Transplantation and artificial organs最新文献

{"title":"Criteria for Selecting Patients for Inclusion in the Waiting List for Heart Transplantation","authors":"O. Tanska","doi":"10.30702/TRANSPAORG/07_20.0112/089-107/7-002","DOIUrl":"https://doi.org/10.30702/TRANSPAORG/07_20.0112/089-107/7-002","url":null,"abstract":"Objective. The aim of the study was to optimize the methods of selecting patients for inclusion in the «waiting list» for heart transplantation on the basis of available international data and the introduction of selection criteria.Materials and methods. The results of the study are based on survey data and dynamic monitoring of 49 patients (median age 38 (16; 65) years; 44 men, 5 women) who were treated from 2008-2018 in the centers: Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus; in the Center of cardiac surgery on the basis of Hospital «Feofania». Patients were examined during the initial examination, after 3 months, 6 months and after 1 year. \u0000Results and discussion. The first group consisted of 24 patients with CHF who were on the waiting list for orthotopic heart transplantation, for circulatory support, median age 40.95 (18.0; 65.0) years, men - 23, women - 1; The second group consisted of 25 patients with CHF who were on the waiting list fororthotopic heart transplantation without circulatory support, median age 38.56 (17.0; 64.0) years, men - 21, women - 4.Conclusions. Scientific novelty of the obtained results. For the first time in Ukraine, a road map has been developed and implemented and the dynamics of the movement of recipients who are in the «waiting list» for heart transplantation has been analyzed. Identified risk factors that affect the long-term outcomes and quality of life of patients with heart failure III-IV functional class according to the NYHA classification. Criteria for selection of patients for primary heart transplantation have been developed and implemented. For the first time in Ukraine, a «waiting list» for a heart transplant has been formed.","PeriodicalId":116695,"journal":{"name":"Transplantation and artificial organs","volume":"154 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130455905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Restoration of the Skin in Patients with Trophic Ulcers of Various Origins","authors":"V. Boyko, A. V. Kravtsov, Yu. I. Isaev, Yu. I. Kozin, T. Kurbanov","doi":"10.30702/TRANSPAORG/03_20.0112/040-049/44-089","DOIUrl":"https://doi.org/10.30702/TRANSPAORG/03_20.0112/040-049/44-089","url":null,"abstract":"A study of the effectiveness of surgical treatment aimed at restoring the skin in 176 patients with trophic ulcers of vascular origin. An algorithm of conservative, local and surgical treatment has been developed, which provides full-fledged replacement of the ulcer defect by performing autodermoplasty operations.Objective. To improve the results of skin plastic operations in the treatment of trophic ulcers based on the optimization of the staged preparation, the performance of surgical intervention and the postoperative management of the wound defect.Materials and methods. The operations of skin grafting over the past 5 years have been performed by us in 176 patients with trophic ulcers. The area of the wound defect ranged from 10 cm2 to 1000 cm2. An algorithm of treatment was developed and used in clinical practice, consisting of 8 stages aimed at preparing ulcers, performing skin grafting, postoperative treatment, and post-transplant adaptation of skin flaps. \u0000Results and discussion. In the course of the treatment, general infusion, drug therapy and local treatment were carried out against the background of which excision of pathological granulations, preparation of wounds, skin plasty and postoperative treatment were performed.A long-lasting positive functional and aesthetic effect was obtained.Conclusions. An algorithm has been developed for the complex treatment of trophic ulcers, including a skin transplantation operation, the clinical application of which provides a longterm healing of a wound defect and an improvement in the quality of life of patients.","PeriodicalId":116695,"journal":{"name":"Transplantation and artificial organs","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121080340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transplantation and artificial organs 1(01) 2020","authors":"O. H. Kotenko, A. Minich, M. Grygorian","doi":"10.30702/TRANSPAORG/01_20.0112/06-017/844","DOIUrl":"https://doi.org/10.30702/TRANSPAORG/01_20.0112/06-017/844","url":null,"abstract":"Changes