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al-Abdullah IH, Anil Kumar MS, Kelly-Sullivan D, Abouna GM. Site for Unpurified Islet Transplantation is an Important Parameter for Determination of the Outcome of Graft Survival and Function. Cell Transplant 2017; 4:297-305. [PMID: 7640869 DOI: 10.1177/096368979500400308] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Transplantation of unpurified islets into the liver, unlike that of purified islets, causes portal hypertension and coagulopathy. The aim of this project was to determine the most suitable alternative site for transplantation of unpurified pancreatic islets in autotransplanted dogs. Twenty-five female mongrel dogs were divided into 5 groups depending on the site of islet transplantation: liver (3), spleen (7), skeletal muscle (5), omental pouch (6), and renal subcapsule (4). Pancreatic digestion of the total pancreatectomized specimen was carried out by distension of the pancreas with 1.5 mg/mL collagenase suspended in 250 mL Hanks' balanced salt solution using a semiautomatic method. The total number of islets equivalent isolated from 25 dogs was 90948 ± 6053. Only islets > 60 μm in diameter were counted, and the mean islet equivalent transplanted per kg body wt was 6762 ± 429. Islet function was achieved with transplantation into spleen in 71%, omental pouch in 50%, and muscle in 20%, but none in the renal subcapsule or liver groups. Glucose tolerance test at 30 d showed a mean K Value (decline in glucose, %/min) of 1.94 ± 0.73,0.79 ± 0.15 and 1.02 in the splenic, omental pouch and muscle groups, respectively. All animals in the liver group, 2 from the splenic group, and 2 from the renal subcapsule group died of diffuse bleeding. Four out of 5 dogs in the muscle group developed necrosis at the site of transplantation and the islets never functioned. This study demonstrates that in dogs, spleen and omental pouch appear to be suitable sites for transplantation of unpurified islets.
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Affiliation(s)
- I H al-Abdullah
- Department of Surgery, Hahnemann University, Philadelphia, PA 19102-1192, USA
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Abstract
The demand for organ transplantation has rapidly increased all over the world during the past decade due to the increased incidence of vital organ failure, the rising success and greater improvement in posttransplant outcome. However, the unavailability of adequate organs for transplantation to meet the existing demand has resulted in major organ shortage crises. As a result there has been a major increase in the number of patients on transplant waiting lists as well as in the number of patients dying while on the waiting list. In the United States, for example, the number of patients on the waiting list in the year 2006 had risen to over 95,000, while the number of patient deaths was over 6,300. This organ shortage crisis has deprived thousands of patients of a new and better quality of life and has caused a substantial increase in the cost of alternative medical care such as dialysis. There are several procedures and pathways which have been shown to provide practical and effective solutions to this crisis. These include implementation of appropriate educational programs for the public and hospital staff regarding the need and benefits of organ donation, the appropriate utilization of marginal (extended criteria donors), acceptance of paired organ donation, the acceptance of the concept of "presumed consent," implementation of a system of "rewarded gifting" for the family of the diseased donor and also for the living donor, developing an altruistic system of donation from a living donor to an unknown recipient, and accepting the concept of a controlled system of financial payment for the donor. As is outlined in this presentation, we strongly believe that the implementation of these pathways for obtaining organs from the living and the dead donors, with appropriate consideration of the ethical, religious and social criteria of the society, the organ shortage crisis will be eliminated and many lives will be saved through the process of organ donation and transplantation.
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Affiliation(s)
- G M Abouna
- Drexel University, College of Medicine, Philadelphia, Pennsylvania, USA.
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Affiliation(s)
- G M Abouna
- Department of Surgery, MCP Hahnemann University, 734 Woodrest Road, Radhor, PA 19087, USA.
