Паёми Сино (Jun 2019)
CLINICAL AND HEMODYNAMIC FACTORS AFFECTING THE INITIAL FUNCTION OF RENAL ALLOGRAFT
Abstract
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.
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