T.R. Hakala

Fourteen patients who developed B cell lymphomas or lymphoproliferative lesions after kidney, liver, heart, or heart-lung transplantation in Pittsburgh during 1981-1983 had active infection with Epstein-Barr virus (EBV) of the primary (six patients), reactivated (seven patients), or chronic (one patient) type. In transplant patients without tumors, the incidence of EBV infection was 30% (39 of 128). Only three of these patients had primary infections. Thus the frequency of active infection was significantly higher in patients with tumors, and patients with primary infections were at greater risk of developing tumors. Five of 13 tumors tested contained EBV nuclear antigen (EBNA) and nine of 11 contained EBV genomes detected by DNA-DNA hybridization with BamHI K, BamHI W, or EcoRI B cloned probes. All EBNA-positive tumors, except one, were also positive by hybridization. Only one tumor was negative for both EBNA and EBV DNA. These data suggest that EBV plays an etiologic role in the development of these lesions.

No AccessJournal of UrologyTransplantation1 Sep 1984A Flexible Procedure for Multiple Cadaveric Organ Procurement T.E. Starzl, T.R. Hakala, B.W. Shaw, R.L. Hardesty, T.J. Rosenthal, B.P. Griffith, S. Iwatsuki, and H.T. Bahnson T.E. StarzlT.E. Starzl More articles by this author , T.R. HakalaT.R. Hakala More articles by this author , B.W. ShawB.W. Shaw More articles by this author , R.L. HardestyR.L. Hardesty More articles by this author , T.J. RosenthalT.J. Rosenthal More articles by this author , B.P. GriffithB.P. Griffith More articles by this author , S. IwatsukiS. Iwatsuki More articles by this author , and H.T. BahnsonH.T. Bahnson More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)49779-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "A Flexible Procedure for Multiple Cadaveric Organ Procurement." The Journal of Urology, 132(3), p. 622 © 1984 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 132Issue 3September 1984Page: 622 Advertisement Copyright & Permissions© 1984 by The American Urological Association Education and Research, Inc.MetricsAuthor Information T.E. Starzl More articles by this author T.R. Hakala More articles by this author B.W. Shaw More articles by this author R.L. Hardesty More articles by this author T.J. Rosenthal More articles by this author B.P. Griffith More articles by this author S. Iwatsuki More articles by this author H.T. Bahnson More articles by this author Expand All Advertisement PDF DownloadLoading ...

Fourteen of 156 renal-transplant recipients treated with cyclosporine and steroids developed Pneumocystis carinii-related pneumonia (PCP) over a 19-month period. This was a significant change from past experience with this disease in renal-transplant patients receiving azathioprine and steroids (six cases among 179 patients from 1977 to 1981). Epidemiological investigation failed to implicate either person-to-person or nosocomial spread of infection. Cases of PCP occurred more frequently in males. Twelve patients (86%) had onset of disease in the third or fourth months after transplantation. Comparison of cases to matched controls revealed that the cases had received lower doses of steroids and had a higher incidence of cytomegalovirus infection. This suggested that the cases may have been more effectively immunosuppressed than the controls. After institution of prophylaxis with trimethoprim-sulfamethoxazole, no further cases of PCP developed.

A cell line designated 253J was established from a biopsy specimen of retroperitoneal metastasis in a man with multiple transitional cell cancers of the urinary tract. The cells in early and late passages were small and epithelial and had a doubling time of 48 hours. The growth of these cells in culture was characterized by the absence of contact inhibition as evidenced by multilayering. There were virus-like particles in both the original surgical specimen and in cells in culture. The particles were in cytoplasmic vesicles, free in the cytoplasm, or outside both normal and degenerating cells. These particles, varying in size from 30 to 130 nm, had an electron-dense nucleoid and were bounded by a unit membrane. Karyotypic analysis showed the presence of a hyperdiploid stemline with persistent marker chromosomes and chromosomes with multiple rearrangements resulting in unusual G and C banding patterns. The malignant nature of the line was verified by 1) the production of transplantable tumors in immune-depressed hamsters after inoculation with 253J cell suspension and 2) the growth of 253J cells in agar. These cells, in culture over 24 months, have been subcultured over 60 times and continue to retain their epithelial morphology and malignancy.