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L Gradowska

Publications and source records attributed to L Gradowska.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Ovarian function in women after kidney transplantation].

The full recovery of reproductive age patients suffering from chronic renal failure due to a successful transplant should include the restoration of normal reproductive functions. In the study data are presented concerning the resumption of menstruation and the evaluation of the ovarian function of renal transplant recipients. After a successful renal transplant the ovarian function improves considerably but isn't always fully restored which can be attributed to the renal efficiency grade or result from the administered immunosuppressive treatment. Approximately 40% of the patients have ovulatory cycles with a normal length of the luteal phase. 40% have also ovulatory cycles but the luteal phase is shorter and the progesterone values are lower. The remaining patients have anovulatory cycles with low estrogen values and a high FSH and LH concentration.

Adolescent↗
PubMed1994

[Tuberculosis in patients after kidney transplantation].

Infection caused by Mycobacterium tuberculosis is common among population in Poland. We analyzed the effect of tuberculosis (TB) on patients and graft survival in the group of renal allograft recipients (RAR), treated in our center. Among 1669 renal allograft recipients transplanted from 1981 to 1992, tuberculosis developed in 33 (2%) patients (16 M/17F, age: 22-57 years). The patients were on following immunosuppressive regiments" Pred+Aza+CsA (12 pts), Pred+Aza (12), Pred+CsA (6) and Pred+Aza+CsA+ATG (3). Acute rejection was diagnosed in 27 of them and was treated with methyloprednisone pulses, and in a few cases additionally with ATG (2 pts) or OKT3 (1 pt). In two pts TB had been diagnosed and successfully treated in the past. In 6 pts, on chest X-ray done immediately before transplantation, healed primary lesion (Ghon complex) had been seen. In 16 pts TB developed in the early posttransplant period (median: 3.8 +/- 1.8, range: 1-6 months) and in 17--late after transplantation (median: 31.2 +/- 1.8, range: 13-156 months). In 19 pts symptoms developed soon after treatment of acute rejection. Clinical manifestations include pulmonary TB (30 pts) and extrapulmonary lesions (15 pts): pleural TB (3 pts), miliary TB (5 pts), tuberculous lymphadenitis (1 pt), uveitis (1 pt), renal allograft (2 pts), skeletal (2 pts) and GI tract (1 pt). Diagnosis of TB was made based on clinical presentation and radiologic findings and it was confirmed by positive cultures in 18 pts, by tissue biopsy in 4 pts and by autopsy examination in 9 pts. Treatment regimen included one of the following drug combinations: INH+EMB+RMP (20 pts), INH+RMB+RMP+PZA (10 pts) or INH+EMB+SM (3 pts). Three pts died before TB was recognized and 4 deaths occurred after treatment was started. All these pts developed renal failure. 26 pts were treated for 3-12 months (median, range: 7.8 +/- 2.9) and in 24 of them complete remission was achieved. In this group renal function remained stable in 16 pts and 6 pts developed terminal failure due to chronic rejection. Authors conclude: 1. TB remains a frequent complication in RAR but can be successfully treated when diagnosed early. 2. Extrapulmonary TB is common in RAR. 3. TB deteriorates one year patients (75%) and graft (49%) survivals.

Adult↗
PubMed1994

[Levels of myoglobin (Myo) in blood of patients during an early phase after kidney transplantation].

UNLABELLED: In uremic subjects Myo levels were significantly higher than in normals. In the present study we aimed to assess the Myo levels immediately after KT. Myo levels were assessed in 25 uremic patients at the early phase after KT and in 12 controls (patients immediately after cholecystectomy). All uremic patients were divided on two groups: group I--patients with immediately good graft function after KT (12 patients) and group II--patients with acute failure of the transplanted kidney (13 patients). In all examined subjects immediately before and during following 30 days after KT or cholecystectomy the Myo levels were assessed using RIA methods. There were found the significant correlations between plasma creatinine and Myo levels in uremic patients. CONCLUSIONS: 1. In all examined KTP the tendency to normalisation Myo levels after transplantation was observed. 2. Acute failure of transplanted kidney delayed normalization Myo levels. 3. Normalization of Myo levels was preferently dependent on the graft function.