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Abouna GM. The Humanitarian aspects of organ transplantation*. Transpl Int 2001. [DOI: 10.1111/j.1432-2277.2001.tb00026.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abouna GM, Ganguly P, Jabur S, Tweed W, Hamdy H, Costa G, Farid E, Sater A. Successful ex vivo liver perfusion system for hepatic failure pending liver regeneration or liver transplantation. Transplant Proc 2001; 33:1962-4. [PMID: 11267589 DOI: 10.1016/s0041-1345(00)02755-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- G M Abouna
- MCP Hahneman University, Philadelphia, Pennsylvania, USA
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Abouna GM, Ganguly PK, Hamdy HM, Jabur SS, Tweed WA, Costa G. Extracorporeal liver perfusion system for successful hepatic support pending liver regeneration or liver transplantation: a pre-clinical controlled trial. Transplantation 1999; 67:1576-83. [PMID: 10401765 DOI: 10.1097/00007890-199906270-00012] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND There is a well recognized need for a system capable of providing effective support for patients with hepatic failure pending liver regeneration or liver transplantation. Recent attempts of using bioartificial liver containing encapsulated porcine hepatocytes, the deployment of emergency whole liver, or hepatocyte transplantation are complex and not consistently successful. The technique of ex vivo hepatic perfusion developed and used clinically by Abouna in the 1970s, has now been redesigned in a perfusion circuitry that mimics the physiological conditions of a normal liver. Before clinical application of this system, a preclinical trial was carried out in dogs with induced hepatic failure. METHODS Acute hepatic failure was induced in dogs by an end-to-side porto caval shunt, followed 24 hr later, by a 2-hr occlusion of the hepatic artery. All animals (n=18) were medically supported and were divided into three groups. In the control group (n=6) only medical support was used. In the experimental group (n=12) the animals were connected to the ex vivo liver support apparatus during acute hepatic failure via an AV shunt using a dog liver (n=6) or calf liver (n=6) (after a temporary extracorporeal bovine kidney transplant to remove preformed xeno antibody). Hepatic perfusion was carried out at 37 degrees C through the hepatic artery and portal vein at physiological pressures, and blood flow rate for 6-8 hr. RESULTS All control animals died of progressive hepatic failure at 14-19 hr after clamping the hepatic artery. The animals treated with ex vivo liver showed remarkable clinical and biochemical improvement. Five animals survived for 36-60 hr. Another seven animals recovered completely and became long-term survivors with biochemical and histological evidence of regeneration of their own liver. Biopsy of the allogeneic ex vivo liver at the end of perfusion showed some interstitial edema. Similar biopsy of the xenogeneic calf liver showed only mild and delayed xenograft rejection, which was most likely due to removal of preformed xeno antibody by temporary transplantation of the calf kidney before liver perfusion. CONCLUSIONS The observations and results obtained in this trial strongly confirm that extracorporeal perfusion through a whole liver, using the system described, is very successful and cost effective for the treatment of acute, but reversible hepatic failure, as well as serving as a bridge to liver transplantation. The time has come for this form of liver support technology to be reintroduced and widely used.
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Affiliation(s)
- G M Abouna
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Abouna GM, al Arrayed AS, Farid E, Awad CK, Sharqawi SA, Tantawi M. Mycophenolate mofetil immunosuppression in high-risk renal transplant recipients. Transplant Proc 1998; 30:4077-8. [PMID: 9865302 DOI: 10.1016/s0041-1345(98)01347-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G M Abouna
- College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Kumar MS, Panigrahi D, Dezii CM, Abouna GM, Chvala R, Brezin J, Kumar AM, Katz SM, McSorley M, Laskow DA. Long-term function and survival of elderly donor kidneys transplanted into young adults. Transplantation 1998; 65:282-5. [PMID: 9458032 DOI: 10.1097/00007890-199801270-00027] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Traditionally, elderly donor kidneys have not been widely accepted for transplantation on the assumption of inferior performance. However, the United Network for Organ Sharing reports an increase in the number of elderly donors from less than 2% in 1982 to 24% in 1995. This trend is commensurate with the increase of older dialysis patients and an overall increase in the elderly population in the United States (1). Optimal utilization of these kidneys is essential to overcome the acute organ shortage. METHODS In this study, we transplanted 25 kidneys from elderly donors (ages 56-72 years) into young adult recipients (ages 20-50 years) (group 1) over a 4-year period. We compared the results with matched recipients of young adult donor kidneys (group 2) with regard to long-term kidney function and graft survival. A pretransplant biopsy of elderly donor kidneys was carried out and a frozen section report was obtained. Only those kidneys showing glomerulosclerosis of less than 20% were accepted for transplantation. All cadaveric kidneys were preserved in University of Wisconsin solution. RESULTS Pretransplant biopsies of elderly donor kidneys showed structural deficits, which included glomerulosclerosis in 85%, arteriolar and/or mesangial thickening in 75%, and interstitial lymphocyte infiltration in 30%. The mean serum creatinine was 2.4+/-0.74, 2.2+/-0.56, and 2.9+/-0.76 mg/100 ml in group 1 and 1.5+/-0.55, 2.3+/-2.24, and 1.7+/-0.62 in group 2 at 1, 3, and 5 years, respectively. The patient survival was 92%, 92%, and 88% in group 1, and 100%, 100%, and 100% in group 2 at 1, 3, and 5 years, respectively. The graft survival was 80%, 64%, and 56% in group 1 and 100%, 96%, and 88% in group 2 at similar time intervals. The differences in the serum creatinine and graft survival between the two groups were statistically significant (P < 0.05). CONCLUSIONS Most of the elderly donor kidneys with structural deficits transplanted into young adults provided suboptimal function and inferior long-term graft survival. To maximize the utilization and optimize the survival of elderly donor kidneys, we propose transplantation of these kidneys into age-matched recipients with similar physiological requirements as those of donors, with regard to kidney function.
