[The HLA phenotype and duodenal ulcers in patients following kidney transplantation]. / HLA-fenotip i duodenal'nye iazvy u bol'nykh posle transplantatsii pochki.

The authors have performed an investigation of the association between ulcer disease of the duodenum and bleedings from the ulcers in 204 patients after transplantations of the kidney with the antigen of HLA system histocompatibility. Duodenal ulcers were found in 25 patients (12.9%), in 11 of them the ulcers were complicated by bleedings which was 5.4% of the total number of the patients with the transplanted kidney. The evaluation of the HLA antigen distribution has revealed an association of duodenal ulcers with A2 and B13 antigens which took place significantly more often than in a group of practically healthy people (RR = 1.85 and 1.9 correspondingly). In patients with the transplanted kidney and following ulcerous bleedings this association was more obvious (RR = 2.32 and 3.74 correspondingly). According to the calculated etiological fraction 40% of the patients can be supposed to have the etiological association of the disease with A2 antigen and 20% of the patients with B13 antigen. A typical feature was the presence of possible "protective" A9 antigen which was found in the group under study two times more seldom than in the control group (RR = 0.25). A comparison of the distribution of HLA antigens in the patients in whom there developed bleeding duodenal ulcers with those who had no such complications has also established the association of the disease with HLA A2 and B13 antigens. The probable "protective" A9 antigen was also found. Since the kidney transplantation is preceded by determination of the recipient's HLA phenotype, these data can be used as prognostic criteria as well as the indications to performing preventive antiulcerous therapy in patients with high risk of the development of ulcerous lesions of the gastrointestinal tract.

[Infectious complications in patients following kidney transplantation]. / Infektsionnye oslozhneniia u bol'nykh posle transplantatsii pochki.

Opportunistic infection (bacterial, viral, parasitic, fungal) acquires an important role under the conditions of immunodeficiency associated with kidney transplantation. Immunodeficiency results not only from the immunosuppressive therapy, but from the main disease and kidney failure as well. The use of cyclosporin selectively suppressing T-cell immunity makes the infectious complications very similar to those complicating AIDS. Its high toxicity increases feasibility of pulmonary complications.

[Arteriovenous fistulas for extrarenal purification of blood using the brachial artery]. / Arteriovenoznye fistuly dlia vnepochechnogo ochishcheniia krovi s ispol'zovaniem plechevoi arterii.

The article analyzes an experience with creation of different variants of arteriovenous fistulas (AVF) for the extrahepatic purification of blood by using the humeral artery. The above mentioned AVFs were shown to be expedient in patients with small diameters of the forearm vessels or in cases with no possibility to make AVF in the forearm. It is better to make AVF with the antegrade blood flow in the veins. The use of vascular transplants is indicated when there are no veins in the upper extremity suitable for AVF.

[Diagnostic and prognostic value of kidney function tests in cadaveric kidney transplantation]. / Diagnosticheskoe i prognosticheskoe znachenie nekotorykh pokazatelei funktsii pochek pri transplantatsii trupnoi pochki.

Within the first 6 weeks after kidney transplantation the diagnostic and prognostic importance of some characteristics of partial renal function was studied in 48 patients with postoperative acute renal failure (ARF), precrisis, acute rejection of the transplant, and a crisis-free course of the postoperative period. It was established that the numerical data and the diagnostic importance of the characteristics under study are determined by the degree of the preceding ischemic lesion of the kidney. Some functional criteria of the crisis irreversibility and the effect on its temporary parameters of postoperative ARF were defined.

[Gastroduodenal ulcers and their complications in kidney transplantation]. / Gastroduodenal'nye iz''iazvleniia i ikh oslozhneniia pri transplantatsii pochki.

The authors report 5 patients who developed acute peptic ulcers following transplantation of a cadaveric kidney and 4 patients who developed erosive gastritis or gastroduodenitis. The diagnosis and treatment of these complications are described.

[Repeat interventions in arteriovenous fistulae for chronic hemodialysis]. / Povtornye vmeshatel'stva pri arteriovenoznykh fistuliakh dlia khronicheskogo gemodializa.

The authors have analyzed causes of disturbances of functions of arterio-venous fistulas (AVF) for chronic hemodialysis in 30 patients requiring repeated operations (fistula thromboses, suppurations, slow blood flow in the vein etc.). They recommend a preserving method of treatment of complications in AVF. Different variants of repeated operations are described depending on the individual cause of disturbances of the AVF functions.

[Extracorporeal fixation of liver slices onto the system of "artificial kidney" apparatus]. / Ekstrakoporal'noe podkliuchenie plastov pecheni v sisteme apparata "iskusstvennaia pochka"

On 36 experimental dogs a new dialyser "liver-kidney" was tested, in which along with the process of dialysis some functions of the liver were carried out on account of placing in the apparatus homologous liver slices 2-3 mm thick. The data of biochemical studies of animals blood have evidenced satisfactory results. The dialyser with heteroliver slices assisted in two patients with hepato-renal failure. One of them made a good recovery and was discharged from the clinic, a favourable immediate result was obtained in the second patient.