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SUMMARIZED CONTENTS BOOK I

Preface 1

I. The State of the Art of Transplantation 21 A. Cellular and Molecular Mechanisms 23 B. Clinical Transplantation 61 C . Immunosuppression 121

II . Current Controversies in Transplantation 137 II I . Progress in Transplantation 177

A. Immunobiology 179 Regulation of Antigen Expression 181 Immunogenic Potential of Graft Components and Various Cell Types 239 T Cell Repertoire: Receptors, Subsets, Cell Functions 265 Induction of the Transplantation Response 296 Recirculation Patterns of White Cells; Generation and Structure of the Inflammatory Response 338 Effector Mechanisms of Graft Rejection 375

Interactions Between Graft and Inflammatory Cells 375 Isolation and Function of Inflammatory Leukocytes 386 Mechanisms and Inhibition of Target Damage 412

Tolerance and Enhancement 446 Induction of Transplantation Tolerance • • 446 Mechanisms of Transplantation Tolerance 483 Isolation and F unction of Suppressor Cells 528

Materno-Fetal Interactions 554 Biological Immunosuppression (Experimental) 568

Immune Sera 568 Monoclonal Antibodies 579 Other Methods 624

Summation of Immunobiology Poster Discussions 635 B. Immunogenetics and Histocompatibility 639

H L A Matching and Transplant Survival 641 Highly Sensitized Recipients 716 Immune Reactivity and Transfusions 735 Relevance of Crossmatch Findings and Methodology 764

Sensitized Patients 764 Antibody Specificity in Sensitized Patients 773 Methods of Crossmatch 789

Molecular Genetics of the Main Histocompatibility Complex 811 Immunogenetics and Polymorphism of the Main Histocompatibility Complex 839 Posttransplant Immune Reactivity 890 Summation of Immunogenetics and Histocompatibility Poster Discussions 902

BOOK I I III . Progress in Transplantation (continued)

C . Experimental Transplantation 905 Experimental Transplantation of Islets and Endocrine Tissue 907

Pancreatic Islet Isolation 907 Sites of Pancreatic Islet Transplantation 925 Storage and Reduction of Immunogenicity 933 Immunosuppression 946 Results of Pancreatic Islet Transplantation 957 Xenografts and Artificial Pancreas 981

Transplantation of Hepatocytes 989

Experimental Pancreas Transplantation 1004 Technical Aspects and Sites of Transplantation 1004 Diagnosis and Treatment of Rejection 1023

Experimental Heart and Heart/Lung Transplantation 1034 Heart \034 Heart/Lung; Lung 1043 Diagnosis and Treatment of Rejection 1053

Experimental Liver Transplantation 1072 Experimental Transplantation of Kidneys, Composite Tissues, and Other Organs 1106

Kidney 1 1 0 6 Composite Grafts, Intestine, and Neurological Tissue It 15

Experimental Xenografts 1137 Mechanism of Action of Cyclosporine and Other Immunosuppressive Drugs 1171

Mechanism of Action of Cyclosporine 1171 Other Effects of Cyclosporine 1205

Experimental Use of Cyclosporine 1230 Distribution of Toxic Effects 1230 Analogues and Use in Combination With Other Drugs 1265

New Immunosuppressive Drugs 1284 Drugs Presumably Affecting Lymphocytes 1284 Drugs Presumably Affecting Macrophages and/or Arachinodic Acid Metabolism 1297

Preservation of Organs 1321 Liver 1321 Heart and Lung 1332 Pancreas and Islets 1337 Kidney 1348

Effects of Cyclosporine on Suboptimally Procured Kidneys 1382 Experimental Transfusions 1407

Blood Constituents 1407 Effects on Graft Survival 1420 Mechanisms of the Transfusion Effect 1429 Transfusion of the Organ Donor 1467 Effects on Tumor Growth 1473

Summation of Experimental Transplantation Poster Discussions 1479 D. Clinical Transplantation: Kidney 1483

Living Donors 1485 Related Donors 1485 Unrelated Donors 1509

Special Donor and Recipient Groups 1518 Children 1518 The Aged 1530 Systemic Disease 1535 Blacks 1546 Nondialyzed Recipients 1555

Immunological Monitoring, Graft Histology and Cytology, and Other Diagnostic Methods 1559 Immunological Monitoring 1559 Needle Biopsy 1618 Fine Needle Aspiration Biopsy 1641 Urinary Cytology 1662 Other Methods 1667

Pharmacokinetics and Side-Effects of Cyclosporine 1695 Pharmacokinetics of Cyclosporine 1695 Nephrotoxicity 1737 Diagnosis of Cyclosporine Nephrotoxicity 1769 Other Side-Effects 1801

BOOK I I I I I I . Progress in Transplantation (continued)

D. Clinical Transplantation: Kidney (continued) Immunosuppression 1833

Cyclosporine 1833 Antilymphocyte Globulins 1874 Monoclonal Antibodies 1898 Triple and Quadruple Drug Combinations 1911 Other Protocols 1961

Conversion of Immunosuppressive Therapy 1998 Preservation of Organs and Acute Tubular Necrosis 2037

Procurement and Preservation of Organs 2037 Prevention of Acute Tubular Necrosis 2056 Cyclosporine and Early Transplant Function 2074

Chronic Rejection and Long-Term Results 2111 Viral Infections 2126

Cytomegalovirus and Herpes 2126 Hepatitis (HB;AG) 2150 Acquired Immune Deficiency (HTL V-LA V) and Epstein Barr Virus 2161 Diagnosis and Prophylaxis 2181

Other Complications 2194 Urologie and Nephrologie 2194 Other 2211

Living Related Donors and Specific Transfusion 2248 E . Clinical Transplantation: Other Organs 2283

Pancreas and Islet Cell Transplantation 2285 Techniques, Results, and Complications 2285 Monitoring and Diagnosis of Rejection 2329 Islet Cell Transplantation 2352

Liver Transplantation 2373 Selection of Patients and Results 2373 Operative Procedures 2406 Immunosuppression 2431 Transplantation in Children 2447 Biopsy Findings 2451

Heart and Lung Transplantation 2487 Selection of Patients and Results 2487 Heterotopic Heart Transplantation 2512 Immunosuppression 2514 Monitoring 2527 Biopsy Findings 2560 Summation of Clinical Heart Transplantation Poster Discussions 2574

Transplantation of Other Organs 2576 Summation of Clinical Transplantation (Other Organs) Poster Discussions 2591

F . Bone Marrow Transplantation 2595 Clinical Bone Marrow Transplantation 2597 Acute and Chronic Graft-Versus-Host Disease 2655 Experimental Bone Marrow Transplantation 2707 Bone Marrow Manipulation 2735

IV. Transplantation Today and Tomorrow 2763

Author Index 2787

Subject Index 2807

CONTENTS BOOK I I I

I M M U N O S U P P R E S S I O N Cyclosporine Australian Multicentre Trial in Cadaver Renal Transplantation Comparison of Short-

and Long-Term Cyclosporine A Therapy With Conventional Therapy B.M. Hall, A.G.R. Sheil, DJ. Tiller, I . Hardie, J. Mahoney, G. Thatcher,

T. Mat hew, N. Thompson, and P. Miach 1833

Risk Factors for Cadaveric Donor Allograft Survival in Cyclosporine-Prednisone-Treated Recipients B.D. Kahan, R. Mickey, S.M. Flechner, M.J. Lorber,

CA. Wideman, R.H. Kerman, P. Terasaki, and C.T. Van Buren 1835

Factors Influencing Kidney Graft Survival in the Cyclosporine Era: A Multivariate Analysis / . Tiwari, P.I. Terasaki, and M.R. Mickey 1839

The Effect of Cyclosporine A in Cadaver Donor Retransplants: A Surprising Effect of the Sex of the Donor J.M. Cecka, J. Cicciarelli, and P.I. Terasaki 1842

Cyclosporine Versus Azathioprine in High Risk Cadaver Kidney Transplant Recipients: A Prospective Randomized Study D.J. Norman, P. Wetzsteon,

J.M. Barry, and W.M. Bennett 1845

The Results of Renal Transplantation With Cyclosporine in Immunologically High-Risk Patients... R.M. Dickerman, P. Vergne-Marini, J. Langley, G. Trevino,

R. Velez, K. Brinker, D. Nesser, D. Long, and A.R. Hull 1846

Cyclosporine in Cadaveric Renal Transplantation: A Comparison of Two Immunosuppressive Protocols M. Koyle, R. Glassock, J. Rajfer, and H. Ward 1849

Does Cyclosporine Eliminate the Need for Preparatory Blood Transfusions? D. W. Stevens, CP. Jensen, andL.E. Stevens 1850

Two-Year Results of a Prospective Randomized Comparison of Cyclosporine/Low Dose Steroid Immunosuppression With Azathioprine and Steroids in Renal Transplantation C.J. Mieny, P.J. Nel, J.H.R. Becker, and J.P. Pretorius 1852

A Prospective Study on the Influence of Cyclosporine and Azathioprine on Renal Allograft Survival and Function .... F.C Henny, A.M.M. Kootte, J.H. Van Bockel,

W.M. Baldwin, J. Hermans, B. Bos, L.A. van Es, and L.C Paul 1853

Two-Year Fate of 100 Kidney Transplants Treated With Low-Dose Cyclosporine Without Biopsy Guidelines G. Civati, E. Del Favero, B. Brando, M.L. Broggi,

G. Busnach, D. Forti, L . Belli, and L . Minetti 1856 (Continued)

CONTENTS (continued)

Low-Dose Cyclosporine or Azathioprine One Year After Renal Transplantation M.A. Forwell, J.A. Bradley, J.D. Briggs, M.W. Brown, BJ.R. Junor,

S.G. Macpherson, and M.A. Watson 1858

Quality of Life on Cyclosporine Versus Conventional Therapy R.G. Simmons and L.K. Abress 1860

Renal Transplantation in Presensitized Patients Treated With Cyclosporine D. Albrechtsen, G. Lundgren, A. Bratlie, H. Brynger, I . Fehrmann, L . Frödin,

H. Gabel, A. Lindholm, and A. Flatmark 1862

Primary Cadaveric Renal Transplantation Using Cylosporine in Patients Over Fifty Years of Age D.M. Mandelbaum, M.L. Henry, B.G. Sommer,

and R.M. Ferguson 1863

A Randomized Study of Cyclosporine With and Without Prednisone in Renal Allograft Recipients A.S. MacDonald, P. Daloze, R. Dandavino, S. Jindal,

L . Bear, J.B. Dossetor, J. Klassen, CR. Stiller, B. Lockwood, CE. Reeve, and the Canadian Transplant Group 1865

Cyclosporine-Steroids Versus Conventional Therapy in Cadaver Kidney Transplantation: Analysis of a Randomized Trial at Two Years P. Gianello,

J.P. Squifflet, Y. Pirson, M. Stoffel, Th. Dereme, and G.PJ. Alexandre 1867

Cadaveric Renal Transplantation After Pulsatile Perfusion, Histocompatibility Matching, and Conversion to Cyclosporine Therapy M. Milgrom,

G.K. Kyriakides, V. Esquenazi, L . Olson, and J. Miller 1873

Antilymphocyte Globulins Superior Renal Allograft Survival and Decreased Rejection With Early High-Dose

and Sequential Multi-Species Antilymphocyte Globulin Therapy F. Thomas, P. Cunningham, J. Thomas, U. Gross, D. Gaskins, C Sash, and K. Parker 1874

