Damage from methylene blue and indigo-carmine dye perfusion of kidneys.
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Biomedical subjects
Publications and source records attributed to R L Burleson.
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In rabbits, autologous peripheral blood leukocytes labeled in vitro with 67Ga citrate have been purified in vitro by the processes of dialysis and cell washing to determine the effect of purification on the accumulation of the labeled cells in abscesses of the abdominal wall. Dialysis was found to be ineffective, but cell washing produced a population of labeled leukocytes that was essentially free of noncell bound radioactivity. The purification process minimally altered the recirculating capacity of the leukocytes but significantly enhanced the relative accumulation of radioactivity in the septic area. Thus, the use of an essentially pure population of labeled leukocytes should offer a significant potential in the definitive scintiscan demonstration of hidden abscesses.
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Calyceal-cutaneous fistula is a serious sequela of renal transplantation occurring in approximately 3% of allografts. This complication occurred in 12% of allografts with multiple renal arteries. A localized area of poor parenchymal perfusion involving less than one-eighth of the kidney was noted at the time of transplantation in only one-third of the kidneys developing fistulae. Attempts of surgical correction of the fistulae in the presence of serious wound and urinary tract sepsis were usually unsuccessful, with the ultimate loss of 7 of 8 kidneys and the death of 3 patients from sepsis. One individual underwent successful partial resection and closure of the fistula with a muscular graft and survives with adequate function. This experience would suggest that if an initial aggressive surgical attempt at repairing a calyceal-cutaneous fistula fails, transplant nephrectomy should be performed.
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Autologous peripheral blood leukocytes, labeled in vitro with 67Ga citrate, have been studied in 20 patients as a radioactive carrier for the scintigraphic visualization of septic inflammatory areas. 67Ga citrate was added to venous whole blood; following incubation, the blood was centrifugated, and the packed cells were reinfused. Scintiscans were obtained four and 24 hours later. The inflammatory process was demonstrated in nine of nine patients with confirmed sepsis. Eleven patients without sepsis had normal scans. There were no false-negative scans and one-false-positive scan. The selective accumulation of the gallium labeled leukocytes in areas of septic inflammation was sufficient to allow scintigraphic demonstration of the inflammatory area.
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The influence of HLA-DR antigen matching in 70 cadaver transplants was studied for up to four years. The overall cumulative renal graft survival at one year was 62 percent, and at two and four years it was 60 percent. The one, two, and four year cumulative graft survival for patients receiving one or two HLA-DR antigen matched grafts was 74 percent, 69 percent, and 69 percent, respectively. In contrast, the one, two, and four year cumulative graft survival for patients receiving zero HLA-DR antigen matched grafts was 51 percent, 47 percent, and 47 percent, respectively. The cumulative graft survival for patients receiving one or two HLA-DR antigen matched grafts was significantly different (p less than 0.05) than for patients receiving zero HLA-DR antigen match grafts. No significant difference in the distribution of other prognostic factors were observed between patients receiving one or two HLA-DR antigen match grafts and patients receiving zero HLA-DR antigen matched grafts. The present authors concluded that matching for HLA-DR antigens exerts an independent beneficial effect on renal graft survival in transplant patients, most of whom have been previously transfused.