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Biomedical subjects

H Brynger

Publications and source records attributed to H Brynger.

At least 127 records · Page 7Linked to original sources
PubMed1981

Acute rejection and angiography in renal transplantation. A prospective study.

In a prospective randomized study, 25 recipients of primary cadaveric renal grafts with immediate onset of function were studied. Thirteen patients were submitted to a "base line" angiography of the graft on days 5 to 11 after transplantation, while 12 patients served as controls. HLA compatibility, pretransplant blood transfusions, and recipient age differed only slightly between the two groups. Six of 13 patients in the angiographed group showed clinical evidence of acute rejection within the first 14 days after grafting; of these rejections, two were diagnosed prior to angiography. In the control group, 9 of 12 patients rejected their grafts within the first 2 weeks. Thus, there was no indication that renal angiography in the early post-transplant period precipitated acute rejection crises, as has earlier been suggested.

Acute Disease↗
PubMed1981

Children of female renal transplant recipients.

Results of follow-up of 5 children, aged 4.5-9 years, who were born to kidney transplanted mothers are presented. Various immunological parameters were mainly within normal limits with the possible exception of 1 child who exhibited a granulocytopenia which normalized at about 5 years of age. Three children whose mothers were carriers of HBsAg during and after pregnancy have become antigen carriers and show slightly elevated levels of liver transferases. One child has a cardiac anomaly and signs of slight neurological dysfunction. In other respects the children are well and show normal psychomotor and somatic development. The rather sparse information from the literature regarding this group of children indicates a surprisingly low frequency of severe physical complications.

Adult↗
PubMed1981

Blood transfusion in cadaveric renal transplantation-a prospective study.

177 consecutive primary cadaveric renal transplantations were performed during April 1977-October 1980 in our centre. The graft survival in 58 recipients who were transfused with two units of blood for "immunological" reasons was the same as for 107 patients transfused with 1-96 units for medical reasons prior to transplantations. Twelve non-transfused patients had a significantly lower graft survival than the transfused ones (p less than 0.01). No additional beneficial effect of transfusions exceeding two in number was found. When three or more units of blood were given peroperatively to earlier transfused recipients, a lower early graft loss due to rejection was demonstrated than when two or less units were administered. The risk of sensitization of the recipient after two units of leucocyte poor blood was low.

Actuarial Analysis↗
PubMed1981

The living donor in renal transplantation.

During the period 1965-1980, 214 living donor nephrectomies were performed with no mortality and a major complication rate of 2.3 per cent, however, with no permanent sequelae. Longterm psychosocial problems followed five otherwise noneventful nephrectomies. An active, although not aggressive donor recruitment policy is followed. Healthy parents and siblings with HLA-identity or one-haplotype identity are accepted. Maximal efforts are made to provide optimal psychological perioperative and surgical care. Careful postoperative follow-up is pursued. A retroperitoneal approach through a subcostal transverse abdominal incision is employed, the right kidney being preferred. The low immediate and late complication rates paired with superior results of LRD transplantations, justify the continued use of volunteering relatives as kidney donors.

Adolescent↗
PubMed1981

Planned third-party transfusions prior to first transplantations from liver related donors.

Seventy-nine first living related donor transplants performed in Gothenburg, Sweden, from April 1977 to October 1980 were studied. The patient survival was 97% at 30 months. The graft survival in HLA-identical sibling combination was 100%. Thirty previously non-transfused recipients of one-haplotype mismatched grafts were given 2 units of third-party blood as preparation for transplantation. The graft survival was 92% at 30 months. No patients became sensitized against their donor. Thirty-one recipients of haplotype-mismatched grafts, previously transfused for medical reasons, had a graft survival of 82% at 30 months. The deliberate third-party blood transfusion protocol has been rewarding and resulted in a highly satisfactory graft survival.

Antilymphocyte Serum↗
PubMed1981

[Extracorporeal kidney surgery and calicovesicostomy in urothelial tumors of the upper urinary tract].

On the basis of 3 own cases it is reported on a new alternative treatment in otherwise inoperable cases in patients with urothelium tumours of the upper urinary tract. The histologically ascertained transitory cell carcinomas are treated by extracorporeal tumour resection and autotransplantation with calicovesicostomy. Main indications are malignant tumours of the renal pelvis and of the ureter in individual kidneys and in bilateral affection.

Aged↗
PubMed1980

Transplantation in patients with diabetic nephropathy.

