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Biomedical subjects

G Kootstra

Publications and source records attributed to G Kootstra.

At least 199 records · Page 11Linked to original sources
PubMed1981

Colon-interposition as replacement for the esophagus. A follow-up study.

The longterm results of the use of colon-interposition as a substitution for the esophagus have been studied. Colon-interposition was carried out in eleven patients. There was one operative death. A second child died of an unknown cause nine years and eight months after operation. Nine patients could be studied from sixteen years and nine months to thirteen months after the operation. In six patients a satisfactory result has been achieved. One child is staying in a psychiatric infirmary. Feeding problems due to recurrent fistulae have led to growth retardation in another patient, while a third patient has regurgitation symptoms. A study of the case histories gives insight into the many early and late complications which occur in this operative procedure. The colon-interposition is a complicated procedure and should only be carried out in centers for pediatric surgery, because of its specific indication, its technique and the occurrence of complications afterwards. The development of alternative, less complicated, methods leaves a restricted indication for colon-interposition.

Adolescent↗
PubMed1981

Total small bowel and colon aganglionosis.

A case of total small bowel and colon aganglionosis is presented and 11 previous cases are briefly reviewed. The relatively long survival of our patient in an excellent condition provided the possibility of studying the behaviour of the aganglionic small bowel, disclosing that in the absence of propulsion, absorption is uninvolved and enteral feeding is possible. Aganglionosis of the ileum does not imply absence of muscle activity (leading to misleading bowel sounds and visible peristalsis on X-ray studies), and often the affected small bowel is dilated. In cases of Hirschsprung's disease with small bowel involvement we recommend as routine a full thickness biopsy of the jejunum, to ensure early diagnosis of the fatal disease of total intestinal aganglionosis.

Colon↗
PubMed1981

The use of paediatric cadaver kidneys for transplantation in adult recipients.

In view of the shortage of cadaveric donors a retrospective study has been performed to determine the results of transplantation of paediatric cadaver donor kidneys into adult recipients. Graft- and patient survival and renal function in the 31 cases analysed in this study showed no adverse effect of the use of paediatric donor kidneys. No vascular complications were encountered. Ureteric leakage occurred in only one case and it was treated successfully. It is concluded that paediatric age is no criterion for donor exclusion and that paediatric donors are to be regarded as a valuable source of cadaveric kidneys for transplantation.

Adult↗
PubMed1981

Results of renal transplantation using grafts from cadaveric donors over 50 years of age.

In view of the persistent shortage of organ donors, the usability for transplantation of cadaveric kidneys from donors over 50 years of age was studied. Out of 5546 cadaveric kidneys, transplanted in the Eurotransplant area in the past ten years, 149 were from donors over 50 years of age. Apart from an increased early graft loss in the advanced age donor group, comparison of cumulative graft survival showed no negative influence of progressing donor age. It is concluded that donors over 50 years of age can be a valuable source of cadaveric kidneys for tranplantation. Inclusion of these donors in harvesting programmes will result in a considerable increase in the amount of potential kidney donors.

Cadaver↗
PubMed1981

[The use of juvenile kidneys for transplantation in adults].

In view of the shortage of cadaveric donors a retrospective study has been performed to determine the results of transplantation of paediatric cadaver donor kidneys into adult recipients. Graft- and patient survival and renal function in the 31 cases, analysed in this study, showed no adverse effect of the use of pediatric donor kidneys. No vascular complications were encountered. In only one case ureteric leakage occurred and was treated successfully. It is concluded that paediatric age is no criterion for donor exclusion and that paediatric donors are to be regarded as a valuable source of cadaveric kidneys for transplantation. Also the possibility to perform nephrectomies in anencephalic newborn infants is to be considered.

Adolescent↗
PubMed1981

Should the upper age limit for cadaveric kidney donors be changed?

In view of the persistent shortage of donor organs a retrospective study was performed to determine whether the upper age limit for cadaveric donors can be changed. As in many transplant centres the arbitrary age limit of 50 years is in use, we studied the results of transplantation of kidneys from donors over 50 years of age. Out of 5546 cadaveric kidneys, transplanted in the Eurotransplant area in the past ten years, 149 were from donors over 50 years of age. Apart from an increased early graft loss in the advanced age donor group, comparison of cumulative graft survival showed no negative influence of progressing donor age. The graft function, measured by creatinine clearance, was satisfactory. It is concluded that donors over 50 years of age can be a valuable source of cadaveric kidneys for transplantation. It seems justified to change the upper age limit for cadaveric kidney donors from 50 to 60 years of age, resulting in a considerable increase in the amount of potential donors.

Adult↗
PubMed1980

Transplantation of contaminated organs.

In cadaveric organ transplantation there is a risk of transfer of infectious agents from donor to recipient. The consequences can be fatal for immunosuppressed recipients. This is illustrated by a case history in which an infection with the fungus Monosporium apiospermum was transferred from a donor to two cadaveric kidney recipients, of whom one died and the other survived with the loss of the graft. These events led to a review of the literature to determine methods of demonstrating possible contamination of donor organs. Analysis of the case history of potential donors, a history taken from relatives or the family doctor, autopsy and laboratory examinations are considered useful. Victims of drowning, patients with severe burns and patients who have been ventilated for a long time are high risk donors.

Abscess↗
PubMed1980

Management of rupture in allografted kidneys.

Allograft rupture is a rare but serious complication in renal transplantation, occurring in 3 to 8.5% of the transplanted kidneys. The consequences for the recipients are fatal in 6% of the cases and graft loss is the outcome in another 53%. Clinical features and treatment of renal allograft rupture are discussed and illustrated by a case history, in which successful management of this complication resulted in salvage of the graft and patient. A literature study with the purpose of determining the pathogenesis of graft rupture revealed that rejection plays a major role.

Adolescent↗