Search PubMed⌕ Search

Biomedical subjects

M A Baltzan

Publications and source records attributed to M A Baltzan.

At least 37 records · Page 2Linked to original sources
PubMed1990

HLA matching enhances long-term renal graft survival but does not relate to acute rejection.

Forty patients with end-stage chronic renal failure received living donor renal grafts, matched at more than 1 HLA haplotype, over the last 25 years. Of these grafts, 33 were first and 7 were second grafts. All recipients received prophylactic corticosteroids. Thirty-four also received prophylactic azathioprine, and 6, prophylactic cyclosporine. Acute rejection occurred in 65% (11/17) of non-cyclosporine treated grafts when the recipient was given 5 or fewer units of blood preoperatively, but in only 18% (3/17) when more than 5 units were given. High-dose steroid therapy reversed the acute rejection each time. Chronic rejection occurred in 2 grafts. Irreversible rejection did not occur in any second graft. Chronic glomerulonephritis, possibly due to recurrent disease, occurred in 1 graft. Five grafts have been lost, 1 each from technical and immunosuppressive complications, and 3 from incidental death. The 1-year actuarial graft survival rate is 95% and the 10-year rate 84%. All surviving patients lead normal lives without significant health restriction, and employ minimal medication. It is postulated that: 1) acute cellular rejection is HLA-independent, and chronic rejection is HLA-dependent, and 2) hyperacute and chronic rejection are related and are parts of a spectrum of humoral immunity.

Actuarial Analysis↗
PubMed1977

Early acute rejection in renal homotransplantation. Angiographic-pathologic correlation.

Early acute rejection occurs between two and ten days after renal homotransplantation and has been recognized in eight of 156 renal transplants. Four of the eight patients developed spontaneous renal rupture unrelated to biopsies. Pathologically, there was acute passive congestion with areas of tubular necrosis, venous thrombi and perivenous lymphoplasia. Glomerular and arterial immunogenic injury was slight. Radiologically, the kidneys were enlarged with stretching of the interlobar and segmental arteries, decreased peripheral filling and a homogeneous nephrogram. Renal vein filling defects were a frequent feature.

Angiography↗
PubMed1973

Early acute rejection of renal homografts: a characteristic clinical syndrome.

Seven of 74 patients with early functioning cadaveric renal homografts developed acute oliguric renal failure after the second but before the ninth day post-transplantation. The syndrome characteristically begins with an abrupt and simultaneous decrease in creatinine clearance, urine volume and urine sodium concentration. After a variable period and despite a reduction in immunosuppressive therapy, a diuretic phase ensues and renal function is restored. Complications associated with the syndrome include groin hematoma, pulmonary edema and renal rupture with shock. Renal rupture does not require nephrectomy: if the hemorrhage is controlled, the transplanted organ will resume function. Angiographic studies show normal nephrograms, stretched arterial vasculature and filling defects in the veins. Percutaneous renal biopsy shows interstitial edema and hemorrhage, venous congestion and tubular necrosis. Evidence is presented to support the hypothesis that this is a form of rejection occurring as the result of injury to the renal venous system.

Acute Kidney Injury↗