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Biomedical subjects

K Butt

Publications and source records attributed to K Butt.

44 records · Page 3Linked to original sources
PubMed1976

Clinical study of second kidney transplantation.

During the period from November 1972 to February 1975, 39 patients received second renal grafts in our institution. The clinical course of the patients was analyzed and compared with 121 patients who received only one graft during the same period. The graft survival either from living related or cadaveric sources was inferior in the second graft group. However, mortality was not increased by re-transplantation. Major differences were noted in the occurrence of hyperacute or accelerated type rejections. There was a high incidence of this type of rejection in the second graft group, especially in the simultaneous retransplant group.

Adult↗
PubMed1976

Urologic complications in renal primary and retransplantation. Experience with 202 consecutive transplants.

In a period of two years, 202 kidneys were transplanted in 162 patients at the Downstate Medical Center. On hundred twenty-nine patients had primary transplantations, twenty-nine second transplantations, and five third transplantations. Urologic complications occurred in twenty-four of the patients (12%). There were eight complications involving the urinary bladder and fifteen ureteric complications. In twenty-one patients the complications appeared within six weeks after surgery. Surgical correction immediately upon diagnosis of the urinary complications resulted in a high degree of early restoration of the urinary tract continuity and preservation of renal function. Leakage from the bladder was frequently associated with previous surgery. In five of eight patients, bladder leakage occurred after the second or third transplantations. Complications of the urinary bladder in general had a significantly favorable prognosis as compared with ureteric complications. Although all the patients with bladder complications fully recovered and maintained good renal function, four patients with ureteric complications either died or lost the graft.

Adult↗
PubMed1976

Transplant nephrectomy and simultaneous second graft retransplantation.

Tranplant nephrectomy and retransplantation has become an established modality in treating patients with rejected kidney allografts. Experience with 29 patients who underwent simultaneous transplant nephrectomy and retransplantation is presented. This procedure did not involve a considerably greater risk than a primary transplant and had an almost equal rate of success. There was no significant correlation between survival or failure of the second graft and the time the patient had been on dialysis prior to the first transplant, the duration of first graft survival, or the source of the first or second kidney. Seventy-five percent of the failures in the second transplant group were due to hyperacute or accelerated rejection, and only 25% were rejected in an acute or chronic fashion. The high frequency of hyperacute and accelerated rejections is presumably a result of presensitization by the first transplant. An inadequate supply of cadaver kidneys prevented performance of the simultaneous procedure in all patients that required it.

Adolescent↗
PubMed1975

Continuous single pass perfusion of the isolated kidney.

The use of continuous single pass perfusion to study the metabolism of isolated kidneys reveals that active metabolic processes continue in the hypothermically preserved kidney. These preliminary experiments described demonstrated a rapid uptake of substrates from the perfusion media in the first 24 hrs of storage, followed by a release of organic acids in the subsequent 24 to 72 hrs. Urea was found to be easily eliminated from the kidney. This technique may be useful for studying events related to loss of renal function by pinpointing specific residual biochemical activity and lesions that occur during prolonged preservations. An eventual correction or prevention of such lesions might be feasible in order to improve preservation techniques.

Animals↗
PubMed1975

Arterialization of the liver in combination with a portacaval shunt in the dog.

A dog preparation has been developed combining an end-to-side portacaval shunt with arterialization of the hepatic portion of the portal vein through an anastomosis between the inferior branch of the splenic artery and the stump of the portal vein. In this dog preparation, total hepatic blood flow, perfusion of the intrahepatic portal vein, and sinusoidal pressure remained within the preoperative range in the majority of the dogs. The data presented indicate that arterialization of the liver, under those conditions, resulted in no histologic damage or atrophy of the parenchyma of the liver and was effective in achieving significant prolongation of life and prevention of most of the adverse metabolic sequelae that follow a portacaval shunt in dogs. The indocyanine green extraction was restored to normal. The extraction of ammonia was impaired in all dogs with shunts; however, a significantly better ammonia extraction was seen in dogs with arterialization of the liver. It is being postulated that the dual perfusion of the liver through the hepatic artery and the portal vein is essential for the maintenance of the normal morphologic and functional states of the liver in dogs. The avoidance of hyperfusion of the sinusoidal bed with arterial blood is the most critical factor in preventing morphologic damage of the liver if arterialization of the portal vein is used.

Ammonia↗
PubMedDate not supplied

Renal artery stent placement for the management of ischemic nephropathy.

PURPOSE: To evaluate the angiographic and clinical results of percutaneously implanted renal artery endoprostheses (stents) for the treatment of patients with ischemic nephropathy. MATERIALS AND METHODS: During a 52-month period, 45 patients with azotemia (serum creatinine > or = 1.5 mg/dL) and atheromatous renal artery stenosis untreatable by, or recurrent after, balloon angioplasty were treated by percutaneous placement of Palmaz stents. Stent implantation was unilateral in 32 cases and bilateral in 11 cases. Clinical results were determined by measurements of serum creatinine and follow-up angiography. Clinical benefit was defined as stabilization or improvement in serum creatinine level. Angiographic patency was defined as less than 50% diameter recurrent arterial stenosis. RESULTS: Stent placement was technically successful in 51 of 54 (94%) renal arteries. Technical failures were stent misdeployment requiring percutaneous stent retrieval (n = 2) and inadvertent placement distal to the desired position (n = 1). Complications included acute stent thrombosis (n = 1) and early initiation of hemodialysis (within 30 days; n = 1). There were two periprocedural deaths. With use of life-table analysis, clinical benefit was seen in 78% of patients at 6 months (n = 36), 72% at 1 year (n = 24), 62% at 2 years (n = 12), and 54% at 3 years (n = 3). In patients with clinical benefit, average creatinine level was reduced from 2.21 mg/dL +/- 0.91 before treatment to 2.05 mg/dL +/- 1.05 after treatment (P = .018). Lower initial serum creatinine level was associated with a better chance of clinical benefit (P = .05). No other variables affected outcome, including patient age, sex, diabetes, implanted stent diameter, unilateral versus bilateral stent placement, or ostial versus nonostial stent positioning. Conventional catheter angiography or spiral computed tomographic (CT) angiography performed in 19 patients (28 stents) at a mean interval of 12.5 months demonstrated primary patency in 75%. Maintained stent patency appeared to correlate with renal functional benefit. CONCLUSIONS: Percutaneous renal artery stent placement for angioplasty failures or restenoses provides clinical benefit in most patients with ischemic nephropathy.

Aged↗