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Biomedical subjects

L S Oei

Publications and source records attributed to L S Oei.

12 recordsLinked to original sources
PubMed1980

Transfusion and renal allograft survival: beneficial effect of transfusions given on day of transplantation.

To determine if the beneficial effect of blood transfusion on renal allograft survival can be obtained without risk of presensitization, we examined the effect of transfusions given on the day of transplant surgery in a series of 180 primary cadaveric renal allografts. Three-month graft survival of those transfused only on the day of transplant was significantly better than the graft survival of those never transfused, and was not significantly different from graft survival of those transfused during the dialysis waiting period. Maximal beneficial effect was achieved by administration of as few as two to three units. We conclude that the benefits of transfusion can be obtained while minimizing the risks of presensitization if transfusion is minimized during the dialysis waiting period and patients are electively transfused at the time of transplant.

Adolescent↗
PubMed1980

Hemosiderosis without cirrhosis: an unusual case of portal hypertension.

A renal transplant recipient presented with bleeding esophageal varices. Needle biopsy, later confirmed by operative wedge biopsy, showed slight periportal fibrosis but no cirrhosis or hepatitis. No etiology for his liver disease could be determined and he could not be differentiated from other reported patients with idiopathic noncirrhotic portal hypertension (IPH). His liver biopsy did show massive hepatic iron deposition. He had received about 115 units of blood while on hemodialysis and had taken oral iron supplementation for 8 years. IPH has been associated with toxin exposure, especially arsenic and vinyl chloride. This case suggests that excessive iron deposition may also lead to IPH and the indiscriminate use of iron supplementation in hemodialysis or renal transplant patients should be avoided.

Adult↗
PubMed1979

Cardiovascular side effects of long-term therapy with tricyclic antidepressants in the aged.

In a study to determine the nature and frequency of cardiac side effects during long-term administration of tricyclic antidepressant drugs in usual dosages in the aged, 32 geriatric patients were followed for an average of 36.6 weeks. Ten of them received amitriptyline in a daily dosage of 20-75 mg for 53 weeks (average); in 2, electrocardiographic side effects developed, viz, inversion of the T waves or evidence of acute coronary insufficiency. Imipramine was administered to 21 patients in a daily dosage of 20-100 mg (average, 66 mg) over a period of 40 weeks; in 3 instances major side effects developed--intermittent left bundle-branch block, acute coronary insufficiency with node dysfunction, or T-wave inversion with sinus tachycardia; in 1 instance there was a minor side effect, viz, tachycardia only. In 1 patient, acute myocardial infarction developed after two 10-mg doses of nortriptyline. Five of the 7 patients with cardiac side effects had prior organic heart disease. It was concluded that the incidence of cardiac side effects in aged persons given tricyclic antidepressant drugs in the usual therapeutic dosages for a prolonged period is great enough to warrant frequent careful monitoring of cardiac status during therapy.

Aged↗
PubMed1979

Effect of blood transfusions on survival of cadaver and living related renal transplants.

The effect of blood transfusion was analyzed in 194 first cadaver renal transplants and 86 living related renal transplants. The association of blood transfusion with HLA genotyping and poor risk recipients was analyzed. Exclusion of poor risk recipients improved graft survival among the transfused group of patients but not in the small subgroup of nontransfused recipients. No effect of blood transfusion was observed in the living related group. Improved graft survival was observed in both the haplotype-matched and nonhaplotype-matched transfused cadaver recipients. The haplotype-transfused recipients had grafts survival rates of 69 and 66% at 1 and 2 years, respectively. The greatest beneficial effect was seen in the double haplotype-transfused cadaver recipients with graft survival rates of 80 and 71% for the same period. The lack of beneficial effect of transfusion in the living related patients is felt to be a result of the fact that the maximum effect had already been achieved by a far superior donor-recipient histocompatibility than is able to be achieved in a large group of cadaver recipients.

Blood Transfusion↗
PubMed1979

Improving graft and patient survival rates in renal transplantation.

This report illustrates the improving trend in patient survival of recipients of cadaver and living-related kidneys. Mortality has been less than 3% for living-related recipients and less than 8% at one year for recipients of cadaver kidneys excluding diabetic patients. Although mortality of the diabetic recipient group receiving cadaver kidneys remains a problem, it has decreased in the last year such that overall mortality of the entire diabetic group is 20% at one year. The various factors leading to improved graft function rate are also emphasized.

Actuarial Analysis↗
PubMed1975

Renin and arterial pressure in perfused dog kidneys.

20 isolated dog kidneys were perfused in vitro at 37 degrees C during 6h in a closed circuit system with a Roller pump maintaining a pulsatile flow with a constant output. The perfusate electrolyte concentrations were kept constant. In 12 experiments where a hemodiluted standardized perfusion fluid was used, a significant (0.01 greater than p greater than 0.001) correlation (r = 0.798) was found in the beginning of the experiments between the mean arterial pressure expressed in mm Hg (y) and the renin level, expressed in log U/1 (x): y = 57.0+76.8x. In 4 other experiments, phenoxybenzamine added to the perfusion fluid decreased the arterial pressure but did not prevent the rise of the renin level. In 4 other experiments where the perfusion fluid did not contain blood, renin level and arterial pressure increased, whereas in the experiments using a circuit without a kidney, the renin level did not rise. The possible role of the renin-angiotensin system in causing increased renal vascular resistance during in vitro kidney perfusions is discussed.

Animals↗
PubMedDate not supplied

Major factors affecting cadaver renal transplant outcome in a single center.

In this center, 3 major factors have favorably improved cadaver renal allograft survival rates. The good risk recipient has been associated with a better graft survival and lower mortality. This factor cannot easily be controlled because of an increasing percentage of poor risk recipients awaiting transplantation in most major centers. Recipient blood transfusions administered both before transplantation and at the operating table have led to a better allograft survival in our center. Cadaver donor genotyping with haplotype matching of donor-recipient pairs has resulted in an improved graft survival. As sharing of kidneys between centers becomes more common, it is encouraging to note that one method of preservation is not superior to the other.

Blood Transfusion↗
PubMedDate not supplied

[Kidney preservation methods (author's transl)].

The results of preservation of the two kidneys of the same animal by two different techniques and then reimplanted on the same femoral artery, have been compared. The two methods are the following: 1) Short starting perfusion by Collins solution and than cold storage a 4 degrees C in the same solution. 2) Continuous perfusion by machine supplied by pulsatile pump, oxigenator, cooling. The first more impressive result by using continuous perfusion is the possibility of nullifying the effects of warm ischemia up to 30'. Kidney preservation with continuous perfusion is like to give less problems in the postoperatory period. Some weeks after transplantation however, the problems seems to increase in comparison with kidneys stored in Collins solution and not rarely sudden GFR decreases or anurias without immunologic rejection has been observed. Cautious conclusion should advise to use Collins solution when there has not been a long warm ischemia.

Animals↗