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Biomedical subjects

G Lundgren

Publications and source records attributed to G Lundgren.

At least 127 records · Page 7Linked to original sources
PubMed1980

The implications of HLA-DR match for the outcome of cadaveric renal transplantation.

Typing for HLA-DR has been performed in cadaver renal transplantations in Stockholm since 1977, but there was no donor-recipient selection based on HLA-DR. During the period 1977-78 76 cadaver renal transplantations were carried out; in 61 of them typing for HLA-DR was performed. There were 4 exclusions, 2 because of a hyperacute rejection of the graft and 2 because the kidney never started to function after the operation owing to irreversible ischemic damage. In 29 of the 57 transplantations remaining for analysis there was one antigen common to the donor and the recipients, and in 28 there was no common antigen; there was no instance of 2 common antigens. The distribution by degree of HLA-A, -B match was the same for the two groups. Graft survival after one year was better for the group with one common HLA-DR antigen, but the difference was not statistically significant.

Graft Survival↗
PubMed1980

The significance of HLA-A, -B matching for the survival of cadaveric kidney transplants performed in Stockholm in 1970-78.

Of the 320 cadaveric renal transplantations carried out between 1970 and 1978 in Stockholm 308 were analysed with respect to dependence of graft survival on HLA-A, -B matching. From November, 1973, kidneys with 3 or 4 HLA-A, -B incompatibilities were accepted much more often than had previously been the case. All but 7 of the 90 grafts with 3 or 4 incompatibilities were transplanted during that period. In order to obtain as homogeneous a group as possible the transplantations performed during this period were analysed separately, and transplantation performed on diabetic patients and retransplantations were excluded. This material comprising 141 transplantations was examined also with respect to other factors that may have a bearing on graft survival. As regards the factors mean age, pre-transplantation dialysis and blood transfusions, primary diuresis at transplantation and high-dose ALG therapy there was no essential difference between the recipients of kidneys from donors with 1 or 2 HLA-A, -B incompatibilities and the 3 or 4 incompatibility group. Thirteen of the 141 transplantations were fully compatible but because this group was small it was not included in the statistical analysis. After 2 years the group with 3 or 4 HLA-A, -B incompatibilities displayed a significantly poorer graft survival than the one with 1 or 2 incompatibilities (p less than 0.05).

Graft Survival↗
PubMed1980

Cadaveric renal graft survival: the bearing of the number of blood transfusions and of dialysis treatment.

In a series of 229 recipients of first-time cadaveric renal grafts the graft survival figures were better the larger the number of blood units transfused prior to transplantation. However, the difference between the groups receiving transfusions and that which did not was statistically significant only for the groups receiving 4 units or more. For the patients receiving more than 20 units there was an elevated incidence of HBs antigenemia and of HLA antibodies. The kidneys received by these patients tended to be better matched than those of the patients given less blood. Graft survival was significantly better for the patients that had been on dialysis than for those that had not. Dialysis was more strongly correlated to graft survival than was blood transfusion.

Blood Transfusion↗
PubMed1980

Renal transplantation in polycystic renal disease--a joint Scandinavian report.

During the period 1965-1977, a total of 339 patients with polycystic renal disease received at least 1 renal transplant at one of 10 transplant centres in Scandinavia. Patient survival at one year was 67%. The one year graft survival of 319 cadaveric grafts was 40%. The average age of the patient was 56.7 years. Patients who were 60 years or older (93 patients) had a significantly poorer patient and graft survival at one year (50% and 29.5% respectively). Patients receiving kidneys with O incompatibilities did significantly better than other donor-recipient combinations. Previous blood transfusions were associated with better graft prognosis, though the difference was only significant for 2 years. The incidence of posttransplant urinary tract infection (present in 47% of all the patients) was twice as common in patients with a history of pretransplant urinary tract infection (seen in 41% of all the patients). There was no association between posttransplant septicaemia and either pre- or post-transplant urinary tract infection. Only 10.5% of the patients were nephrectomized at the time of transplantation, half of these had urinary tract infection. Twenty-four per cent of the patients were nephrectomized in the posttransplant period, half of these because of infection. There was no difference in the graft survival data of the patients with or without pretransplant urinary tract infection. These findings justify a restrictive practice with regard to pretransplant nephrectomy in patients with polycystic renal disease.

