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Biomedical subjects

R Sindhi

Publications and source records attributed to R Sindhi.

40 records · Page 3Linked to original sources
PubMed1986

In vitro C5a generation by synthetic vascular prostheses: implications for graft incorporation in vivo.

C5a, released during activation of the complement cascade, was measured by radioimmunoassay in human plasma incubated with Dacron, preclotted Dacron, glutaraldehyde treated human umbilical vein (HUV), polytetrafluoroethylene (PTFE), and Dacron-collagen composite vascular grafts. Expressed as percent of C5a in control plasma incubated without graft, C5a generation by preclotted Dacron, and by the HUV was similar to that by Dacron (941 +/- 206% S.E.M.), while that due to PTFE was markedly less (p = 0.005). The Dacron-collagen composite vascular graft also generated significantly less C5a than Dacron and was similar to PTFE in this respect. These results expand on previous work suggesting that lower C5a generation by PTFE explained the negligible polymorphonuclear infiltrate seen on its surface in vivo, allowing it to endothelialise as rapidly as Dacron despite poorer attachment of seeded endothelial cells. The role of complement as a factor limiting endothelialisation of synthetic vascular prostheses needs further investigation.

Blood Vessel Prosthesis↗
PubMedDate not supplied

Duodenal segment complications in vascularized pancreas transplantation.

Bladder drainage by the duodenal segment (DS) technique is currently the preferred method of pancreas transplantation (PTX) but is associated with unique complications. Over a 7-year period, 191 diabetic patients underwent 201 whole-organ PTXs with bladder drainage using a 6 to 8 cm length of DS as an exocrine conduit. A retrospective chart review was performed to document all DS morbidity. DS complications occurred in 38 cases (19%). Twelve patients developed DS leaks and required operative repair. DS bleeding was documented in 26 cases, necessitating cystoscopy in 22 patients and open repair in eight patients for significant hematuria. Cytomegalovirus (CMV) duodenitis was diagnosed in seven cases, with four presenting as DS leaks and three with hematuria. Five patients experienced ampullary obstruction early after PTX. Rejection of the DS was confirmed by biopsy in 13 patients, including eight cases of acute and five cases of chronic rejection. Two patients had stone formation from the DS staple line. Enteric conversion was performed in five patients for DS abnormalities (leaks in 2 cases, bleeding in 2, and CMV duodenitis in 1). Among patients with DS complications, patient survival is 84% and pancreas graft survival is 68% after a mean follow-up of 44+/-12 months. Complications related to the DS remain an important source of morbidity but rarely cause death after PTX. In spite of unique side effects, transplantation of the DS remains an acceptable alternative for exocrine drainage after PTX.

Adult↗
PubMedDate not supplied

Factor V inhibitor in a liver transplant patient associated with porcine xenoperfusion.

The development of a high-titer factor V inhibitor is described in a patient who underwent orthotopic liver transplantation followed by porcine xenoperfusion after an acute rejection episode. The inhibitor showed no cross-reactivity to either porcine or bovine factor V, nor was it accessible to human platelet factor V. The limitations of treatment modalities including intravenous immunoglobulin, steroids, cytotoxic therapy, intense plasmapheresis and platelet transfusions are discussed.

Adult↗