Search PubMed⌕ Search

Biomedical subjects

F Harder

Publications and source records attributed to F Harder.

At least 307 records · Page 17Linked to original sources
PubMed1980

[Blood transfusions and kidney transplantation: selection or conditioning of recipients?].

Pretransplant blood transfusions have been shown in retrospective studies to prolong the survival of kidney grafts. We have therefore introduced a new prospective transfusion policy. All patients waiting for a kidney transplant received if possible 5 transfusions at monthly intervals, then 1 every 6 months. From 1.1. 1977 to 31.12. 1978 we transplanted 51 transfused patients. In the present study we investigated: 1. the occurrence of lymphocytotoxic antibodies, 2. the time on dialysis until transplantation and 3. the kidney graft survival. 65% of all patients never had antibodies. Only 6 patients produced antibodies with broad spectrum activity. The occurrence of these antibodies did not significantly influence the graft survival. The majority of the patients without antibodies waited 5 months for transplantation. The few hyperimmunized waited far longer, but nevertheless all finally got a transplant. The actuarial graft survival rate at 1 year was 72%. The results of our program with systematic pretransplant transfusions indicate that the advantages of transfusions override the risk of hyperimmunisation.

Antibody Formation↗
PubMed1980

Modification of kidney graft survival in dog and man by pre-operative transfusion to the donor.

The present experiments indicate that the transplantation reaction is not solely caused by immunocompetent cells of the recipient, but also by immunocompetent cells in the donor organ. Immunisation of the donor did modify the immune response as demonstrated with kidney grafts in rat, dog and man. In the dog prolonged kidney graft survival by one peroperative blood transfusion was reduced to control level by transfusion of the donor on day -1 with 100ml third party blood. In the rat third party blood transfusion to the donor reduced kidney graft survival significantly, but donor pretreatment with recipient lymphocytes induced significantly prolonged survival. This suggests that the modification of graft survival by donor transfusion is an immunological phenomenon. Immunisation of the donor with recipient cells may induce specific immunoreactive cells in the graft that causes a local graft versus host reaction, which inhibits the rejection reaction. In man 44 recipients were studied who only received blood peroperatively. Significantly impaired graft survival was noted if the donor was not transfused, resulting in 19% 3-month kidney function, versus 61% with transfused donors.

Animals↗
PubMed1980

[Hemodialysis: the arteriovenous fistula in the wrist].

The arterio-venous fistulaula distal to the processus styloideus radii in the "tabatière" offers a most useful additional and very peripheral vascular access for chronic hemodialysis. It in no way compromises the further construction of arterio-venous anastomoses in the forearm in fistula failure. The results of 53 such fistulas are reported.

Arteriovenous Shunt, Surgical↗
PubMed1979

Blood transfusions, cytotoxic antibodies, and kidney graft survival. Preliminary results of a systematic transfusion protocol.

Since pretransplant blood transfusions have been shown to prolong the survival of kidney grafts, a new transfusion policy has been started in the frame of Swisstransplant. Before surgery all patients receive at least two and, if possible, five transfusions (whole blood or packed red blood cells). The present study includes 101 recipients of primary cadaver grafts. Of these, 41 were transfused regularly according to the new protocol, 46 had irregular transfusions because of therapeutic necessity, and 14 had no transfusion before grafting. The 1-year survival rate in pretransfused patients was over 70% as compared to 45% in the nontransfused group. There was no significant association with the number of transfusions, but a slight improvement in graft survival was seen in patients deliberately transfused when compared with those transfused because of severe anaemia. A delay of more than 3 months between the last transfusion and transplantation significantly decreased graft survival at 6 months (84 versus 58%; P less than 0.02). The occurrence of cytotoxic antibodies, both antiperipheral blood lymphocytes (PBL) and anti-B cell antibodies, was investigated in relation to the number of transfusions received. Broad-spectrum anti-PBL antibodies (greater than 50% of random panel) were found in 5 of 74 patients transfused according to the protocol (7%) and in 15 of 93 patients transfused for severe anaemia (16% P, not significant). Of 71 recipients followed up for 6 months, 15 (21%) produced anti-PBL antibodies with limited specificity (less than 50%), and 4 (6%) produced broad-spectrum antibodies. Anti-B cell antibodies (less than 50%) were produced in 21 of 64 patients (33%). Six patients (9%) had broad-spectrum activity. The occurrence of these antibodies was not associated with the number of transfusions received and did not significantly influence the graft survival at 6 months. The change in transfusion policy seems to have improved graft survival without producing strong presensitization in a prohibitive proportion of the patients on hemodialysis.

Antilymphocyte Serum↗
PubMed1979

[Recipient conditioning with beagle plasma and beagle liver: prolongation of kidney-graft function without preoperative lymphocytotoxic antibody formation].

Donorspecific recipient conditioning in the non-related beagle produces prolonged kidney-graft survival without any postoperative immunosuppression. Besides 2 donor blood injections on days--18 and--11 followed by a 6-day preoperative immunosuppressive pulse (Procarbazine, ATS) donor plasma and a donor liver preparation are equally active. Additional long-term low dose preoperative immunosuppression with azathioprine tends to strengthen the effect. Lymphocytotoxic antibody formation is avoided in the recipient where no whole blood is used.

Animals↗
PubMed1978

[Traumatic hemobilia. A case report (author's transl)].

A case of traumatic hemobilia is reported. After ligation of the left hepatic artery and additional dearterialisation a third bleeding period occured due to a porto-hepatic communication, diagnosed by a transumbilical portography. A left hepatic lobectomy was finally necessary to achieve hemostasis. This case demonstrates that a selective artery ligation for the treatment of hemobilia is only successful if a complete dearterialisation is performed at the first operation. Furthermore a porto-hepatic communication may require partial hepatectomy.

Adult↗
PubMed1978

Myoxomas of the jaws.

A retrospective study on 15 patients with myxomas of the jaws was carried out. Follow-up information was obtained in 10 patients. Clinical, radiologic, and microscopic features were examined and the results of extensive resection versus conservative surgery were evaluated. The results seem to be in favor of the latter. Four cases are presented in detail.

Adolescent↗
PubMed1978

[Preoperative immunosuppression in the kidney-transplanted dog in connection with specific antigenic pre-treatment].

Postoperative, nonspecific routine immunosuppressive therapy fails in up to 50% in human cadaver renal transplantation. Donorspecific preoperative immunological conditioning of the host is harder to induce in dogs than in some rodents. In a pilot study 2 i.v. donorblood injections on days -18 and -11 followed by a 6-day preoperative pulse without any postoperative therapy induce a significant albeit limited prolongation of graft function.

Animals↗