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Biomedical subjects

R Y Calne

Publications and source records attributed to R Y Calne.

At least 217 records · Page 12Linked to original sources
PubMed1984

Adult respiratory distress syndrome and convulsions associated with administration of cyclosporine in liver transplant recipients.

A "capillary leak" syndrome resulting from cyclosporine-induced membrane toxicity has been postulated as the cause of convulsions and pulmonary edema in bone marrow transplant recipients. We describe here the occurrence of similar complications in a group of 21 adults receiving liver transplants since July 1982. Of 12 patients treated with i.v. cyclosporine (4 mg/kg/day), 2 developed an adult respiratory distress syndrome (ARDS) within five days of the operation, but it was not found in those given prednisolone (0.05-1.0 mg/kg/day) and azathioprine (1.0 mg/kg/day). ARDS only occurred when cyclosporine was administered through a central vein, and therefore might be related to high concentrations of cyclosporine reaching the pulmonary circulation and causing damage to vascular membranes. Convulsions occurred in one patient given i.v. cyclosporine, and in three when therapy was changed and cyclosporine and corticosteroids were used in combination. Convulsions did not occur inthe same patients as ARDS, were not part of a generalized "capillary leak" syndrome, and were not associated with hypertension or renal failure, as reported elsewhere in children. Fluid retention consequent on cyclosporine administration aggravated by the use of corticosteroids appears to be the most likely explanation of the convulsions.

Adult↗
PubMed1983

Nephrotoxicity of parenterally administered cyclosporine after orthotopic liver transplantation.

The frequency of nephrotoxicity in the absence of identifiable prerenal or postrenal causes within five days of operation in 27 liver transplant recipients was found to be 71% in those treated with i.v. cyclosporine alone, 37.5% with i.m. cyclosporine alone, and 16.7% with prednisolone and azathioprine. Renal failure following i.v. cyclosporine was characterized by an immediate fall in urine output and creatinine clearance with well-preserved tubular function--findings consistent with a reduction in renal blood flow or glomerular filtration rate, or both.

Acute Kidney Injury↗
PubMed1983

A surgical experience with five hundred thirty liver transplants in the rat.

A surgical experience with 530 orthotopic liver transplants in rats is reviewed with technical details. Liver transplantation in the rat can provide important data in a variety of areas, including immunology. Nevertheless, technical problems have limited the widespread use of this valuable investigative tool. Cuff techniques for microvascular anastomosis have simplified the portal venous anastomosis and have minimized the anhepatic phase in the recipient. These had previously been the most frequent causes of failure in the utilization of liver transplantation in the rat. The technique for rat liver transplantation described here was found to be reliable with a 95.3% long-term survival (longer than 100 days) in a recent group of 85 transplants where rejection was not a factor. In the early experience, most deaths were due to bleeding, infection, and biliary complications. The improvements in technique have eliminated most of these errors. We feel that the use of these technical modifications would increase the success rate of rat liver transplantation in the hands of others.

Animals↗
PubMed1983

Transplantation of the pancreas in man.

This short communication reports on the outcome of eleven insulin dependent diabetics with microangiopathy of the retinae and kidneys treated with vascularised segmental pancreatic and renal allografts from the same donor. Cyclosporin A was the sole immunosuppressant.

Adult↗
PubMed1983

Tc-99m labeled HIDA imaging in suspected biliary leaks after liver transplantation.

Tc-99m labeled HIDA imaging has been used to investigate suspected biliary leaks following orthotopic liver transplantation. In two patients the diagnosis of bile leakage was confirmed and appropriate surgical intervention undertaken. In a third patient, despite clinical suspicion, no leakage was apparent on HIDA imaging, and unnecessary surgery was avoided. HIDA imaging is a useful, noninvasive technique for confirming biliary leakage after liver transplantation.

Adult↗
PubMed1982

Renal and segmental pancreatic grafting with draining of exocrine secretion and initial continuous intravenous cyclosporin A in a patient with insulin-dependent diabetes and renal failure.

A patient with renal failure and insulin-dependent diabetes received renal and segmental pancreatic allografts from the same donor, with exocrine drainage of the pancreas being directed into the bowel. An attempt was made to maintain the serum concentrations of cyclosporin A between 300 and 1000 mug/l to avoid serious nephrotoxicity and rejection. Considerable difficulty was experienced in controlling the serum concentrations even with continuous intravenous infusion. When the concentrations were maintained between 300 and 1000 mug/l function in both allografts was satisfactory.At seven months the patient required no insulin and had good renal function. He was not receiving corticosteroids.

Adult↗
PubMed1982

Recurrence of primary biliary cirrhosis after liver transplantation.

Three patients who had undergone orthrotopic liver transplantation for primary biliary cirrhosis and were being maintained on immunosuppressive therapy were investigated 31/2 to 41/2 years later because of the redevelopment of pruritus and mild jaundice. In one patient pigmentation was again evident, and all three had a rise in the titer of serum mitochondrial antibody after an initial fall. Liver histology showed features of primary biliary cirrhosis with non-suppurative destructive cholangitis, lymphoid aggregates, and increased deposition of copper-binding protein in the absence of cholestasis. None of these features was found in patients who had received grafts for other conditions and had lived for comparable periods, nor were they found in patients who had had rejection with bile-duct abnormalities. The overall findings indicate a recurrence of primary biliary cirrhosis in the donor organ.

Adult↗