Cadaveric kidney donor management

Hippokratia 1997, 1(4):177-188

G Vergoulas

Abstract

In recent years, renal transplantation has assumed an important role in the treatment of patients with end stage renal failure due to various diseases. However, even today, the greatest limitation in kidney transplantation is the shortage of renal grafts. It is well known that cadaveric donors consist the main source of renal grafts all over the world, as well as that correct management of these donors can augment the number and the quality of cadaveric grafts. Unfortunately, till now in Greece, has not been paid proper attention to this matter which results in graft losses. This review addresses management of cadaver heart beating, non-heart beating or anencephalic kidney donors. The knowledge of all the aspects related with the correct management of cadaveric donors and the alertness of I.C.U. teams to apply a scheduled reasonable approach to them (early declaration of coming brain death, quick assessment of candidate for kidney donation, diagnosis of brain death, management of disturbances that appear during the event of brain death, resuscitation measures for cadaveric donors with reversible cardiac arrest, and in situ preservation of renal grafts with triple lumen double balloon catheter placed in abdominal aorta, management of anencephalic donors etc) has been shown to result in higher numbers and improved quality of cadaveric kidneys.

Read PDF

Neuropathologic findings of the central nervous system in patients with transplantation

Hippokratia 1997, 1(4):189-199

NA. Flaris, AD. Konstantinidou

Abstract

Neurological complications resulting in considerable morbidity and mortality are still frequently seen in transplant patients, despite the gradually prolonged survival rate, improved transplantation techniques and finer control of transplant rejection. Lesions in the central nervous system of 38 transplant patients were studied histopathologically. 33 patients (17 women and 16 men, mean age 32,3 years) underwent autopsy with neuropathologic examination of the CNS. Lesions of the CNS were seen in 21 of 33 of them (63%) and they were the cause of death of the patient in 9 of the 33 (27%). 14 of 33 (42%) showed cerebrovascular lesions and 6 of 33 (18%) infections of the CNS. Encephalitis was most commonly seen histologically in patients with infection. 5 patients (3 men and 2 women, mean age 27,4 years) developed focal lesions of the CNS and underwent brain biopsy. Each of them had different diagnoses. Leukoence-phalopathy was noted in 3 patients (2 with autopsy and 1 with biopsy). Two of these patients had received a bone marrow transplant and their lesions were multifocal, perivascular in location, accompanied by mild perivascular inflammation with no other histologic findings of encephalitis and could probably be attributed to graft vs. host disease. From the aforementioned data, it is evident that transplant patients can present with a wide spectrum of CNS lesions, which have complex pathogenesis. Cerebrovascular events and infections are the complications most commonly seen.

Read PDF

Frown scleral incision without phacoemulcification (Sutured and unsutured technique)

Hippokratia 1997, 1(4):200-205

P. Traianidis, G. Sakkias, S Avramides

Abstract

Objective: To assess prospectively the reduction of post operative astigmatism with the frown incision (chord length 5-5.5 mm) which is mostly located in the astigmatism neutral area. Study design: Prospective study of surgical technique and postoperative results concerning induced astigmatism with a minimum follow-up time of 4 months, maximum of 11 months and a mean 5,46 months. Setting: Department of Ophthalmology Hippokratio Thessaloniki General Hospital, Thessaloniki Greece. Patients: 238 patients with relatively soft cataracts were randomly assigned in two groups (155 patients sutured group, 83 patients unsutured group) and underwent extracapsular cataract extraction with the frown incision technique from March 1994 to September 1994. Main outcome measures: Early and late postoperative astigmatism. Results: The mean induced astigmatic change in dioptres was: 0.47, 0.35, 0.27, 0.22 (1st day, 10th day, 1st month, 3rd month) in the sutured group, whereas the corresponding figures in the unsutured group were: 0.73 (p < 0.01), 0.54 (p < 0.01), 0.42 (p < 0.05), 0.35 (p < 0.05) respectively. Conclusions: The small scleral (5-5.5 mm) frown incision is easy to perform, causes a significant reduction of early and late postoperative astigmatism and the sutured technique gives better results than the unsutured one.

Read PDF

The effect of testicular seminoma in semen quality.

Hippokratia 1997, 1(4):206-209

D. Panidis, D. Roussos, H. Vainas, K. Pazaitou, K. Pistevou, K. Stergiopoulos, M. Mamopoulos

Abstract

Clinical sub fertility has been reported among men with a variety of malignancies most notably testicular carcinoma. The aim of this study was the evaluation of the effect of testicular seminoma in semen quality. For this aim, semen specimens from 12 men with seminoma and 60 fertile men were studied. Our results support the view that seminoma exerts a deleterious effect on semen quality. The cause of this effect, however, is not known

Read PDF

Purulent pericardidis

Hippokratia 1997, 1(4):210-212

E. Basagiannis, D. Kranitsas, B. Athyros, B. Abramidis, A. Kontopoulos

Abstract

We present a case of purulent pneumococcal pericardiatis that was promptly diagnosed and successfully treated in our Hospital. Pericardiocentesis yielded purulent material and cultures grew streptococcus pneumonic. The treatment was a combination of surgical removal of pericardial segment and antibiotics failover with cultures results. The follow up to the patient one year after showed that the patient is doing well.

Read PDF

Current Issue 20 (3)