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V A Goriaĭnov

Publications and source records attributed to V A Goriaĭnov.

At least 19 recordsLinked to original sources
PubMed2006

[The influence of Daclizumab (Zenapaxe) on the postoperative period in allogenic kidney recipients].

The subjects of the study were 48 patients who were administered Daclizumab (Zenapaxe) immediately after transplantation (main group), and 17 controls. The number of infusions depended on the dynamics of the absolute CD-25 number in the peripheral blood, and varied between 1 and 11. The following variables were measured in order to evaluate the influence of Zenapaxe on the course of the postoperative period: 24-hour proteinuria, blood creatinine, steroid pulse number, blood pressure, and the doses of oral corticosteroids. All the patients were examined before discharge and 1 year after transplantation. Comparative analysis revealed the following: 1. In the main group proteinuria was 1.5 times lower 1 year after surgery vs. its level before discharge, while in the controls proteinuria grew up; 2. Steroid pulses in the controls were 4 times more frequent than this parameter in the main group; 3. Blood pressure and blood creatinine in the main group decreased during the first year after surgery, while in the control group the situation was the opposite. Thus, Zenapaxe (Daclizumab) is an effective immunosuppressive agent, displaying positive influence on the course of the posttransplantation period.

Adolescent↗
PubMed2006

[Transplantation of kidney with multiple arteries].

One hundred and nine kidney transplantations have been performed. All the patients have been divided into 2 groups: 1st group consisted of 91 patients whose transplant had 1 artery, 2nd group -- 18 patients whose transplant had 2 to 5 arteries. In 2.5 years after transplantation the function of transplant and degree of arterial hypertension were identical in both groups. It is concluded that the short- and long-term results of transplantation of kidneys with multiple arteries don't differ from ones with single artery.

Adult↗
PubMed2002

[Influence of posttransplantation plasmapheresis on results of transplantation of a cadaveric kidney].

Plasmapheresis was performed with "Haemonetics" (USA), PCS-Ultralite and MCS+ devices. During one procedure 1750-3550 ml of plasma were removed. Results were evaluated by the following parameters: diuresis within 24 hours after surgery, number of hemodialysis sessions after surgery, period of normalization of creatinine in blood. In patients of the study group oligoanuria was seen 4.5 times more rarely than in the control group, they needed less sessions of hemodialysis. Level of creatinine normalized earlier in the study group. Actually survival of patients with potent transplants was higher in the study group than in the controls. It is concluded that plasmapheresis has positive influence on the course of posttransplantation period.

Adult↗
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↗
PubMed1994

[Risk factors in bilateral nephrectomy as a method for preparation of patients for kidney transplantation].

In the period from April 1965 to August 1988 the kidneys of 65 patients were removed in the pretransplantation period in the Department of Kidney Transplantation of the All-Union Research Center of Surgery, AMS USSR. The operation was undertaken for the hypertonic form of chronic glomerulonephritis in 36 and for pyelonephritis and polycystic disease of the kidneys in 34 patients. The effect of anemia and hypoproteinemia on postoperative lethality was analysed. A direct correlative dependence between the postoperative lethality and the above-listed factors was detected. The results of the study provide evidence of the importance of the effect of the character of the preoperative preparation on the results of nephrectomy in the early postoperative period.

Adult↗
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

[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

[Differential diagnosis of the rejection crisis and toxic and immune-induced nephropathy].

The work is based on the analysis of materials concerning 26 patients with transplanted allogeneic kidneys. All the patients received immunodepressive therapy with a combination of prednisolone and sandimmune. The posttransplantation period was complicated by sandimmune nephropathy in 11 and by a rejection crisis in 15 patients. The following tests were used in the differential diagnosis of these two complications: clinical (firmness of the allogeneic kidney determined by palpation, arterial hypertension, hyperthermia), laboratory (level of creatinine in blood and its clearance, potassium and sodium in urine), and instrumental-functional (ultrasonic examination, electrothermometry, rheography). With the use of these tests, nephrotoxicity of sandimmune origin and rejection crisis were differentiated successfully in all cases.

Adolescent↗