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Affiliation(s)
- M S Kumar
- Department of Surgery, Allegheny University, Hahnemann Division, Philadelphia, Pennsylvania 19102-1192, USA
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Kumar MS, Panigrahi D, Dezii CM, Laskow DA, Abouna GM, Brezin J, Chvala R, Katz SM, Phillips K. Experience with transplantation of elderly donor kidneys. Transplant Proc 1997; 29:3281-2. [PMID: 9414715 DOI: 10.1016/s0041-1345(97)00911-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M S Kumar
- Department of Surgery, Allegheny University Hospital-Hahnemann Division, Philadelphia, Pennsylvania 19102, USA
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Kumar MS, Panigrahi D, Dezii CM, Abouna GM, Brezin J, Chvala R, Katz SM, McSorley M, Laskow DA. Transplantation of elderly donor kidneys into young adults. Transplant Proc 1997; 29:3377-8. [PMID: 9414755 DOI: 10.1016/s0041-1345(97)00947-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M S Kumar
- Division of Transplantation, Allegheny University-Hahnemann Division, Philadelphia, Pennsylvania 19102, USA
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Affiliation(s)
- G M Abouna
- College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Abouna GM, al-Abdullah IH, Ilia H, Kelley-Sullivan D. Comparison of the effect of plasmapheresis using human albumin or dextran 40 on the survival of pig-to-dog renal xenografts. Transplant Proc 1996; 28:212-4. [PMID: 8644183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- G M Abouna
- Medical College of Pennsylvania, Department of Surgery, Philadelphia 19102-1192, USA
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al-Abdullah IH, Kumar MS, Kelly-Sullivan D, Ilia HC, Abouna GM. Autotransplantation of unpurified pancreatic islets of Langerhans into different sites in the canine model. Transplant Proc 1995; 27:2645-6. [PMID: 7482864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- I H al-Abdullah
- Department of Surgery, Hahnemann University, Philadelphia, PA 19102-1192, USA
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Abouna GM, Kumar MS, Chvala R, McSorley M, Samhan M. Transplantation of single pediatric kidneys into adult recipients--a 12-year experience. Transplant Proc 1995; 27:2564-6. [PMID: 7482826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- G M Abouna
- Division of Transplantation Surgery, Hahnemann University, Philadelphia,PA19102-1192, USA
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Abouna GM, Kumar MS, Curfman K, Phillips K. Kidney transplantation in patients older than 60 years of age--is it worth it? Transplant Proc 1995; 27:2567-8. [PMID: 7482827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- G M Abouna
- Division of Transplantation, Hahnemann University, Philadelphia, PA 19102-1192, USA
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Kumar MS, Cridge P, Molavi A, Stephan R, Abouna GM. Infectious complications in the first 100 days after renal transplantation. Transplant Proc 1995; 27:2705-6. [PMID: 7482882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- M S Kumar
- Department of Surgery, Hahnemann University Hospital, Philadelphia, PA 19102-1192, USA
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Abouna GM, Kumar MS, al-Abdullah IH, Loose J, Sullivan DK, Phillips K, Yost S, Seirka D. Induction immunosuppression with antithymocyte globulin in renal transplantation using a variable dose according to the absolute number of CD3+ T cells. Transplant Proc 1995; 27:2676-8. [PMID: 7482872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- G M Abouna
- Department of Surgery, Hahnemann University, Philadelphia, PA 19102-1192, USA
