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Biomedical subjects

R J Corry

Publications and source records attributed to R J Corry.

At least 91 records · Page 5Linked to original sources
PubMed1987

Duodenopancreatectomy for transplantation.

Forty duodenopancreatectomies for transplantation were performed. The technique focused on the maintenance of the cardiovascular hemodynamics of the donor during the procedure, the meticulous dissection and preservation of all vascular supplies to the duodenum and the pancreas, and the suppression of warm ischemia by in situ cooling. Recipient euglycemia was established within two hours of the revascularization in 37 of 38 pancreata transplanted. Only six of the 78 renal transplant recipients receiving more than one organ from the same donor required postoperative dialysis, for a 7.7% incidence of delayed graft function. Immediate function was observed in all six cardiac allograft recipients.

Duodenum↗
PubMed1987

Metabolic effects of urinary diversion of exocrine secretions in pancreatic transplantation.

We have compared the metabolic consequences of two forms of exocrine drainage for pancreaticoduodenal transplant, duodenojejunostomy (DJ) and duodenocystostomy (DC). DC offered the advantage of avoiding opening of the recipient small intestine with its potential for wound sepsis, as well as a reliable method for early detection of pancreatic rejection as measured by an abrupt fall in urinary amylase and bicarbonate concentration. However, DC led to a large urinary loss of bicarbonate with a concomitant mild metabolic acidosis. During periods of renal dysfunction, the patients with DC developed severe hyperchloremic acidosis. Use of DC for pancreatic exocrine diversion may require patients to take supplemental bicarbonate even with a well-functioning renal transplant.

Acid-Base Equilibrium↗
PubMed1987

Results of conversion from cyclosporine to azathioprine in cadaveric renal transplantation.

Between December 1983 and August 1985, 110 cadaver transplants were performed at our institution. All were started on cyclosporine (CsA) and prednisone (P) for immunosuppressive therapy. Of the 110 patients, 46 were converted from CsA to azathioprine (AZA) for a variety of reasons (cost, toxicity, patient preference, prolonged dysfunction posttransplant, or nonresponsive rejection). The course and outcome of these patients are described. The only group of patients who had consistent benefit and stable course following the CsA-to-AZA switch were primary cadaver transplants with stable renal function (serum creatinine less than 2 mg/dl) who were converted an average of 7.97 months posttransplant. All other groups of patients had severe problems or graft loss postconversion.

Azathioprine↗
PubMed1986

Stroke in renal transplant recipients.

Cerebrovascular events are the most common neurological complications seen in renal transplant recipients. Cerebral infarction and transient ischemic attacks are the most common events and may occur years after transplantation. Recipients older than 40 years at the time of transplantation and those with diabetes mellitus are at greater risk. No instances of aneurysmal subarachnoid hemorrhage occurred among 31 patients with polycystic kidney disease who had undergone transplantation.

Adolescent↗
PubMed1986

Surgical treatment of diabetic nephropathy with simultaneous pancreatic duodenal and renal transplantation.

Twenty consecutive patients with diabetes who were dependent upon insulin underwent simultaneous pancreatic-duodenal and renal transplantation at our center between March 1984 and August 1985. Eighteen patients are alive, 17 have functioning renal allografts and 13 have normal fasting blood sugar levels and are free of insulin use. Pancreatic graft loss was secondary to venous thrombosis in four instances and inadequate perfusion in one. Graft versus host disease occurred in three patients with composite pancreatic and splenic grafts, which led to a policy of not including the spleen as part of the graft. Serum creatinine levels were a more sensitive indicator of rejection than blood sugar levels which represent a distinct advantage of the simultaneous pancreatic and renal procedure, as compared with pancreatic transplantation after renal transplantation. Duodenal intestinal anastomosis appeared to be a satisfactory way of establishing exocrine pancreatic drainage. As results of pancreatic transplantation continue to improve, this procedure should no longer be considered as experimental.

Actuarial Analysis↗