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Biomedical subjects

J F Mahony

Publications and source records attributed to J F Mahony.

At least 37 records · Page 2Linked to original sources
PubMed1989

Immunoglobulin abnormalities in renal transplant recipients.

Five renal transplant recipients were observed to have recurrent infections in association with low serum immunoglobulin levels. They have benefited from parenteral gamma globulin therapy. Following this observation, 110 renal transplant recipients were assessed; 46% had abnormal serum immunoglobulins with 4 patients identified as having monoclonal gammopathies, 8 polyclonal gammopathies, and 39 low levels of 1 or more immunoglobulins. Those with abnormal serum immunoglobulins had been immunosuppressed longer, but maintenance immunosuppression dosage was not different from those with normal immunoglobulins. Respiratory tract infection and skin cancer were more frequent in those with low immunoglobulin levels.

Adolescent↗
PubMed1989

Peritoneal morphology on maintenance dialysis.

Thirty-eight peritoneal biopsies from 37 patients with normal renal function or with end-stage renal failure without replacement therapy or utilizing continuous ambulatory peritoneal dialysis (CAPD), haemodialysis (HD) or a functioning transplant were examined histologically. No abnormality in peritoneal membrane morphology was observed in uraemia in the absence of dialysis. Significant abnormalities of peritoneal membrane morphology were observed in association with CAPD, the predominant finding being the development of peritoneal fibrosis which had a deleterious effect on membrane function. Abnormal peritoneal morphology was less commonly observed in patients on maintenance HD and with functioning transplants but may have implications regarding the future use of CAPD in these patients.

Adult↗
PubMed1989

Loss of ultrafiltration in continuous ambulatory peritoneal dialysis (CAPD).

Fifteen patients on long-term continuous ambulatory peritoneal dialysis (CAPD) were assessed with respect to net ultrafiltration capacity. Eight patients were defined as having good and seven as having poor ultrafiltration on the basis of net ultrafiltrate obtained/mmol glucose infused. Subsequently, dialysate was sampled at times 0, 1, 15, 30, 60, 90, 120, 180, and 240 min. No difference in residual volume was observed between the groups. A significantly greater decrease in dialysate sodium during the initial dialysis period in those patients with good as compared to those with poor ultrafiltration occurred, reflecting a greater transcapillary movement of electrolyte poor ultrafiltrate. In those with good ultrafiltration, glucose transfer was normal in five and rapid in three, suggesting the latter had low rates of lymphatic reabsorption. Five of seven patients with poor ultrafiltration had no fall in dialysate sodium in association with a high rate of glucose transfer, suggesting a low rate of transcapillary water movement and normal to high lymphatic absorption. Two patients with low ultrafiltration had an initial fall in dialysate sodium with a normal glucose transfer and thus net ultrafiltration is low due to elevated lymphatic reabsorption. We thus propose that the relative contribution of transcapillary water movement and lymphatic reabsorption can be determined by assessing net ultrafiltration and dialysate sodium concentration in conjunction with solute transfer.

Biological Transport↗
PubMed1989

Problems associated with pregnancy in renal allograft recipients.

Of 18 pregnancies in 11 renal transplant recipients, three were terminated and in the remaining 15 (in 8 women) there were 10 live births (including one set of twins), five intrauterine deaths, and one spontaneous abortion. Graft function deteriorated in six women, from obstruction of the transplanted ureter in two, recurrent glomerulonephritis in two, rejection in one, and pelvi-ureteric junction obstruction in one. Hypertension worsened or developed in all but one of the pregnancies and proteinuria appeared in eight. Of the 10 live births only one reached 38 weeks gestation (mean 35 weeks) and four neonates were small for gestational age. One infant died early from intraventricular hemorrhage and hyaline membrane disease, one fetus had hydrocephalus, and the others were normal. Factors associated with a poor fetal outcome were deterioration in graft function during pregnancy, pre-existing hypertension, or the development of hypertension before the third trimester.

Abortion, Induced↗
PubMed1986

Phenacetin and papillary necrosis: independent risk factors for renal pelvic cancer.

A case-control study was undertaken to determine whether renal papillary necrosis (RPN) is an essential step in the genesis of analgesic-associated cancer of the renal pelvis (CaP). Kidneys of 66 patients (and 86 cases of renal parenchymal cancer (CaK), for comparison) were examined for evidence of RPN. Information concerning past consumption of phenacetin-containing analgesics (PhA) was obtained from all cases and 751 population controls by means of a questionnaire. Separately, RPN and regular consumption of PhA each conferred a relative risk for CaP of 3-1/2 to 7, while together they increased the risk some 20 times that for non-consumers without RPN. This suggests that each factor has independent, and when they coexist sequential, effects. The risk for CaK was doubled by regular PhA consumption but was not increased by RPN.

