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Biomedical subjects

P Michielsen

Publications and source records attributed to P Michielsen.

151 records · Page 9Linked to original sources
PubMedDate not supplied

Surgical gastro-intestinal complications in 277 renal transplantations.

In 277 consecutive renal transplantations, 49 of 254 patients (19%) developed a gastrointestinal complication causing a mortality rate of 29% (14/49 patients). Oesophageal, gastro-duodenal, pancreatic and ileocolonic complications are reviewed and discussed. Acute gastro-duodenal ulcerations proved to be the most common problem (45--22/49 patients). The loss of allograft in this group of 22 patients was 42% (9/22 patients). To overcome their high mortality (27%--6/22 patients) efforts were made to prevent these complications. After introduction of prophylactic surgery, mortality dropped from 4 to 2%, after systematic long-term prophylactic use of cimetidine, mortality even dropped to 0%. In this last series of 52 patients only one bleeding ulcer was seen immediately after allograft nephrectomy. Ileocolonic complications in renal transplant patients, difficult to diagnose and treat, are associated with a high morbidity and lethality. In 6 patients with colonic complications, 4 could be saved by early and aggressive surgery (67% survival rate). Two recipients developed a de novo gastrointestinal malignancy. Early, accurate, diagnosis and surgical therapy of gastro-intestinal complications after renal transplantation are directly related to the graft and/or patient survival rate. Every effort is therefore necessary to prevent these complications.

Gastrointestinal Diseases↗
PubMedDate not supplied

[Kidney preservation methods (author's transl)].

The results of preservation of the two kidneys of the same animal by two different techniques and then reimplanted on the same femoral artery, have been compared. The two methods are the following: 1) Short starting perfusion by Collins solution and than cold storage a 4 degrees C in the same solution. 2) Continuous perfusion by machine supplied by pulsatile pump, oxigenator, cooling. The first more impressive result by using continuous perfusion is the possibility of nullifying the effects of warm ischemia up to 30'. Kidney preservation with continuous perfusion is like to give less problems in the postoperatory period. Some weeks after transplantation however, the problems seems to increase in comparison with kidneys stored in Collins solution and not rarely sudden GFR decreases or anurias without immunologic rejection has been observed. Cautious conclusion should advise to use Collins solution when there has not been a long warm ischemia.

Animals↗
PubMedDate not supplied

Prevention of vertical transmission of hepatitis B virus infection. Is there a standard policy in Flanders (Belgium)?

The perinatal transmission of hepatitis B virus (HBV) from mother to child can be effectively prevented by the combined administration of hepatitis B immunoglobulins (HBIg) and hepatitis B vaccine (HB vaccine) immediately after birth. This requires prenatal screening of all pregnant women for HBsAg. In Belgium, a standard prevention policy does not exist. This study evaluated the current prevention policy of paediatricians in Flanders, regarding the prevention of vertical transmission of HBV, and their knowledge regarding the reimbursement of the HB vaccine for neonates of HBsAg-positive mothers. Ninety-one percent out of 134 participants administered both HBIg and HB vaccine. The recommended timing, within 12 hours post-partum, was observed in 60.0% for HBIg and in 50.3% for HB vaccine. Twenty-five percent of the respondents answered not to be well informed regarding the reimbursement of the HB vaccine. A preliminary study in Flanders among gynaecologists showed that 27 out of 29 routinely screened pregnant women for HBV, but the type of serology tested and the timing of this prenatal screening were very heterogeneous. We conclude that a standard policy regarding the prevention of vertical transmission of HBV is currently lacking in Flanders.

Belgium↗