Parathyroid hormone as a causative factor of primary non-function in renal transplants.
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Biomedical subjects
Publications and source records attributed to S F Lui.
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A total of 731 sera were collected from general hospital patients, divided into five distinct subgroups, and tested for the presence of immunoglobulin (IgG) to cytomegalovirus (CMV) and herpes simplex virus (HSV). The results indicate a high level of association between the two viruses, although HSV was found to be more prevalent in the earlier years of life, whereas CMV was acquired constantly throughout life. An increase in age was also accompanied by significantly higher antibody levels to both viruses. Individuals with antibody to HSV were significantly more likely to have antibodies to CMV, suggesting that these viruses are transmitted by similar routes (?saliva). In addition, 430 sera from 94 homosexual and 336 heterosexual males attending a clinic for sexually transmitted diseases were tested for antibody to CMV, HSV, and human immunodeficiency virus (HIV). Homosexual males were more likely to have antibody to CMV and HIV than were heterosexuals, but no difference was seen for HSV antibodies. The levels of CMV-specific IgG were significantly raised in homosexuals, compared with heterosexuals, but again no difference was seen for HSV antibodies as in the general hospital patients, however, individuals with HSV antibodies were significantly more likely to possess antibodies to CMV. However, the additional association of CMV antibodies with a homosexual lifestyle suggests that an alternative route for acquisition of this virus exists (?semen). As raised levels of CMV antibodies, but not HSV antibodies, were found among homosexuals, this suggests that frequent CMV reinfections, rather than merely reactivation of latent herpes viruses, may be occurring.
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At 3, 6 and 12 months, there was no difference in renal function and survival between a group of renal transplant recipients who received cadaveric donor kidneys of extremely prolonged cold ischaemic time (group median 60 h; range 35-82 h), compared to a group who received cadaveric donor kidneys of shorter cold ischaemic time (group median 20 h; range 6-44 h). The prolonged cold ischaemic time group had a higher incidence of primary non-function, but the duration of primary non-function was not different between the two groups. The prolonged cold ischaemic time group had significantly fewer episodes of rejection. Despite the increased incidence of primary non-function, this study shows that it is safe to use low-dose cyclosporin A in kidney grafts with an extremely prolonged cold ischaemic time.
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