in liver blood flow and functional status of liver transplants with different types of venous outflow reconstruction have not been fully studied. A graft with optimal blood flow characteristics in a living family donation is one of the key factors that determines its functional state. \u0000 The Aim. Comparison of regional hemodynamics of the liver and biochemical parametersof blood after transplantation of the right lobe from a living related donor with and without amedian vein.Materials and methods. Based on our algorithm, which included analysis of the variational anatomy of the hepatic veins of the donor to determine the type of dominant vein, transplants were selected for 76 recipients: 39 patients (group 1) were transplanted right lobe of the middle vein and 37 patients (group 2) – right lobe without meddle vein. For comparative analysis, we used data from blood biochemical parameters and data from regional hemodynamics of grafts: volumetric portal blood flow, linear velocity and resistance index in the hepatic artery in both groups during the first week and on the 10th, 14th, 21st, 30th day after transplantation.Results. Using the described graft selection algorithm, we obtained the following results on the 30th day after transplantation: in group 1 there were higher values of volumetric portal blood flow compared to group 2 at all stages of observation (1110 ± 62 ml/min and 922 ± 41 ml/min, p = 0,013864 in groups 1 and 2, respectively); the resistance index in the hepatic artery was statistically significantly higher in group 2 – 0.61 ± 0.01 compared with group 1 (0.63 ± 0.01, p = 0.042722); serum bilirubin level in group 1 was statistically significantly lower compared to group 2 (33.4 ± 9 and 39.8 ± 3.4 μmol/l, respectively, p = 0.0377); serum transaminases, alanine aminotransferase and aspartate aminotransferase, were statistically significantly lower in group 1 compared with group 2 – alanine aminotransferase – 50 ± 3.3 and 78.6 ± 8.2 U/l, respectively (p = 0.0022), aspartate aminotransferase – 42 ± 2.9 and 62.4 ± 8.9 U/l, respectively (p = 0.0282)).Conclusions. With the dominant type of middle hepatic vein in transplants of the right lobe, it is necessary to perform the right lobe of the liver with the middle vein. If the right vein is dominant – the right lobe of the liver without the inclusion of the middle vein. Adequate venous outflow, with a sufficient volume of the graft of the right lobe of the liver, determines the functional mass of the graft.","PeriodicalId":116695,"journal":{"name":"Transplantation and artificial organs","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123318473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the stages of psychological preparation of transplant coordinators (as part of the implementation of the bulk program)","authors":"A. P. Poplavskaya","doi":"10.30702/TRANSPAORG/10_20.0112/126-129/089.843","DOIUrl":"https://doi.org/10.30702/TRANSPAORG/10_20.0112/126-129/089.843","url":null,"abstract":"This article presents an analysis of the stages of psychological training of future transplant coordinators within the framework of the implementation of the first ZMAPO Transplant Coordinator Program. The introduction of the newly developed program for the training of future transplant coordinators has reflected some of the complexities of the psychological and pedagogical process: first, a lack of purely psychological knowledge and skills, certain problems of mastering new theoretical material, certain difficulties in overcoming barriers to communication. But all this was offset by a desire to get new interesting information, a desire to learn something new, and to develop skills for direct dialogue with potential donors and their relatives.","PeriodicalId":116695,"journal":{"name":"Transplantation and artificial organs","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123638133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Circulatory Support in Patients with End-Stage Heart Failure","authors":"V. Tanskyi","doi":"10.30702/TRANSPAORG/02_20.0112/018-039/089","DOIUrl":"https://doi.org/10.30702/TRANSPAORG/02_20.0112/018-039/089","url":null,"abstract":"Objective. The aim of the study is to establish the effectiveness of mechanical support of blood circulation of patients with end-stage heart failure depending on the method of surgical correction. \u0000Materials and methods. The results of the study are based on the data of