Year 2017 Vol. 25 No 5

TRANSPLANTOLOGY

S.L. ZYBLEV 1, T.S. PETRENKO 1, S.V. ZYBLEVA 2, Z.A. DUNDAROV 1, A.V. VELICHKO 2

THE EARLY DIAGNOSIS OF RENAL GRAFT DYSFUNCTION

EE “Gomel State Medical University” 1,
SI “Republican Scientific and Practical Center for Radiation Medicine and Human Ecology” 2, Gomel,
The Republic of Belarus

Objectives. To develop diagnostic technology of the reperfusion injury due to imbalance of pro-/antioxidant state of recipient in the post-transplant period.
Methods. The examination results of 60 patients with the stage 5 chronic kidney disease (CKD) have been analyzed. Kidney transplantation has been performed in all patients. The balance of pro-/antioxidant state of the organism was assessed by the method of luminol-dependent chemiluminescence (LDCL) of the blood plasma before the surgery and 24 hours after it. To study the influence of anesthetic support and surgery treatment on the state of pro-/antioxidant balance, the group of patients (n=20) was examined who underwent the scheduled surgery treatment under general anesthesia.
Results. The kidney transplantation has been found out to cause a significant shift in the balance of pro-/antioxidants to pro-oxidants and a significant reduction of the potency of antiradical body system within the patients with the stage 5 CKD during the first 24 hours already. When analyzing the pro-/antioxidant balance level and the capacity of antioxidant organism system in the group of patients with the immediate graft function (IGF), the index of pro-/antioxidant balance in the first day after the surgery was 24.0 [11.9; 44.6]%, and the capacity of antioxidant system was 35.8 [12.7; 40.8]%. In the group of patients with the delayed graft function (DGF) in the first 24 hours in the postoperative period a more significant balance shift to pro-oxidant up to 10.7 [6.1; 19.2]% (p=0.011) was detected, the antioxidant organism system was exhausted up to 12.7 [6.1; 29.3]% (p=0.024). There were no significant changes identified in the indices of pro-/antioxidant balance level of the blood plasma within the group of patients who underwent the scheduled surgical treatment in the postoperative period.
Conclusions. The determination of the severity of reperfusion injury within the patients after kidney transplantation can be performed on the basis of detection of pro-/antioxidant state imbalance and the potency index of the organism antioxidant system that expands the diagnostic possibilities of early risk detection of the delayed graft function.

Keywords: kidney transplantation, postoperative period, reperfusion injury, delayed graft function, balance of pro-/antioxidant state, luminol-dependent chemiluminescence, chronic renal insufficiency
p. 481-487 of the original issue
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Address for correspondence:
246000, Republic of Belarus,
Gomel, Lange str., 5,
EE “Gomel State Medical University”
Department of Surgical Diseases ¹2,
tel. mob.: 375 029 109-21-09,
e-mail: S.zyblev@yandex.by,
Sergey L. Zyblev
Information about the authors:
Zyblev S.L. PhD, Ass. Professor of Department of Surgical Diseases N2, EE “Gomel State Medical University”.
Petrenko T.S. PhD, Ass. Professor of Department of Clinical Laboratory Diagnostics, Allergology and Immunology, EE “Gomel State Medical University”.
Zybleva S.V. PhD, Immunologist, Academic Secretary of SI “Republican Scientific and Practical Center for Radiation Medicine and Human Ecology”
Dundarov Z.A. MD, Professor, Head of Department of Surgical Diseases N2, EE “Gomel State Medical University”.
Velichko A.V. PhD, Ass. Professor, Head of Surgical Department (transplantation, reconstructive and endocrine surgery), SI “Republican Scientific and Practical Center for Radiation Medicine and Human Ecology”.
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