Biomedical subjects
Publications and source records attributed to G Benoit.
When harvesting kidneys, a double balloon catheter can be inserted either at the bedside if cardiac arrest occurs or in the operating room. This catheter reduces the time required for dissection of the aorta and decreases the amount of fluid needed to cool the organs.
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Multiple abdominal organ procurement should enable the kidneys, the liver and the whole pancreas to be removed. Simultaneous removal of the liver and pancreas depends on arterial variations. In subjects with one single hepatic artery simultaneous removal of the liver and the whole pancreas is always possible. In subjects with right hepatic artery, the whole pancreas can only be removed if the right hepatic artery and the median hepatic artery can be left to the liver transplanter and if the coeliac trunk, the common hepatic artery, the gastroduodenal artery and the splenic artery can be preserved to feed the pancreas.
Immunohistochemical techniques were used to investigate leucocyte subpopulations in the bladders of patients with superficial transitional cell carcinoma treated with BCG Pasteur. Leucocyte subsets were enumerated with a panel of monoclonal antibodies which included CD3, CD4, CD8, TQ1, Leu7, CD15, HLA-DR, CD25, CD22. We demonstrated in the bladders of patients treated with BCG a particular lymphocyte population; the major subset was an inducer (CD4+, TQ1-) which was activated (CD25+, HLA-DR+) and associated with polymorphonuclear eosinophils. There was neither inducer of suppression nor major cytotoxic/suppressive subsets. CD8+ and NK cells could not be the primary mediators of BCG activity. These data supported the hypothesis of a helper T lymphocyte activity associated with lymphokine production and activation of effector killer cells.
Combined liver and whole pancreas procurement is feasible provided that anatomical variations of the hepatic a. are kept in mind and recognised. In case of a single middle hepatic a., the pancreas can be procured with the celiac axis and the superior mesenteric a. The liver is harvested with all its artery. In case of a left hepatic a., the liver should have the celiac axis, the left and the middle hepatic a. The pancreas is harvested with the superior mesenteric a. on which the splenic a. will be implanted, provided that the dorsal pancreatic a. is really coming from the splenic a. In case of a right hepatic a., the liver is procured with the middle hepatic a., the right hepatic a. and the superior mesenteric a. The pancreas will have the celiac axis, the common hepatic a. with the gastroduodenal branch and the splenic a.
We report on eight kidney-allografted patients treated for delayed ureteral obstruction between January 1986 and January 1987. In all cases, standard endourological dilation was performed using a balloon catheter, and this was followed by insertion of a pigtail stent. All eight cases showed improvement 1 month after dilation (decrease in creatinine and caliceal dilation). At 6 months, renal function had deteriorated in six patients but remained good in two. One of the six patients was redilated with apparently good results. The remaining five were operated on using their own ureter. We conclude that while internal drainage helps in distinguishing between obstruction and other causes of creatinine increase, antegrade dilation is the treatment of choice for delayed ureteral obstruction.
UW (University of Wisconsin) solution, formulated by Belzer's team in Madison, has already been proved to increase cold ischemia time in liver and pancreas preservation. A multicentre clinical trial is being conducted to compare renal preservation in human transplantation using two different solutions: UW and Eurocollins (EC). This paper, whose results will be included in the multicentre trial, reports local comparative results between UW and EC perfused Kidneys. The two donor populations UW (28 cases) and EC (47 cases) were not randomized. They were however comparable in renal function prior to harvesting but not in age (35 +/- 13.4 years EC versus 27.7 +/- 12.4 years UW). The two recipient populations (48 EC versus 48 UW) were more homogeneous. Comparative results were significant with better graft function in the UW group: creatinine at one week: 499.2 +/- 296.3 EC versus 277.6 +/- 226.2 mumol/l, p less than 0.0001; creatinine at one month: 228.7 +/- 135 EC versus 159.7 +/- 135.6 mumol/l, p less than 0.02 and a decrease in acute tubular necrosis (39.5% EC versus 14.5% UW) and hospital stay. These results justify the use of UW solution by intraaortic flush especially during multi-organ procurement.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors report fourteen cases of lymphocele in a series of one thousand consecutive renal transplantations (1.4%). The prevention of these lymphoceles depends on rigorous lymphostasis. The diagnosis is based on ultrasonography. The treatment indicated in cases of voluminous lymphoceles consisted in marsupialization and omentoplasty.
Hypothermia remains the basic principle of all organ preservation. This review shows some main cellular mechanisms involved with normo and hypothermia, particularly during ischemia. Different pathways and target sites concerned in preservation are explained. Commonly used preservation techniques and cold storage solutions are also discussed. Cryopreservation especially vitrification seems to be promising perhaps in the near future; it allows a state of almost a cellular metabolic arrest and consequently a theoretically unlimited preservation time.
Twenty patients with clinical acute pyelonephritis were investigated by routine CT scan. This examination was positive in 19 cases, demonstrating either a hypodense triangular image reflecting a disorder of blood supply or a mass syndrome. The CT scan can therefore confirm the diagnosis of acute pyelonephritis. It also defines the severity of the lesions and helps to guide treatment.
The authors report a series of 100 endoscopic resections performed in patients over the age of 75 years. In patients with no risk factors, there was no mortality and the morbidity was 5%. In patients with one risk factor, mortality was 5% and morbidity was 10%.
The authors studied, by means of immunohistochemical analyses, the lymphocyte subpopulations in bladder biopsies from 20 patients treated for a urothelial bladder tumour (Tis TA, T1) by intravesical BCG (group A). The biopsies were taken from optically healthy zones and were then frozen. The lymphocyte populations in the urothelium and chorion were studied by means of monoclonal antibodies T3, T4, T8, TQ1, Leu-7, OKM-1, HLA-DR, TAC, Pan-B. Four patients without bladder cancer constituted the control group (group B) and 10 patients with bladder cancer not treated by intravesical BCG constituted group C. In group A, the T4 + TQ1 lymphocytes predominated in the urothelium and in the chorion. An inversion of the T4/T8 ratio was observed in the urothelium of groups B and C (p less than 0.01) and in the chorion of group B (p less than 0.01). There was no significant difference in the T4/T8 ratio in the chorion in groups A and C. In group A, 17 patients expressed the presence of receptors for interleukin 2 (TAC + HLA-DR) on their T lymphocytes. In these cases, the lymphocytic infiltration was associated with the presence of eosinophils (p less than 0.05) and the total absence of NK cells was observed. No B lymphocytes were detected, apart from a few rare lymphoid follicles.