ABSTRACT
Operations of transplantation of kidneys taken from donors with expanded criteria with satisfactory results were made on 27 recipients of the older age group (from 60 through 76 years). Standard transplantation of the kidney was made to 20 recipients, and dual renal transplantation to 7 recipients. Mean level of creatinine in elderly patients on the 21st day was (340.9 +/- 49.3) microM/l, on the 90th day (124.6 +/- 6.9) microMl/l.
Subject(s)
Donor Selection , Kidney Transplantation , Kidney , Organ Preservation , Tissue and Organ Harvesting , Aged , Cadaver , Cause of Death , Donor Selection/methods , Donor Selection/standards , Female , Humans , Kidney Failure, Chronic/physiopathology , Kidney Failure, Chronic/surgery , Kidney Function Tests , Kidney Transplantation/methods , Kidney Transplantation/standards , Male , Middle Aged , Organ Preservation/methods , Organ Preservation/standards , Patient Selection , Tissue and Organ Harvesting/methods , Tissue and Organ Harvesting/standards , Treatment OutcomeABSTRACT
A hundred and twenty-nine victims aged 16 to 60 years who had skin burns in the area of 15 to 60% of the body surface without severe concomitant somatic disease (SAPS less than 9 scores). The clinical symptoms of a systemic inflammatory response (SIR) and the signs of wound infection were recorded in all the examinees. The victims underwent a comprehensive clinical and laboratory examination, 55 of them were immunologically studied over time (on admission, on days 3 and 10). To reveal the predictive clinical and immunological criteria for sepsis, the examinees were divided into 3 groups. Group 1 comprised 33 burnt persons who were observed to have the symptoms of SIR and the signs of burn wound infections without impaired function of organs and systems. Group 2 included 46 victims with severe sepsis and a good outcome of burn disease. Group 3 consisted of 50 patients who had died from severe sepsis. Analysis of the results of the study has indicated that the count of formed blood elements by calculating the leukocytic intoxication index, the estimation of the level of lysosomal cation proteins in the neutrophilic granulocytes, the detection of populations of T helper cells, cytotoxic lymphocytes, as well as histomorphological and bacteriological findings are early and valid criteria for the development of infectious complications. Their use for the diagnosis and prediction of sepsis permits initiation of its treatment at early stages, without awaiting the appearance of the signs of a septic process.
Subject(s)
Burns/complications , Systemic Inflammatory Response Syndrome/immunology , T-Lymphocytes/immunology , Adolescent , Adult , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Humans , Lipopolysaccharide Receptors/immunology , Middle Aged , Prognosis , Receptors, Interleukin-2/immunology , Systemic Inflammatory Response Syndrome/etiology , Systemic Inflammatory Response Syndrome/microbiology , Systemic Inflammatory Response Syndrome/mortality , Trauma Severity IndicesABSTRACT
The authors present results of their investigation of the state of kallikrein-kinin system (KKS) and lipid peroxidation (LP) in blood of 22 patients operated upon for acute diffuse peritonitis as a complication of different surgical diseases. In 8 patients who later died the respiratory distress-syndrome of adults (RDSA) developed at the early postoperative period. Activation of KKS and LP were observed in all the patients both in the venous and arterial blood, but it was more intensive in patients with RDSA. In the same group of patients the level of the metabolites under study was higher in the arterial than in the venous blood, which suggests a disturbances of the metabolic function of the lung. The results of the investigation allow a conclusion that antiprotease drugs should be included in the complex treatment of RDSA.
