First Russian experience of liver and kidneys transplantation obtained from the donor with out-of-hospital irreversible cardiac arrest

At present, it is widely recognized that machine perfusion allows for a decreased rate of delayed function of the renal graft and of the risk of liver graft early dysfunction. The aim of the review is to present the actual changes of the donor pool related to prevailing numbers of donors by expanded criteria, to determine the prospects of expanding of the available donor pool based on their selection, as well as development of functional rehabilitation and modification at tissue, cell and molecular levels with the help of perfusion technologies. The article presents the state-of-the art view on the mechanisms of ischemic-reperfusion injury of donor organs, delineates the trends in the maintenance of their viability, and gives the literature data on the role and outlook of perfusion methods in organ transplantation. The authors provide the rationale for a comprehensive systemic approach to the assessment of the functional status of a donor organ with any baseline parameters and discuss a number of theoretical provisions on the implementation of a personalized perfusion approach to ensure the availability of transplantation care.

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Preservation and perfusion rehabilitation of donor organs: achievements of the last decade

Резник

Скворцов

Мойсюк

2020

Alʹm. klin. med.

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Analysis of complications after living-related kidney transplantation: a single-center experience

Хаджибаев¹,

Шарипова²,

Sultanov³

2021

Transplantologiâ (Mosk.)

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Background. The one-year renal graft survival rates have grown to 93.4% for transplantation from cadaveric and 97.2% from living donors. Early detection and elimination of complications after kidney transplantation improve these figures.The study purpose was to develop an algorithm for the diagnosis and treatment tactics of postoperative complications after kidney transplantation by reviewing literature data and analyzing the results of our own experience.Material and methods. The study included 75 patients who underwent kidney transplantation from a living donor at the Republican Research Centre of Emergency Medicine from March 2018 to December 2019.Results. The original authors' algorithm developed for the diagnosis and treatment of complications after kidney transplantation covers all postoperative complications that lead to renal transplant dysfunction. It is based on assessing the symptoms that typically occur in a specific complication. The main instrumental methods in the diagnosis of postoperative complications are ultrasound and radiological investigational techniques. The biopsy has the main role in diagnosing a graft rejection. Among 75 patients after kidney transplantation, 23 (30.6%) developed various early postoperative complications, including both surgical and immunological ones. Renal graft dysfunction was eliminated in 17 (73.9%) of 23 patients. The loss of a transplanted kidney was associated with the death of 7 recipients (9.3%). The causes of death were pulmonary embolism in 2 (2.7%) cases, infection and sepsis as a result of immunosuppression in 2 (2.7%) cases, hypovolemic shock in 2 (2.7%) cases, and acute ischemic stroke in 1 (1.3%) case. Two recipients underwent renal transplant nephrectomy. The cause of nephrectomy was graft rejection and bleeding from the renal artery. A oneyear survival rate was 90.7%. The proposed treatment and diagnostic algorithm showed a 95.7% diagnostic value in identifying the complications, and 91.3% of the therapeutic effect in coping with a renal transplant dysfunction.Conclusions. Early treatment of revealed complications allows saving the transplanted kidney function. Step-bystep differential diagnosis of complications after kidney transplantation, according to the proposed algorithm, allows choosing the treatment tactics based on complication pathogenesis.

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Some Aspects of the Development of Medical Transplantology in the Works of Russian Authors (Literature Review)

Balayan

2020

Terapevt (General Physician)

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Despite the statistically substantiated relevance of the transplantation procedure among patients, there is an acute problem of the shortage of donor organs associated with various problems of a social, ethical and scientific nature in Russia. These problems have a significant impact on the development of national transplantology, affect the formation of areas of medical thought. During the period of absence of an alternative of an effective care for patients with severe organ failure, continuous improvement of the federal regulatory framework in the field of transplantology is required, as well as the study of the experience of other countries.

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First Russian experience of liver and kidneys transplantation obtained from the donor with out-of-hospital irreversible cardiac arrest

Cited by 3 publications

References 32 publications

Preservation and perfusion rehabilitation of donor organs: achievements of the last decade

Preservation and perfusion rehabilitation of donor organs: achievements of the last decade

Analysis of complications after living-related kidney transplantation: a single-center experience

Some Aspects of the Development of Medical Transplantology in the Works of Russian Authors (Literature Review)

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