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Transplantation Proceedings 11/1993; 25(5):2898-9. · 1.00 Impact Factor
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ABSTRACT: There are many conflicting reports on the survival of cultured keratinocyte allografts (CKAs). Studies were performed in the rabbit model to elucidate further the fate of CKAs. Of 24 CKAs, 7 were identified as technical failures, 13 displayed classical macroscopic evidence of rejection with a prolonged mean survival time of 2.8 days, compared to non-cultured allograft controls (p < 0.01), and 4 failed to display typical macroscopic evidence of rejection. Furthermore, the time to eventual wound healing of the classically rejected CKAs were delayed by 6.0 days (p < 0.0001), compared to identical non-grafted control wounds.
British Journal of Plastic Surgery 05/1993; 46(3):235-9. · 1.29 Impact Factor
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ABSTRACT: Blood transfusion prior to renal transplantation improves subsequent renal allograft survival, and some experimental studies have shown that allogeneic transfusion significantly increases growth of subsequently transplanted tumors. The aim of the present study was to examine the influence of the timing of transfusion on tumor growth. Six experiments were performed, each with different intervals between blood transfusion and inoculation of mice with an immunogenic B16 melanoma cell line. Each experiment contained three groups of C57 BL/6J mice which received intravenously normal saline, syngeneic blood, or allogeneic blood. Allogeneic transfusion 7 and 10 days before, but not at the time of, tumor inoculation produced a significant increase in tumor growth. Allogeneic transfusion within the first 10 days after tumor inoculation was associated with larger and heavier tumors than those observed in animals treated with saline or syngeneic blood, although the differences were not always statistically significant. Multiple transfusions after tumor inoculation and transfusions in animals bearing well-established tumors significantly increased tumor growth. The study shows that growth of a transplantable immunogenic murine tumor can be increased by prior allogeneic transfusion and, perhaps more importantly, by allogeneic transfusions given after the tumor has become established.
Journal of Surgical Research 04/1993; 54(3):237-41. · 2.25 Impact Factor
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ABSTRACT: To examine the potential use of immunoconjugates of drugs and antibodies as immunosuppressive agents, mice were treated with a short course (4 days) of T-cell-specific anti-Ly-2.1 monoclonal antibody, or MAB conjugated to an anthracycline, idarubicin (IDA). The anti-Ly-2.1 MAB had no significant effect on the survival of BALB/c (Ly-2.2) heart allografts in CBA (Ly-2.1) mice, but was a potent immunosuppressive agent when coupled to IDA, with most grafts surviving for > 100 days following treatment with doses ranging from 10 to 120 micrograms IDA, covalently coupled to 1-8 mg MAB. IDA-MAB treated mice with long-surviving heart grafts showed donor-specific tolerance. They did not reject donor-type skin grafts (these survived for > 50 days), but rejected third-party skin in 10-14 days. Heart allografts in these mice survived for > 100 days. Allografts placed 30 days after treatment were rejected, showing a recovery of peripheral T cell function at this time. Newly derived thymic T cells were, however, not required for this recovery since adult thymectomized, IDA-MAB treated animals also recovered T cell function and rejected heart allografts. FACScan analysis of T cells from mice treated with 80 micrograms IDA-4 mg MAB, which had received a heart allograft, showed 95% T cell depletion in the spleen compared with ungrafted, IDA-MAB treated animals, and untreated controls with or without allografts. Splenic T cell depletion was however not significant in CBA mice immunosuppressed with the lower dose of 10 micrograms IDA-MAB. Thus rapid depletion of splenic T cells was not required for immunosuppression induced by IDA-MAB conjugates. However, the minor subpopulation of Ly-2+, which was activated by alloantigen while carrying IDA-MAB, may be depleted during the T cell response to the allograft, resulting in a state of alloantigen-specific tolerance in mice with long-surviving heart allografts.
Transplantation 04/1993; 55(3):484-90. · 4.00 Impact Factor
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ABSTRACT: To determine the outcome of patients with end-stage chronic renal failure treated by live donor renal transplantation at the Royal Melbourne Hospital and Royal Children's Hospital between 1973 and 1991, during which time two distinct immunosuppressive regimens were used.
Data about live donor renal transplant recipients were retrieved from the Australian and New Zealand Dialysis and Transplantation Association Registry, to which we have submitted data on all transplant recipients at six monthly intervals since the commencement of our dialysis and transplant programs.
Seventy-two patients with chronic renal failure who received live donor renal transplants during the 19 years from February 1973 to February 1992 were included.
Patient survival, transplant survival, transplant function, change in prednisolone requirements, and duration of hospital stay.
The first 32 patients were treated with immunosuppressive regimens based on combinations of prednisolone and azathioprine ("dual therapy"), while the next 40 patients were treated with combinations of cyclosporin, prednisolone and azathioprine ("triple therapy"). Survival of patients in each group five years after transplantation was 97%. Actuarial graft survival at 5, 10 and 15 years in the dual therapy group was 58%, 52% and 47%, compared with a 5-year actuarial graft survival in the triple therapy group of 96%. There was no statistically significant difference in renal transplant function between the two groups within the first 6 years after transplantation. Twelve of 26 patients (46%) treated initially with triple therapy were able to stop treatment with prednisolone within 12 months of transplantation. Median hospital stay was 12 (range, 6-35) days during the period 1973-1985 and 8 (range, 5-20) days for the 1985-1992 period.
