Pub Date : 2022-04-25DOI: 10.15825/1995-1191-2022-2-51-57
N. Koloskova, A. Shevchenko
The role of frailty in cardiovascular disease is becoming increasingly recognized. Up to 79% of patients with heart failure are frail. Frailty is associated with reduced quality of life and poor prognosis. This review summarizes the available literature on frailty and its key role in waitlisting patients for heart transplantation.
{"title":"The role of frailty in selecting patients for heart transplantation","authors":"N. Koloskova, A. Shevchenko","doi":"10.15825/1995-1191-2022-2-51-57","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-2-51-57","url":null,"abstract":"The role of frailty in cardiovascular disease is becoming increasingly recognized. Up to 79% of patients with heart failure are frail. Frailty is associated with reduced quality of life and poor prognosis. This review summarizes the available literature on frailty and its key role in waitlisting patients for heart transplantation.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72840869","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}
Pub Date : 2022-04-25DOI: 10.15825/1995-1191-2022-2-39-50
I. Iljinsky, O. Tsirulnikova
Autoimmune hepatitis (AIH) can occur at any age and is more common in women. The disease is a manifestation of autoimmune predisposition caused in genetically susceptible people exposed to certain environmental factors. The pathogenetic mechanism of AIH is not yet fully understood, but it involves an aggressive cellular immune response. The pathogenesis and severity of AIH also depend on various cytokines. This disease is characterized by elevated levels of transaminases – aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Liver histology plays a crucial role in confirming or supporting the clinical diagnosis of AIH. Diagnosis of AIH remains a challenge in clinical practice. AIH is one of the few liver diseases for which pharmacologic treatment has been shown to improve survival. Standard treatment is based on high-dose prednisone alone or prednisolone plus azathioprine. It leads to disease remission in 80%-90% of patients. Approximately 20% of patients do not respond to the standard steroid treatment and are treated with second-line immunosuppressive drugs: mycophenolate mofetil, budesonide, cyclosporine, tacrolimus, everolimus, and sirolimus. There have been reports on the use of infliximab and rituximab. In the natural course of AIH and resistance to therapy, there is a tendency for cirrhosis to develop and for the disease to progress to an end stage. These patients, as well as those diagnosed with fulminant liver failure, require liver transplantation.
{"title":"Historical aspects and current understanding of autoimmune hepatitis. When is liver transplantation indicated? (Review)","authors":"I. Iljinsky, O. Tsirulnikova","doi":"10.15825/1995-1191-2022-2-39-50","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-2-39-50","url":null,"abstract":"Autoimmune hepatitis (AIH) can occur at any age and is more common in women. The disease is a manifestation of autoimmune predisposition caused in genetically susceptible people exposed to certain environmental factors. The pathogenetic mechanism of AIH is not yet fully understood, but it involves an aggressive cellular immune response. The pathogenesis and severity of AIH also depend on various cytokines. This disease is characterized by elevated levels of transaminases – aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Liver histology plays a crucial role in confirming or supporting the clinical diagnosis of AIH. Diagnosis of AIH remains a challenge in clinical practice. AIH is one of the few liver diseases for which pharmacologic treatment has been shown to improve survival. Standard treatment is based on high-dose prednisone alone or prednisolone plus azathioprine. It leads to disease remission in 80%-90% of patients. Approximately 20% of patients do not respond to the standard steroid treatment and are treated with second-line immunosuppressive drugs: mycophenolate mofetil, budesonide, cyclosporine, tacrolimus, everolimus, and sirolimus. There have been reports on the use of infliximab and rituximab. In the natural course of AIH and resistance to therapy, there is a tendency for cirrhosis to develop and for the disease to progress to an end stage. These patients, as well as those diagnosed with fulminant liver failure, require liver transplantation.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91172352","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}
Pub Date : 2022-04-25DOI: 10.15825/1995-1191-2022-2-71-82
E. B. Makarova, M. Korch, F. Fadeyev, D. G. Bliznets, A. V. Bugayova, T. Shklyar, A. Safronov, K. A. Nokhrin, F. Blyakhman
