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The Diagnosis of Brain Death 脑死亡的诊断
Pub Date : 2021-10-27 DOI: 10.30702/transpaorg/10_21.2710/1384-101/88.07
Dr. Ricardo H. Brau
Organ transplantation is impossible without donation which is performed both intra vitam and posthumously. Each case of multi-organ collection provides help to 4 to 6 patients. We believe that presentation of modern algorithms for diagnosing brain death is quite feasible, and such information can be useful not only for anesthesiologists, but also for doctors of other specialties. This paper presents materials related to organ donation. Diagnostic criteria for human brain death, as well as the procedure for ascertaining human brain death and the actions of doctors of healthcare institutions in relation to persons who are in these institutions and who have clinical indications for the diagnosis of brain death, are determined by "The procedure for cancellation of active measures to maintain the patient's life…". Active measures (ventilation, infusion therapy and vasopressor support, etc.) to support the patient's life are cancelled after the patient's brain death is ascertained, except for cases where the deceased person is considered a potential donor. Verification of the human brain death is carried out by the case management team of the healthcare institution involving, if necessary, members of consultative and diagnostic mobile team, specialists of other healthcare institutions. The head of the healthcare institution is responsible for timely and proper engagement and work of the case management team. The responsible person determines the membership of the case management team by making an appropriate entry in the case record and is responsible for its work. An anesthesiologist and a neurologist (neurosurgeon) who have at least 5 years of practical experience in the specialty are engaged in the case management team to ascertain brain death in persons over 18 years of age. Physicians involved in the removal of human anatomical materials and transplantation thereof, as well as transplant coordinator, may not be included in the case management team.
器官移植是不可能没有捐赠,这是在维生素内和死后进行的。每例多器官采集可帮助4 ~ 6例患者。我们相信,诊断脑死亡的现代算法的呈现是非常可行的,这些信息不仅对麻醉师有用,而且对其他专业的医生也有用。本文介绍了有关器官捐献的资料。人类脑死亡的诊断标准、确定人类脑死亡的程序以及保健机构的医生对在这些机构中有脑死亡临床诊断指征的人采取的行动,由"取消维持病人生命的积极措施的程序…"确定。在确定患者脑死亡后,取消支持患者生命的主动措施(通气、输注治疗和血管升压支持等),但死者被认为是潜在供体的情况除外。脑死亡的验证由医疗机构的病例管理小组进行,必要时包括咨询和诊断流动小组成员以及其他医疗机构的专家。医疗机构的负责人负责病例管理团队的及时和适当的参与和工作。负责人通过在病例记录中作出适当的记录来确定病例管理小组的成员,并对其工作负责。一名麻醉师和一名在该专业至少有5年实践经验的神经科医生(神经外科医生)参与病例管理小组,以确定18岁以上的人的脑死亡。参与人体解剖材料切除及其移植的医生以及移植协调员可能不包括在病例管理团队中。
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引用次数: 4
Cell Technologies in the Treatment of Chronic Wounds in Patients with Diabetes Mellitus 细胞技术在糖尿病患者慢性伤口治疗中的应用
Pub Date : 2021-10-27 DOI: 10.30702/transpaorg/10_21.2710/1151-65/4.001.4
Y. Ivanova, S. Gramatiuk, V. Prasol, K. Miasoiedov, O. O. Zarudnyi, K. A. Holtsev
