[The development of kidney transplantation in the GDR].

The experience gained by the performance of 2249 allogenic transplantations of the kidneys is presented. Direct correlations between the systematic dialysis, successful transplantation and the follow-up of patients operated on are explained. Discussing the reasons for the procedure limitations, the author emphasizes the importance of clinical ones.

[PUVA treatment of organ transplants--experimental and clinical results].

The aim of the present study was to evaluate the influence of a pretreatment of the heart and kidney donor with the photosensitizer 8-methoxypsoralen plus ex vivo longwave ultraviolet irradiation of the graft (PUVA) on survival time and immunogenicity of rat heart and kidney allografts. PUVA pretreatment significantly prolonged the survival of these transplants in allogenic recipients. Furthermore, a synergistic effect with conventional immunosuppression (azathioprine, cyclosporine) was demonstrated.

[Improvement in the prognosis of renal cell carcinoma by percutaneous transvascular embolization].

In a retrospective study of 303 patients with renal cell carcinomas the prognostic influence of the percutaneous transvasal embolization of the renal artery was demonstrated. In form of the life-table-method we compared statistically the survival rates of preoperatively or palliatively embolized patients with such ones who were only nephrectomized or treated only symptomatically. In the tumour stages T2 and T3 the preoperative percutaneous transvasal embolization leads to a clearly higher survival rate; in stage T2 statistically significant.

Photochemical donor pretreatment in clinical kidney transplantation--preliminary report.

Extended experimental experience with the efficacy of pretreating the kidney donor and the allograft by means of photochemotherapy (photosensitizer + UVA irradiation = PUVA) was adopted in clinical kidney transplantation. In a preliminary unrandomized study similar patient populations were treated by generally uniform methods. Thirty-three PUVA-pretreated kidneys (group A) were compared with the experience regarding 26 non-pretreated kidney allografts (group B).

Synergistic effect of donor pretreatment with 8-methoxypsoralen and ultraviolet irradiation of the graft plus azathioprine and prednisolone therapy in prolonging rat renal allograft survival.

Pretreatment of the kidney donor with 8-methoxy-psoralen (8-MOP) and direct longwave ultraviolet (UVA) irradiation of the kidney graft (PUVA therapy) significantly prolonged survival in allogeneic recipients. 40% of the recipients survived more than 100 days with normal transplant function. The addition of standard clinical immunosuppressive agents azathioprine and prednisolone (both at dosages of 15 mg/kg body weight/day for 21 days) to the PUVA therapy further improved graft survival rate, with a recipient survival rate of 62.

[Indications for antirefluxplasty in childhood].

By own experiences on 336 children, 212 of whom were operated on, and a critical review of the relevant literature, the indication to the antireflux plastic in childhood is derived. It is tried to establish certain principles which shall facilitate the treatment. It is referred to the extraordinarily complex character of the diagnosis and the individual techniques are valuated.

Prolongation of rat renal allograft survival time by donor pretreatment with 8-methoxypsoralen and longwave ultraviolet irradiation of the graft (PUVA therapy).

Pretreatment of the kidney donor with 8-methoxypsoralen (8-MOP) and ex vivo longwave ultraviolet irradiation (UVA) of the kidney prolonged the subsequent survival on allogeneic recipients. The efficacy of this treatment seems to be dependent on the time and dose of UVA irradiation rather than on the dose of 8-MOP. In conclusion, PUVA treatment is effective in reducing the immunogenicity of the rat kidney allograft, although the mechanism remains unclear.

Extracorporeal microsurgical repair of injured multiple donor kidney arteries prior to cadaveric allotransplantation.

To prevent the complications of ureteral and parenchymal ischemia it is important to revascularize all accessory and main branches of the renal arteries in kidney transplantation. 11 allografts underwent ex vivo microsurgical repair of injured polar arteries prior to allotransplantation, and 1 patient had an in situ repair. Three extracorporeal reconstructive techniques are used that are applicable to most of the vascular injuries presented by multiple renal arteries.

[Complications and reconstructive interventions of the efferent urinary system following kidney transplantation].

It is reported on early and late complications on the efferent urinary system by 667 transplantations of allogenic kidneys of corpses. The complication rate runs to 6.3%.

C-reactive protein and clinical kidney transplantation.

50 patients were serially monitored for C-reactive protein (CRP) in serum after kidney transplantation. Compared with a control group the post-operative peak at days 1 and 3 was strongly depressed in the immunosuppressive-treated transplant group (p less than 0.01).

[The significance of sex determined antigens for kidney transplantation prognosis--an analysis of 500 transplantations at a center].

In a retrospective analysis of survival after 587 kidney transplants from dead donors performed in one centre, the influence of incompatibilities in the HLA-A-B system and the influence of the sex of the donor were analysed. The survival curves for 0, 1, 2, 3 and 4 incompatible antigens of the A and B loci showed no significant differences from the 1st to the 4th years after transplantation. The best survival rate was found among 212 men with kidneys from male donors, despite other disadvantageous factors in this group, whereas 155 women with kidneys from male donors (with a histoincompatibility of the H-Y antigen) had statistically significant low survival rates between 10.

[Pregnancy after kidney transplantation. Report of 6 successful cases with multiple risk factors].

The long-term course before, during and after successful pregnancy in six women 3 to 6 years after receiving CD-kidney transplants from dead donors is described. Multiple risk factors such as hypertension, considerable proteinuria, preceding rejection crises etc. have been taken into account.

[Urethroplasty against endoscopic urethrotomy].

From 1970 to 1981 urethroplasty was done in 79 patients and internal urethrotomy under vision was done on 166 urethral strictures from 1977 to 1981. We feel that urethroplasty and internal urethrotomy complete each other. Both of them are successful in some 85% of cases.

Prevention of osteonecrosis following renal transplantation by using vitamin D2 (ergocalciferol).

Osteonecrosis is a frequently disabling complication of renal transplantation. Thirty-one of 244 patients (12.7%), who received cadaver renal transplants from 1968 to 1978 developed an osteonecrosis.

[Transplantation of the kidneys from newborn donors, using the Mini-Lewe minipig as a model].

The importance of kidneys from newborn donors in transplantation has not been clearly defined. The purpose of this study was to investigate the degree of morphological and functional adaptation of the newborn kidney in an adult recipient. 7 MLS-matched kidneys from Lewe minipig puppies (age: 3-4 weeks) had been transplanted en bloc to their mothers with immediately bilateral nephrectomy.