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Biomedical subjects

U Frei

Publications and source records attributed to U Frei.

At least 163 records · Page 9Linked to original sources
PubMed1988

[Combined heart and kidney transplantation in terminal myocardial and renal insufficiency].

In a 38-year-old man combined heart and kidney transplantation was performed successfully in one operation. Both organs have functioned well postoperatively: the patient was discharged from hospital on the 19th postoperative day and has remained in functional class I (New York Heart Association) eight months later. Only two episodes of cardiac rejection have been observed during this period, responding to treatment, and there was no evidence of rejection of the kidney. Such combined heart-kidney transplantation from one donor seems to be a promising form of treatment for patients in end-stage myocardial and renal failure. The frequency of cardiac rejections my be lower after combined heart-kidney transplantation than after cardiac transplantation alone.

Adult↗
PubMed1988

[Erythropoietin and hypertension].

Recombinant human erythropoietin (rhEpo) has been demonstrated in several studies to be effective in correcting the anemia of regular dialysis patients. This was accompanied by a significant improvement of the physical work capacity shown by exercise testing. The main side effect of rhEpo treatment has been the development or aggravation of hypertension in approximately 30% of the treated patients. In 2% hypertensive encephalopathy and convulsions occurred. Data obtained by measurements of regional blood flow indicate the peripheral resistance did increase probably due to rise of blood viscosity and reversal of preexisting hypoxic vasodilatation. To avoid hypertensive complications anemia should be corrected slowly over a period of 12-16 weeks. Target hematocrit should not exceed 30-35 vol. %. Blood pressure and volume status should be monitored closely.

Anemia↗
PubMed1988

Gastrointestinal blood loss in haemodialysis patients during use of a low-molecular-weight heparinoid anticoagulant.

In a randomised cross-over study we assessed total blood loss in 14 dialysis patients using 59Fe as a marker for measurement in a whole-body counting system. In one period the patients received standard heparin, in the other ORG 10172, a new low-molecular-weight-heparinoid. Our results show no significant difference between the two study periods with regard to blood loss and dialyser blood retention. In some patients a delayed bleeding ('oozing') from the puncture site was noticed as a side-effect of treatment with the low-molecular-weight-heparinoid. We conclude that this heparinoid is effective as an anticoagulant in regular dialysis treatment, but it seems to have no advantage over standard heparinisation with regard to occult bleeding. This may be related to the prolonged plasma anti-Xa activity (30.8 h) of this compound compared to standard heparin in dialysis patients.

Adult↗
PubMed1988

The engymetric determination of acute functional impairment in kidney graft function caused by cyclosporine A.

Engymetry offers a new means of continuously measuring nuclear radiation fields without any need of restricting the patient's mobility. In this study, kidney function was measured simultaneously and continuously for 6.6 h with engymetry, after application of a 12 h therapy dose of Cyclosporine A (CsA) of 4.0 +/- 1.8 mg per kg bodyweight (bw). 15 kidney transplanted patients participated in this study. 370 MBq 99Tcm-DTPA and 10 MBq 131I-OIH were injected during routine transplant scintigraphy. Renal function was monitored from the external disappearance curves of the tracers recorded by portable double radionuclide detectors. Renal impairment could be seen in the rising phase of CsA or coincided with the CsA maximum in 13 of the 15 patients. Under the impairment the half-life of 99Tcm-DTPA increased from 4.1 +/- 1.2 to 15.9 +/- 12.3 h (p less than 0.005) for 61 +/- 45 min and the half-life of 131I-OIH increased from 3.2 +/- 0.7 to 12.7 +/- 8.4 h (p less than 0.001) for 71 +/- 37 min. With noninvasive engymetry it is possible to detect renal functional impairment during long observation periods. Acute restriction in glomerular filtration and renal blood flow was discovered in human kidney graft recipients after the application of a low therapeutic CsA dose.

Acute Kidney Injury↗
PubMed1986

[Complicated pregnancy course following kidney transplantation].

During the last decade the rate of pregnancies in renal transplant recipients has been increasing. Now as before severe and unexpected complications can occur. After treatment with Dihydralazine in combination with Fenoterol we observed a drastic deterioration of kidney and heart function in one of our patients. Therefore such a drug combination does not seem to be recommendable for renal transplant recipients.

Adult↗
PubMed1986

Single nephron hyperfiltration and proteinuria in a newly selected rat strain with superficial glomeruli.

Alterations in glomerular permeability were studied in female MWF/Ztm rats, newly selected from the Munich Wistar rats with a high number of superficial glomeruli. This strain is characterized by a diminished number of functioning nephrons, an elevated arterial blood pressure and a high proteinuria averaging 24 mg/24 h. Samples of Bowman capsular space (BCS) obtained by free-flow renal micropuncture techniques with pressure control were analyzed for albumin and high-molecular-weight (HMW) proteins by ultramicrodisc electrophoresis. The measured mean albumin and HMW protein concentration in BCS were 1.72 g/l and 0.66 g/l, respectively. The glomerular filtration rate (GFR) averaged 0.74 ml/min/g kidney weight and the single nephron GFR (SNGFR) 48 nl/min. Ultrastructural studies revealed focal bleb-like alterations of the podocytes as has been observed in hyperfiltration states. We suggest that the reduced number of functioning nephrons in the kidneys of these rats could induce glomerular hyperfiltration and permselectivity changes, which cause a high glomerular protein leakage.

Animals↗
PubMed1983

Acute vascular rejection treated by plasma exchange.

Since 1980 we have treated in 14 patients 19 steroid resistant acute vascular rejection (AVR) episodes by plasma filtration (PF). Each episode was treated by six PF with 5L plasma being filtered and simultaneously replaced by 3.5 per cent Albumin-Ringer-lactate. After each PF 20g immunoglobulin (Intraglobin) was given intravenously. In all cases renal function improved following PF. In the long term one graft was lost due to chronic irreversible vascular rejection, all others are still functioning, nine of them six months and eight of them 12 months post PF treatment. They show no signs of rejection. PF with repletion of immunoglobulins after treatment is a simple and safe procedure, which in our hands proved to be quite effective in reversal of AVR.

Biopsy↗
PubMed1983

Renal allograft survival in patients transfused perioperatively only.

We investigated in a prospective study the effects of perioperative blood transfusions on the outcome of renal transplantation. All patients (n = 105) receiving their first cadaveric renal allograft were transfused perioperatively (i.e. 0-6 hours before transplantation) with two units of non-washed, unfiltered packed red cells. Forty-eight were transfused perioperatively only; 57 patients had received blood earlier and thus were transfused pre- and perioperatively. Graft survival one and two years post-transplant was 79 per cent at both time intervals in the group transfused perioperatively only, and 85 per cent and 74 per cent in the pre- and peroperatively transfused group. No adverse effects were observed concerning perioperative transfusions. In patients transfused perioperatively only, acceptable graft survival rates are obtainable. In these patients the risk or presensitisation is avoided, and thus their chance of successful transplantation increased.

Adolescent↗