized prior to nephrectomy. Histological examination showed no evidence of vascular obstruction in any kidney, but only tubular necrosis in nonheparinized, traumatized second kidneys. Weight gain in optimally removed kidneys was 41%, but only 8% in ischemic kidneys. RVR decreased unexpectedly in ischemic kidneys during 3 hours of perfusion (p less than 0.01). Release of vasoactive substances by damaged kidneys and arteriovenous shunting may explain these findings. Separate perfusion systems seem to be justified when one of two cadaver kidneys is of marginal quality.

Animals↗
PubMed1978

Complications associated with arteriovenous fistulas in patients undergoing chronic hemodialysis.

Over a two-year period, 100 venous angiograms were performed on 75 patients because of difficulty with vascular access. Seventy percent of the patients had decreased arterial flow or increased venous resistance. High output failure, sepsis, and aneurysm formation were also found. Venous angiography of the fistula demonstrated significant stenosis in 40% of the cases as well as total occlusion by thrombus in 9%, aneurysm formation in 7%, and abnormal fistula needle placement or anatomic abnormalities in 20% of the cases. Definitive diagnosis with the aid of venous angiography permitted specific surgical intervention in 62% of the cases, and identified new sites for needle placement in 18% of the cases, thus prolonging fistula life and reducing the need for new fistula placement. Our experience with local cellulitis of the fistula site and sepsis is also discussed.

Adult↗
PubMed1977

Carpal tunnel syndrome following vascular shunts for hemodialysis.

Carpal tunnel syndrome developed in the hands of two patients five to six months after Quinton-Scribner vascular shunts for hemodialysis were removed from the forearm of the symptomatic upper extremity. Thickened flexor tendon synovium within the carpal tunnel in al three cases suggests that the cause is an increase in the volume of the contents within the rigid confines of the carpal canal. Division of the transverse carpal ligament and synovectomy resulted in complete relief of symptoms 4, 14, and 23 months after operation. Carpal tunnel syndrome should be considered an additional new complication of vascular shunt procedures in patients treated by hemodialysis for renal failure.

Adolescent↗
PubMed1977

Human renal allograft blood flow and early renal function.

Renal allograft blood flow (RBF) was measured at operation by electromagnetic flow meter and probes in 45 patients (34 cadaver donors and 11 living related donors). Mean RBF in 26 patients without acute tubular necrosis (ATN), was 412 +/- 80 ml/min and in 19 patients with ATN, 270 +/- 100 ml/min (p less than .001). Only two of 24 transplants (8%) with RBF greater than 350 ml/min had ATN; whereas, 17 of 21 transplants (81 per cent) with RBF less than 350 ml/min had ATN (p less than .001). In cadaver donor transplants, RBF did not correlate with duration of ATN, warm ischemia time, total ischemia time, pulsatile perfusion time or renal vascular resistance during perfusion. Measurement of renal allograft blood flow can predict presence or absence of postoperative ATN in 87% of patients.

Adolescent↗
PubMed1977

Prolongation of murine skin allografts by prostaglandin E1.

The effects of 16,16-dimethyl prostaglandin E2 methyl ester (di-M-PGE2) and indomethacin (an inhibitor of endogenous prostaglandin biosynthesis) on mouse skin allograft survival were studies in B10.D2 female mice receiving skin allografts from (B10.BR X B10.D2)F1 mice. Control animals with and without i.p. diluent injections had a mean allograft survival of 13.8+/-0.6 and 13.5+/-0.5 days, respectively. Daily administration of di-M-PGE2 (200 microng/kg) prolonged mean allograft survival, both when administered alone, 16.7+/-0.6 days (P less than 0.001), or with indomethacin, 4 mg/kg thrice weekly, 16.0+/0.6 days (P less than 0.005). Increasing concentrations of indomethacin (4, 6, and 8 mg/kg thrice weekly) were inversely corrleated with allograft survival ((12.7+/-0.2, 11.8+/-0.2, and 10.9+/-0.4 days, respectively), coefficient of correlation=-0.6986; P less than 0.001. Mean plasma PGE levels at the time of total allograft rejection were 879+/-80 pg/ml in control, 717+/-59 pg/ml in 100 micron g of indomethacin-treated mice, and 654+/-59 pg/ml in 200 microng of indomethacin-treated mice (P less than 0.05). Exogenous di-M-PGE2 prolonged skin allograft survival in mice. Inhibition of endogenous prostaglandin biosynthesis by indomethacin chortened allograft survival, but this effect was completely abrogated by concurrent injection of di-M-PGE2.

Animals↗
PubMed1977

Antitubular basement membrane antibodies in renal allograft rejection.

In a patient with an episode of acute renal allograft rejection, antibodies to tubular basement membranes (TBM) were noted by direct immunofluorescence in a renal biopsy and by indirect immunofluorescence in the serum. The serum antibodies decreased gradually and became undetectable 3 months after the rejected kidney was removed. Anti-RBM antibodies eluted from the rejected kidney were capable of binding in vitro to TBM but not to glomerular basement membranes (GBM) in 39 of 40 human kidneys and various animal kidneys. The specificity was confirmed by blocking studies showing inhibition with ultrasonicated human TBM but not with GBM preparations. Passive transfer experiments showed that anti-TBM antibodies were able to bind in vivo to normal rabbit kidneys, although they could not elicit an inflammatory response. The possible mechanisms of production of anti-TBM antibodies and their potential significance in graft loss are discussed.

Adolescent↗