Transplantologiya. The Russian Journal of Transplantation最新文献

{"title":"Therapeutic agents for machine perfusion of donor organs","authors":"O. Rzhevskaya, V. M. Magilevets, R. S. Islamgazin, B. I. Yaremin, E. Y. Anosova, A. Balkarov, M. Novruzbekov","doi":"10.23873/2074-0506-2024-16-1-116-134","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-116-134","url":null,"abstract":"Background. The urgency of the unmet need for transplant care dictates the necessity to use organs from suboptimal donors. Machine perfusion, which is actively developing at the present time, is designated to solve this problem. The literature presents novel technologies of ex vivo and in vivo machine perfusion of donor organs, which make it possible to improve their functions and perform a successful transplant. The most promising areas of research both in animals and in humans may be identified by reviewing the literature sources on this subject.The aim was to analyze the world experience of using therapeutic agents in machine perfusion of donor organsMaterial and methods: sources from 2015 to 2023 found in PubMed, Google Scholar, eLibrary databasesConclusion. The rapid progress in lung, liver and kidney transplantation has made it possible to use grafts from asystolic donors for patients in urgent need of donor organs. In turn, these advances have also prompted the study of potential therapeutic agents that can be used during perfusion.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140214776","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":"Ex vivo lung perfusion in lung transplantation","authors":"A. P. Fabrika, E. P. Tychina, A. Bayramkulov, E. A. Tarabrin","doi":"10.23873/2074-0506-2024-16-1-99-115","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-99-115","url":null,"abstract":"Introduction. The number of lung transplants performed worldwide is not enough because of a shortage of suitable (ideal) donors, missed chances to use lungs from donors who died of cardiac arrest, the lack of resources to perform this technically complex operation in poor, developing countries and due to a number of other reasons.) The world literature sources contain information about an increase in the number of lung transplantations by using organs from non-ideal (suboptimal and marginal) donors. This became possible thanks to the technology of ex vivo normothermic perfusion of donor lungs.Aim. To demonstrate the possibilities in the assessment, therapy and restoration of the function of non-ideal (suboptimal and marginal) donor lungs by using the technique of ex vivo lung perfusion.Material and methods. We reviewed scientific articles published in the period from 2003 to 2023 in the PubMed and Google Scholar databases for the key query \"ex vivo lung perfusion\".Conclusion. The ex vivo lung perfusion technique is a promising and effective procedure for lung evaluation, recondition and regeneration for) transplantation. A rapid development of technologies for this treatment modality makes it possible to increase the number of lungs suitable for transplantation, reduce the number of post-transplant complications and mortality rates on the waiting list, and improve the outcomes of lung transplantations.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140218488","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":"Specific features of anesthetic management in simultaneous pancreas and kidney transplantation in a recipient with morbid obesity","authors":"M. V. Lebedev, N. K. Kuznetsova, A. M. Talyzin, E. Korotkova, S. V. Zhuravel","doi":"10.23873/2074-0506-2024-16-1-88-98","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-88-98","url":null,"abstract":"Introduction. Anesthetic management in simultaneous pancreas and kidney transplantation in recipients has some specific features. In addition to the presence of underlying pathology in the form of type 1 diabetes mellitus and secondary diabetic complications, pronounced comorbidities can often make some difficulties for an anesthesiologist.Aim. We have reported a clinical case showing the specific features of anesthetic support for simultaneous pancreas and kidney transplantation in a recipient with morbid obesity.Clinical Case Report. Specific features of the anesthetic management of a 42-year-old patient L. with morbid obesity (body mass index 43.3 kg/m2) and hypertension who underwent simultaneous pancreas and kidney transplantation have been described. A preoperative examination of this patient revealed predictors of difficult airways, so endoscopically assisted intubation was performed. The Trendelenburg position of the patient during surgical intervention due to an excess body weight led to the increased intrathoracic pressure intraoperatively. The pressure ventilation mode, the neutral position of the patient on the operating table, and the monitoring of ventilation efficiency made it possible to return the elevated intrathoracic pressure to normal. A preoperative examination by a cardiologist, timely diagnosis and treatment of hypertension at the stage of placing the patient on the waiting list made it possible to exclude adverse hemodynamic reactions at the main stages of the operation. The patient was extubated on surgery completion in the Operating Room. The pancreatic graft function and the kidney graft function were satisfactory.Conclusion. Our approaches ensured the safety and efficacy of anesthesiological support and contributed to the successful implementation of simultaneous pancreas and kidney transplantation in the recipient having the concomitant pathology in the form of morbid obesity.