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Biomedical subjects

E Möller

Publications and source records attributed to E Möller.

At least 199 records · Page 11Linked to original sources
PubMed1981

Bone marrow transplantation for aplastic anemia and acute leukemia at Huddinge Hospital.

Eight patients with aplastic anemia were transplanted with marrow from HLA-identical donors. Two patient rejected their grafts and died while 5 patients (71%) show no ill effects 3 months, 10 months, and more than 1, 2 and 4 years after the transplantation. Three of the patients who received unirradiated donor buffy coat after transplantation developed chronic graft-versus-host disease (GVHD) which, however, resolved following treatment with Prednisolone and Azathioprine. One patient with end-stage acute myeloid leukemia, who was transplanted with marrow from an identical twin, died 6 days after the transplantation of bleedings and sepsis. Eight patients with acute non-lymphoblastic leukemia (ANL) were transplanted, while in remission, with marrow from HLA-identical siblings. One patient died of interstitial pneumonia 3 months after transplantation, while another patient recovered from GVHD of the gut at 5 months after the transplantation. Seven out of 8 patients with ANL (88%) are home and well between 2 and 12 months after the transplantation.

Acute Disease↗
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↗
PubMed1981

Fulminating anti-A autoimmune hemolysis with anuria in a renal transplant recipient: a therapeutic role of plasma exchange.

In this communication we present a case of fulminating anti-A autoimmune hemolysis with anuria occurring during the postoperative course after a successful renal transplantation. The patient was treated with repeated plasma exchange in an effort to remove antibodies directed against the red cells and also to eliminate the products of hemolysis known to cause acute renal failure. Subsequently the hemolysis receded and the patient regained graft function. Repeated plasma exchange, in addition to immunosuppression, appeared to have contributed to the ultimate recovery of the patient.

Acute Kidney Injury↗
PubMed1980

Suppression of the immune response to altered self induced by immunogenic and nonimmunogenic altered self structures.

Fluorescein (FITC)-haptenated mouse spleen cells are capable of inducing a B cell immune response characterized by the production of antibodies directed against hapten-altered self structures. The induction of this response is thymus-independent and strictly dependent on the hapten concentration used for labeling the cells. Pretreatment of mice with immunogenic, labeled spleen cells strongly suppressed the plaque-forming cell response to a subsequent challenge with FITC-labeled spleen cells, sheep (SRC) or horse (HRC) red cells labeled with the same hapten and native FITC-dextran. Mice primed with lightly haptenated (nonimmunogenic) cells 7 days before challenge were completely unresponsive to the immunogenic dose of labeled cells and displayed a significantly reduced response to FITC-SRC or FITC-HRC. However, the response to FITC-dextran was enhanced, as compared to unprimed animals. The concept of immunogenic vs. nonimmunogenic requirements of an antigen to induce unresponsiveness, and the specificity of the B cell clones affected by suppression is discussed.

Animals↗
PubMed1980

Improved renal graft survival in transfused uremics. A result of a number of interacting factors.

In a series of 229 first-time recipients of cadaveric renal grafts the graft survival was better for the patients that had received 4 or more units of blood, than for those patients that had never received blood; on the other hand, for the patients 1 to 3 units the survival was not better. A relationship between blood transfusion and graft survival was found only for patients receiving kidneys with two or less HLA-A and B incompatibilities. Among the patients receiving 20 or more units of blood, one-half became long-term HBsAg carriers and 60% developed HLA antibodies. A larger proportion of these patients had received grafts with a good HLA-A,B match. The graft survival was better for patients that had been on regular dialysis before the transplantation than those that had not. The choice of dialysis method was also significant, the survival being better for patients that had been on peritoneal dialysis than those on hemodialysis. It would appear that blood transfusion and dialysis treatment had an additive effect on graft survival.

Antibodies↗
PubMed1980

Clinical significance of mitogen-induced responses in lymphocytes from patients with chronic lymphocytic leukemia.

The mitogenic response patterns as well as surface membrane receptors of peripheral blood lymphocytes were investigated repeatedly during progression of the disease in 27 patients with chronic lymphocytic leukemia. Each patient was characterized by a reproducible mitogenic response pattern. Eleven patients, who required treatment within 0-24 months after diagnosis, had significantly higher cellular responses to dextran sulphate (DxS) and lipopolysaccharide (LPS) than 10 patients who have not required treatment within an observation time of 10-40 months from diagnosis. The high LPS and DxS responses, which may indicate leukemias composed of more immature cells, appear to predict a poor prognosis.

