Prevention of oliguric ATN following living renal transplantation by PRE-operative allopurinol

The incidence of pathologically documented oliguric A.T.N. following living renal transplantation was studied in 481 cases using different perfusion protocols with comprised together with surface cooling perfusion with 500 ml lactated Ringer's solution at room temperature to which 5000 units heparin were added together with 5 mg verapamil and 2 ml 2% procaine HC1 in the firs group, or 6 ml 2% procaine HC1 in the second and third groups. This was followed in the 3 groups by cold [0C] perfusion of 500 ml lactated Ringer's solution to which 500 units heparin were added. Perfusion time ranged form 3-5 minutes. Oliguric A.T.N. occurred in 6/159 cases [3.8%] of the first group and in 13/227 cases [5.7%] of the second group. Oliguric A.T.N. was not encountered in any of the 95 cases in whom allopurinol was given to both donor and recipient as 300 mg orally 48 and 24 hours preoperatively and using procaine HCL for perfusion. A.T.N. Was not related to the duration of the ischemia time [35-65 minutes], number of arteries or tissue matching which were comparable among the studied groups. Allopurinol is believed to protect against reperfusion injury mediated by free oxygen radicals

Study of the effect of the duration of regular dialysis treatment [RDT] on T-lymphocytes subsets in chronic renal failure [CRF]

To study the effect of duration of RDT on T-lymphocytes subsets, 41 C.R.F. Patients on RDT for variable durations < 6, <12, <36 and <60 months were studies, in addition to 10 healthy controls, age and sex matched. The patients were 26 males and 12 females with mean age 38.8 +/- 17.9 years having mean predialysis serum creatinine of 11 +/- 1.8 mg%. They were subjected besides clinical assessment and routine predialysis laboratory investigations to total and absolute lymphocytic count, detection of percentage of T-cell subsets by the indirect immunofluorescent technique using the monoclonal antibodies OKT3, OKT4 and OKT8

Subclavian vein [SCV] as a vascular access for hemodialysis is a potential risk

Subclavian vein cannulation by double lumen catheters as a vascular access for hemodialysis was reported to be associated with several acute and delayed complications. Double lumen Maborker subclavian catheters has been fixed for 60 cases in the last six months. There was difficult introduction in 9 cases with initial cannulation of the internal jugular vein instead of the superior vena cava [SVC] in 4 of them. One case was resuscitated from cardiac arrest during introduction and 3 cases were treated for septicemia as a result of infection at the catheter site. The tip of the catheter: assessed by plain chest films was most in the right atrium in 34 cases, in the SVC in 24 cases and in the inferior vena cava in 2 cases. The mean dwelling time of the catheters was 4.68 +/- 1.8 weeks. Follow-up venography was done for 20 cases 3-6 months after removal of the catheter. It revealed the occurrence of subclavian vein thrombosis in 8 cases and stenosis in 2 of these 8 cases. Subclavian venography on the side of the fistula done for 20 patients on regular dialysis treatment for more than 3 years was normal. It was concluded that the subclavian vein as a route of vascular access for hemodialysis is a potential risk and should be approached only when obligatory

Study of the effect of the duration of regular dialysis treatment [RDT] on T-lymphocytes subsets in chronic renal failure [CRF]

To study the effect of duration of RDT on T-lymphocytes subsets, 41 C.R.F. Patients on RDT for variable durations < 6, <12, <36 and <60 months were studies, in addition to 10 healthy controls, age and sex matched. The patients were 26 males and 12 females with mean age 38.8 +/- 17.9 years having mean predialysis serum creatinine of 11 +/- 1.8 mg%. They were subjected besides clinical assessment and routine predialysis laboratory investigations to total and absolute lymphocytic count, detection of percentage of T-cell subsets by the indirect immunofluorescent technique using the monoclonal antibodies OKT3, OKT4 and OKT8

Subclavian vein [SCV] as a vascular access for hemodialysis is a potential risk

Subclavian vein cannulation by double lumen catheters as a vascular access for hemodialysis was reported to be associated with several acute and delayed complications. Double lumen Maborker subclavian catheters has been fixed for 60 cases in the last six months. There was difficult introduction in 9 cases with initial cannulation of the internal jugular vein instead of the superior vena cava [SVC] in 4 of them. One case was resuscitated from cardiac arrest during introduction and 3 cases were treated for septicemia as a result of infection at the catheter site. The tip of the catheter: assessed by plain chest films was most in the right atrium in 34 cases, in the SVC in 24 cases and in the inferior vena cava in 2 cases. The mean dwelling time of the catheters was 4.68 +/- 1.8 weeks. Follow-up venography was done for 20 cases 3-6 months after removal of the catheter. It revealed the occurrence of subclavian vein thrombosis in 8 cases and stenosis in 2 of these 8 cases. Subclavian venography on the side of the fistula done for 20 patients on regular dialysis treatment for more than 3 years was normal. It was concluded that the subclavian vein as a route of vascular access for hemodialysis is a potential risk and should be approached only when obligatory

Treatment of resistant ascites by extracorporeal concentration and reinfusion

Resistant ascites still forms a clinical problem, and trials for its treatment are not yet satisfactory. In this study we tried to manage patients with such problem by ascitic fluid aspiration, concentration by ultrafiltration, and reinfusion of the concentrate mainly intraperitoneally and partially intravenously. Ten cirrhotic patients with resistant ascites were studied. They were 5 males and 5 females. Their mean age was 48.6 +/- 9.6 years. Each underwent 2 sittings 1 week apart. In each sitting 3 Lit ultrafiltrate were discarded and 3 Lit concentrate were collected and infused intravenously. There was a significant loss of weight of 10 +/- 1.49 kg, increase in daily urine output of 405 +/- 167.4 ml. The procedure did not grossly affect the liver functions, but significantly improved the kidney functions. It almost did not alter the FENA which was normal. The procedure seems to be a safe and efficacious method for management of resistant ascites of cirrhosis