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":" 101","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140213295","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":"Perioperative regional anaesthesia in kidney transplantation","authors":"V. Sharipova, F. K. Siyabaev, A. K. Alimov, M. M. Sadikov","doi":"10.23873/2074-0506-2024-16-1-34-42","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-34-42","url":null,"abstract":"Background. Postoperative analgesia in kidney transplant recipients is challenging due to potential nephrotoxicity of nonsteroidal anti-inflammatory drugs and the reduced clearance of opioid metabolites during transient renal impairment. Opioid-sparing multimodal postoperative analgesia using regional analgesia methods could provide better pain control and early activation after kidney transplantation.Aim. To evaluate the clinical results of treatment using regional pain management methods in kidney transplant recipients.Material and methods. A single-center study was conducted at Republican Research Center of Emergency Medicine from 2020 to 2022. The study included 97 patients who underwent heterotopic kidney transplantation from a living related donor. Patients were divided into 3 groups. In group 1 (31 patients), general anesthesia was used. For postoperative analgesia opioid analgesics in combination with metamizole 1000 mg were used. In group 2 (33 recipient patients), a combination of general anesthesia and open transversus abdominis plane block was used. In group 3 (33 recipient patients), a combination of general anesthesia and erector spine plane block was performed. Opioid analgesics were used as a \"rescue analgesia\" when necessary. The primary study end points were the pain intensity assessed by a visual analogue scale and opioid consumption on the first day after surgery. Secondary endpoints were the time of intestinal motility recovery, the presence of nausea and vomiting, the Intensive Care Unit length of stay and the hospital length of stay.Results. Pain intensity 6 hours after surgery in patients of group 1 was 13.5% and 24.6% higher than in patients of group 2 and 3, respectively. In group 2, pain intensity was 12.8% higher compared to group 3 (p=0.0017). At 12 hours after surgery, the pain intensity was 42% higher in group 1 compared to group 2 and group 3 (p<0.0001). After 18 hours, the pain score in group 3 was 48.5% and 35.7% lower compared to groups 1 and 2, respectively (p<0.0001 and p=0.0016). 24 hours after surgery, the sensation of pain was 18.6% and 65.3% higher in group 1 compared to groups 2 and 3 (p<0.0001). The mean dose of narcotic analgesic equivalent to morphine in group 1 was 22.6±8.6 mg, which was 18.5% higher than in group 2 patients. In group 3, it was 12.0±4.3 mg and was 47% lower compared to group 1 (p<0.0001) and 34.7% lower compared to group 2 (p<0.0001) (all comparisons are statistically significant). The adequacy of analgesia and less opioid consumption contributed to the absence of postoperative nausea and vomiting in 75% of cases, early restoration of intestinal motility in 63% compared with the group of patients where opioid analgesics were used for postoperative pain relief.Conclusion. The combined use of general anesthesia and erector spine plane block may be recommended as a method of effective perioperative analgesia in kidney transplantation.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":"124 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223585","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":"Transversus abdominis plane block as a component of anesthesia in kidney transplantation","authors":"A. Shabunin, E. P. Rodionov, P. Drozdov, A. A. Malyshev, B. A. Smolev, A.  A. Efanov, S.  A. Fedorishchev, R. I. Malashenko, S. А. Astapovich, E. A. Lidzhieva","doi":"10.23873/2074-0506-2024-16-1-10-20","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-10-20","url":null,"abstract":"Aim. To evaluate the safety and efficacy of the transversus abdominis plane block in kidney transplantation from deceased donor.Material and methods. The first stage included a retrospective comparative analysis of the results using the transversus abdominis plane block in renal transplantation. Group I (n=30) included patients who underwent transversus abdominis plane block after kidney transplantation; in comparative group II (n=58) the TAP-block wasn’t performed. We assessed the daily requirement for trimeperidine on the first day after kidney transplantation. The second stage was a prospective randomized placebo-controlled study. The patients were randomly divided into 2 groups with respect to whether the transversus abdominis plane block was provided with an active drug, or placebo was used; so the sodium chloride 0.9% was injected into the transversus abdominis plane in the intermuscular fascial plane between the internal oblique and transversus abdominis muscle in patients of Group III (n=31), and a local anesthetic was injected in patients of Group IV (n=34).) The daily