Live donor renal transplantation has provided a highly satisfactory means of treating patients with end-stage chronic renal failure in the short and long term. Our recent experience indicates that excellent patient and graft survival and adequate renal function can be achieved by treating live donor renal transplant recipients with a triple immunosuppressive regimen of low dose cyclosporin, prednisolone and azathioprine.
The Medical journal of Australia 03/1993; 158(4):244-7. · 2.81 Impact Factor
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ABSTRACT: Spontaneous renal allograft rupture occurred in six patients in a series of 384 consecutive renal transplants performed between July 1983 and December 1990. All cases occurred in patients treated with Azathioprine and Prednisolone, and none occurred in patients immunosuppressed with Cyclosporine. Acute allograft rejection was the underlying cause of rupture. All patients underwent urgent operation and repair of the ruptured transplant. Four patients had good renal function 74-84 months after repair, while two returned to dialysis 3 and 65 months after repair because of irreversible rejection.
Australian and New Zealand Journal of Surgery 03/1992; 62(2):130-4.
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Transplantation Proceedings 03/1992; 24(1):227-8. · 1.00 Impact Factor
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Transplantation Proceedings 03/1992; 24(1):222-3. · 1.00 Impact Factor
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Transplantation Proceedings 03/1992; 24(1):229-30. · 1.00 Impact Factor
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Transplantation Proceedings 03/1991; 23(1 Pt 1):499-500. · 1.00 Impact Factor
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Transplantation Proceedings 03/1991; 23(1 Pt 2):1323-4. · 1.00 Impact Factor
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Transplantation Proceedings 03/1991; 23(1 Pt 1):346-7. · 1.00 Impact Factor
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Transplantation Proceedings 03/1991; 23(1 Pt 1):737-8. · 1.00 Impact Factor
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ABSTRACT: Pregraft transfusion combined with immunosuppression at the time of grafting improves the survival of clinical and experimental allografts. The mechanisms responsible for this effect were investigated in the murine model of cardiac transplantation, combining transfusions 7 to 30 days prior to transplantation with cyclosporine 100 mg/kg, 7 to 20 days pregraft or on days 0, 4, and 6 after grafting. Pregraft DST, third-party blood, and CsA all improved graft survival in the BALB/c-to-CBA donor-recipient combination. In animals treated with DST at 14 days pregrafting, 4/9 grafts survived for greater than 100 days. In those given C57BL/6 blood, or CsA on days 0, 4, 6 postgraft, 1/9 grafts survived for greater than 100 days. When 10(7) spleen cells from DST-treated CBA mice with long-surviving BALB/c heart grafts were transferred to naive CBA mice that then received a BALB/c heart 24 hr later, the transferred cells prolonged graft survival, with all grafts functioning at greater than 40 days, and 4/7 at greater than 100 days. Selective removal of T cells from the spleen cell population prior to transfer showed that L3T4+ T cells, but not Ly-2+ T cells, were required to maintain BALB/c allografts. Combining a short course of CsA with DST was more effective than either treatment alone. The most effective combined treatment was DST at day -14 with 100 mg/kg CsA given on days 0, 4, and 6 postgrafting (8/10 grafts survived greater than 100 days). This treatment also induced splenic suppressor T cells of the L3T4+ Ly-2- phenotype. These results clearly show that L3T4+ splenic T suppressor cells are induced by donor-specific blood transfusion with or without CsA treatment, and that these cells play a role in maintaining long-term tolerance to allografts in the mouse heart transplant model.
Transplantation 01/1991; 50(6):1033-7. · 4.00 Impact Factor
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ABSTRACT: Hyperparathyroidism is a common complication of chronic renal failure. Although many patients can be managed by conservative measures, surgery is sometimes necessary. One of two operations can be performed: subtotal parathyroidectomy or total parathyroidectomy with reimplantation of parathyroid tissue into muscle. A case is presented of a patient who underwent the first and then the second of these procedures for recurrent hyperparathyroidism. A further recurrence was found to be caused by the implanted parathyroid tissue in a forearm muscle, requiring a third procedure for control of the disorder.
Australian and New Zealand Journal of Surgery 11/1990; 60(10):821-3.
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Transplantation Proceedings 11/1990; 22(5):2097-8. · 1.00 Impact Factor
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Transplantation Proceedings 11/1990; 22(5):2111-2. · 1.00 Impact Factor
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Transplantation Proceedings 11/1990; 22(5):2139-40. · 1.00 Impact Factor
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Transplantation 05/1990; 49(4):835-7. · 4.00 Impact Factor
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ABSTRACT: A technique is described for the culture of disaggregated rabbit keratinocytes and the production of confluent sheets of immunologically pure keratinocytes suitable for use in transplantation studies. The benefits of various feeder layers, nutrients and growth hormones were examined by the use of paired controls. The ability of the cultured keratinocyte sheets to be removed from the culture vessel intact and survive as viable autografts was demonstrated, thus establishing a new animal model for the investigation of allograft rejection responses to cultured keratinocytes. The benefits of using the rabbit model for such studies and the advantages of this culture technique over a previously described method of rabbit keratinocyte cell culture are discussed.
Immunology and Cell Biology 05/1990; 68 ( Pt 2):119-26. · 3.66 Impact Factor
