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Biomedical subjects

A Prokurat

Publications and source records attributed to A Prokurat.

10 recordsLinked to original sources
PubMed1997

Primary vascular thrombosis after renal transplantation in children.

The aim of the study was to assess the incidence, causes, diagnostic and treatment modalities, and outcome of vascular thrombosis after kidney transplantation in children. Between 1984 and 1995 we performed 176 kidney transplants in pediatric recipients aged 1 to 18 years. Vascular thrombosis followed 7 transplants, 4 were renal vein and 3 arterial thromboses. Venous thromboses occurred 2 to 12 days after transplantation. All of the patients with a renal vein thrombosis lost their grafts. Arterial thrombosis developed in 2 cases of double renal arteries which were separately anastomosed into the recipient vessels. One graft was lost, but the other was saved by thrombolytic therapy (streptokinase). One child experienced intrarenal segmental artery thrombosis during acute vascular rejection, which resolved following combined anti-rejection and thrombolytic (intra-arterial streptokinase) treatment with full recovery of graft function. In all, vascular thrombosis complicated 7 out of 176 transplants (4.0%), and was the cause of 5 graft losses (2.8%). The incidence of vascular thrombosis was not increased in grafts with vascular anomalies (3/34 v. 4/142; p>0.05, chi sq.). We conclude that acute tubular necrosis, rejection and unstable volemia may predispose to vascular thrombosis. In selected cases, early diagnosis of vascular thrombosis may enable graft salvage by surgical or thrombolytic treatment.

Adolescent↗
PubMed1996

Pregnancy and delivery after liver transplantation.

The first case of pregnancy in a patient after an orthotopic liver transplantation (OLT) in Poland is presented. A 21-year-old woman was liver grafted 3 years prior to the pregnancy. Before having conceived the patient's graft function was stable. The woman was on immunosuppressive therapy with cyclosporine A and prednisolone. During pregnancy no significant changes in biochemical tests of liver function and liver blood flow were noted. Starting at the second trimester, a slight anemia occurred and the quantity of blood platelets continued to decrease, the latter having been observed immediately after the transplantation. The intrauterine growth of the fetus was monitored by ultrasound and the assessment of blood flow to the placenta was made. No abnormality was observed. In the second and third trimester the presence of HCV-RNA in the serum was found. In the 41-st week of pregnancy labor commenced. The threat of intrauterine infection indicated a cesarean delivery. The newborn weighed 4180 g and had an Apgar score of 10. The cesarean section, as well as puerperium, was normal. The immunosuppressive therapy was continued, and antibiotics were administered for prophylactic reasons. During the first month the infant was treated with antibiotics because of pneumonia and the suspicion of meningitis. Nine months after the delivery, the patient's health is satisfactory and the baby is making normal progress.

Adult↗
PubMed1996

Diagnosis and monitoring of cytomegalovirus infection after liver transplantation in children.

Cytomegalovirus infection (CMV) complicated the posttransplant course in 9 of 24 children after liver transplantation. We found specific antibodies (IgG and IgM) to be of very low value in diagnosis and monitoring of CMV infection after liver transplantation. Detection of CMV-DNA by PCR method in the blood or urine was very useful for diagnosis, but less for monitoring of the course of disease and its treatment. Measurements of early immediate CMV antigen (IEA), in peripheral blood leucocytes allowed for very early diagnosis of CMV infection and correlated well with the course of disease and response to treatment of the patient.

Antibodies, Viral↗
PubMedDate not supplied

The surgical approach to hyperinsulinism and hypoglycemia in children.

Authors present 19 children aged from 2 weeks to 16 y with severe hypoglycemia. In 3 oldest children a single nesidioma was found. In other 16 children mainly infants nesidioblastosis has been recognised, and in those cases the subtotal pancreatectomy was performed. In 4 infants the additional resection of the pancreas was done because after the primary procedure hypoglycemia persisted. All patients survived and were euglycemic. Severe hypoglycemia leads to brain damage and therefore should be treated as an urgent state.

Adolescent↗