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Biomedical subjects

M Slapak

Publications and source records attributed to M Slapak.

At least 55 records · Page 3Linked to original sources
PubMed1980

Serious renal transplant rejection and adrenal hypofunction after gradual withdrawal of prednisolone two years after transplantation.

Ten patients with stable renal function two years after transplantation had their sole immunosuppressive treatment (oral prednisolone 10 mg daily) withdrawn by reducing the daily dose by 1 mg at monthly intervals. Plasma prednisolone concentration, cortisol concentration, creatinine clearance, and serum creatinine concentration were measured in all patients, and the adrenal response to corticotrophin was determined in five by measuring plasma cortisol concentrations before and after tetracosactrin injection. No episodes of rejection occurred in patients taking over 7 mg prednisolone daily. Although three patients apparently required only minimal immunosuppressive treatment (less than 5 mg daily) the remainder suffered episodes of rejection at daily doses below 7 mg. There was a tenuous association between rejection and low plasma cortisol concentration, but neither the pattern of plasma prednisolone concentrations nor the response to tetracosactrin were related to episodes of rejection. Reducing the daily dose of oral prednisolone to under 7 mg should not be attempted in patients with renal transplants unless there are extenuating circumstances.

Adrenal Insufficiency↗
PubMed1979

The role of plasmapheresis in renal transplantation.

Plasmapheresis has been studied in ten patients who received cadaveric renal allografts. In six patients (group A), plasma was carried out on the first post-operative day and then on alternate days until six treatments had been completed. No beneficial effect was observed but treatment was well tolerated and there were no complications. One patient retains a functioning graft. Plasma exchange was carried out on six consecutive days in five patients (group B) who were actively rejecting their grafts and in whom conventional methods of treatment had failed. All five patients showed improvement in graft function. Rejection was reversed in four patients and was contained in one patient. Subsequently rapid recrudescence of graft rejection occurred in one patient, extended graft survival was seen in two patients, and the other two patients have retained life supporting grafts. Plasmapheresis may have a part to play in the treatment of renal allograft rejection and further evaluation of this treatment is indicated.

Antibodies↗
PubMed1975

Fulminant liver failure: clinical and experimental study.

Clinical experience of some newer methods of hepatic support is described. The results are unpredictable and far from satisfactory. The need for an animal model in which potential therapeutic methods can be studied is emphasized. Such a model based on carefully imposed ischaemic insult to the liver in the absence of portacaval shunting is described. It is suggested that bacterial presence in the bowel together with a depression of the liver reticuloendothelial function plays an important part in the early and rapid mortality of acute liver failure. Temporary auxiliary liver transplantation using an allograft or a closely related primate heterograft seem to be the 2 best available methods of hepatic support for potentially reversible acute liver failure.

Adult↗