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Biomedical subjects

Lj Ignjatovic

Publications and source records attributed to Lj Ignjatovic.

3 recordsLinked to original sources

[Tuberous sclerosis].

Tuberous sclerosis is a rare hereditary disease which appears immediately after birth of during the second and third year of life. It is a multiorgan disorder characterized by convulsions, mental retardation and focal angiofibromyoma. The main findings are brain lesions including tuberous and astrocytes hamarthomas by which this disease was named. Renal alterations are angiofibromyolipoma and cysts, which are present in 40-80% of patients. The diagnosis is based on clinical, radiological and histological findings. This disease has a progressive course and fatal outcome. The therapy is symptomatic and surgical. The aim of this paper was to present this rare disease, which occurred in this patient during fourth year of life. Besides brain changes the patient also has extensive morphological renal alterations and renal failure. She died in 40th year of life due to multiorgan dysfunction.

Adult↗

[Use of mycophenolate mofetil in kidney transplantation].

Mycophenolate mofetil (MMF) is a new immunosuppressive agent for the prevention of renal allograft rejection. MMF is a prodrug of mycophenolic acid (MPA), a fermentation product of several Penicillium species of fungus. MPA acts at a late stage in T and B lymphocyte proliferation by selective, uncompetitive and reversible inhibition of inosine monophosphate dehydrogenase, a key enzyme in the de novo pathway of purine nucleotide synthesis. The three large studies individually and the combined (pooled) 1-year patient efficacy data have shown that MMF, given in combination with cyclosporine and corticosteroids, significantly reduces the incidence of acute rejection episodes (by 50%), without detectable difference in patient mortality. Analysis of secondary efficacy endpoints revealed that patients treated with MMF required less additional immunosuppressive therapy for treatment of acute rejection episodes and showed better renal function. In another studies, the efficacy of MMF in the treatment of first acute rejection episodes and in the treatment of refractory, acute, cellular renal transplant rejections has been shown. The principal adverse events associated with MMF administration included diarrhea, vomiting, leukopenia and a higher frequency of certain types of infections. The efficacy of MMF for the treatment of chronic allograft nephropathy is controversial. The ability of MMF to reduce the occurrence of acute rejection episodes and improve allograft function may have significant implications for promoting the long-term survival of renal allografts, but we need long-term observations to prove this benefit.

Graft Rejection↗

[Outcome of kidney transplantation in patients on peritoneal dialysis].

The initial experience suggested that kidney transplantation could be hazardous for patients on peritoneal dialysis due to the high risk of peritonitis and a possible high incidence of acute rejection. In this paper we have presented our experience with kidney transplantation in these patients. During the last four years kidney transplantation was performed in 9 patients on peritoneal dialysis. The average time spent on peritoneal dialysis was 20.6 +/- 7.6 months. In all patients peritoneal catheter was removed during the surgery. During the posttransplantation period a triple immunosuppressive therapy including steroids, cyclosporin and azathioprineor mycophenolate mofetil was administered in all patients. In comparison to patients on hemodialysis no significant difference in the incidence of acute rejection episodes, delayed graft function, graft arterial thrombosis and graft function recovery was observed. Patients on peritoneal dialysis had significantly greater and longer wound drainage in comparison to patients on hemodialysis. It was concluded that peritoneal dialysis had no negative influence on short-term outcome of kidney transplantation.

Adult↗