Sequential Antilymphoblast Globulin and Cyclosporine For Renal Transplantation B.G. Sommer, M.L. Henry, and R.M. Ferguson 1879

Place of Antilymphocyte Globulins in the Immunosuppressive Regimen for Kidney Transplantation J . L . Touraine, N. Lefrancois, J.M. Dubernard, JL. Gamier,

J.P. Eygonnet, N. Gibelin, H. Betuel, and J. Traeger 1881

Use of Cyclosporine and Minnesota Antilymphoblast Globulin in the Early Postoperative Treatment of Primary Cadaveric Renal Transplant Recipients

W. Kupin, K.K. Venkat, H.K. Oh, S. Dienst, and N. W. Levin 1882

Treatment of Acute Rejection Crisis by Antilymphocyte Globulins: A Randomized Prospective Study in Pediatric Kidney Transplantation M. Broyer, P. Niaudet,

M. Bijaoui, and M-F. Gagnadoux 1886

(Continued)

CONTENTS (continued)

Use of Antithymocyte Globulin and Cyclosporine to Treat Steroid-Resistant Rejection Episodes in Renal Transplant Recipients A.I. Benvenisty, G.A. Tannenbaum,

D.J. Cohen, G. Appel, and M.A. Hardy 1889

Antilymphoblast Globulin Treatment of Steroid-Resistant Rejection in Cyclosporine Immunosuppressed Renal Transplant Recipients V.A. Tellis, A.J. Matas,

T.A. Quinn, D. Glicklich, R.J. Weiss, RJ. Soberman, and FJ. Veith 1892

Alternative Antirejection Treatment With Steroids or Antilymphoblast Globulin in Renal Transplant Patients Receiving Cyclosporine S.A. Veremis,

M.S. Maddux, R. Pollak, S.S. Kline, and M.F. Mozes 1893

Antibody Formation Following Administration of Antilymphocyte Serum G. Niblack, K. Johnson, T. Williams, W. Green, R. Richie, and R. MacDonell 1896

Monoclonal Antibodies Prophylactic Use of an Antilymphocyte Monoclonal Antibody Following Renal

Transplantation: A Randomized Controlled Trial P.J. Friend, R.Y. Calne, G. Hale, H. Waldmann, D.B. Evans, K. Rolles, S. Thiru, andS. Gore 1898

The Use of OKT3 to Treat Steroid-Resistant Renal Allograft Rejection in Patients Receiving Cyclosporine J.R. Thistlethwaite, Jr, B.W. Haag, A.O. Gaber,

J.K. Stuart, A J. Aronson, J.T. Mayes, D.M. Lloyd, and F.P. Stuart 1901

Immunosuppression With Monoclonal Anti-T3 Antibody (WT32) in Renal Transplantation W.J.M. Tax, H.M.W. van de Heijden, H.W. Willems,

A J. Hoitsma, J.H.M. Berden, PJ.A Capel, and R.A.P. Koene 1905

Rescue of Severe Steroid-Resistant Rejection With OKT3.PAN C Ponticelli, E. Rivolta, A. Tarantino, A. De Vecchi, and A. Vegeto 1908

Anti-T12 Monoclonal Antibody Therapy of Acute Renal Allograft Rejection E.L. Milford, CB. Carpenter, R.L. Kirkman, N.L. Tilney, G. Mazoujian,

T.B. Strom, J.M. Lazarus, S.F. Schlossman, R.D. Guttmann, R. Lowry, L . Rocher, D.A. Campbell, Jr, D.M. Salomon, and W.W. Pfaff 1910

Triple and Quadruple Drug Combinations Triple Combination of Low-Dose Cyclosporine, Azathioprine, and Steroids in First

Cadaver Donor Renal Allograft D. Fries, C Hiesse, B. Charpentier, P. Rieu, N. Neyrat, M. Cantarovich, M. Ouziala, J. Bellamy, and G. Benoit 1911

Potent Immunosuppression Overcomes Retransplantation, Presensitization, and Historical Positive Crossmatch as Transplant Risk Factors A.O. Gaber,

J.R. Thistlewaite, Jr, B.W. Haag, J. Stuart, J. Mayes, S. Fellner, and F.P.Stuart 1915

(Continued)

CONTENTS (continued)

Quadruple Therapy for Cadaver Renal Transplantation M.H. Deierhoi, H. W. Sollinger, M. Kalayoglu, and F. O. Beizer 1917

Triple Drug Therapy: An Alternative Regimen in Renal Transplantation M.L. Henry, B.G. Sommer, and R.M. Ferguson 1920

Triple and Quadruple Therapy After Renal Transplantation in Patients From Developing Countries M. Slapak, T. Shell, N. Digard, D.C. Gosling,

G. Qerchi della Rovera, R.C. Crockett, and K. Ahmed 1922

Immunosuppression With Cyclosporine, Azathioprine, and Prednisolone in Cadaver Renal Allograft Recipients R.M. Jones, J.A. Murie, R. Allen, A. Jaskowski,

and P.J. Morris 1926

Quadruple Drug Therapy Prevents Graft Loss From Acute Rejection Without Increasing Mortality J.A. Light, A. Aquino, A. Ali, R. Rodriquez, and S. Ali 1927

Intermodal Immunosuppression for Cadaver Renal Transplantation: Results Using Antilymphocyte Globulin, Azathioprine, Cyclosporine, and Prednisone

P. Halloran, D. Ludwin, R. Bear, M. Aprile, B. McQuarrie, R. Poole, and N.White 1931

A Controlled Prospective Trial of Triple Therapy With Low-Dose Azathioprine, Cyclosporine, and Methylprednisolone in Renal Transplantation A. De Vecchi,

A. Tarantino, G. Montagnino, F. Egidi, A. Vegeto, L . Berardinelli, andC Ponticelli 1933

A Controlled Trial of Triple Therapy in Renal Transplantation J.R. Salaman, P.J.A. Griffin, W.B. Ross, and J.D. Williams 1935

Reduction of Nephrotoxicity and Improvement of Immunosuppression by Combination of Cyclosporine A and Azathioprine W.D. Schareck, V.T. Hopt,

GH. Müller, B. Greger, T. Risler, andH. Bockhorn 1937

Decreased Interleukin 2 Production and Increased LEU 2a-Positive Suppressor Cells in Renal Transplant Patients on Triple Therapy with Mizoribine, Cyclosporine A, and Prednisolone M. Okubo, Y. Kaneko, M. Mizukoshi, K. fnoue, N. Sato,

K. Kamata, X-M. Chen, H. Uchida, and T. Endo 1940

A Flexible Immunosuppression Protocol for Organ Transplantation Utilizing Cyclosporine, Azathioprine, and Prednisone R.T. Schweizer, M. Rovelli,

L . Roper, and S.A. Bartus 1944

Cox Regression Analysis of Outcome Risk Factors in 519 Renal Allograft Recipients D.M. Canafax, S.K. Savik, CA. Draxler, CT. Le, N.L. Ascher, W.D. Payne,

D.E.R. Sutherland, R.J. Migliori, R.L. Simmons, J.S. Najarian, and D.S. Fryd 1947

Influence of Total Lymphoid Irradiation Plus Cyclosporine on Kidney Graft Outcome in High-Risk Patients R. Cortesini, P. Berloco, A. Famulari, A. Trovati,

M. Iappelli, E. Renna Molajoni, A. Bachetoni, R. Pretagostini, G. Marinucci, A. Capua, M. Rossi, and D. Alfani 1949

(Continued)

CONTENTS (continued)

Management of Immunosuppressive Problems in Renal Allograft Recipients M.I. Lorber, S.M. Flechner, CT. Van Buren, K. Sorensen, R.H. Kerman,

andB.D.Kahan 1951

Immunosuppression Wi th Low-Dose Cyclosporine Combined With Bredinin and Prednisolone K. Aso, H. Uchida, K. Sato, K. Yokota, T. Osakabe,

Y. Nakayama, M. Ohkubo, K. Kumano, T. Endo, K. Koshiba, K. Watanabe, and N. Kashiwagi 1955

An Immunosuppressive Protocol Compatible With the United States Kidney Transplant Diagnosis Related Grouping F.P. Stuart, J.K. Stuart,

J.R. Thistlethwaite, Jr, A.O. Gaber, and J. Mayes 1959

Other Protocols Pretreatment of Human Renal Allografts With Monoclonal Antibodies to Induce

Long-Term Tolerance D. Taube, K.I. Welsh, M. Bewick, F.E. Dische, A. Palmer, V. Parsons, and S. Snowden 1961

Results of the South-Eastern Organ Procurement Foundation Strategy for Transplanting Sensitized Patients R.R. Bollinger, W. Vaughn, F. Sanfilippo,

B. Lucas, W. Lefor, T. Peters, and W. Bias 1964

A Randomized Study of Buffy Coat Transfusions in Cadaveric Renal Transplantation DJ. Norman, L . Fletcher, and J. Barry 1967

Has Cyclosporine Really Relegated Pretransplant Blood Transfusion to Therapeutic Obsolescence? J.S. Melzer, R.M. Musing, N.J. Feduska, S.J. Tomlanovich,

F. Vincenti, WJ.C Amend, M. Garovoy, and O. Salvatierra, Jr 1971

Wide Field Low-Dose Total Lymphoid Irradiation in Clinical Kidney Transplantation J.A. Myburgh, A.M. Meyers, J.R. Botha, P.D. Thomson, J.A. Smit, S. Browde,

andR.Lakier 1974

Comparison of Three Immunosuppressive Regimens in High-Risk Patients: Immunologic Aspects E. Renna Molajoni, A. Bachetoni, P. Cinti, F. Sallustio,

M. Rossi, R. Pretagostini, A. Orlandini, P. Berloco, D. Alfani, and R. Cortesini 1978

Adverse Effects of Low-Dose Azathioprine on Australian Primary Graft Survival (1978-1984) A.P.S. Disney 1981

M L R Suppression and MLR-Suppressor Activity Induced by Thoracic Duct Drainage Prior to Transplantation Y. Ono, S. Ohshima, T. Kinukawa,

O. Matsuura, and S. Hirabayashi 1985

Renal Allograft Survival in Highly Sensitized Patients Treated With Cyclosporine M. Doran, M. Coppage, J. Ruth, J. Fish, O. Winsen, andS. Vaidya 1988

(Continued)

CONTENTS (continued)

Early Postoperative Monitoring of Natural Anti-A and Anti-B Isoantibodies in ABO-Incompatible Living Donor Renal Allografts R. Reding, J.P. Squifflet,

D. Latinne, M. De Bruyere, Y. Pirson, and G.P.J. Alexandre 1989

The Impact of Selected Risk Variables on the Outcome of Renal Transplantation K. V. Rao, J.H. Andresevic, and A.L. Ney 1991

Effects of Pretransplant Splenectomy: Univariate and Multivariate Analyses B.A. Lucas, W.K. Vaughn, F. Sanfilippo, T.G. Peters, and J.W. Alexander 1993

A Controlled Trial Comparing Sequential Antilymphocyte Sera and Cyclosporine Therapy to Conventional Therapy in Renal Transplant Recipients

C.J. Cardella, M.E. Harding, G.A. deVeber, J. Honey, and G. T. Cook 1996

C O N V E R S I O N OF I M M U N O S U P P R E S S I V E T H E R A P Y Prolonged Cyclosporine Therapy to Induce Solid Engraftment After Renal

Transplantation W. Weimar, D.J. Versluis, G.J. Wenting, F.H.M. Derkx, M.A.D.H. Schalekamp, and J. Jeekel 1998