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Abouna GM, al-Abdullah IH, Kelly-Sullivan D, Kumar MS, Loose J, Phillips K, Yost S, Seirka D. Randomized clinical trial of antithymocyte globulin induction in renal transplantation comparing a fixed daily dose with dose adjustment according to T cell monitoring. Transplantation 1995; 59:1564-8. [PMID: 7778170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Antithymocyte globulin (ATG) has been used successfully for induction therapy as well as for treatment of established allograft rejection. However, this therapy has often been associated with problems of overimmunosuppression and increased costs. In a randomized clinical trial, we compared the immunosuppressive benefits, complication rates, and treatment costs when ATG is given as a fixed daily dose or when the dose is adjusted daily according to its biologic effects on T cells. Forty-five recipients of cadaver renal allografts were randomized into two groups. In group 1 (n = 23), ATG (ATGAM) was administered in variable doses to maintain the absolute number of peripheral CD3 T cells at 50-100/microliters. In group 2 (n = 22), ATG was given at a fixed dose of 15 mg/kg/day. All patients received azathioprine and prednisone. ATG was discontinued at 7-14 days when cyclosporine was introduced. In both groups, CD2, CD3, CD4, CD8, and CD19 cells were measured by flow cytometry and the levels of cytokines IL-1 beta, IL-2R, ICAM-1, IL-6, IL-7, and levels of cytokines IL-1 beta, IL-2R, ICAM-1, IL-6, IL-7, and levels of cytokines IL-1 beta, IL-2R, ICAM-1, IL-6, Il-7, and IL-10 were measured by ELISA. In group 2, the levels of all T cell subsets were profoundly suppressed. In group 1, the number of CD3 and other T cells was maintained at about 100 cells/microliters, while the CD19 T cells remained unsuppressed. Cytokine levels were greatly suppressed in group 2 compared with group 1, except for IL-10 levels, which remained elevated in the latter group. Patient survival, graft function, and the incidence of acute and recurrent rejections were similar in the two groups. Bone marrow suppression and infective complications were greater in group 2 than in group 1. The mean daily dose and the total quantity of ATG used in group 1 were significantly smaller than in group 2, resulting in a savings of $2,398.00 per patient per treatment. It is concluded that monitoring of ATG by its biologic effects on T cells is a rational and safe method of regulating the dose of this important agent; in this way, it is possible to reduce the total amount of the drug given to patients with consequent reduction in undesirable complications as well as in the cost of treatment without loss of immunosuppressive benefits.
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Affiliation(s)
- G M Abouna
- Department of Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102, USA
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al-Abdullah IH, Anil Kumar MS, Kelly-Sullivan D, Abouna GM. Site for unpurified islet transplantation is an important parameter for determination of the outcome of graft survival and function. Cell Transplant 1995. [PMID: 7640869 DOI: 10.1016/0963-6897(95)00005-i] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Transplantation of unpurified islets into the liver, unlike that of purified islets, causes portal hypertension and coagulopathy. The aim of this project was to determine the most suitable alternative site for transplantation of unpurified pancreatic islets in autotransplanted dogs. Twenty-five female mongrel dogs were divided into 5 groups depending on the site of islet transplantation: liver (3), spleen (7), skeletal muscle (5), omental pouch (6), and renal subcapsule (4). Pancreatic digestion of the total pancreatectomized specimen was carried out by distension of the pancreas with 1.5 mg/mL collagenase suspended in 250 mL Hanks' balanced salt solution using a semiautomatic method. The total number of islets equivalent isolated from 25 dogs was 90948 +/- 6053. Only islets > 60 microns in diameter were counted, and the mean islet equivalent transplanted per kg body wt was 6762 +/- 429. Islet function was achieved with transplantation into spleen in 71%, omental pouch in 50%, and muscle in 20%, but none in the renal subcapsule or liver groups. Glucose tolerance test at 30 d showed a mean K Value (decline in glucose, %/min) of 1.94 +/- 0.73, 0.79 +/- 0.15 and 1.02 in the splenic, omental pouch and muscle groups, respectively. All animals in the liver group, 2 from the splenic group, and 2 from the renal subcapsule group died of diffuse bleeding. Four out of 5 dogs in the muscle group developed necrosis at the site of transplantation and the islets never functioned. This study demonstrates that in dogs, spleen and omental pouch appear to be suitable sites for transplantation of unpurified islets.
