PubMed Health⌕ Search

Biomedical subjects

R Máñez

Publications and source records attributed to R Máñez.

14 recordsLinked to original sources
PubMed2004

Liver transplantation from maastricht category 2 non-heart-beating donors: a source to increase the donor pool?

INTRODUCTION: The demand for liver transplantation has increasingly exceeded the supply of cadaver donor organs. Non-heart-beating donors (NHBDs) may be an alternative to increase the cadaver donor pool. The outcome of 20 liver transplants from Maastricht category 2 NHBD was compared with that of 40 liver transplants from heart-beating donors (HBDs). After unsuccessful cardiopulmonary resuscitation (CPR), cardiopulmonary support with simultaneous application of chest and abdominal compression (CPS; n = 6) or cardiopulmonary bypass (CPB; n = 14) was used to maintain the donors. RESULTS: At a minimum follow-up of 2 years, actuarial patient and graft survival rates with livers from Maastricht category 2 NHBD were 80% and 55%, respectively. Transplantation of organs from these donors was associated with a significantly higher incidence of primary nonfunction, biliary complications, and more severe initial liver dysfunction compared with organs from HBDs. The graft survival rates was 83% for livers from NHBDs preserved with CPS and 42% in those maintained with CPB.

Adolescent↗
PubMed2003

Elicited non-anti-alphaGAL antibodies may cause acute humoral rejection of hDAF pig organs transplanted in baboons.

The combination of immunosuppression and GAS 914, a polylysine containing alphaGal trisaccharide type 2 (TRI 2), has been associated with the prevention of acute humoral xenograft rejection (AHXR) in human decay accelerating factor (hDAF) pig-to-baboon xenotransplants. The aim of this study was to investigate the role of immunosuppression and GAS 914 to neutralize xenoantibodies before and after xenotransplantation. Eight baboons underwent heteropic heart xenotransplantation with hDAF transgenic pig organs, receiving GAS 914 before and after transplantation. Six baboons (Group A) were treated with an immunosuppression protocol that included cyclophosphamide (CyP), Neoral, ERL, and steroids. The other 2 baboons (Group B) were treated with the same immunosuppression but with a 50% reduction in the doses of CyP. No xenograft from Group A underwent acute humoral xenograft (median survival, 27 days), whereas the 2 in Group B experienced rejection (median survival, 6 days). GAS 914 depleted both immunoglobulin (Ig)M and IgG anti-alphaGAL disaccharide (DI), trisaccharide type 2 (TRI 2), and trisaccharide type 6 (TRI 6), before and after transplantation in Groups A and B. However, cytotoxic antibodies with other anti-pig specificities were elicited by the xenografts in Group B leading to AHXR.

Acute Disease↗
PubMed2001

Clinical transplantation: optimizing immunosuppressive treatment without compromise.

Transplant 2001, the second joint meeting of the American Society of Transplantation and the American Society of Transplant Surgeons, was held from May 13 to 16, 2001, in Chicago, Illinois, U.S.A. The congress highlighted the constantly improving outcomes of organ transplantation. Incidence of rejection is under 15% for most transplants as a result of the availability of various immunosuppressants, which in turn permit an expanding number of treatment combinations as well as treatments increasingly tailored to the condition and needs of each patient.

Journal Article↗
PubMed2000

Natural anti-alpha-galactosyl antibodies in patients undergoing peritoneal dialysis and hemodialysis.

Anti-alpha-galactosyl antibodies (anti-Gal) seemingly mediate rejection of pig organs transplanted into humans and Old World monkeys. These natural antibodies appear to be produced by a subpopulation of B cells residing in the peritoneum. Therefore, peritoneal dialysis (PD) may have an impact on anti-Gal levels. In this cross-sectional study, blood anti-Gal levels were quantified by ELISA in 17 patients undergoing PD and 18 patients undergoing hemodialysis (HD), and the results were compared with those from a control group of 30 healthy blood donors. The effects of the mode of dialysis therapy and other epidemiologic variables on anti-Gal levels were also evaluated. The PD and HD patients were comparable with regards to age, sex, percentage having diabetes, time on dialysis, distribution of blood groups, and total serum levels of immunoglobulins A (IgA), G (IgG), and M (IgM). In patients and controls, IgG anti-Gal levels were not significantly different, but IgM anti-Gal levels were significantly lower in both PD and HD patients compared with controls. A nonsignificant trend toward lower IgM anti-Gal levels in PD patients compared with HD patients was also observed. IgG anti-Gal levels correlated positively with time on dialysis in the HD patients, but not in the PD patients. IgG anti-Gal levels also were found to be markedly elevated in three patients with chronic liver disease, but no other scrutinized variable appeared to influence IgG or IgM anti-Gal levels.

