- citati u SCIndeksu: 0
- citati u CrossRef-u:0
- citati u Google Scholaru:[
 ]
- posete u poslednjih 30 dana:1
- preuzimanja u poslednjih 30 dana:0
|
|
|
2000, vol. 57, br. 4, str. 387-392
|
|
Hemoterapija kod transplantacije bubrega
Hemotherapy in kidney transplantation
Vojnomedicinska akademija, Institut za transfuziologiju i hemobiologiju, Beograd
Sažetak
U periodu od 1996. do kraja oktobra 1999. Godine u VMA je urađeno 40 transplantacija bubrega (37 muškaraca i 3 žene) od živih davalaca (1. grupa) i 10 transplantacija bubrega (6 muškarca i 4 žene) od kadavera (2. grupa). Test na limfocitotoksičnost je urađen pre svake transplantacije bubrega i on je bio negativan kod svih primalaca transplantata. Svi davaoci bubrega bili su iste krvne grupe u ABO sistemu kao i primaoci. U perioperativnom transfuziološkom zbrinjavanju (hemoterapija) primalaca transplantata bubrega korišćen je određeni volumen filtrovanih eritrocita (F-Er) i/ili filtrovanih trombocita (F-Tr), shodno intraoperativnom gubitku krvi ili trombocita, kao i prema kliničkom nalazu. Upotrebljavali smo leukoreduktivne filtre radi prevencije aloimunizacije u sistemu HLA. Od svih primalaca transplantata bubrega samo kod 4 (8%) iz 1. grupe perioperativno nije primenjena transfuziološka terapija. Kod 36 (72%) primalaca transplantata bubrega iz 1. grupe prosečno je upotrebljeno po 3,27 jedinica F-Er (929,44 ml) intraoperativno, kod 10 (20%) prosečno po 1,9 jedinica F-Er (521 ml) pre transplantacije, a kod 26 (52%) 2,65 jedinica F-Er (739,23 ml) postoperativno. Kod svih primalaca iz 2. grupe primenjena je transfuziološka terapija perioperativno. Prosečno su korišćene po 3,4 jedinice F-Er (953 ml) intraoperativno, a upotrebljeno je i prosečno po 4,9 jedinica F-Er (1 328 ml) i 1,4 jedinice F-Tr postoperativno. Svi primaoci transplantata bubrega su dobro podnosili terapiju i nisu zabeleženi nepovoljni efekti hemoterapije. Potrebe za transfuziološkom terapijom intraoperativno bile su približno iste u obema grupama primalaca, dok je kod primalaca transplantata od kadavera bila neophodna mnogo veća transfuziološka potpora u posttransplantacijskom periodu.
Abstract
A total of 40 kidney transplantations (37 males and 3 females) from living donors (Group I) and 10 kidney transplantations (6 males and 4 females) from cadavers (Group II) were performed in the period 1996-October 1999 at the Military Medical Academy (MMA). Lymphocytotoxic crossmatching was done before each kidney transplantation and results from all tests were negative for all recipients. All donors had the same blood group in ABO system as the recipients. In perioperative transfusion treatment (hemotherapy) determined quantity of filtred red blood cells (F-RBCs) and/or filtred platelets (F-PLT) were given to recipients according to intraoperative blood loss and their clinical state. Leukoreduction filters were used to prevent HLA alloimmunization. In only 4 (8%) recipients in group I transfusion therapy was not applied perioperatively. An average of 3.27 units of F-RBCs (929.44 mL) was used intraoperatively in 36 (72%) recipients in group I, an average of 1.9 units of F-RBCs (521 mL) was used before kidney transplantation in 10 (20%) recipients in group I and an average of 2.65 units of F-RBCs (739.23 mL) was used postoperatively in 26 (52%) recipients. In all recipients from group 11 transfusion therapy was applied perioperatively. An average of 3.4 units of F-RBCs (953 mL) was used intraoperatively. An average of 4.9 units (1.328 mL) and an average of 1.4 units of F-PLT were used postoperatively.All recipients well tolerated the therapy and no adverse effects of the therapy were observed. The need for transfusion therapy intraoperatively was approximatively same in both recipient groups, while in recipients from cadavers need for transfusion support in posttranspfantation period was much higher.
|
|
|
|
Reference
|
|
1 
|
Blumberg, N., Heal, J.M. (1994) Transfusion-associated immunomodulation. u: Anderson K.C., Ness P.M. [ur.] Scientific basis of transfusion medicine: Implications for clinical practice, Philadelphia: WB Saunders Company, str. 580-97
|
|
5  
|
Bordin, J.O., Heddle, N.M., Blajchman, M.A. (1994) Biologic effects of leukocytes present in transfused cellular blood products. Blood, 84(6): 1703-21
|
|
|
Casati, S., Passerini, P., Campise, M.R., Graziani, G., Cesana, B., Perisic, M., et al. (1987) Benefits and risks of protracted treatment with human recombinant erythropoietin in patients having haemodialysis. BMJ, 295(6605): 1017-1020
|
|
1 
|
Dzik, S., Blajchman, M.A., Blumberg, N., Kirkley, S.A., Heal, J.M., Wood, K. (1996) Current research on the immunomodulatory effect of allogeneic blood transfusion. Vox Sang, 70(4): 187-94
|
|
1
|
Dzik, W.H. (1994) Mononuclear cell microchimerism and the immunomodulatory effect of transfusion. Transfusion, 34(11): 1007-12
|
|
2
|
Gligorović, V., Stolić, I., Simonović, R. (1998) Sistem HLA - humani glavni kompleks histokompatibilnosti. u: Gligorović V., Balint B. [ur.] Klinička transfuziologija, Beograd: Zavod za udžbenike i nastavna sredstva, str. 453-80
|
|
1
|
Meryman, H.T. (1989) Transfusion-induced alloimmunization and immunosuppression and the effects of leukocyte depletion. Transfus Med Rev, 3(3): 180-93
|
|
1
|
Napier, J.A. (1995) Handbook of blood transfusion therapy. Chicester: John Wiley & Sons, 2nd ed
|
|
1
|
Radović, M., Balint, B. (1994) Kako smanjiti upotrebu homologne transfuzije?. Bil Transf, 22: 26-34
|
|
1
|
Radović, M. (1991) Usmerena hemoterapija. Beograd: Udruženje anestezista, reanimatora i transfuzista Jugoslavije
|
|
1
|
Radović, M., Balint, B. (1995) Intervencije za smanjenje upotrebe homologne transfuzije. Beograd: Udruženje anestezista, reanimatora i transfuziista Jugoslavije
|
|
|
Ramsey, G., Sherman, L.A. (1994) Transfusion therapy in solid organ transplantation. Hematol Oncol Clin North Am, 8(6): 1117-29
|
|
|
Samtleben, W., Ivanovich, P., Gurland, H.J. (1989) Recombinant human erythropoietin in nephrology. Biomedicine & Pharmacotherapy, 43(8): 607-612
|
|
1
|
Stanković, B., Radović, M., Balint, B., Taseski, J., Vasiljević, N. (1996) Imunohematološki značaj sistema HLA. Anestez Reanim Transfuz, 25: 87-90
|
|
|
Veys, N., Dhondt, A., Lameire, N. (1998) Pain at the injection site of subcutaneously administered erythropoietin: Phosphate-buffered epoetin Alpha compared to citrate-buffered epoetin Alpha and epoetin beta. Clin Nephrol, 49: 41-44
|
|
|
|
|