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Biomedical subjects

S L Kountz

Publications and source records attributed to S L Kountz.

At least 19 recordsLinked to original sources
PubMed1979

Results of renal transplantation using pediatric cadaver donors.

In order to determine the results of transplantation using pediatric cadaver donors, a retrospective analysis of a series of 502 renal transplant recipients was carried out. Methods of procurement, preservation, recipient selection, and immunosuppressive regimen were similar for all patients. Sixty-five recipients were approximately equally divided into three groups whose donors were younger than 5 years of age, 6 to 10 years old, and 11 to 15 years. These three groups then were compared with each other and to a randomly selected representative group of recipients whose donors were adults (16 years or older) for the following parameters: actuarial graft and patient survival, causes of graft failure and patient death, level of serum creatinine in currently functioning grafts, and recipient age. There were no statistically significant differences between groups for any parameter except that the mean age of recipients was approximately 16 years for the donors up to 5 years of age and was between 31 and 36 years for the other donor age groups (P = 0.01). These results support the contention that brain-dead pediatric patients of any age should be considered to be potential cadaveric kidney donors. Exclusion of these patients is very wasteful and also is unnecessary since results of transplantation equal to those obtained with adult donors can be expected. Technical graft failures should not be more frequent than with adult kidneys, and there is no need to modify the basic surgical technique for small kidneys in order to achieve this.

Adolescent↗
PubMed1978

Relationship of renal transplantation to hypertension in end-stage renal failure.

The relationship of renal transplantation to new onset or persistence of previously established hypertension was analyzed in 164 transplant recipients in whom the renal allograft functioned for six months or longer. Of the 164, thirty-seven (23%) had normal blood pressure and 127 (77%) were hypertensive prior to transplantation. Following transplantation 83 patients (51%) were normotensive; high blood pressure was found in 81 (49%). Posttransplant hypertension could not be correlated with the recipient's original renal disease, age, sex, renal donor source, donor age, or maintenance dose of prednisone. More normotensive paients had undergone prior binephrectomy when compared with the hypertensive group (P less than .05). Mean serum creatinine levels was higher (2.0 mg/dl) in hypertensives than in normotensives (1.54 mg/dl) (P greater than .05). Selective renal veins' renin measurements in patients with severe hypertension were not helpful in predicting the beneficial effects of either bilateral nephrectomy or surgical correction of transplant renal artery stenosis.

Adult↗
PubMed1978

Liver and immune responses. IV. Characteristics of the liver cell-lymphocyte interaction.

Rat liver cells prepared by collagenase treatment and separated by density gradient centrifugation with Ficoll-Hypaque solution (specific gravity 1.120), containing only hepatocytes (80%) and Kupffer cells (20%), were found to stimulate strongly Ag-B-incompatible lumphocytes without 2-mercaptoethanol in culture. The same liver cells could also stimulate Ag-B-compatible lymphocytes in the presence of 2-mercaptoethanol. A positive response was only seen when the liver cell numbers were 1 approximately 2% of the responding lymphocytes. Viable liver cells inhibited the reaction in a two-way culture.

Animals↗
PubMed1977

Successful renal transplantation in infancy.

This infant's post renal transplantation course, representing apparently the smallest long term survivor, illustrates that neither age nor size are contraindications to successful renal transplantation in infants with end stage renal failure. Additional experience with the transplantation of a single kidney into a 1-yr-old baby weighing 4650 gm with congenital bilateral renal hypoplasia has also been successful with a 3-mo follow-up. Both cases demonstrate that single or double renal transplantation in infants is feasible and should be considered when indicated.

Acute Kidney Injury↗
PubMed1977

The impact of 1,000 renal transplants at one center.

A large, comprehensive renal transplant program has a major impact not only on patient care, but also on the medical center itself and the larger community. The program at this center has advanced from 15 transplants in 1964 to 141 transplants in 1976. Fifty-nine per cent of patients transplanted have functioning kidneys at this time, including 76 children. Rehabilitation was equal to prerenal disease level in 91% of 169 recipients who lived five years with a functioning graft. Basic research in such diverse areas as renal preservation and immunology, as well as clinical research in optimum immunosuppressive therapy, resulted in significant contributions. Refinement of the mixed lymphocyte culture improved living-related graft survival at two years: 100% for HLA-identical and 91% for non-HLA-identical grafts, compared to 66% reported by the Transplant Registry for the combined group. Modification of immunosuppression improved patient survival at two years: 100% and 86% for recipients of living-related and cadaver grafts, respectively, compared to 83% and 65% reported by the Transplant Registry. The complexity of care of the patient with end-stage renal failure has required active interaction between transplant surgeons and almost every major specialty. The vast clinical material has been a great asset for training transplant surgeons, nephrologists, fellows and residents of multiple specialties, and medical students. The medical center's relationship with communities within a 250 mile radius has been strengthened, as reflected in patient referrals and the development of a multi-community-supported organ procurement system, which has allowed us to perform over 100 cadaver transplants per year for the past three years. Thus the performance of 1,000 renal transplants at this center has resulted not only in rehabilitation of many renal failure patients, but also in expanded and improved research and teaching capabilities, bringing support from multiple medical disciplines and the general community.

Adolescent↗
PubMed1977

Patient self-referral for kidney transplantation.

A total of 634 patients referred for transplantation was followed for up to 5 yrs, 149 being self-referred and 485 being referred by their physicians. The survival rates of those transplanted in both groups were compared to those not transplanted. The self-referred group increased their chances of receiving a transplant by 20% and did not increase their risk of mortality. These findings suggest that transplantation should be recommended to all patients with end-stage renal failure as the procedure of choice.

Adolescent↗
PubMed1977

Mixed heart cell-lymphocyte reactions and graft survivals in Ag-B-compatible rats.

A method of dissociation of the rat heart cell for the mixed lymphocyte culture purpose is described. The treatment of the young rat heart with 0.1% collagenase-hyaluronidase solution yielded satisfactory heart cell suspension. The hear cells, thus obtained after mitomycin C treatment but not irradiation, stimulated allogeneic lymphocytes in the presence of 2-mercaptoethanol. In the Fischer to Lewis combination compatible at the Ag-B locus, strong reactions of Lewis lymphocytes to the dissociated heart and skin cells of the Fischer rat were related to the acute rejection of heart and skin grafts, while negative reactions by the kidney and spleen cells reflected a prolonged survival of the kidney graft. The role of skin- and hear-specific antigens in the rejection phenomenon is discussed.

Animals↗