examination and dynamic observation of 73 patients (median age 44 (16-69) years, 68 men, 5 women) who were treated from 2008-2019 іn the following medical institutions: Republican Scientific and Practical Center «Cardiology» (Minsk, Republic of Belarus) and Center of cardiac surgery on the basis of Hospital «Feofania». Patients were examined during the initial examination, after 3 months and after 1 year. \u0000Results and discussion. As a result of the study found, indications for surgical treatment of patients with end-stage heart failure those are the following criteria: left ventricular ejection fraction (LV EF) <20%, (p < .0001). Pulmonary artery occlusion pressure (PAL) from 25 mm Hg up to 35 mm Hg (p < .0001). Peak myocardial oxygen consumption <14 ml/kg/min on the background of maximum drug therapy (p < .0001). Pulmonary vascular resistance (PVR) <5 units by Wood, (p < .0001). Transpulmonary gradient up to 15 mm Hg (p < .0001). Indications for LVAD therapy are the following criteria: left ventricular ejection fraction (LV EF) <20%, (p <0001). Pulmonary artery occlusion pressure > 35 mm Hg (p < .0001). Pulmonary vascular resistance (PVR) >5 units by Wood, (p < .0001). Transpulmonary gradient >15 mm Hg (p < .0001). Against the background of work LVAD after 3 months there was a decrease in the left ventricular cavity by 30%, (p < .0001), decrease in the pancreatic cavity by 25.5%, (p < .0001), increase in fraction LV emission by 21%, (p < .0001). According to direct pulmonary arterial tonometry with LVAD therapy, there was a decrease in pulmonary vascular resistance «Wood» by 34%, (p < .0001), reduction in pulmonary arterial pressure by 24%, (p < .0001), a decrease of transpulmonary gradient by 21%, (p < .0001). The results of the change in functional indicators in patients on LVAD therapy after 3 months: increase maximum myocardial oxygen consumption by 6% (p < .0001), increase exercise tolerance by 15% (p < .0001). Indications for BiVAD-therapy are the following criteria: biventricular insufficiency, (p < .0001). Pulmonary artery occlusion pressure >35 mm Hg, (p < .0001). Pulmonary vascular resistance >5 units by Wood, (p < .0001). Transpulmonary gradient >15 mm Hg, (p < .0001). Against the background of BiVAD work in 3 months was noted reduction of the right ventricular (RV) enddiastolic volume (EDV) by 6% (p <0001), reduction of the RV end-systolic volume (ESV) by 10%, (p < .0001), increase in LV EF by 33%, (p < .0001), decrease in left ventricular (LV) ESV (M-mode) by 36.3%, (p < .0001), a decrease in LV EDV (M-mode) by 30%, (p < .0001), a decrease in LV ESV (B-mode) by 22.5%, (p < .0001), increase in tricuspid systolic excursion (TAPSE) by 21.4%, (p < .0001). According to t","PeriodicalId":116695,"journal":{"name":"Transplantation and artificial organs","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114473301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replacement of Mandible Defect by a Rib Autotransplant","authors":"N. Barannik, O. O. Mosieyko, O. M. Manukhina, A. Sidoryako, K. P. Volchykhina","doi":"10.30702/TRANSPAORG/06_20.0112/078-088/035","DOIUrl":"https://doi.org/10.30702/TRANSPAORG/06_20.0112/078-088/035","url":null,"abstract":"Aims. Improve the technique of bone plastics of the mandible with a free autogenous rib graft.Materials and methods. A retrospective analysis of 41 case histories of patients undergoing surgical treatment in connection with the replacement of the mandibular defectsacquired due to tumors, injuries, osteomyelitis at the clinic of maxillofacial surgery in 2003-2018 was carried out. \u0000The technique of osteoplasty of the mandible with free autogenous rib graft has been improved by expanding the technical possibility of reliable fixation of bone fragments with titanium plates and screws, as well as tight installation of autograft in the bone defect and creating favorable conditions for the primary osseointegration. \u0000The own method of harvesting and formation of autogenous rib graft is proposed. For 15 years, not a single complication was identified and there was no rejection of the free autogenous rib grafts.Conclusions. This technique is simple, safe, and can be effectively used to reconstruct long-span mandibular defects with minimal complications in selected patients. \u0000  \u0000 ","PeriodicalId":116695,"journal":{"name":"Transplantation and artificial organs","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127867206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}