Lewis Burrows

Rejection of the homotransplanted dog liver in the absence of hepatic insufficiency.

Summary A method is presented for transplantation of a donor liver into the pelvis of recipient dogs without disturbing the recipient liver. This surgical preparation has been designed for the study of the immunologic rejection of the liver in the absence of hepatic insufficiency and of jaundice. The recipient liver shows only nonspecific changes. No evidence of an immunologic attack of the graft on the host liver is recognizable. The donor liver exhibits transient anoxic changes which do not appear to interfere with hepatic function as judged by its sequential biliary secretion. Bile secretion ceases within 8 days. Piecemeal necrosis, particularly accentuated on the lobular periphery near the portal tracts, leads to a relentless elimination of all liver cells and their replacement by immunologically active cells within 20 days. The initial stage of this rejection resembles the peripheral piecemeal necrosis of chronic active hepatitis and progressing cirrhosis in man.

Living-related donor nephrectomy by eleventh rib intraperitoneal extrapleural incision

Living-related kidney transplants continue to yield the best results. The two primary approaches for living-related donor nephrectomy are the intraperitoneal and extraperitoneal operations. We herein describe a series of 8 cases in which an eleventh rib intraperitoneal extrapleural incision was used for living-related donor nephrectomy. The advantages of the operation in terms of improved ability to manage vascular anomalies is described. No complication has been encountered.

Scintigraphic detection of the loss of one kidney following en bloc transplantation of paired pediatric kidneys

Vascular occlusion of one of the transplanted kidneys represents a potential complication following en bloc transplantation of two pediatric kidneys into adults. Serial renal scans with Tc-99m DTPA, performed on a 26-year-old woman who underwent en bloc transplantation, revealed good perfusion and function of both kidneys in the early postoperative period but acute loss of perfusion and function in one kidney on the ninth postoperative day. Surgical exploration and open biopsy excluded rejection and twisting of the vascular pedicle as possible causes for the acute loss of perfusion and function in this kidney