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Biomedical subjects

B Berg

Publications and source records attributed to B Berg.

At least 91 records · Page 5Linked to original sources
PubMed1981

Further experience with antihuman lymphocyte globulin (Behring): no effect on cadaveric renal graft survival.

In 1977 we reported that 1 year cadaveric renal graft survival was improved in patients treated with high dose anti-human lymphocyte globulin (AHLG) (Behring). Such a beneficial effect of this agent was not confirmed in the present study with an enlarged series of patients and with a longer follow-up time. Nor was there any gain in respect of renal function or any steroid sparing effect. The only indication of an immunosuppressive effect is that the rejection episodes possibly occurred later in the patients given the high dose AHLG.

Antilymphocyte Serum↗
PubMed1981

The influence of HLA-D matching on the outcome of intrafamilial kidney transplantation with special emphasis on the predictive value of the relative response in MLC.

One hundred and three recipients of kidney transplants from living related donors were analyzed for the influence of HLA-D matching on graft survival. Sixty-two donors were parents and 41 brothers or sisters. Twenty-two of the siblings were HLA-A, B identical. The degree of HLA-D compatibility was measured in a mixed lymphocyte culture reaction. Whereas nonresponsiveness was found with HLA-A, B identical sibling donors, the haploidentical donors were found to initiate varying degrees of stimulation. The stimulation was, calculated as the relative response (RR) to the donor in relation to an unrelated individual or to lymphocytes pooled from a number of individuals. It was found that RR values above 55% predicted a graft survival that was significantly inferior to the group with values less than 20% (p less than 0.01) and also to the group with RR values between 20% and 55% (p less than 0.05).

Actuarial Analysis↗
PubMed1981

Use of rabbit anti-human thymocyte globulin in cadaver kidney transplantation. Preliminary experiences.

Rabbit anti-human thymocyte globulin was given as an adjunctive immunosuppressive agent to 23 recipients of cadaver kidneys in the immediate 14 day post-transplantation period. A drastic reduction in the number of T-lymphocytes in the peripheral blood was recorded and there was a very low frequency (13%) of early, acute rejection episodes. Two to 8 months after transplantation 13 of 14 patients (93%) below 55 years of age survive with a functioning graft. Among 9 older recipients, the patient and graft survival was 56 and 33% and 4 of the patients died with septic complications. It is concluded that the elderly patients were over-immunosuppressed and we will no longer use RATG in this patient category.

Anaphylaxis↗
PubMed1981

The influence of HLA-DR match on cadaveric renal graft survival. Experience from Stockholm.

The influence of HLA-DR match on graft and patient survival was analyzed in 124 cadaveric kidney transplant recipients treated between January 1977 and September 1980. The material consisted of 90 primary transplant and 34 retransplants. The mean patient age was 49 years, 72 were males and 52 females. Eighteen of the recipients were diabetics. Sera against the HLA-DR antigens 1-5, 7 and DRw8 were available, for DRS only during the later half of the period. When the case material was divided according to the number of donor-recipient HLA-DR antigens shared, a significant improvement in graft survival was found if one antigen was shared as compared to none shared. When 2 antigens were shared graft survival was excellent but there were only 7 such cases. When division was performed according to the number of existing HLA-DR incompatibilities, a significant improvement in graft survival was noted when there were no incompatibilities as compared with 2 incompatibilities. The distribution of foreign HLA-A, B antigens was even between the DR match groups and did therefore not constitute a bias. We conclude that matching for the HLA-DR antigens has a major beneficial effect on cadaveric kidney graft survival.

Actuarial Analysis↗
PubMed1980

Experience with pancreatic transplantation in Stockholm.

Eight attempts at segmental pancreatic transplantation were made in 6 diabetic patients. While the indications for transplantation differed all the patients were severely incapacitated by the disease. None was uremic. The body and tail of the pancreas from cadaveric donors was used, the grafts were revascularized to the recipient's iliac vessles. Six of the grafts provided control of blood glucose for 7-51 days. Five of the grafts then failed owing to rejection, and one had to be removed while still functioning, because of arterial bleeding. Important lessons have been learned concerning both surgical and immunological aspects of this form of treatment : 1) Ducto-jejunostomy should be used to provide exocrine pancreatic drainage. 2) HLA-DR typing for donor-recipient selection and thoracic-duct drainage as an adjunctive immunosuppressive measure should be used to reduce the incidence of graft rejection. 3) An elevation of the postprandial blood glucose concentration is a first sign of rejection and should cause treatment. 4) Graft rejection can be reversed by conventional steroid medication.

Adult↗
PubMed1980

Segmental pancreatic transplantation with duct ligation or drainage to a jejunal Roux-en-Y loop in nonuremic diabetic patients.

The results of seven segmental pancreas transplantations in diabetic patients, using a jejunal Roux-en-Y loop for drainage of digestive enzymes, are presented. An initial case with pancreatic duct ligation is also included. The patients ranged in age from 30 to 45 yr, with duration of diabetes from 8 to 24 yr, and were incapacitated but not uremic. Immunosuppression was attempted with azathioprine, prednisone, and antilymphocyte globulin, and, in one patient, thoracic duct drainage was added. The pancreas tolerated at least 16 min of warm ischemia and at least 4 h of cold storage; flushing with a balanced electrolyte solution was optimal. Six of the grafts provided control of blood glucose for 7--51 days, and, in one patient, an intravenous glucose tolerance test was normal at 7 and 21 days. Five of the grafts failed due to rejection 7--51 days after transplantation, and one was removed at 14 days, while still functioning, due to bleeding. In one case, early detection of rejection by a rise in post-prandial blood glucose was treated and reversed by corticosteroid administration. Two failed in the immediate postoperative period from vascular thrombosis. Drainage of pancreatic secretions from a fistula was a common problem.

Adult↗
PubMed1980

The implications of HLA-DR match for the outcome of cadaveric renal transplantation.

Typing for HLA-DR has been performed in cadaver renal transplantations in Stockholm since 1977, but there was no donor-recipient selection based on HLA-DR. During the period 1977-78 76 cadaver renal transplantations were carried out; in 61 of them typing for HLA-DR was performed. There were 4 exclusions, 2 because of a hyperacute rejection of the graft and 2 because the kidney never started to function after the operation owing to irreversible ischemic damage. In 29 of the 57 transplantations remaining for analysis there was one antigen common to the donor and the recipients, and in 28 there was no common antigen; there was no instance of 2 common antigens. The distribution by degree of HLA-A, -B match was the same for the two groups. Graft survival after one year was better for the group with one common HLA-DR antigen, but the difference was not statistically significant.

Graft Survival↗