Adult↗
PubMed1993

[Levels of beta-2-microglobulin (B2MG) in blood serum of patients during the early phase after kidney transplantation].

In uremic subjects serum B2MG levels was significantly higher than in normals. In kidney transplant patients (KTP) serum B2MG levels was 3-4 times higher than in normals. Elevated serum B2MG levels in KTP seems to depend not only on the kind of immunosuppressive therapy but also on other factors. In the present study we aimed to asses serum B2MG levels immediately after KT. B2MG were assessed in 25 uremic patients at the early phase after KT and in 12 controls (patients immediately after cholecystectomy). All uremic patients were divided on two groups: group I-patients with immediately graft function after transplantation (12 patients) and group II--patients with acute failure of the transplanted kidney (13 patients). In all examined subjects immediately before and 1, 2, 3, 4, 5, 10, 15, 20, 25, and 30 days after transplantation serum B2MG levels were assessed using RIA methods. In group I we observed gradually decline of B2MG concentrations parallel with creatinine after KT while in group II normalization of B2MG and creatinine levels were delayed (approximate 10 days). The significant positive correlation was found between plasma B2MG and creatinine levels in all examined patients. We concluded: 1. In all examined groups the tendency to normalization of B2MG levels after KT was observed. 2. Acute failure transplanted kidney delayed normalization of B2MG concentrations. 3. Normalization of B2MG levels was preferentially dependent on the graft function.

Adult↗
PubMed1993

Low dose heparin: efficacious treatment for chronic renal allograft rejection.

Recent data indicate that aside from its anti-coagulant action heparin has potent immunobiological activities inhibiting cell trafficking to a site of antigen. In addition, heparin inhibits smooth muscle cell proliferation and decreases the synthesis of the extracellular matrix proteins. As those phenomena are thought to play a major role in the pathogenesis of chronic allograft rejection, we performed a trial evaluating the efficacy of low dose heparin (5 U/kg/day) in 23 recipients of renal allografts with biopsy-proven rejection. In 16 patients (70%) a tendency for improvement was seen which in 57% was statistically significant. Our data suggest that low dose non-anticoagulant heparin may be an efficacious means for treatment of chronic rejection.

Adult↗
PubMed1993

[Effect of immunosuppression method on levels of plasma erythropoietin (EPO) and parathyroid hormone (PTH) during acute graft rejection in kidney transplantation (KTP)].

UNLABELLED: Acute rejection is characterized by renal ischaemia which in turn is a triggering factor of EPO synthesis. On the other side during acute rejection (AR) the plasma PTH level (which is incriminated as an uraemic toxin) increases. This facts justified our present study which aimed to assess: 1. the influence of acute graft rejection (AR) on plasma EPO and PTH levels in KTP and 2. the influence of kind of antirejection therapy i.e. high dose of methylprednisolone (MP) vs thymoglobuline (TG) + moderate dose of methylprednisolone on plasma EPO and PTH levels respectively. A total of 28 KTP were studied who were divided into two groups: the first one designed as group MP comprised 17 KTP treated by high doses of MP while the second one designed as group ATG--consisted of 11 KTP treated by thymoglobulin+moderate doses of MP. The control group consisted of 16 healthy subjects. Before AR KTP showed inappropriately reduced EPO plasma levels when related to the degree of anaemia. AR was accompanied by a significant increase of plasma EPO and PTH levels in all examined KTP groups. After subsidence of AR normalization of plasma EPO and a significant decline of plasma PTH was noticed. A significant positive correlation was found between plasma EPO and PTH levels before the AR period in both examined groups. CONCLUSIONS: 1. KTP are characterized by relative EPO deficiency at the immediate (2-3 weeks) post transplantation period. 2. AR episodes are characterized by a significant rise of both plasma EPO and PTH levels. 3. Changes in plasma EPO and PTH do not seem to be interrelated at the AR episodes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Level of erythropoietin and parathormone in blood plasma during acute rejection of kidney transplant].

