Biomedical subjects

J Sandberg

Publications and source records attributed to J Sandberg.

17 recordsLinked to original sources

PubMed1997

Renal transplantation in children less than two years old.

Twenty-one infants, 2 years old or younger, received 21 renal transplants between 1983 and 1995. Six of the transplantations were performed from 1983 to 1989, and the remaining 15 were performed from 1990 to 1995. The median age at transplantation was 16.0 months and the median body weight was 9.0 kg. Living-related donor kidneys were used in 15 cases, an adult cadaveric donor kidney was used in one case, and pediatric cadaveric donor kidneys were used in five cases. All grafts were placed intra-abdominally. The immunosuppressive therapy consisted of cyclosporine, azathioprine, and prednisolone. No prophylactic antithymocyte globulins were used. Five infants have died, one with a functioning graft and four after loss of graft function. All graft losses and deaths occurred during the first 6 months after transplantation. The 5-year patient survival and graft survival rates were 87% for recipients of living donor grafts and 44% for recipients of cadaveric grafts. The median height SD score increased from -3.7 before operation to -1.9 at 1 year, -0.7 at 3 years, and -1.1 at 5 years. The glomerular filtration rate in absolute values remained stable in all infants, whereas a reduction in glomerular filtration rate related to body surface area was seen at follow-up, 5 years after transplantation. We conclude that renal transplantation can be performed with good long-term results in children less than 2 years old.

Adult↗

PubMed1996

Gingival overgrowth in renal transplant patients administered cyclosporin A in mixture or in capsule form. A longitudinal study.

Cyclosporin A (CsA)-induced gingival overgrowth was longitudinally studied in 45 adult renal transplant patients randomly assigned to be administered CsA orally in mixture or in capsule form. After 1 year of CsA therapy, 37% of the mixture and 43% of the capsule patients exhibited gingival overgrowth. In mixture patients gingival overgrowth was present, already after 1 month of CsA therapy and, after 12 months, mixture patients exhibited an increased number of sites with gingival overgrowth in the regions of the upper front and lower molars compared to capsule patients. In addition, the relative increase in gingival width of the interdental papillae of the maxillary central incisors and the mandibular first molars, measured buccolingually on stone casts, was also higher in mixture patients than in capsule patients. In a stepwise multiple logistic regression analysis, the use of nifedipine and the total CsA dose administered during the first 6 posttransplant months were the predictors associated with gingival overgrowth. The study suggests that concomitant administration of nifedipine in renal transplant patients should be avoided and a change from the mixture form of CsA to the capsule form should be considered in order to minimize the development of CsA-induced gingival overgrowth.

Adult↗

PubMed1996

Improved results with a simplified technique for pancreaticoduodenal transplantation with enteric exocrine drainage.

A simplified technique for pancreaticoduodenal transplantation with enteric exocrine drainage is described. The whole-organ pancreaticoduodenal transplant is placed intraperitoneally with vascular anastomosis to the right common iliac artery and the caval vein, respectively. The graft duodenum is anastomosed side-to-side to the most proximal part of the donor jejunum. No Roux-en-Y loop or pancreatic duct catheter is used to protect the anastomosis with this technique. Nevertheless, excellent results have been obtained, with no graft losses occurring due to leakage or infection. With this technique, the 1-yr patient and graft survival rates in uremic recipients of simultaneous renal and pancreas transplants are 100% and 87%, respectively.

Anastomosis, Surgical↗

PubMed1996

Bone demineralization after renal transplantation: contribution of secondary hyperparathyroidism manifested by hypercalcaemia.

BACKGROUND: Renal transplantation patients often present signs and symptoms of bone disease. METHODS: In a cross-sectional study, dual-energy X-ray absorptiometry was used to examine bone mineralization in kidney transplantation patients. The contribution of secondary hyperparathyroidism manifested by hypercalcaemia was assessed. Twenty transplantation patients with long-standing (> 6 months) hypercalcaemia (> 2.6 Ca mmol/l) after transplantation, 21 normocalcaemic transplantation patients, and 20 healthy controls were examined. RESULTS: Bone mass density (BMD) was significantly less in the hypercalcaemic (1.00 +/- 0.1 g/cm2) and in the normocalcaemic groups (1.11 +/- 0.15 g/cm2) compared to the healthy controls (1.17 +/- 0.11 g/cm2). Decreased bone mineralization was evident shortly after transplantation and may well have been present before surgery. Females had less BMD compared to males and their BMD decreased further with age. CONCLUSION: Kidney transplantation patients with persistent hypercalcaemia comprise a risk group with regard to bone demineralization.

Adult↗

PubMed1995