[Gamma-irradiation of kidney transplant in complex treatment of rejection crisis].
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Biomedical subjects
Publications and source records attributed to V I Shumakov.
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In transplantation of 245 kidneys in patients with chronic renal insufficiency in the right (75% of all grafting procedures) and in the left iliac region several variants of vascular anastomoses were elaborated and employed. Technical details are described, and some valuable recommendations are given.
Experiments were conducted on rabbits. A study was made of peculiarities of blood coagulation and of the functional changes in platelets at the period of the thrombus organization, and also at various stages after its formation in the femoral vein. It appeared that at the period of the thrombus formation and during the first 5 minutes after its organization there occurred hypercoagulation changes in the blood and hypocoagulation of the plasma against the background of decrease in fibrinogen, hyperfibrinolysis, hyperheparinemia and thrombocytopenia. One to three days after the thrombosis of the femoral vein the blood hypercoagulation capacity becomes less pronounced. At this time thrombocytosis, an increase in fibrinogen content, hypoheparinemia and inhibition of fibrinolysis are observed. In the authors' opinion, hemocoagulation changes in venous thrombosis were chiefly caused by the hypercoagulation activity of the blood formed elements.
The authors stress the importance of reactions associated with the concentration of biologically active substances in the body tissues, in particular their influence on the contractility and escitability of the heart muscle. They cite the results consequent upon a study on the catecholamines and acetylcholine content in the myocardial tissue of the left ventricle and left auricle of the heart before and after institution of an auxilliary circulation effected with the aid of a valveless pump connected to the subclavicular artery in 22 dogs. An analysis of the results demonstrated that by producing counter-pulsation with the pump the concentration of catecholamines and acetylcholine in the tissues of the left head diminishes, but the fall of the catecholamines concentration does not reach the level typical of cardiac insufficiency. The authors believe that investigations of this kind may help elaborate optimal conditions and a permissible duration of the auxilliary circulation.
The authors studied the effect of electric potential arising on the plastic surface upon the blood clotting process. The study was performed according to the Breddin method. The study concerned fluorosilicone rubber, fluoroplast, polyester, polyethylene and polyvinyl chloride with various surface potentials. The authors found that the negatively charged blood platelets adhere to negatively charged plastic surfaces only to a low extent and undergo no disintegration and agglomeration. To the surfaces of the same plastics being electrically neutral, only small aggregates of blood platelets adhere. On the other hand, on the positively charged surfaces the accumulation of blood platelets takes place with concurrent aggregation and disintegration, thus initiating the thrombus formation. The authors observed the intensity of these changes using blood platelet adhesion index and fluorescence microscope.
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The report is concerned with the results of a study of polyneuropathy in 75 patients with acute and chronic renal insufficiency. The authors described the clinical characteristics of the different forms of neuropathy. In acute renal insufficiency the first signs of polyneuropathy appear during the stage of polyuria and are reversible. In chronic renal insufficiency and hemodialysis treatment of subclinical an sensory forms of neuropathy are mainly seen (2/3 of the patients). It was demonstrated that there was a retardation in the velocity of excitative conductivity through the nerves depending upon the severity of polyneuropathy. A longterm adequate hemodialysis may prevent the further development of polyneuropathy.
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