Blood Transfusion↗
PubMed1979

Successful treatment with prednisone and graft-versus-host disease in an allogeneic bone-marrow transplant recipient.

A 51-year-old patient with aplastic anaemia in whom a successful allogeneic bone-marrow transplantation had been performed developed acute graft-versus-host disease in spite of prophylactic administration of methotrexate. There was severe liver injury but no involvement of the skin or intestines. When prednisone therapy was introduced the fever and the eosinophilia disappeared and liver damage was rapidly reversed. There was no haematological impairment. It would seem warranted to consider a wider use of prednisone in the treatment of acute GVHD in human recipients of allogeneic bone-marrow.

Anemia, Aplastic↗
PubMed1979

Effect of physostigmine and atropine on acetylcholine turnover in mouse brain.

The effect of physostigmine salicylate (0.5 mg/kg, i.p.) alone and in combination with atropine sulfate (25 mg/kg, i.p.) on levels of acetylcholine (ACh) and choline (Ch) and turnover of ACh has been studied in whole brain and striatum of mice. The animals were killed by focussed microwave irradiation and the turnover of ACh was studied after i.v. injection of deuterium labelled Ch by employing mass fragmentography. Physostigmine increased the levels of ACh in whole brain from 24.5--28.0 nmol/g(P less than 0.001) whereas there was no significant increase in striatum. The levels of Ch were also increased. The turnover rate of ACh was decreased in whole brain from 15.4 to 8.4 and in striatum from 52.9 to 24.4 nmol/g . min. Physostigmine given before or after atropine did not completely block the ACh lowering effect of atropine. When atropine was given before physostigmine the turnover rate of ACh in whole brain was increased to 24.2 nmoles/g . min. The results seem to indicate that there is no clear cut relation between the turnover rate and level of ACh in vivo. The increase of the turnover rate induced by atropine is masked unless a cholinesterase inhibitor is given to protect the newly synthesized labelled ACh released by atropine.

Acetylcholine↗
PubMed1979

Reticuloendothelial function in human renal allograft recipients.

The phagocytic and metabolic functions of the reticuloendothelial system (RES) were determined, by measuring the plasma clearance rate of 125I-labelled microaggregated human serum albumin and the increase in plasma metabolites of this test substance, in patients with chronic renal failure and in renal transplant recipients at different times after transplantation. All transplant recipients received triple immunosuppressive therapy consisting of azathioprine, corticosteroids, and antilymphocyte globulin. The intravascular clearance of microaggregated albumin was significantly depressed in patients when tested at 1 to 12 days (P less than 0.001), 1 to 4 months (P less than 0.02), and 6 to 9 months (P less than 0.001) after transplantation compared to pretransplantation. The 1- to 3-year transplant survivors had a normal RES phagocytosis. Furthermore, the metabolic RES function in all groups of transplant recipients except the group of patients tested at 1 to 4 months after transplantation was significantly impaired compared to pretransplantation. Administration of antilymphocyte globulin and extremely high daily doses of steroids were probably responsible for the significant depression in the RES functions recorded immediately post-transplantation. The further development of the phagocytic ability of the RES was shown to be correlated to the cumulative dose of steroids given over the last 12 months. The azathioprine regime seemed to have no influence on the RES functions.

Adult↗
PubMed1979

Renal transplantation in insulin-treated diabetics.

In our view, renal transplantation in the uremic diabetic patient is justified. Recipients should be selected with caution. Patients with both loss of vision and heart disease will only rarely benefit from renal transplantation. Living related donor should be preferred if possible.

Adult↗
PubMed1979

Attempt at enzyme replacement in Gaucher disease by renal transplantation.

In Gaucher disease there is a deficiency of the lysosomal enzyme, cerebroside-beta-glucosidase, as a result of which cerebroside (glucosylcereamide) accumulates in various organs. In northern Sweden 22 patients with a juvenile form of this disease have been identified. In one such patient, a girl of 10 years, we have attempted enzyme replacement by renal transplantation. After this operation the hepatic glucocerebroside content fell significantly. In another child afflicted with Gaucher disease in whom splenectomy was performed for severe splenomegaly and hypersplenism there was a progressive increase in the level of this lipid. These findings suggest that enzyme replacement was achieved by transplantation of a normal organ.

Child↗