Antibodies↗
PubMed2000

Goals for transplantation in the new millennium.

Presentations at the XVIII International Congress of the Transplantation Society covered all key organ-specific and subspecialty areas of transplantation. Highlights were sessions under the auspices of two new sections of the Society, the International Xenotransplantation Association and the Section on Transplant Infectious Disease.

Journal Article↗
PubMed2000

Basic and patient-oriented research in organ transplantation.

The first joint congress of the American Society of Transplant Surgeons (ASTS) and the American Society of Transplantation (AST)--TRANSPLANT 2000--, was held May 13-17, 2000, in Chicago, Illinois, U.S.A. Results were presented on the latest clinical advances in organ transplantation, as well as aspects of basic research, where genetics studies and gene therapy approaches are gaining in importance. In the clinic, immunosuppressants continue to play a key role in transplantation, and the appearance of new drugs (e.g., mycophenolate mofetil, sirolimus) in recent years has led to increased possibilities of combination regimens, some including as many as four drugs. First clinical studies with three new immunosuppressants--FTY-720, leflunomide and rituximab) were also presented. The stellar presentation at TRANSPLANT 2000 was of a trial of pancreatic islet transplantation in type-1 diabetic patients which led to sustained insulin independence.

Journal Article↗
PubMed1992

[Immunologic prognostic parameters in infection by the human immunodeficiency virus].

BACKGROUND: To evaluate the use of quantitative and functional immunologic parameters as prognostic markers of infection by the human immunodeficiency virus (HIV). METHODS: The number of CD4 and CD8 lymphocytes, the CD4/CD8 ratio, the percentage of interleukin 2 (IL-2) receptors, the response to phytohemaglutinin (PHA) and the production of interferon tau (IFN-tau), were analyzed in 85 patients with HIV infection: 14 with acquired immunodeficiency syndrome (AIDS) (stage IV), 16 with persistent generalized adenopathies (stage III), and 55 asymptomatic patients (stage II). Similarly, a control group of 35 blood donors with negative HIV serology was studied. RESULTS: Over a period of 30 months, 17 patients (5 of stage III and 12 of stage II) evolved to stage IV. In a multivariate analysis the decrease in the number of CD4 lymphocytes in stage II and the decrease in the production of IFN-tau in stage II and III were the parameters associated with progression to stage IV. CONCLUSIONS: The decrease in the production of interferon tau in patients with infection by the human immunodeficiency virus in stage II and III as well as the decrease in the number of CD4 lymphocytes in stage II are prognostic factors associated with the evolution to stage IV of the infection.

CD4-CD8 Ratio↗
PubMed1988

Disseminated intravascular coagulation and mesenteric venous thrombosis in fatal Amanita poisoning.

1. A case of fatal Amanita phalloides poisoning in a 14-year-old boy is described. 2. The patient presented severe acute liver dysfunction, disseminated intravascular coagulation and refractory hypoxaemia, and died on the 9th day after mushroom ingestion. 3. Post-mortem examination revealed mesenteric venous thrombosis, massive liver necrosis and haemorrhagic pulmonary alveolitis.

Adolescent↗
PubMedDate not supplied

[The use of immunologic parameters to assess the effectiveness of parenteral nutrition. Preliminary study].

Malnutrition leads to cellular and humoral immunological response disorders. A study protocol on malnourished patients has been designed in order to assess immune response mechanisms that may be altered due to malnutrition and may or may not recover once normal metabolic conditions have been restored prior to starting the patient on parenteral feeding and control. The immune response was assessed especially regarding immunoglobulin, lymphocyte subsets and mitogen response levels. It is important to know the different malnutrition-related immunologic disorders, disorders secondary to diseases that hinder correct oral feeding, and immunologic tests may be used to assess nutritional parameters. The malnourished patients included in this trial has to be free of any other immunologic or neoplastic disease, and not receive immune response suppression therapy. The trial patients showed lower total and relative CD3 and CD4 lymphocyte values at the onset of the study, although the former lymphocyte subset recuperated sooner at the expense of increasing CD8 lymphocytes, while CD4 lymphocytes still remained low after 15 days of parenteral nutrition. Immunoglobulin levels remained within normal limits. The mitogen response capacity, which was sensibly low at the beginning, recuperated in 50% of the cases treated with parenteral nutrition. This parameters may be used as an index to assess the nutritional status of these patients. The cases studies allowed us to conclude that there was a decrease in CD4 cells and mitogen response in malnourished patients. After 15 days of parenteral nutrition, the cells did not recuperate but their function measured in terms of phytohemagglutinin, was normal in 50% of the cases.

Humans↗