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Biomedical subjects

M J Slooff

Publications and source records attributed to M J Slooff.

At least 199 records · Page 11Linked to original sources
PubMed1983

Captopril-induced deterioration of graft function in patients with a transplant renal artery stenosis.

We evaluated nine captopril-treated patients with transplant renal artery stenosis. Captopril treatment always resulted in a dramatic decrease in renal function; in two patients complete anuria developed. Only in two patients with a stenosis in one out of two renal arteries was a satisfactory fall in blood pressure achieved. The mechanisms which may lead to these remarkable results will be discussed.

Acute Kidney Injury↗
PubMed1983

The use of Marlex mesh in patients with generalized peritonitis and multiple organ system failure.

Patients with generalized peritonitis form a rather threatened group, with a high mortality and risk of complications which increases when multiple organ failure develops. In 20 patients with this condition, the laparotomy wound was closed without tension using a Marlex mesh prosthesis, after surgical treatment of the underlying illness and drainage of the abdominal cavity. The mortality was lower than expected, according to data from the literature; also, pulmonary complications, residual abscesses and wound dehiscence occurred less frequently. This method seems to be a valuable contribution to the complex treatment of these patients.

Abscess↗
PubMed1983

Non-thrombotic complications of PTFE grafts for haemodialysis.

In a consecutive series of 76 PTFE grafts (37 Impra and 39 Gore-Tex), 30 non-thrombotic complications were observed. Twenty-one (70%) of these grafts could be salvaged either by conservative means (2) or by an aggressive surgical approach (19). The median survival time of the salvaged grafts was 12 months. Only nine grafts (30%) were lost as a result of the complications. Lesions caused by punctures techniques seemed more frequent in Impra grafts than in Gore-Tex grafts. Apart from this observation it is concluded that an aggressive surgical approach to non-thrombotic complications in PTFE grafts is worthwhile.

Aneurysm↗
PubMed1982

Safe removal of failed transplanted kidneys.

The surgical removal of a transplanted kidney following rejection or failure can be hazardous. A total of 110 grafts were removed consecutively in 84 patients (in 21 cases a second graft and in 5 cases a third graft was removed). Two surgical techniques were applied: extracapsular and intracapsular removal. The extracapsular technique was associated with complications in 11 out of 69 cases (16 per cent) and the intracapsular technique, in 3 out of 36 cases (8 per cent). In 5 cases the operative technique could not be determined from the records. In the 14 cases developing complications, wound infection was observed in 7 cases, wound haematoma in 4 and mycotic aneurysm, pulmonary embolism and clotting in the bladder each in 1 case. One patient (1.2 per cent) died due to late complications after allograft nephrectomy following rupture of a mycotic aortic aneurysm. The technique of kidney transplant removal by either the intra- or extra-capsular route of the exact timing of the operation are important features for safe treatment of patients with end-stage graft failure.

Adolescent↗
PubMed1982

Functional studies in 6 days successful preserved canine kidneys.

In 2 groups of 6 dogs each the right kidney was removed, flushed with Collins and then perfused in a Gambro preservation machine for 6 days. After this period the kidneys were reimplanted in the neck of the subsequently nephrectomized donor. The only difference in Group 2 was that halfway the 6-day hypothermic perfusion the kidneys were taken from the machine and perfused ex vivo for 3 hours by connections with the femoral vessels of the same donor dog. After implantation, only 1 dog from group 1 survived. All 6 dogs in group 2 survived. A low filtration fraction (less than 0.26) after implantation, measured 1 hour after implantation, correlated well with and predicted life sustaining kidney function. During the ex vivo perfusion in group 2, an improving proximal tubular secretion and water reabsorption was observed.

Animals↗
PubMed1981

The use of paediatric cadaver kidneys for transplantation in adult recipients.

In view of the shortage of cadaveric donors a retrospective study has been performed to determine the results of transplantation of paediatric cadaver donor kidneys into adult recipients. Graft- and patient survival and renal function in the 31 cases analysed in this study showed no adverse effect of the use of paediatric donor kidneys. No vascular complications were encountered. Ureteric leakage occurred in only one case and it was treated successfully. It is concluded that paediatric age is no criterion for donor exclusion and that paediatric donors are to be regarded as a valuable source of cadaveric kidneys for transplantation.