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Affiliation(s)
- I H al-Abdullah
- Department of Surgery, Hahnemann University, Philadelphia, PA 19102-1192, USA
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al-Abdullah IH, Kumar MS, Abouna GM. Combined intraductal and interstitial distension of human and porcine pancreas with collagenase facilitates digestion of the pancreas and may improve islet yield. Transplant Proc 1994; 26:3384. [PMID: 7998184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- I H al-Abdullah
- Department of Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102-1192
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Abouna GM, Kumar MS, Samhan M. Kaposi's sarcoma in renal transplant recipients: a case report. Transplant Sci 1994; 4:20-22. [PMID: 7804693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- G M Abouna
- Division of Transplantation, Hahnemann University, Philadelphia, PA 19102
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Abouna GM, Micaily B, Lee DJ, Kumar MS, Jahshan AE, Lyons P. Salvage of a kidney graft in a patient with advanced carcinoma of the cervix by reimplantation of the graft from the pelvis to the upper abdomen in preparation for radiation therapy. Transplantation 1994; 58:520-2. [PMID: 8073523 DOI: 10.1097/00007890-199408270-00021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- G M Abouna
- Department of Surgery, Hahnemann University, Philadelphia, Pennsylvania
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Abouna GM, Kumar MS, Miller JL, Rose LI, Brezin J, Chvala R, Lyons P, Katz SM, McSorley M. Combined kidney and pancreas transplantation from pediatric donors into adult diabetic recipients. Transplant Proc 1994; 26:441-2. [PMID: 7513453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- G M Abouna
- Division of Transplantation, Hahnemann University, Philadelphia, Pennsylvania 19102
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Kumar MS, Stephan R, Chui J, Chvala RP, Brezin J, Katz SM, Abouna GM. Donor age and graft outcome in cadaver renal transplantation. Transplant Proc 1993; 25:3097-8. [PMID: 8266467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- M S Kumar
- Division of Transplantation, Hahnemann University, Philadelphia, PA 19102-1192
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Abouna GM, Kumar MS, Miller JL, Rose LI, Brezin J, Lyons P, McSorley M. Combined kidney and pancreas transplantation for diabetes mellitus using modified bladder-drainage technique and employing pediatric donors. Transplant Proc 1993; 25:2232-3. [PMID: 8516882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- G M Abouna
- Division of Transplantation Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102
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Abouna GM, Kumar MS, Stephan R, Prior JE, Lyons P, Bulova SI, al-Abdullah IH. Induction therapy with antithymocyte globulin reduces the incidence of allograft rejection and improves graft survival in cadaver renal transplantation. Transplant Proc 1993; 25:2241-2. [PMID: 8516886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- G M Abouna
- Division of Transplantation Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102-1192
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Abouna GM. Negative impact of trading in human organs on the development of transplantation in the Middle East. Transplant Proc 1993; 25:2310-3. [PMID: 8516911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- G M Abouna
- Department of Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102
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Abouna GM, Kumar MS, Brezin J, Chvala RP, Prior J, Katz SM, Chui J, Samhan M. Transplantation of single pediatric cadaveric kidneys into adult recipients. Transplant Proc 1993; 25:2170-1. [PMID: 8516856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- G M Abouna
- Division of Transplantation, Hahnemann University, Philadelphia, PA 19102-1192
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Kumar MS, Stephan R, Chui J, Brezin J, Lyons P, Katz SM, Abouna GM. Comparative study of cadaver donor kidneys preserved in University of Wisconsin solution for less than or longer than 30 hours. Transplant Proc 1993; 25:2265-6. [PMID: 8516895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M S Kumar
- Division of Transplantation Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102-1192
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30
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Kumar MS, Stephan R, Chui J, Chvala RP, Olshan A, Krevolin L, Abouna GM. Effect of donor age on graft function and graft survival in cadaver renal transplantation. Transplant Proc 1993; 25:2183-4. [PMID: 8516862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M S Kumar
- Division of Transplantation, Hahnemann University, Philadelphia, PA 19102-1192
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31
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Abouna GM, Kumar MS, Silva OS, Samhan M, Cheriyan G, al-Abdulla I, White AG. Reversal of myocardial dysfunction following renal transplantation. Transplant Proc 1993; 25:1034-5. [PMID: 8442030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- G M Abouna
- Department of Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102
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32
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Abouna GM, Kumar MS, Samhan M, Silva OS. Transplantation of small pediatric cadaver kidneys into adult recipients. Transplant Proc 1991; 23:2604-5. [PMID: 1926498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G M Abouna
- Department of Surgery, Hanhemann University, Philadelphia, PA 19102
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33
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Kumar MS, Samhan M, al Sabawi N, al Abdullah IH, Silva OS, White AG, Abouna GM. Preservation of cadaveric kidneys longer than 48 hours: comparison between Euro-Collins solution, UW solution, and machine perfusion. Transplant Proc 1991; 23:2392-3. [PMID: 1926398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- M S Kumar
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University
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34
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al-Abdullah IH, Kumar MS, al-Adnani MS, Abouna GM. Improvement in allograft survival of islets of Langerhans by pretreatment with deoxyguanosine. Diabetes Res 1991; 17:181-7. [PMID: 1823639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In vitro pretreatment of isolated islets of Langerhans prior to transplantation with deoxyguanosine (dGuo) was found to be effective in improving the survival in fully allogeneic diabetic rats (Wistar----PVG). Post transplant immunosuppression was not used. Islets pretreated with various concentrations of dGuo, 1, 1.35, 1.5 and 2 microM dGuo per islet showed a graft survival of 9, 36, 9 and 14% respectively.
