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O S Belorusov

Publications and source records attributed to O S Belorusov.

At least 19 recordsLinked to original sources
PubMed1998

[Aspects of the transplantation of kidneys from relatives].

104 transplantations of the kidney from living relative donors (LRD) in patients with an end-stage of chronic renal insufficiency (CRI) were carried out in Research Center of Surgery from April 15, 1965 to November, 1993. Donors of the kidneys were: mother (55), father (21), sister (18), brother (10). Analysis of the accumulated data showed, that the results of LRD transplantations (one year survival of recipients 84 +/- 6%) are much better than those from cadaver donors (one year survival of recipients 33 +/- 6%). The examination of the relative donors in long-term periods after the operation has demonstrated, that nephrectomy in them entails small risk, because it does not negatively influence their psycho-emotional sphere and social status. The reserved (retained) kidney is able to support homeostasis of donor organism during all his life. Therefore the operation of kidney transplantation from living relative donors is the most effective method of treatment of patients with an end-stage of chronic renal insufficiency.

Adolescent↗
PubMed1998

[Pyogenic infectious complications in recipients with allogenic kidneys: clinical and bacteriological aspects].

The bacteriological study of wound discharge indicated no changes in the structure of the microflora in the allogenic kidneys of recipients throughout the follow-up. Among microbes isolated there were prevalent gram-positive microbes whose proportion has slightly increased in the past year, with Staphylococcus, mainly epidermal Staphylococcus, which contributes to the etiology. At the same time, studies of wound discharge in the past years showed that the incidence of mixed infections had increased from 4.3 in 1989-1991 to 15.6% in 1994-1997. Bacteriological urinalysis found no great differences in the etiological structures of the microflora. Gram-negative microbes are prevalent in all patients in three periods of follow-up. Noteworthy, there was an increase in the amount of yeast fungi (from 5.7 to 21.1%). Urinalysis showed that the rates in the isolation of bacterial and bacterial and fungal associations were steady-state and higher in all patients (20, 4-23, 5%). Examining the etiological structure of the pathogens of sepsis ascertained that patients of the early observation were found to isolate gram-negative microorganisms more frequently, while those of other observation periods have gram-positive ones. The overall proportion of microbial and microbe-fungal associations was 10.3% in the past 9 years. Since the patient's body is occupied by other pathogens due to immunosuppression, sepsis or wound infection was accompanied by high bacteriuria, cytomegalovirus infection, pneumocystic pneumonia, fungal infection, etc. For this reason, the patients had actually much higher quantities of mixed infections in sepsis, wound infection, or urinary infection than those taken into account while studying the only type of an infectious complication. The above leads to the conclusion that the incidence of mixed infection of recipients of allogenic kidneys is rather high. This infection substantially makes the choice of drugs and therapy difficult, the course of a wound process aggravated. For successful control of mixed infections, it is necessary to introduce new drugs having a high activity against bacteria, fungi, viruses, and protozoa and to use the latest differentially diagnostic culture media, to make diagnosis and treatment of pyoseptic diseases better.

Adolescent↗
PubMed1997

[Storage of cadaver kidney by trans-organ oxygen insufflation].

Transorganic oxygen preservation was used in storage of 87 cadaver kidneys. The kidneys were stored for 14 to 56 h (34 +/- 1.95 on the average). After storage, all organs were transplanted to 87 patients with chronic renal insufficiency in the terminal stage. The patients age ranged from 18 to 55 years. All recipients were divided into 3 groups according to the results of the operation. Group 1 (55 patients)-the function of the organ was restored immediately, blood creatinine normalized on the 5th-10th postoperative day; subsidiary hemodialysis was not needed. Group 2 (22 patients)-the function of the transplant was restored 14-21 days after the operation; 2 to 8 sessions of hemodialysis had to be conducted. Group 3 (10 patients)-the transplant did not function due to acute irreversible canalicular necrosis or irreversible rejection. No correlative dependence between restoration of the transplant function and the duration of storage was noted (r = 0.15). Our experience allows us to assert that transorganic oxygen perfusion can ensure long-term safe storage of cadaver kidneys.

Adolescent↗
PubMed1997

[Intraoperative hemodynamics in relative living donors].

The intraoperative hemodynamics was evaluated in 42 relative kidney donors. Electromagnetic flowmetry was used for the evaluation. The rate of blood flow was calculated with the formula of Hunt. The comparison of the existing rate of blood flow with a proper one has demonstrated the existence of intrakidney angiospasm. The donors over 50 years of age and the female donors are more predisposed to angiospasm. It was noted that in harvesting the right kidney the intraorganic angiospasm is expressed much more strongly than in harvesting the left kidney. The phenomena of intrakidney angiospasm in harvesting kidneys in live donors is of practical importance. Special measures should be undertaken to prevent this complication.

