Transplant Surgery

doi: 10.25005/2074-0581-2019-21-2-279-284
CLINICAL AND HEMODYNAMIC FACTORS AFFECTING THE INITIAL FUNCTION OF RENAL ALLOGRAFT

S.Kh. Tagoev1, M.K. Gulov2, Kh.Yo. Sharipova3, N.A. Alimova3

1Department of Organs and Tissues Transplantation, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of General Surgery № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
3Department of Propedeautics of Internal Diseases, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To establish predictors of optimal functioning of renal allograft (RAG) and reversibility of cardiovascular disorders when comparing functional-hemodynamic indicators in patients with terminal chronic renal failure (TCRF) before and after kidney transplantation (KT).

Methods: In the prospective (14-18 weeks after KT) study included 71 patients between the ages of 17 and 63 years (average age 36.4±1.3) with TCRF, which was examined by the Scientific and Practical Center of Organs and Tissues Transplantation

Results: Found that recipients with delayed and slow initial function (IF) of RAG was older, and the values of the comorbidities – significantly higher (р<0.05) than any recipients with immediate (excellent) IF. The positive dynamics of structural and functional indicators are well expressed in recipients with immediate (excellent) IF RAG, which when compared with the group of recipients with slow-motion IF RAG, significant both in reducing blood pressure levels, heart failure, and in structural indicators. In recipients with delayed IF RAG when compared with a group with excellent IF, the positive dynamics of the initial structural and functional shifts in all indicators was significantly lower (р<0.05).

Conclusion: Delayed and slow-motion IF RAG is most commonly observed in older age groups (р<0.05), with a high comorbidity index and with the initial high severity of CHF (р<0.05). Positive dynamics of the initial cardiovascular shifts and the degree of decrease in the severity of CHF in recipients with excellent (immediate) IF RAG are significant (р<0.05) compared to recipients with slow-motion and delayed IF. The results allow considering the age of the initial severity of the CHF and the level of comorbidity of the recipients, as predictors of the initial function of the RAG and the reversibility of the original cardiovascular disorders.

Keywords: Kidney failure, renal allograft function, comorbidity, reversibility of hemodynamic indicators..

Download file:


