ПРИМЕНЕНИЕ ПЛАЗМАФЕРЕЗА В ЛЕЧЕНИИ БОЛЕЗНИ КОРОНАРНЫХ АРТЕРИЙ ПЕРЕСАЖЕННОГО СЕРДЦА И ОЦЕНКА ЕГО ЭФФЕКТИВНОСТИ

The paper presents the experience with plasmapheresis in the treatment of сoronary artery disease with drug therapy. 19 recipients at different time after cardiac transplantation with coronary artery disease confi rmed by angiography were treated by therapeutic plasmapheresis courses. The effectiveness was estimated by radioisotope, immunomorphological and laboratory methods. After the course there were increase of regional and local myocardium contractility, increase in left ventricle ejection fraction, reducing intraventricular asynchrony, permission immunocomplex syndrome and lack of local intravascular blood coagulation. Plasmapheresis is considered as a promising method for the impact on the factors contributing to the accelerated nature of the development of coronary arteries lesions in transplanted heart.В работе представлен опыт применения плазмаферезов в лечении БКА наряду с медикаментозной терапией. 19 реципиентам в разные сроки после трансплантации сердца с БКА, подтвержденной ангиографически, проводили курсы лечебного плазмафереза. Эффективность последнего оценивали радиоизотопными, иммуноморфологическими и лабораторными методами. После проведенного курса отмечались увеличение региональной и локальной сократимости миокарда, рост ФВ левого желудочка, снижение внутрижелудочковой асинхронии, разрешение иммунокомплексного синдрома и отсутствие локального внутрисосудистого свертывания крови. Плазмаферез рассматривается как перспективный метод воздействия на факторы, способствующие ускоренному характеру развития поражения коронарных артерий в трансплантированном сердце

THE USE OF PLASMAPHERESIS IN THE TREATMENT OF CORONARY ARTERY DISEASE OF TRANSPLANTED HEART AND EVALUATION OF ITS EFFECTIVENESS

The paper presents the experience with plasmapheresis in the treatment of сoronary artery disease with drug therapy. 19 recipients at different time after cardiac transplantation with coronary artery disease confi rmed by angiography were treated by therapeutic plasmapheresis courses. The effectiveness was estimated by radioisotope, immunomorphological and laboratory methods. After the course there were increase of regional and local myocardium contractility, increase in left ventricle ejection fraction, reducing intraventricular asynchrony, permission immunocomplex syndrome and lack of local intravascular blood coagulation. Plasmapheresis is considered as a promising method for the impact on the factors contributing to the accelerated nature of the development of coronary arteries lesions in transplanted heart

GATED SPECT IN PATIENTS WITH BIOPSY-NEGATIVE CARDIAC TRANSPLANT REJECTION

Humoral rejection of the cardiac allograft is still a challenging problem associated with high incidence of graft loss and patient mortality. These episodes of rejection are often more severe, and more difficult to treat, than classical acute cellular rejection. Hemodynamic compromise, in the absence of acute cellular rejection, called biopsy-negative rejection occurs in 10 to 20% of cardiac allograft recipients. The assessment of hemodynamic compromise can provide functional data in transplant patients that is complementary to myocardial biopsies if the biopsy can miss significant rejection. We present three cases of the biopsy-negative rejection. All patients have studied with gated SPECT phase analysis