Oral and portal venous tolerance in the interferon-gamma knockout (GKO) mouse.

Background: The role of the proinflammatory cytokine interferon-gamma (IFN-gamma) in the development of oral or portal venous tolerance is poorly defined. By using knockout mice for IFN-gamma (GKO mice), we investigated the effect of both oral and portal venous administration of alloantigen on the systemic delayed type hypersensitivity (DTH) response to alloantigen rechallenge.

Materials And Methods: C57BL/6 (B6) control and GKO mice (also on a B6 background) were given either saline or BALB/c spleen cells (25 million) by oral gavage (PO) or by injection into the portal vein (PV) on day 0.

Intraoperative salvage in patients undergoing elective abdominal aortic aneurysm repair: an analysis of cost and benefit.

Purpose: Although autologous blood procurement has become a standard of care in elective surgery, recent studies have questioned its cost-effectiveness. We therefore reviewed our 3-year experience with intraoperative cell salvage in patients who underwent elective abdominal aortic aneurysm repair.

Methods: A 3-year retrospective chart review of elective abdominal aortic aneurysm (infrarenal and suprarenal) repair was performed.

Renal transplants: can acute rejection and acute tubular necrosis be differentiated with MR imaging?

Magnetic resonance (MR) imaging was used in 40 renal transplant recipients to determine whether this modality can enable distinction of acute tubular necrosis (ATN) and acute rejection by means of corticomedullary differentiation (CMD). Each patient underwent initial MR imaging after allograft renal transplantation. Twenty-nine of these 40 patients (72%) also underwent subsequent follow-up MR imaging.

Essential fatty acid depletion of renal allografts and prevention of rejection.

A central hypothesis in transplantation biology is that resident leukocytes expressing class II histocompatibility antigens may determine the immunogenicity of an organ. By means of a novel method to deplete the kidney of resident leukocytes, essential fatty acid deficiency (EFAD), this hypothesis was tested in an intact, vascular organ. Kidneys subjected to EFAD and thus depleted of resident Ia-positive macrophages survived and functioned when transplanted across a major histocompatibility antigen barrier in the absence of immunosuppression of the recipient.

Extra reactivities detected in flow-cytometry-positive, CDC-negative crossmatches are definable HLA specificities.

In this preliminary study, additional reactions were detected in sera that were not found by T-AHG-CDC. The reactions had definable HLA specificities. In our laboratory, the procedures described in this article had the following relative sensitivities for detecting class I HLA alloantibody specificities: FC = B-AHG-CDC greater than T-AHG-CDC greater than B-CDC greater than T-CDC.

Effect of treatment with cyclosporine versus azathioprine on incidence and severity of cytomegalovirus infection posttransplantation.

The incidence and severity of cytomegalovirus (CMV) infection were evaluated in 24 renal transplant patients treated with steroids and cyclosporine and compared with 40 patients treated with steroids and azathioprine: 58% of patients receiving azathioprine and 33% of patients receiving cyclosporine required additional therapy with antithymocyte globulin (ATG) to treat steroid-resistant rejections. CMV antibody titers and cultures of urine and saliva were determined monthly for 4-6 months following transplant in all patients. Both the frequency of CMV infection (occurring in 58% of patients on steroids and cyclosporine and in 48% of patients on steroids and azathioprine) and its severity (21% of cyclosporine-treated patients and 22% of azathioprine-treated patients with symptoms) were similar in both groups.

Disseminated Mycobacterium chelonei infection following cadaveric renal transplantation: favorable response to cefoxitin.

This article describes a case of disseminated Mycobacterium chelonei infection in a renal transplant recipient. This patient, who underwent thoracic duct drainage prior to cadaveric renal transplantation, developed M chelonei bacteremia and numerous subcutaneous nodules a few weeks after transplantation. The M chelonei initially responded to amikacin and tetracycline.

Renal perfusion preservation without cannulation. Prevention of posttransplantation renal artery stenosis.

Cadaver kidneys were preserved by a technique that uses hypothermic pulsatile perfusion without cannulation of the renal arteries. This avoids the mechanical trauma that is inevitably associated with cannulation and preserves a maximum of untraumatized arterial tissue. Cannulation injury is thus eliminated as a potential cause of renal artery stenosis.