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  • 1
    ISSN: 1432-2277
    Keywords: Vasculitis, kidney transplantation, cyclosporin ; Familial Mediterranean fever, kidney transplantation, vasculitis ; Polyarteritis nodosa, kidney transplantation, cyclosporin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients with amyloidosis secondary to familial Mediterranean fever (FMF) are known to tolerate cyclosporin A poorly. We report a case of severe cyclosporin toxicity in a patient with FMF amyloidosis who underwent kidney transplantation. The clinical syndrome consisted of severe gastrointestinal, neuromuscular, and psychiatric disturbances. Histological examination of the transplanted kidney revealed vasculitis of the polyarteritis nodosa type. We hypothesize that FMF patients are more vulnerable to the acute vascular toxicity of cyclosporin due to defective inhibition of complement activation, leading to a widespread vasculitis of the polyarteritis nodosa type.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Transplant international 3 (1990), S. 47-48 
    ISSN: 1432-2277
    Keywords: Azathioprine, hypersensitivity to ; Hypersensitivity, azathioprine, kidney transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hypersensitive reactions to azathioprine have been reported infrequently, and always in nontransplanted patients. Here, a renal transplant recipient with a severe hypersensitive reaction to azathioprine is described. We suggest that, until recently, hypersensitivity to azathioprine was suppressed in transplant recipients by the association of high doses of corticosteroids. Since the introduction of cyclosporin, azathioprine therapy is usually associated with corticosteroids in a much lower dose, so an increasing occurrence of azathioprine hypersensitivity in transplanted patients might be expected.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2277
    Keywords: Kidney transplantation, RFLP, DNA ; Tissue typing RFLP, kidney transplantation ; RFLP, kidney transplantation ; HLA matching, RFLP
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Historical HLA class II serological typing results of transplantations performed in “The Leuven Collaborative Group for Transplantation” were subjected to retrospective Restriction Fragment Length Polymorfism (RFLP) DNA control typing by the Collaborative Transplant Study (CTS) DNA project using Polymerase Chain Reaction (PCR)-based DNA methods. We re-evaluated the serology/RFLP-discrepant CTS DNA data for our local patients transplanted during a historical period (January 1988 until May 1992) before any class II DNA typing was performed in our tissue typing laboratory. These retyping results confirm both the CTS data for patient typing and the Eurotransplant data for donor typing. A confirmed high discrepancy rate of 19.0% (after exclusion of 2.2% transcription error) was found in the patient population. A low discrepancy rate of 6.8% (after exclusion of 2.2% transcription errors) for the donor population is concordant with the Eurotransplant donor data. Only 4 of the 588 individuals were found to be incorrectly typed by the RFLP method; all involving the specificities DRB1*1102. This indicates that RFLP typing, as performed by the CTS DNA project, can be considered a valid, retrospective DNA typing system for the accurate interpretation of class II matching in organ transplantation. A second conclusion to be drawn from this study is the need for prospective DNA typing for kidney transplant recipients, as the discrepancy rate in this cohort is high. Our results suggest that with good quality serological HLA-DR typing, prospective donor DNA typing is not urgently needed.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2277
    Keywords: Renal transplantation ; Diabetes ; Cyclosporin A ; Total lymphoid irradiation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 20 renal transplant patients with end-stage diabetic nephropathy entered a randomized controlled trial comparing preoperative, fractionated total lymphoid irradiation (TLI) (radiation dose, 20–30 Gy) with postoperative cyclosporin A (CsA). Both groups received postoperative low-dose methylprednisolone maintenance therapy. The 3-year patient and graft survival was similar for both groups (100% and 71% in the TLI and 75% and 75% in the CsA group, respectively). Rejection crises occurred significantly more frequently (P〈0.01) in the TLI-treated recipients. The incidence of infectious or diabetic complications was not significantly different in both groups. It is concluded that TLI and CsA are both effective treatment modalities for cadaveric renal transplantation in diabetics; CsA, however, is superior in preventing rejection crises.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1084
