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Biomedical subjects

J Cerilli

Publications and source records attributed to J Cerilli.

At least 37 records · Page 2Linked to original sources
PubMed1985

The vascular endothelial cell antigen system.

Vascular endothelial cells (VEC) are clearly immunogenic and express antigens unique to vascular endothelial cells. The observation that peripheral blood monocytes also express this VEC antigen system made prospective testing feasible. Preformed antibody to the VEC/monocyte antigen system of the donor usually leads to graft rejection in HLA-identical combinations, but antibody directed against donor monocytes exclusively (monocyte-specific antigens) appears to be benign. Clearly the VEC antigen system is an important immunogen in HLA-identical living-related donor combinations--and, in addition, this antigen system may be equally important in the non-HLA-identical combinations. The identification of antibody directed against the VEC/monocyte antigens of the donor is frequently masked by the concurrent development of anti-HLA antibody. Preliminary family segregation studies support the concept of genetic linkage between the VEC/monocyte antigen system and the major histocompatibility complex. A group of 153 consecutive, prospective monocyte crossmatches performed have yielded approximately a 7% incidence of positive monocyte crossmatches, with traditional crossmatches being negative. This frequency of patients sensitized to the VEC/monocyte antigens of the donor could conceivably account for up to 70% of the observed early graft loss in living-related donors. We think a positive monocyte crossmatch to the donor in the presence of positive reactivity to concordant VEC and monocytes remains a contraindication to transplantation.

Endothelium↗
PubMed1985

Identification of the antibody to vascular endothelial cells in patients undergoing cardiac transplantation.

Acute cardiac dysfunction occurred in four cardiac allograft recipients with negative donor-specific lymphocyte crossmatches. In two recipients the transplanted heart was removed and the patients were maintained on bypass for several hours until a second cardiac allograft was available. In these patients the second transplanted heart also underwent acute dysfunction. The lymphocyte crossmatch was again negative in both second transplants. Two of the four recipients had no detectable antibody to a panel of lymphocytes. Examination of the hearts demonstrated histologic findings consistent with hyperacute rejection. Direct immunofluorescence performed on the transplanted hearts revealed the presence of immunoglobulin and complement deposited on the vascular endothelium. Pathology data was available on 3 of the 4 patients who experienced acute cardiac dysfunction. Pretransplant sera from these four recipients were screened for the presence of antivascular endothelial cell (VEC) antibody. The sera from all four recipients were found to contain antibody against an endothelial cell panel. In addition, donor-specific aorta and vena cava were available from one of the heart donors. The recipient was found to have donor-specific antibody to VEC. Thus, antibody directed against VEC specific antigens appears to be related to hyperacute rejection of heart allografts.

Antibodies↗
PubMed1983

The significance of the monocyte crossmatch in recipients of living-related HLA identical kidney grafts.

Monocytes and vascular endothelial cells (VEC) carry a "cell specific" antigen system that has been found to play an important role in the pathogenesis of rejection. In a preliminary study utilizing a standard crossmatch technique with the peripheral blood monocyte as target, recipients of HLA identical living-related grafts who had either pretransplant or who developed posttransplant anti-monocyte antibody, had a high incidence of early graft rejection. This larger study of recipients of HLA identical living-related grafts represents the results of 21 patients from 13 separate transplant centers in the United States. Results from this study seem to indicate a positive monocyte crossmatch represented a degree of sensitization toward donor monocyte antigens which lead to a poor clinical course.

Antigens, Surface↗
PubMed1983

Hypertensive crisis induced by eating in a patient with pheochromocytoma.

Catecholamines have an important effect on the gastrointestinal tract. Patients with pheochromocytomas frequently have gastrointestinal complaints. We report a 13-year-old girl with a 250-g intra-abdominal pheochromocytoma who presented with symptoms of excessive catecholamines release and hypertensive crisis that was provoked by eating. The patient's pheochromocytoma was so large that it was palpable and compressing the greater curvature of the stomach.

Adolescent↗
PubMed1983

A new technique for placement of catheters for peritoneal dialysis.

We have described a technique for placement of a peritoneal dialysis catheter which involves fixing the end of the catheter to the pelvic wall and creating a peritoneal tunnel near the distal end. This technique prevents malfunction of the catheter due to malposition and rotating superiorly.

Catheterization↗
PubMed1980

The significance of mixed lymphocyte culture in related renal transplantation.