requirements for trimeperidine, tramadol were assessed as well as the pain severity according to visual analogue scale at 1, 6, 12, 24 hours after surgery, the incidence of adverse events in the gastrointestinal tract; and several laboratory parameters (cortisol, interleukin-1, interleukin-6) related to pain syndrome were analyzed.Results. As a result of pseudorandomization, 17 cases were included in each of two retrospective stage, which were comparable in terms of patients' main characteristics (p>0.05). The daily requirement for trimeperidine in the transversus abdominis plane block group (Group I) was lower than in the comparison group with a trend toward statistical significance (p=0.07). The median daily dose of trimeperidine in Group III (placebo control) was 59.5 mg (interquartile range: 51.5–72.0), which was higher than in Group IV (45.5 mg; interquartile range: 38.5–62.0) (p=0.039). The postoperative pain severety assessed by visual analogue scale was also statistically significantly higher in group III at the timepoint of 12 hours after surgery, making 4.0 points (interquartile range: 2.5–5.0) versus 1.5 points (interquartile range: 0.5–2.5) in group VI (p=0.015). There were no differences between the groups in pain severity at 1, 6, and 24 hours after surgery. The daily requirement for tramadol was also statistically significantly higher in Group III, amounting to 50 mg (interquartile range: 0–100) versus 0 (interquartile range: 0–55 mg) in the active drug Group IV (p=0.045).Conclusion. Our study showed that the use of the transversus abdominis plain block was safe and effective, yielding encouraging results, which demonstrated a clinically significant reduction in the need for opioid analgesics and in the incidence of adverse events in the postoperative period after transversus abdominis plane block which contributes to the early activation of patients. Theref","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221549","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":"Comparing the Indices predictive of the thermal injury outcome","authors":"E. A. Zhirkova, T. G. Spiridonova, A. Sachkov, A. O. Medvedev, E. A. Eliseenkova, I. G. Borisov, M. Rogal, S. Petrikov","doi":"10.23873/2074-0506-2024","DOIUrl":"https://doi.org/10.23873/2074-0506-2024","url":null,"abstract":"Introduction. While developing the algorithms for diagnosis and treatment of patients with thermal injury, an injury outcome prediction index with the best predictive properties should be used.Aim. To compare the predictive properties of the Revised Frank Index and other specialized indices.Material and methods. A retrospective observational study included 307 patients with thermal injury, of whom 80 (26%) died. We compared the discriminatory ability, as well as sensitivity, specificity, positive predictive value and negative predictive value, the accuracy of the diagnostic test in relation to predicting a fatal outcome for 8 specialized prediction indices: RFI, FI, Baux, RBS, PBI, ABSI, BOBI, and Ryan.Results. RFI showed the largest area under the ROC curve: 0.942 [0.913–0.971], other indices had a smaller area: FI 0.827 [0.768–0.886], Baux 0.860 [0.811–0.909], RBS  0.891 [0.848–0.933], PBI 0.893 [0.848–0.937], ABSI 0.838 [0.786–0.890], BOBI 0.865 [0.819–0.910], Ryan 0.816 [0.764–0.869]. The Ryan index had the highest sensitivity (95%), but its specificity (49%) was the lowest, and the proportion of false positive results was 60%. The RBS index had high sensitivity (84%) and specificity (80%), but the false positive rate was 40%. The RFI and PBI indices showed similar sensitivity (81%), however, the proportion of false positive results for RFI (23%) was lower than that of PBI (39%) and all other indices, and the RFI accuracy in predicting the outcome was the highest among the other indices, making 89%.Conclusion. The predictive properties of the Revised Frank Index are better than those of other specialized indices.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222083","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":"Echocardiographic evaluation of myocardial structural and functional changes in patients with stage 5 chronic kidney disease before and after kidney transplantation","authors":"M. Khubutiya, E. V. Shuvalova, O. Rzhevskaya, L. T. Khamidova, A. A. Ivannikov, K. Alidzhanova, A. Balkarov, I. Dmitriev","doi":"10.23873/2074-0506-2024-16-1-21-33","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-21-33","url":null,"abstract":"Introduction. Chronic kidney disease, stage 5, leads to structural remodeling of the myocardium, and heart failure. Kidney transplantation promotes normalization of structural and functional parameters of the myocardium through reverse remodeling with an improvement of its systolic function.Aim. To evaluate structural and functional changes of the myocardium in patients before and after kidney transplantation, using echocardiography.Material and methods. A retrospective cross-sectional study included 111 individuals of whom 36 patients underwent evaluation for kidney transplant waiting list placement program (Group I), and 51 patients received kidney transplants from deceased donors (Group II). Group III consisted of 24 individuals without kidney pathology. All patients underwent transthoracic two-dimensional echocardiography using