Objective: to evaluate the features of reparative chondrogenesis and osteogenesis in animal experiments with the implantation of porous poly(2-hydroxyethyl methacrylate) (pHEMA) hydrogel into osteochondral defects. Materials and methods. Cylindrical pHEMA implants (5 mm in diameter) were synthesized by radical polymerization. The implants were subjected to light microscopy and mechanical tests to characterize the structure and viscoelastic properties of the material. In experimental group #1, four pHEMA specimens were implanted into formed defects in the distal femoral epiphysis of rabbits. In experimental group #2, allogeneic chondrocytes were applied to the surface of four specimens before implantation. In the control series, four defects were not replaced with implants. Tissue regeneration was investigated by morphological and morphometric methods 30 days after operation. Results. The pHEMA implants were heterogeneous specimens with irregularly shaped pores – up to 30 × 10 μm at the surface and 300 × 120 μm inside. With >10% static compressive stress, the Young’s modulus was 54.7 kPa. For dynamic stress, increased frequency of compression-relaxation cycles from 0.01 Hz to 20.0 Hz led to increased storage modulus from 20 kPa to 38 kPa on average, and increased loss modulus from 2 kPa to 10 kPa. Indicators of semi-quantitative assessment of local inflammatory response to pHEMA implantation had the following values in points: pHEMA, 4.7 ± 0.3; pHEMA with allogeneic chondrocytes, 6.0 ± 1.0; control, 4.3 ± 0.3. The ratio of connective, bone, and cartilage tissues proper in the regenerates had the following respective values: pHEMA, 79%, 20%, 1%; pHEMA with chondrocytes, 82%, 16%, 2%; control, 9%, 74%, 17%. Conclusion. In a short-term experiment, pHEMA implants did not trigger a pronounced inflammatory response in the surrounding tissues and can be classified as biocompatible materials. However, the tested implants had low conductivity with respect to bone and cartilage cells, which can be improved by stabilizing the pore size and increasing the rigidity when synthesizing the material.
{"title":"Testing of the pHEMA hydrogel as an implantation material for replacement of osteochondral defects in animals","authors":"E. B. Makarova, M. Korch, F. Fadeyev, D. G. Bliznets, A. V. Bugayova, T. Shklyar, A. Safronov, K. A. Nokhrin, F. Blyakhman","doi":"10.15825/1995-1191-2022-2-71-82","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-2-71-82","url":null,"abstract":"Objective: to evaluate the features of reparative chondrogenesis and osteogenesis in animal experiments with the implantation of porous poly(2-hydroxyethyl methacrylate) (pHEMA) hydrogel into osteochondral defects. Materials and methods. Cylindrical pHEMA implants (5 mm in diameter) were synthesized by radical polymerization. The implants were subjected to light microscopy and mechanical tests to characterize the structure and viscoelastic properties of the material. In experimental group #1, four pHEMA specimens were implanted into formed defects in the distal femoral epiphysis of rabbits. In experimental group #2, allogeneic chondrocytes were applied to the surface of four specimens before implantation. In the control series, four defects were not replaced with implants. Tissue regeneration was investigated by morphological and morphometric methods 30 days after operation. Results. The pHEMA implants were heterogeneous specimens with irregularly shaped pores – up to 30 × 10 μm at the surface and 300 × 120 μm inside. With >10% static compressive stress, the Young’s modulus was 54.7 kPa. For dynamic stress, increased frequency of compression-relaxation cycles from 0.01 Hz to 20.0 Hz led to increased storage modulus from 20 kPa to 38 kPa on average, and increased loss modulus from 2 kPa to 10 kPa. Indicators of semi-quantitative assessment of local inflammatory response to pHEMA implantation had the following values in points: pHEMA, 4.7 ± 0.3; pHEMA with allogeneic chondrocytes, 6.0 ± 1.0; control, 4.3 ± 0.3. The ratio of connective, bone, and cartilage tissues proper in the regenerates had the following respective values: pHEMA, 79%, 20%, 1%; pHEMA with chondrocytes, 82%, 16%, 2%; control, 9%, 74%, 17%. Conclusion. In a short-term experiment, pHEMA implants did not trigger a pronounced inflammatory response in the surrounding tissues and can be classified as biocompatible materials. However, the tested implants had low conductivity with respect to bone and cartilage cells, which can be improved by stabilizing the pore size and increasing the rigidity when synthesizing the material.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80111097","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}
Pub Date : 2022-04-25DOI: 10.15825/1995-1191-2022-2-134-145
R. Kantaria, O. Vetchinnikova, C. A. Pasov, V. A. Dudakov
Cardiovascular disease is the leading cause of death in patients with a transplanted kidney and in graft loss. We present the first clinical case of successful surgical correction of ascending aortic dissection (DeBakey type I) in a young patient with a functioning kidney graft. The patient underwent the first cadaveric kidney transplantation (KTx), which was complicated by acute humoral rejection and suboptimal graft function. High blood pressure, anemia, elevated blood levels of triglycerides, phosphorus, parathyroid hormone, and uric acid were recorded. A repeat KTx was performed five years later; the patient’s condition and kidney function were satisfactory. Three years later,the patient started experiencing severe pain along the thoracic and lumbar spine; his blood creatinine level was 408 μmol/L. Computed tomography and echocardiography diagnosed DeBakey type I aortic dissection (AD) with critical narrowing of the true aortic lumen at certain levels, dissection of aortic branches. Aortic resection surgery with prosthetic replacement of the ascending aorta according to David procedure with reimplantation of coronary artery orifices according to Kouchoukos technique, prosthetic replacement of the aortic arch with debranching of brachiocephalic artery and left common carotid artery were successfully performed as planned under endotracheal anesthesia, cardiopulmonary bypass and selective pharmacological cold cardioplegia. The peculiarities of the course, possible causes and outcomes of surgical correction of thoracic AD in the patient are discussed.
