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Y B Koh

Publications and source records attributed to Y B Koh.

At least 19 recordsLinked to original sources
PubMed2006

A case of benign retroperitoneal cyst of Müllerian type in kidney transplant patient.

Müllerian cysts of the retroperitoneum, which considered to be a subtype of urogenital cysts, are extremely rare disease entities. Herein we have presented successful excision from a second kidney transplantation from a brain-dead donor to a 38-year-old woman with previous kidney graft failure. During the second cadaveric kidney transplantation operation, two fist-sized cysts were found in the left retroperitoneal pelvic space extending from the left common iliac artery to the prevesical region, which compromised the iliac vessels for vascular anastomosis. After complete cyst excision, vascular anastomoses were performed. Histologically, the cysts were lined with benign Müllerian-type epithelium. We report a rare case of benign retroperitoneal cyst of the Müllerian type, which was incidentally found during kidney transplant surgery.

Adult↗
PubMed2006

Second and third kidney transplantations.

We reviewed the results of second and third kidney transplantations at our center. Among 1500 patients who had undergone kidney transplantation from 1968 to October 2005, we discovered 77 (male 55 and female 22 of overall mean age = 48.9 years) second transplantations and 5 (male 4, female 1; mean age = 46.8 years) third transplantations. The 82 kidneys were derived from living donors in 67 patients and from cadaveric donors in 15 patients. The mean duration from the first to the second transplantation was 89 months, and from the second to the third transplantation, 32.7 months. Among the second and third transplantations and graft nephrectomies, we failed to observe additional surgical complications compared with first transplants and over 80% graft survival at 1 year.

Cadaver↗
PubMed2006

Abdominal aortic aneurysm repair in kidney transplant recipients.

Renal transplant recipients currently survive many years with a consequent increase in the risk of presentation with vascular diseases. So aortic reconstruction in transplant patients has been increasingly reported the most common procedures involving abdominal aorta aneurysms (AAAs). The most important problem during the operation is ischemic injury to the transplanted kidney during aortic clamping. Protection for the grafted kidney from ischemic or reperfusion injury may be achieved by permanent or temporary axillo-femoral, femoro-femoral, aorto-iliac bypass, cold perfusion, local cold preservation, or autotransplantation. Some authors have reported protection of the transplanted kidney function without any other procedures. We had experience with four AAA cases in kidney transplant patients, including two cases of direct reconstruction of the AAA without any other surgical protection, one autotransplantation, and one AAA excision with using temporary aortofemoral bypass with good results. Herein, we report two cases of successful AAA excision without a surgical procedure for graft protection.

Aorta, Abdominal↗
PubMed1998

Clinical course of cytomegalovirus (CMV) viremia with and without ganciclovir treatment in CMV-seropositive kidney transplant recipients. Longitudinal follow-up of CMV pp65 antigenemia assay.

This study was designed to evaluate the longitudinal history of cytomegalovirus (CMV) infection and to test the capacity of ganciclovir as effective therapy in CMV-seropositive renal transplant recipients. The CMV viremia was detected with CMV pp65 antigenemia assay in 153 renal transplants. The recipients were classified as having low-grade and high-grade CMV infections according to the severity of CMV infection. The recipients with low-grade CMV infections were observed without ganciclovir treatment, and the recipients with high-grade CMV infection were randomly assigned to ganciclovir-treated and untreated groups. The clinical course between low-grade and high-grade CMV infections was evaluated. All recipients with low-grade CMV infection (n = 62) showed spontaneous remission regardless of immunosuppresants. In high-grade CMV infection (n = 31), the ciclosporin A treated group (n = 11) showed no evidence of CMV disease, and the methylprednisolone-treated group (n = 8) showed CMV disease in 1 (25%) of 4 ganciclovir-untreated recipients. In the OKT3 group (n = 12), symptomatic CMV infection was observed in 6 (100%) ganciclovir-untreated recipients contrary to no CMV disease in the ganciclovir-treated group (p < 0.05). In conclusion, the CMV antigenemia assay is effective in monitoring CMV viremia, and ganciclovir treatment should be done during early CMV viremia in OKT3-treated recipients.

Adult↗
PubMed1996

Early graft dysfunction due to renal vein compression.

