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Biomedical subjects

J McCauley

Publications and source records attributed to J McCauley.

At least 91 records · Page 5Linked to original sources

[Clinical experience with FK 506].

FK 506 is a superior immunosuppressive agent that should improve patient survival after the commonly performed transplant procedures, make feasible transplantations that have been previously impractical, allow immune intervention for serious autoimmune diseases, and create a better spin-off understanding of basic biologic processes including signal transduction.

Autoimmune Diseases↗

The question of FK 506 nephrotoxicity after liver transplantation.

Formal studies have not been published on the nephrotoxicity of FK 506 when the drug was used from the outset. This kind of information was sought in 101 recipients of primary livers, 24 hearts, and 3 double lungs or heart-lung. Perioperative renal dysfunction was commonly seen, which appeared to be related to FK 506 doses and plasma levels, particularly when the drug was given IV. This was reversible. Late renal function has been generally satisfactory in all three cohorts of patients, and the incidence of hypertension has been low. The therapeutic index of FK 506 is a good one, as revealed by these observations in patients whose most notable achievement was a low mortality.

Anti-Bacterial Agents↗

A comparison of the renal effects (ERPF, GFR, and FF) of FK 506 and cyclosporine in patients with liver transplantation.

1. The mean "cost" in milliliters per minute of ESLD alone, prior to transplantation, was 35% + 23% (1 SD). In GFR it was 15%. 2. The additional burden of CyA + OLT increases the loss in ERPF an additional 18%; in GFR, it increases loss another 10%. Thus, the total loss in CyA-treated patients was 53% and 25%, respectively. 3. The decrease imposed by FK 506 + OLT on ERPF was only 7%, with no decrease in GFR. 4. Therefore, from the renal point of view, FK 506 would appear to be the superior drug. 5. The large error around mean values underlines the desirability of performing these tests on the individual patient rather than on information from groups, since many values fall near the threshold of the azotemic range (ERPF approximately 175 mL/min). 6. As renal mass was compromised, ie, fall in the ERPF, the GFR increased relatively, ie, the renal filtering membrane became more permeable and the FFs gradually increased. 7. The loss of renal function was significantly less in OLT patients on FK 506 than CyA. However, the greatest loss in expected renal function was due to the basic ESLD itself.

Adult↗