Interaction of oxotremorine and hemicholinium on brain acetylcholine formation in vitro.
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Biomedical subjects
Publications and source records attributed to G Lundgren.
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In 45 recipients of intrafamilial kidney transplants, the one year survival of sibling grafts was 95% and of parental grafts 71%. HL-A compatible grafts had a one year survival of 94% compared to 75% of HL-A incompatible grafts. At the same time, the survival of MLC compatible grafts was 100% and that of MLC incompatible grafts 74%. These differences are not statistically significant but suggest a prognostic importance of MLC, as well as HL-A matching. MLC compatibility might be more crucial than HL-A compatibility. MLC test performed after transplantation when the recipients were on maintenance immunosuppressive therapy, did not show reduced reactivity of recipient lymphocytes as compared to tests performed prior to surgery.
The study comprises 101 cadaveric kidneys transplanted in the last three years (1971-1974). Twenty-one retransplantations were included since the graft and patient survival in this group were equivalent to primary transplantations. There were 13 compatible grafts (A and B matches), 29 displaying one incompatible antigen (C match), 35 with two (D match) and 24 with 3 or 4 mismatches (E and G matches). At 9 months, there was a significantly lower graft survival in the E and G match group (33%) compared to the rest (p less than 0.01). For reasons discussed we will, however, for the first time being continue to transplant also the badly matched cadaveric kidneys.
Avascular necrosis of bone is a serious complication associated with steroid therapy in high dose. Ninetynine patients with functioning renal allografts transplanted 1964-1973 and subjected to steroid therapy were examined with regard to this complication. Osteonecrosis developed in 8 patients afflicting 13 joints. The process was localized to the femoral head, the condyles of the femur, tibia and the head of the humerus. The symptoms became manifest 7-33 months after the first transplantation. The severity of the disorder in 3 patients did not allow rehabilitation by conservative means. The roentgenographic, scintigraphic and clinical findings are described and the orthopaedic treatment discussed.
In 248 kidney transplant recipients, 28 (11%) developed serious gastrointestinal complications after the transplantation. Upper gastrointestinal bleeding was the most common complication and accounted for 19 of the cases. Most of the haemorraging occurred during the first 6 months after transplantation and in conjunction with an episode of graft rejection. The mortality following upper gastrointestinal bleeding was 58%. Other serious complications encountered were lower gastrointestinal bleeding (4 cases), perforation of the colon (4 cases) and mesenteric vascular occlusion (1 case). Overall mortality was 43%.
In 30 chronically uremics, 37 renal transplanted patients and 31 controls, the number of T- and B-cells was calculated as well as the lymphocyte response to the mitogens PHA, Con A and anti-B2m. In uremics the relative number of T-cells was normal, the number of B-cells was reduced and the response to mitogens was suppressed. During the early post transplantation period the relative number of both T- and B-cells was reduced as well as the mitogenic response. Following three months of successful transplantation the relative counts of T-cells and the response to mitogens returned to normal. The relative number of B-cells remained lowered however.
Three patients reveived segmental pancreatic transplants. In two the main indication was hyperlabile diabetes, and in the third progressive loss of vision. Vascular anastomoses were to the iliac vessels, the graft being placed extraperitoneally. The pancreatic duct was ligated in the first case, while the other two, the transected end of the pancreatic graft was implanted into a jejunal Roux-Y loop. Two of the patients had normal blood glucose levels without insulin administration for 40 and 35 days, respectively. The grafts then underwent rejection and were removed. In both cases the postoperative course was complicated by pancreatic fistulae. In the 3rd patient the graft failed on the day after operation, due to venous trombosis.
In Sweden, organs for transplantation can not be removed from cadaver donors until cardiac arrest has occured. We describe a technique for removal of kidneys and pancreas in which the whole abdominal contents are freed and reflected so that the retroperitoneal organ lie uppermost. The aorta is opened longitudinally and the relevant arteries are cannulated via the orifices. Cold perfusion of the three organs can usually be initiated 5-15 min after cardiac arrest and significant ischaemia is avoided. The full length of the vascular pedicles can be preserved and the dissection of the retroperitoneal organs is greatly facilitated.