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Biomedical subjects

P Orlić

Publications and source records attributed to P Orlić.

At least 19 recordsLinked to original sources
PubMed2004

[Carcinoma of the Bellini duct with an unusual clinical picture].

A 37-year-old male patient presented with a Bellini duct carcinoma, at first as a metastatic illness of the paraaortal lymph nodes, without significant radiologic signs of a kidney tumor. Cytological diagnostics did not recognize this tumor. Macroscopically and microscopically the tumor fulfilled the major and minor criteria of Sringly et al., but immunohistochemical findings did not show cell affinity for UEA-1, which, according to the literature, typically confirms its origin from Bellini ducts. This rare neoplasm, primarily found in a younger population, still represents a diagnostic and therapeutical challenge as a result of its aggressive clinical course. In our patient, as in the majority of cases presented in the literature, tumor prognosis was very poor, in spite of aggressive surgical, radium and immune therapy.

Adult↗
PubMed1995

The diagnostic capacity of serum amyloid A protein for early recognition of kidney allograft rejection.

We used new micro-ELISA test with sequence-specific antibody for every day monitoring of serum amyloid A protein (SAA) in 20 patients with kidney allografts in order to facilitate an early diagnosis of rejection. Altogether 44 SAA peaks were observed (beside those caused by surgery) and 22 of them were caused by allograft rejections. When allograft rejection occurred in postsurgical period (first 4 days), SAA levels rose to mean 706 +/- 161 mg/l while initial SAA peaks (caused by surgical trauma) reached the mean value 306 +/- 55 mg/l. The statistical significance was very high, P < 0.0001. In all nine rejection episodes in this period SAA peaks were higher than 400 mg/l, so we chose this level as a reference limit for this period. SAA peaks caused by allograft rejection in later period were also markedly higher (mean 461 +/- 176 mg/l) than those caused by infections or other complications (mean 133 +/- 82 mg/l, P < 0.001). Baseline mean level was 9 +/- 5 mg/l. In all 13 rejection episodes in this period SAA peaks were higher than 200 mg/l, so we chose this level as a reference limit for this period. In 20 of 22 rejection episodes (91%) SAA elevation predicted rejection and usually started to rise sharply 2 days before it. An excellent correlation between kidney allograft rejection and SAA reaction was found in this study (better than with CRP reaction) so we recommend everyday monitoring of SAA concentrations in patients with kidney allograft as a valuable aid in the early diagnosis and prediction of acute allograft rejection.

C-Reactive Protein↗
PubMed1994

Organ transplantation at the Rijeka Clinical Medical Center--from kidney to pancreas.

From January 1971 to January 1994 the authors performed 560 kidney, and two simultaneous pancreas and kidney, transplantations at the Rijeka Clinical Medical Center. Three hundred and nine kidneys (55%) were from a related living donor (two from unrelated living donors), while 253 (45%) kidney and two pancreas grafts were from cadaveric donors. Analyzing the mean patients' age at the time of transplantation the authors noticed its steady increase over five-year periods, a decrease of chronic glomerulonephritis from 76% to 60%, and a gradual increase in diabetic nephropathy from 0 to 6%. Cumulative 1- and 5-year patient survival rates after living donor transplants including conventional immunosuppression were 95 and 83%, respectively; with Cs the survival rates were 94% and 90% (N. S.). For living donor kidney grafts the 1- and 5-year survival rates with conventional immunosuppression were 76% and 50%, respectively. With Cs the survival rates were considerably higher: 88% after 1 year and 71% after 5 years (p < 0.01). Cumulative survival rates of patients with cadaveric transplants receiving conventional immunosuppression were 82% and 71%, respectively; with Cs they were 87% and 78% (N.S.). The survival rate of cadaveric transplants was 51% after one year and 38% after five years in the first period, but it improved significantly after introduction of Cs. increasing to 81% and 52%, respectively (p < 0.001). Renal transplantation in diabetics does not preclude the recurrence of diabetic nephropathy in the graft; successful pancreas and kidney transplantation does, however, and thus offers the patient a better quality of life.

Adult↗
PubMed1990

[Kidney transplantation in Croatia].

This review first presents historical data regarding clinical kidney transplantation in the world and in Yugoslavia. The need for kidney transplantation in the Socialist Republic of Croatia is estimated to be 250 per year while 50-60 are performed annually. A total number of kidney transplantations performed in Yugoslavia amounts to about 750, the center in Rijeka being the most active with 427 transplantations performed till the end of unts to About 750, The center in Rijeka 1988. The long-term results of living related transplantations (85% two-year-survival) at our institution are better than those of cadaver kidney transplantations (58% two-year-survival). There is a great difference in graft survival after 1983 (23% 4-years-survival before 1983 and 79% 4-years-survival after 1983) owing to multiple factors. A special significance was attributed to the cadaveric explanation programme and possible modes of its improvement.

Humans↗
PubMed1989

[Reoperation after kidney transplantation].

On Surgical Clinic KBC and Medical faculty at Rijeka in the period from 30.01.1971 to 30.03.1988 403 kidney transplantations were performed. There were 257 (63.8%) transplant from living related donor, 2 (0.5%) from living nonrelated donor and 144 (35.7%) from cadaver. On 90 patients 104 reinterventions were performed. There were 29 reinterventions in 24 patients because of vascular complications. 14 patients lost their graft, and two patients died because of sepsis and liver failure. Among 140 patients with uretero-ureteral anastomoses 18 reinterventions were performed in 16 patients, patients lost the graft. In the group of 271 patients with ureterocystoneostomia there were 18 reinterventions in 17 patients. One patient died because of pulmonary emboli on the first postoperative day. Wound infections were surgically treated 39 times in 33 patients. 3 grafts were lost because of acute rupture, and one patient died in haemorrhagic shock. The complications after kidney transplantation should be recognized as soon as possible and if it is necessary to start surgical reintervention immediately.

Graft Rejection↗
PubMed1989

[Emergency surgical conditions after kidney transplantation].

During the period from 30. 01. 1971 to 30. 03. 1988 403 kidney transplantations were performed on the Surgical clinic KBC and Medical faculty at Rijeka. Satisfactory results were achieved concerning surviving of patients and grafts. Emergency vascular complications leads to lost of graft in most cases. Urologic complications less affecting the graft but because of possible infection could jeopardize the life of patient. In the surgical treatment of urological complications recipient ureter was used in most cases and in two patients isolated ileal loop. Among gastrointestinal complications bleeding from gastroduodenal ulcer was the major problem. After onset of routine use of antagonists of histamine H2 receptors those complications has been reduced from 6.6% to 1.5%. In five patients a spontaneous rupture of graft has happened. In two patients direct suture of rupture saved the graft. All our activities with the patients after kidney transplantation should be in careful treatment and early recognition of complications and aggressive surgical approach when it is necessary.

Acute Disease↗
PubMed1989

[Renal transplantation--a possible factor in the development of circulatory insufficiency in the lower extremities].

The major subjects of this presentation are: 1. Angiological aspects of living and cadaveric transplant donor; 2. The possibilities and importance of angiosurgical procedures during the transplantation operation; 3. Vascular complications of kidney transplantation; 4. Occlusive arterial diseases and the possibilities of treatment. The experiences after 423 renal transplantations have been overviewed and special problems of interest commented.

Adult↗