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Biomedical subjects

R Y Calne

Publications and source records attributed to R Y Calne.

At least 307 records · Page 17Linked to original sources
PubMed1977

Percutaneous needle biopsies of renal allografts: the relationship between morphological changes present in biopsies and subsequent allograft function.

In the Cambridge renal transplant unit percutaneous needle biopsies of renal transplants have been extensively used to help identify the cause of impaired allograft function. During the period 1966--1973, 154 of the 269 renal allografts transplanted were biopsied at least once during the first 90 days after transplantation. In this survey the relationship between morphological changes in these biopsy specimens and allograft function 1, 3 and 5 years after transplantation is assessed. A highly significant direct relationship exists between early graft failure and the presence of medial necrosis of arteries, acute glomerular lesions and interstitial haemorrhage. Less than 10% of grafts with one or more of these changes and none in which all three types of lesion were present were capable of supporting life at 1 year. There is a significant association between poor subsequent graft function and mononuclear cell infiltration of the intima of arteries. No clear relationship exists, however, between the function of grafts at 1 and 3 years and the degree of mononuclear cell infiltration of the interstitial tissue. Tubular necrosis was frequently observed and future graft performance is related to the extent and cause of the tubular damage.

Adolescent↗
PubMed1976

A new technique for biliary drainage in orthotopic liver transplantation utilizing the gall bladder as a pedicle graft conduit between the donor and recipient common bile ducts.

A technique for biliary drainage in orthotopic liver transplantation has been developed in which the gall bladder is used as a pedicle graft between the donor and recipient common bile ducts. In 7 patients this technique has produced encouraging results. There has been no incidence of bile leakage or stenosis of the anastomoses. The gall bladder permits the widest possible anastomoses for obliquely cut ends of the donor and recipient common ducts. It eliminates tension and retains the advantage of the sphincter of Oddi. Although the followup is short, the incidence of biliary complications using other techniques has been so high that the procedure described here would appear to have distinct advantages.

Adolescent↗
PubMed1975

Respiratory failure after liver transplantation.

A rapidly growing haemangioendothelial sarcoma of the liver in a twenty-two year old woman was treated by liver transplantation. Disseminated intravascular coagulation resulted in massive blood loss during surgery, and contributed to the death of the patient from respiratory failure on the fourth post-operative day, despite continuous post-operative intermittent positive-pressure ventilation. Other factors leading to her respiratory failure are discussed. There was no evidence of dysfunction in the transplanted liver.

Adult↗
PubMed1975

Bile composition and bile cast formation after transplantation of the liver in man.

Transplantation of the liver in man is frequently complicated by biliary fistula and obstruction of the biliary tree by casts, which suggests that the composition of the bile may be abnormal. In part of the present study, bile composition was investigated in three recipients during the first few weeks after transplantation, when a T tube was in place. Supersaturation of bile with cholesterol was found in two patients immediately after surgery and during episodes of acute rejection, but bile was never lithogenic in the third. There was no evidence of bile stasis in the absence of acute rejection and bile viscosity was normal in all three patients throughout the study. Free bile acids and free bilirubin, which are relatively insoluble products of bacterial metabolism, were not present in the bile of any patient. However, chemical analysis of casts found at autopsy in a fourth recipient showed that the major component was free bilirubin. Escherichia coli was grown in cultures of the casts and the organisms were shown to possess glucuronidase activity, thus providing an explanation for the high bilirubin content. There was also some evidence in one case that damage to the bile duct mucosa has led to the precipitation of material upon it, and it is concluded that a number of factors, including infection, supersaturation with cholesterol, and mucosal damage, may be involved in bile case formation after transplantation of the liver.

Adult↗
PubMed1975

Transplantation.

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Brain Death↗
PubMed1974

Kidney transplantation: analysis of 200 cases.

The first 200 renal allograft operations performed at Addenbrooke's Hospital, Cambridge, have been analysed. At the time of writing the fractional graft survivals at one, two, and three years were 53%, 49%, and 39% respectively, and these showed no observable change through the seven years of the programme. On the other hand, the survival of patients undergoing renal transplantation steadily improved, the most recent survival rates at one, two, and three years being 83%, 78%, and 67%, whereas the overall rates were 74%, 66%, and 54% respectively. The survival of second allografts was similar to that of first allografts. Ninety per cent. of the patients whose allografts functioned for a year or more returned to active and gainful employment. The return of children to school and of housewives to running a household was similarly gratifying. We conclude on both social and economic grounds that renal transplantation is fully justified as a therapeutic procedure.

Adolescent↗
PubMed1974

Renal transplantation in patients with carcinoma.

Four patients in terminal renal failure who had various malignant tumours were treated by haemodialysis and cadaveric renal transplantation. One patient with a testicular seminoma and one with leiomyosarcomatous changes in polycystic kidneys were successfully grafted after removal of the tumours and both were healthy at three and two-and-a-half years afterwards without evidence of recurrence of tumour.One patient with an invasive carcinoma of the renal pelvis was successfully transplanted and remained well for eight months but rapidly deteriorated and died of extensive metastases. Another patient with a malignant melanoma died more than one year after unsuccessful grafting.The presence of concomitant malignant disease in patients with chronic renal failure need not necessarily exclude them from the chance of long-term treatment, including renal transplantation. Each patient should be considered individually from the point of view of the nature of the malignancy, its duration, and treatment.

Adult↗