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E Andres

Publications and source records attributed to E Andres.

8 recordsLinked to original sources
PubMed1991

[Antilymphocyte serum, cyclosporine and corticoids, versus OKT3, cyclosporine, and corticoids in kidney transplantation].

UNLABELLED: The use of the antilymphoblast globulin (ALG) or OKT3 associated with cyclosporine (CyA) and steroids has been useful in kidney cadaveric transplantation. 101 patients who received their first cadaveric renal transplant were randomized according to the immunosuppression used. Group A (n = 53): horse ALG 15 mg/kg just before transplant surgery; ALG 12 mg/kg on the first day after transplant followed by 4 doses of 10 mg/kg on alternate days; Cya p.o 8 mg/kg/d; prednisone 0.25 mg/kg/d. Group B (n = 48): OKT3 5 mg just before transplant followed by 4 doses of 5 mg/d.; CyA and prednisone were administered using the same schedule as group A. RESULTS: the incidence of rejection during the first 3 months was: group A: 13 percent, group B: 17 percent (NS). The probability of being free of acute rejection (Kaplan-Meier) 24 months after transplant was 89 percent in group A and 79 percent in group B (NS). The day of onset of the first acute rejection episode was 25 +/- 20 days after transplant in group A, and 17 +/- 10 day in group B (NS). Incidence of tubular necrosis: group A 21 percent, group B 19 percent (NS).

Adrenal Cortex Hormones↗
PubMed1990

Antilymphoblast globulin, cyclosporine, and steroids in cadaveric renal transplantation.

In order to avoid cyclosporine (CsA) nephrotoxicity and rejection, especially during the early posttransplant periods, different immunosuppression regimens have been adopted. A prospective trial was conducted to evaluate the benefits of initially low CsA doses associated with antilymphoblast globulin and steroids in the first days after transplant, in comparison with higher doses of CsA and steroids. Between 1/86 and 1/88, two groups of first-cadaver renal transplant recipients were documented based on the immunosuppression regimen used. In group A (n = 50), oral CsA was started at 8 mg/kg/day and subsequent doses adjusted to maintain CsA whole-blood levels between 300 and 600 ng/ml. Horse ALG at 10 mg/kg was given the day after transplant and on alternate days to a maximum of 6 doses. After 3 doses, ALG was stopped if CsA blood levels were equal to or greater than 400 ng/ml. ALG dosage modifications were made in order to maintain peripheral CD3+ cells between 10 and 20%. Prednisone was given at 0.25 mg/kg/day. In group B (n = 50), oral CsA was started at 15 mg/kg/day. The CsA whole-blood levels were maintained between 300 and 800 ng/ml. Prednisone was administered at 0.5 mg/kg/day. The incidence of postransplant renal failure was the same in both groups (16%), but the duration of oliguria was lower in group A than in group B (3.3 +/- 2 vs. 16.2 +/- 10.7 days, P less than 0.05), as well as the incidence of acute rejection during the first 3 months (18% vs. 40%, P = 0.01. The cumulative doses of CsA and steroids were significantly lower in group A than in group B. Mean serum creatinine at 6 and 12 months remained similar in both groups. There was no difference between the 2 groups in the incidence of infection. There was no mortality in either group. The actuarial graft survival was significantly higher in group A than in group B at one (100% vs. 94%), two (97% vs. 87%), and three years (89% vs. 73%), respectively (P = 0.041). In summary, the triple regimen using simultaneously low-dose CsA, ALG, and steroids minimizes early graft dysfunction, provides efficient immunosuppression without severe infections, and gives good long-term patient and graft survival.

Adult↗
PubMed1985

Sequential hypertonic dialysis.

We have investigated the usefulness and practicability of the so-called sequential hypertonic dialysis in 2 selected patients with severe hemodialysis-induced hypotension; 190 mmol/l of sodium dialysate during the 1st and 3rd h and 132 mmol/l throughout the 2nd and 4th h were used, with a Drake-Willock-Bi proportionating unit, which was electronically modified for the purpose of the study. Crossover was made, patients serving as their own controls in two consecutive cycles: 3 weeks conventional hemodialysis followed by 4 weeks sequential hypertonic dialysis, using high-flux dialyzers. At the end of sequential hypertonic dialysis a greater weight loss was achieved (p less than 0.001) with absolute stability of blood pressure. There were no significant changes in plasma osmolality and plasma volume during sequential hypertonic dialysis when compared with conventional hemodialysis. Dialysis symptoms and complications were less frequently recorded during sequential hypertonic dialysis (p less than 0.001). At the end of each sequential hypertonic dialysis period, hemoglobin, potassium, and phosphate plasma levels improved significantly and plasma sodium concentrations remained within the normal range. We conclude that sequential hypertonic dialysis is an easy and routine feasible procedure with our methodology. It is possible to achieve the ideal dry weight with no symptomatic hypotension. Sequential hypertonic dialysis constitutes an alternative to sequential ultrafiltration in selected patients, as it minimizes the falloff in plasma volume and osmolality observed during conventional hemodialysis.

Adult↗