KIDNEY TRANSPLANTATION IN AN AGED PATIENT WITH MULTIPLE COMORBIDITIES: A REVIEW BASED ON UNUSUAL CLINICAL CASE

O. Shchur, Volodymyr Melnykov, Volodymyr Marina, R. Yaremkevych, R. Zhuk, V. Bochar, Vitaliy Petrov, O. Samchuk, Dmytro Romanchak
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Abstract

The article raises a question about the possible and effective kidney transplantation in elderly patients with various severe comorbidities. The analysis is based on an example of successful kidney transplantation from a deceased donor when a 67-year-old patient had severe concomitant background: obesity, diabetes mellitus, and cardiovascular disturbances. Despite unfavorable prognosis and further unpredictable illnesses such as COVID-19, candidal esophagitis, coronary attack, and pneumonia, the patient has not develop graft injury or rejection and kept sufficient kidney function. The research was mainly focused on coexisting illnesses and their influence on kidney transplantation consequences. Following disease groups were discussed regarding their impact on transplantation outcomes and prognosis: arterial hypertension, cardiac disorders, diabetes mellitus, and obesity. Patient’s age, previous interventions, and comorbidities were observed for association with outcomes and risk of graft rejection. A review of available publications compared approaches for recipient selection in different clinical centers as well.
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肾移植治疗合并多种合并症的老年患者:基于罕见临床病例的回顾
本文对有各种严重合并症的老年患者进行肾移植的可行性和有效性提出了疑问。该分析基于一个成功的肾移植案例,该患者为67岁,有严重的伴随背景:肥胖、糖尿病和心血管疾病。尽管预后不佳,并有其他不可预测的疾病,如COVID-19、念珠菌性食管炎、冠状动脉发作和肺炎,但患者没有发生移植物损伤或排斥反应,并保持了足够的肾功能。研究主要集中在共存疾病及其对肾移植后果的影响。以下疾病组讨论了它们对移植结果和预后的影响:动脉高血压、心脏疾病、糖尿病和肥胖。观察患者的年龄、既往干预和合并症与结果和移植排斥风险的关系。对现有出版物的回顾比较了不同临床中心的受体选择方法。
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