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Biomedical subjects

L Koep

Publications and source records attributed to L Koep.

7 recordsLinked to original sources
PubMed1980

Decline in survival after liver transplantation.

Twenty-three recent cases of orthotopic liver transplantation were individually reviewed in an effort to determine why survival had declined from the 50% one-year survival rate of an immediately precedent series. In the series of 23, only six (26%) achieved one-year survival. Faulty case selection, technical complications, the use of damaged organs, and complications of immunosuppression were the main causes of death. Attention was directed to the possible use of preoperative lymphoid depletion to improve the effectiveness and safety of immunosuppression.

Adolescent↗
PubMed1980

Preliminary evidence of dual-marked lymphocytes in thoracic duct lymph fluid.

Thoracic duct lymphocytes from patients receiving thoracic duct drainage as a pretransplant therapy were examined for cell surface markers. Patients followed over the drainage time period showed a variable but decreasing percentage of E-rosette-positive cells in the lymph fluid. A substantial percentage of these E-rosette-positive cells also had C3 receptors on their cell surface. Reactions of the whole lymphocytes with a heteroantisera to human B-lymphocyte antigens reflected the increasing proportion of B cells in the samples, but also indicated that a fraction of the T cells have Ia-like antigens on their surface marker characteristics. Significance of these cells with respect to graft survival is discussed.

Animals↗
PubMed1979

Retrospective tests of B-cold lymphocytotoxins and transplant survival at a single center.

Sera from 203 recipients prior to transplantation were examined against a panel of 30 T and B lymphocytes at 5 degrees C and 37 degrees C. Those patients classified as having B-cold cytotoxins only had higher 1-year transplant survival rates from cadaver donors (82%) than patients with no antibodies (58%) or patients with antibodies reactive to T and B lymphocytes in the warm (37%). These results based on transplants from a single center confirm earlier studies derived from patients in 27 centers.

Antilymphocyte Serum↗
PubMed1977

The clinical significance of retroperitoneal fibrosis.

A total of 481 cases of retroperitoneal fibrosis (RPF) presented in the literature have been reviewed. Ten additional cases from this hospital have been added. One etiological factor, methysergide, has been implicated in 12.4 percent of cases, but the majority remain unexplained. Characteristically, the patient will be male (2:1 ratio), in his 50's (30.9 percent), with vague lower back pain (34.2 percent) or possibly flank pain (34.0 percent). Physical examination usually will be unrevealing. The patient's serum chemistry probably will show some degree of azotemia (55.4 percent) and perhaps anemia (13.6 percent). The intravenous pyelogram characteristically shows bilateral hydroureteronephrosis (67.6 percent) or unilateral hydroureteronephrosis (20.3 percent) associated with medial deviation of the ureter due apparently to external compression of the ureter. Methysergide should be discontinued if implicated. Laparotomy for ureteral compression characteristically will reveal a dense, rubbery plaque in the retroperitoneum. Generous frozen section biopsies show fibrosis, usually with some chronic inflammation, suggestive of RPF. Careful inspection of retroperitoneal nodes and liver may reveal the presence of malignancy in 7.9 percent of patients. In the absence of malignancy, the ureters should lyse fairly freely and peristasis may return. If no malignancy is present on permanent sections of biopsy material, the patient can be given a fairly optimistic prognosis (cumulative mortality rate, 9 percent). Suboptimal improvement probably is an indication for steroid therapy and surgical re-exploration may become indicated. In these cases further search for malignancy should be undertaken.

Adolescent↗