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Affiliation(s)
- I H al-Abdullah
- Department of Surgery, Hahnemann University, Philadelphia, Pennsylvania 19102
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35
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al-Abdullah IH, Kumar AM, al-Adnani MS, Abouna GM. Prolongation of allograft survival in diabetic rats treated with cyclosporine by deoxyguanosine pretreatment of pancreatic islets of Langerhans. Transplantation 1991; 51:967-71. [PMID: 2031280 DOI: 10.1097/00007890-199105000-00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In vitro pretreatment of islets of Langerhans with deoxyguanosine (dGuo) has been shown to be effective for the prolongation of islet allograft survival in rats. [This study evaluates the effect of pretreatment of islets with dGuo transplanted into CsA-treated recipients.] Transplantation of dGuo-treated islets from Wistar rats into diabetic hooded (PVG) rats resulted in 36% graft survival without immunosuppression (dGuo-group) and 89% islet survival after a short course of cyclosporine was used in recipients (dGuo + CsA group). In contrast, transplantation of untreated islets into rats without immunosuppression (controls) and with CsA (CsA group) immunosuppression resulted in 0 and 56% survival, respectively. The differences in graft survival between dGuo versus control group (P less than 0.001), (dGuo + CsA) versus control group (P less than 0.0001), and CsA versus control group (P less than 0.002) are statistically significant. Donor-strain skin-graft challenge failed to induce rejection of transplanted normoglycemic rats in (dGuo) and (dGuo + CsA) groups. The results indicate that a state of immunologic unresponsiveness may have been induced in the recipients of dGuo-treated islets, and further treatment with CsA synergistically prolongs islet survival in fully mismatched rats.
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Affiliation(s)
- I H al-Abdullah
- Department of Organ Transplantation and Pathology, Faculty of Medicine, Kuwait University, Safat
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36
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Abouna GM, Kumar SM, White AG, Samhan M, Kalawi M, al-Sabawi N. Cyclosporine withdrawal in renal transplant recipients maintained on triple therapy. Transplant Proc 1991; 23:1009-10. [PMID: 1989140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G M Abouna
- Department of Organ Transplantation, Kuwait University, Faculty of Medicine
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37
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al-Abdullah IH, Kumar MS, Abouna GM. Preservation of the functional integrity of islets for transplantation: Ficoll versus dextran gradients for purification. Transplant Proc 1990; 22:2046-7. [PMID: 1697122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- I H al-Abdullah
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University, Kuwait
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38
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Abouna GM, Kumar MS, Samhan M, Dadah SK, John P, Sabawi NM. Commercialization in human organs: a middle eastern perspective. Transplant Proc 1990; 22:918-21. [PMID: 2349704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- G M Abouna
- Department of Organ Transplantation, Faculty of Medicine, University of Kuwait
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39
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al-Abdullah IH, Kumar MS, Abouna GM. Islet transplantation in outbred rats using cyclosporine. Transplant Proc 1990; 22:873-4. [PMID: 2109425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- I H al-Abdullah
- Department of Organ Transplantation, Kuwait University, Faculty of Medicine, Kuwait City
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40
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Abouna GM, John P, Samhan M, Kumar MS. Transplantation of single pediatric cadaveric kidneys into adult recipients after prolonged preservation. Transplant Proc 1990; 22:407. [PMID: 2326935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- G M Abouna
- Department of Organ Transplantation, University of Kuwait, Faculty of Medicine, Kuwait City
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41
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al-Abdullah IH, al-Ali SY, Kumar AM, Abouna GM. Electron and light microscopy of pancreatic islets of Langerhans isolated by Trowell's T8 medium. Int J Pancreatol 1990; 6:97-107. [PMID: 2230364 DOI: 10.1007/bf02933044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The isolation and purification of high yields of islets of Langerhans are important areas of investigation. Although it is well established that warm and cold ischemia affect islet yield and function, little information is available about the damage that occurs during the digestion period. We used Trowell's T8 medium and conventional Hank's balanced salt solution to obtain high yields of islets with morphologically-intact cells. Light and electron microscopy were used to characterize the islets isolated by the two media. Results reveal that the islets isolated by Trowells T8 medium were less fragmented and had better fine-structural integrity than those isolated by the conventional medium.
