Background. The new SARS-CoV-2 coronavirus infection is understudied; despite its worldwide prevalence, case reports of organ transplant recipients are rare.Aim. A dynamics evaluation and treatment outcome improvement in a transplanted cadaveric kidney patient with 100% parenchymal lung damage caused by SARS-CoV-2 coronavirus bilateral pneumonia.Materials and methods. We describe a successful treatment case of a transplant kidney patient having the new coronavirus infection (COVID-19) (of 03.12.2020). COVID-19 pneumonia was diagnosed on day 7 of the early post-transplant period. On day 14, the patient was admitted to an infectious ward and transferred to intensive care upon disease aggravation. Despite ongoing treatment, pulmonary parenchymal lesion reached 100% in CT scan on 24.12.2020. The patient was transferred to Surgery Unit No. 3 for further therapy on 11.01.2021 upon revealing a clinical improvement, positive laboratory dynamics and SARS-CoV-2-negative smear PCR tests. The patient was discharged for outpatient treatment on day 10.Results and discussion. No evidence of focal infiltrative pulmonary change was detected in control chest CT after 4 months. Within 5 months since discharge, there were observed a general well-being improvement, 98% oxygen saturation, absent oedema, satisfactory transplanted kidney function.Conclusion. Post-kidney-transplant patients are particularly susceptible to infection due to inherent chronic immunosuppression. The presented case of a kidney transplant patient having a favourable COVID-19 outcome demonstrates the efficacy of a timely treatment.
Introduction. Liver transplantation is currently considered to be the only method of radical treatment for adults and children with incurable liver diseases. The most important aspects of liver transplantation are the correct selection of an appropriate recipient and compilation and maintenance of a liver transplant waiting list. This article aims to analyze the structure of the severe chronic liver disease patient population included in the liver transplant waiting list at the G. G. Kuvatov Republican Clinical Hospital (the City of Ufa).Materials and methods. We analyzed the waiting list drawn and maintained over the 2007-2018 period based on the examination of 789 patients with liver cirrhosis of various etiologies.Results and discussion. Out of all the patients with liver cirrhosis of different etiologies (Child-Pugh score classes A, B, and C) 149 (18.8 %) were included in the waiting list. The ages of patients included in the liver transplant waiting list ranged from 19 to 69. The mortality rate amounted to 38.9 % (58 people); of these patients 31 (53.4 %) had hepatic cirrhosis (HC) of autoimmune etiology, 18 (31.0 %) — HC of viral etiology, and 6 (10.3 %) — alveococcosis of the liver. The rate of the waiting list expansion for patients aged 20-29 compared to those aged 0-19 amounted to 1.32 %. Such a dynamics for the 30-39 age group compared to the 20-29 age group was 11.51 %. The number of people aged 40-49 compared to the preceding age group remained the same.Conclusion. Our analysis of the waiting list sets the percentage of patients with autoimmune HC in the population of patients with this disease at 59 %. These patients are characterized by a rapid progression of liver failure and high mortality. The statistical analysis of liver transplant waiting lists facilitate the optimization of procedures used to select and manage such patients, as well as to prevent, in a timely manner, the development of complications thus improving the prognosis of survival.
In surgical practice, with operations in the duodenum using different types of suture material. The experiment used 4 types of suture material: Vikryl, polidiaksonon, kapron and silk. Vikryl seams can be seen as more preferable in terms of prevention cicatrices expressed changes in the intervention of intestinal wall, while maintaining good strength properties.
During the period of 1996 – 2013 237 organ transplantations were carried out in the Republic of Bashkortostan, including 235 kidney transplantations (141 from deceased donors, 94 from living related donors), 1 liver transplant from deceased donor and 1 heart transplantation. For the period of 2006-2009, no transplantation was made in the republic from deceased donors. Activities of the Government of the Republic of Bashkortostan, aimed at improving the work of deceased organ donation allowed in 2012 to reach the level of 38 kidney transplants and to begin multi organ explantation. As a result, in 2013 the first liver and heart transplantations have been performed in the Republic of Bashkortostan.
Aim. To improve the results of surgical treatment of patients with chronic transplant nephropathy (CTN) in nephrotransplantectomy (NTE) using preventive endovascular transplant arteries embolization (ETAE). Materials and methods. The results of clinical examination and surgical treatment of 30 patients with chronic transplant nephropathy in the period from 2004 to 2012 were assessed. Patients were divided into two groups: group 1, in which NTE was performed after ETAE and group 2 – NTE without ETAE. Both groups were compared by the hemorrhage volume, surgical complications, medical measures. Results. Intraoperative hemorrhage in group 1 was from 20 to 50 ml, on the average 40±10,5 ml. In group 2 – from 100 to 600 ml, on the average 295±50,4 ml ( p =0,04). No surgical complications, such as vascular damage when performing NTE in group 1 were noted. In group 2 there was registered vascular damage in 15% of cases ( n =3).No intra-and postoperative hemotransfusions connected with hemorrhage were detected in group 1. In group 2 erythrocytic mass infusion was administered in 75% of cases ( n =15). Conclusion. Preventive ETAE permits to significantly reduce the hemorrhage degree (from 295±50,4 ml to 40±10,5 ml) during NTE that is very important for patients with nephrogenic anemia against the background of tCPN transplant. ETAE allows to completely abolish immunosuppression in the early period after this manipulation, to carry out nephrectomy in the delayed terms and to grade the risk of immunological conflict with subsequent allotransplantations to these recipients.
The article contains materials research aimed at improving surgical interventions on the duodenum. In the comparison group, accounting for 182 patients, the formation of a conventional anastomotic suture, and in the main group, accounting for 106 patients, used vikril thread. Analyzing the results of surgical treatment of the next group and the comparison of the main group of patients, it may be noted that the incidence of complications that required repeat surgery in the early postoperative period, which amounted to 6.6% of the comparison group, patients declined the study group to 4.7%.