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Biomedical subjects

D E Sutherland

Publications and source records attributed to D E Sutherland.

At least 433 records · Page 24Linked to original sources
PubMed1989

Transplant renal artery stenosis.

A group of 31 patients with transplant renal artery stenoses was identified among 2002 patients undergoing renal transplantation at the University of Minnesota; 29 of the stenoses were at the anastomosis. A total of 43 procedures were performed to correct the stenosis. Angioplasty was performed 25 times, with 3 patients cured and 2 patients improved; 20 procedures resulted in a poor result (3) or a failure (17). The failures were usually due to recurrent stenosis (7 patients) or to arterial injury that resulted in graft loss (4 patients) or successful emergency surgery to save the transplant (3 cases). Surgical repair of the stenosis was performed 18 times. No grafts were lost and 13 patients were cured or improved. These data suggest that angioplasty for anastomotic stenosis yields poor results and that a surgical repair is probably warranted. All 7 patients who had a poor results or failed a technically successful intervention did not have a rise in creatinine secondary to captopril or had a systolic pressure gradient of less than 60 mmHg across the anastomosis. These data also suggest that patients without physiological evidence of renal artery stenosis may not have improvement in their hypertension following repair.

Angioplasty, Balloon↗
PubMed1989

Combined hepatic and pancreaticoduodenal procurement for transplantation.

We have used a procurement method whereby both the liver and whole pancreas grafts are procured from the same donor and successfully transplanted. During the combined procurement, the hepatic artery is completely mobilized; the splenic artery is transected from the hepatic artery and the gastroduodenal artery is ligated from the hepatic artery. The portal vein is mobilized 2 centimeters from the head of the pancreas. The whole pancreas graft includes the splenic artery and the superior mesenteric artery, which are reconstructed. The hepatic graft includes the entire length of the hepatic artery with the celiac axis, and no further reconstruction is required. Using this technique, we have performed nine combined hepatic and whole pancreas procurements; only one liver was not transplanted because of technical complications. When a replaced right hepatic artery is identified from the superior mesenteric artery, we have abandoned the pancreatic retrieval. All combined retrievals have included successful renal retrieval, and the majority have been associated with cardiac retrieval also. Combined hepatic and whole pancreas procurement is feasible with minimal technical complications with the liver or the pancreatic graft and should be standard in most procurements.

Cadaver↗
PubMed1989

Use of the circular stapler in construction of the duodenoneocystostomy for drainage into the bladder in transplants involving the whole pancreas.

The use of a circular stapler to construct a duodenoneocystostomy for exocrine drainage of transplants of whole pancreas is described herein. All but one of 15 grafts were technically successful, and the one failure was not related to the anastomosis. This method is easier than the handsewn technique we had been using, and the complication rate may be lower.

Anastomosis, Surgical↗
PubMed1989

Glomerular capillary morphology in normal humans.

Knowledge of quantitative glomerular structure in normal man is limited. At the time of renal transplantation, 28 living-related normal kidney donors had renal biopsies performed. Tissue was processed for light and electron microscopy using standard techniques. Standard stereologic techniques were used to determine mean glomerular volume, capillary length density, fractional volumes of mesangium and capillary lumen, surface densities of the peripheral capillary, mesangial-epithelium interface, and the lumenal-mesangial interface. Volume of total mesangium/glomerulus, capillary lumenal volume/glomerulus, peripheral capillary filtration surface/glomerulus, capillary mesangial-epithelial surface/glomerulus, capillary lumenal-mesangial surface/glomerulus, capillary length/glomerulus, and average capillary diameter were calculated. There were no significant differences between males and females in any structural parameter. There were no significant correlations between age or body surface area and any structural parameter. In comparison with these normal values, previously reported diabetic patients with clinical nephropathy demonstrate markedly expanded mesangial volume/glomerulus and a diminished filtration surface/glomerulus. The availability of these normal values will allow comparison with functional data in normal humans and greater understanding of human glomerular disease.

Adult↗