In juvenile--onset diabetes uremia is the main cause of death. Since 1972 until Oct. 1979 a total of 47 diabetics have been transplanted in Gothenburg, of these 40 were juvenile--onset diabetics without concomitant renal disease. Twenty-four were male and 16 female. The diabetic nephropathy was not an isolated phenomenon. Complications from other organs were present parallel with the kidney disease. Hypertension was present in 39 of 40 patients before transplantation. Most patients have been transplanted in terminal uremic stage, 21 were on dialysis. The overall mortality at the end of the observation period was 33% but during the later part, that is from 1976 onwards only 2 out of 26 transplanted patients have died so far (8%). Fourteen of these 26 patients were grafted with kidneys from living related donors compared to one of fourteen during the first period. This may be one of the main reasons to the improved results during the last years.

Diabetes Mellitus, Type 1↗
PubMed1980

The social rehabilitation and quality of life in patients living with kidney transplants for more than 10 years.

Forty-six patients lived with kidney grafts for more than 10 years. The kidney function was excellent or good in 35 patients. Thirty-seven patients were in excellent physical and mental condition and were considered fully restored. Nine patients had disabling diseases of varying severity. Thirty-eight patients were employed and several had all their occupational education after transplantation. Nine of the 31 patients of fertile age at transplantation had born or fathered 15 normal children. Forty-six patients who lived with kidney grafts for more than 10 years were very well socially rehabilitated and had reached a quality of life quite comparable to that of people of the same age.

Female↗
PubMed1980

Kidney transplantation in patients 60 years and older.

Between 1967 and 1978 41 patients were transplanted at an age of 60 years or more. The patient survival was approximately 50% at two years. Most of the dead patients died with functioning grafts. Infections and cardiovascular complications dominated as causes of death. Main complications were cardiovascular diseases, infections, musculosceletal diseases and diabetes. During the last three years results have improved and we will continue to offer kidney transplantation to elderly patients in terminal renal failure.

Aged↗
PubMed1980

Active treatment of uremia in the city of Göteborg 1966-1977.

137 patients were actively treated because of chronic uremia, during 1966 to 1977 in the city of Göteborg. One year patient survival increased from 51% (1966 to 1968) to 81% (1975 to 1977). Peritoneal dialysis decreased as the initial mode of treatment, and only 3% of the patients started dialysis treatment with this mode of therapy in the last 3-year period. Mean age of the actively treated patients was 44 years. A decreasing mean age of the actively treated patients was found towards the end of the period, reflecting more liberal criteria for accepting young patients with different systemic diseases. If the initial mode of treatment was dialysis, 1-year patient survival in the last 3-year period was 77%.

Adult↗
PubMed1980

Pretreatment with blood transfusions in primary kidney transplantation.

Since 1977 a deliberate pretransplant transfusion protocol consisting of two units of leucocyte poor blood given minimum 6 weeks prior to transplantation was applied to earlier not transfused recipients of primary renal transplants in Gothenburg. Graft loss due to rejection at 6 months was 17% and 8% in cadaver and one shared HLA-haplotype living donor recipients, respectively. These results were very much superior to those earlier obtained in not transfused recipients in this centre. The risk of presensitization seemed low.

Blood Transfusion↗
PubMed1980

Renal transplantation in patients with polycystic kidney disease in Gothenburg.

The results have been reviewed of 120 renal transplants performed on 82 patients with polycystic kidney disease in Gothenburg. Actual patient survival and graft survival at one year were 64% and 31% resp. Graft survival at three months to 12 months was significantly higher in patients transfused prior to transplantation compared to non-transfused patients. Since there was no difference in the incidence of sepsis or urinary tract infections in nephrectomized compared to non-nephrectomized patients it seems safe to leave polycystic kidneys in situ, provided there are no specific indications for nephrectomy.

Female↗
PubMed1980

Clinical kidney preservation with Sacks' solution.

One hundred and eleven cadaver kidneys were preserved by simple hypothermic storage in Sacks' solution for periods up to 41 hours. All kidneys were viable and in 72% of the cases there was significant graft function within three days. These results compare favourably with our previous experience with machine perfusion. It is concluded that perservation of cadaver kidneys in Sacks's solution is a reliable method for periods up to at least 30 hours which corresponds well to our clinical needs. Simple hypothermic storage is thus today our routine method of preservation.

Cold Temperature↗