Improvement of Renal Function After Conversion From Cyclosporine Only to Prednisolone-Azathioprine Followed by Late-Onset Graft Failure in Renal Transplant Patients A.M. Tegzess, W.J. van Son, J.M. Beelen, W.J. Sluiter,

S. Meijer, and M.J.H. Slooff 2000

Conversion From Azathioprine and/or Prednisolone to Cyclosporine A in Renal Allograft Recipients H. Ebel and H. Lange 2005

Conversion From Cyclosporine to Azathioprine Improves Renal Function Without Increased Risk of Graft Failure M.S. Maddux, S.A. Veremis, R. Pollak,

and M.F. Mozes 2007

Safe Conversion from Cyclosporine P.L. Adams, J.M. Burkart, R.W. Hamilton, W.B. Lorentz, M.C. Browning, J.H. Meredith, and E.R. Heise 2010

The Fate of Living Related Donor Kidney Recipients After Conversion From Cyclosporine to Azathioprine T. Oka, Y. Omori, I . Aikawa, T. Yasumura,

J. Nakai, and S. Matsui 2012

Elective Conversion From Cyclosporine to Azathioprine: Long-Term Follow-Up P.S. Veitch, J.D. Taylor, J. Feehally, J. Walls, and P.R.F. Bell 2017

Cyclosporine to Azathioprine Conversion in Cadaveric Renal Transplant T.A. Gonwa, D.D. Nghiem, and R.J. Corry 2018

Withdrawal of Methylprednisolone at the Sixth Month in Renal Transplant Recipients Treated With Cyclosporine L . Cristinelli, G. Brunori, G. Setti, A. Manganoni,

A.M. Manganoni, F. Scolari, S. Sandrini, P. Scaini, S. Savoldi, C. Camerini, and R. Maiorca 2021

(Continued)

CONTENTS (continued)

Corticosteroid Withdrawal With Substitution of Azathioprine in Cyclosporine-Treated Primary Cadaveric Renal Transplant Recipients W. Kupin,

K.K. Venkat, D. Florence-Green, C. Norn's, H.K. Oh, S. Dienst, and N.W. Levin 2024

Stopping Prednisone in Kidney Transplant Recipients Taking Cyclosporine: Safety Conditions J. Lloveras, J. Masramon, A. Orfila, X. Cuevas, and J. Aubia 2027

Effects of H L A Matching and Panel Reactive Antibodies in the Development of Rejection After Conversion of Cyclosporine To Azathioprine S.M. Zemel,

S. Y. Shen, M.R. Weir, FJ. Dagher, and F.R. Bent ley 2029

Conversion of Cyclosporine to Azathioprine in Renal Transplant Patients ....S.Y. Shen, S.M. Zemel, M.R. Weir, F.J. Dagher, and F.R. Bentley 2032

P R E S E R V A T I O N OF O R G A N S A N D A C U T E T U B U L A R NECROSIS Procurement and Preservation of Organs The Value of Hormonal Therapy in Improving Organ Viability in the Transplant

Donor D. Novitzky, D.K.C. Cooper, and B. Reichart 2037

Preservation of the Cortical Renal Microcirculation: A Prerequisite for Immediate Renal Allograft Function D. Anaise, H. Lehr, H. Atkins, Z. Oster, A. Arnold,

W.C Waltzer, and F. T. Rapaport 2039

Usefulness of Radionuclide Scintiphotography to Evaluate Preserved Kidney Viability K. Sato, H. Asari, Y. Masaki, M. Uchida. K. Aso, K. Yoda, K. Ishii, D. Anaise,

W. Waltzer, andF.T. Rapaport 2043

A Controlled Comparison of Kidney Preservation by Two Methods: Machine Perfusion and Cold Storage J.E. Heill, D.M. Canafax, D.E.R. Sutherland,

R.L. Simmons, M. Dunning, and J.S. Najarian 2046

Preservation Effect on Oligo-anuria in the Cyclosporine Era: A Prospective Trial With 26 Paired Cadaveric Renal Allografts R. Mendez, R.G. Mendez, N. Koussa,

S. Cats, T.P. Bogaard, and U. Khetan 2047

Limiting Factors in Successful Preservation of Cadaveric Kidneys With Ischemia Times Exceeding 50 Hours G.M. Abouna, M.S. Samhan, M.S.A. Kumar,

A.G. White, and O.S.G. Silva 2051

Prevention of Acute Tubular Necrosis The Effect of Intraoperative Fluid Management of the Incidence of Acute Tubular

Necrosis... /. Dawidson, P. Peters, A. Sagalowsky, D. Abshier, and L . Coorpender 2056 (Continued)

CONTENTS (continued)

The Causes and Consequences of Failure of Cadaver Kidneys to Function: A Case-Control Study M. Aprile, P. Halloran, S. Zeldin, P. Brasher,

and V. Farewell 2058

Successful Long-Term Preservation and Transplantation of Human Cadaveric Kidneys J. Szmidt, M. Karolak, K. Made], T. Sablinski, S. Frunze,

A. Je I one k, and J. Nielubowicz 2060

The Influence of Cold Ischemia on the Function of Cadaveric Renal Transplants in Cyclosporine A-Treated Patients.... Hm. van Goor, R.M.H. Wijnen, W. Geerlings,

A.M. Tegzess, and M.J.H. Slooff 2061

Important Role for Mannitol in the Prevention of Acute Renal Failure After Cadaveric Kidney Transplantation A.J. Hoitsma, A.F. Groenewoud,

J.U.M. Berden, H.J.J, van Lier, and R.A.P. Koene 2063

Increased Incidence of Immediate Function After Cadaveric Kidney Transplantation Resulting From Lidocaine Pretreatment of the Donor W. Rowinski,

A.O. Gaber, A. Chmura, A. Kobryn, T. Lazowski, A. Zawadzin, T. Or lows ki, F. Buckingham, J. Stuart, J. Mayes, J.R. Thistlethwaite, Jr, and F.P. Stuart 2065

Prediction of Risk Factors in Acute Tubular Necrosis Following Cadaver Kidney Transplantation J . L . Gamier, A. Mercatello, D. Long, A. Zannier, J . L . Faure,

J . L . Touraine, J.F. Moskovichenko, J.M. Dubernard, and J. Traeger 2068

Does the Donor Age Influence Graft Survival in Renal Transplantation? G. Sakellariou, M. Daniilidis, E. Alexopoulos, A. Karagiannis,

and M. Papadimitriou 2071

Cyclosporine and Early Transplant Function Improved Early Course After Cadaveric Renal Transplantation by Reducing the

Cyclosporine Dose and Adding Azathioprine G. Lundgren, D. Albrechtsen, H. Brynger, A. Fiatmark, L . Frodin, H. Gabel, H. Persson, and CG. Groth 2074

Successful Use of Cyclosporine in Renal Grafts With Prolonged Ischemic Times R. W.S. Chang, D. Saltissi, A. AI K had er, M. Abomelha, and M. Jawdat 2080

The Effect of Cyclosporine on the Early Postoperative Function of Allografted Kidneys With Warm Ischemic Damage S. Ohshima, T. Fujita, H. Asano,

andY.Ono 2081

The Effect of Acute Tubular Necrosis on Cyclosporine-Treated Kidney Transplants O.N. Paramasivan, P.J.A. Griffin, W.B. Ross, and J.R. Salaman 2085

Increase in N-Acetyl-Beta-Glucosaminidase Excretion as a Marker of Kidney Damage in Cyclosporine-Treated Renal Allografts A.W. Avolio, G. Nanni, F. Citterio,

U. Pozzetto, S.C Magalini, B. Zappacosta, R.M. Tacchino, C Zuppi, and M. Castagneto 2086

(Continued)

CONTENTS (continued)

Effect of Initial Versus Delayed Cyclosporine Therapy in Cadaveric Renal Transplant Patients R. Lewis, E. Hodge, A. Novick, D. Steinmuller, S. Streem,

R. Cunningham, C. Swift, M. Goormastic, and K. Badhwar 2088

The Long-Term Deleterious Effect of Delayed Graft Function in Cyclosporine-Treated Renal Allograft Recipients L.L. Rocher, C. Landis, D.C. Dafoe,

C. Keyserling, R.D. Swartz, and D.A. Campbell, Jr 2093

Significance of Delayed Function in Cyclosporine-Treated Cadaver Kidney Transplants P. Belitsky, AS. MacDonald, J. Gajewski, J. Boudreau,

H. Bitter-Suermann, and A. Cohen 2096

Cyclosporine Immunosuppression and Delayed Graft Function In 455 Cadaveric Renal Transplants RJ. Taylor, M.D. Landreneau, L . Makowka,

T.J. Rosenthal, R.D. Gordon, A.G. Tzakis, T.E. Starzl, and T.R. Hakala 2100

Cyclosporine Immunosuppression and Perfusion Preservation of Cadaver Kidneys J. W. Bradley, S.I. Cho, A.B. Cosimi, and A.P. Monaco 2104

Impact of Immunosuppressive Regimen on Early Posttransplant Renal Function J.H. Hong, G.S. Lipkowitz, C.Y. Yen, S.M. Greenstein, T. Manis,

and K.M.H. Butt 2106

C H R O N I C R E J E C T I O N A N D L O N G - T E R M R E S U L T S First Kidney Transplants in Children 5 Years of Age or Younger J.S. Najarian,

S.K.S. So, R.L. Simmons, S.M. Mauer, T.E. Nevins, D.E.R. Sutherland, N.L. Ascher, BM. Chavers, W.ü. Payne, and D.S. Fryd 2111

High Long-Term Graft Survival Rates in Kidney Transplantation With the Sequential Association of Antithymocyte Globulin and Cyclosporine A Monotherapy

M. Hourmant, F. Buzelin, P. Dubigeon, and J.P. Soulillou 2113

New Approach to Management of Chronic Vascular Rejection With Prostacyclin Analogue After Kidney Transplantation S. Teraoka, K. Takahashi, H. Torna,

T. Yagisawa, Y. Yamaguchi, T. Sanaka, S. Fuchinoue, H. Honda, T. Kawai, K. Tanabe, M. Yasuo, Y. Hayasaka, T. Agishi, and K. Ota 2115

Long-Term Survivor of Kidney Transplantation, Mortality, Rehabilitation, and Immunologic Reactivities H.M. Lee, N. Kenyon, G. Mendez-Picon,

and M.P. Posner 2120

Prevention of Chronic Rejection by Cyclosporine and Prednisone A.N. Arnold, D. Anaise, F. Miller, W.C. Waltzer, and F.T Rapaport 2122

Promethazine: Results of Triple-Drug Immunosuppression for Kidney Transplantation T. Ortowski, Z. Gaciong, and L . Pqczek 2124

(Continued)

CONTENTS (continued)

V I R A L I N F E C T I O N S Cytomegalovirus and Herpes The Source of Cytomegalovirus Infection in Seropositive Renal Allograft Recipients Is

Frequently the Donor Kidney J.E. Grundy, M. Super, S. Lui, P. Sweny, and P.D. Griffiths 2126

The Clinical Application of a Rapid Diagnostic Test for the Detection of Cytomegalovirus Infection in Renal Transplant Recipients S.F. Lui, P. Sweny,

J.E. Grundy, A. Blaxill, P.D. Griffiths, J.E. Moorhead, and O.N. Fernando 2129

Cytomegalovirus Infection in Fifty-Two Renal Transplant Recipients E. Godeaut, N. Galezowski, P. Berche, C. Bonissol, A. Debure, and H. Kreis 2131

