Blood group ABO-incompatible (A2 to O) kidney transplantation in human subjects: a clinical, serologic, and biochemical approach.
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Biomedical subjects
Publications and source records attributed to L Rydberg.
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HLA-ABC and DR typing was performed on 50 patients with mastocytosis. Lymphocyte stimulation with concanavalin A has earlier been performed in 22 of these patients. No phenotypic aberrations were detected in the patient group. 8 patients had the HLA-B12 phenotype. Lymphocytes from the HLA-B12 phenotype stimulated with a lymphocyte mitogen have earlier been shown to react with decreased inhibitory effect to histamine. 2 patients in this study had the HLA-B12 phenotype and systemic mastocytosis with high histamine turnover, but these patients reacted with a low mitogen response of the lymphocytes.
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The distributions of ABO, rhesus, and Lewis blood group antigens were studied in patients with alcoholic cirrhosis, alcoholic pancreatitis, chronic active hepatitis, and primary biliary cirrhosis. There were no differences in frequencies of ABO and rhesus blood group antigens between the groups or in comparison with a control group of blood donors. Lewis phenotype Le (a- b-), however, was more common on erythrocytes than in saliva in patients with alcoholic cirrhosis, alcoholic pancreatitis, and severe renal disease but equally common in saliva and on red blood cells in patients with non-alcoholic liver disease. It is suggested that Lewis typing should be performed on saliva because blood typing may give misleading results in some patients.
Forty-five of 52 consecutive patients with chronic low back pain were screened for presence of HLA-B27 antigen one year after they were included in a rehabilitative program. Six (13.3%) were positive and, when re-examined radiographically, 2 had signs of ankylosing spondylitis. The proportion of antigen-positive individuals is similar to that found in a population study of healthy Swedish blood donors, and within the range of other populations of healthy controls. It is concluded that HLA-B27 is of limited diagnostic value as a screening test for ankylosing spondylitis in a patient group with chronic low back pain.
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The outcome of 11 renal transplants with kidneys from blood group A2 donors to blood group O recipients is reported. Eight grafts had a satisfactory function, three early losses were noted: one acute rejection after four weeks, two technical failures. The longest survival is four years, the patient died from septicaemia with a functioning graft. Obviously, the blood group A2-O incompatibility is not an obstacle to successful organ transplantation.
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1. Human leucocyte ABC antigens were determined by means of a lymphocytotoxicity test in 27 patients with previous essential malignant hypertension and in 500 blood donors. 2. In 18 patients with grade IV retinopathy human leucocyte antigen B15 (HLA B15) was found in 44%, as compared with 23% in the control subjects (P = 0.888). 3. All patients with HLA B15 had a positive family history for hypertension. 4. In 18 patients with grade IV retinopathy HLA B15 was found in eight whereas none of the nine patients with grade III retinopathy had this antigen (P = 0.039). 5. Of the 27 patients, 19 had a positive family history of hypertension and of these eight had HLA B15, whereas none of the eight patients with a negative family history had this antigen (P = 0.068). 6. The findings do not rule out that HLA B15 may be associated with the development of the malignant phase in patients with essential hypertension, but a statistically significant relationship could not be established.
The prevalence of 39 HLA antigens of series A, B and C was determined in 63 patients with Giant cell arteritis. In 44 patients the diagnosis was established by means of temporal artery biopsy and in 19 it was based on clinical criteria. The prevalence of the antigens was compared with that in two control groups of different ages. No significantly increased antigen prevalence was seen in our patients, as compared with controls. There were no differences in the prevalence of HLA antigens between groups of patients with different clinical forms of GCA. Nor was any difference in the prevalence of HLA antigens found between younger and older healthy individuals.
The HLA-A, -B -C typing of 100 bricklayers was performed. 50 bricklayers had developed contact allergy to chromium while 50 were healthy bricklayers. The distribution of HLA antigens were equal in the 2 groups.
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The anti-A response in a group B patient accidentally given 1 unit transfusion of A1 blood is described. The antibody response is characterized both with conventional agglutination techniques and with radioimmunoassay using pure group A antigens with different core saccharide structures (type 1, 2, and 4 chains) and class-specific second antibodies. The anti-A titer rose to a maximum Days 11 to 14 after the incompatible transfusion. The antibodies involved were mainly of the IgG and IgA types, while the IgM response was moderate. The IgA antibodies seemed to be nonselective with respect to group A antigen type, while the IgG antibodies showed a specificity against type 2 chain group A antigens.