Eighty-one donor-recipient pairs were evaluated prior to renal transplantation to obtain histocompatibility profiles. Standard tissue typing was used to detect serologically defined A and B locus antigens, and mixed lymphocyte cultures were employed to detect lymphocyte defined antigens. Results of both tests were correlated with each other and with allograft rejection. It was shown that as serologically defined histocompatibility at the A and B loci decreases, both the rate of graft rejection and the percentage of high mixed lymphocyte culture stimulation increase. Within each serologically defined category were found patients with a high and a low stimulation index in mixed lymphocyte culture. Regardless of the degree of serologically defined histocompatibility, patients with a high stimulation index had a statistically significant higher graft rejection rate than did patients with a low stimulation index. It appears that the mixed lymphocyte culture assay is a method superior to standard tissue typing in predicting renal allograft rejection with related donors, and therefore all potential donors for renal transplantation should be screened, utilizing the mixed lymphocyte culture technique.

Adolescent↗
PubMed1979

Significance of migration stimulatory factor in human renal allotransplantation.

Seventy-four recipients of related donor renal allografts were tested for the presence of cellular immunity to specific donor lymphocyte antigens using the direct migration inhibition factor (MIF) assay. Responses on the assay fell into one of the following three statistically distinct groups: (1) greater than 20% inhibition of macrophage migration, (2) nonresponsiveness, +/- 10% of control migration, and (3) greater than 12% stimulation of macrophage migration. Migration stimulation was shown to be reproducible and to correlate well with a very benign post-transplant clinical course. The production of migration stimulatory factor appears to be an immunological response analagous to the production of migration inhibition factor.

Female↗
PubMed1978

Clinical significance of the 1-hour biopsy in renal transplantation.

Biopsy specimens were obtained from 43 transplanted kidneys at the time of excision from the donor but prior to revascularization, and 1 hr after revascularization. Two independent laboratories evaluated specimens by immunofluorescent techniques for the presence of IgM, IgA, IgG, C'3, and fibrin. Results from the two laboratories examined for reproducibility and immunological specificity, and correlated with clinical course. Results show that immunoglobulin deposition seen in the 1-hr renal biopsy specimens is of little significance, because: (1) immunoglobulin deposition was difficult to quantitate reliably, (2) the presence of immunoglobulins did not correlate with clinical course, and (3) the majority of immunoglobulin deposition detected was not immunologically specific, since it was most often either present prior to vascularization or disappeared with vascularization.

Biopsy↗
PubMed1978

Correlation of tissue typing, mixed lymphocyte culture, and related donor renal allograft survival.

Results of mixed lymphocyte culture reactions and tissue typing were correlated with the clinical courses of recipients of living related donor renal allografts. Forty-nine patients tested by the mixed lymphocyte culture technique were divided into two response groups: stimulation index greater than 5 and stimulation index less than 5. Seventy patients were tested by standard tissue typing methods and were categorized by the number of misstimulation in mixed lymphocyte culture than with mismatched antigens, suggesting that lymphocyte-defined histocompatibility is more important than serologically defined histocompatibility in selecting the best possible allograft donor.

Graft Rejection↗
PubMed1977

Successful simultaneous renal transplantation and abdominal aortic aneurysmectomy.

At the time of related donor renal transplantation, a 49-year-old man with chronic glomerulinephritis was found to have a large fusiform aneurysm involving the internal and external iliac arteries, the abdominal aorta, and both common iliac arteries. Transplantation and abdominal aneurysmectomy using a standard Dacron bifurcation graft were successfully carried out. This patient has had no associated complications and is currently five years after transplantation and aneurysmectomy, with excellent renal function. It is believed that transplantation may now be offered to an older age group of patients with end-stage renal disease in whom atherosclerosis wll have developed as a natural process of aging.

Aneurysm↗
PubMed1977

Hodgkin's disease in human renal transplantation.

After transplantation Hodgkin's disease developed in two recipients of related donor renal allografts. Only one case of Hodgkin's disease had previously been reported in this specific patient population and these two cases demonstrate the very atypical biologic behavior of Hodgkin's disease in the immunosuppressed renal transplant patient.

Adolescent↗
PubMed1977

Antivascular endothelial cell antibody--its role in transplantation.

Sera samples from eight different groups of patients were tested for the presence of circulating antibody (IgG) directed against vascular endothelial cell antigens. The indirect immunofluorescent method which used either whole blood vessels or single endothelial cells as targets was compared to lymphocytotoxicity panels. The indirect immunofluorescent antibody test (IFA) consistently detected antibody in sera samples which were negative for lymphocytotoxic activity, and the presence of IFA antibody to vascular endothelial cells had a much better correlation with both clinical course and renal allograft rejection than did the lymphocytotoxicity panels. Single vascular endothelial cells appeared to be a more sensitive target for the detection of IFA antibody than did whole vessels. Preliminary absorption studies suggest that cell-specific as well as HL-A antigens play a role in the immunological response to vascular endothelial cells.

Antibodies↗