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Biomedical subjects

V Kocandrle

Publications and source records attributed to V Kocandrle.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Central and peripheral circulation in patients after orthotopic transplantation of the heart].

Heart transplantation in human medicine is a unique model which makes it possible to study circulatory changes in complete denervation of the heart. The authors examined repeatedly the central and peripheral haemodynamics after orthotopic heart transplantation (OTS) in 11 patients (11 males, 1 female; mean age 44 +/- 4 years) following an interval of three months to four years after the operation. The values of central haemodynamics at rest varied in the majority within the normal range. After a load, in patients after OTS the heart rate rises only slowly. There is an abnormal rise of the filling pressure in both ventricles which leads also to an abnormal rise of pressure in the pulmonary artery with regard to flow. The cardiac output and stroke volume increase adequately. The peripheral circulation is characterized by persisting vasoconstriction in the area of resistant vessels and the venous circulation. The above changes reflect the different regulation of cardiac output after complete denervation of the heart by transplantation when the magnitude of the cardiac output is controlled mostly by the Frank-Starling mechanism. Changes of the tonus of the peripheral circulation contribute under these conditions to the maintenance of an adequate output.

Adult↗
PubMed1989

[Urinary excretion of catecholamines by the transplanted kidney].

In 88 patients after kidney transplantation (Tx) and in 30 healthy volunteers the urinary adrenaline, noradrenaline and dopamine excretion in 24 hours was examined. The results were calculated per values of glomerular filtration rate (Ccr). In patients after Tx an increased adrenaline excretion was found and its relative predominance over noradrenaline in urine, as it is the case in renal insufficiency. The absolute reduction of noradrenaline excretion was, when calculated per Ccr values, proportional to the number of functional nephrons. The absolute dopamine excretion was proportional to Ccr values and when calculated per glomerular filtration rate it was significantly higher than in controls. The elevated values of fractional sodium excretion in group Tx suggest that in the residual functional nephrons the increased sodium supply may act as a stimulus for dopamine formation in the kidney.

Adult↗
PubMed1988

Natural killer cells and cytomegalovirus and Epstein-Barr virus infection in cardiac graft recipients.

The serum of 10 male patients undergoing heart transplantation was found to contain anamnestic antibodies (IgG) against cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Patients with decreased natural killer (NK) cell activity displayed specific IgM against these viruses, a fact suggesting their activation and reproduction. Patients whose NK activity was within the range of that of healthy blood donors did not have serum IgM against CMV and EBV. Decreased NK activity and presence of specific IgM are associated with an increased number of LGL and monocytes, determined both by a monoclonal antibody (MEM-18) against their surface antigen, and morphologically.

Adult↗
PubMed1988

Percutaneous transluminal angioplasty of renal transplant artery stenosis in patients with rejection nephropathy.

A total of 13 procedures of percutaneous transluminal angioplasty were performed in 11 kidney graft recipients with renal transplant artery stenosis. Nine procedures were technically successful in eight patients (one redilatation was necessary because of restenosis). Graft biopsy confirmed rejection nephropathy in all cases. The outcome could not be evaluated in one patient who died of a concomitant disease shortly after angioplasty. The remaining seven patients (eight percutaneous transluminal angioplasties) showed improvement in hypertension in 63% and in glomerular filtration rate in 50% of procedures, persisting for 6-13 months. A single major complication encountered was a loss of graft related to unsuccessful percutaneous transluminal angioplasty. The results suggest that percutaneous transluminal angioplasty may bring prolonged increase in effective renal plasma flow and glomerular filtration rate even in patients experiencing rejection nephropathy.

Adolescent↗
PubMed1987

Preparation and implementation of pancreas transplantation programme in diabetic patients.

Having reviewed the state-of-the art trends in pancreas transplantation over the world, the authors describe their own experimental studies preceding elaboration of the technique of pancreatic segment transplantation with duct obliteration. In their technique, the splenic artery is interposed in the course of the iliac arteries of the recipient. The procedure of the selection of diabetic patients suitable for a combined pancreas and kidney transplantation is presented. The results in 13 recipients with insulin-dependent diabetes and progressed organ complications are evaluated. In these patients a combined pancreas and kidney transplantation is of a better prognosis compared with the conventional treatment methods.

