The Outcome of Kidney Retransplantation

The survival of 66 patients with retransplanted kidneys, from August 1963 to March 1973, was evaluated. The life expectancy after retransplantation is less than that after primary transplantation but the difference is mainly due to an increased early postoperative mortality. The prognosis after retransplantation is greatly improved if the second kidney is from a related donor. The prognosis is likewise improved if a longer period of time has elapsed between the two transplantations. Surprisingly, previous exposure to specific HL-A antigens does not worsen the prognosis for a subsequent transplanted kidney. © 1974, American Medical Association. All rights reserved

Cryptococcosis after renal transplantation: report of ten cases

Ten cases of cryptococcosis have been identified in a 13 year experience with more than 650 renal transplants. Eight patients had meningitis, one patient had a cerebral granuloma, and in one patient the infection appeared to be limited to the lungs. The central nervous system infection often masqueraded as brain tumor and was not suspected initially. The most useful diagnostic test was cerebrospinal fluid examination including India ink preparation. Various therapeutic regimens with amphotericin B and 5 fluorocytosine were effective in suppressing the infection. A combination of low doses of amphotericin B, not affecting kidney function, with 5 fluorocytosine for at least 3 months was associated with remission of disease in five patients who still are alive, including three patients without recurrence for longer than one year. Five deaths 3 weeks to 4 years after the beginning of treatment were not due to cryptococcosis; death resulted from vascular disease and septicemia in three of the four patients with known causes of death. Central nervous system cryptococcosis, with the exception of the rare cerebral granuloma, is associated with little inflammation. If early death from increased intracranial pressure or cerebral edema is prevented, prolonged therapy with amphotericin B and 5 fluorocytosine may be expected to control the infection, even in immunosuppressed patients

Progress in and deterrents to orthotopic liver transplantation, with special reference to survival, resistance to hyperacute rejection, and biliary duct reconstruction.

Before I begin, I want to add my own personal reminiscence. I knew Dave Hume for almost 14 years, slightly for the first 4 and well for the last 10. I first talked to him at an elevator entrance at the Greenbrier Hotel in West Virginia, in April, 1959, and for the last time in April, 1973, in the lower lobby of the Century Plaza Hotel in Los Angeles. In May, 1973, I was in the railroad station in Albuquerque, New Mexico, when I learned from my grief-stricken youngest son that Dave was dead. It is strange how the exact details of these and some other memories in between, of the time I spent with Dave Hume, stand out with the same clarity as what I was doing when I learned of the bombing of Pearl Harbor, the assassination of John Kennedy, but very few other things. The most eloquent tribute to Dave Hume I have heard was the briefest, coming from a non-medical friend who told me sadly, “He really was a dynamite guy!

Five cases and five unusual indications for autogenic renal transplantation

Five cases of renal autotransplantation representing five different indications for the procedure are presented and discussed