Materials and methods. The results of treatment of 8 patients with chronic wounds and diabetes mellitus (DM) type 2 and stage IV chronic ischemia of the lower extremities by Fontaine were analyzed, in 2 cases there was a combination of venous and arterial insufficiency. Revascularization of the lower extremities was performed through open (2), endovascular (4) and hybrid surgery (2). In case of venous insufficiency, sclerotherapy of perforator veins was performed. After surgical treatment of the purulent focus, specific bacteriophages were used (after microflora identification). Hydrogel dressings were applied daily, alongside with transplantation of 5,000,000 mesenchymal stem cells (MSC) (CD73+, CD90+, CD105+ and CD45-, CD34-, CD14-, CD79-) by injection into muscle tissue around the wound, then the wound surface was closed with hMSC-fibroblast matrix. Results. After the closure of the wound surface with fibroblast matrix, the patients noted the disappearance of the pain syndrome. The surface area of the wounds averaged 91.3 ± 30.42 cm 2 before the start of treatment, 89.8 ± 34.21 cm 2 on day 5 and – 73.95 ± 21.2 cm 2 on day 12. Spontaneous epithelialization was achieved in the period from 35 to 141 days (depending on the initial state of the wounds). The average hospital stay was 22.6 ± 2.4 days. Discussion. It is known that human epithelial cells (hECs) and human mesenchymal stem cells (hMSCs) suppress proliferation, production of inflammatory cytokines and differentiation of T cells. At the same time, they stimulate the formation of regulatory T cells (Tregs). Soluble factors secreted by hECs, including PGE2, TGF-β, Fas-L, AFP, MIF, TRAIL and HLA-G, block differentiation of dendritic cells and M1 macrophages and promote differentiation of monocytes into the anti-inflammatory M2 phenotype. Moreover, hECs and hMSCs are known to be responsible for modulating the host immune system, mainly by suppressing TNF-α, IFN-γ, MCP-1 and IL-6 and increasing the level of anti-inflammatory cytokines. In vitro and in vivo results show increased cell migration and epithelialization leading to accelerated wound healing.
材料和方法。本文分析方丹治疗8例慢性创伤合并糖尿病(DM) 2型及IV期下肢慢性缺血患者的疗效,其中2例出现静脉和动脉功能不全。下肢血管重建术通过开放手术(2)、血管内手术(4)和混合手术(2)进行。静脉功能不全时,对穿支静脉进行硬化治疗。化脓性病灶手术治疗后,使用特异性噬菌体(微生物群鉴定后)。每天应用水凝胶敷料,同时移植500万个间充质干细胞(CD73+、CD90+、CD105+和CD45-、CD34-、CD14-、CD79-)注入创面周围肌肉组织,然后用hmsc -成纤维细胞基质封闭创面。结果。用成纤维细胞基质缝合创面后,疼痛综合征消失。治疗前创面面积平均91.3±30.42 cm 2,第5天创面面积平均89.8±34.21 cm 2,第12天创面面积平均- 73.95±21.2 cm 2。在35至141天(取决于伤口的初始状态)内实现了自发上皮化。平均住院时间为22.6±2.4天。讨论。众所周知,人上皮细胞(hec)和人间充质干细胞(hMSCs)抑制增殖、炎症细胞因子的产生和T细胞的分化。同时,它们刺激调节性T细胞(Tregs)的形成。hec分泌的可溶性因子包括PGE2、TGF-β、Fas-L、AFP、MIF、TRAIL和HLA-G,可阻断树突状细胞和M1巨噬细胞的分化,促进单核细胞向抗炎M2表型分化。此外,已知hec和hMSCs负责调节宿主免疫系统,主要通过抑制TNF-α, IFN-γ, MCP-1和IL-6以及增加抗炎细胞因子的水平。体外和体内实验结果显示,增加的细胞迁移和上皮化导致伤口愈合加速。
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引用次数: 0
Expectations and Reality in Surgical Rehabilitation of Cataract Patients 白内障患者手术康复的期望与现实
Pub Date : 2021-10-27 DOI: 10.30702/transpaorg/10_21.2710/0866-77/07.036
N. Lutsenko, O. Isakova, O. Rudycheva, T. Kyrylova
The aim. To study the effect of surgical treatment of cataracts on the quality of life of patients and assess satisfaction with the results after implantation of a monofocal or multifocal intraocular lens (IOL), depending on the initial refraction. Materials and methods. We examined 140 patients (280 eyes) who underwent phacoemulsification with IOL (bilateral) according to the standard technique using multimodal anesthesia. The observation groups were divided depending on the initial type of refraction and the type of intraocular correction (mono- or multifocal