Interaction Between Cytomegalovirus and Staphylococcus Aureus Protein A in Immunoglobulin Secretion and D N A Synthesis T. Paul in and O. Ringden 2133

Proliferative Response Against Cytomegalovirus and Prognosis of Renal Transplant and IgA Nephropathy Patients T. Sakamaki, H. Kashiwabara, K. Omori,

N. Nagata, T. Hachisu, S. Tateno, H. Shishido, and T. Yokoyama 2135

Morbid Outcome of Cytomegalovirus-Negative Transplant Recipients Receiving Cytomegalovirus-Positive Kidneys M.R. Weir, B.C. Irwin, A.W. Maters,

G. Genemans, S.Y. Shen, P. Charache, and G.M. Williams 2137

Viral Infections in Kidney Transplant Patients Immunosuppressed With Cyclosporine K. Takahashi, T. Yagisawa, S. Teraoka, H. Torna, T. Agishi, K. Ota,

and S. Kobayashi 2142

Hepatitis (HBs Ag) Renal Transplantation in Hepatitis B Surface Antigen-Positive Patients A.G. White,

M.S.A. Kumar, O. Strannegard, and G.M. Abouna 2150

Prognostic Significance of Hepatitis B Surface Antigenemia in Cadaveric Renal Transplant Patients E. Rivolta, A. De Vecchi, A. Tarantino, C Castelnovo,

L . Berardinelli, and C Ponticelli 2153

The Influence of Hepatitis B Infection on the Outcome of Renal Allotransplantation G.L. Flagg, H. Silberman, S.K. Takamoto, and T.V. Berne 2155

Hepatitis B and Renal Transplantation..../). Scott, A. Mijch, CR. Lucas, V. Marshall, N. Thomson, and R. Atkins 2159

(Continued)

CONTENTS (continued)

Acquired Immune Deficiency (HTLV-LAV) and Epstein-Barr Virus Observations Relating to the Incidence of Acquired Immune Deficiency Syndrome and

Other Possibly Associated Conditions In a Large Population of Renal Transplant Recipients N.J. Feduska, H.A. Perkins, J. Melzer, W.J.C. Amend, F. Vincenti,

S. Tomlanovich, M. Garovoy, and O. Salvatierra 2161

The Value of Human T-Lymphotropic I I I Screening at the Time of Cross-Match S.A. Karmi, S.C. Frantz, M.L. Sloan, S.L. Milliken, and T.M. Phillips 2167

Human T-Lymphotropic Virus I I I Antibody Screening in Kidney Transplant Recipients and Patients Receiving Maintenance Hemodialysis.... H-H. Neumayer,

W. Fassbinder, S. Kresse, and K. Wagner 2169

Investigation of Human T-Lymphotropic Virus I I I Serology in a Renal Transplant Population R.H. Kerman, SM. Flechner, CT. Van Buren, M.I. Lorber,

G. Dawson, L . Falk, R. Gutierrez, J.B. Hollinger, and B.D. Kahan 2172

H T L V - I I I / L A V Infection in Kidney and Liver Transplantation D. Shaffer, R.H. Pearl, R.L. Jenkins, S.M. Hammer, W.J. Dzik, J.E. Groopman,

P.N. Benotti, and A.P. Monaco 2176

Chronic Epstein-Barr Virus Reactivation After Renal Transplantation: Immunosuppression With Cyclosporine Versus Azathioprine G. Hillebrand,

L.A. Castro, S. Schleibner, W. Land, and J.H. Gurland 2179

Diagnosis and Prophylaxis T Cell Subset Analysis Predicts Virus Infection but not Rejection in Cyclosporine

A-Treated Renal Allograft Recipients H.J. Metselaar, J. Jeekel, Ph.H. Rothbarth, L.M.B. Vaessen, G.J. Wenting, and W. Weimar 2181

Cell Cycle Analysis of Activated Mononuclear Blood Cells of Renal Allograft Recipients A.J. Walle, M. Suthanthiran, Z. Darzynkiewicz, A.L. Rubin,

and K.H.Stenzel 2183

Monitoring of the Serum Neopterin/Creatinine Ratio in Renal Transplantation D. Hacini, C. Guerin, P. Berthoux, G. Ville, and F. Berthoux 2185

Monitoring of Interferon-a2-Treated Renal Transplant Patients Using Fine-Needle Aspiration Biopsy U. Dendorfer, C. Hammer, S. Schleibner, L.A. Castro,

G. Hillebrand, W. Land, and W. Brendel 2187

Effectiveness of Oral Acyclovir Prophylaxis in Renal Transplant Recipients M. Stoffel J.P. Squifflet, Y. Pirson, M. Lamy, and G.P.J. Alexandre 2190

(Continued)

CONTENTS (continued)

O T H E R C O M P L I C A T I O N S Urologie and Nephrologie Percutaneous Transluminal Angioplasty: The Procedure of Choice for Renal Allograft

Artery Stenosis S.M. Greenstein, A. Verständig, G.K. McLean, D.C. DaFoe, D.R. Burke, S.G. Meranze, A. Naji, K.L. Brayman, R.A. Grossman, LJ. Perloff,

and C.F. Barker 2194

Hemodialysis or Continuous Ambulatory Peritoneal Dialysis Before Transplantation: Prospective Comparison of Clinical and Hemodynamic Outcome

A. Odor-Morales, G. Castorena, C. Jimeno, J.C Pena, J. Bordes, C de la Rosa, and F. Chävez-Peön 2197

Rejection of the Ureter: A New Component of Renal Allograft Rejection J.P. Katz, A. Hakki, S.M. Katz, and S. Simonian 2200

Percutaneous Interventional Radiologic Procedures for Diagnosis and Treatment of Urologie Complications in Renal Transplant Patients J.J. Warner,

T.A.S. Matalon, D.N. Rabin, S.K. Patel, SC. Jensik, and F.K. Merkel 2203

Percutaneous Interventional Procedures in the Management of Urologie Complications of Renal Transplantation D. Van Gansbeke, C Matos,

P. Gevenois, L . De Pauw, J. Struyven, and P. Kinnaert 2205

The Incidence of Membranoproliferative Glomerulonephritis in Renal Allografts M.J. Moritz, J.F. Burke, B.E. Jarrell, and R.A. Carabasi 2206

Disappearance of Mesangial IgA Deposits From the Kidneys of Two Donors After Transplantation X. Ceuvas, J. Lloveras, M. Mir, J. Aubia, and J. Masramon 2208

Parameters Governing Function in 100 Consecutive Cadaveric Kidney Transplants K.V. Athersmith, N.J. Digard, B. Gardner, K.R. Harris, G. Venkat-Raman,

andM.Slapak 2210

Other Cancers Following Cyclosporine Therapy /. Penn 2211

Cancer Incidence in Renal Transplant Patients Treated With Azathioprine or Cyclosporine A.G.R. Sheil, S. Flavel, A.P.S. Disney, T.H. Mathew,

and B.M.Hall 2214

Human Antibody Response to Antilymphocytic Preparations in Renal Transplant Patients CF. Shield HI, AJ. Fucello, P. Marlett, and G. Goldstein 2217

Deep Venous Thrombosis After Renal Transplantation J.A. Murie, R.D. Allen, CA. Michie, and P.J. Morris 2219

(Continued)

CONTENTS (continued)

Prospective Study and Long-Term Follow-Up of Liver Damage in Renal Transplant Recipients S. Takahara, H. Ihara, Y. Ichikawa, S. Nagano, T. Fukunishi,

T. Sonoda, and Y. Shinji 2221

Mechanism of Liver Cell Injury From Iron Overload in Renal Transplant Recipients K. V. Rao and W.R. Anderson 2225

Symptomatic Renal Osteodystrophy After Renal Transplantation: Treatment with 1-a-Hydroxycholecalciferol P.S. Williams, A.N. Hillis, A.J. Carty, R.A. Sells,

and J.M. Bone 2227

Type I I Hyperlipoproteinemia, Hyperapobetalipoproteinemia, and Hyperalphalipoproteinemia Following Renal Transplantation: Prevalence and Precipitating Factors R.P. Lowry, G. Soltys, R. Mangel, P. Kwiterovitch,

and A.D. Sniderman 2229

Peptic Ulcer Disease Following Renal Transplantation S.J. Knechtle, K. Kempf, and R.R. Bollinger 2233

Adrenal Function as an Index of the Immunosuppressive Activity of Glucocorticoids (Prednisolone) in Renal Allograft Recipients... M. Kozaki, T. Hirano, and K. Oka 2237

Testicular Histology in Patients Receiving Renal Transplantation H. Nakamura, M. Takao, K. Nagakura, M. Hata, M. Murai, K. Mukai, and S. Tamai 2240

Transmission of Medulloblastoma From Cadaver Donor to Three Organ Transplant Recipients... TV. Lefrancois, J . L . Touraine, D. Cantarovich, F. Cantarovich,

J . L . Faure, J.M. Dubernard, G. Dureau, J.J. Colpart, R. Bouvier, and J. Traeger 2242

Kaposi's Sarcoma After Renal Transplantation M. Al-Suleiman, A. Haleen, and A. Al Khader 2243

Chromosome Aberration in Kidney Transplant Recipients M. Fukuda, I . Aikawa, Y. Ohmori, N. Yoshimura, I . Naki, S. Matui, and T. Oka 2245

L I V I N G R E L A T E D D O N O R S A N D S P E C I F I C T R A N S F U S I O N Three Year Experience of Donor Specific Transfusion and Concomitant

Cyclosporine A A.N. Hillis, J. Duguid, CM. Evans, J.M. Bone, and R.A. Sells 2248

Optimization of Donor Specific Blood Transfusion in Kidney Transplantation J.S. Cheigh, M. Suthanthiran, W.T. Stubenbord, M. Fotino, R.R. Riggio,

N. Schechter, K.H. Stemel, and A.L. Rubin 2250

Donor Specific Transfusions: A Five Year Experience With Alternative Protocols D.J. Norman, K. Henell, L . Fletcher, and J. Barry 2252

Kinetics of Antidonor Mixed Lymphocyte Culture Responses in Donor Specific Transfusion Plus Azathioprine-Treated Patients W.J. Burlingham, A. Grailer,

E.M.F. Sparks-Mackety, P.M. Sondel, and H. W. Sollinger 2255 (Continued)

CONTENTS (continued)

Interleukin 2 Response Inhibition Following Donor Specific Transfusions Given With Azathioprine J.D. Tyler, C.B. Anderson, and G.A. Sicard 2258

Antiidiotypic Antibody Activity in Patients Receiving Donor Specific Transfusions and Cyclosporine A K.N. Stewart, D.A. Power, A.N. Hills, and G.R.D. Catto 2262

Role of Donor Specific Blood Transfusions in Prolongation of Kidney Graft Survival T. Matsumoto, K. Sakagami, and K. Or it a 2264

Evaluation of the Risk Factors Associated With Donor Specific Blood Transfusion S. Vaidya, B.G. Sommer, E.A. Paget, M. Koegel, and R.M. Ferguson 2268

The Effects of Donor Specific Transfusion and Cyclosporine A On Graft Outcome M. Haberai, Z. Oner, N. Aybasti, G. Arslan, M. Turan, and N. Bilgin 2269

Donor Specific Blood Transfusions Do Not Improve Graft Survival in Living Related Donor Transplantation V.D. Garcia, E.S. Kraemer, CA. Prompt, A. Santos,

