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Biomedical subjects

D E Cross

Publications and source records attributed to D E Cross.

At least 19 recordsLinked to original sources
PubMed1988

Successful transplantation of blood group A2 kidneys into non-A recipients.

The ABO subgroup A2 has been reported to be less reactive with the anti-A1 antibody naturally occurring in the serum of group O and B recipients and to occur in approximately 20% of group A individuals. Between March 1986 and February 1987, the Midwest Organ Bank (MOB) in Kansas City, screened all group A renal donors for the A2 subgroup. A total of 190 cadaverdonor kidneys were retrieved during this time, of which 68 were subgroup A1 and 16 were subgroup A2 (incidence of A2 = 19% of As and 8.5% of all donors). Of the subgroup A2 kidneys, 13 were transplanted into 9 group O and 4 group B recipients. One group O recipient received an HLA-identical A2 living-related graft. Recipients were not preselected or modified by splenectomy, plasmapheresis, or other means, and were treated with cyclosporine, steroids--and, in most cases, azathioprine, after transplantation. There was one hyperacute rejection and there were 5 acute cellular rejection episodes, 3 of which were reversed. One additional patient died at 2.5 months with a functioning graft. Including the successful living-related graft, 10 of 14 patients (71%) have functioning grafts, with a follow-up of 5 to 14 months, and a mean creatinine of 1.7 mg/dl. We find that the A2 subgroup represents a small but important minority of A donors, and that transplantation into non-A recipients can generally, but not universally, be safely accomplished. We recommend the screening of A donors for the A2 subgroup in both the cadaver-donor and living-related groups, and suggest that the utilization of A2 donors in non-A patients may contribute to the transplantation of group O and highly sensitized patients--and, in some cases, improve the degree of HLA matching.

ABO Blood-Group System↗
PubMed1986

Prediction of crossmatch outcome in highly sensitized dialysis patients based on the identification of serum HLA antibodies.

High levels of allosensitization (greater than 50%), which often occur in dialysis patients awaiting renal transplant, make donor selection difficult. Such patients may be included in elaborate protocols in which they are crossmatched with all available ABO compatible donors, or crossmatching may be deferred until a very-well-matched donor becomes available. The former approach of random crossmatching is costly and inefficient, while the latter approach may overlook crossmatch-compatible donors. We believe that the identification of antibodies present in highly reactive sera and the use of this information in donor selection would increase the frequency of crossmatch-negative donors for these patients. In this study eleven sera, reactive with 70% to 100% of a random cell panel, were obtained from multiply transfused dialysis patients. Sera were analyzed by standard (CDC) and antiglobulin augmented (AHG-CDC) lymphocytotoxicity, and by differential absorption with HLA-typed platelets. All sera contained only one or two antibodies directed against the high frequency public HLA epitopes, accounting for 85% to 100% of each serum's total reactivity. These characterized sera were crossmatched with 114 random normal donors. The frequency of negative crossmatches was 20.5%. However, if the serum antibody data had been used to preselect donors for crossmatch--that is, to exclude donors that were likely to be positive--the negative crossmatch frequency would have increased to 86.4%. The use of the serum analysis data in donor selection would have reduced the total number of required crossmatches by 78%. Serum analysis correctly predicted the outcome of 95.6% of crossmatches performed with an average of 3% false positives and 1.3% false negatives. This approach to donor selection reduces unnecessary crossmatching and increases the likelihood of finding crossmatch-compatible donors for highly reactive patients.

ABO Blood-Group System↗
PubMed1983

Relation between finger reaction time and voice reaction time in stuttering and nonstuttering children and adults.

Nine stutterers and nine nonstutterers at each of three age levels (5 years, 9 years, and 18 years and above) responded to the onset of 21 1-kHz tones by depressing the index finger of their preferred hand on a response key. Finger reaction times (FRTs) were measured to the nearest millisecond and compared to the voice reaction times (VRTs) obtained from the same subjects. Increased speed and stability of the finger reaction times were observed as an inverse function of age for both groups. The stutterers, as a group, exhibited mean FRTs which were significantly longer and more variable than those of the nonstutterers at each of the three age levels. High correlations also were found between the finger and voice reaction scores for both the stutterers and the nonstutterers. Results support the inference that some stutterers may exhibit difficulty in the consistent execution of motor control strategies common to both speech and nonspeech movements.

Acoustic Stimulation↗
PubMed1979

Specific and nonspecific cytotoxicity of leukocytes from human renal allograft recipients against donor fibroblasts.