{"title":"Successful surgical correction of ascending aortic dissection in a kidney transplant patient","authors":"R. Kantaria, O. Vetchinnikova, C. A. Pasov, V. A. Dudakov","doi":"10.15825/1995-1191-2022-2-134-145","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-2-134-145","url":null,"abstract":"Cardiovascular disease is the leading cause of death in patients with a transplanted kidney and in graft loss. We present the first clinical case of successful surgical correction of ascending aortic dissection (DeBakey type I) in a young patient with a functioning kidney graft. The patient underwent the first cadaveric kidney transplantation (KTx), which was complicated by acute humoral rejection and suboptimal graft function. High blood pressure, anemia, elevated blood levels of triglycerides, phosphorus, parathyroid hormone, and uric acid were recorded. A repeat KTx was performed five years later; the patient’s condition and kidney function were satisfactory. Three years later,the patient started experiencing severe pain along the thoracic and lumbar spine; his blood creatinine level was 408 μmol/L. Computed tomography and echocardiography diagnosed DeBakey type I aortic dissection (AD) with critical narrowing of the true aortic lumen at certain levels, dissection of aortic branches. Aortic resection surgery with prosthetic replacement of the ascending aorta according to David procedure with reimplantation of coronary artery orifices according to Kouchoukos technique, prosthetic replacement of the aortic arch with debranching of brachiocephalic artery and left common carotid artery were successfully performed as planned under endotracheal anesthesia, cardiopulmonary bypass and selective pharmacological cold cardioplegia. The peculiarities of the course, possible causes and outcomes of surgical correction of thoracic AD in the patient are discussed.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74624404","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}
Pub Date : 2022-02-15DOI: 10.15825/1995-1191-2022-1-7-14
D. Granov, I. I. Tileubergenov, V. N. Zhuikov, A. Sheraliev, A. Polikarpov, A. Moiseenko
Objective: to demonstrate the experience of unresectable hilar cholangiocarcinoma treatment using neoadjuvant therapy followed by liver transplantation (LT).Materials and methods. From 2017 to 2021, six patients were included in the treatment protocol for unresectable Klatskin tumor followed by liver transplantation at Granov Russian Scientific Center for Radiology and Surgical Technology. The neoadjuvant therapy included endobiliary photodynamic therapy (PDT), as well as regional and systemic chemotherapy. Each method was used at least three times for 4 to 5 months with radiological evaluation and measurement of CA 19-9 levels. Patients were placed on the waiting list when the tumor marker reduced, or when there were no radiological signs of disease progression and there was no acute cholangitis. The recipients underwent laparoscopic abdominal revision for carcinomatosis and assessment of lymph nodes in the hepatoduodenal ligament with urgent morphological examination. Where there was no extrahepatic spread, LT was performed according to the classical technique with paracaval, para-aortic and hepatoduodenal lymphodissection, biliodigestive anastomosis by an isolated Roux loop of small intestine. The operation was performed in three patients, all of them were men aged 40 to 55 years (mean 48). The mean time from the start of treatment to transplantation was 9.3 months (range 6 to 14). Mean CA 19-9 level at the time of intervention was 81.3 IU/mL (8 to 212).Results. In three patients, CA 19-9 levels more than doubled on average over four months despite treatment. According to data from computed tomography RECIST assessment, two of the patients showed disease progression. In one patient, carcinomatosis was detected by diagnostic laparoscopy. In three patients, CA 19-9 levels decreased more than fourfold. Two of these patients were radiologically confirmed to have the disease stabilized, and one had a partial response. One patient died from sepsis three years after transplantation as a result of secondary biliary cirrhosis and biliary abscesses without signs of progression. Two patients are still alive after 6 and 21 months without signs of tumor progression.Conclusion. LT for unresectable Klatskin tumor is effective in controlling the bioactivity of the tumor through the use of neoadjuvant therapy
