[Significance of mixed lymphocyte culture (MLC) in renal transplants from living donors]. / Significatività del MLC nel trapianto renale da donatore vivente.

Results of MLC were correlated with kidney-graft survival of recipients of living related donor. The 56 patients tested by MLC were divided into two groups according as the stimulation index was more or less than 5. In 20 of these patients transplanted, renal allograft survival correlated better with low stimulation in MLC, suggesting more histocompatibility.

[Relation between cytomegalovirus infection and the so-called intolerance to azathioprine in renal transplantation]. / Rapporto tra infezione da virus citomegalico e la cosiddetta intolleranza all'azatioprina nel trapianto renale.

Renal transplant recipients can develop hepatic function abnormalities or severe leucopenia after transplantation. Generally it is thought to be due to azathioprine intolerance and patients are treated by curtailment of immunosuppressive therapy, being subsequently at risk to lose their allograft because of rejection. Evidence of Cytomegalovirus (CMV) infection is also common after renal transplantation. It is generally thought that the majority of these infections are asymptomatic, but they can be accompanied by leucopenia and/or hepatic function abnormalities. Sixty-nine renal transplant recipients have been studied for at least three months in order to investigate the relationship between CMV and azathioprine intolerance after transplantation. Twenty-five out of 58 patients who underwent seroconversion to CMV (a fourfold or greater rise in titer of CMV antibodies) after transplantation or who had a high CMV titer (greater than or equal to 1 : 16) prior to transplant, developed azathioprine intolerance. None of 11 patients who before renal transplantation had low CMV titers and who did'nt underwent seroconversion did not tolerate azathioprine. Therefore the Authors advance the hypothesis that azathioprine intolerance following renal transplantation can be often due to an asymptomatic and unknown CMV infection.

[HLA and rejection of renal transplants from cadavers]. / HLA e rigetto nel trapianto renale da cadavere.

Seventy-two patients were typed for HLA-A and HLA-B. Kidney-graft survival, reversibility and time of appearance of reject episodes were comparated with matching level. Matching level had double classification: NIT and Verona; the validity of tissue-typing as prediction of the best result of transplantation and major reversibility of reject episodes.

[Diagnosis and therapy of lymphocele as a complication of renal transplantation]. / Diagnostica e terapie del linfocele quale complicazione del trapianto renale.

Of 165 renal transplanted patients, three (1.8%) developed a pelvic lymphocele. Decreased renal function, leg edema, a lower quadrant abdominal mass and fluid retention represented suspicion as the possibility of lymph collection in the perirenal space. Excretory urography associated with pelvic tomography, Computerized Tomography and B scan ultrasound confirmed diagnosis and were helpful in the post-operative follow-up. Drainage procedure restored normal renal function and morphology. External drainage and marsupialization into the peritoneum have been used successfully.

[Aseptic osseous necrosis after renal transplantation]. / La necrosi ossea asettica dopo trapianto renale.

Of 165 renal Transplantated patients, 12 developed aseptic bone necrosis in the femoral head (6 patients), in the femoral condyle (5 patients), in the astragalus (1 patient). The onset of symptoms was 6 to 23 months after transplantation. 99mTc-O4-MDP bone scintigraphy and radiological examination associated with clinical signs confirmed the diagnosis. Unresolved hyperparathyroidism, phosforus depletion, ponderal increase, total i.v. prednisolone-boluses and trauma represented conditions which might predispose to the development of lesion. 8 patients were managed with conservative treatment. 4 patients required a total of 8 operations: head replacement arthroplasty and articular cartilage reimplant in two patients with disease involving femoral head; articular cartilage reimplant and condyle replacement arthroplasty in two patients with disease involving femoral condyle.

Serum gastrin levels in patients with renal failure on maintenance haemodialysis and after successful kidney transplantation.

Chronic renal failure in man is associated with a hypergastrinaemia which is not corrected by haemodialysis. Serum gastrin concentrations were measured in 66 patients on maintenance haemodialysis and in 27 patients after successful kidney transplantation. The basal gastrin levels distinguished 2 groups of patients on maintenance haemodialysis: a first group with gastrin values less than or equal to 120 pg/ml (mean 58+/-29.88 pg/ml) and a second group with gastrin values greater than 120 pg/ml (mean 295+/-257 pg/ml). The onset of urine output after kidney transplantation was associated with a dramatic fall in gastrin concentration (3 patients studied in the early post-transplant period). 24 patients with stabilized transplant function had serum gastrin levels less than 120 pg/ml (mean 21.33+/- 17.29 pg/ml). The gastrin response to a standard protein meal depended on the basal gastrin concentration and was different in patients with renal failure on maintenance haemodialysis and those with a successful kidney transplantation.