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Biomedical subjects

J Szmidt

Publications and source records attributed to J Szmidt.

At least 73 records · Page 4Linked to original sources
PubMed1981

Hepatic lesions in dogs treated with horse antidog lymphocyte globulin (HADLG) after kidney transplantation.

Microscopical examination of the liver of dogs which after allogenic kidney transplantation were transiently treated with antilymphocyte globulin revealed infiltrates of mononuclear cells (lymphocytes, plasma and reticulum cells). These infiltrates were usually situated in perivascular spaces (around the central veins or on the portobiliary tract). A proportion of capillaries showed endothelial proliferation and the narrowing of their lumen. The authors were unable to determine whether these lesions resulted from the direct toxic effect of antilymphocyte globulin or represented a nonspecific reaction to the used preparation.

Animals↗
PubMed1980

Inductive displacement gauge.

Strain gauges are often used for the measurement of contractile activity of muscle tissue. In these cases the strain gauge is used as a force measuring device. Because of its stiffness, the strain-gauge-type transducer resists changes in length produced by contraction, and this could cause secondary effects. This paper describes an alternative method to evaluate contractions. Displacement rather than force is measured. The device offers very little resistance to motion and thus does not constrain the tissue. The sensitivity of the transducer is very high. An additional feature is the low cost of the transducer compared to strain-gauge devices.

Action Potentials↗
PubMed1979

Factors responsible for the functional pattern of cadaveric kidneys stored up to 25 hours before transplantation.

The functional outcome after the transplantation of 97 cadaveric kidneys stored up to 25 hours with simple hypothermia was analysed in relation to age of donor, extent of pre-agonal kidney damage, the length of warm, cold and standardised ischaemic times and the presence of multiple renal arteries. Analysis of various factors showed that the most important for function after transplantation were pre-agonal anoxic damage and the ratio of the cold/warm ischaemia time. Based on that observation, a diagram has been proposed which allows calculation of the safe cold storage time after retrieval of the kidney.

Adolescent↗
PubMedDate not supplied

Duodenal patch and sphincterotomy: modification of an old technique to prevent graft pancreatitis.

The aim of this study was to preliminarily evaluate the duodenal patch technique combined with open sphincterotomy in terms of prevention of graft pancreatitis. From April 2003 to March 2005, 17 simultaneous pancreas and kidney transplantations were performed using this technique. All recipients are alive with good renal transplant function. Directly after sphincterotomy in 16 pancreatic grafts a good outflow of clear pancreatic juice and a lessening of graft tenseness were observed during surgery. In two transplants an additional sphincterotomy of the Santorini duct sphincter was necessary. In one recipient no pancreatic juice secretion was observed and insulin independence was not obtained. This graft was explanted shortly afterward. In 13 recipients no graft pancreatic or peripancreatic fluid collection requiring intervention was observed. Of the three recipients who developed graft pancreatitis, two required graft pancreatectomy. In conclusion, Sphincterotomy facilitates pancreatic juice outflow by reducing intraoperative graft edema, which could lead to subsequent inflammation. Further studies on the factors inducing graft pancreatitis are necessary to eliminate this severe complication.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Use of drotrecogin alpha (recombinant human activated protein C, rhAPC) in the treatment of severe sepsis induced by graft pancreatitis after simultaneous pancreas and kidney transplantation: a case report.

We present our experience with recombinant human activated protein C (rhAPC) to treat a 40-year-old preemptive simultaneous pancreas-kidney transplant (spktx) recipient who developed septic shock due to graft pancreatitis. We diagnosed intra-abdominal septic complications with septicemia induced by multiple pathogens and cardiopulmonary insufficiency. Until the 59th posttransplant day, 21 peritoneal lavages were performed to treat peritonitis and intra-abdominal abscesses. On the 53rd day when septic shock was diagnosed, rhAPC was administered, after which the patient improved, vasoconstrictive agents were reduced, and respiratory insufficiency resolved. The Physiologic and Operative Severity Score for enumeration of Mortality and Morbidity (POSSUM) scale showed a decrease in predicted mortality from 93% to 17% on day 7 after rhAPC initiation. The patient was discharged at 128 days after spktx with good function of both grafts. Administration of rhAPC limited systemic inflammatory response syndrome (SIRS) and may be considered when faced with the dilemma of stopping immunosuppression to save a recipient's life but at the cost of rejection of a functioning graft.

Adult↗
PubMedDate not supplied

C4d complement split product in diagnosis of immunological activity of chronic allograft nephropathy.

INTRODUCTION: Activation of the humoral branch of the immunological response is currently believed to play an important role in pathogenesis of chronic allograft nephropathy. The impact of humoral alloreactivity, indicated by the presence of C4d deposits in peritubular capillaries of a renal allograft, on the development of chronic allograft nephropathy is a significant problem in transplantation. The aim of the study was to assess and correlate C4d expression in patients with chronic allograft nephropathy, with clinical and morphological variables, as well as to assess the impact of a change in immunosuppression regimen on posttransplant course and renal allograft morphology. PATIENTS AND METHODS: Twenty-six patients with chronic allograft nephropathy underwent biopsies to correlate C4d expression with clinical parameters and morphological findings. In all patients azathioprine was replaced with mycophenolate mofetil with additional CsA dose reduction in 12 patients. After 1 year, 14 protocol biopsies were performed. RESULTS: The frequency of C4d peritubular capillary deposition among patients with chronic allograft nephropathy was 30%. C4d expression appeared later after transplantation, was correlated with chronic allograft glomerulopathy and proteinuria but not other clinical or histological variables. C4d deposits displayed no independent impact on serum creatinine level. Proteinuria was significantly more reduced in the C4d(+) group. Progression of chronic morphological changes was significantly accelerated in the C4d(+) group. CONCLUSION: C4d peritubular capillary expression did not differentiate patients after immunosuppression enhancement, but it predisposed to progression of chronic morphological findings during 1-year observation.

Adult↗
PubMedDate not supplied

A solution to organ shortage: vascular reconstructions for pancreas transplantation.

Multiorgan harvesting (MOH) accounts for approximately 40% of all organ procurements in Poland. Simultaneous procurement of the pancreas and liver necessitates division of the vessels supplying both organs. Therefore, reconstruction of the pancreas vasculature is mandatory for proper function of the transplanted organ. The aim of this study was to present various methods of vascular reconstruction to prepare the pancreas for transplantation. Between January 1999 and April 2005, among 42 whole pancreas transplantations, 35 came from MOH necessitating arterial reconstruction. In 32 cases, the splenic artery (SA) and superior mesenteric artery (SMA) were sewn into a single trunk using the common iliac arterial bifurcation. Occasionally, the iliac Y-graft was unsuitable for vascular reconstruction due to atherosclerosis or iatrogenic injury. Therefore, the SA was anastomosed to the side of the SMA in two cases. In one case we utilized the brachiocephalic trunk bifurcation. Portal vein elongation employed an external iliac vein procured from the donor in all 35 cases. Good perfusion was achieved in all transplanted pancreata. During the early follow-up period, two venous and one arterial thromboses were noted. No negative effects of pancreatic vessel reconstruction were observed in postoperative graft function. Reconstruction of the pancreas vasculature did not affect the long-term function of the allograft while significantly increasing the available donor organ pool.

Humans↗