IOL). The analysis of the results of surgical treatment of cataracts with IOL was assessed taking into account the initial refraction according to objective data, i.e. determination of distance and near visual acuity, and subjective data, i.e. the NEI-VFQ-25 quality of life questionnaire, patient questionnaire survey and assessment of the quality of vision in general, as well as distance, near, and night vision. Results and discussion. Before surgery, the mean values of indicators by all scales of the questionnaire of the quality of life related to the quality of vision ranged from 40 to 60 points and averaged 47 ± 0.5 points. After cataract surgery, the numerical indicator by each of the scales shifted to the range of 85 to 100 points. The difference in values by the scales “activity associated with distance vision” and “driving a car” was obtained. In patients with multifocal IOL, these indicators were lower compared with monofocal implantation. Dissatisfaction with distance vision was observed during the implantation of a multifocal IOL only in patients with hyperopia (12.5%), dissatisfaction with near vision was noted only in patients with myopia (16.7%), and no cases of dissatisfaction were observed in the group of patients with emmetropia. Analysis of night vision in patients with emmetropia also revealed the minimum percentage (2.5%) of cases of dissatisfaction in patients with hyperopia (5.0%) and the maximum in those with myopia (16.7%). Conclusions. IOL implantation is a single cataract treatment option that provides a high level of the patient’s satisfaction with the quality of life and visual functions. However, careful individual approach is required to select the type of implantable IOL, taking into account the patient’s needs and baseline refraction.
的目标。目的:探讨白内障手术治疗对患者生活质量的影响,并根据初始屈光度评估单焦点或多焦点人工晶状体植入术后的满意度。材料和方法。我们检查了140例(280只眼)采用多模态麻醉的双侧超声乳化人工晶状体植入术。根据初始屈光类型和眼内矫正类型(单焦或多焦IOL)分为观察组。采用NEI-VFQ-25生活质量问卷、患者问卷调查、总体视力、远视、近视、夜视质量评估等主观数据,结合初始屈光度对人工晶状体白内障手术治疗结果进行评价。结果和讨论。术前,与视力质量相关的生活质量问卷各量表各项指标的平均值为40 ~ 60分,平均为47±0.5分。白内障手术后,各量表的数值指标在85到100分之间。得到了“与远距离视觉相关的活动”和“驾驶汽车”量表值的差异。在多焦点人工晶状体患者中,这些指标低于单焦点人工晶状体。多焦点人工晶状体植入术中,只有远视患者对远视力不满意(12.5%),只有近视患者对近视力不满意(16.7%),远视患者无一例不满意。对远视患者的夜视情况进行分析,远视患者的不满意率最低(2.5%),近视患者的不满意率最高(16.7%)。结论。人工晶状体植入术是一种单一的白内障治疗选择,可为患者提供高水平的生活质量和视觉功能满意度。然而,考虑到患者的需求和基线屈光,需要谨慎地选择植入式人工晶状体的类型。
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引用次数: 0
The Influence of Risk Factors on Perioperative Results of Multivessel Coronary Artery Bypass Grafting Through the Left Anterior Minitoracotomy 危险因素对经左前小切口多支冠状动脉搭桥术围手术期疗效的影响
Pub Date : 2021-10-27 DOI: 10.30702/transpaorg/10_21.2710/0317-36/132.2
O. Babliak, V. Demianenko, D. Babliak, A. Marchenko, E. Melnyk, K. Revenko, L. V. Pidgaina, O. Stohov
Multivessel coronary artery bypass grafting (CABG) through the left anterior minitoracotomy using the technique of total coronary revascularization via left anterior thoracotomy (TCRAT) is routinely performed in our institution since July 2017. This technique is used in all patients regardless of the number of anastomoses, quality and location of coronary targets, body mass index, age, comorbidities and predicted postoperative risk. The aim. To present the results of 349 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive CABG. To compare