{"title":"Combined treatment of unresectable hilar cholangiocarcinoma with subsequent liver transplantation","authors":"D. Granov, I. I. Tileubergenov, V. N. Zhuikov, A. Sheraliev, A. Polikarpov, A. Moiseenko","doi":"10.15825/1995-1191-2022-1-7-14","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-1-7-14","url":null,"abstract":"Objective: to demonstrate the experience of unresectable hilar cholangiocarcinoma treatment using neoadjuvant therapy followed by liver transplantation (LT).Materials and methods. From 2017 to 2021, six patients were included in the treatment protocol for unresectable Klatskin tumor followed by liver transplantation at Granov Russian Scientific Center for Radiology and Surgical Technology. The neoadjuvant therapy included endobiliary photodynamic therapy (PDT), as well as regional and systemic chemotherapy. Each method was used at least three times for 4 to 5 months with radiological evaluation and measurement of CA 19-9 levels. Patients were placed on the waiting list when the tumor marker reduced, or when there were no radiological signs of disease progression and there was no acute cholangitis. The recipients underwent laparoscopic abdominal revision for carcinomatosis and assessment of lymph nodes in the hepatoduodenal ligament with urgent morphological examination. Where there was no extrahepatic spread, LT was performed according to the classical technique with paracaval, para-aortic and hepatoduodenal lymphodissection, biliodigestive anastomosis by an isolated Roux loop of small intestine. The operation was performed in three patients, all of them were men aged 40 to 55 years (mean 48). The mean time from the start of treatment to transplantation was 9.3 months (range 6 to 14). Mean CA 19-9 level at the time of intervention was 81.3 IU/mL (8 to 212).Results. In three patients, CA 19-9 levels more than doubled on average over four months despite treatment. According to data from computed tomography RECIST assessment, two of the patients showed disease progression. In one patient, carcinomatosis was detected by diagnostic laparoscopy. In three patients, CA 19-9 levels decreased more than fourfold. Two of these patients were radiologically confirmed to have the disease stabilized, and one had a partial response. One patient died from sepsis three years after transplantation as a result of secondary biliary cirrhosis and biliary abscesses without signs of progression. Two patients are still alive after 6 and 21 months without signs of tumor progression.Conclusion. LT for unresectable Klatskin tumor is effective in controlling the bioactivity of the tumor through the use of neoadjuvant therapy","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72831291","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}
Pub Date : 2022-02-11DOI: 10.15825/1995-1191-2022-1-36-47
S. V. Arzumanov, Nikolay Polyakov, A. Ryabov, D. Galitskaya
The first successful kidney autotransplantation was performed in 1902. The technique has undergone several changes since then. The indications and surgical technique are presented in this literature review. Kidney autotransplantation is the treatment of choice for preserving renal function. Three clinical observations on the use of kidney autotransplantation in urological and oncological practice are described: a patient after iatrogenic ureteral injury and two patients with primary retroperitoneal tumor. Literature analysis and clinical observations from urological and oncological practice show that kidney autotransplantation could be safely used for strictly selected indications.
{"title":"Kidney autotransplantation: a method for treating ureteral lesions in urological and oncological practice","authors":"S. V. Arzumanov, Nikolay Polyakov, A. Ryabov, D. Galitskaya","doi":"10.15825/1995-1191-2022-1-36-47","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-1-36-47","url":null,"abstract":"The first successful kidney autotransplantation was performed in 1902. The technique has undergone several changes since then. The indications and surgical technique are presented in this literature review. Kidney autotransplantation is the treatment of choice for preserving renal function. Three clinical observations on the use of kidney autotransplantation in urological and oncological practice are described: a patient after iatrogenic ureteral injury and two patients with primary retroperitoneal tumor. Literature analysis and clinical observations from urological and oncological practice show that kidney autotransplantation could be safely used for strictly selected indications.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76436737","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}
Pub Date : 2022-02-10DOI: 10.15825/1995-1191-2022-1-15-22
I. Iljinsky, O. Tsirulnikova
Primary biliary cholangitis (PBC) is an autoimmune liver disease resulting from the destruction and inflammation of intrahepatic bile ducts. This end-stage disease was once the most common cause of liver transplantation. The use of ursodeoxycholic and obeticholic acids as a first-line and second-line treatment, respectively, slows down the disease. However, treatment is not effective in about 40% of PBC patients, and the disease may progress to cirrhosis and end-stage liver disease. These patients undergo liver transplantation to save their lives. After surgery, recurrent PBC can develop in a milder form and rarely requires liver retransplantation.
