Experience in one center of combined kidney and liver transplantation in 22 patients: incidence of graft rejection and long-term graft outcome.
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Biomedical subjects
Publications and source records attributed to G Benoit.
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1,224 renal transplant patients were studied. 50 kidneys were obtained from living related donors. The mean age of the recipients was 34.6 years (16.8 to 67.6 years) Ureteric reimplantation was initially performed by uretero-ureteric anastomosis (19%), then into the bladder according to the Leadbetter-Politano technique (69%) and subsequently according to the Lich-Gregoire extra-vesical technique (10%). A cutaneous ileostomy or reimplantation into the renal pelvis was performed in the remaining 2% of cases. The risk of one or more urological complications was 11.2% (137/1,224) and 7.9% when only those patients requiring surgical intervention were taken into account. These complications were classified into 3 categories: strictures (60.6%), fistulae (35.8%) and stones (6.6%). The frequency of urological complications was lower with the Lich-Gregoire technique (4.1%) which we have currently adopted. The renal transplant was lost in 6.1% of cases directly related to a urological complication. The presence of urinary tract fistulae had an unfavourable influence on graft survival due to detransplantations. Whenever possible, our preferred approach consists of percutaneous and/or endourological techniques as first-line treatment followed by second-line surgical treatment in the event of failure of the percutaneous approach.
Out of a series of 614 renal transplantation performed over a 4-year period, using cyclosporin and cimetidine, 100 patients developed a gastrointestinal complication: 9.6% of gastroduodenal ulcers, 4.4% of intestinal complications, 1.3% of pancreatic complications. 7 patients died: 5 from stress haemorrhages, 2 from peritonitis secondary to intestinal perforation. 32% of patients who developed an ulcer had a history of ulcer, but none of them developed a serious complication of their ulcer under cimetidine treatment. 18% of patients with colonic diverticula developed a diverticular complication after transplantation. The patients who died died from stress haemorrhage generally in a context of sepsis or from peritonitis secondary to intestinal perforation diagnosed after a delay of 24 hours.
The association between chronic lymphocytic leukemia and a solid tumor is well known. When the leukemia appears before the tumor a question may be asked : is the tumor a cancer or a localisation of the leukemia ? When the cancer is diagnosed before the leukemia, an other question may be asked : is it a true leukemia or is it a paraneoplasic leukemoid reaction ?
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Plasmatic concentrations of thyroxine (T4-D-) and triiodothyronine (T3 RI) were evaluated in 32 Graves' diseases on treatment by carbimazol. Among 131 measures, T4 and T3 were dissociated in 56%, with T3 more elevated than T4 in 89%. Compensated hypothyroidism was frequently seen (35%).