We here report on an unusual case of early renal transplant dysfunction due to renal vein compression. Graft function was initially good but oliguria and massive hematuria developed on the 3rd day after transplantation. Duplex sonography showed turbulent blood flow of the renal vein, and renal venography confirmed renal vein compression. Exploratory laparotomy was performed and diuresis was initiated just after nephropexy. In conclusion, renal vein compression is a rare complication but should be included in the possible causes of early renal transplant dysfunction since this can be simply diagnosed by duplex sonography and is easily remedied by nephropexy.

Adult↗
PubMed1996

Synergistic inhibitory effect of angiotensin-converting enzyme inhibitor and heparin on intimal hyperplasia after rat aorta injury.

The respective efficacies of angiotensin-converting enzyme (ACE) inhibitor and standard heparin were investigated with respect to their inhibitory effects on intimal hyperplasia after balloon denudation of rat aorta. Local angiotensin II effects in the artery wall may participate in regulation of the vascular response to arterial injury, apparently independent of the plasma renin and angiotensin system. ACE inhibitors have been shown to block intimal hyperplasia after arterial injury in rats. Increasing evidence points toward an inhibitory effect of heparin on intimal hyperplasia independent of anticoagulation. Balloon catheter aortic denudation was performed in 25 rats pharmacologically treated from six days or one day before to fourteen days after surgery and split into four groups: group A (control group), normal feeding; group B (ramipril group), ramipril 10 mg/kg/day orally; group C (heparin group), heparin 1200 IU/kg/day subcutaneously; group D (combined group), both ramipril and heparin. Animals were killed and aortas were perfused and fixed at physiologic pressure fourteen days after denudation. Cross-sectional intima-to-media area ratios (I-M ratio) were calculated by an image analyze system.

Angioplasty, Balloon↗
PubMed1996

Factors on graft survival of living donor kidney transplantation in a single center.

We analyzed the potential factors that could influence the survival of graft, focused on primary graft living-donor kidney transplantation with cyclosporine (CsA) therapy. 680 cases were enrolled in this study. Patients and graft survival rates were calculated by a Kaplan-Meier product limit estimate with a 1-day time interval. The analyzed variables were donor relationship, HLA matching, recipient age and sex, donor age and sex, ABO blood type compatibility, diabetic status, hepatitis virus infection, donor specific or non-specific blood transfusion and acute rejection episode. The results suggested that acute rejection episode was the most prognostic factor in graft survival. An HLA-matched donor and a young male donor, i.e. a greater donor nephron mass for less recipient body mass, will show better long-term survival. Diabetes and hepatitis B infection have some negative effects on the long-term survival of graft kidney, but age of recipient, donor-specific transfusion and donor-recipient relationship have little effect.

ABO Blood-Group System↗
PubMed1995

Prevalence and clinical course of hepatitis B and hepatitis C liver disease in ciclosporin-treated renal allograft recipients.

We performed this study to evaluate prevalence and clinical course of hepatitis B surface antigen (HBsAg)-positive and anti-hepatitis C virus (HCV)-positive renal transplant recipients. HBsAg positivity was 13.7 and anti-HCV positivity 12.8%. Before transplantation, the HBsAg positivity was observed in in 83.5% of the patients, and 16.4% of the patients acquired HBsAg after renal transplantation. In the HCV group, anti-HCV positivity was observed in 47.1% before transplantation, and 19.6% acquired anti-HCV after renal transplantation. The prevalence of chronic hepatitis in the hepatitis B virus (HBV) and in the HCV groups was not different (25.7 vs. 25.5%). Among those with chronic hepatitis in the HBV group, 4 cases progressed to fulminant hepatic failure, 1 case progressed to the end-stage liver cirrhosis, and 1 case to hepatocellular carcinoma. However, in the HCV group, no case showed progression of chronic hepatitis. The overall mortality in the HBV and HCV groups was 25.3 and 7.8%, respectively (p = 0.001). Among 20 fatal cases in the HBV group 9, cases were liver disease related, but no liver disease related death occurred in the HCV group. In conclusion, HCV as well as HBV infections are quite prevalent and important causes of posttransplant chronic hepatitis, and the clinical course of anti-HCV-positive recipients is less aggressive than that of HBsAg-positive recipients.

Adult↗