perioperative outcomes of minimally invasive CABG in patients with existent risk factors for CABG and to identify possible contraindications to the use of this CABG technique. Materials and methods. From July 2017 to January 2020, 357 consecutive patients were underwent multivessel CABG at our institution. Eight (2.3%) patients in whom CABG was performed through the median sternotomy were excluded from the study. The remaining 349 (97.7%) patients underwent complete myocardial revascularization through the left anterior minitracotomy using TCRAT technique (peripheral cannulation for cardiopulmonary bypass (CPB), cold blood cardioplegia). All the patients were divided into groups according to the presence of risk factors (obesity, old age, diabetes, risk of postoperative mortality greater than 2.0 calculated by EuroSCORE II scale) to analyze the impact of these factors on intraoperative and postoperative parameters. Results. Intra- and postoperative parameters in patients of all groups were within safe limits. There was no statistically significant difference between the patients older and younger than 70. Diabetic and obese patients had a longer total operation time (on average by 5%, p = 0.003 and 7%, p = 0.019, respectively), CPB time (on average by 8%, p = 0.002 and 11%, p = 0.0001, respectively) and intensive care unit stay (on average by 15%, p = 0.004 and 17%, p = 0.013, respectively) compared to the patients without these conditions. The patients with EuroSCORE II risk more than 2.0 were had longer main phase of the operation (on average by 12 minutes, i.e. 8%, p = 0.013), they required longer ventilation time (by 27%, p = 0.036), longer stay in the intensive care unit (by 23%, p = 0.0004), had a longer hospital stay (by 15%, p < 0.0001), they were more likely to have acute kidney damage that required hemodialysis, and mortality was observed only in this group of patients. However, even in this group of severe patients, the incidence of complications and mortality did not exceed the predicted rates. Conclusions. The technique of minimally invasive CABG through the left anterior thoracotomy allow the possibility to avoid median sternotomy in 97.7% of patients with multivessel coronary artery disease. The technique of minimally invasive multivessel CABG through the left anterior thoracotomy is universal and does not require patient selection, because
自2017年7月起,我院常规行左前开胸全冠状动脉重建术(TCRAT)经左前小切口行冠状动脉旁路移植术(CABG)。该技术适用于所有患者,不论吻合口数量、冠状动脉靶的质量和位置、体重指数、年龄、合并症和预测的术后风险。的目标。介绍349例连续行微创冠状动脉搭桥治疗的孤立性多支冠状动脉疾病患者的结果。比较存在CABG危险因素的患者微创CABG的围手术期结果,并确定使用该技术可能的禁忌症。材料和方法。2017年7月至2020年1月,我院连续357例患者行多血管冠脉搭桥。8例(2.3%)通过胸骨正中切开术行冠脉搭桥的患者被排除在研究之外。其余349例(97.7%)患者采用TCRAT技术(外周插管体外循环(CPB),冷血心脏截瘫)通过左前小切口行心肌血运重建术。所有患者根据是否存在危险因素(肥胖、高龄、糖尿病、术后死亡风险大于2.0的EuroSCORE II量表计算)进行分组,分析这些因素对术中及术后参数的影响。结果。各组患者的术中及术后参数均在安全范围内。年龄大于70岁的患者与年龄小于70岁的患者无统计学差异。糖尿病和肥胖患者的总手术时间(平均增加5%,p = 0.003和7%,p = 0.019)、CPB时间(平均增加8%,p = 0.002和11%,p = 0.0001)和重症监护病房时间(平均增加15%,p = 0.004和17%,p = 0.013)均高于无上述情况的患者。第二EuroSCORE患者风险超过2.0操作的主要阶段较长(平均12分钟,即8%,p = 0.013),他们需要再通风时间(27%,p = 0.036),再呆在重症监护病房(23%,p = 0.0004),住院时间较长(15%,p < 0.0001),他们更可能有急性肾损伤,需要血液透析,观察和死亡率只有在这组病人。然而,即使在这组重症患者中,并发症的发生率和死亡率也没有超过预期。结论。经左前开胸行微创冠状动脉搭桥术可避免97.7%的多支冠状动脉疾病患者胸骨正中切口。通过左前开胸行微创多血管冠脉搭桥技术是普遍的,不需要患者选择,因为无论肥胖、糖尿病或老年,都可以有效、安全地使用。该技术可用于任何EuroSCORE II评分的患者,而不会增加死亡率。
