Improvement of cadaver renal transplantation outcomes with verapamil: a review
Article Abstract:
Cyclosporine is a potent immunosuppressive drug administered to a large number of organ transplant patients to prevent rejection of the implanted organ. Although it is quite effective in blocking graft-induced activation of the immune system, cyclosporine also causes hypertension (high blood pressure) and reversible toxic effects on the kidney. In cases where the kidney is the transplanted organ, kidney toxicity can be fatal. Experiments done in mice showed that cyclosporine administration decreased formation of the small blood vessels supplying a transplanted kidney; if this same consequence results from cyclosporine administration in humans, it could largely explain the toxic effects of the drug. Administration of the calcium antagonist drugs, which block the passage of calcium from the blood into cells, is emerging as a highly effective way to reverse the adverse effects of cyclosporine. When the calcium antagonist verapamil was administered to patients prior to kidney transplant, blood flow to that organ was maintained. Kidney function was also improved; there were significantly fewer rejection episodes (3 of 22 for verapamil-treated patients compared with 10 of 18 for nontreated patients). In a study currently underway, transplant patients were given verapamil injection into the renal artery (the artery supplying blood to the kidney) during surgery, and orally administered verapamil for 14 days thereafter. Verapamil treatment reduced the number of cases in which treatment (such as dialysis) had to be administered to assist the kidney, and (excluding technical failures) there were no instances of transplant rejection among verapamil-treated patients. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Acute respiratory failure and death caused by fulminant Haemophilus influenzae pneumonia
Article Abstract:
The microorganism Haemophilus influenzae is a primary infective agent in adult pneumonia, and has been reported to cause other nonpulmonary diseases in older persons. However, recent studies have reported the occurrence of H. influenzae pneumonia in younger patients, specifically those with AIDS, AIDS-related complex (ARC), or increased risk for developing AIDS. Two cases are described of patients with a different form of community-acquired H. influenzae, which had a rapidly developing course, and affected younger patients with normal or non-suppressed immune systems. Both patients had symptoms of cough, fever, and lethargy, and evidence of pneumonia, as indicated by lung X-ray. Both patients died from sudden, rapidly progressive pneumonia within hours of their admission to the hospital. These cases are unusual in that both patients were relatively young, previously healthy, and without risk factors for AIDS or ARC. In both cases, autopsy of the lungs revealed abscesses, which occur only in the severe form of H. influenzae pneumonia. Thus, H. influenzae is capable of causing diffuse accumulation of fluid in the lungs and respiratory failure. Physicians should be aware of the potential of H. influenzae to cause life-threatening pneumonia in young, previously healthy adults. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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