{"title":"Liver transplantation for primary biliary cholangitis (review)","authors":"I. Iljinsky, O. Tsirulnikova","doi":"10.15825/1995-1191-2022-1-15-22","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-1-15-22","url":null,"abstract":"Primary biliary cholangitis (PBC) is an autoimmune liver disease resulting from the destruction and inflammation of intrahepatic bile ducts. This end-stage disease was once the most common cause of liver transplantation. The use of ursodeoxycholic and obeticholic acids as a first-line and second-line treatment, respectively, slows down the disease. However, treatment is not effective in about 40% of PBC patients, and the disease may progress to cirrhosis and end-stage liver disease. These patients undergo liver transplantation to save their lives. After surgery, recurrent PBC can develop in a milder form and rarely requires liver retransplantation.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89242543","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}
Pub Date : 2022-02-09DOI: 10.15825/1995-1191-2022-1-31-35
A. D. Smagulov, M. Rysmakhanov, Zh. M. Koishybayev, Y. Sultangereyev, N. M. Mussin
.
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{"title":"Application of indocyanine green fluorescence for ureter imaging: review","authors":"A. D. Smagulov, M. Rysmakhanov, Zh. M. Koishybayev, Y. Sultangereyev, N. M. Mussin","doi":"10.15825/1995-1191-2022-1-31-35","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-1-31-35","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74494396","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}
Pub Date : 2022-02-09DOI: 10.15825/1995-1191-2022-1-107-116
A. Deryugina, O. P. Abaeva, S. V. Romanov, M. Vedunova, E. Ryabova, S. Vasenin, N. A. Titova
Organ transplantation is an effective treatment for many end-stage diseases. However, reperfusion injury constitutes a major complication of transplantation, which is associated with microcirculatory disorders and aggregation of blood corpuscles. Red blood cells (RBC) play an essential role in maintaining hemodynamic and rheological properties of the blood. Moreover, the study of mechanisms of changes in RBC functional indices is an urgent task. The main indicator of RBC functioning is the stability of RBC membrane structure. The issue of RBC membrane modification in organ transplantation has not been studied so far. Objective: to study the protein composition of RBC membranes, their aggregation and electrokinetic parameters in liver and kidney recipients, as well as in related kidney and liver fragment donors before and after operation. Research materials. Blood of 12 kidney recipients and 5 related kidney donors, 8 liver recipients and 4 related liver fragment donors – 1–2 hours before surgery, 1 week, 1, 2, 7, 10, 12 months after surgery. The control group consisted of 8 healthy volunteers. Research methods. Protein separation was done by Laemmli electrophoresis. RBC electrophoretic mobility, which characterizes the electrokinetic properties of cells, was measured by microelectrophoresis. Aggregation was calculated microscopically by counting unaggregated RBCs. Obtained values were compared by Mann-Whitney U test. Results. Examination of the RBC membrane of kidney recipients revealed a significant decrease in the amount of Band 3 protein and glycophorin before and after transplantation. Band 3 protein levels reduced at 1 month, glycophorin reduced at 7 months after surgery, with a maximum decrease in these protein fractions by more than 50% by 7 days compared with control values. There was also a decrease in spectrin content for 2 months after surgery with a maximum decrease of 30% by 1 month. In liver recipients, analysis of RBC membrane proteins revealed a decrease in the amount of glycophorin before surgery and further decrease at 2 months of post-transplant period. The maximum decrease in this index was 72% by 7 days after surgery. In addition, there was a fall in spectrin and Band 3 protein levels at 1 month by more than 60% relative to the control values. In donors, there were changes in the protein fraction of RBC membranes in the long-term post-operative period: spectrin and Band 3 protein levels reduced by 2 times at month 2 in kidney donors, while glycophorin levels reduced by 2.3 times at month 1 after operation in liver donors. Similarly, both groups of donors had increased actin levels at month 1 after surgery. The revealed changes in protein levels in the protein phase of RBC membranes were combined with functional indices of RBCs. In kidney recipients, decreased RBC electrophoretic mobility and increased aggregation were detected at 2 months. In liver recipients, the changes in these indicators were at 1 month. A decrease in RBC