Adult↗
PubMed1987

Experience with orthotopic heart transplantation.

Improving results of heart transplantation have led to a substantial increase in the number of transplantations performed each year ever since the early 1980s. The paper offers a review of our own experience with orthotopic heart transplantation. In the period between January 1984 and October 1986, a total of 11 transplantations has been carried out. Two patients died in the early postoperative period, nine were discharged from the hospital. There were two deaths in the late postoperative period. The seven surviving patients are in a satisfactory condition. Experience gathered hitherto in the world, and confirmed by our own results, shows that heart transplantation has become a therapeutic modality in patients selected on the basis of stringent criteria. The procedure, however, must be performed only in centres having a sufficient body of experience in cardiology, cardiac surgery, and transplantation of other organs.

Adult↗
PubMed1987

The fate of patients who met the criteria for heart transplantation.

In the 1975-1986 period, the authors registered 26 male patients (mean age 42 +/- 12 years) with manifestations of severe heart failure refractory to any internal treatment currently available. The disease was not manageable by any conventional surgical intervention either. All patients met the criteria for heart transplantation. The overwhelming majority of them (88%) died within 6 months after inclusion in the study. The authors discuss the criteria, warranting responsible decision-making on indication for heart transplantation.

Adolescent↗
PubMed1987

Monitoring of immunological parameters before and after heart transplantation.

At the immunological examinations carried out prior to heart transplantation, it is crucial to check the compatibility in the ABO blood group system (regardless of the Rh factor) and to perform the cross match (which must be negative). In time pressure, cross match can be omitted provided the patient does not possess cytotoxic antibodies against a representative panel of lymphocytes. Other immunological tests before transplantation are of an auxiliary nature and should provide information whether the patient is a low or high responder, whether he does not suffer from an autoimmune disease or latent viral infection. In 37 out of 44 potential cardiac graft recipients, a strongly suppressed cell-mediated immune response was observed already in the pre-transplantation period. In the post-transplantation period, patients treated with corticoids and Cyclosporin A display a marked prolonged decrease in the absolute values of T4 positive lymphocytes. The absolute values of T3 and T4 lymphocytes represent a reliable parameter to assess the degree of achieved immunosuppression. Long-term monitoring did not reveal a significant association between the values of the T4/T8 index and the rejection episodes.

Antigen-Antibody Complex↗
PubMed1987

State of the art and future trends in heart transplantation and ventricular assist devices.

The authors present a short review of the milestones in clinical heart transplantation and the prerequisites they regarded as indispensable to be able to start a clinical programme in their own centre. Next, they describe various types of ventricular assist devices (VAD) and the indications for their use. In conclusion, the authors discuss the prospects of, and future trends in, heart transplantation and VAD that have become, despite their short history, a clinical reality and whose practical importance is to grow further.

Assisted Circulation↗
PubMed1987

Acute myocardial infarction after renal transplantation.

The authors evaluated the incidence of acute myocardial infarction (AMI) in a group of 355 renal graft recipients operated on at the Institute for Clinical and Experimental Medicine between 1976 and 1984. AMI was diagnosed in 12 (3%), mostly male, patients. The age of AMI survivors was higher on the average (47.5 years) than that of other renal graft recipients whose mean age was 37 years. Another difference was a higher proportion of patients aged 50 and more. Compared with a selected control group of transplant recipients (n = 97) of corresponding age and follow-up period, the incidence of AMI rose to 9%. The prognosis of renal graft recipients with AMI was a favourable one, only in two cases was AMI and its complications the immediate cause of death. Cumulative doses of immunosuppressive drugs (prednisone, azathioprine, and methylprednisolone) were higher in AMI patients. The difference was not statistically significant in view of the low number of patients. The observed differences should be taken into account when designing corticosteroid dosing schedules in elderly graft recipients.

Adult↗