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Biomedical subjects

M N Maeser

Publications and source records attributed to M N Maeser.

3 recordsLinked to original sources

Salvage operations for malfunctioning polytetrafluoroethylene hemodialysis access grafts.

During the study period a cohort of 170 of patients receiving long-term hemodialysis treatment required placement of 214 polytetrafluoroethylene grafts for vascular access; within this period 74 of these patients had significant graft malfunction that required 149 salvage operations. The most common failure/malfunction was thrombosis, and the most commonly appreciated mechanical cause of graft failure was outflow venous stenosis. Complex revisions were required to address this problem. First, second, and third revisions were successful in 65%, 53%, and 44% of cases, respectively. Multiple revisions, including thrombectomy, were required in some, but the functional life of these salvaged grafts was nearly equal to that of grafts that did not require revision. Abandonment of grafts because of secondary infection exacted a toll in both groups.

Adolescent↗

A natural resource. Prevalence of cadaver organs for transplantation and research.

To determine the prevalence of potential cadaver kidney, eye, and research-tissue donors in a tertiary referral hospital, the charts of 718 patients who died were studied. We found a potential kidney-donor rate of 2.4 per 100 hospital deaths, a potential eye-donor rate of 45.4 per 100 deaths, and a potential pancreas-donor rate of 26.5 per 100 deaths. In the study year, 20 potential cadaver kidney donors were projected, theoretically meeting the needs of the transplantation center. Recognized potential eye and pancreas donors were remarkably numerous. Effective education, surveillance, and procurement programs are necessary to salvage these potential donor tissues.

Adolescent↗

Improved renal function after renal artery revascularization.

An experience with 20 patients with renovascular hypertension and renal insufficiency secondary to renal artery stenosis is presented. The mean follow-up was 29 months. Eighteen patients had atherosclerotic renal artery stenosis and two patients had transplant renal artery stenosis. The mean preoperative blood pressure of 162 +/- 5 mmHg decreased significantly to 105 +/- 2 mm Hg (p less than 0.001). The serum creatinine also decreased from a mean preoperative level of 4.7 +/- 0.7 mg/dl to a mean postoperative level of 2.3 +/- 0.3 mg/dl (p less than 0.001). Similarly, the creatinine clearance improved from a mean preoperative level of 28 +/- 2 ml /min to a mean postoperative level of 45 +/- 8 ml/min (p less than 0.03). Four patients (20%) with improved renal function died from 4 days to 15 months postoperatively. Two patients (10%) have progressed to end stage renal disease. These findings demonstrate that renal revascularization is clearly beneficial in the short-term and long-term improvement of renal function.

Adult↗