Adult↗
PubMed1995

[Radiologically-guided dilatation in arterial stenosis of transplanted kidney].

Stenosis of the artery of a transplanted kidney is a grave complication of the posttransplanation period. Two method are applied for correction of the disease: reconstructive operation and radiologically-guided endovascular dilatation (RED). The primary method of choice is RED of the stenosis. We applied it in 20 patients. The result of the operation in the early postdilatation period was good in 15 (75%) patients, satisfactory in 2 (10%) patients. In 3 cases the method of RED of the stenosis failed because of technical complications. Restenosis occurred in 8 (47%) patients in the late-term periods after correction. Attempts to repeat RED were successful in 5 patients.

Adolescent↗
PubMed1993

[Etiology and classification of arterial stenosis of transplanted kidney].

Stenosis of the artery of a transplanted kidney, which developed in late-term periods after allogeneic kidney transplantation, was revealed in 30 patients, which accounts for 6% of the total number of patients who underwent transplantation. The authors discuss the etiology of this complication in detail and suggest their own classification.

Adolescent↗
PubMed1991

[Characteristics of the early postoperative period following kidney allotransplantation and immunosuppression using Sandimmune (cyclosporin A)].

The authors analysed the early postoperative period in 100 patients who received sandimmune (cyclosporine A) as the main immunosuppressant after kidney allotransplantation and compared it to that in a control group of 60 patients treated by the usual measures of immunosuppression: azathioprine and steroids. The number of rejection crises was 1.9 times less in the group of patients given sandimmune than in the control group and were more benign in character, while the number of irreversible crises reduced from 26% to 6%. In treatment with sandimmune the dose of oral prednisolone was reduced by 1.9 times and the dose of intravenous methypred by 1.4 times. Nephrotoxicity was the main side effect of sandimmune, it was encountered in 26% of patients. All sandimmune side effects are reversible in decreasing the dose. Sandimmune improves the results of kidney transplantation significantly.

Azathioprine↗
PubMed1991

[Transplantation of the kidney with numerous arteries from a living relative-donor].

Among 99 operations for transplantation of a kidney from a living kindred donor 6 were carried out with the use of kidneys which had many arteries. Five patients received a kidney with 2 arteries, and one patient, a kidney with 3 arteries. The donors were: a mother (1), a father (2), a sister (2), a brother (1). The left kidney was transplanted in all cases. In 5 patients kidney implantation was preceded by extracorporeal reconstruction on the arteries of the kidney (accessory arteries were anastomosed end-to-side with the main trunk of the renal artery) carried out under conditions of cold storage. In one female patient first the kidney was implanted by the standard method whereas the artery of the lower pole was anastomosed end-to-end with the inferior epigastric artery by means of microsurgical techniques. The transplants functioned well from the first day after the operation in all patients. In one patient the transplant was rejected 2 years and 7 months after the operation. The others function satisfactorily. The longest follow-up period is 5 years and 8 months, the shortest, 9 months. It is concluded that transplantation of a kidney with numerous arteries from a living kindred donor is an effective method for the treatment of patients suffering from the terminal stage of chronic renal insufficiency.

Adolescent↗
PubMed1991

[Selection of the approach to conducting nephrectomy in donors- patients' relatives].

The comparative assessment of two types of an approach (lumbotomy and thoracolumbotomy) for the performance of nephrectomy in 99 related donors was carried out. Lumbotomy was performed in 47 donors, the complications developed in 6 (12.8%) of them, including the severe ones--in 4 (8.5%). Duration of hospital stay was in average 27.26 days. Thoracolumbotomy was performed in 52 donors, the complications developed in 14 (26.9%) of them, including a severe one--in 1 (1.9%). Duration of hospital stay of the donors was in average 16 days.

Adult↗
PubMed1990

[Problem of kidney transplantation (on the 25th anniversary of the first successful transplantation of the kidney in the USSR)].

The first successful transplantation of a kidney from an alive relative donor in the USSR was performed by B. V. Petrovsky at the All-Union Research Institute of Clinical and Experimental Surgery (now the All-Union Surgery Research Center, AMS, USSR) on April 15, 1965. In November, 1965 he transplanted a cadaver kidney for the first time with a good outcome. The Center possesses an experience with 987 kidney transplantations to date, among which 101 were related transplantations. The authors discuss the progress made in this field of surgery in a period of 25 years. The longest survival period among recipients with a functioning related kidney is 22 years and among those with a cadaver kidney, 19 years. With the use of Cy A 86% of transplanted related kidneys and 76% of cadaver kidneys function for 12 months or longer. The authors discuss the advantages of a new original method for transorganic oxygen preservation of a kidney suggested by G. A. Asoyan, instrumental-functional methods developed at the Center for appraising the hemodynamics of the transplanted kidney and diagnosis of the rejection crisis, cyclosporine nephrotoxicity, and progress in the techniques of kidney transplantation and immunosuppressive therapy. The authors believe that further improvement in the results of allogeneic kidney transplantation is well-grounded.

