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Biomedical subjects

R Y Calne

Publications and source records attributed to R Y Calne.

At least 289 records · Page 16Linked to original sources
PubMed1979

[Orthotopic liver transplantation in rats. Prolonging of survival time of allotransplants using cyclosporin A in an acute rejection model].

Livers from inbred DA rats were transplanted orthotopically into inbred BN rats. Within 15 days all animals died due to rejection of the transplant. However, when rats were treated with Cyclosporin A (four different regimens) they survived for at least 60 days, even if therapy was withdrawn at day 28. It could be shown that the histologic changes in the graft stood in an inverse relationship to the extent of immunosuppressive therapy.

Alkaline Phosphatase↗
PubMed1979

Is it really worth re-transplanting patients?

Increasingly patients whose first renal transplant fails are being re-transplanted. A study of patients in one unit was undertaken to assess whether second kidney grafts were as successful as first allografts and whether certain factors determined the outcome of secondary transplants. Second and subsequent grafting can be performed with confidence of a successful outcome provided a careful selection of patients is made. The outcome of subsequent grafts should show no significant difference from the overall results of first renal allografts.

Graft Rejection↗
PubMed1978

Prolonged survival of pig orthotopic heart grafts treated with cyclosporin A.

Cyclosporin A was given to pigs receiving orthotopic cardiac allografts from donors mismatched at the major locus. Median survival in 20 control pigs was only 6 days; in 5 pigs given cyclosporin A at 15 mg/kg on 3 days median survival was 22 days; and when 6 animals were given 25 mg/kg intramuscularly for 2 days and then orally median survival is greater than 68 days, with 4 animals still alive.

Administration, Oral↗
PubMed1978

Transplantation of the liver.

Liver transplantation has had a long gestation period in being accepted as standard therapy. The main reason for this is the formidable operation to which the patient is subjected and because of this, referral of cases tends to be too late. Increasing confidence in the operation should result in earlier surgery. The low incidence of uncontrollable rejection is an encouraging finding which should, in the future, make the results of grafting for nonmalignant parenchymatous liver disease better than those currently obtained with kidney grafts from cadaver donors. The surgery requires a large team of strongly motivated doctors, nurses and technicians, who must have continuing experience with technically successful orthotopic liver grafts in experimental animals.

Biliary Tract Surgical Procedures↗
PubMed1978

Biliary sludging following liver transplantation in man.

Following orthotopic liver transplantation in man biliary, obstruction has been produced by masses of inspissated bile--biliary "sludge." Bile studies in two groups of patients following transplantation show that bile is lithogenic in the early postoperative period but that reestablishment of the entero-hepatic circulation of bile salts corrects this. Such changes, however, do not appear to be important in sludge formation and biochemical and histological studies of bile sludge show a major constituent to be necrotic collagen from the donor bile duct walls.

Alkaline Phosphatase↗
PubMed1978

Rupture of the allografted kidney--is repair possible?

Allograft rupture after transplantation is an uncommon but serious complication. A review of the literature suggests a significant mortality and very high incidence of graft loss. Data will be presented which suggests that conservative management of the allograft rupture is possible.

Adult↗
PubMed1977

C6: synthesis by the liver in vivo.

The allotype of the sixth component of complement was determined in a patient before and after liver transplantation. The C6 phenotype changed from A before transplantation to B (the donor phenotype) within 10 days of the transplant and remained wholly of the donor phenotype at 17 wk. This demonstrates that the liver is the exclusive or predominant site of C6 synthesis in vivo in man.

Blood Transfusion↗
PubMed1977

Orthotopic liver transplantation: the first 60 patients.

Between May 1968 and 31 December 1976 60 orthotopic liver allografts were transplanted by the Cambridge-King's College Hospital team. During this period there were changes in the selection of patients and their management. Initially some patients were operated on when they were too ill, often because of a prolonged wait for a donor. There was a high incidence of fatal complications of biliary drainage in patients who survived longer than the first week after operation. Improved results have been due to the development of a simple method of preserving the liver, thereby increasing the pool of potential donors, and by a new technique of biliary drainage, which allows well-vascularised anastomoses without tension, retains the sphincter of Oddi, and leaves access for radiological examination of the biliary tree. Uncontrollable rejection of the liver has occurred in less than 10% of cases. This contrasts strongly with the incidence of rejection among kidney transplants. Six patients have lived for over a year, the longest surviving for more than five years, and 13 patients were still alive at the beginning of 1977.

Adult↗
PubMed1977

Observations on preservation, bile drainage and rejection in 64 human orthotopic liver allografts.

The combined Cambridge/King's College Hospital series of 64 orthotopic liver grafts' experience dates back to 1968. Many patients were referred for liver grafting late in the course of their diseases and were operated on when they were too ill or died before suitable livers could be found. Complications of biliary drainage were the most frequent causes of death. In the past two years we have acquired experience of a method of liver preservation which permits up to 8 hours of safe storage without any complicated machines and we have been able to transport 22 livers by air and road from other institutions to our own unit. This has enlarged the pool of potential donors and therefore reduced the average waiting time for a liver transplant. A new method of biliary drainage has been employed in 24 patients using the vascularised gall bladder as a conduit between the donor and recipient common ducts. This has resulted in a marked reduction in early postoperative complications of biliary fistula and obstructed bile drainage. Now that survival has improved, it has become clear that uncontrollable rejection of the allografted liver in man is much less severe than that experienced with kidney transplants. The results of liver grafting in our unit during the past year are better than those obtained with kidneys from cadaver donors.

Common Bile Duct↗
PubMed1977

Simple hypothermic preservation for transporting human livers long distances for transplantation. Report of 12 cases.

Since 1973, 12 patients in the Cambridge-King's College Hospital liver transplant programme have received livers from donors dying in hospitals considerable distances from the transplant centre in Cambridge. The method of preservation used to transport these livers from 35 to 110 miles was flush perfusion with plasma protein fraction and hypothermic storage in ice. The ischaemia times ranged from 2 hr and 42 min to 4 hr and 22 min. All of the recipients had good or excellent postoperative function of the grafts and 6 of the 12 recipients are alive, the longest survival being 29 months. The preservation technique is simple and easily portable and has given reliable 4-hr preservation of the human liver.

Adolescent↗