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Biomedical subjects

D Samuel

Publications and source records attributed to D Samuel.

At least 181 records · Page 10Linked to original sources
PubMed1992

[Kaposi's sarcoma following liver transplantation].

A 54-year-old man developed Kaposi's sarcoma 2 months following orthotopic liver transplantation for hepatitis B-associated liver cirrhosis. At that time he was on combined immunosuppressive therapy (azathioprine, prednisone and cyclosporine A). The disease is very prevalent among immunosuppressed patients following renal transplantation, but is considered to be relatively rare following liver transplantation. The patient ran a relatively benign course without organ involvement and with only the skin disease. This is the first case of Kaposi's sarcoma following liver transplantation reported in Israel.

Humans↗
PubMed1992

[Pregnancy after hepatic transplantation. 17 pregnancies].

The number of orthotopic liver transplantations (OLT) is increasing and longterm survival is improving. More women recipients may choose to become pregnant. We report a one-center experience with the course and outcome of 17 pregnancies in 17 liver transplant out of 675 OLT since 1985. 10 women delivered of 10 healthy infants at 38 +/- 1.5 week's gestation. There was no preterm delivery and the mean birth weight was 2.990 +/- 370 g, birth weight was adequate for gestational age in any case. Four cesarean sections were performed for obstetrical indications. No congenital anomalies occurred in the children. Hypertension occurred in 2 out of twelve patients and appeared as the main complication to deal with. There was one case with graft function impairment at 37 weeks' gestation. One uncomplicated pregnancy is ongoing at 29 weeks' gestation. There were 4 spontaneous and 2 therapeutic abortions for impaired liver function. Pregnancy is successful in a large proportion of these patients but must be planned and managed as high-risk situations by an obstetrician and a specialist of the liver transplant. Pregnancy should be advised against in patients with poor liver function or active viral infection; a 12 months interval from OLT to pregnancy is since to be the minimal requirement. Post-transplant immunosuppressive therapy consisted of azathioprine, corticosteroids and ciclosporin A, and was maintained throughout pregnancy. Genetic counselling should be provided when the primary liver disease is inherited. This being said, as shown by the results of our study and those reported in the literature, pregnancy is not only feasible but also successful in a large proportion of OLT recipients.

Abortion, Spontaneous↗
PubMed1991

[Liver transplantation in non-alcoholic cirrhosis in adults].

Liver transplantation has become the treatment of end-stage cirrhosis. The results of transplantation should be improved by a better knowledge of prognostic criteria in cirrhosis, which would help in timing the transplantation, and by a better prevention of graft reinfection with hepatitis viruses.

Adult↗
PubMed1991

Passive immunoprophylaxis after liver transplantation in HBsAg-positive patients.

110 HBsAg-positive patients underwent orthotopic liver transplantation and received long-term anti-hepatitis B virus (HBV) passive immunoprophylaxis with anti-HBs immunoglobulin. During a mean follow-up period of 20 months, all patients became HBsAg negative after transplantation but circulating HBsAg reappeared in 25 (22.7%). Overall 1-year survival was 83.6% and overall 2 year actuarial recurrence of HBsAg was 29% (59% after posthepatitis B cirrhosis, 13% after posthepatitis B-delta cirrhosis, and 0% after fulminant hepatitis B). Patients with HBV cirrhosis who were HBV-DNA positive had a much greater risk of HBsAg recurrence than patients who were HBV-DNA negative (96% vs 29% at 2 years). Reappearance of HBsAg was associated with evidence of HBV replication and abnormal histological findings in the graft. Long-term passive anti-HBV immunoprophylaxis significantly reduced HBV reinfection and improved survival in patients without evidence of active HBV replication before orthotopic liver transplantation.

Adolescent↗
PubMed1991

[Liver transplantation and the major histocompatibility complex].

We have carried out a retrospective study over 308 liver transplant patients (31 of them have had a retransplantation) in Professor Bismuth's Department at Paul Brousse Hospital. The purpose of the study was a search for the possible effect of donor/recipient major histocompatibility complex on the evolution of the transplantation. We chose to study four parameters: early acute rejection; chronic rejection; retransplantation cases and death frequency; graft survival. We observed the following: for HLA A locus: in cases of total or partial compatibility there are more moderate early acute rejections than in the case of incompatibility (p less than 0.02); for HLA B locus: in the case of total compatibility there are more chronic rejections than in cases of partial or total incompatibility (p less than 0.03); for joint A and B locus: the results are similar to those of A locus (p less than 0.03); for HLA class I: we observed no effect either on graft survival or on retransplantation cases or on death frequency; for HLA DR: we did not find any effect on the studied parameters. Considering the low statistical significance of these results and in order to confirm our analysis, we have started a prospective study in collaboration with two other European Transplantation Centers.

Graft Rejection↗
PubMed1991

A comparative study of X-ray pelvimetry and CT pelvimetry.

