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Biomedical subjects

M J Ricart

Publications and source records attributed to M J Ricart.

At least 19 recordsLinked to original sources
PubMed1995

Fibrillary glomerulonephritis and pulmonary hemorrhage in a patient with renal transplantation.

Fibrillary glomerulonephritis is an unusual kidney disease characterized by the deposition of immunoglobulins in a fibrillar pattern. Until recently it has been considered to involve the kidneys alone. We describe a patient who underwent renal transplantation and developed fibrillary glomerulonephritis with rapidly progressive renal failure and severe pulmonary hemorrhage two years and a half after transplantation. Nephropathy prior to transplantation was thought to be focal and segmental glomerulosclerosis. Diagnosis of fibrillary glomerulonephritis in renal allograft was confirmed by postmortem examination. 50% of the glomeruli with extracapillary crescents were observed on light microscopy. By immunofluorescence main deposition of IgA was detected in the glomerular capillar walls and the mesangium. Electron microscopy showed fibrillo-reticular deposits in the same place. Lung histology showed both old and recent areas of alveolar hemorrhage. Granular staining for IgA was observed in the alveolar walls by immunofluorescence. Ultrastructural analysis of the lung made evident fibrillo-reticulary deposits in the interstitium, similar than those observed in the glomeruli. The presence of these deposits in both renal and pulmonary tissues indicates the possibility of systemic involvement in fibrillary glomerulonephritis. In our case it could be related to the recurrence of this glomerulopathy in renal allograft.

Fatal Outcome↗
PubMed1994

Quality of life after successful pancreas-kidney transplantation.

Quality of life assessment has emerged as an important approach to evaluate the effect of pancreas transplantation in diabetic patients with end-stage renal failure (ESRD). The aim of this study was to evaluate the impact of the ESRD treatment modality on the quality of life in patients with Type I (insulin-dependent) diabetes mellitus. Thirty-two patients of similar age, sex and diabetes duration, treated for more than 1 year with simultaneous kidney and pancreas transplantation (Group 1, n = 12), or kidney transplantation (Group 2, n = 10), or hemodialysis (Group 3, n = 10) were studied. Quality of life was assessed using a questionnaire (34 questions with 103 possible answers) including social (sickness pension, working capacity) and subjective (general health perception), index of Spizer and index of reintegration to normal life of Wood Dauphine) quality of life indicators, working capacity, as well as physical ability (Karnofsky index), sports training and sexual activity. Patients in Group 1 showed highest scores on general health perception (p = 0.012), Karnofsky index (p = 0.076) and sexual activity (p = 0.026). There were no significant differences between groups on social index, as well as index of Spizer, index of reintegration to normal life and sport activity. Patients on hemodialysis treatment presented the lowest scores in all the items evaluated. In conclusion, in our experience simultaneous pancreas and kidney transplantation is the treatment modality that offers better quality of life to diabetic patients with ESRD; however, this does not translate into a higher socio-labor yield.

Activities of Daily Living↗
PubMed1993

Successful pregnancy after combined pancreas-kidney transplantation.

In this paper we report a successful pregnancy after combined pancreas-kidney transplantation. During pregnancy the patient was treated with prednisone and cyclosporin. Pancreatic and renal function remained normal during pregnancy, but moderate hypertension was detected in the 28th week. A healthy baby of 1900 g (below the tenth percentile) was born at 36 weeks. In this case, urine pregnancy tests were negative throughout the pregnancy, probably due to the exocrine secretion of the pancreas, which had been diverted to the urinary bladder. This possibility has not been previously reported.

Adult↗
PubMed1993

Native and graft pancreatitis following combined pancreas-renal transplantation.

Ten patients who had undergone whole-organ pancreas transplantation and pancreatoduodenocystostomy from a total of 60 simultaneous cadaveric kidney-pancreas transplants met the criteria for graft pancreatitis. This condition is clearly different from acute rejection on the basis of marked hyperamylasaemia and significant local findings over the allograft. Graft rejection was the cause of graft loss in one of the patients; eight are alive, seven with a functioning graft 61, 30, 27, 25, 21, 18 and 14 months after transplantation. Two patients died: one from severe graft pancreatitis and the other from cytomegalovirus infection. Bladder drainage with or without antibiotics has been the most common therapy, based on the theory that damage is caused by duodenal content and infected urine reflux. To prevent graft loss, antiviral treatment should be given when pancreatitis due to cytomegalovirus is suspected or diagnosed. Two patients with native pancreatitis are also described; the disease was severe and surgery was required in both cases. The pancreas grafts have now been functioning for 2 years 7 months and 2 years 10 months respectively.

Adult↗