A microcytotoxicity assay was used to search for cell-mediated cytotoxicity, serum-blocking factors, and antibody-dependent cell-mediated cytotoxicity (ADCC) against fibroblasts of donor origin in 19 human renal allograft recipients. Peripheral mononuclear cells (PMC) were frequently cytotoxic when they were obtained within 6 days prior to rejection, following sustained rejections, and within 1 month after removal of rejected grafts, but the toxicity was usually nonspecific. Recipient PMC were noncytotoxic when they were obtained within 6 days after the onset of an acute reversed rejection and during quiescent intervals when there was no evidence of rejection within 6 days before or after the assay. These data suggest that, regardless of its lack of specificity, there is some relationship between cytotoxicity of recipient PMC and allograft rejection. In none of 69 post-transplant serum samples was ADCC against donor target cells detected with the microcytotoxicity assay.

Cytotoxicity Tests, Immunologic↗
PubMed1979

DRw antigen matching and B-cell antibody crossmatching: their effect on clinical outcome of renal transplants.

In a series of 36 cadaver transplants, we have found that matching the DR antigens had greater value in predicting good transplant outcome than did matching the A and B antigens. A much larger series of transplants utilizing DR antigen matching will be necessary to confirm these promising results; however, it would appear that performed donor-specific BLC detected at room temperature have no relationship to subsequent transplant outcome. It is, however, important to differentiate them from weak HLA-A,B,C antibodies which have been proven to lead to accelerated rejection. We recommend that the clinical crossmatch include simultaneous B-cell-depleted and B-cell-enriched tests to avoid this problem.

Antibodies↗
PubMed1979

HLA-B7 in presumed ocular histoplasmosis maculopathy.

Sixty-four patients that fulfill the clinical criteria of the presumed ocular histoplasmosis syndrome were typed for common histocompatibility antigens. The clinical criteria included the presence of multiple peripheral punched out choroidal atropic scars, a clear vitreous, and compatible macular disciform lesions in at least one eye. Thirty-four patients were found to have HLA-B7, which is statistically significant at the p less than 0.005 level when compared to a normal population. Though this is statistically significant, other factors must be involved, as there still remain many patients with this clinical picture who do not demonstrate a common histocompatibility antigen.

Gene Frequency↗
PubMed1978

Association of presumed ocular histoplasmosis with HLA-B7.

Thirty-one white patients who fulfilled the clinical criteria of the syndrome recognized as presumed ocular higtoplasmosis were typed for common histocompatibility antigens. These clinical criteria included the presence of multiple peripheral punched out choroidal atrophic scars, compatible macular disciform lesion in at least one eye, and clear vitreous. Seventeen out of 31 patients were found to have HLA-B7, which is statistically significant at the P less than .005 level when compared to a normal population. More patients should be tested to establish this correlation more firmly. Though this is statistically significant, other factors must be involved as there still remain many patients who fulfill the clinical criteria but do not demonstrate a common histocompatibility antigen.

Eye Diseases↗
PubMed1977

Possible evidence for a new C-locus specificity: studies of the serum Pullium.

We have presented data from our own experience and from the first serum exchange of the HLA Workshop of the Americas that indicate the serum Pul may identify a new low-frequency specificity of the C locus. One informative family has been studied, and the results are consistant with a C-locus inheritance pattern. No correlation was found with antisera that identify known antigens of the A, B, or C locus. One additional serum, also available for study, seems to react with the same specificity as the serum Pul.

Adolescent↗
PubMed1976

Organized kidney retrieval on a regional basis. A new approach.

A network of small to medium-sized communities has been developed to increase the supply of cadaveric kidneys for renal allotransplantation. After a training period, community physicians and the community hospitals were designated as members of the transplant team to retrieve kidneys. A threefold increase in the number of cadaveric kidneys has resulted from this project. This mechanism for organized kidney retrieval on a regional basis could be used to augment the supply of cadaveric organs in other areas of the United States.

Hospitals, Community↗
PubMed1976

Self- versus investigator-administered presumed fluency reinforcing stimuli.

The effects of self-administered and investigator-administered presumed fluency reinforcing monetary rewards for perceived fluency increases on the disfluency frequency rate of 17 adult stutterers were studied. Subjects read aloud during 11 one-minute segments under three conditions: one in which no reinforcer was administered at the end of each one-minute segment, a self-administered reinforcement condition, and an investigator-administered reinforcement condition. Although less stuttering was found in the two experimental conditions (with significantly less stuttering occurring in the self-administered fluency reinforcing condition than in the control condition), an increase in stuttering was observed in those reading segments which followed the administration of presumed fluency reinforcing stimuli. These results were interpreted to suggest that although the concept of self-reinforcement may be clinically useful, the operant learning paradigm may be insufficient in providing an adequate description of the events taking place following the administration of fluency contingent reinforcing or punishing stimuli.

Adolescent↗