In this study 24 patients who had conventional erect lateral X-ray pelvimetry had a CT pelvimetry done after delivery to complete the pelvimetry views. The erect lateral pelvimetry was read independently by a Consultant Radiologist, Consultant Obstetrician and a Medical Officer training in Obstetrics and Gynaecology. Using CT pelvimetry as the 'gold standard' (as the error of measurement was known with the machine used) the 3 readings were compared. There was no statistical difference in the values suggesting that X-ray pelvimetry is comparable to CT pelvimetry. However CT pelvimetry is preferred, if available, because of the lower dose of radiation involved, more comfort for the patient and shorter time in performing the procedure. Measurements done are easily read directly from the CT console.

Adolescent↗
PubMed1991

[Osteoarticular complications after hepatic transplantation].

Between January and December 1989, among 396 patients receiving liver transplantation, 27 have developed 33 post-transplantation osteoarticular complications (27 non septic and 6 septic episodes). After liver transplantation, non septic complications are distinct from the pattern observed after kidney transplantation with a lower prevalence of avascular bone necrosis (n = 4) but a higher prevalence of new vertebral fractures (n = 18) and presence of stress fracture (n = 3). This difference is probably caused by the lower steroids dosage in liver transplantation and by the preexisting bone status which is different in kidney and liver graft recipients. These complications are essentially observed in cirrhosis (n = 12) and primary biliary cirrhosis (n = 10). Staphylococcus aureus is found in 5/6 osteoarticular infections whereas extra-osteoarticular (essentially intra-abdominal) infections are mainly due to Gram negative bacteria and candidiasis. Finally, 2 patients presented hypertrophic osteoarthropathy associated with chronic graft rejection, reversible after liver retransplantation.

Adult↗
PubMed1990

A single-step method for the purification of anti-FITC antibodies by use of a coumarin immunosorbent.

Monoclonal anti-fluorescein isothiocyanate (FITC) antibody cross-reacts with 7-hydroxy coumarin derivatives conjugated to BSA. This property permitted the affinity purification of monoclonal anti-FITC antibodies from ascitic fluid using an-immunosorbent consisting of a 7-hydroxy coumarin derivative linked to Sepharose 4B. Ascitic fluid was applied to the immunosorbent column and, after washing, the bound antibody was eluted under extremely mild conditions using 3 M MgCl2. Antibody eluted in this manner was greater than 96% pure as assessed by SDS-PAGE. A polyclonal sheep anti-FITC antibody was also purified from serum on the same immunosorbent to greater than 94% purity. This simple and rapid method for the purification of anti-FITC antibodies will find applications in both immunodiagnostic procedures and in studies of hapten-antibody interactions. The affinity constant of the purified monoclonal anti-FITC antibody conjugated to horseradish peroxidase was assessed by ELISA and was found to be 1.5 x 19(9) M-1.

Animals↗
PubMed1990

Liver transplantation across ABO blood group barriers.

In a study of 234 liver transplants the 2-year graft survival for ABO-compatible elective (80%) or emergency (76%) liver transplants was significantly higher than that for ABO-incompatible emergency liver transplants (30%). The low survival of ABO-incompatible liver allografts was therefore not related to the emergency conditions. Among 17 patients who received ABO-incompatible liver allografts, primary humoral rejection, with haemorrhagic infiltration of portal tracts and deposition of IgM and fibrinogen on sinusoidal and endothelial cells, developed in 6. Other disadvantages of ABO-incompatible liver allografts were significantly higher frequencies of severe rejection crises, arterial thrombosis, and cholangitis. However, the 1-year survival rate of the patients who received ABO-incompatible grafts was 66%, so the use of ABO-incompatible liver grafts is justifiable in emergencies, when no other donor is available; such transplants may help to save the patient, even at the cost of retransplantation in half of the cases.

ABO Blood-Group System↗
PubMed1990

Changes in striatal cholinergic, gabaergic, dopaminergic and serotoninergic biochemical markers after kainic acid-induced thalamic lesions in the rat.

Kinetic parameters of 3H-choline, 3H-GABA and 3H-dopamine (DA) uptakes in striatal homogenates containing nerve endings were determined 2 to 3 weeks after kainic acid injection into the ipsilateral "centre médian"-parafascicular complex area of the thalamus in the rat. Results showed a marked decrease in 3H-choline uptake concomitant with a selective decrease in Vmax. Data also showed a large decrease in 3H-GABA uptake resulting from a decreased affinity of uptake sites for their substrate. These data were associated with the previously described decrease in choline acetyltransferase and increase in glutamic acid decarboxylase apparent activity, respectively. An apparent marked increase in 3H-DA uptake was likewise measured, mainly related to an increase in Vmax. Determination of serotonin (5HT) and 5-hydroxyindole acetic acid (5HIAA) endogenous contents showed in the deafferented striatum a decrease in 5HT concentrations associated with an increase in 5HIAA levels. Taken together, all these changes in neurotransmitter markers suggest that, directly through the thalamostriatal pathway or indirectly, the thalamus can exert a complex influence on striatal cholinergic and GABAergic neuronal functions as well as on the activity of dopaminergic and serotoninergic striatal afferent fibers.

Animals↗