the Phillips Epiq 7 device to determine the structural and functional parameters of the heart, including the use of speckle-tracking technique to assess longitudinal and circumferential myocardial deformation of the left ventricle.Results. There were no statistically significant differences in transthoracic echocardiography results between patients in Group I and Group II. When compared to the parameters of patients in Group III, statistically significant differences were found in the following parameters: volume and volume index of the left atrium, end-diastolic volume index, left ventricular mass index, interventricular septum thickness and posterior wall thickness of the left ventricle, as well as diastolic function parameters (E/A). Patients in Group I and Group II had significantly higher values of left atrium diameter: 32 (26.0;38.0) mmHg and 31.0 (27.3;40.0) mmHg, respectively, (p1-2=0.949), while in Group III this parameter value was 22.5 (20.8;25.3) mmHg (p1-3<0.001, p2-3<0.001). Correlation analysis revealed statistically significant correlations between left ventricular mass index and global circumferential strain (r=0.41, p=0.0027), as well as between E/e' ratio and left ventricular mass index (r=0.323, p=0.00197). It was found that after 3 months post kidney transplantation, there was a decrease in the left atrium diameter, volume, and volume index. The values of left atrium diameter immediately after kidney transplantation and after 3 months were 40 (32.5;45) mmHg and 35 (25.5;41.0) mmHg (p=0.049); those of the left atrium volume were 62.5 (50.0;77.3) and 51.5 (47.5;64.5) ml (p=0.03); and those of the left atrium volume index were 33.4 (29.3;40.2) and 28.3 (25.5;33.6) ml/m2 (p=0.01) respectively.Conclusions. Patients with chronic kidney disease stage 5 have a high incidence of functional and structural abnormalities of the left heart chambers; left ventricular mass index positively correlates with E/e' and global circumferential strain. At 3 months after kidney transplantation, there was a slight positive trend manifested in the form of a decrease in left atrium diameter and a decrease in left ventricle v","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":" 60","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221415","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":"The efficacy of using the allogeneic osteoplastic material in skull trepanation","authors":"A. A. Ofitserov, N. Borovkova, A. Talypov, O. V. Leshchinskaya, N. E. Kudryashova, A. Mironov, M. S. Makarov, I. N. Ponomarev, A. S. Kozhanov, A. A. Budaev","doi":"10.23873/2074-0506-2024-16-1-43-53","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-43-53","url":null,"abstract":"Introduction. When performing osteoplastic craniotomy, there is a need to fill the diastasis between the skull bone and the explanted bone fragment. Grafts based on allogeneic bone chips and collagen (bone-plastic material) may be very effective for cranial bone repair in diastasis area.Aim. To evaluate the safety and clinical efficacy of osteoplastic material during the osteoplastic craniotomy.Material and methods. A retrospective and prospective clinical study was conducted at the N.V. Sklifosovsky Research Institute for Emergency Medicine and included 12 patients treated in Urgent Neurosurgery Department with diagnoses suggesting the need for craniotomy. Allogenic osteoplastic material was obtained from a 0.7-0.9% solution of type I collagen and spongy bone chips with a fraction size of 315-630 microns. Osteoplastic material grafts were used intraoperatively at the cranioplastic stage of the operation after the main stages had been completed. The efficacy and safety of the use of osteoplastic material were evaluated clinically and radiologically in the early postoperative period.Results. In the early postoperative period, the study patients had no pyo-septic complications, severe pain or soft tissue swelling. All patients were discharged from the hospital in satisfactory condition to be followed-up by the physician or neurologist at the out-patient facility. The computed tomography performed in the early postoperative period visualized the diastasis lines along the bone flap line in the comparison group patients (without osteoplastic material); and in the main group, the osteoplastic material was clearly visualized. At computed tomography of the skull performed after 6–9 months and after 2–18 months, the signs of bone tissue consolidation were visualized in the patients of the main group. The radiodensity of the autologous bone flap in both groups did not significantly change at any periods. In the diastasis area, the radiodensity of diastasis in the main group was significantly higher than in the comparison group. After 1-1.15 years the radiodensity values in the diastasis area increased by average of 1.95 times (p<0.05) in the patients of the main group, while in the patients without osteoplastic material, this parameter did not significantly change during the entire follow-up period.Conclusions. In patients with intraoperative cranioplasty osteoplastic material grafts did not cause complications in the early and late postoperative period. Intraoperative cranioplasty performed with using osteoplastic allogeneic material caused no complications in either early or late postoperative periods. The presence of osteoplastic material contributed to the consolidation of the autologous bone flap and healthy bone.