[Bladder catheter--pro and con].
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Biomedical subjects
Publications and source records attributed to G Dathe.
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We investigated in a prospective study the effects of perioperative blood transfusions on the outcome of renal transplantation. All patients (n = 105) receiving their first cadaveric renal allograft were transfused perioperatively (i.e. 0-6 hours before transplantation) with two units of non-washed, unfiltered packed red cells. Forty-eight were transfused perioperatively only; 57 patients had received blood earlier and thus were transfused pre- and perioperatively. Graft survival one and two years post-transplant was 79 per cent at both time intervals in the group transfused perioperatively only, and 85 per cent and 74 per cent in the pre- and peroperatively transfused group. No adverse effects were observed concerning perioperative transfusions. In patients transfused perioperatively only, acceptable graft survival rates are obtainable. In these patients the risk or presensitisation is avoided, and thus their chance of successful transplantation increased.
Between 1973 and 1981 23 transplantations of kidneys from living related donors have been performed in Frankfurt/Main. Donor complications were haematopneumothorax (1 case) and reversible urinary tract infections (3 cases). All donors were discharged after 8-12 days, all have until now (6 months to 8 years postoperatively) normal excretory renal function and normal arterial blood pressure. Patient-survival in the recipients is 5 years postoperatively 96% and graft-survival is 90%. Nine patients received HLA-identical kidneys, all have excellent to fair function of the grafts, 7 patients are off steroids. In 14 cases kidneys were transplanted, although donor and recipient shared only one haplotype. In these patients 5-year graft survival is 84%. Seven patients have normal graft function, whereas 6 patients have a reduced function or have rejected. One patient died. Results of kidney transplantation using living related donors are--even when donors with only one haplotype-identity are accepted--much better than those obtainable when using cadaveric donors. When renal transplantation is considered, patients should be informed about the favourable results attainable with kidneys from living related donors.
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In our own controlled bacteriological investigations, ciclacillin showed a good effect in urological infections at a daily dosage of 3 g for 10 days. The efficacy is comparable to that of ampicillin and corresponds to that of the double blind trials bescribed in the literature. The specially good tolerance is worthy of note.
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The clinical signs of 2 arteriovenous fistulas are discussed and compared with the literature. Arteriovenous fistulas following percutaneous kidney bioposies are very frequent. Most of them are not to be treated. In contrast to the common spontaneous closure of these fistulas in the kidney periphery, central arteriovenous fistulas should be operated always by partial resection.