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A prospective randomised controlled trial of acute normovolaemic haemodilution (ANH) in major gastro-intestinal surgery and its effect on coagulation
Sanders G, Mellor NJ, Rickards K, Brodribb JA, Rushton AR, Christie I,, et al.,
Blood. 2002;100((11, Pt 2):):58a.. Abstract No. 209.
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2.
Acute normovolaemic haemodilution does not reduce allogeneic transfusion rate in major gastrointestinal surgery: a randomised controlled trial
Sanders G, Mellor NJ, Rickards K, Brodribb AJ, Rushton ARA, Christie I,, et al.,
British Journal of Haematology. 2002;117((Suppl 1):):3. Abstract No. 7.
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3.
A randomized trial of solvent/detergent and standard fresh frozen plasma in the treatment of the coagulopathy seen during orthoptopic liver transplantation
Freeman JW, Williamson LM, Llewelyn C, Fisher N, Allain JP, Bellamy M,, et al.,
Vox Sanguinis. 1998;75((Suppl 1):): Abstract No. 5.
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4.
Influence of posttransplantation blood transfusion on kidney allograft survival: a one-center, double-blind, prospective, randomized study comparing cryopreserved and fresh red blood cell concentrates
Lang P, Bierling P, Buisson C, Fruchaud G, Busson M, Belghiti D, Seror T, Dahmane D, Beaujan F, Benmaadi A,, et al
Transplantation Proceedings. 1993;25((1, Pt 1):):616-8.
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5.
The induction of immunologic hyporesponsiveness by preoperative donor-specific transfusions and cyclosporine in human cadaveric transplants. A preliminary trial
Alexander JW, Babcock GF, First MR, Davies CB, Madden RL, Munda R, Penn I, Fidler JP, Cofer BR, Stephens G,, et al
Transplantation. 1992;53((2):):423-7.
Abstract
A prospective randomized preliminary trial was performed in patients undergoing cadaveric renal transplantation to determine the potential benefits, disadvantages, and logistic problems associated with the administration of donor-specific transfusions and cyclosporine initiated 24 hr before transplantation. Ten patients received DST followed by continuous intravenous CsA approximately 24 hr before cadaveric renal transplantation from the same donor. Twelve patients receiving sequential therapy with Minnesota antilymphoblast globulin, azathioprine, and steroids with subsequent conversion to CsA served as controls. Patient demographics and the donor characteristics were evenly matched in the two groups. While the study group had longer cold ischemia time and more evidence of renal dysfunction within the first two weeks, subsequent renal function was identical in the groups and there were fewer episodes of severe rejection requiring treatment with OKT3 within the first six months in the DST group (5 vs. 0, P less than 0.05), which also had less reactivity in mixed lymphocyte cultures against preserved donor-specific lymphocytes than did the control group (stimulation index 9.0 +/- 3.0 vs. 25.3 +/- 6.0, respectively, P less than 0.05). The need for dialysis, incidence of infections and other complications, and subsequent immunosuppressive therapy were not different in the two groups. It is concluded that DSTs and intravenous CsA initiated 24 hr prior to transplantation are capable of inducing reduced immunologic responsiveness against the specific donor. Patients treated with this therapy should receive organs from "ideal" donors without risk factors and cold ischemia time should not exceed 30 hr. Further clinical studies of this approach are warranted.
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6.
Final analysis of primary cytomegalovirus disease prevention in renal transplant recipients with a cytomegalovirus-immune globulin: comparison of the randomized and open-label trials
Snydman DR, Werner BG, Tilney NL, Kirkman RL, Milford EL, Cho SI, Bush HL Jr, Levey AS, Strom TB, Carpenter CB,, et al
Transplantation Proceedings. 1991;23((1 Pt 2):):1357-60.
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7.
Use of cytomegalovirus immune globulin to prevent cytomegalovirus disease in renal-transplant recipients
Snydman DR, Werner BG, Heinze-Lacey B, Berardi VP, Tilney NL, Kirkman RL, Milford EL, Cho SI, Bush HL Jr, Levey AS,, et al
New England Journal of Medicine. 1987;317((17):):1049-54.
Abstract
We undertook a prospective randomized trial to examine whether an intravenous cytomegalovirus (CMV) immune globulin would prevent primary CMV disease in renal-transplant recipients. Fifty-nine CMV-seronegative patients who received kidneys from donors who had antibodies against CMV were assigned to receive either intravenous CMV immune globulin or no treatment. The immune globulin was administered in multiple doses over the first four months after transplantation. The incidence of virologically confirmed CMV-associated syndromes was reduced from 60 percent in controls to 21 percent in recipients of CMV immune globulin (P less than 0.01). Fungal or parasitic superinfections were not seen in globulin recipients but occurred in 20 percent of controls (P = 0.05). Only 4 percent of globulin recipients had marked leukopenia (reflecting serious CMV disease), as compared with 37 percent of the controls (P less than 0.01). There was a concomitant but not statistically significant reduction in the incidence of CMV pneumonia (17 percent of controls as compared with 4 percent of globulin recipients). A significant reduction in serious CMV-associated disease was observed even when patients were stratified according to therapy for transplant rejection (P = 0.04). We observed no effect of immune globulin on rates of viral isolation or seroconversion, suggesting that treated patients often harbored the virus but that clinically evident disease was much less likely to develop in them. We conclude that CMV immune globulin provides effective prophylaxis in renal-transplant recipients at risk for primary CMV disease.