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Biomedical subjects

F K Merkel

Publications and source records attributed to F K Merkel.

At least 37 records · Page 2Linked to original sources
PubMed1980

Machine preservation of 450 cadaver kidneys.

Cadaver kidneys procured from homeostatic donors can be preserved for periods up to 67 hours without adversely affecting graft survival. Donor creatinine, use of vasopressors, and perfusion characteristics do not seem important factors.

Adolescent↗
PubMed1977

The application of ileal conduits in pediatric renal transplantation.

Our experience with the use of ileal conduits as receptors of renal homografts in 5 of 41 transplant recipients during the preceding 4 years is described. These 5 chronic renal failure patients were between 6 months and 17 years old, and had unsalvageable bladders that required an ileal conduit at an elective time before transplantation. The causes of renal failure in these children included dysplasia and chronic urinary tract infection. In an attempt to retard the rate of renal insufficiency all patients underwent multiple operative procedures on the lower urinary tract. Two cadaveric and 3 kidneys from living relatives were transplanted. One infant (6 months old) died of severe fluid and electrolyte imbalance 5 days post-transplantation. Of the remaining patients 3 are now 2 to 3 1/2 years post-transplantation and exhibit normal homograft function, and 1 died recently of chronic rejection. All conduits functioned well without evidence of ureteroileal obstruction, significant infection or stomal stenosis.

Adolescent↗
PubMed1977

Return of function in the thrombosed kidney after transplantation.

The incidence of intraglomerular thrombi in renal allografts and factors regulating their resolution were studied. A case report is presented in which resolution of intraglomerular thrombi is documented. In addition, 17 transplanted patients with renal biopsies were serially studied. Intraglomerular thrombi were found in 4 of 8 specimens taken 1 h after reanastamosis, all from donors with a terminal course involving prolonged hypotension. Glomerular fibrinolytic activity was markedly diminished in 4 of 11 patients' subsequent biopsy specimens; all taken during acute rejection. Resolution of thrombi was documented when signs of rejection were absent.

Adult↗
PubMed1977

The effect of length of preservation on renal transplant survival.

Pulsatile preservation of cadaver kidneys for periods of 36 to 67 hours does not adversely affect the success rate following transplantation. Immediate urine output correlated well with an increased chance for short and long term transplant kidney function. No kidneys should be discarded because of perfusion periods as long as 36 to 67 hours if the ground rules for organ retrieval and preservation have been followed.

Cadaver↗
PubMed1976

Microvascular techniques for polar artery reconstruction in kidney transplants.

The complications of ureteral ischemia make revascularization of polar vessels attractive in cadaver and live-related transplants. Thirty-two patients underwent reconstruction of polar vessels of 1.2 to 2.5 mm, in diameter after revascularization of the major vessels as follows: (1) inferior epigastric artery to polar artery, ten patients - six cadaver transplants, four living-related transplants (The vessels are spatulated and sutured precisely by microvascular techniques with Nos. 7-0 or 8-0 Tevdek); (2) polar vessel with a patch of aorta to iliac artery, one patient - living relative donor; (3) polar artery to the main renal artery or branch, 17 patients - 14 cadaver transplants, three living-related transplants [A Waters "MOX"-100 machine is used with cryoprecipitated plasma (800 mg. of SoluMedrol and 80 U. of insulin added) for preservation.]; (4) autogenous saphenous vein graft, two patients - one child receiving on adult live-related kidney and one cadaver transplant with three arteries and a stenosis of the inferior polar vessel; (5) polar artery to vein patch in iliac artery, two patients - cadaver transplants. Follow-up was done by arteriography (18 patients), direct observation (two patients), and by use of ultrasound (one patient). The remaining 11 patients have exhibited no evidence of occlusion. Twenty of 21 patients exhibited patent vessels; one thrombosed at the time of the transplant operation. Long-term patency in those patients studied was 95%. We advocate small-vessel reconstruction in human renal transplantation, either during ex vivo preservation (workbench surgery) or at the time of transplantation.

Arteriovenous Shunt, Surgical↗
PubMed1975

An intraluminal technique for arterial occlusion during renal transplantation.

A simple technique was developed for occlusion of atherosclerotic vessels in patients undergoing renal transplantation. Fogarty catheters were placed within the iliac arteries via a stab wound and the balloons inflated to provide safe and gentle occlusion of atherosclerotic vessels during the transplant operation.

Arteriosclerosis↗