Začetak transplantacije bubrega u jugoistočnoj Europi

Organ transplantation is one of the most important medical achievements of the 20th century. Kidney transplantation is the most efficient method of renal replacement therapy. The first successful kidney transplantation in human was performed in 1954 in Boston, USA. In former Yugoslavia, the first kidney transplantation was performed on April 16, 1970 in Ljubljana, Slovenia, and second one on January 30, 1971 in Rijeka, Croatia. In both cases, the mother donated kidney to the son. In the article, we describe the prerequisite conditions for this operation, the characteristics of first patients, and the impact of transplantation program on the development of the hospitals and medical schools.Transplantacija organa zasigurno predstavlja jedno od najvećih dostignuća 20. stoljeća. Transplantacija bubrega je najučinkovitija metoda od svih oblika nadomještanja bubrežne funkcije. Prva uspješna transplantacija bubrega u ljudi je učinjena u Bostonu, SAD, 1954. godine. U bivšoj Jugoslaviji prva transplantacija bubrega je učinjena 16. travnja 1970. u Ljubljani, Slovenija, a potom 30. siječnja 1971. u Rijeci, Hrvatska. Darivatelj je kod oba bolesnika bila majka, a primatelj sin. U članku ćemo prikazati što je prethodilo ovim operacijama, značajke prvih bolesnika te utjecaj transplantacijskog programa na razvoj matičnih bolnica i fakulteta

Treatment of Advanced Peripheral Arterial Insuffifi ciency in the Elderly

Peripheral arterial insuffi ciency appears at all stages regardless of the patient age; however its appearance is most common in the elderly in which cases it mostly appears as stage described by Fontaine as stage III or IV. The most common cause of peripheral arterial insuffi ciency is atherosclerotic degeneration, and is remarkably often accompanied by the diabetes. In the years 2012 and 2013 department of vascular surgery, University Hospital Rijeka admitted 169 patients older than 70 with peripheral arterial insuffi ciency of type Fontaine III and IV. That number represents 68.8% of total number of patients admitted for peripheral arterial insuffi ciency. The goal of this research is to identify to what extent and in what percentage can patients older than 70 with advanced peripheral arterial insuffi ciency be subjected to vascular treatment and if there exist and absolute indication for angiographic treatment of such patients. In majority of patients, 148 of them, three or more comorbidities were present. Diabetes was present at almost half of patients, to be exact 46.7%. Assessment of possibility for vascular treatment and the need for angiographic treatment was followed in patients in three age groups: 70–75 years of age, 76–80 years of age and over 80 years of age. Angiography was performed on 69 patients and the insight into angiographic fi nding resulted in only 33 patients being subjected to some type of vascular treatment. From the total number of patient’s subjected to vascular treatment 20 had symptoms of Fontaine III while the remaining 13 had symptoms of Fontaine IV. Amputation procedure was performed 119 times. The research shows that angiographic treatment is not a routine treatment in mentioned patients and that the number of vascular procedures is signifi cantly higher in the 70–75 years age group

Treatment of Advanced Peripheral Arterial Insuffifi ciency in the Elderly

Peripheral arterial insuffi ciency appears at all stages regardless of the patient age; however its appearance is most common in the elderly in which cases it mostly appears as stage described by Fontaine as stage III or IV. The most common cause of peripheral arterial insuffi ciency is atherosclerotic degeneration, and is remarkably often accompanied by the diabetes. In the years 2012 and 2013 department of vascular surgery, University Hospital Rijeka admitted 169 patients older than 70 with peripheral arterial insuffi ciency of type Fontaine III and IV. That number represents 68.8% of total number of patients admitted for peripheral arterial insuffi ciency. The goal of this research is to identify to what extent and in what percentage can patients older than 70 with advanced peripheral arterial insuffi ciency be subjected to vascular treatment and if there exist and absolute indication for angiographic treatment of such patients. In majority of patients, 148 of them, three or more comorbidities were present. Diabetes was present at almost half of patients, to be exact 46.7%. Assessment of possibility for vascular treatment and the need for angiographic treatment was followed in patients in three age groups: 70–75 years of age, 76–80 years of age and over 80 years of age. Angiography was performed on 69 patients and the insight into angiographic fi nding resulted in only 33 patients being subjected to some type of vascular treatment. From the total number of patient’s subjected to vascular treatment 20 had symptoms of Fontaine III while the remaining 13 had symptoms of Fontaine IV. Amputation procedure was performed 119 times. The research shows that angiographic treatment is not a routine treatment in mentioned patients and that the number of vascular procedures is signifi cantly higher in the 70–75 years age group