[Kidney preservation by a nonperfusion method].
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Biomedical subjects
Publications and source records attributed to N A Onishchenko.
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Comparative histoenzymatic, electron microscopic and histologic studies of kidney preservation without perfusion have shown that the pattern of precipitation of tetrazolium reaction products correlates with the degree of ultrastructural damage to the epithelium of renal tubules. A previously made suggestion on the possibility of using the tetrazolium reactions for estimating the degree of preservation of ischemized organs and tissues has been confirmed.
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The authors claim that the specific clinical symptoms of multiple organ failure (MOF) are explained by impaired interactions of two functionally related systems: the immune system (IS) responsible for regeneration and the reticuloendothelial system (RES) responsible for inflammation. Organ regeneration during MOF is suppressed as a result of suppressed morphogenetic function of lymphocytes, imbalanced macrophage-lymphocyte interactions, and RES hyperactivation. For prevention and treatment of MOF, the authors recommend stimulation of reparative processes in the organs by splenic therapy: assisted xenospleen, infusion of splenic perfusate or xenosplenic peptides. Xenospleen therapy is preferable to other methods of immunocorrection due to more expressed morphogenetic activity of splenic T lymphocytes and their cytokines.
A relationship of the functional status of the viscera with the immune system was studied in 38 cardiac surgical patients with septic complications and multi-organ failure in the postoperative period. In deceased patients (n = 13), the total functional organ compensation index was lower whereas the total functional decompensation index was higher than those in survivors (n = 25). In the deceased patients, each vital organ was more commonly decompensated than that in the survivors, but a definite discrepancy was ascertained only in the immune system (92% versus 16%, p < 0.0001). The average number of decompensated organs was found to increase with the severity of immunological disorders. Therefore, there is a rather high correlation between the functional status of vital organs and the degree of immunological imbalance. The authors show it necessary to use immunity-corrective drugs (splenopid) to enhance the efficiency of treatment organ failure.
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