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As any new field in medicine develops, an the history of transplantation and the current accompanying documentation occurs in a rea status of hemodialysis as it relates to trans sonable and logical sequence. Early in the de plantation. In addition, the areas of tissue his to velopmental life of clinical transplantation, compatability typing, patient evaluation, the many research articles and case reports were transplant operation, immunosuppressive drugs, presented in the literature, and shortly there and follow-up investigations are well and clearly after, a series of textbooks were published. documented, as are the medical complications These textbooks dealt primarily with the per and the psychiatric and social problems en sonal experiences of clinicians working in the countered in kidney transplantation. major centers, who were embarking in the new Although Dr. Chatterjee draws primarily on field, as were Dr. Starzl, Dr. CaIne, Dr. Sim his own experiences, he fairly presents all the mons, and myself. This field of investigation has issues in areas in which there is controversy or now become an accepted clinical discipline, and differences of opinion. Most major university thus it is highly desirable that a manual should medical centers now have a clinical renal trans be available for the residents and house staff plantation service, and I feel that this manual who will receive training in this important area. will be an invaluable tool for their house staff In this manual, Dr. Satya N. Chatterjee pre and students alike.
|Publisher:||Springer New York|
Table of Contents1 History of Human Renal Transplantation.- References.- 2 Role of Hemodialysis and Medical Management.- Technical Considerations.- Fluid, Electrolyte, and Acid-Base Metabolism.- Uremic Toxins.- Cardiovascular Complications.- Pulmonary Complications.- Drug Therapy.- Neurological Complications 18 Hematological-Immunological Complications.- Endocrine-Metabolic Complications.- References.- 3 Transplant Histocompatability.- Histocompatibility Antigens.- The Influence of HLA Matching on Renal Transplants.- Blood Transfusions and Kidney Transplants.- Future Directions.- References.- 4 Selection and Preparation of Recipients for Renal Transplantation.- Selection of the Recipient.- The Patient’s Own Disease.- Preparation of the Patient.- References.- 5 Vascular Access for Hemodialysis.- History.- Quinton-Scribner Shunts.- Internal Arteriovenous Fistula.- Substitute Grafts.- Sapheneous Vein Grafts.- Bovine Carotid Artery Heterograft.- Human Umbilical Cord Vein Allograft.- Synthetic Grafts.- Polytetrafluoroethylene Grafts.- Tertiary Methods.- References.- 6 Living DonersSelection and Acceptability.- Preoperative Preparation.- Technique of Living Donor Nephrectomy.- Complications of Living Donor Nephrectomy.- Renal Function Studies After Nephrectomy in Renal Donors.- Psychiatric Aspect of Living Donors.- References.- 7 Acceptability and Procurement of Cadaver Kidneys.- Acceptability of Cadaver Renal Donors 69 Procurement of Kidneys vis-á-vis the Donor Source.- Pharmacological Aspects of Kidney Procurement.- Legal Aspect of Organ Procurement.- Organizational Aspects of Organ Procurement.- Procurement of Cadaver Kidneys for Transplantation.- Operative Procedure.- Kidney Preservation.- References.- 8 Operative Techniques for Transplantation.- Preoperative Preparation.- Surgical Techniques.- Immediate Post-Transplant Care.- Postoperative Dialysis.- References.- 9 Anesthesia in Renal Transplantation.- State of the Patient.- Anesthetic Drugs.- Anesthetic Techniques.- References.- 10 Immunosuppressive Drugs.- Drugs.- Immunosuppressive Procedures.- Treatment of Rejection Crisis.- Analysis of Risk Factors in Treating Rejections.- References.- 11 Follow-up Investigations.- Daily Tests.- Weekly Tests.- Special Tests.- Diet and Fluid Balance in the Immediate Postoperative Period.- Once-a-Week Clinic Follow-up Tests.- Twice-a-Month Clinic Follow-up Tests.- Once-a-Month Clinic Follow-up Tests.- Second-Year Follow-up Tests 122 Maintenance Level of Immunosuppressive Drugs.- Special Tests.- References.- 12 Complications of Renal Transplantation.- Side Effects of Immunosuppression.- Side Effects of Steroid Therapy.- Side Effects of Azathioprine 139 Technical Complications of Renal Transplantation.- Endocrine Complications.- Cardiovascular Complications.- Local Complications.- Gastrointestinal Complications.- Cutaneous Complications.- Pulmonary Complications.- Abnormalities of the Musculoskeletal System.- Neurological Complications.- Ocular Complications.- Hematological Complications.- Metabolic Complications.- References.- 13 Psychiatric Factors in Renal Transplantation.- Donor Selection.- Donor Motivation.- Psychological Relationship Between Donor and Recipient.- Cadaveric Transplants.- Postoperative Psychiatric Complications and Body Image Changes.- Sexual Problems of Transplant Patients.- Relationship Between Emotions and Rejection.- Conclusions.- References.- 14 Renal Transplantation in Children.- Incidence.- Causes of Renal Failure.- Hemodialysis Technique.- Recipient Selection.- Preparation of the Recipient.- Donor Selection.- Immunosuppressive Therapy.- Alternate Day Therapy.- Nursing Implications.- Operative Technique.- Rejection Episodes.- Complications.- Recurrence of Disease.- Other Diseases.- Results.- Rehabilitation.- Psychological Aspects.- References.