The acute rejection of kidney transplant is accompanied by kidney ischaemia which in turn is a triggering factor for erythropoietin (EPO) synthesis. It was shown, on the other hand, that during the rejection an increase in blood serum parathormone (PTH) concentration takes place. The present study was aimed at answering the question what is the effect of acute rejection of kidney transplant on blood serum concentrations of EPO i PTH. Seventeen patients with kidney transplant participated in the study. In all the patients the investigations were carried out four times: 1--few days before rejection, 2--after ascertaining that kidney transplant is being rejected, 3--immediately after rejection, and 4--few days after completing the anti-rejection therapy. High doses of methylprednisolone were used as anti-rejection therapy. Control group consisted of 16 healthy persons. Acute rejection of kidney transplant was accompanied by a significant increase in blood serum concentrations of EPO and PTH. After methylprednisolone therapy, normalization of EPO and decrease in PTH concentration were observed in kidney transplant patients. Significant positive correlations were found between EPO and PTH concentrations in blood serum. It was concluded that acute rejection of kidney transplant is characterized by a significant increase in blood serum concentrations of EPO and PTH. Despite the existence of a significant positive correlation between blood serum concentrations of EPO and PTH in patients with kidney transplant, any pathogenic relation between the observed disturbances of secretion of the two hormones seems to be of little probability.

Acute Disease↗
PubMed1991

[Serum erythropoietin level during acute rejection of transplanted kidney].

Acute rejection is characterized by renal ischaemia which in turn is a triggering factor of EPO synthesis. This fact justified our present studies which aimed to assess the influence of acute rejection (AR) on plasma EPO level in KTP. A total of 17 KTP were examined some days before AR (I), at the onset of AR (II), immediately (III) and some days after (IV) discontinued therapy of AR episodes by methylprednisolone. The control group consisted of 16 healthy subjects. KTP 2-3 weeks after renal transplantation showed relative EPO deficiency both during efficient excretory function and rejection episodes. At acute graft rejection episodes a marked increase of plasma EPO level was found. Results presented in this study suggest absence of the physiological relationship between EPO secretion and erythropoiesis 2-3 weeks after transplantation.

Acute Disease↗
PubMed1991

[Plasma erythropoietin levels of kidney transplant patients in the early period after transplantation].

Plasma erythropoietin (EPO) levels were assessed in 51 uraemic patients immediately after kidney transplantations and in 16 healthy subjects. Before transplantation EPO levels were significantly higher than in normals. In patients with acute renal failure of the transplanted kidney, a significant increase of plasma EPO level was noticed. Such an increase of plasma EPO was absent in patients with a normally functioning kidney transplant. In these last patients normalization of plasma EPO was found during the first month after transplantation. No significant correlation was found between plasma EPO level and the haematocrit value in kidney transplant patients. From results obtained in this study it seems, that factors other than EPO are also involved in the pathogenesis of anaemia in patients at the early phase after kidney transplantation.

Acute Kidney Injury↗
PubMed1991

[Plasma erythropoietin levels in patients with stabilized function of the transplanted kidney].

Plasma erythropoietin level was assessed in 96 kidney transplant patients with stabilized function of the graft 3 months up to 5 years after transplantation and in 16 healthy subjects. In kidney transplant patients on CyA or azathioprine respectively, plasma erythropoietin levels were significantly higher during the first three months after transplantation than in normals. Normalization of erythropoietin levels were observed 6 to 12 month after kidney transplantation. As compared with patients on CyA, in azathioprine treated patients plasma erythropoietin levels were significantly higher 12 to 60 months after transplantation. These elevated erythropoietin levels in azathioprine treated patients seem to be due also to factors other than higher prednisone dosage.

Adult↗
PubMed1991

[Plasma erythropoietin levels in kidney transplant patients with impaired function of the renal graft].

