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Biomedical subjects

N M Thomson

Publications and source records attributed to N M Thomson.

At least 37 records · Page 2Linked to original sources
PubMed1991

Improved left ventricular function after renal transplantation.

Patients with severely impaired left ventricular function are known to have a poor prognosis. We describe a 20-year-old man with end-stage renal failure, on dialysis, with severely impaired left ventricular function which dramatically improved after renal transplantation. This suggests that poor left ventricular function need not preclude renal transplantation and may, in fact, offer an alternative to combined renal and cardiac transplantation.

Adult↗
PubMed1991

Anthropometry underestimates body protein depletion in haemodialysis patients.

The body composition of 62 haemodialysis patients (41 males) and 63 controls (30 males) was assessed using anthropometry and in vivo neutron activation analysis of body nitrogen. There was no significant difference between patients and controls in body mass index (BMI) and percentage body fat. Arm muscle circumference was significantly reduced in males. Lean body mass was strongly correlated with body nitrogen in controls (r = 0.951) but less so in patients (r = 0.876). The mean standardised body nitrogen index (NI) was reduced in male patients by 13% (95% confidence interval -9 to -17%) and in females by 4% (95% confidence interval +4 to -12%). Of the 16 patients with a NI below the control range, arm muscle circumference was below the control range in only 3 and BMI less than 18 kg/m2 in 2. NI was correlated negatively with the duration of renal replacement therapy, duration of haemodialysis, the number of previous failed transplants and the total dose of steroids received but not with current energy or protein intakes. Steroid dose was the only significant independent variable. Anthropometry underestimates body protein depletion in haemodialysis patients and the degree of protein loss is related to the cumulative dose of corticosteroids previously received.

Adrenal Cortex Hormones↗
PubMed1990

Dialysis and renal transplantation in children: long term and recent experience.

The outcome of 38 children with endstage renal failure who entered a dialysis and renal transplant programme over a period of 16 years is reported. The initial care was given in an adult programme but in 1985 this was changed to a comprehensive and specifically paediatric programme. Patient survival was 97, 86 and 80% at 1, 5 and 10 years respectively. Thirty-four of the patients spent a mean period of 19 months (range 1-160 months) on dialysis with the preferred form of dialytic therapy being continuous ambulatory peritoneal dialysis. Primary cadaveric graft survival was 72 and 42% at 1 and 3 years respectively; although since 1985 1 year graft survival has risen to 90%. The major long term problems have been growth failure and poor social development. Eighty-seven per cent of children have been able to continue normal schooling, and of the 18 who have left school 14 (78%) are employed or undertaking tertiary education. Thus dialysis and transplantation has allowed not only excellent patient survival but also the achievement of satisfactory educational standards and subsequent employment for the majority of patients.

Adolescent↗
PubMed1989

Phenotypic definition of primed T cells in human renal allografts. Use of the CD45R marker.

Immunohistological studies indicate that T cells and macrophages are the major components of human kidney allograft infiltrates. Recent work has demonstrated a division of T lymphocytes into 2 subpopulations with distinct functions on the basis of their expression of the CD45R antigen (CD45R+ "naive" and CD45R- "memory" T cells). This study analyzes CD45R expression on circulating T cells and T cells infiltrating renal allografts in patients undergoing rejection and/or cyclosporine nephrotoxicity. The percentage of circulating T cells that expressed CD45R in patients with rejecting (63 +/- 4) or stable grafts (66 +/- 3) was not different from values obtained for normal donors (62 +/- 3). In contrast, the percentage of T cells expressing CD45R infiltrating rejecting grafts was 21 +/- 2 and was not affected by the stage of rejection; in patients with CsA toxicity the value was 22 +/- 6. The reduced proportion of T cells that expressed CD45R in the allograft may reflect a change in status from the naive state due to alloantigenic stimulation (which can be demonstrated in vitro) and/or a propensity of memory T cells to enter or be retained in an allograft.

Antigens, CD↗
PubMed1988

Nonhepatitis B-associated liver disease in a renal transplant population.

The spectrum of liver disease in a population of 293 patients receiving 353 renal transplants (1971-1984) was reviewed. This study looked retrospectively at the histological features of liver disease in this population, and prospectively at the clinical and biochemical features of liver disease associated with renal transplantation. In all patients, infection with hepatitis B was excluded. Six deaths, primarily attributable to hepatic failure have occurred: one, acute herpes simplex infection; one, subacute massive hepatic necrosis of uncertain etiology; two, pretransplant liver disease; and two, posttransplantation cirrhosis of uncertain etiology. Review of the hepatic histology of 26 patients with known liver disease following transplantation revealed a wide range of pathologies with few specific correlations with their clinical status or biochemical tests of liver function. The prevalence of hepatic dysfunction following transplantation in our patient population was assessed by prospective biochemical screening of 111 transplant recipients over a 6-month interval. During this time period, 27 patients (24%) displayed biochemical evidence of hepatic dysfunction. Liver disease was known to have predated transplantation in only three of 27. Episodes of abnormal liver function occasionally occurred during an identifiable acute illness (six of 27), although the majority (21 of 27) had chronic hepatic dysfunction. Transplant recipients with abnormal liver function could not be differentiated from a cohort with normal liver function on the basis of age, sex, duration of graft function, or alcohol/drug intake. The possible etiologies of nonhepatitis B liver dysfunction following renal transplantation are discussed, and the high prevalence of biochemical evidence of hepatic dysfunction in this population free of hepatitis B infection is emphasized.

Adult↗