Adult↗
PubMed1981

[The use of juvenile kidneys for transplantation in adults].

In view of the shortage of cadaveric donors a retrospective study has been performed to determine the results of transplantation of paediatric cadaver donor kidneys into adult recipients. Graft- and patient survival and renal function in the 31 cases, analysed in this study, showed no adverse effect of the use of pediatric donor kidneys. No vascular complications were encountered. In only one case ureteric leakage occurred and was treated successfully. It is concluded that paediatric age is no criterion for donor exclusion and that paediatric donors are to be regarded as a valuable source of cadaveric kidneys for transplantation. Also the possibility to perform nephrectomies in anencephalic newborn infants is to be considered.

Adolescent↗
PubMed1981

Transplantation of cadaveric paediatric donor kidneys into adult recipients.

To assess the justification for the use of cadaveric paediatric donor (CPD) kidneys in adult recipients, the results of transplantation of 50 CPD kidneys into adult recipients (CPD group) were compared to the outcome of 250 transplantations of adult cadaveric donor kidneys into adult recipients (ACD group). No differences in graft and patient survival were observed between both groups. The functional capacity of the kidneys and the incidence of surgical and urological complications was not different in both groups. Hypertension was observed more frequently in recipients of CPD kidneys compared to recipients of ACD kidneys (p less than 0.025). The occurrence of hypertension was related to the surgical technique used for the arterial anastomosis. When no arterial patches were available hypertension occurred more frequently in the CPD group (9/9 cases) compared to the ACD group (31/70 cases) (p less than 0.01). In recipients of CPD kidneys the incidence of hypertension was lower then arterial patches were used (11/19 cases) compared to recipients of CPD kidneys where no patches were used (9/9) (p less than 0.05). The results indicate that the use of CPD kidneys in adult recipients is justified. However, to diminish the occurrence of hypertension, donor nephrectomy of CPD kidneys should take place according to the so-called en bloc technique, so that arterial patches can be obtained.

Adolescent↗
PubMed1980

Management of rupture in allografted kidneys.

Allograft rupture is a rare but serious complication in renal transplantation, occurring in 3 to 8.5% of the transplanted kidneys. The consequences for the recipients are fatal in 6% of the cases and graft loss is the outcome in another 53%. Clinical features and treatment of renal allograft rupture are discussed and illustrated by a case history, in which successful management of this complication resulted in salvage of the graft and patient. A literature study with the purpose of determining the pathogenesis of graft rupture revealed that rejection plays a major role.

Adolescent↗
PubMed1980

Non-heartbeating donors, is it worthwhile?

In view of the shortage of cadaveric organ donors a retrospective study has been performed to determine the results of transplantation of non-heartbeating donor kidneys. Graft and patient survival and renal function in the 60 cases analysed in this study, showed no adverse effect of the use of non-heartbeating donor kidneys. The initial graft function was best after in situ cooling of the kidneys, using an intra-aortic double balloon catheter, followed by machine preservation. It is concluded that nephrectomy of non-heartbeating donors is worthwhile and that these donors should be included in all organ harvesting programmes.

Cadaver↗
PubMed1980

The Bishop-Koop anastomosis-a find in pediatric surgery.

A technique of intestinal anastomosis, developed for the treatment of meconium ileus, was used by the authors in the treatment of neonates suffering from various other intestinal anomalies such as atresia, volvulus and apple-peel syndrome. This technique was used in 6 neonates to make a safe intestinal reconstruction.

Female↗
PubMed1979

Cadaveric kidney retransplantation, is it justified?

Results of 44 second cadaveric kidney transplantations are reported and compared with the results of 149 primary cadaveric transplantations. No difference in patient survival is observed. Patients with a non-immunological first graft failure (NIF) had a better two year second graft survival (60%) when compared with patients with an immunological first graft failure (IF) (20%). This difference was not due to a higher degree of presensitisation in the IF group. The use of scarce cadaveric kidneys for retransplantation in patients whose first graft was rejected is considered questionable.

Adult↗