ÔÀÐÌÀÊÎËÎÃÈ×ÅÑÊÀß ÏÐÎÒÅÊÖÈß ÎÐÃÀÍΠÍÀ ÄÎÍÎÐÑÊÎÌ ÝÒÀÏÅ 1 ÓÇ «Áðåñòñêàÿ îáëàñòíàÿ áîëüíèöà» 2 ÃÓ «Ìèíñêèé íàó÷íî-ïðàêòè÷åñêèé öåíòð õèðóðãèè, òðàíñïëàíòîëîãèè è ãåìàòîëîãèè» 3 ÃÓÎ «Áåëîðóññêàÿ ìåäèöèíñêàÿ àêàäåìèÿ ïîñëåäèïëîìíîãî îáðàçîâàíèÿ» Öåëü èññëåäîâàíèÿ: îöåíèòü ýôôåêòèâíîñòü ðàçðàáîòàííîé ñõåìû ÃÇÒ ÏÄ è ôàðìàêîëîãè÷åñêîé çàùèòû äîíîðñêèõ îðãàíîâ íà ýòàïå ýêñïëàíòàöèè, ñ äàëüíåéøåé îöåíêîé ôóíêöèè òðàíñïëàíòàòà â ðàííåì ïîñëåîïåðàöèîííîì ïåðèîäå. Ìàòåðèàëû è ìåòîäû. Ïðîâåäåíî ðàíäîìèçèðîâàííîå ïðîñïåêòèâíîå, îäíîöåíòðîâîå èññëåäîâàíèå ýôôåêòèâíîñòè ïðåäëîaeåííîé íàìè ñõåìû ÃÇÒ (ìåòèëïðåäíèçîëîí, ëåâîòèðîêñèí, èíñóëèí, ìåòôîðìèí, äåñìîïðåññèí) íà ýòàïå êîíäèöèîíèðîâàíèÿ ÏÄ è èñïîëüçîâàíèÿ ôàðìàêîëîãè÷åñêèõ ïðåïàðàòîâ: ãåïàðèíà, ñòðåïòîêèíàçû, ýáðàíòèëà íà ýòàïå ýêñïëàíòàöèè ñ âêëþ÷åíèåì 80 ïîòåíöèàëüíûõ äîíîðîâ ñî ñìåðòüþ ìîçãà è èçó÷åíèåì ðåçóëüòàòîâ 144 òðàíñïëàíòàöèé ïî÷êè. Ðåçóëüòàòû èññëåäîâàíèÿ. Óñòàíîâëåíî, ÷òî ó âñåõ ïàöèåíòîâ, ïîëó÷àâøèõ ÃÇÒ ïðè êîíäèöèîíèðîâàíèè ÏÄ íà äîíîðñêîì ýòàïå, ñòàòèñòè÷åñêè äîñòîâåðíî ñíèaeàëàñü ïîòðåáíîñòü â äîçå âàçîïðåññîðîâ, ïîâûøàëñÿ îñíîâíîé îáìåí è óñèëèâàëàñü òåïëîïðîäóêöèÿ. Èñïîëüçîâàíèå ôàðìàêîëîãè÷åñêîé ïðîòåêöèè óëó÷øàåò ìåòàáîëè÷åñêèå è ýëåêòðîëèòíûå ïîêàçàòåëè ýôôëþýíòà ïîñëå ôëàøèíãà äîíîðñêîé ïî÷êè. Äîñòîâåðíî çíà÷èìî óâåëè÷èëîñü êîëè÷åñòâî ìóëüòèîðãàííûõ çàáîðîâ äîíîðîâ è ïåðâè÷íî-ôóíêöèîíèðóþùåãî òðàíñïëàíòàòà ïî÷êè â ñðàâíåíèè ñ êîíòðîëüíîé ãðóïïîé. Çàêëþ÷åíèå. Èñïîëüçîâàíèå ðàçðàáîòàííîé àâòîðàìè ÃÇÒ è ôàðìàêîëîãè÷åñêîé ïðîòåêöèè äîíîðñêèõ îðãàíîâ ïîçâîëÿåò óëó÷øèòü êà÷åñòâî êîíäèöèîíèðîâàíèÿ ïîòåíöèàëüíûõ äîíîðîâ è ðåçóëüòàòû òðàíñïëàíòàöèè ïî÷êè. Êëþ÷åâûå ñëîâà: ïîòåíöèàëüíûé äîíîð, ãîðìîíçàìåñòèòåëüíàÿ òåðàïèÿ, êîíäèöèîíèðîâàíèå ïîòåíöèàëüíîãî äîíîðà, òðàíñïëàíòàöèÿ ïî÷êè. ËÀÂÐÈÍÞÊ Ð.