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Transplantologiya. The Russian Journal of Transplantation

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Vol 11, No 4 (2019)
View or download the full issue PDF (Russian)
https://doi.org/10.23873/2074-0506-2019-11-4

EDITORIAL

ACTUAL ISSUES OF TRANSPLANTATION

282-289 1380
Abstract

Background. Today, the programmed hemodialysis belongs to the clinical medicine area where patients are at a constant risk of viral hepatitis infection. This is associated with surgical interventions on the vessels, fairly frequent transfusions of blood components, and regular hemodialysis procedures. But in recent years, the ratio of reported cases of viral hepatitis B and C in patients on programmed hemodialysis has changed significantly. With an abrupt increase in the incidence of viral hepatitis C, there is a decrease in the number of registered viral hepatitis B cases.

The aim. To study the clinical, epidemiological and pathogenetic features of viral hepatitis C in hemodialysis units.

Material and methods. A multicenter study was conducted that enrolled the patients from the Programmed Hemodialysis Units in Tashkent and the regional departments of the Republic of Uzbekistan. The study involved 395 patients on programmed hemodialysis for 7.5 ± 0.7 years. The age of patients was 43.5 ± 0.91 years. The diagnosis of chronic viral hepatitis C was made on the basis of medical history, clinical and laboratory data, and detection of anti-HCV IgG and RNA-HCV in blood.

Results. When analyzing the clinical examination and laboratory test results of 395 patients, the parenteral viral infection markers were detected in 181 patients (45.8%). The analysis of the overall incidence of viral hepatitis showed that chronic viral hepatitis C had the highest rates and was found in 125 patients (31.6%). The analysis of the chronic viral hepatitis C course in the presence of the end-stage chronic renal disease showed that in 11 (34%) of 32 patients of the Main group the disease proceeded as a fulminant form of chronic renal-hepatic failure with the development of adverse outcomes. Twenty seven patients (84%) in this group developed progressive anemia. In 16 patients (50%), persistent polyserositis developed in the form of hydrothorax, ascites, and pericarditis, which reflected the aggravating effect of chronic viral hepatitis C on the course of chronic renal disease.

Conclusions. In Hemodialysis Units, both in the city of Tashkent, and in the regional departments of the Republic of Uzbekistan, the incidence of chronic viral hepatitis C prevails, having the form of a pathological process with a minimally low activity. Chronic viral hepatitis C has an aggravating effect on the course of the underlying disease with the development of adverse outcomes.

290-300 949
Abstract

Introduction. Studies on the effects of hyperbaric oxygenation have often been represented as animal model experiments. Currently, the number of studies on the use of hyperbaric oxygen therapy in the post-transplant period in humans is growing. The need in investigating the efficacy of hyperbaric oxygen therapy in the postoperative period in female transplant patient with tumors of the reproductive system is dictated by time.

The aim of the study was to evaluate the efficacy of hyperbaric oxygen therapy in the complex treatment of transplant patients at an early stage of the postoperative period.

Material and methods. We have studied the course of an early postoperative period in 8 female transplant patients with reproductive system tumors treated in N.V. Sklifosovsky Research Institute for Emergency Medicine, using hyperbaric oxygenation. The hyperbaric oxygen therapy sessions were provided in a single-patient hyperbaric chamber at 1.2–1.6 ATA for 40 minutes. The status of the redox homeostasis system was assessed based on the data of the platinum electrode open circuit potential measured in blood plasma by using the potentiometric method; and the blood plasma antioxidant activity was assessed by cyclic voltammetry.

Results. The analysis of the results showed that there was a direct relationship indicating the positive effect of hyperbaric oxygen therapy on the balance status of the pro- and antioxidant systems of the body, and on the improvement of blood counts.

Conclusion. The early inclusion of hyperbaric oxygen therapy in the complex treatment of transplant patients with tumors of the reproductive system contributes to a more rapid recovery of pro- and antioxidant systems of the body, blood counts.

CASE REPORTS

301-310 945
Abstract

Introduction. Cardiovascular diseases rank leading in the world. The decompensation of chronic heart failure is the direct cause of death in most patients. The choice of a definitive treatment tactics is the key factor in these patients.

Clinical case. A patient who had experienced myocardial Q-infarction with an ST segment elevation of anterior septal location complicated by the left ventricle anterior wall aneurysm and a decreased myocardial contractility was hospitalized with subcompensated chronic heart failure. Previously, and initially with that hospitalization, the patient was considered a candidate for heart transplantation. After the examination, a decision was made on the possibility of a multi-component reconstructive heart surgery, which was performed with a good clinical effect.

Conclusion. The presented clinical case has confirmed the possibility of correcting the combined pathology in a patient with low myocardial contractility obtaining good immediate and long-term (1.5 years after surgery) results.

REVIEW ARTICLES AND LECTURES

311-319 1248
Abstract
In recent years, the mechanical support of blood circulation has proved to be a vital therapy for a terminal heart failure, and is considered as a "bridge" to transplantation or is used on a permanent basis in a patient who can not be included in the waiting list for a donor organ. Recent studies of the critical heart failure treatment during an assist device in situ have shown the myocardial recovery at the molecular and cellular levels. However, the transition of these changes to a functionally stable recovery of the heart function, which would allow the long-term results to be achieved without a heart transplant or switching off the mechanical support, is now rather an exception to the rule. At this time, the cause of the discrepancy between the high rate of recovery at the cellular and molecular levels and the low rate of cardiac function recovery remains poorly understood. Patients with chronic progressive heart failure can demonstrate the normalization of many structural myocardial abnormalities after a mechanical support that is actually a reverse remodeling. However, the reverse remodeling is not always considered equivalent to clinical recovery. The aim of this research is to study a significant improvement in the structure and function of the myocardium during the mechanical support of blood circulation.
320-329 1021
Abstract
Recent statistics have shown increased rates of morbidity and mortality from Clostridium difficile infection worldwide. This problem is mainly typical for surgical patients and is associated with an antibiotic therapy and a prolonged hospital stay. Recipients of solid organs are at a high risk of developing severe forms of C. difficile infection due to immunosupression. Existing recommendations for the treatment of C. difficile infection are based on the severity of the disease and do not consider patients after liver transplantation. The aim of this work is to determine an actual tactics for the diagnosis and treatment of C. difficile in organ recipients in clinical practice.

HISTORY OF MEDICINE

330-348 805
Abstract
This paper has first put into scientific circulation the transcript of the Meeting of the Presidium of the USSR Healthcare Ministry Council for the Coordination of Scientific Research and Implementation of the Scientific Achievements that was held on October 8, 1963, and discussed the current state and development of scientific research in organ transplantation in the USSR. The presentations of the meeting participants who discussed the reports of V.P. Demikhova and V.I. Burakovsky have been described and analyzed. The concept of organ homotransplantation put forward by V.P.Demikhov who did not take into account (in some speakers's opinion) the latest achievements in immunobiology was reasonably criticized. V.I.Burakovsky's proposals on establihing a Research Institute of Organ and Tissue Transplantation and the Problem Commission for Transplantology were considered rational, supported, and included in the Presidium Resolution.

DATES AND EVENTS

ПРАВИЛА ДЛЯ АВТОРОВ



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ISSN 2074-0506 (Print)
ISSN 2542-0909 (Online)