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引用次数: 0
Selection Criteria for Heart Transplantation in Patients with End-Stage Heart Failure 终末期心力衰竭患者心脏移植的选择标准
Pub Date : 2021-10-27 DOI: 10.30702/transpaorg/10_21.2710/0908-16/46.616
K. Rudenko, O. Dudnyk, M. Rzhanyi
Today, heart transplantation remains the gold standard of treatment for patients with end-stage heart failure (HF). As the number of donors is limited and the risk of intervention is quite high, the key to achieving optimal outcomes and reducing the incidence of complications is the proper selection of patients who meet clearly defined criteria for inclusion in the waiting list for heart transplantation. This review presents the latest knowledge on indications and contraindications for inclusion recipients in the waiting list for heart transplantation, including the latest clinical guidelines of The International Society for Heart and Lung Transplantation (ISHLT) published in 2016. Thus, the absolute indications are dependence on intravenous inotropic and mechanical circulatory support; inoperable heart diseases or a history of volume reducing operations; refractory angina or life-threatening refractory arrhythmias despite maximal drug therapy and/or surgical correction; reduction of maximum oxygen consumption up to <12-14 ml/kg/min when performing the maximum cardiopulmonary exercise test. While including patients in the waiting list for heart transplantation, it should be noted that the low left ventricular ejection fraction <30%, a history of documented NYHA class III-IV HF, low maximum oxygen consumption as the only criterion of terminal HF and poor prognosis for annual survival in HF calculated on prognostic scales are not sufficient indications. Absolute contraindications include a systemic disease with a life expectancy of less than 2 years and irreversible pulmonary hypertension. The current procedure for the distribution of recipients by urgency status for heart transplantation is presented according to the updated recommendations of the United Network for Organ Sharing (UNOS) published in 2018 which consists of 6 degrees, compared with the 1999 edition which contained 3 degrees.
今天,心脏移植仍然是治疗终末期心力衰竭(HF)患者的金标准。由于供体数量有限,干预风险相当高,实现最佳结果和减少并发症发生率的关键是正确选择符合明确定义标准的患者进入心脏移植等待名单。本综述介绍了心脏移植等待名单中受者的适应症和禁忌症的最新知识,包括2016年国际心肺移植学会(ISHLT)发布的最新临床指南。因此,绝对适应症是依赖静脉肌力和机械循环支持;不能手术的心脏疾病或有减容手术史;顽固性心绞痛或危及生命的顽固性心律失常,尽管最大的药物治疗和/或手术纠正;最大心肺运动试验时最大耗氧量降低至<12-14 ml/kg/min。在纳入心脏移植候诊名单的患者时,需要注意的是,左室射血分数<30%、有NYHA III-IV级HF病史、最大耗氧量低作为终末期HF的唯一标准,以及预后量表计算的HF年生存率预后差,这些都不是充分的适应症。绝对禁忌症包括预期寿命小于2年的全身性疾病和不可逆的肺动脉高压。目前按心脏移植紧急状态分配受者的程序是根据2018年发布的器官共享联合网络(UNOS)的更新建议提出的,该建议由6个度组成,而1999年的版本包含3个度。
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引用次数: 0
Development of National Arthroplasty (Results of 30-Year Research) 全国关节成形术发展(30年研究成果)
Pub Date : 2021-10-27 DOI: 10.30702/transpaorg/10_21.2710/0437-50/451.30(477)
O. Loskutov, O. Y. Oliinyk, O. Loskutov, D. Syniehubov