Ï., ÊÐÈÂÅÍÊÎ Ñ.²., ÑÀÄÎÂÑÊÈÉ Ä.Í., ÐÓÌÌÎ Î.Î., ÏÈÊÈÐÅÍß ².². ÔÀÐÌÀÊÎËÎò×ÍÀ ÏÐÎÒÅÊÖ²ß ÎÐÃÀͲ ÍÀ ÄÎÍÎÐÑÜÊÎÌÓ ÅÒÀϲ Ìåòà äîñë³äaeåííÿ: îö³íèòè åôåêòèâí³ñòü ðîçðîáëåíî¿ ñõåìè ãîðìîíîçàì³ñíî¿ òåðàﳿ (ÃÇÒ) ïîòåíö³éíèõ äîíîð³â (ÏÄ) ³ ôàðìàêîëîã³÷íîãî çàõèñòó äîíîðñüêèõ îðãàí³â íà åòàï³ åêñïëàíòàö³¿, ç ïîäàëüøîþ îö³íêîþ ôóíêö³¿ òðàíñïëàíòàòà â ðàííüîìó ï³ñëÿîïåðàö³éíîìó ïåð³îä³. Ìàòåð³àëè òà ìåòîäè. Ïðîâåäåíî ðàíäîì³çîâàíå ïðîñïåêòèâíå, îäíîöåíòðîâå äîñë³äaeåííÿ åôåêòèâíîñò³ çàïðîïîíîâàíî¿ íàìè ñõåìè ÃÇÒ (ìåòèëïðåäí³çîëîí, ëåâîòèðîêñèí, ³íñóë³í, ìåòôîðì³í, äåñìîïðåñèí) íà åòàï³ êîíäèö³îíóâàííÿ ÏÄ ³ âèêîðèñòàííÿ ôàðìàêîëîã³÷íèõ ïðåïàðàò³â: ãåïàðèíó, ñòðåïòîê³íàçè, åáðàíò³ëó íà åòàï³ åêñïëàíòàö³¿ ç âêëþ÷åííÿì 80 ïîòåíö³éíèõ äîíîð³â ç³ ñìåðòþ ìîçêó ³ âèâ÷åííÿì ðåçóëüòàò³â 144 òðàíñïëàíòàö³é íèðêè. Ðåçóëüòàòè äîñë³äaeåííÿ. Âñòàíîâëåíî, ùî ó âñ³õ ïàö³ºíò³â, ÿê³ îòðèìóâàëè ÃÇÒ ïðè êîíäèö³îíóâàíí³ ÏÄ íà äîíîðñüêîìó åòàï³, ñòàòèñòè÷íî äîñòîâ³ðíî çíèaeóâàëàñÿ ïîòðåáà â äîç³ âàçîïðåñîð³â, ï³äâèùóâàâñÿ îñíîâíèé îáì³í ³ ïîñèëþâàëàñÿ òåïëîïðîäóêö³ÿ. Âèêîðèñòàííÿ ôàðìàêîëîã³÷íî¿ ïðîòåêö³¿ ïîêðàùóº ìåòàáîë³÷í³ ³ åëåêòðîë³òí³ ïîêàçíèêè åôôëþåíòà ï³ñëÿ ôëàøèíãà äîíîðñüêî¿ íèðêè. Äîñòîâ³ðíî çíà÷èìî çá³ëüøèëàñü ê³ëüê³ñòü ìóëüòèîðãàííèõ çàáîð³â ó äîíîð³â ³ ïåðâèííî-ôóíêö³îíóþ÷îãî òðàíñïëàíòàòà íè...
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