References
  1. Johnston N, Dargie H, Jardine A. Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease. Heart. 2008;94:1080-8.
  2. Cianciolo G, Donati G, La Manna G. The cardiovascular burden of end-stage renal disease patients. Minerva Urol Nefrol. 2010;62(1):51-66.
  3. Hemmelgarn BR, Manns BJ, Tonelli M. Interdisciplinary Chronic Disease Collaboration/A decade after the KDOQI CKD Guidelines: a perspective from Canada. Am J Kidney Dis. 2012;60(5):723-4.
  4. Carpenter MA, Weir MR, Adey DB. Inadequacy of cardio vascular risk factor management in chronic kidney transplantation – evidence from the FAVORIT study. Clin Transplant. 2012;26(4):438-46.
  5. Gulov MK, Sharipova KhYo, Tagoev SKh, Sokhibov RG. Terminal’naya khronicheskaya pochechnaya nedostatochnost’: otsenka riska, etapy terapii i kardial’nye problemy [Terminal chronic renal failure: risk assessment, stages of therapy, and cardiac problems]. Vestnik Avitsenny [Avicenna Bulletin]. 2013;2:153-9
  6. Diskin CJ. The use of new concepts in vascular physiology and pharmacology to improve hemodialysis access outcomes. Minerva Urol Nefrol. 2010; 62 (4): 387-410.
  7. Babich VP, Chernousov SV, Zabolotskikh IB, Trembach NV Oso-bennosti gemodinamiki u patsientov programmnogo gemodializa [Hemodynamic features in programmed hemodialysis patients]. Kubanskiy nauchnyy meditsinskiy vestnik. 2010;9:18-23.
  8. López-Oliva MO, Rivas B, Pérez-Fernández E, Ossorio M, Ros S, Chica C, Aquilar A, et al. Pretransplant peritoneal dialysis relative to hemodialysis improves long-term survival of kidney transplant patients: a single-center observational study. Int Urol Nephrol. 2014;46(4):825-32. Available from: http://dx.doi.org/10.1007/s11255-013-0521-0.
  9. Van Deursen VM, Urso R, Laroche C, Damman K, Dahlström U, Tavazzi L. Comorbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey. Eur J Heart Fail. 2014;16:103-11.
  10. Tomilina NA, Bikbov BT. Sostoyanie zamestitel’noy terapii pri khronicheskoy pochechnoy nedostatochnosti v Rossii v 1998-2011 gg. (po dannym registra Rossiyskogo dializnogo obshchestva) [The status of replacement therapy for chronic renal failure in Russia in 1998-2011 (according to the register of the Russian Dialysis Society)]. Vestnik transplantologii i iskusstvennykh organov. 2015;17(1):35-58. Available from: http://dx.doi.org/10.15825/1995-1191- 2015-1-35-58.
  11. Abdelwahab HH, Shigidi MM, Ibrahim LS, El-Tohami AK. Barriers to kidney transplantation among adult Sudanese patients on maintenance hemodialysis in dialysis units in Khartoum state. Saudi J Kidney Dis Transpl. 2013;24(5):1044-9.
  12. Ismoilov SS, Dostiev AR, Fayzullaev AKh. Pervye shagi trans-plantattsii pochki v Respublike Tadzhikistan [The first steps of kidney transplantation in the Republic of Tajikistan]. Vestnik transplantologii i iskusstvennykh organov. 2012;14:24-26.
  13. Khubutiya MSh, Gulov MK, Ismoilov SS. Prognosticheskaya tsennost’ faktorov riska, vliyayushchikh na dlitel’nost’ vyzhivaniya bol’nykh i transplantatov posle rodstvennoy peresadki pochki [The predictive value of risk factors affecting the duration of survival of patients and transplants after a related kidney transplant]. Vestnik Avitsenny [Avicenna Bulletin]. 2016;3:7-10.
  14. Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: Toward a more uniform methodology. Ann Family Med. 2012;10(2):142-51.
  15. Ismoilov SS, Gulov MK, Gulshanova SF. Sostoyanie shchitovidnoy zhelezy u bol’nykh s khronicheskoy pochechnoy nedostatochnost’yu terminal’noy stadii na programmnom dialize [The state of the thyroid gland in patients with chronic renal insufficiency of the terminal stage on a program dialysis] Vestnik Avitsenny [Avicenna Bulletin]. 2013;3:13-5.
  16. Yazbek DC, de Carvalho AB, Barros CS. Cardio vascular disease in early kidney transplantation: comparison between living and deceased donor recipients. Transplant Proc. 2012;44(10):3001-6.
  17. Fomin IV, Ostanina AA, Polyakov DS, Lipatov KS. Sushchestvuet li optimal’nyy uroven’ arterial’nogo davleniya u patsientov s terminal’noy khronicheskoy pochechnoy nedostatochnost’yu do i posle transplantatsii pochki? [Is there an optimal level of blood pressure in patients with terminal chronic renal failure before and after kidney transplantation?]. Sovremennye tekhnologii v meditsine. 2014;2(6):53-60.

Authors' information:


Tagoev Sukhrob Khamroevich
, Assistant of the Department of Organs and Tissues Transplantation, Avicenna Tajik State Medical University

Gulov Mahmadshoh Kurbonalievich
, Doctor of Medical Sciences, Full Professor, Professor of the Department of General Surgery № 1, Avicenna Tajik State Medical University

Sharipova Khursand Yodgorovna
, Doctor of Medical Sciences, Full Professor, Professor of the Department of Propedeautics of Internal Diseases, Avicenna Tajik State Medical University

Alimova Nargiz Amirovna
, Assistant, Department of Propedeautics of Internal Diseases, Avicenna Tajik State Medical University

Conflicts of interest: No conflict

Address for correspondence:


Sharipova Khursand Yodgorovna
Doctor of Medical Sciences, Full Professor, Professor of the Department of Propedeautics of Internal Diseases, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (935) 811297

E-mail: sharipovakh@mail.ru

Materials on the topic: