[EMG study of the external anal sphincter: current diagnostic aids].
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Biomedical subjects
Publications and source records attributed to G Claes.
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An attempt was made to, in a controlled study, avoid hyperacute rejection by pretreatment of a renal graft pepsine digested anti-donor antibodies. It turned out to be unsuccessful, but there were some indications that the chain of events that leads to the destruction of the graft was delayed for some hours. There may be several reasons for this failure but we think it is possible to improve this method even if its importance in clinical use is still doubtful.
A 52-year-old man with an extremely instable insulin-treated diabetes mellitus, were transplanted with a duct-ligated pancreatic segment from a brain-dead donor. The graft showed immediately a satisfying endocrine function. The blood glucose levels were normalized and no exogenous insulin was administered. After five days a clear fluid with high contents of protein and high concentration of amylase started to drain from the wound. The drainage ceased spontaneously after 30 days. On day 41 after transplantation, the function of the graft suddenly stopped. At exploration, the graft was found thrombotized but with a well preserved architecture, and the oversewn end of the graft was intact. The patient is back on insulin treatment, and he is in the same condition as before the transplantation.
In a retrospective study of 173 immediately functioning primary kidney transplants correlation between angiography and renal allograft rejection was studied during the first 14 days. Rejection was more frequent in kidneys undergoing angiography compared to those not angiographied. In kidneys undergoing angiography an overwhelming number of rejections started the day after angiography. These differences could not be explained by differences in HL-A matching or the origin of the kidney. The findings indicate that angiography might elicite an acute rejection. A possible mechanism for starting this reaction might be activation of the complement system.