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  • Pugsley DJ
Australian & New Zealand Journal of Medicine. 1981;11:599.
Presented at the Annual Scientific Meeting of the Australasian Society of Nephrology, Surfers Paradise, 25-27 March, 1981
  • Buckels JA
  • Mackintosh P
  • Barnes AD
Proc Eur Dial Transplant Assoc. 1981;18:394-9.
  • Frey FJ
  • Amend WJ
  • Lozada F
  • Frey BM
  • Holford NH
  • et al.
Eur J Clin Pharmacol. 1981;21(3):235-42 doi: 10.1007/BF00627926.
  • Vertuno LL
  • Bansal VK
  • Hano JE
  • Giacchino JL
  • Geis WP
Nephron. 1981;27(4-5):273-7 doi: 10.1159/000182067.

We analyzed 50 consecutive cadaver renal transplants to ascertain what benefit, if any, accrued from pretransplantation splenectomy. Because antithymocyte globulin was administered in a random fashion to some patients, its effects were also analyzed. Recipient modification with either modality enhanced graft survival in first transplants when compared to no modification (splenectomy versus no modification 62 versus 27%, p = 0.06; ATG versus modification 75 versus 27%, p = 0.01). The collective experience with splenectomy, its rationale, and its complications are discussed.

  • Eklund B
  • Ahonen J
  • Häyry P
  • Kauste A
  • von Willebrand E
  • et al.
Scand J Urol Nephrol Suppl. 1981;64:179-84.

In order to study the immunosuppressive effect of methylprednisolone, thirty cadaver kidney recipients where randomly allocated into two groups: the low dose control group and the high dose experimental group. In 12 patients in the control group a clinical rejection episode occurred within two weeks of the transplantation, 3 rejections were irreversible, whereas 7 patients rejected in the experimental group, there were no irreversible rejections. In the low dose group the clinical rejection occurred significantly earlier. Fine needle aspiration biopsies of the grafts showed that the number of macrophages infiltrating the graft was significantly lower in the experimental group. Increasing the dose of methylprednisolone given prophylactically can modify the number and severity of rejection episodes early after renal transplantation.

  • Bucin D
  • Lindholm T
  • Löw B
  • Husberg B
  • Low B
Scand J Urol Nephrol Suppl. 1981;64:89-92.
  • Jakobsen A
  • Flatmark A
  • Lundgren G
  • Solheim B
  • Groth CG
Scand J Urol Nephrol Suppl. 1981;64:205-12.

To assess the effect of Pressimmune (AHLG-Behring), in high doses, (30 mg/kg/bdw for 21 days) as an adjuvant immunosuppressive drug a prospective, randomized controlled trial was carried out in 60 recipients of first time cadaveric renal allografts. There was no improvement in graft survival in the treatment group, and there was no steroid sparing. In the patients receiving Pressimmune, the T-lymphocyte count fell to about half pretransplant levels, and the first rejection episode occurred later than in the control patients, but eventually equally many kidneys were lost from rejection.

  • Filo RS
  • Smith EJ
  • Leapman SB

A randomized and controlled study was conducted to evaluate the efficacy of adjunctive antithymocyte globulin (ATG) therapy for the treatment of the initial rejection episode in first cadaveric transplants. When compared to the control group (29), which received only standard antirejection treatment (SAT) of steroid pulsing and local irradiation, the adjunctive ATG treatment group (23) demonstrated significantly faster recovery rates (8.9 +/- 4.1 versus 6.9 +/- 3.7 days, P = 0.05, respectively) and better graft survival rates (62 +/- 9% versus 91 +/- 7%, respectively) after the first rejection. ATG treatment did not result in fewer subsequent rejection episodes than SAT but long-term allograft survival rates remained superior to controls for the entire 3-year study period. By avoiding ATG treatment in those patients who never experienced clinical rejection on maintenance immunosuppressive therapy, i.e., nonresponders (23 of 90), complications associated with excessive immunosuppression were minimized. The combined results of the non-responder group of patients and ATG-treated patients resulted in a 1-year patient survival of 97% and graft survival of 86%. These results suggest that the most efficacious use of ATG is therapeutic and not prophylactic in renal transplant patients.

  • Marshall VC
  • Pass RF
  • Whitley RJ
  • Diethelm AG
  • Whelchel JD
  • Reynolds DW
  • et al.
J Infect Dis. 1980 Jul;142(1):9-17 doi: 10.1093/infdis/142.1.9.

Fifty-six of 67 patients with antibody to cytomegalovirus before transplantation shed cytomegalovirus from urine and/or saliva postoperatively. Symptomatic reactivation occurred in 17 (25%) patients, five of whom had pneumonitis. The symptomatic patients were more likely to have received a cadaver kidney (P = 0.004) and high-dosage antithymocyte globulin (P = 0.003) and to be viremic (P < 0.0001), compared to patients with silent infection. Forty-eight of 49 patients treated with antithymocyte globulin received cadaver or parent donor kidneys. Twenty-four were given a low-dosage intramuscular regimen, and 25 received a higher dosage intravenously. In the latter group 48% experienced symptomatic reactivation adn 48% viremia, compared to 21% and 17%, respectively, in the former group (P < 0.05 for both comparisons). There were no symptomatic cytomegaloviral infections among 18 patients not treated with antithymocyte globulin, all of whom received related donor kidneys. Renal transplant patients who receive both a poorly matched graft and antithymocyte globulin are at increased risk of morbidity due to cytomegalovirus.