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Affiliation(s)
- I H al-Abdullah
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University, Safat
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al-Abdullah IH, Kumar MS, al-Adnani MS, Abouna GM. Transplantation of islets of Langerhans isolated by Trowell's T8 medium in outbred rats: effect of cyclosporine. Diabetes Res 1990; 13:29-34. [PMID: 2097093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study was carried out to investigate the efficacy of cyclosporine to prolong islets isolated by collagenase in Trowell's T8 medium and Ficoll gradient separation. Our results demonstrate that a short course of cyclosporine is effective in minimizing rejection of transplanted islets in outbred rats.
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Affiliation(s)
- I H al-Abdullah
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University, Safat
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Abstract
Stimulation of human lymphocytes from 20 individuals with phytohaemagglutinin (PHA) for 60 min resulted in a fall in intracellular adenosine triphosphate (ATP) of 35% compared to unstimulated controls of 19% (p less than 0.001). There was a significant (p less than 0.01) correlation (r = 0.57) between ATP decrease at 60 min and deoxyribonucleic acid (DNA) synthesis at 72 h in PHA-stimulated cells. The technique described here is simple, rapid and has possible application in immunodiagnosis and immunologic monitoring.
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Affiliation(s)
- A G White
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University
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Samhan M, Panjwani DD, Dadah SK, Kumar MS, Araj G, Abouna GM. Is tuberculosis a contraindication for renal transplantation? Transplant Proc 1989; 21:2036-8. [PMID: 2652666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M Samhan
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University, Kuwait City
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45
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Ruka MP, White AG, Kumar MS, al-Abdullah IH, Abouna GM. Changes in the weight of the pancreas during preservation in various solutions. Transplant Proc 1989; 21:1372-5. [PMID: 2711438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M P Ruka
- Department of Organ Transplantation, Faculty of Medicine, University of Kuwait, Safat
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46
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Kumar MS, Samhan M, John P, al-Adnani MS, Abouna GM. Chronic cyclosporine nephrotoxicity in renal transplantation: is it the effect of preservation? Transplant Proc 1989; 21:1552-3. [PMID: 2652503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M S Kumar
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University, Kuwait City
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47
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Panjwani DD, Kalawi M, Kumar MS, Elhag K, Araj G, Abouna GM. Septicemia in renal transplant recipients: epidemiology and prognosis. Transplant Proc 1989; 21:2112-3. [PMID: 2652681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- D D Panjwani
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University, Safat
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48
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Kobryn A, Pacsa A, White AG, Kumar MS, Abouna GM. Are peripheral blood lymphocytes the source of elevated B-2-microglobulin in renal transplant recipients? Transplant Proc 1989; 21:302-3. [PMID: 2650128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- A Kobryn
- Department of Organ Transplantation, Faculty of Medicine, Safat, Kuwait
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49
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Abouna GM, Samhan M, Kumar MS, Silva OS, Shuwaiki I. Unilateral native nephrectomy carried out at the time of renal transplantation is effective in the treatment of dialysis-resistant hypertension. Transplant Proc 1989; 21:2028-30. [PMID: 2652663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- G M Abouna
- Department of Organ Transplantation, Faculty of Medicine, Kuwait University, Kuwait City
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50
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Abouna GM, Panjwani D, Kumar MS, White AG, Al-Abdulla IH, Silva OS, Samhan M. The living unrelated donor--a viable alternative for renal transplantation. Transplant Proc 1988; 20:802-4. [PMID: 3055504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- G M Abouna
- Department of Organ Transplantation, Kuwait University Faculty of Medicine
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