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Biomedical subjects

H Brynger

Publications and source records attributed to H Brynger.

At least 73 records · Page 4Linked to original sources
PubMed1987

Severe kidney graft rejection in combined kidney and pancreas transplantation.

With a low dose, triple drug protocol for immunosuppression, more frequent and severe rejection episodes, and lower, kidney graft survival appeared after combined kidney and pancreas transplantation than after kidney transplantation alone. With increased immunosuppression using the quadruple drug protocol that includes prophylactic ATG treatment, the results after combined transplantations improved.

Antilymphocyte Serum↗
PubMed1986

HLA-matching and pretransplant blood transfusions in cadaveric renal transplantation--a changing picture with cyclosporin.

613 patients were included in a study to assess the extent to which HLA-matching and pretransplant blood transfusions affect the outcome of cadaveric renal transplantation in patients treated with cyclosporin and low doses of prednisolone. Matching for the HLA-DR-antigens significantly reduced the frequency of rejection episodes, but neither HLA-matching nor pretransplant blood transfusions influenced the patient and graft survival rates.

Analysis of Variance↗
PubMed1986

HLA-matching in cyclosporine treated renal transplant recipients: a prospective Swedish-Norwegian multicenter study.

1. In this prospective study of 613 CD and 205 one haplotype mismatched LRD transplant recipients treated with CyA, there was no influence of HLA-matching (A, B, DR or combinations) on graft survival rate at one and two years. 2. Patients who successfully received HLA-DR-matched kidneys (CD or LRD) had fewer rejection episodes during the first six months after transplantation. 3. Three factors significantly reduced the cadaveric graft survival rate: (a) presence of panel reactive T-cell antibodies in a current recipient serum, (b) cold ischemia time beyond 27 hours, and (c) recipient age above 55 years. 4. The survival rate of one haplotype mismatched LRD kidneys was excellent and is considered to be the optimal treatment for uremia also in CyA-treated patients. 5. Based on this study, exchange of well HLA-matched CD kidneys to non-sensitized patients has been terminated provisionally in Scandia-transplant. Exchange of HLA-A, B-matched kidneys will be maintained, however, for sensitized patients inasmuch as this will increase the chance of obtaining a negative cross-match and possibly improve graft survival in this high-risk patient group.

Cyclosporins↗
PubMed1985

Streptozotocin diabetes in juvenile pigs. Evaluation of an experimental model.

Spontaneous diabetes in the domestic pig, an animal suitable for metabolic and endocrine studies and for experimental surgery, is extremely rare. In this study we have compared the diabetogenic response of various doses of streptozotocin in comparison to surgically induced diabetes. Streptozotocin in a low dose, 35 mg/kg body weight did not influence glucose metabolism while an intermediate dose, 85 mg/kg, resulted in a transient diabetic reaction. Streptozotocin, 100-150 mg/kg body weight, caused a complete and permanent diabetes. Animals made diabetic by means of pancreatectomy did not survive more than 10 days due to their poor general condition and diabetes. Streptozotocin induced diabetic animals survived with insulin treatment up to seven months. The results show that juvenile pigs made diabetic with 100-150 mg/kg body weight of streptozotocin may be useful in experimental work on glucose-, insulin- and C-peptide-metabolism in a large animal. Therefore it is potentially useful in pancreatic transplantation research.

Animals↗
PubMed1985

Emergency ligation of the external iliac artery.

During a 19-year period, 35 of 1526 renal transplant operations were complicated by gross hemorrhage from infected arteriotomies. In 13 patients the common or external iliac artery was ligated and resected without immediate reconstruction for arterial continuity. There was no mortality from this procedure, and there was no limb loss. Early signs and symptoms of arterial insufficiency were rapidly reversed in most patients. Six patients, presently alive and 4-10 years after iliac artery ligation, were subjected to follow-up examinations of their distal circulation. One hemodialysis patient had slight symptoms of intermittent claudication, while the others were totally free of symptoms during daily activities. All patients had adequate distal arterial blood pressures. Postischemic maximal blood flows, obtained in three patients, were only slightly decreased. It is concluded that, for control of massive hemorrhage from infected arteriotomies in renal transplant patients, the iliac arteries can safely be ligated without immediate arterial reconstruction. The risk of limb loss is little but necessitates optimal postoperative support of the patient and close surveillance for early detection of irreversible arterial insufficiency.

Adult↗
PubMed1985

Function of human autologous kidney grafts after extracorporeal preservation with Sacks' II solution.

The function of 18 human kidney grafts was studied before and 3 months after autotransplantation without prior bench surgery on the parenchyma or the vessels. Kidney protection was accomplished by pre-treating the patient with mannitol and low molecular weight dextran solution and flushing the kidney with a Xylocaine-heparin mixture and cold Sacks' II solution. The mean cold ischaemia time was 239 min (range 140-345 min). The glomerular filtration rate (GFR) remained unchanged post-operatively in terms of both total and split kidney GFR. Proximal and distal tubular integrity, as studied by determination of beta2-microglobulin excretion and concentration ability respectively, was also preserved.

Adult↗
PubMed1985

Proteinuria and renal function in kidney transplant donors 10-18 years after donor uninephrectomy.

Ten to eighteen years after donor uninephrectomy (UN) the compensatory increase in renal function is maintained. Albuminuria was slightly increased in a few donors compared to the controls. We found no evidence for donor uninephrectomy to carry a risk for progressive renal failure. Further studies 2-3 decades after UN will provide additional insight in how UN affects the development of proteinuria and renal function.

Adult↗
PubMed1985

Clinical experiences with phosphonoformate (foscarnet) treatment of viral diseases following renal transplantation.

The effect of the antiviral drug phosphonoformate (Foscarnet) was studied in 32 patients following renal transplantation. Viral diagnosis was verified in 29 of 33 episodes of suspected clinical virosis. The clinical effect of Foscarnet was good in 12 of 14 primary cytomegalovirus infections. In 5 of 7 varicella-zoster virus, in 4 of 6 secondary cytomegalovirus and in 2 herpes simplex virus (type 1; type 2) infections the effect of the treatment was clinically judged as good. The beneficial effect could in these patients be overestimated as the natural courses of the viral infections were unknown. No clinical side effects of Foscarnet were found. Clinically unimportant changes in s-calcium were noted in 6 patients. The dosage of Foscarnet was increased during the study. At present an initial bolus dose followed by 14 days of parenteral infusions can be recommended.

Adult↗
PubMed1985

Malignant disease in renal transplant patients.

The incidence of malignant disease (renal cancer and skin cancer excluded) was analyzed in 934 renal transplant patients from one center, transplanted between 1965 and 1981, and followed through 1983. National Cancer Registry data were used for statistical comparison. Cancers of the lip, vulva, and anus and malignant lymphomas were heavily overrepresented. Other types of malignancy did not occur with increased frequency, with the exception of a possibly incidental finding of a 5-fold increase in colorectal cancer.

Adenocarcinoma↗