Abstract. Development of modern arthroplasty in Ukraine, according to Academician of the National Academy of Sciences and the National Academy of Medical Sciences of Ukraine O.O. Korzh, began thanks to the activities of O.Ye. Loskutov (Dnipro) who managed to create his own Ukrainian endoprosthesis on the basis of the relevant enterprises of the city and establish specialized endoprosthetic clinic. The article reflects 30 years of experience in the de velopment of national arthroplasty. To solve the problem of development of national arthroplasty, the Orthopedic Joint Replacement initiative program (ORTEN) has been developed. For this purpose, an intersectoral problem laboratory was created which united the efforts of the scientists of different specialties and key enterprises of the Dnipro region. Biomechanical researches on native studying of mechanical properties of articular sites of bones have been carried out through mathematical modeling. Estimation of a stress-strain state of subchondral, spongy bone and various sites of long bones in "bone-implant" system has been carried out in order to define primary and secondary stability of different kinds of the developed im plants. Numerous biochemical, histochemical and toxicological studies on laboratory animals have been performed to evaluate the effects of implant materials and the developed types of protective coatings. X-ray morphometric and anthropometric studies of articular surfaces of bones were used in various pathologies of the joints for the development of implants; technical methods were used to assess the mechanical properties of implants under load. The developed designs of endoprostheses have passed certification and have been brought into pro duction. Clinical introduction of domestic endoprostheses was implemented in the Ukraine’s first specialized department of joint arthroplasty which was opened in Dnipro. The developed methods and methodological support for the use of the elaborated designs of endoprostheses allowed to organize the basic training of Ukrainian specialists through the Basic Course of Prof. O.Ye. Loskutov which was taken by almost 350 Ukrainian orthopedists.
摘要乌克兰国家科学院院士和乌克兰国家医学科学院院士O.O. Korzh表示,乌克兰现代关节成形术的发展得益于O.Ye的活动。Loskutov(第聂伯罗),他在城市相关企业的基础上创建了自己的乌克兰内假体,并建立了专门的内假体诊所。这篇文章反映了30年来国民关节置换术发展的经验。为解决我国关节置换术发展的问题,制定了骨科关节置换术行动计划(ORTEN)。为此目的,建立了一个部门间问题实验室,将第聂伯罗地区不同专业的科学家和主要企业的努力联合起来。生物力学研究是通过数学建模对骨骼关节部位力学特性的原生研究进行的。对“骨-植体”系统中软骨下骨、海绵骨和长骨各部位的应力-应变状态进行了估计,以确定不同种类植物发育的植体的初级和次级稳定性。在实验动物上进行了大量的生物化学、组织化学和毒理学研究,以评估植入材料和开发的保护涂层的效果。骨关节表面的x射线形态测量学和人体测量学研究被用于关节的各种病理,以促进植入物的发展;采用技术方法评估种植体在载荷作用下的力学性能。所研制的内假体已通过认证,并已投入生产。在乌克兰第聂伯罗开设的第一家关节成形术专业部门实施了国内内源性假体的临床引进。为使用精心设计的内假体而开发的方法和方法学支持,使乌克兰专家能够通过oye教授的基础课程组织基本培训。近350名乌克兰骨科医生拍摄了洛斯库托夫。
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引用次数: 0
Stem Cells in the Treatment of Renal Allograft Diseases 干细胞治疗同种异体肾移植疾病
Pub Date : 2021-10-27 DOI: 10.30702/transpaorg/10_21.2710/0278-83/576.3/4
O. S. Nikonenko, I. Rusanov, T. N. Nykonenko, S. Vildanov
In recent years, there has been growing interest in the use of stem cells as a therapeutic agent for the restoration of the damaged tissues and organs. We present a clinical case. Male, 39 y.o. Diagnosis: Glomerulonephritis. On 10/09/2012, he underwent heterotopic renal allotransplantation from a live relative donor. On 09/23/2020, he was admitted to the hospital due to renal allograft pyelonephritis. On 10/28/2020, a cell based donor umbilical cord blood product was infused. Cell therapy enabled to minimize the consequences of the graft damage, to preserve the graft function and satisfactory condition of the recipient.