Cells, Cultured↗
PubMed1980

In vitro characterization of immunological responsiveness of uremic patients.

Uremic patients are thought to have deficient immune reactivity. The mechanisms for immunosuppression are not known. We have studied various in vitro immune response parameters in lymphocytes from uremic patients and from healthy controls. Using polyclonal activating substances, it was found that PHA and LPS responses were reduced in cells from the patient group compared to the control group (p < 0.05). Furthermore, MLC responsiveness using pooled stimulator cells and polyclonal antibody secretion induced by Staphylococcus aureus bacteria in vitro were reduced in the patients (p < 0.05). No differences with regard to proportions of T/B cells in blood were noted between the two groups. No correlation was found between responses of individual cells to different activating substances, with the exception of PHA and ConA. However, low responses to PHA were usually accompanied by a general low responsiveness. Patients were further subdivided into groups according to the type of dialysis treatment, peritoneal dialysis (PD) or hemodialysis (HD), and to the duration of the hemodialysis period (< and > 1 year). Patients treated with PD showed impaired T cell reactivity with loer PHA responses compared to the HD patients (p < 0.05). Between the HD groups there were no significant differences in mitogen or MLC responses. We believe that the differences between PD and HD were due to the facts that the PD patients were older and not in the same nutritional state as the HD patients.

Adolescent↗
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↗
PubMed1980

The significance of HLA-A, -B matching for the survival of cadaveric kidney transplants performed in Stockholm in 1970-78.

Of the 320 cadaveric renal transplantations carried out between 1970 and 1978 in Stockholm 308 were analysed with respect to dependence of graft survival on HLA-A, -B matching. From November, 1973, kidneys with 3 or 4 HLA-A, -B incompatibilities were accepted much more often than had previously been the case. All but 7 of the 90 grafts with 3 or 4 incompatibilities were transplanted during that period. In order to obtain as homogeneous a group as possible the transplantations performed during this period were analysed separately, and transplantation performed on diabetic patients and retransplantations were excluded. This material comprising 141 transplantations was examined also with respect to other factors that may have a bearing on graft survival. As regards the factors mean age, pre-transplantation dialysis and blood transfusions, primary diuresis at transplantation and high-dose ALG therapy there was no essential difference between the recipients of kidneys from donors with 1 or 2 HLA-A, -B incompatibilities and the 3 or 4 incompatibility group. Thirteen of the 141 transplantations were fully compatible but because this group was small it was not included in the statistical analysis. After 2 years the group with 3 or 4 HLA-A, -B incompatibilities displayed a significantly poorer graft survival than the one with 1 or 2 incompatibilities (p less than 0.05).

Graft Survival↗
PubMed1980

Cadaveric renal graft survival: the bearing of the number of blood transfusions and of dialysis treatment.

In a series of 229 recipients of first-time cadaveric renal grafts the graft survival figures were better the larger the number of blood units transfused prior to transplantation. However, the difference between the groups receiving transfusions and that which did not was statistically significant only for the groups receiving 4 units or more. For the patients receiving more than 20 units there was an elevated incidence of HBs antigenemia and of HLA antibodies. The kidneys received by these patients tended to be better matched than those of the patients given less blood. Graft survival was significantly better for the patients that had been on dialysis than for those that had not. Dialysis was more strongly correlated to graft survival than was blood transfusion.

Blood Transfusion↗
PubMed1979

Successful treatment with prednisone and graft-versus-host disease in an allogeneic bone-marrow transplant recipient.

A 51-year-old patient with aplastic anaemia in whom a successful allogeneic bone-marrow transplantation had been performed developed acute graft-versus-host disease in spite of prophylactic administration of methotrexate. There was severe liver injury but no involvement of the skin or intestines. When prednisone therapy was introduced the fever and the eosinophilia disappeared and liver damage was rapidly reversed. There was no haematological impairment. It would seem warranted to consider a wider use of prednisone in the treatment of acute GVHD in human recipients of allogeneic bone-marrow.

Anemia, Aplastic↗
PubMed1979

Mitogen-induced differentiation of human CLL lymphocytes to antibody-secreting cells.

Peripheral blood lymphocytes from nine patients with chronic lymphatic leukaemia (CLL) have been stimulated by photohaemagglutinin, pokeweed mitogen and Epstein-Barr virus. Our results provide proof that the leukaemic B cells in CLL are capable of responding to mitogenic signals by producing and secreting antibodies, transforming into blast cells, and, probably, increasing their rate of DNA synthesis.

Antibody Specificity↗