Search PubMed⌕ Search

Biomedical subjects

J Ahonen

Publications and source records attributed to J Ahonen.

At least 109 records · Page 6Linked to original sources
PubMed1991

The association of HLA-DR antigens with acute steroid-resistant rejection and poor kidney graft survival.

The association of an early steroid-resistant rejection (SRR) with HLA-DR antigens was analyzed in 410 kidney transplantations. A severe SRR leading to a poor (45%) 1-year graft survival (GS) occurred in 22 transplantations (5%). An acute reversible rejection (ARR) with a GS of 94% was found in 80 transplantations (20%). For the 308 (75%) transplantations with no early rejection episodes the GS was 91%. HLA-DR5 and -DR8 present in the donor as incompatible antigens were strongly associated with SRR. Further, a mismatched DR1 from the kidney donor predicted a rejection, either reversible or irreversible. These findings may have practical implications for an early diagnosis of SRR and for considering of rescue therapy whenever transplantation with disparities in these loci has been performed.

Adult↗
PubMed1991

Renal allograft immunosuppression. IV. Comparison of lipid and lipoprotein profiles in blood using double and triple immunosuppressive drug combinations.

Serum lipid and lipoprotein profiles were performed in order to investigate lipid abnormalities 2 years post-transplantation in first cadaveric renal allograft recipients immunosuppressed with cyclosporin (CyA), azathioprine (Aza), and methylprednisolone (MP), or with any combination of two drugs. CyA was used in low doses. Total serum cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, HDL2 cholesterol, HDL3 cholesterol, apolipoprotein A1, and apolipoprotein B were determined in 88 prospectively randomized patients with functioning grafts. When considering only the patients who remained on the original randomized treatment, there were no significant differences between the four groups in any of the measured variables. Mean total cholesterol was highest in the group receiving Aza and MP (6.8 mmol/l) and lowest in the group receiving triple therapy (5.8 mmol/l; NS). Mean triglyceride level was highest in the group receiving Aza and MP (2.3 mmol/l) versus 1.8-2.2 mmol/l in the groups receiving triple therapy, Aza + CyA, and CyA + MP. For all patients mean triglyceride level was highest in the group receiving Aza and MP (2.7 mmol/l) and lowest in the group receiving triple therapy (1.7 mmol/l; P less than 0.05). Mean HDL cholesterol ranged from 1.5 to 1.6 mmol/l in all groups. Neither CyA concentration nor CyA or MP dose correlated with cholesterol or triglyceride concentration. However, the average MP dose was twice as high in the group receiving Aza and MP as in the other two groups employing steroids. Serum cholesterol and triglyceride concentrations were related to body mass index (r = 0.28, P = 0.045 and r = 0.30, P = 0.029, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Renal allograft immunosuppression. VI. Triple drug therapy versus immunosuppressive double drug combinations: histopathological findings in renal allografts.

The long-term effects of different immunosuppressive drugs and regimens on renal allograft histology are virtually unknown. Therefore, in order to investigate the long-term effects of triple drug treatment versus different combinations of two immunosuppressive drugs on allograft histology, a prospective, randomized trial was performed. One group received triple therapy consisting of low-dose cyclosporin (CyA), azathioprine (Aza), and methylprednisolone (MP), and three groups received combinations of two drugs, i.e., Aza plus CyA, Aza plus MP, and CyA plus MP. At 2 years, there were no significant differences with regard to graft (80%) or patient (87%) survival, or to graft function between the four groups. After 2 years, a protocol core biopsy was taken of all 102 patients having a functioning graft. Of these patients, 61 (60%) were still following the original, randomized treatment protocol; in the remaining cases, changes had occurred in the original protocol and so these cases were considered drop-outs in this study. Histological specimens were examined blindly by two independent observers. Most of the 34 histological variables examined showed no changes. Diffuse fibrosis was most frequent in the CyA plus MP group (70%) and significantly more severe than in the triple therapy group. Mesangial matrix increase in glomeruli was significantly less common in the triple therapy group (8%) than in any one of the double drug combination groups (47%). Two other changes in glomeruli--Bowman capsular thickening and global glomerular sclerosis--were also less frequent in the triple therapy group.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Therapy, Combination↗
PubMed1990

The effect of intravesically applied antibiotic solution in the prophylaxis of infectious complications of renal transplantation.

The effect of intravesically applied antibiotic solution in the prevention of infectious complications of renal transplantation was evaluated in a prospective, randomized study. The bladder was filled preoperatively with saline solution containing cephalotin in the test group, and with saline solution only in the controls. Both groups of patients received IV doses of cephamandole during, and once after, surgery. Two hundred consecutive patients were randomly allocated to the study groups. The overall incidence of urinary tract infection was 10.4% during the first 4 postoperative weeks; that of wound infections was 1.6% and of septicemia 3.3%. The addition of cephalotin to the bladder irrigation fluid did not have any effect on the overall incidence of infectious complications.

Administration, Intravesical↗
PubMed1990

Short-term high-dose corticosteroids and gastroduodenal mucosa. A prospective clinical study on renal transplant recipients.

In order to evaluate the effect of a short-term high-dose corticosteroid therapy on the gastric and duodenal mucosa, 30 consecutive renal transplant recipients (mean age 39.1 years, 10 women and 20 men) underwent an endoscopic examination of gastroduodenal mucosa 12 and 30 days after renal transplantation. In addition to the postoperative immunosuppressive medication (methylprednisolone and azathioprine), antacids and H2-receptor antagonists were given. Seventeen patients showed no signs of acute rejection, whereas 11 patients experienced one episode and 2 patients two episodes of rejection during endoscopic follow-up. Each rejection episode was treated with a high-dose regimen of methylprednisolone. The two groups of patients studied, i.e., those who did and those who did not experience rejection, were matched for age, sex, period of preoperative dialysis treatment, period of postoperative time elapsed from transplantation, serum creatinine level, and dose of methylprednisolone or azathioprine at the beginning of the endoscopic follow-up, as well as for ulcer prophylactic medication during follow-up. The gastroduodenal mucosa was similar in the two patient groups, both endoscopically and histologically, at the start of the study. During the observation period of 2 weeks, erosive antral gastritis increased significantly in patients who did not experience rejection, whereas in patients with acute rejection and concomitant high-dose corticosteroid therapy, the antral mucosa remained nearly unchanged. Also, the gastric corpus and the duodenum remained unaltered in both groups during follow-up. No ulcer complications occurred in the series.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

The value of repeated renal retransplantations.

The outcome of 64 repeated renal retransplantations (50 third, 13 fourth, and 1 fifth) during a period of 25 years was retrospectively evaluated. The prognosis of third and subsequent grafting was greatly improved if cyclosporine was included in the induction immunosuppressive regimen (one-year graft survival 79.9%, compared with 32.4% if CsA was not used). The onset of graft function was not delayed by CsA and the proportion of never functioning grafts was significantly lower (5.3%) in patients treated with CsA than in those treated without it (43.2%). Survival of the previous grafts for longer than one year favorably influenced the outcome of the subsequent grafts.

Adult↗