J. Caovila, A. Duarte, A.N. Filho, andJ.C Goldani 221 \

Donor Specific Blood Transfusion in Renal Transplantation: Analysis of 22 Cases D.H. Casadei, R. Cambariere, H. Leanza, C. Najün Zarazaga, N. Vila,

and L . Cristaldo 221A

Randomized Clinical Trial of Cyclosporine or Donor Specific Transfusions in High Risk Living-Related Donor Transplantation J. Bordes-Aznar, A. Odor,

A. Dib-Kuri, F. Gabilondo, J. Kasep, J.C Pena, J. Herrera-Acosta, and F. Chävez-Peön 2216

Related Donor Kidney Transplantation Is the Best Form of Treatment for Uremia CG. Groth, I . Fehrman, O. Ringden, and G. Lundgren 2278

Renal Retransplantation From Living Related Donors Using Donor Specific Blood Transfusions Z. Shapira, A. Yussim, D. Shmueli, A. Mahinson,

E. Reichenthal, and C. Servadio 2280

CLINICAL TRANSPLANTATION: OTHER ORGANS

P A N C R E A S A N D I S L E T C E L L T R A N S P L A N T A T I O N Techniques, Results, and Complications Simultaneous Pancreas and Kidney Transplantation: Long Term Results and

Comparison of Two Surgical Techniques J.M. Dubernard, E. La Rocca, A. Gelet, J . L . Faure, D. Long, X. Martin, N.L. Lefrancois, N. Blanc, L . Monti,

J . L . Touraine, and J. Traeger 2285 (Continued)

CONTENTS (continued)

Glucose Control After Simultaneous Segmental Pancreas and Kidney Transplantation I.G.M. Brons, R.Y. Calm, K. Rolles, P.F. Williams, N.G. Fishwick,

and D.B.Evans 2288

Recurrent Diabetic Nephropathy in Renal Allografts Placed in Diabetic Patients and Protective Effect of Simultaneous Pancreatic Transplantation S-O. Bohman,

H. Wilczek, G. Tyden, G. Jaremko, G. Lundgren, and CG. Groth 2290

Metabolic Control at Two Months to 4.5 Years After Pancreatic Transplantation With Special Reference to the Role of Cyclosporine G. Tyden, C Brattström,

R. Gunnarsson, G. Lundgren, L . Ost, J. Ost man, and CG. Groth 2294

Quadruple Immunosuppressive Therapy in Whole Pancreas Transplantation H. W. Sollinger, M. Kalayoglu, R.M. Hoffman, M.H. Deierhoi, and F.O. Beizer 2297

Use of Recipient Mesenteric Vessels for Revascularization of Segmental Pancreas Grafts: Technical and Metabolic Considerations.../).^/?. Sutherland, F.C Goetz,

K.C Moudry, G.M. Abouna, and J.S. Najarian 2300

Critical Analysis of Mortality and Graft Loss Following Simultaneous Renal-Pancreatic Duodenal Transplantation R.J. Corry, D.D. Nghiem,

B. Schanbacher, and T.A. Gonwa 2305

Preservation of Human Pancreatic Allografts in Cold Storage for Six to 24 Hours G.M. Abouna, D.E.R. Sutherland, G. Florack, J. Heil, and J.S. Najarian 2307

Evolution of Metabolic and Endocrine Function in Ten Neoprene-Injected Segmental Pancreas Allografts at Three to 54 Months After Transplantation, Versus Preliminary Results in Nine Whole Pancreas Allografts With Enteric Diversion

D. Cantarovich, J. Traeger, E. La Rocca, L.D. Monti, N. Lefrancois, F. Cantarovich, H. Betuel, N. Blanc-Brunat, J . L . Faure, A. Gelet,

J.M. Dubernard, G. Fozza, and J . L . Touraine 2310

A New Variant for Whole Pancreas Grafting G. Kootstra, J.P. van Hooff, P.J.G. Jörning, K.M.L. Leunissen, C.J. van der Linden, E. Beukers,

and W.A. Buurman 2314

Complications of Pancreas Transplantation—Effect of Technique L.H. Toledo-Pereyra and V.K. Mittal 2319

Incidence of Fistulas Following Human Pancreas Transplantation—Positive Influence of Reabsorption of Pancreatic Secretions by the Peritoneum W-D. Illner,

Th. Gottwald, D. Abendroth, and W. Land 2323

Are Late Diabetic Complications Reversible After Pancreas Transplantation? A New Method of Follow-up of Microcirculatory Changes D. Abendroth, W-D. Illner,

R. Landgraf, and W. Land 2325

Effects of Successful Combined Pancreatic and Renal Transplantation on Advanced Diabetic Neuropathy: A One-Year Follow-up Study H. Wilczek, G. Solders,

R. Gunnarsson, G. Tyden, and A. Persson 2327 (Continued)

CONTENTS (continued)

Monitoring and Diagnosis of Rejection Role of Pancreas Graft Biopsies in the Diagnosis and Treatment of Rejection After

Pancreas Transplantation D.E.R. Sutherland, D. Casanova, and R.K. Sibley 2329

Studies of the Exocrine Secretion of Segmental Pancreatic Grafts With Special Reference to the Diagnosis of Rejection and to the Penetration of Drugs Into the Pancreatic Juice C Brattström, G. Tyden, A.S. Malmborg, G. Lundgren,

L . Ost, and CG. Groth 2332

Monitoring of the Pancreatic Allograft by Analysis of Exocrine Secretion ....£. Steiner, G. Klima, D. Niederwieser, A. Königsrainer, M. Herold, and R. Margreiter 2336

Physiologic Consequences of Pancreatic Allograft Exocrine Drainage Into the Urinary Tract W. W. Tom, R. Munda, M.R. First, and J. W. Alexander 2339

Synchronous Pancreatic and Renal Allografts With Urinary Tract Drainage of the Pancreas R. Munda, M.A. Weiss, M.R. First, and J.W. Alexander 2343

Diagnosis of Rejection in Simultaneous Renal/Pancreas (Urinary Bladder Drained) Transplantation D.C Dafoe, D.A. Campbell, Jr, L . Rocher, R. Schwartz,

andJ.G. Turcotte 2345

Rejection in Pancreas Transplantation M. Prieto, D.E.R. Sutherland, L . Fernandez-Cruz, J.B. Heil, and J.S. Najarian 2348

Metabolic Monitoring in Renal-Pancreatic Transplants With Urinary Pancreatic Exocrine Diversion D.D. Nghiem, T.A. Gonwa, and R.J. Corry 2350

Islet Cell Transplantation Results of Cultured Fetal Pancreatic Islet Transplantation in Juvenile Diabetic

Patients Gy. Farkas, S. Karäcsonyi, M. Szabo, and G. Kaiser 2352

Effect of Human Fetal Pancreas Transplantation on Secretion of C-Peptide and Glucose Tolerance in Type I Diabetics R.P. Robertson, K.J. Lafferty,

CE. Haug, and R. Weil III 2354

Experience With Human Fetal Pancreatic Allografts Over a Three-Year Period B.E. Tuch, G. Shell, A.B.P. Ng, and J.R. Turtle 2357

Islet Cell Transplantation in Type I Diabetes Mellitus R. Alejandro, D.H. Mintz, J. Noel, Z. Lauf, N. Koh, E. Russell, and J. Miller 2359

Islet Cell Alio- and Xenotransplantation—Effect of Collagenase-Free Processing and Renal Subcapsular Site K.O. Bandlien, L.H. Toledo-Pereyra, and D.A. Gordon 2362

Intraportal Transplantation of Cryopreserved Human Fetal Pancreata.... R. Simonsen, I . Dawidson, S. Aggarwall, K.R. Diller, R. Rajotte, L . Coorpender,

and D. Abs hier 2365

(Continued)

CONTENTS (continued)

Effect of Skin Grafts on Pancreatic Islet Cell Allografts in the Renal Subcapsular Space J. Amiel, L.H. Toledo-Pereyra, K. Bandlien, D. Gordon,

and G. MacKenzie 2368

The Principal Results of Pancreatic Islet Cell Culture Transplantation in Diabetes Mellitus Patients V.l. Shumakov, V.N. Bljumkin, S.N. Ignatenko,

N.N. Skaletsky, T.A. Slovesnova, and R.A. Babikova 2372

L I V E R T R A N S P L A N T A T I O N Selection of Patients and Results Late Mortality and Morbidity After Liver Transplantation S. fwatsuki, T.E. Starz I,

R.D. Gordon, CO. Esquivel, S. Todo, A.G. Tzakis, L . Makowka, J. W. Marsh, Jr, and CM. Miller 2373

Analysis of Donor Criteria for the Prediction of Outcome in Clinical Liver Transplantation L . Makowka, R.D. Gordon, S. Todo, N. Ohkohchi,

J.W. Marsh, A.G. Tzakis, H. Yokoi, J. Ligush, CO. Esquivel, M. Satake, S. Iwatsuki, and T.E. Starzl 2378

Criteria of Selection for Liver Transplantation D. Samuel, J.P. Benhamou, H. Bismuth, J. Gugenheim, M. Ciardullo, and F. Saliba 2383

Immunoprophylaxis of Hepatitis B Virus (HBV) Reinfection in Recipients of Human Liver Allografts W. Lauchart, R. Müller,

and R. Pichlmayr 2387

A Positive Lymphocyte Cross-Match and Major Histocompatibility Complex Mismatching Do Not Predict Early Rejection of Liver Transplants in Patients Treated With Cyclosporine S.B. Moore, RH. Wiesner, J.D. Perkins,

D.M. Nagorney, S. Sterioff, and R.A.F. Krom 2390

Development of Class I-Directed Lymphocytotoxic Antibodies After Liver Transplantation CF. Bryan, J.T. Newman, R.L. Tillquist, B. Husberg,

G.B. Klintmalm, and M.J. Stone 2392

Incidence and Outcome of Donor Arterial Anomalies in Liver Allografts M. Decurtins, P.J. Friend, and R.Y. Calne 2394

Orthotopic Liver Transplantation for Secondary Malignancies of the Liver F. Mühlbacher and F. Piza 2396

Incidence of Cytomegalovirus Infection and Its Relationship to Donor-Recipient Serologic Status in Liver Transplantation J. Rakela, R.H. Wiesner,

H.F. Taswell, P.E. Hermans, T.F. Smith, J.D. Perkins, and R.A.F. Krom 2399

(Continued)

CONTENTS (continued)

Tumor Recurrence After Liver Transplantation Followed by High-Dose Cyclophosphamide, Total Body Irradiation, and Autologous Bone Marrow Transplantation for Treatment of Metastatic Liver Disease R. Margreiter,

D. Niederwieser, H. Frommhold, D. Schönitzer, A. Gratwohl, and C. Ruber 2403

Designation of Liver Transplant Centers in the United States N.L. Ascher and R. W. Evans 2405

Operative Procedures Hepatic Artery in Liver Transplantation S. Todo, L . Makowka, A.G. Tzakis,

J.W. Marsh, Jr, F.M. Karrer, M. Armany, C Miller, M.B. Tallent, CO. Esquivel, R.D. Gordon, S. Iwatsuki, and T.E. Starz I 2406

Vascular Problems in Liver Transplantation G. Blumhardt, B. Ringe, W. Lauchart, M. Bur dels ki, W.O. Sechst ein, and R. Pich I may r 2412

