COUPLED PLASMAFILTRATION AND ADSORPTION IN SEPTIC COMPLICATIONS IN RENAL TRANSPLANT RECIPIENTS
https://doi.org/10.15825/1995-1191-2014-1-5-11
Abstract
In the article first experience with the usage of coupled plasmafiltration and adsorption in the treatment of sepsis in patients after kidney transplantation has been presented. Aim: to make a comparative assessment of the impact of hemofiltration and coupled plasmafiltration and adsorption (CPFA) on systemic hemodynamics and alveolar-capillary diffusion, as well as the dynamics of the pro- and antiinflammatory cytokines in patients with sepsis after renal transplantation.
Methods and results. The study included 24 recipients. In the main group (n = 14), we used a combination of CPFA and hemofiltration. The patients of the comparison group (n = 10) we used an isolated hemofiltration. In patients of both groups we observed improvement of hemodynamics and lung function. In doing so by the fifth day after the second procedure in patients of the main group the results were significantly better. This effect we mainly associate with a reduction in the activity of the systemic inflammatory response and the rate of progression of sepsis. This is confirmed by the fact that circulating pro- and anti-inflammatory cytokines were expressly removed during the CPFA.
Conclusion. As a result of the CPFA and the hemofiltration we observed an increase in mean arterial blood pres- sure, improving gas exchange in the lungs, as well as reducing the need for vasopressor support. In this case, the additional sorption removal of circulating inflammatory mediators reduces the activity of the systemic inflam- matory response, which can significantly increase the effectiveness of the therapy.
About the Authors
A. V. Vatazin
Government Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Division of Transplantation, nephrology and surgical hemocorrection, Moscow, Russian Federation
A. B. Zul'karnaev
Government Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Division of Transplantation, nephrology and surgical hemocorrection, Moscow, Russian Federation
M. Krstich
Government Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Division of Transplantation, nephrology and surgical hemocorrection, Moscow, Russian Federation
A. A. Podojnitsyn
Government Budget Health Institution of Moscow region «M.F. Vladimirsky Moscow Regional Research Clinical Institute», Department of Urology, Moscow, Russian Federation
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Review
For citations:
Vatazin A.V., Zul'karnaev A.B., Krstich M., Podojnitsyn A.A. COUPLED PLASMAFILTRATION AND ADSORPTION IN SEPTIC COMPLICATIONS IN RENAL TRANSPLANT RECIPIENTS. Russian Journal of Transplantology and Artificial Organs. 2014;16(1):5-11. (In Russ.) https://doi.org/10.15825/1995-1191-2014-1-5-11
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