    Keywords: Key words: Kidney ; transplantation ; Kidney ; neoplasms ; Kidney neoplasms ; diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A large urothelial tumor was detected by ultrasonography in the dilated collecting system of a well-functioning renal allograft 15 years after transplantation. The tumor was confirmed at computed tomography. Nephrectomy showed a transitional cell carcinoma. The occurrence of malignant tumors in renal allografts is a well known but rare complication.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2277
    Keywords: Key words Tacrolimus ; Cyclosporine ; Kidney transplantation ; High risk
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy and safety of tacrolimus- and cyclosporine-based immunosuppressive regimens were compared in a prospectively defined subgroup of kidney transplant recipients from the European, open, multicentre, 2 : 1 randomised, parallel group study. Patients were stratified as high risk for immunological events if they had a panel-reactive antibodies grade greater than 80 % and/or a previous transplant functional for less than 1 year. The primary efficacy variables evaluated were the incidence of acute rejection, steroid usage and patient and graft survival. Safety was assessed based on adverse events and laboratory evaluations. At 1 year, the tacrolimus group (n = 22) had a lower incidence of biopsy-proven acute rejection (31.8 %) and a higher graft survival (86.0 %) than the 11 patients in the cyclosporine group (54.5 % and 72.0 %, respectively). The frequencies of adverse events were similar between the two groups. The tacrolimus regimen appears more beneficial for high risk patients than cyclosporine.
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  • 7
    ISSN: 1432-2277
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-2277
    Keywords: Key words Kidney transplantation ; Pretransplant diagnostic evaluation ; Waiting list ; Geographic factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated which diagnostic procedures are mandatory for all transplant candidates irrespective of their individual situation in European transplant centres, how homogeneously these are applied and what centre characteristics determine differences in the diagnostic approach. A questionnaire was sent to European renal transplant centres asking which of 45 listed diagnostic procedures are mandatory for every transplant candidate. The 154 participating centres require 15.6 ± 5.6 (4–33) mandatory tests, with significantly less mandatory diagnostics in centres in the UK (8.5 ± 3.9) and Scandinavia (9.8 ± 2.3). Geographic location is the single significant factor in multifactorial analysis of possibly related factors. Detailed analysis revealed 16 tests that are required significantly less often in the north of Europe. There are significant differences in the evaluation of renal transplant candidates across Europe. In some parts of Europe transplant candidates are either investigated more discriminately or less comprehensively than in other regions.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Infection 9 (1981), S. 208-209 
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im vorliegenden Bericht wird eine Septikämie durchYersinia enterocolitica serotyp 0:9 bei einer Nierentransplantatempfängerin beschrieben, die unter kombinierter immunsuppressiver Therapie stand. Der Erreger wurde aus Blut, Stuhl und einem thrombophlebitischen Infektionsherd an einer Katheterpunktionsstelle am Arm isoliert. Die Patientin erholte sich unter allerdings nicht optimaler antibiotischer Therapie vollständig. Wenngleich nierentransplantierte Patienten ständig durch bakterielle Infektionen mit Keimen der Darmflora und pathogenen Erregern gefährdet sind, wurde bisher nur ein einziger Fall einerYersinia enterocolitica Septikämie bei einem solchen Patienten mitgeteilt.
    Notes: Summary This report describes a case ofYersinia enterocolitica serotype 0:9 septicaemia in a female renal transplant patient receiving combined immunosuppressive therapy. The bacterium was isolated from the blood, the stool and from a thrombophlebitic infection of the arm at the site of an intravenous catheter. Under less than optimal antibiotic treatment, the patient recovered completely. Although renal transplant patients are notoriously susceptible to bacteriaemic infection caused by enteric commensals and pathogens, there has been only one previous report ofY. enterocolitica septicaemia in such a patient.
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