近年来,人们对利用干细胞作为一种治疗药物来修复受损的组织和器官越来越感兴趣。我们报告一个临床病例。男,39岁。诊断:肾小球肾炎。2012年9月10日,他接受了来自活体亲属供体的异位肾移植。2020年9月23日因肾移植肾盂肾炎住院。2020年10月28日,输注基于细胞的供体脐带血制品。细胞治疗能够最大限度地减少移植物损伤的后果,保持移植物的功能和受体的满意状态。
{"title":"Stem Cells in the Treatment of Renal Allograft Diseases","authors":"O. S. Nikonenko, I. Rusanov, T. N. Nykonenko, S. Vildanov","doi":"10.30702/transpaorg/10_21.2710/0278-83/576.3/4","DOIUrl":"https://doi.org/10.30702/transpaorg/10_21.2710/0278-83/576.3/4","url":null,"abstract":"In recent years, there has been growing interest in the use of stem cells as a therapeutic agent for the restoration of the damaged tissues and organs. \u0000We present a clinical case. Male, 39 y.o. Diagnosis: Glomerulonephritis. On 10/09/2012, he underwent heterotopic renal allotransplantation from a live relative donor. On 09/23/2020, he was admitted to the hospital due to renal allograft pyelonephritis. On 10/28/2020, a cell based donor umbilical cord blood product was infused. Cell therapy enabled to minimize the consequences of the graft damage, to preserve the graft function and satisfactory condition of the recipient.","PeriodicalId":116695,"journal":{"name":"Transplantation and artificial organs","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132648638","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}
引用次数: 0
Treatment of Trophic Ulcers in Patients With Chronic Venous Insufficiency Using Phototherapy and Synthetic Wound Coverings 光疗和合成创面覆盖物治疗慢性静脉功能不全患者的营养性溃疡
Pub Date : 2020-12-16 DOI: 10.30702/TRANSPAORG/04_20.0112/050-059/831
Y. Ivanova, V. Prasol, Kyrylo Miasoiedov, L. M. Al Kanash
The aim of the study was to improve the results of treatment in patients with chronic venous insufficiency with trophic ulcers due to the use of artificial wound dressings and platelet-rich growth factors. The study included 34 patients who had trophic ulcers on the skin of the lower leg (n/3 and c/3). Group I (comparisons) included 11 (32.4%) patients who received conventional treatment; in the second group - 23 (67.6%) patients who underwentcomprehensive treatment according to the method developed by us. The criteria for the study was the presence of trophic ulcers of the leg, which were unhealed for a long time; the presence of posttroflebitic disease; preserved pulsation on the arteries of the limbs. Patients were treated with trophic ulcers by phototherapy, by scleroobliteration of insolvent perforant,and by closing the wound defect with a synthetic wound cover. In all patients of the main group, the treatment time did not exceed 39 days. In the comparison group, this indicator ranged from 28 to 53 days (depending on the area of wounds and the characteristics of thecourse of the wound process).
该研究的目的是改善慢性静脉功能不全并营养性溃疡患者的治疗结果,这是由于使用人工伤口敷料和富血小板生长因子所致。该研究包括34例下肢皮肤有营养性溃疡的患者(n/3和c/3)。第一组(比较)包括11例(32.4%)接受常规治疗的患者;第二组23例(67.6%)患者采用本方法进行综合治疗。该研究的标准是腿部存在长期未愈合的营养性溃疡;关节后疾病的存在;四肢动脉的搏动被保留了下来。对营养性溃疡患者采用光疗、无清偿穿孔剂硬膜冲洗和用合成创面盖闭合创面缺损等方法治疗。主组患者治疗时间均不超过39天。在对照组中,该指标范围为28至53天(取决于伤口面积和伤口过程的特点)。
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引用次数: 0
Prospects of the Artificial Organs Structures 3D Printing Technology 人工器官结构3D打印技术展望
Pub Date : 2020-12-16 DOI: 10.30702/TRANSPAORG/08_20.0112/108-115/77
E. Sid
Transplantation technologies are now highly effective modern methods of medical care for patients with irreversible stage of chronic diseases of vital organs. The success of transplantology allowed to start solving the problems of improving the quality of patients’ life who live with transplanted organ, their adaptation to society, return to work, to authentic family relationships. The aim of the study is to perform analysis of modern literary sources related to the prospects of application of artificial organs structures bioprinting 3D technology.The shortage of donor organs for transplantation, the high cost of traditional transplantation and the problem of immunocompatibility of donor tissues led to the search for alternative, cost-effective and efficient organ replacement technologies. There are different methods of making 3D structures, each of which has its advantages and disadvantages. The technology is selected depending on the properties of the material, the desired characteristics of the finished structure and its application. To date, bioprinters are able to print bone and cartilage implants quickly enough. Thus, 3D bioprinting is now becoming a real breakthrough in regenerative medicine. Every day there are more and more different techniques to improve this technology.
