Splenectomy and Thymectomy in Human Renal Homotransplantation

Five patients with terminal renal failure have been treated with renal homografts. Total body irradiation and cytotoxic drugs were used to prevent rejection. In addition, the thymus and spleen were surgically removed prior to the homotransplantation. Four of the 5 patients are alive with good renal function after 105 to 198 days. The role of thymectomy and splenectomy in conditioning patients for the receipt of homografts is highly speculative at present. However, the early success rate in this group of patients exceeds that generally attained with renal homografts, and appears to justify further clinical evaluation of this approach under carefully controlled experimental conditions. The data are insufficient to allow a recommendation for the general use of these adjuvant procedures. © 1963, SAGE Publications. All rights reserved

Infections Complicating Orthotopic Liver Transplantation: A Study Emphasizing Graft-Related Septicemia

In 93 recipients of 102 orthotopic liver homografts, the incidence of bacteremia or fungemia exceeded 70%. The graft itself was usually an entry site for systemic infection after both immunologic and nonimmunologic parenchymal injury, especially if there was defective biliary drainage. The role of the homograft itself as the special infectious risk factor has prompted increased use of defunctionalized jejunal Roux limbs to reduce graft contamination. It has also stimulated very aggressive postoperative diagnostic efforts to rule out remedial mechanical complications of the transplant. © 1976, American Medical Association. All rights reserved