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":"156 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222655","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 fatal outcome structure in acute poisoning with hypotensive and antiarrhythmic drugs","authors":"K. K. Ilyashenko, G. N. Sukhodolova, M. V. Belova, A. Y. Simonova, M. M. Potskhveriya","doi":"10.23873/2074-0506-2024-16-1-54-63","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-54-63","url":null,"abstract":"Background. In many countries, there is an increase in the number of poisoning with antihypertensive and antiarrhythmic drugs taken either accidentally or for suicidal purposes. The mortality rate for these poisonings reaches 6.5%.The aim of the study was to analyze the causes of fatal outcomes in patients with acute poisoning with hypotensive and antiarrhythmic drugs.Material and methods. The inpatient medical records (Form No. 003/y), autopsy reports of forensic chemical and forensic histological studies of 80 people who died from acute poisoning with hypotensive and antiarrhythmic drugs at the N.V. Sklifosovsky Research Institute for Emergency Medicine for the period from 2011 to 2020 were analyzed.Results. The age of patients with acute poisoning with antihypertensive and antiarrhythmic drugs ranged from 16 to 94 years, of which 85% of patients were over 60 years old. Women made up 70%. Twenty five patients died in the toxicogenic stage of poisoning, other 55 died in the somatogenic stage. The causes of poisoning were the intake of hypotensive drugs (mainly calcium channel blockers) in 67% of cases, the intake of antiarrhythmic drugs from the group of beta-blockers in 33%. Poisoning on suicidal intent was recorded in 81.2% of cases. The main causes of death in the toxicogenic stage of poisoning were the following (listed in order of decreasing incidence): exotoxic shock, primary cardiotoxic effect, acute cardiovascular insufficiency. The main cause of patient death in the somatogenic stage was pneumonia.Conclusion. Acute poisoning with antihypertensive and antiarrhythmic drugs, in the vast majority of cases, occurs in patients over 60 years of age. Suicidal attempts make the main cause of poisoning. The main cause of death in the toxicogenic stage of poisoning is exotoxic shock, that one in the somatogenic stage is nosocomial pneumonia.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223835","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":"Application of mesenchymal stem cells in severe acute experimental pancreatitis","authors":"O. A. Kudelich, G. G. Kondratenko, M. P. Potapnev, O. V. Klimenkova","doi":"10.23873/2074-0506-2024-16-1-74-87","DOIUrl":"https://doi.org/10.23873/2074-0506-2024-16-1-74-87","url":null,"abstract":"Background. The significance of the problem of acute pancreatitis is due to an increase in the incidence with an increase in the number of common forms of pancreatic necrosis, accompanied by a high incidence of severe complications.Aim. To determine the effect of regional application of mesenchymal stromal cells on the systemic manifestations of severe acute experimental pancreatitis.Material and methods. This experimental study was carried out on 42 adults Wistar rats. Acute pancreatitis was induced by administering 0.3 ml of 5% solution of non-ionic polyethylene glycol octylphenol ether detergent into the caudal part of the pancreas. The animals were randomly divided into 4 groups: Group I (n=6) consisting of intact animals, Group II (control group) (n=12) of rats with untreated pancreatitis, Group III (n=12) of rats with pancreatitis treated: anesthesia + infusions of 0.9% sodium chloride solution (saline), and Group IV (n=12) of rats with pancreatitis treated: anesthesia + infusions of saline + regional application of mesenchymal stromal cells. Animals were taken out of the experiment by euthanasia on the 3rd and 7th day. The hematological parameters, markers of systemic manifestation of the pathological process (pancreatic amylase, aspartate aminotransferase, alanine aminotransferase, urea, creatinine), markers of endogenous intoxication (lipid peroxidation activity, nitric oxide level), markers of systemic inflammatory response (C-reactive protein, tumour necrosis factor-alpha, interleukin-6) have been evaluated.Results. The application of mesenchymal stromal cells in the early stages of acute pancreatitis made a favourable effect on the platelet count, the level of glycemia, helped to reduce the content of endogenous intoxication elements (malonic dialdehyde, nitric oxide) and of those of the systemic inflammatory response (interleukin-6, tumor necrosis factor-α, C-reactive protein), which are key links in the pathogenesis of severe acute pancreatitis.Conclusion. Comparison of different treatment regimens for acute experimental pancreatitis has shown that the early use of mesenchymal stromal cells has a systemic positive effect and confirms the therapeutic efficacy of the method in the treatment of this disease.","PeriodicalId":508006,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":"82 S362","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223991","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}