PubMed Health⌕ Search

Biomedical subjects

J Van Geertruyden

Publications and source records attributed to J Van Geertruyden.

At least 73 records · Page 4Linked to original sources
PubMed1979

Liver disease in patients undergoing hemodialysis and kidney transplantation.

Liver dysfunction was observed in 33% of patients treated by hemodialysis and kidney transplantation. Fifty-eight percent of these cases of hepatitis occurred in patients with past or present HBs antigenemia, and 77% of HBsAg-positive patients showed evidence of LD. However, during the course of a program conducted from 1969 to 1976 and involving 267 patients, the decrease in the prevalence of HBs antigenemia observed during the last two years did not lead to any reduction in LD incidence. In a small number of patients, potentially hepatotoxic drugs could be incriminated, but in our experience azathioprine never appeared to be involved. In a few patients, LD was due to granulomatous disease of the liver, such as tuberculosis and schistosomiasis. Twenty-one (7%) of the 267 patients at risk developed chronic hepatitis, which contributed to death in nine patients. In 12 cases (three deaths), this form of hepatitis occurred in HBsAg-positive patients, and in nine cases (six deaths), in HBsAg-negative patients. In three of these latter individuals, cytomegalovirus could be incriminated. Routine monthly screening for CMV in kidney recipients confirmed the high incidence of this viral infection in such patients. Studies on murine CMV infection have demonstrated that this infection can be enhanced by histoincompatible graft or by cyclophosphamide in a model that is very close to the kidney recipient. As in mice, CMV infection in kidney recipients apparently results from reactivation of a latent infection. It seems to play a major role in the LD observed and could apparently lead to chronic hepatitis and even to cirrhosis of the liver. Finally, the occurrence of LD in HBsAg-, anti-HBs- and antiCMV-negative patients would suggest the responsibility of other viruses for the pathogenesis of liver disease in patients treated by hemodialysis and kidney transplantation. Besides Epstein-Barr virus, other viruses, such as hepatitis C virus, should be thoroughly scrutinized.

Adult↗
PubMed1977

Nine years' experience with internal arteriovenous fistulas for haemodialysis: a study of some factors influencing the results.

Data were collected concerning 314 internal arteriovenous fistulas created in 242 adult patients (92 women and 150 men). The immediate failure rate for the various techniques used ranged from 7-7 to 12-0 per cent, except for ulnar fistulas which had a rate of immediate thrombosis of 20-7 per cent. Survival rates were significantly lower for patients submitted to a combined therapy of dialysis and kidney transplantation when compared with patients treated with dialysis alone. The probability of survival of an arteriovenous fistula was lower in women than in men but the difference was significant only in patients undergoing transplantation. Survival rates at 2 years in dialysed patients were 87-6 per cent for distal radial-cephalic side-to-side fistulas, 100 per cent for radial-cephalic end-to-side fistulas located in the mid-forearm, 78-5 per cent for radial-cephalic end-to-side fistulas created near the wrist, 53-1 per cent for distal radial-cephalic end-to-end fistulas and 60-9 per cent for ulnar fistulas. Thrombosis was responsible for 87-2 per cent of 109 late failures. The incidence of infection was 1 case/11 patient years of haemodialysis.

Adult↗
PubMed1977

Kidney graft rejection crisis: time-evolution, prognostic significance and role in infection.

For 255 kidney grafts performed during the past twelve years, 622 rejection crises (RC) were analysed. Irreversible RC occurred more frequently in second than in first grafts during the first post-operative trimester. A clear relationship between long term graft tolerance and RC occurring during the first post-operative month was observed. Infection was related to RC in 61% of cases. Infections following corticosteroid therapy after short intervals were usually characterised by a poor prognosis. These clinical features have practical implications for immunosuppressive treatment.

Adult↗
PubMed1976

[Polycystic kidney treated by iterative hemodialysis and kidney transplantation. 25 cases].

Between January 1968 and December 1975, 25 patients (13 men and 12 women) were treated in the dialysis and transplantation unit of the Brugmann Hospital for terminal renal insufficiency secondary to polycystic disease. Nine patients (36%) underwent repeated surgery in order to ensure adequate successful vascular access for haemodialysis, whilst only 14.1% of patients suffering from renal insifficiency of another cause had to undergo operation on more than one occasion in order to be treated. In the majority of cases vasospasm was responsible for the obliteration of internal or external arterio-venous shunts. It was particularly common in women with a normal or low blood pressure. In this group, 3/4 of the patients needed several operations in order to make dialysis possible. Fourteen patients underwent bilateral nephrectomy. One death occurred in a patient who had received a renal transplant during the same operation. Fifteen kidney grafts were carried out and percentages of functional transplants at one and two years were 45.4 and 37.8% respectively. These poor results may be explained by the fact that 13 of our 15 patients were aged more than 40 years.

Age Factors↗
PubMed1976

Prognostic significance of hepatitis B antigenemia in kidney transplantation.

Serial hepatitis B antigen (HBAg) serum screenings were performed in 98 cadaver kidney transplant recipients: 51 were persistently found HBAg-negative while 47 became HBAg-positive, the majority of them acquiring HBAg postoperatively. In 28 patients, HB antigenemia persisted over 6 months postoperatively. 1- and 2-year graft survival rates were significantly greater in HBAg-positive than in HBAg-negative recipients. This finding suggests that HBAg tolerance is due to the ill-defined processes which determine kidney graft tolerance.

Adolescent↗
PubMed1976

Kidney transplantation in primary oxalosis.

A 33 year old patient with primary oxalosis was submitted to cadaver kidney transplantation after 15 months treatment by hemodialysis. During the dialysis period, he developed complete heart block which immediately followed bilateral nephrectomy. The transplant functioned correctly and was found to excrete large amounts of oxalate. Death, which supervened 7 months after transplantation, was due to miliary tuberculosis. The patient's own kidneys and various organs examined post mortem showed extensive oxalate deposits, which were mainly observed in the graft, conducting system of the heart, ocular structures, spleen and pancreas. The problems of managing terminal uremia secondary to primary oxalosis are discussed.

Adult↗
PubMed1975

Pulmonary infections after kidney transplantation.

Seventy-five pulmonary infections out of 173 kidney transplantations have been observed in 62 graft-recipients, from 1965 to 1973. The aetiologic organism is a bacteria in 80% of the cases, a fungus in 8% of the cases, cytomegalovirus and Pneumocystis Carinii in 11% of the cases. A close relationship between infection and a previous transplant crisis was noted in 66% of the cases. The most efficient diagnostic procedures were pleural and open lung biopsy as well as cultures of blood, pleural fluid and tracheobronchial secretions. Treatment was effective in 60% of bacterial and Pneumocystitis Carinii infections; on the other hand, it was less useful in fungal infections and totally ineffective in cytomegalovirus infections. Despite a possible increase in the risk of rejection, reduction or even arrest of immunosuppressive therapy is recommended in severe infections.

Bacterial Infections↗