Female↗
PubMed1990

[Transplantation of the kidney from living related donor].

Ninety-nine alive related kidney donor transplantations were done in patients with terminal chronic renal failure in the Department for Transplantation of the All-Union Research Surgery Centre of USSR AMS in 1965-1989. The donors were mothers (n = 49), fathers (n = 22), sisters (n = 18), and brothers (n = 10). Donors were selected according to the criteria accepted at the Centre. To assess the degree of operative risk for the donor and the functional status of the preserved kidney, the course of the postoperative period was studied. Complications were seen in 20.2% of the donors, of which severe in 3.1%. All the complications were managed successfully and the donors were discharged quite healthy with normal blood levels of nitrogenous residues. Based on their own findings, the authors conclude that the operative risk faced by an alive related donor is insignificant, while the favourable transplantation outcomes make the risk justifiable. Besides, taking into account the deficient hemodialysis centres in this country and their poor technical equipment, the problem of alive related renal transplantation becomes especially significant.

Adolescent↗
PubMed1990

[Early postoperative rejection crises after transplantation of the kidney from the living related donors].

The frequency of the development of rejection crises in the early postoperative period in 32 recipients of allogeneic kidneys from alive related donors was analysed depending on the histocompatibility according to the antigens of the HLA-AB system and the nature of the immunosuppressant therapy. The results of the analysis showed that the frequency of rejection crises was 100% when the donor and recipient were compatible in 1-2 antigens, and 40% in compatibility according to 3-4 antigens. The incidence of rejection crises was 71.4% among patients who received the standard immunosuppressant therapy (corticosteroids + azathioprine) and 36% among those given also sandimmune. Analysis of the frequency of rejection crises according to the ABO blood group system to which the donor-recipient pair occurred, showed that rejection crises occurred most frequently among patients with A (II) blood group.

ABO Blood-Group System↗
PubMed1989

[Substantiation and use of a new method of transorganic oxygen preservation of the kidneys].

A new method has been developed for effective normobaric transorganic oxygen preservation of the kidneys. According to this method, oxygen is insufflated simultaneously through an artery, a vein and a ureter. A portable autonomously-operated device has been developed and used successfully for its clinical application. In experimental conditions, transorganic oxygen preservation ensures viability of the preserved kidney for up to 48 hours, with immediate post-transplantation recovery of renal function, and for 72 hours, with delayed functional recovery. The success of transorganic oxygen preservation was controlled by cellular metabolism assessment. Changes in adenylic acid components, lactic acid and lipid peroxidation products were measured in renal tissue. In clinical conditions, the outcome of transplantation could be predicted with high probability on the basis of intraoperative transplant hemodynamic studies. Two groups of patients were compared: 43 patients to whom a cadaver kidney, preserved by transorganic oxygenation for up to 52 hours, was transplanted, and recipients of contralateral kidneys, obtained from the same donors and preserved in Eurocollins solution for not more than 26 hours without perfusion. Preservation by transorganic oxygenation was shown to be preferable when clinical results were analysed.

Animals↗
PubMed1989

[Transplantation of allogeneic veins and xenogeneic arteries in the reconstructive surgery of occlusive diseases of arteries of the lower extremities].

The article discusses the results of 91 reconstructive operations with the use of allogeneic veins and xenogeneic arteries in the management of occlusive lesions of the arteries of the lower limbs. The method of obtaining and storing the grafts and the operative techniques are described. Patency of the allogeneic and xenogeneic shunts in occlusions of the lower limb arteries was 47% in the long-term follow-up periods.

Adult↗
PubMed1989

[Study of parameters of central hemodynamics in patients during hemodialysis].

The article discusses the results of study of the cardiac output (CO) and circulation blood volume (CBV) in patients at the beginning and end of hemodialysis. The dynamics of changes of these parameters during hemodialysis was studied in 31 patients (42 sessions). The CO and CBV reduced significantly. In a group of 10 patients who felt worse, the CO reduced by more than 30 per cent in 7, the CBV diminished by 25 and 30 per cent in 2, and CBV and CO reduced by more than 30 per cent in 1 patient in relation to the initial level. The CO and CBV were measured by means of the method of dilution of electroimpedance indicators.

Blood Volume↗