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Biomedical subjects

W Land

Publications and source records attributed to W Land.

At least 163 records · Page 9Linked to original sources
PubMed1989

Angiography of segmental pancreatic transplants.

Arteriography was routinely performed in patients with suspected vascular complications after pancreas transplantation. Dysfunction of the grafts was suggested by 99mTc-DTPA scanning and metabolic tests. Thirty arteriograms obtained in 25 patients were evaluated. Nineteen conventional film angiograms and 11 intraarterial DSA were performed. Five different angiographic patterns were observed: normal vascular anatomy, low-flow phenomenon, arterial or venous thrombosis, and venous neovascularity. On the basis of the angiographic findings, various reasons for graft failure were identified. Recipient venous collaterals or well-functioning grafts without angiographically detectable blood supply were observed in 9 cases, and must be considered to represent neovascularisation by donor and recipient vessels.

Angiography, Digital Subtraction↗
PubMed1988

Renal transplantation at the Munich Transplant Center: a retrospective single-center review.

The use of different immunosuppressive protocols (high-dose/low-dose CsA) has little effect on first cadaveric transplants in nonsensitized patients. However, low-dose CsA induction treatment reduces early nephrotoxic crises. There is a clear benefit of quadruple drug induction treatment for retransplants and sensitized transplant candidates. Steroid-free immunosuppressive therapy can be applied to a majority of long-term patients.

Cyclosporins↗
PubMed1988

Pancreatic transplantation using the duct occlusion technique.

Since 1979, the Munich Group has gathered experience with 100 consecutive pancreas transplants using the duct occlusion technique. At the present time, 40 of the pancreas grafts (44%) and 56 of the renal grafts (65%) of 90 patients who received both a pancreas and a kidney are still functioning. The mortality rate of 18% in the early period was relatively high. In the period from 1984 until 1988--using the simple transplantation technique--only one patient died. During this period, our overall results improved with the use of a modified surgical technique and different immunosuppressive and anticoagulative measures along with better patient selection. Normalization of the glucose metabolism seems to improve the rate of late diabetic complications. The duct occlusion technique in isolated pancreas transplants might have been a disadvantage in accounting for the poor results. With regard to metabolic studies, there is now ample evidence to suggest that successful pancreatic transplantation leads to complete normalization of glucose metabolism including normoglycemia in more than 70% of all patients. In addition, clinical data are accumulating that suggest successful pancreatic transplantation has a beneficial effect on the late secondary syndrome of Type I diabetes mellitus.

Cyclosporins↗
PubMed1987

[Coronary heart disease and heart valve diseases in patients with terminal kidney insufficiency].

Cardiac catheterisation and coronary angiography were performed in 100 patients preceding a planned renal transplantation. Coronary heart disease was revealed in 64 patients: stenoses of 50-70% in 28, 71-90% in 16, over 90% in 20 patients. For stenoses above 50% the sensitivity of clinical symptoms was 0.52, their specificity 0.64. For stenoses over 70% the specificity was 0.58; over 90% it was 0.70. Typical symptoms of angina were less common in dialysis patients with coronary heart disease than is usual in other patients with coronary heart disease. Total duration of dialysis as well as frequency and severity of coronary heart disease did not correlate. In 19 of the 100 patients valvar disease was also present, with a discrepancy between the severity of clinical and of hemodynamic findings. Incidence and severity of valvar disease increased with the duration of dialysis. Transplantation was postponed in 11 patients (bypass operation in 3, balloon dilatation in 2, valve replacement in 6). Transplantation was advised against in four (severe coronary heart disease in 2, cardiomyopathy in 2).

Adult↗
PubMed1987

[Status of pancreatic organ and pancreatic islet cell transplantation].

The results of allogeneic clinical islet cell transplantation continue to be rather disappointing. However, results of clinical pancreatic transplantation in Type-I-diabetes are still improving: some centres (incl. the Munich centre) have reported a 1-year-graft survival rate of more than 70%. In 60-65% of successfully transplanted patients a normalisation of glucose tolerance can be achieved. There is accumulating evidence suggesting that successful pancreatic transplantation exerts a curative effect in Type I diabetes mellitus: Long term investigations have shown a subjective and objective improvement of diabetic retinopathy, nephropathy, polyneuropathy and peripheral microangiopathy.

Blood Glucose↗