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Biomedical subjects

N Sumrani

Publications and source records attributed to N Sumrani.

64 records · Page 4Linked to original sources
PubMed1990

The pattern of organ donation in a large urban center.

Despite increasing referrals for organ donation in metropolitan New York, procurement has remained essentially unchanged from 1983 through 1988 at 9 to 13 per million population, falling far short of increasing demand. This is not due to delay in the diagnosis of brain death, higher discard rates, or increased medical unsuitability, although exclusion because of human immunodeficiency virus (HIV) disease, or risk thereof, has increased and now accounts for 38% of exclusions. Consent for organ donation remains consistently low among blacks (24%), has increased among Hispanics from 17% in 1984 to 47% in 1988, and remains the highest, but without improvement, among whites. Causes for the observed stagnation and potential corrective factors include poorly focused educational efforts, lack of sensitivity to the grieving family by hospital personnel, physician frustration at the increasingly prominent role of government and its regulations in the practice of medicine, and eradication of competition between local organ procurement agencies.

Humans↗
PubMedDate not supplied

Orthotopic hepatic transplantation in the dog.

Orthotopic hepatic transplantation has become a well-established treatment modality for end-stage liver disease, and research in this field is constantly evolving. Of the 34 canine liver transplants performed in this study, 17 (50%) survived more than 3 days (mean survival time 15 days). Causes of perioperative death included hemorrhage (4), anesthetic complications (3), systemic anaphylaxis (3), portal vein thrombosis (3), hepatic venous outflow block (2), and hepatic artery thrombosis (2). Gentle handling with minimal dissection of the donor liver in situ resulted in a decreased incidence of hepatic venous outflow block. The incidence of biliary leak was similar irrespective of the method of biliary reconstruction, although the incidence of acute cholangitis was 56% in the cholecystoduodenostomy group compared with 0% in the choledochocholedochostomy cohort. Using celiac to common hepatic end-to-side arterial anastomosis with preservation of the gastroduodenal artery, thrombosis of the hepatic artery was encountered in four instances, an incidence similar to previously reported studies where end-to-end hepaticohepatic arterial anastomosis or donor aortic conduit was utilized. The incidence of postoperative intestinal intussusception was reduced from 40 to 0% in those who underwent transmesenteric intestinal plication following implantation of the liver. Among short-term survivors, sepsis was the most frequent noted complication (10), followed by intestinal intussusception (6), rejection (6), and gastrointestinal bleeding (1). Among recipient dogs that survived more than 3 days, rejection was the most common cause of graft loss (5), followed by biliary leak (4) and hepatic artery thrombosis (2).

Animals↗
PubMedDate not supplied

Racial differences in renal transplant outcome of insulin-dependent diabetic recipients in the cyclosporine era.

In an attempt to analyze the influence of race on renal allograft outcome among insulin-dependent diabetic uremics, all 109 cyclosporine treated transplants were studied. Black recipients were noted to have inferior 1 year survival for both living related and cadaver donor grafts when compared with both whites and Hispanics (67% and 43% vs. 92% and 84%, 100% and 80%, respectively, p less than 0.01). Nonimmunologic causes accounted for 69% of graft losses among blacks, compared with 39% and 33% in whites and Hispanics, respectively. Among long-term survivors, however, renal function remained relatively stable among all racial groups. This differing trend among black diabetic recipients suggests the need for aggressive cardiac workups before transplantation, and judicious immunosuppression in the posttransplant period.

Adult↗
PubMedDate not supplied

Renal allograft outcome in the cyclosporine era: comparison between intermediate-term failure and long-term survival.

A single center experience of 160 cyclosporine-treated renal allografts that survived longer than 1 year was reviewed in an attempt to analyze the contribution of selected parameters to long-term survival. Sixty-one grafts were lost between 1 and 5 years, with the remaining functioning for longer than 5 years. Parameters with a significant influence on long-term survival included both quality of early graft function, with 13% of long-term survivors having delayed function, compared to 52% among the short-term survival group, and the incidence of acute rejection in the first year posttransplant (31% in long-term survivors compared to 63% in the short-term survival group). A marker for long-term survival (greater than 5 years) was a lower serum creatinine at 1 year (1.9 +/- 0.1 mg/dl, compared with 2.6 +/- 0.2 mg/dl in the short-term survival group). Recipient race, original renal disease, number of transplants and/or transfusions, panel reactive antibodies, and human leukocyte antigens matching did not appear to influence long-term outcome.

Adult↗
PubMedDate not supplied

Long-term outcome of one haploidentical live related donor transplantation in children.

UNLABELLED: We report on 69 children, 6 months to 18 years old, who received a one-haploidentical live related donor transplantation from 11/72 through 4/89. Thirty patients were maternal and 22 were paternal recipients; 23 were Black, 27 Caucasian, 17 Hispanic, and 1 each Oriental and Arabic. The original diagnoses in these patients were aplastic/dysplastic kidneys 13%, obstructive uropathy 30%, focal segmental glomerulosclerosis (FSGS) 23% and lupus nephritis 10%. RESULTS: 1-, 5-, 10- and 15-year actuarial patient and graft survivals were 98, 84, 84, 84% and 94, 70, 41, 30% respectively. Actual 5-year graft survival of paternal recipients was better than maternal recipients (p less than 0.05). No differences were noted comparing actuarial graft survival between Blacks, Caucasians and Hispanics. 1/16 FSGS and 1/7 lupus nephritis patients had recurrence of their original disease. Posttransplant therapy in 37 patients consisted of azathioprine and prednisone while 32 patients received ciclosporin A (CSA) and prednisone. At transplantation, CSA and prednisone patients were younger, i.e., 10.7 years (range 0.5-18) compared to 13.3 years (range 4-18) and (p less than 0.03) in azathioprine and prednisone patients. The 5-year actuarial graft survival of azathioprine and prednisone patients was 57% compared to 76% in CSA and prednisone patients. 16/32 CSA and prednisone patients had their prednisone discontinued for a mean duration of 18 months (3-54 months). Ten of these 16 patients were prepubertal and had their growth hormone levels measured. All had an adequate level (greater than or equal to 10 ng/ml) poststimulation. Five of the 10 patients were less than 6 years of age and exhibited accelerated growth.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