Humoral and cellular immunity to paternal antigens in trophoblastic neoplasia.
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Biomedical subjects
Publications and source records attributed to J B Dossetor.
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Details are presented of three aspects of immunological monitoring in a single instance of severe irreversible rejection of a renal allograft. Rejection is associated with strong evidence of lymphocyte mediated cytotoxicity (LMC). During this period reduced responsiveness of recipient cells to stimulation in vitro by donor cells is observed; this is more reduced than is responsiveness to random cells. Donor-specific suppressor cells also develop, as detected in two systems. It is postulated that the data are evidence that competition exists between different agressive and suppressive subpopulation of recipient lymphocytes.
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The results of treatment in 213 patients with end-stage renal disease who underwent hemodialysis, peritoneal dialysis or transplantation, or a combination, between 1962 and 1975 were analysed. Comparison by censored survival analysis showed significantly better (P less than 0.01) patient survival with the integrated therapy of dialysis and transplantation than with either form of dialysis alone. There was no significant difference in survival of males and females but survival at the extremes of age was poorer. Analysis of survival by major cause of renal failure indicated best survival in patients with congenital renal disease. Graft and patient survival rates at 1 year after the first transplantation were 42% and 69%. The major cause of death in this series was vascular disease but infection was responsible for 50% of deaths after transplantation. While integration of dialysis with transplantation produces best patient survival, this course is possible only when sufficient cadaver kidneys are available.