移植技术是目前重要器官慢性疾病不可逆期患者高效的现代医疗手段。移植手术的成功让我们开始解决一些问题,提高移植器官患者的生活质量,让他们适应社会,重返工作岗位,建立真正的家庭关系。本研究的目的是分析与人工器官结构生物打印3D技术应用前景相关的现代文献资料。用于移植的供体器官短缺、传统移植的高成本以及供体组织的免疫相容性问题导致寻找替代的、具有成本效益的和有效的器官替代技术。制作3D结构有不同的方法,每种方法都有其优点和缺点。该技术的选择取决于材料的性能,成品结构的所需特性及其应用。迄今为止,生物打印机能够足够快地打印骨骼和软骨植入物。因此,3D生物打印现在正在成为再生医学的真正突破。每天都有越来越多的不同的技术来改进这项技术。
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引用次数: 0
Principles of Circulatory Support in a Potential Donor with Adequate Oxygenation at the Prehospital Stage: Review of International Protocols and Recommendations 院前阶段潜在供体充氧循环支持原则:国际协议和建议综述
Pub Date : 2020-12-16 DOI: 10.30702/TRANSPAORG/09_20.0112/116-125/843
I. Filimonova, B. Goldovsky, S. O. Potalov, K. Serikov, T. Semenova, S. Korogod, R. V. Filimonov, D. V. Lelyuk
Objective. Study the issues of ensuring the vital functions of the organism of a potential donor at the prehospital stage in the structure of transplantology.In our work, an analysis of specialized literature and studies on the functioning of the body of a potential donor at the prehospital stage has been carried out.The complex of measures for the maintenance of the vital functions of the body of a deceased person is a more difficult task compared to carrying out standard intensive care in severely ill patients. At present, this amount of work is poorly studied and often condemned (including by colleagues) the workload for resuscitation department staff and heads of medical institutions.In recent years, experimental and clinical studies have been conducted on new alternative methods that should improve blood flow during cardiopulmonary resuscitation (CPR) and patient survival. Automated systems for compression of the chest, which do not require manual intervention, are developed, as well as the prevention of fatigue in persons who perform CPR. The automation of the execution of the compress allows the personnel to be freed, and helps the honey staff to pay attention to other tasks necessary to maintain the patient’s livelihood.Conclusions. Correct and well-organized organization of aid at the prehospital stage in the event of a sudden death of a person can significantly help not only the development of such a branch of medicine as transplantology, but also increase the percentage of successfully performed resuscitation measures. 
目标。研究在移植结构的院前阶段确保潜在供体器官的重要功能的问题。在我们的工作中,对院前阶段潜在供体身体功能的专业文献和研究进行了分析。与对重病患者进行标准的重症监护相比,维持死者身体重要功能的复杂措施是一项更困难的任务。目前,人们对这一工作量的研究很少,而且经常谴责(包括同事)复苏科工作人员和医疗机构负责人的工作量。近年来,人们对新的替代方法进行了实验和临床研究,以改善心肺复苏(CPR)过程中的血流量,提高患者的生存率。开发了不需要人工干预的自动胸部按压系统,以及防止实施心肺复苏术人员的疲劳。按压的自动化执行使工作人员得到解放,并帮助蜂蜜工作人员专注于维持患者生活所需的其他任务。在一个人猝死的院前阶段,正确和组织良好的援助组织不仅可以显著帮助移植等医学分支的发展,而且还可以增加成功实施复苏措施的百分比。
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引用次数: 0
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Transplantation and artificial organs
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