{"title":"Protein composition and functional parameters of RBC membranes in liver and kidney transplantation","authors":"A. Deryugina, O. P. Abaeva, S. V. Romanov, M. Vedunova, E. Ryabova, S. Vasenin, N. A. Titova","doi":"10.15825/1995-1191-2022-1-107-116","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-1-107-116","url":null,"abstract":"Organ transplantation is an effective treatment for many end-stage diseases. However, reperfusion injury constitutes a major complication of transplantation, which is associated with microcirculatory disorders and aggregation of blood corpuscles. Red blood cells (RBC) play an essential role in maintaining hemodynamic and rheological properties of the blood. Moreover, the study of mechanisms of changes in RBC functional indices is an urgent task. The main indicator of RBC functioning is the stability of RBC membrane structure. The issue of RBC membrane modification in organ transplantation has not been studied so far. Objective: to study the protein composition of RBC membranes, their aggregation and electrokinetic parameters in liver and kidney recipients, as well as in related kidney and liver fragment donors before and after operation. Research materials. Blood of 12 kidney recipients and 5 related kidney donors, 8 liver recipients and 4 related liver fragment donors – 1–2 hours before surgery, 1 week, 1, 2, 7, 10, 12 months after surgery. The control group consisted of 8 healthy volunteers. Research methods. Protein separation was done by Laemmli electrophoresis. RBC electrophoretic mobility, which characterizes the electrokinetic properties of cells, was measured by microelectrophoresis. Aggregation was calculated microscopically by counting unaggregated RBCs. Obtained values were compared by Mann-Whitney U test. Results. Examination of the RBC membrane of kidney recipients revealed a significant decrease in the amount of Band 3 protein and glycophorin before and after transplantation. Band 3 protein levels reduced at 1 month, glycophorin reduced at 7 months after surgery, with a maximum decrease in these protein fractions by more than 50% by 7 days compared with control values. There was also a decrease in spectrin content for 2 months after surgery with a maximum decrease of 30% by 1 month. In liver recipients, analysis of RBC membrane proteins revealed a decrease in the amount of glycophorin before surgery and further decrease at 2 months of post-transplant period. The maximum decrease in this index was 72% by 7 days after surgery. In addition, there was a fall in spectrin and Band 3 protein levels at 1 month by more than 60% relative to the control values. In donors, there were changes in the protein fraction of RBC membranes in the long-term post-operative period: spectrin and Band 3 protein levels reduced by 2 times at month 2 in kidney donors, while glycophorin levels reduced by 2.3 times at month 1 after operation in liver donors. Similarly, both groups of donors had increased actin levels at month 1 after surgery. The revealed changes in protein levels in the protein phase of RBC membranes were combined with functional indices of RBCs. In kidney recipients, decreased RBC electrophoretic mobility and increased aggregation were detected at 2 months. In liver recipients, the changes in these indicators were at 1 month. A decrease in RBC","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88240666","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}
Pub Date : 2022-02-09DOI: 10.15825/1995-1191-2022-1-23-30
Z. Matkarimov, F. S. Bahritdinov, R. Ibadov, A. Suyumov, Q. Mahmudov, A. Ahmedov, S. I. Shernazarov, M. O. Rustamov, Z. U. Abdugafurov, U. M. Saatova, J. Urinov
This paper presents a brief outline of the history of transplantation service in the Republic of Uzbekistan, which originated at the country’s Center for Kidney Transplantation. The role played by outstanding scientists in Uzbekistan, their works and efforts towards the creation of a separate area of clinical and scientific medicine in Uzbekistan, are highlighted. Achievements by the research school of U.A. Aripov, Academician of the Academy of Sciences of the Republic of Uzbekistan, who performed the first successful kidney transplantation in 1972, are shown. The ups and downs of national transplantation nephrology, as well as the birth of a national school of kidney transplantation, domiciled at the Vakhidov Republican Specialized Scientific and Practical Medical Center of Surgery, headed by academician F.G. Nazirov, and giving a stimulus to the «second breath» of the national school of transplantology, is reflected. Separate attention is devoted to the actual problems of national transplantology, moral, ethical and regulatory issues that inevitably accompany this scientific and clinical direction are reflected. Kidney transplant outcomes in Uzbekistan are given, the prospects for further scientific and clinical directions are indicated.
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