Roux-En-Y Hepatojejunostomy: A Safe Procedure for Biliary Anastomosis in Liver Transplantation H. Bismuth, D. Castaing, J. Gugenheim, O. Traynor,

and M. Ciardullo 2413

Experience With Veno-Venous Bypass in Human Liver Transplantation B. Ringe, A. Bornscheuer, G. Blumhardt, W.O. Beckstein, K. Wonigeit, and R. Pichlmayr 2416

Hemodynamics During Liver Transplantation With Veno-Venous Bypass A.W. Paulsen, T.R. Valek, W.S. Blessing, D.D. Johnson, R.I. Parks, J.T. Pyron,

M. Ramsay, B.R. Simpson, T. Swygert, P. Walling, and G. Klintmalm 2417

Selective Bowel Decontamination to Prevent Gram-Negative Bacterial and Fungal Infection Following Orthotopic Liver Transplantation R.H. Wiesner, P. Hermans, J. Rakela, J. Perkins, J. Washington, S. DiCecco, and R.A.F. Krom 2420

Vasopressin Use in Human Liver Transplantation P.M. Daloze, R. Arnoux, J. Corman, C Smeesters, G. St Louis, and M. Beaudouin 2424

Prognostic Perioperative Factors Predicting the Outcome of Liver Transplantation P.G. Stock, J.A. Estrin, D.S. Fryd, W.D. Payne, K.G. Belani, B.A. Elick,

J.S. Najarian, and N.L. Ascher 2427

Beneficial Effect of Topical Ice Cooling in Donor Hepatonephrectomy S.I. Cho, B.P. Zalneraitis, and J. W> Bradley 2429

Immunosuppression A Randomized Clinical Trial Comparing OKT3 and Steroids for Treatment of

Hepatic Allograft Rejection A.B. Cosimi, S.I. Cho, F.L. Delmonico, MM. Kaplan, R.J. Rohrer, and R.L. Jenkins 2431 (Continued)

CONTENTS (continued)

Conversion From Standard Cyclosporine to Low-Dose Cyclosporine and Azathioprine Therapy as Treatment of Cyclosporine-Related Complications in Liver Transplant Patients J.D. Perkins, S. Sterioff, R.H. Wiesner, K.P. Offord,

J. Rakela, E.R. Dickson, and R.A.F. Krom 2434

Development of Anti-Idiotypic Antibodies to H L A Antigens in Human Hepatic Allograft Tolerance T. Mohanakumar, S.K. Hoover, C. Rhodes,

G. Mendez-Picon, M. W. Flye, and H.M. Lee 2437

A Comparison of Azathioprine and Cyclosporine in Liver Transplantation: A Study of Two Personal Series R.A.F. Krom, R.H. Wiesner, E.B. Haagsma, J. Ludwig,

C.H. Gips, A.J.K. Grond, and H.J. Houthoff 2440

OKT3 in the Reversal of Acute Hepatic Allograft Rejection CO. Esquivel, J.J. Fung, B. Markus, S. Iwatsuki, R.D. Gordon, L . Makowka,

J. W. Marsh, Jr, A.G. Tzakis, S. Todo, and T.E. Starzl 2443

Transplantation in Children Results and Problems in Paediatric Liver Transplantation in the Cambridge/Kings

College Hospital Series: 1968 to July 1986 N.V. Jamieson, R.Y. Calne, K. Rolles, N.D. Barnes, and A. P. Mow at 2447

Analysis of Current Results of Liver Transplantation in Children K. Schmidt, M. Burdelski, U. Bernsau, J. Brodehl, B. Ringe, W. Lauchart, K. Wonigeit,

R. Pichl may r, and H. Milbradt 2449

Biopsy Findings Use of Triple Therapy and Percutaneous Needle Biopsy to Minimize Graft Failure

Following Liver Transplantation J.A. St Cyr, B. Elick, D. Freese, H. Sharp, W. Payne, J. Bloomer, P. Stock, D. Snover, J.S. Najarian,

and N.L. Ascher 2451

Orthotopic Liver Transplantation in Humans: Monitoring by Serial Graft Biopsies F. Saliba, J. Gugenheim, D. Samuel, M. Ciardullo, M. Reynes, and H. Bismuth 2454

An Analysis of Histological Prognostic Features of Liver Allograft Rejection Based on 270 Serial Biopsies D.C Snover, D.K. Freese, J.R. Bloomer, H.L. Sharp,

and N.L. Ascher 2457

Histologic Response to OKT3 Therapy for Hepatic Allograft Rejection.... R.J. Rohrer, R.L. Jenkins, U. Khettry, P.N. Benotti, T.F. Dodson, CG. Karlson, B.A. Georgi,

and A.P. Monaco 2459

Correlation of Amino Acid Metabolism and Liver Biopsies in Preoperative and Postoperative Patients Receiving Hepatic Transplants G.H.A. Clowes, Jr,

R.H. Pearl, S. Bosari, R.L. Jenkins, and U. Khettry 2462 (Continued)

CONTENTS (continued)

Class I Major Histocompatibility Complex Antigens are Induced on Hepatocytes in Rejecting Human Liver Grafts S.K.S. So, D.C Snover, N.L. Ascher,

and J . L . Piatt 2464

Modified Patterns of Major Histocompatibility Complex-Antigen Expression in Human Liver Grafts During Rejection G. Steinhoff, K. Wonigeit, B. Ringe,

W. Lauchart, J. Kemnitz, and R. Pichlmayr 2466

Analysis of T Lymphocytes Infiltrating Human Hepatic Allografts B.H. Markus, J.J. Fung, A. Zeevi, T.E. Starzl, A.J. Demetris, and R.J. Duquesnoy 2470

Immunohistologic Labeling of Infiltrating T Lymphocytes in Hepatic Allografts: A Rejection Indicator J.D. Perkins, R.H. Wiesner, P.M. Banks, N.F. LaRusso,

and R.A.F. Krom 2474

Consequences of Hepatic Artery Pathology After Orthotopic Liver Transplantation E.J. Hesselink, M.J.H. Slooff, K.H. Schuur, Ch. Bijleveld, and Ch. Gips 2476

Modifications of Biliary and Vascular Basement Membrane Laminin in Serial Hepatic Biopsies After Hepatic Transplantation in Man M. Reynes, V. Tricottet,

J.C. Gugenheim, D.J. Hartmann, A.M. Szekely, and H. Bismuth 2478

Safety and Utility of a Simple Technique of Liver Biopsy Following Liver Transplantation R.J. Jenkins, C.A. Gallik-Karlson, B.A. Georgi, R.J. Rohrer,

U. Khettry, P.N. Benotti, T.F. Dodson, R.B. Freeman, and C. Trey 2480

Diagnosis of Rejection in Liver Transplantation K. Hockerstedt, I . Lautenschlager, T.M. Scheinin, J. Ahonen, B. Eklund, P. Hayry, C. Korsbäck, P. Maury,

K. Salmela, and E. Taskinen 2483

Cellular Characteristics of Liver Allograft Rejection /. Lautenschlager, H. Höckerstedt, J. Ahonen, B. Eklund, C. Korsbäck, E. Pettersson,

K. Salmela, T.M. Scheinin, E. von Willebrand, and P. Häyry 2485

H E A R T A N D L U N G T R A N S P L A N T A T I O N Selection of Patients and Results The Influence of H L A Matching in Cardiac Allograft Recipients Receiving

Cyclosporine and Azathioprine M. Yacoub, H. Festenstein, P. Doyle, M. Martin, D. McCloskey, J. Awad, A. Gamba, A. Khaghani, and J. Holmes 2487

Current Results With Triple Therapy for Heart Transplantation R.M. Bolman HI, M.T. Olivari, J. Saffitz, R. Sibley, J. Spadaro, C Cance, and B. Elick 2490

Cardiac Transplantation in the Sixth Decade of Life S. Szentpetery, M. Thames, J. Hanrahan, J. Morris, and R.R. Lower 2492

(Continued)

CONTENTS (continued)

A Detailed Study of Cytomegalovirus Infections in the First 160 Heart and Heart/Lung Transplant Recipients at Papworth Hospital, Cambridge, England

T.G. Wreghitt, M. Hakim, J.J. Gray, S. Kucia, R. Cory-Pear ce, J. Wallwork, and T.A.H. English 2495

Immediate Graft Failure Treated With Partial Cardiopulmonary Bypass and Emergency Cardiac Retransplantation J.S. Morris, R.R. Lower,

and S. Szentpetery 2497

Clinical Heart Transplantation J.G. Losman 2500

Selected Characteristics of 444 Heart Donors R.W. Evans, D.L. Manninen, and A.M. Maier 2501

The Effect of Blood Pretransfusion on Orthotopic Cardiac Transplantation ...A. Keogh, D. Baron, and V. Chang 2503

Late Acute Rejection After Cardiac Transplantation: Incidence and Treatment H. Warnecke, S. Schueler, and R. Hetzer 2504

Endocrine Response to Exercise in Cardiac Transplant Patients S. Schüler, D. Thomas, M. Thebken, U. Frei, T. Wagner, H. Warnecke, and R. Hetzer 2506

Neurologic Complications After Heat Transplantation: The Influence of Immunosuppression H. Warnecke, S. Schueler, J. Schlijfka, and R. Hetzer 2510

Heterotopic Heart Transplantation Are There Indications for Heterotopic Heart Transplantation Today? E. Becerra,

D.K.C Cooper, D. Novitzky, andB. Reichart 2512

Immunosuppression Individualized Immunosuppression in Heart Transplant Recipients A. Haverich,

K. Frimpong-Boateng, H-J. Schäfers, Th. Wahlers, H.G. Fieguth, G. Herrmann, K. Wonigeit, and H.G. Borst 2514

Determinants of Cyclosporine Nephrotoxicity Following Cardiac Transplantation M. Martin, D. Packham, C. Kingswood, H. Cairns, A. Khaghani, D. Thompson,

and M. Yacoub 2516

Prevention of Toxic Side Effects of Cyclosporine in Heart Transplantation S. Schüler, H. Warnecke, and R. Hetzer 2518

Results of "Immunoconversion" From Cyclosporine to Azathioprine in Heart Transplant Recipients With Progressive Nephrotoxicity S.A. Hunt,

E.B. Stinson, P.E. Oyer, M.E. Billingham, P. Gamberg, J. Miller, J.S. Schroeder, J.C Baldwin, and N.E. Shumway 2522

(Continued)

CONTENTS (continued)

Avoidance of Perioperative Renal Toxicity by a Modified Immunosuppression Protocol R.L. Kormos, A. Trento, R.L. Hardesty, B.P. Griffith, M. Thompson,

and H.T. Bahnson 2525

Monitoring Acute Rejection of the Heart-Lung Allograft and Methods of Its Detection

B.P. Griffith, S.J. Durham, R.L Hardesty, A. Trento, and l.L. Paradis 2527

Predictors of Rejection of Cyclosporine-Treated Cardiac Allograft Recipients T.L. Burstain, O.H. Frazier, M.J.M. Schnee, R.H. Kerman, M.I. Lorber,

D.A. Cooley, B. Radovancevic, R. Colon, H. McAllister, B.D. Kahan, and CT. Van Buren 2531

Increase In Transferrin Receptors as a Marker for Rejection and Infection in Human Cardiac Transplantation K. Hoshinaga, T. Mohanakumar, N.L. Wood,

S. Szentpetery, and R.R. Lower 2534

Bronchoalveolar Macrophage-Lymphocyte Reactivity in Heart-Lung Transplant Recipients A. Zeevi, J.J. Fung, l.L. Paradis, S. Gryzan, J.H. Dauber,

