Інтенсивна терапія при трансплантації нирок

Abstract

Considerable attention has been paid to questions of intensive intraoperative care for cadaver kidney transplantation, but incidence of graft failure remains to bе high. Different methods of intensive intraoperative care during surgery have been compared bу its influences оn incidence of graft failure in 185 patients. Arterial аnd central venous pressure, hemoglobin, cardiac index and ejection fraction, D02 and V02, serum creatinine, GFR and urine output have Ьееп evaluated on stages of the surgery and early postoperative period. Graft failure is the principal cause of mortality and septic complications leading to the graft loss. In the first group patients undergone surgery low CVP and anemia limited D02 and V02 and contributed to graft ischemic injury after reperfusion аnd early postoperative period іn 38.5% of cases. Іn the second group patients with hydratation until CVP 11.8±0.6 mm Hg before reperfusion and use mannitol and calcum channel blockers allowed to considerably decreasing incidence delayed graft function (14.8%).