In 81 patients with failing kidney transplant, plasma levels of erythropoietin, iron, ferritin and TIBC were assessed. Progression of failure of the excretory function of the kidney transplant was accompanied by decreasing Hb and Ht values but increasing plasma levels of erythropoietin. In all examined patients presence of iron deficiency could be excluded. Results obtained in this study suggest that relative erythropoietin deficiency is the major cause of anaemia in patient with a failing kidney transplant.

Acute Kidney Injury↗
PubMed1988

Long-term immunosuppressive therapy of idiopathic membranoproliferative glomerulonephritis.

Fifty cases of idiopathic membranoproliferative glomerulonephritis were followed up for an average of 10 +/- 0.9 (SE) years. Forty of them, who presented a nephrotic syndrome, were treated by immunosuppressive drugs (prednisone, azathioprine, chlorambucil, cyclophosphamide) for 79 +/- 9.7 (SE) months. Cumulative survival ratio for 5, 10 and 15 years after enrollment was 0.90, 0.82 and 0.77 and after appearance of first symptoms or signs of kidney disease as determined by anamnestic data 0.97, 0.91 and 0.90 accordingly. Triple-drug therapy (prednisone and azathioprine combined with chlorambucil or cyclophosphamide) was more effective in improving proteinuria than other immunosuppressive regimens. No serious side effects were encountered.

Adult↗
PubMed1983

The comparison of antibody-dependent (ADCC) and lectin-induced (LICC) cytotoxic activities of human blood lymphocytes in healthy and diseased subjects.

Antibody-dependent and PHA-induced cytotoxicity of peripheral blood lymphocytes in healthy human subjects and in patients with primary glomerulopathies (non-treated and on immunosuppressive treatment) as well as hemodialyzed and transplanted patients were investigated. Heavy disorders of ADCC and LICC activity in the groups of uremic patients and in patients on immunosuppressive therapy were found. Higher sensitivity to immunosuppressive treatment demonstrated that the lymphocytes exerted an antibody-dependent rather than a PHA-induced cytotoxicity. Results presented suggested the participation of two different lymphocyte subpopulations with ADCC and LICC activity in the regulatory and pathological processes.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1982

Cytomegalovirus antibodies in renal transplant recipients.

The relationship between CMV infections and the development of various viral antibodies were studied in successively taken sera from 5 renal kidney recipients. In all of the cases tested the infections were connected with the development of antibodies to immediately early antigens and then specific IgM and antibodies to various CMV early antigens. The increase of antibodies measured by ELISA, CF and immunofluorescence for late CMV antigens were observed in samples taken from two patients. Based on serological findings the relation between CMV infections and quantity of blood received before transplantation was established.

Antibodies, Viral↗
PubMed1981

Diagnostic and prognostic value of antibody-dependent cellular cytotoxicity and lectin-induced cellular cytotoxicity tests for renal graft rejection.

Peripheral blood lymphocytes from both normal subjects and kidney allograft recipients, before and on the 4th to 5th days after transplantation, were examined for antibody-dependent cellular cytotoxicity (ADCC) and lectin-induced cellular cytotoxicity (LICC). The graft recipients were treated with standard immunosuppression, which included azathioprine and prednisolone. 51Cr-labeled L1210 cells were used as targets for these two tests. ADCC and LICC activity were evaluated in the presence of rabbit anti-L1210 anti-serum and phytohemagglutinin (PHA), respectively. Comparison of the results obtained from healthy subjects with those of patients before grafting showed a significantly higher LICC activity in the latter group. The ADCC activity did not differ between the groups of healthy females and those awaiting transplantation but it was significantly decreased in the group of males awaiting transplantation as compared to healthy males. Four to 5 days after transplantation, the activity of ADCC and LICC remained unchanged in spite of the immunosuppressive treatment in 37 and 61% of the patients studied, respectively. In most of the patients, high ADCC and/or LIcC activity was followed by an accelerated acute rejection episode. A correlation between the ADCC and LICC activities, measured 4 to 5 days after transplantation, and the time of the first rejection episode was found. We conclude that double screening with ADCC and LICC tests in the 1st week after transplantation is valuable.

Antibody-Dependent Cell Cytotoxicity↗