R.L. Hardesty, B. Griffith, A. Trento, S. Saldman, and R.J. Duquesnoy 2537

Cytoimmunologic Monitoring for the Noninvasive Diagnosis of Cardiac Rejection H.G. Fieguth, A. Haverich, H.J. Schaefers, T. Wahlers, and J. Kemnitz 2541

First Pass Radionuclide Scintigraphy for Long-Term Follow-up After Heart and Heart-Lung Transplantation.... B.M. Kemkes, H. Reichenspurner, G. Osterholzer,

M. Anthuber, N. Schad, A. Maccio, E. Erdmann, and R. Rienmiiller 2543

Appearance of Cells Bearing the Interleukin-2 Receptor in Peripheral Blood of Cardiac Transplant Patients and Their Correlation With Rejection Episodes

M. Coles, M. Rose, and M. Yacoub 2546

Immunological Monitoring of Heart Allograft Recipients O. Lungu, E. Reed, C Smith, E. Rose, C Marboe, M. Hardy, K. Reemtsma, J. Fenoglio,

and N. Suciu-Foca 2548

The Role of Bronchoalveolar Lavage in Diagnosing Pulmonary Rejection After Heart-Lung Transplantation H-J. Schäfers, A. Haverich, L . Dammenhayn,

T. Takayama, Th. Wahlers, K. Worch, and J. Kemnitz 2551

Frequency Analysis of Surface Electrocardiogram and Two-Dimensional Echocardiography for Noninvasive Diagnosis of Rejection After Heart Transplantation....//. Reichenspur ner, B.M. Kemkes, R. Haberl, Ch. Angermann,

M. Weber, G. Osterholzer, M. Anthuber, and G. Steinbeck 2552

Circadian Variation of Heart Rate But Not of Blood Pressure After Heart Transplantation G.J. Wenting, A.H. v.d. Meiracker, M.L. Simoons, E. Bos,

H.J. Ritsema v. Eck, A.J. Mann in't Veld, W. Wiemar, and M.A.D.H. Schalekamp 2554

(Continued)

CONTENTS (continued)

Doppler Echocardiographic Indices of Diastolic Function as Markers of Acute Cardiac Rejection H. Valantine, M. Fowler, L . Hatle, S. Hunt, M. Billingham,

E. Stinson, and R. Popp 2556

Biopsy Findings Sequential Infiltration of Class I and Class I I Specific Alloreactive T Cells in Human

Cardiac Allografts RJ. Duquesnoy, A. Zeevi, J.J. Fung, C. Kaufman, T.R. Zerbe, B. Griffith, A. Trento, R. Kormos, and R. Hardesty 2560

Biopsy Assessment of Donor Hearts Prior to and During Transplantation S. Darracott-Cankovic, R. Cory-Pearce, P.G.L Stovin, T. Wallwork,

D. Wheeldon, and T.A.H. English 2564

Sequential Studies of Major Histocompatibility Complex Antigen Expression (Common Class I and Class I I Determinants, DR or DQ) in Cardiac Biopsies Following Human Cardiac Transplantation A. Suitters, M. Rose, A. Khaghani,

and M. Yacoub 2566

Myocyte Injury in Acute Cardiac Transplant Rejection and in Lymphocytic Myocarditis Is Similar and Reversible ... N.B. Ratliff, J . L . Myles, J.T. McMahon,

L . Golding, R. Hobbs, G. Rincon, R. Sterba, and R. Stewart 2568

Transvenous Lung Biopsy: A New Technique M. Hakim, P. Stovin, T. English, and J. Wallwork 2573

S U M M A T I O N OF C L I N I C A L H E A R T T R A N S P L A N T A T I O N P O S T E R DISCUSSIONS By J.G. Losman 251A

T R A N S P L A N T A T I O N OF O T H E R O R G A N S The Importance of H L A - D R Matching in Corneal Transplant Recipients Treated

With Cyclosporine A H.v. Keyserlingk, G. Offermann, M. Wiederholt, and F. Hoffmann 2576

Use of Locally Injected Anti-T Monoclonal Antibodies in the Treatment of Acute Corneal Graft Rejection G. Ippoliti and A. Fronterre 2579

Autotransplantation of the Adrenal Gland Using Microvascular Anastomosis M.Matsuda 2581

(Continued)

CONTENTS (continued)

Clinical Small Intestinal Transplantation Using Cyclosporine A and Methylprednisolone Z. Cohen, R. Silverman, G. Levy, R. Wassef,

and B. Langer 2588

SUMMATION OF C L I N I C A L T R A N S P L A N T A T I O N -O T H E R O R G A N S -P O S T E R DISCUSSIONS By C.G. Groth,

O. Klintmalm, J.G. Losman, and N.L. Ascher 2591

BONE MARROW TRANSPLANTATION

C L I N I C A L B O N E M A R R O W T R A N S P L A N T A T I O N Current Status of Bone Marrow Transplantation for Severe Aplastic Anemia: A

Preliminary Report From The International Bone Marrow Transplant Registry E. Gluckman for the Advisory Committee of the International Bone Marrow Transplant Registry 2597

European Experience of Bone Marrow Transplantation for Leukemia O. Ringden, F. Zwaan, J. Hermans, A. Gratwohl for the Leukemia Working Part

of the European Group for Bone Marrow Transplantation 2600

A Prospective Randomized Study of Acute Graft-v-Host Disease in 107 Patients With Leukemia: Methotrexate/Prednisone v Cyclosporine A/Prednisone

S.J. Forman, K.G. Blume, R.A. Krance, P.J. Miner, G.E. Metter, L.R. Hill, M.R. O'Donnell, A.P. Nademanee, and D.S. Snyder 2605

Marrow Transplantation for Leukemia and Aplastic Anemia: Two Controlled Trials of a Combination of Methotrexate and Cyclosporine v Cyclosporine Alone or Methotrexate Alone for Prophylaxis of Acute Graft-v-Z/os? Disease R. Storb,

H.J. Deeg, J. Whitehead, V. Farewell, F.R. Appelbaum, P. Beatty, W. Bensinger, CD. Buckner, R.A. Clift, K. Doney, J.A. Hansen, R. Hill, L.G. Lum, P. Martin, R. McGuffin, J.E. Sanders, J. Singer, P. Stewart,

K.M. Sullivan, R.P. Witherspoon, and E.D. Thomas 2608

(Continued)

CONTENTS (continued)

Allogeneic Bone Marrow Transplantation Without Graft-v-Host Disease: True Tolerance of Graft Against the Host Through Depletion of Donor T Lymphocytes Pregrafting in Malignant and Nonmalignant Disorders S. Slavin, R. Or,

E. Naparstek, L . Weiss, M. Mumcuoglu, Z. Weshler, H. Brautbar, G. Cividalli, M. Glikson, G. Hale, and H. Waldmann 2614

Graft Failure and Leukemia Relapse Following T Lymphocyte-Depleted Bone Marrow Transplants: Effect of Intensification of Immunosuppressive Conditioning R.E. Champlin, W.G. Ho, R. Mitsuyasu, M. Burnison,

P. Greenberg, G. Holly, D. W. Winston, S.A. Feig, and R.P. Gale 2616

Distinct Types of Donor and Recipient T Cell Clones Functionally Related to Host-v-Graft Reactivity and Autologous Remission After Bone Marrow Transplantation For Severe Aplastic Anemia E.M. Schneider, G. Pawelec,

M. Haen, G. Ehninger, P. Ostendorf, J. Kömpf, V. Schöllhorn, and P. Wernet 2620

Bone Marrow Transplantation for Acute Leukemia: A Preliminary Report From the International Bone Marrow Transplant Registry.... R. Champlin, for the Advisory

Committee of the International Bone Marrow Transplant Registry 2626

Bone Marrow Transplantation in Leukemia Using Family Donors Other Than HLA-Identical Siblings: A Preliminary Report From the International Bone Marrow Transplant Registry M.M. Bortin,for the Advisory Committee of the

International Bone Marrow Transplant Registry 2629

Discrimination Value of Class H I and Glyoxalase Alleles for Selection of Histocompatible Bone Marrow Donors A. Wölpl, S. F. Goldmann,

Th. Eier mann, and R. Arnold 2632

DNA Restriction Fragment Length Analysis of the Human Class I I Genes (DR, DQ) of Bone Marrow Transplant Donor-Recipient Pairs by D N A - D N A Hybridization

L . Gaidulis, K.W. Lange, G.M. Schmidt, H. Toyoda, R.B. Wallace, and K.G. Blume 2636

Risk Factors for Interstitial Pneumonitis Following Allogeneic Bone Marrow Transplantation for Severe Aplastic Anemia: A Preliminary Report

R.S. Weiner and K.A. Dicke for the Advisory Committee of the International Bone Marrow Transplant Registry 2639

Long-Term Follow-up of Patients Who Received Transplants for Aplastic Anemia or Leukemia E. Gluckman, A. Devergie, J. Meletis, H. De Castro, P. Lehn,

J.H. Bourrhis, H. Keable, M. Cavazzana, F. Varrin, D. Bombail, E. Vilmer, N. Lemercier, N. Alby, M. Boiron, and J. Dausset 2643

Increased H L A - D R Compatibility Between Patients With Acute Myeloid Leukemia and Their Parents: Implications for Bone Marrow Transplantation

N.A. Carpentier and M. Jeannet 2644

Fibronectin Restores Defective In Vitro Proliferation of Lymphocytes From Patients After Marrow Grafting H-G. Klingemann, M-S. Tsoi, and R. Storb 2646

(Continued)

CONTENTS (continued)

Prediction of Leukemic Relapse Soon After Bone Marrow Transplantation J.A. Tratkiewicz and J. Szer 2648

Urinary Neopterin in Bone Marrow Recipients L . Volin, S-E. Jansson, U. Turpeinen, U-M. Pomoell, and T. Ruutu 2651

A C U T E A N D C H R O N I C G R A F T - V E R S U S - H O S T DISEASE Acute Graft-Versus-Host Disease Following Bone Marrow Transplantation in

Humans: Prognostic Factors M.M. Bort in, for the Advisory Committee of the International Bone Marrow Transplant Registry 2655

Thalidomide Induction of Bone Marrow Transplantation Tolerance G.B. Vogelsang, A.D. Hess, G. Gordon, R. Brundrette, and G.W. Santos 2658

Acute Graft-Versus-Host Disease: Pathogenesis and Prevention With a Monoclonal Antibody In Vivo J. Ferrara, A. Marion, G. Murphy, and S. Burakoff 2662

A Class I I Antigen-Specific T Cell Clone Can Suppress Graft-Versus-Host Reactivity in Murine Allogeneic Bone Marrow Chimeras C.C-K Shih and R.L. Truitt 2664

Graft-Versus-Leukemia in the Rat—The Antileukemic Efficacy of the Syngeneic and Allogeneic Graft-Versus-Host Disease P.J. Tutschka, S.D. Berkowitz,

S.Tuttle, and J.Klein 2668

Detection of Anti-non-MHC-Directed T Cell Reactivity Following In Vivo Priming After HLA-Identical Marrow Transplantation and Following In Vitro Priming in Limiting Dilution Cultures C. Irle, B. Chapuis, M. Jeannet, M. Kaestli,

N. Montandon, and B. Speck 2614

Haploidentical Bone Marrow Transplantation Using Soybean Agglutinin-Processed, T-Depleted Marrow K. Matthay, D.W. Wara, A.J. Ablin, and M.J. Cowan 2678