Aged↗
PubMed1986

Successful pregnancy in a renal transplant recipient taking cyclosporin A.

A 27 year old woman with a fourth cadaveric renal transplant successfully completed a 33 week pregnancy whilst taking cyclosporin A and prednisolone. Her renal function remained stable despite recurrent urinary tract infections, hypertension, gestational diabetes, and Clostridium difficile associated diarrhea. The infant, delivered electively at 33 weeks, was small for gestational age but otherwise normal.

Adult↗
PubMed1985

Myelodysplasia in cadaver renal allografts: a report of four cases.

A report of four cases of severe myelodysplastic syndromes (MDS) culminating in death in cadaver renal recipients is presented. All patients received predominantly antimetabolite immunosuppressive therapy. Abnormal cytogenetics were found in two cases. Survival was brief in all cases from the time of diagnosis. These cases add to the increasing number of patients treated with antimetabolite drugs for nonmalignant conditions who develop severe hematological abnormalities which might be a prodrome of acute nonlymphocytic leukemia.

Adult↗
PubMed1983

The vascular lesions associated with skin necrosis in renal disease.

Three renal allograft recipients and one uraemic patient presented with skin necrosis. In all cases, the subcutaneous arteries and arterioles were narrowed or occluded by mural calcification with or without intimal fibrosis. A review of the literature shows that uraemic patients or allograft recipients with skin necrosis involving the trunk or thighs have a poor prognosis while recovery is common in patients with more peripheral lesions. The aetiology of the arterial lesions is unknown. Their relationship to renal disorders and/or hyperparathyroidism is uncertain and therapy remains unsatisfactory.

Adult↗
PubMed1982

Delayed complications of renal transplantation and their prevention.

The complications of cadaveric renal transplantation in a group of 10-year survivors are presented. Fifty-two (44%) of 119 graft recipients survived more than 10 years, 48 with their original allograft. The major causes of death in the others were bacterial (24%) and other (10%) infections, cerebral (12%) and myocardial (7.5%) vascular disease. Serious morbidity in the survivors included infectious episodes (55%), skin cancer (40%), vascular disease (30%), cataracts (45%) and aseptic necrosis of bone (13%). Only six (12%) patients had no complications. Although complications were frequent, 34 patients (72%) were fully rehabilitated to work or household duties. Several recipients have become parents. Prevention of the late complications of transplantation must be aimed at reducing the known risk factors early in the course of renal failure. These include hypertension, obesity, cigarette smoking and sun exposure.

Adolescent↗
PubMed1982

Long-term survival after cadaveric renal transplantation.

In a series of 404 consecutive first cadaver kidney transplants performed since 1967 the actuarial five- and 10-year survival of patients were 61% and 47% respectively and of grafts 46% and 36%. In more than four-fifths of the patients surviving these intervals the original cadaveric grafts were functioning at these times, and most of the remainder were sustained by subsequent grafts. Although graft survival has remained static since 1967, patient survival improved. Results for 43 consecutive second cadaver transplants were similar after five years to those of first grafts. These results promote the acceptability of cadaveric transplantation as a long-term treatment for chronic renal failure.

Adolescent↗
PubMed1982

Heinz-body haemolysis in haemodialysed patients caused by chloramines in Sydney tap water.

In August 1981, there was an outbreak of Heinz-body-positive haemolytic anaemia among patients who were undergoing dialysis in Sydney Hospital. This appeared to be due to excessive chloramines in and inadequate carbon filtration of, the water used for haemodialysis. After improvement of the carbon filtration system, there have been no further cases of anaemia.

Anemia, Hemolytic↗
PubMed1982

Treatment of renal transplant artery stenosis by percutaneous transluminal dilatation.

Transluminal arterial dilatation using a balloon catheter was performed in four patients with renal allografts and transplant artery stenosis. In three patients the procedure was uncomplicated and resulted in reduction in mean blood pressure from 180/100 mm Hg to 135/85 mm Hg immediately after and 135/90 mm Hg at a mean of eight months after angioplasty; renal function remained stable. In one patient with two stenoses the procedure was abandoned because of inaccessibility of the stenotic sites to the dilatation catheter; however, reversible acute renal failure ensued. Percutaneous transluminal angioplasty may thus offer a successful alternative to conventional surgical techniques in renal transplant artery stenosis in suitable patients.

Adult↗