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D Golinger

Publications and source records attributed to D Golinger.

7 recordsLinked to original sources

Renal transplantation. 12-Year experience.

The results of cadaveric renal transplantation in one centre over 12 years are reviewed. One hundred and sixty-eight grafts have been performed in 147 recipients. At one year after transplantation, patient survival rate was 86%, and graft survival rate was 63%. Analysis of factors influencing graft survival show that the age of recipients, the lack of blood transfusions, and the use of poorly matched grafts (three to four HLA mismatches against 0 to two mismatches), all had adverse effect on survival. Death was a significant cause of graft loss in patients over the age of 45 years. Patients who had not received blood transfusions, and who received grafts which were mismatched for three to four HLA antigens, did especially badly, graft survival rate at six months being only 24% compared with that of 70% in patients who received blood transfusions.

Adolescent↗

Orthopaedic problems of renal transplantation.

One in six patients receiving renal transplants has orthopaedic problems. Osteoporosis with accompanying fractures is common, as is avascular necrosis of the hips, knees, and other bones. Immunosuppressive therapy with steroids is implicated and its mode of action discussed. No means of prophylasix is known. If treated conservatively, aseptic necrosis of bone is much more disabling than is commonly believed as judged by the critical assessment technique of Charnley. The authors therefore recommend that a surgical approach should be adopted whenever possible.

Adult↗

The diagnosis and treatment of lymphocoeles associated with renal transplantation. A report of 6 cases and a review of the literature.

Six patients have developed a lymphocoele after renal transplantation, an incidence of 4%. A lymphocoele should be suspected in a patient who develops a rising creatinine with a pelvic mass or pressure effects on the pelvic veins 1 or more months after operation. The diagnosis is confirmed by intravenous urography, venography and ultrasonography: the use of the latter as a diagnostic measure is recommended. Treatment is by marsupialisation into the peritoneum or external drainage with breakdown of all loculi. Aspiration is unsatisfactory.

Abdomen↗