Herpes Virus Immunity and Acute Graft-Versus-Host Disease J.W. Gratama, H.T. Weiland, A.C. Hekker, T.F. Weijers, T.H. The, T. Stijnen, F.E. Zwaan,

and J.M. J. J. Vossen 2680

Cyclosporine-Induced Syngeneic Graft-Versus-Host Disease: Assessment of T Cell Differentiation A.D. Hess, G.B. Vogelsang, J. Heyd, and W.E. Beschorner 2683

Demonstration of Strong Classic Reactivity After Total-Body Irradiation for Bone Marrow Transplantation. Implications for Human T-Depleted Bone Marrow Transplantation W. Gassmann, M.v. Kolszynski, H-U. Wottge,

and W. Müller-Ruchholtz 2687

Characteristics and Functions of Inflammatory Cells Isolated From Acute Graft-Versus-Host Disease Target Organs After Bone Marrow Transplantation in the Rat R. Renkonen, D. Leszczynski, A. Wangel, and P. Hayry 2689

(Continued)

CONTENTS (continued)

Reduction of Acute Graft-Versus-Host Disease-Related Mortality and Cytotoxic Lymphocyte Induction After Pretreatment of the Recipient With Anti-Asialo GM1 Antibody in the Murine P-to-F, Model K. Varkila and M. Hurme 2690

Role of Suppressor Cells and Thymic Hormone Function in the Early and Late Phases of Murine Graft-Versus-Host Reactions Ph. Lang, S. Moritz, W. Savino,

C Rostoker, and M. Dardenne 2692

Survival and Immune Recovery in Dogs Following Fetal Liver Transplantation G.R. Cain, R. E. Champlin, and R.P. Gale 2695

Induction and Suppression of Graft-Versus-Host Reactivity in B6.C-H-2 Mutant Mice A. Molendijk, RJ.H.L.M. van Gurp, A. van Oudenaren, and R. Benner 2698

Transfusion Effect on Graft-Versus-Host Disease and Leukemic Relapse in HLA-Matched Bone Marrow Transplantation G.C de Gast, P.G. Beatty,

D. Amos, K. Sullivan, J.E. Anderson, E.D. Thomas, and J.A. Hansen 2700

T Cell Depletion of H L A and Haploidentical Marrow Reduces Graft-Versus-Host Disease But I t May Impair a Graft-Versus-Leukemia Effect P.J. Henslee,

J.S. Thompson, E.H. Romond, M.A. Doukas, M. Metcalfe, M.E. Marshall, andJ.S.MacDonald 2701

E X P E R I M E N T A L B O N E M A R R O W T R A N S P L A N T A T I O N Hyperfractionation of Total-Body Irradiation and Engraftment of Marrow From

DLA-Haploidentical Littermates L.K. Lösslein, H.J. Kolb, S. Porzsolt, E. Schäffer, S. Scholz, M. Meissner, E. Holler, W. Wilmanns,

and S. Thierfelder 2707

Phenotypic and Functional Alterations of Recipient Lymphocytes After Transfusion of UV-Irradiated and Normal Blood—Implications for Marrow Transplantation

H.J. Deeg, J. Aprile, E. Severns, J. Rajantie, E. Schmidt, R.F. Raff, K.E. Green, and R. Storb 2709

Immunogenetic Analysis of Fully Allogeneic Rat Bone Marrow Transplantation E. Marquarding, J. Klempnauer, B. Steiniger, G. Filler, K. Wonigeit,

and R. Pichlmayr 2715

Role of Radiation-Resistant Large Granular Lymphocytes in the Rejection of Unrelated DLA-Nonidentical Marrow Grafts in Dogs R.F. Raff,

T.P. Loughran, Jr, H.J. Deeg, J.A. Aprile, T.C Graham, G.E. Sale, and R. Storb 2718

Selective Multiplication of Hematopoietic Stem Cells For Bone Marrow Transplantation in Mice and Rhesus Monkeys G. Wagemaker 2721

(Continued)

CONTENTS (continued)

Cell-Mediated Immune Responses in Rat Cytomegalovirus Infection A.H. Esa, G.B. Vogelsang, G.R. Sandford, R. Sarai, A.D. Hess, and W.H. Burns 2726

Lysosomoal Enzyme Replacement of Neural Tissue by Allogeneic Bone Marrow Transplantation Following Total Lymphoid Irradiation in Canine Fucosidosis

R.M. Taylor, B.R.H. Farrow, G.J. Stewart, P.J. Healy, and K. Tiver 2730

B O N E MARROW M A N I P U L A T I O N Ex Vivo Depletion of Human Bone Marrow T Lymphocytes by Soybean Lectin

Fractionation Followed by Treatment with an Anti-pan-T Cell (CD5) Ricin A-Chain Immunotoxin S. Siena, S. Villa, G. Bonadonna, M. Bregni,

and A.M. Gianni 2735

Cytogenetic Evidence of Partial Chimerism After T Cell-Depleted Allogeneic Bone Marrow Transplantation in Leukemic H L A Matched Patients M.F. Bertheas,

B. Mascret, D. Maraninchi, M. Lafage, D. Blaise, J. Fraisse, CP. Brizard, Y. Carcassonne, and C Mawas 2738

H L A - D P Matching in Allogeneic Bone Marrow Transplantation G. Pawelec, G. Ehninger, H. Schmidt, A. Rehbein, L Balko, and P. Wernet 2741

Lymphocyte Reconstitution in Children Receiving Soybean Agglutinin T-Depleted Bone Marrow Transplants M.J. Cowan, T. McHugh, W. Smith, D. Wara,

K. Matthay, A. Ablin, C Casavant, and D. Stites 2744

Peripheral Blood Chemiluminescence as an Early Indicator of Successful Bone Marrow Transplantation A. Toivanen, J. Nikoskelainen, E-M. Lilius,

T.T. Salmi, K. Kätkä, T-T. Pelliniemi, A-L. Mäki, and B. Rajamäki 2745

Transfer of B Memory Cells to a T-Dependent Antigen in Murine Bone Marrow Transplantation B. Tsuberi, S. Slavin, E. Kedar, and B. Leshem 2747

Specific Inhibition of Hybrid Resistance of B6D2F1 Mice Pretreated With Parent Strain B6 Cells: Role of a Nylon Adherent Cell Induced in the Spleen of the B6-Pretreated B6D2F1 Hybrid K. Kosmatopoulos, S. Orbach-Arbouys,

and G.Mat he 2750

A Murine Model for Pharmacological Marrow Purging ... E.A. Copelan, S.C Johnson, M.R. Grever, and P.J. Tutschka 2754

Transplantation of T Cell-Depleted Bone Marrow in Histoincompatible Rabbits: Improved Engraftment and Long-Term Chimeras After the Addition or Irradiated Donor Buflfy Coat Cells and Irradiated Autologous Cryopreserved Bone Marrow A. Gratwohl, H. Baldomero, C. Nissen, and B. Speck 2756

Effector Cells of Graft-Versus-Host Disease, Host Resistance, and the Graft-Versus-Leukemia Effect: Summary of a Workshop on Bone Marrow Transplantation O. Rigden, H.J. Deeg, W. Beschorner, and S. Slavin 2758

(Continued)

CONTENTS (continued)

PART IV TRANSPLANTATION TODAY

AND TOMORROW Immunology and Immunogenetics Synopsis M. Simonsen 2765

Summary: Immunosuppression C.B. Carpenter 2770

Critical Issues in Bone Marrow Transplantation R. Storb 211A

Clinical Organ Transplantation A.G.R. Sheil 2782

Author Index 2787

Subject Index 2807

Incidence of Fistulas Following Human Pancreas Transplantation—Positive Influence of Reabsorption

of Pancreatic Secretions by the Peritoneum

W-D. Iiiner, Th. Gottwald, D. Abendroth, and W. Land

THERE IS EVIDENCE suggesting that transplantation of the pancreas is the

only approach to a curative treatment of type I diabetes.1 - 3 The results of this surgical method improved during the last years with the new agent cyclosporine (Cs) and better patient management. In 1982 the one-year-survival-rate of pancreas grafts was about 20% worldwide, whereas in 1984 it had risen to 38%.4 In spite of this improvement, pan­creas transplantation is still less successful than transplantation of other organs. One major reason for this fact is the difficulty in optimal handling of exocrine secretion.

Since 1979 the Munich group has been using prolamine (Ethibloc, Ethicon) in a con­secutive series of 56 patients. Despite occlu­sion of the duct, a high incidence of pancreatic fistulas occurred, implicating the risk of a secondary bacterial contamination.

By modifying our surgical technique5 to a strictly intraperitoneal placement of the pan­creas graft, we wanted to know whether the resorption capacity of the peritoneum would provide a reduction of the incidence of fistu­las.

PATIENTS AND METHODS Fifty-two of those 56 patients received a pancreas and a

kidney graft simultaneously. In these 52 patients we evaluated fistula incidence, frequency of reintervention, and graft loss rate secondary to an infected fistula. According to the different surgical techniques there are two groups: group 1 (n = 25), in which the segmental pancreas graft was placed partially extra-and intraperito-neally6; and group 2 (n = 27), in which the pancreas graft was placed strictly intraperitoneal^ along the ascending colon. The peritoneal cavity was continuously irrigated with saline solution over the first postoperative days.

RESULTS The incidence of fistulas in group 1 was

52% compared to 44% in group 2. The rate of secondary bacterial contamination of a fistula with subsequent surgical reinterventions showed no significant difference betweeen both groups (2 v 2.5). In five patients in group 1 the rescue of an infected fistula failed, compared to two cases in group 2.

DISCUSSION

Our working hypothesis claimed that reab­sorption of residual exocrine secretion by the peritoneum would reduce the incidence of fistulas. This could not be confirmed, because neither the fistula incidence rate nor the re-operating rate were statistically different. Specific and specific defense mechanisms of the peritoneum seem to have a positive effect against secondary infection of a fistula. Graft loss due to a fistula occurred in only 8% of patients treated with the modified technique (group 2) compared to 20% of the patients in group 1.

The improvement of graft survival rate (15% difference between group 1 and group 2) is probably based on defense mechanisms of the peritoneum. Therefore, we will continue to use the strictly intraperitoneal placement of duct-occluded pancreas grafts.

From the Transplantation Centre, Department of Sur­gery, Klinikum Grosshardern University of Munich.

Address reprint requests to Dr W-D. Illner, Trans­plantation Centre, Klinikum Grosshardern, Marchion-istr.15, 8000 München 70, FRG.

© J 987 by Grune & Stratton, inc. 0041-1345/87/190I-0877$03.00/0

Transplantation Proceedings, Vo l X IX , No 1 (February) , 1 9 8 7 : pp 2 3 2 3 - 2 3 2 4 2 3 2 3

2 3 2 4 I L L N E R E T A L

REFERENCES 1. Sutherland D E R , Najarian JS: In Brooks JR (ed):

Surgery of the Pancreas. Philadelphia, Saunders, 1983, p 424

2. Landgraf R, Abendroth D, Land W: Horm Metab Res 13:57, 1983 (suppl)

3. Dubernard J M , Traeger J , Possa G , et al: Trans­plant Proc 15:1318, 1983

4. Sutherland D E R : World J Surg 8:270, 1984

5. Land W, von Liebe S, Hopp H, et al: Chir Prax 27:15, 1980

6. Dubernard J M , Traeger J , Neyra P, et al: Surgery 84:633, 1978