РЕЗУЛЬТАТЫ ТРАНСПЛАНТАЦИИ ПОЧЕК В АКТЮБИНСКОЙ ОБЛАСТИ КАЗАХСТАНА

Aim: to analyse the results of the initial experience of kidney transplantation of the regional hospital of the Republic of Kazakhstan.Materials and methods. The results of kidney transplantations which were performed to 31 patients in the Aktobe Medical Center (AMC, Aktobesity) for the period from November 2014 to 2017 are presented. Kidney transplantations were performed in compliance with clinical protocols according to the generally accepted methodology. In 25 cases transplantation performed from a living donor, in 6 cases – from deceased donors. The most of living donors underwent laparoscopic nephroureterectomy with manual assistance (70.8%).Results. After nephrectomy operations complications were not observed in donors, all patients were discharged in a satisfactory state on the 5th–8th postoperative day. The following complications were observed in recipients in the early postoperative period: acute tubular necrosis – 1, postoperative bleeding (retroperitoneal hematoma) – 2, lymphorrhagia – 2, urinary leakages – 2. One recipient was died in the late postoperative period after infection complications and the development of sepsis.Conclusions. Kidney transplantation is undoubtedly effective method for treating patients with terminal chronic kidney failure. The results of the initial experience of kidney transplantation in the Aktobe regional hospital of the Republic of Kazakhstan are not differ from the average results of leading domestic and other foreign transplant clinics.Цель. Анализ результатов первоначального опыта пересадки почек в условиях областной больницы Республики Казахстан.Материалы и методы. Представлены результаты трансплантации почек, проведенных на базе Актюбинского медицинского центра (АМЦ, г. Актобе) 31 пациенту за период с ноября 2014 года по 2017 год. Операции по трансплантации проводились с соблюдением установленных протоколов по общепринятой методике. В 25 случаях проведена трансплантация от живого донора, в 6 случаях – от трупных доноров. Основная часть живых доноров подверглась лапароскопической нефроуретерэктомии с ручной ассистенцией (70,8%).Результаты. После операций по нефроуретерэктомии у доноров осложнений не наблюдалось, все были выписаны в удовлетворительном состоянии на 5–8-е сутки после операции. У реципиентов в послеоперационном периоде наблюдались следующие осложнения: острый канальцевый некроз – 1, послеоперационное кровотечение (забрюшинная гематома) – 2, лимфорея по дренажу – 2, несостоятельность мочевого анастомоза – 2. Умер 1 реципиент в отдаленном послеоперационном периоде на фоне инфекционных осложнений с развитием сепсиса.Выводы. Трансплантация почки, бесспорно, является более эффективным методом лечения больных с терминальной хронической почечной недостаточностью. Результаты первоначального опыта трансплантации почек в условиях областной больницы Актюбинской области Республики Казахстан не отличаются от среднестатистических результатов ведущих отечественных и зарубежных клиник

RESULTS OF KIDNEY TRANSPLANTATION IN AKTOBE REGION OF KAZAKHSTAN

Aim: to analyse the results of the initial experience of kidney transplantation of the regional hospital of the Republic of Kazakhstan.Materials and methods. The results of kidney transplantations which were performed to 31 patients in the Aktobe Medical Center (AMC, Aktobesity) for the period from November 2014 to 2017 are presented. Kidney transplantations were performed in compliance with clinical protocols according to the generally accepted methodology. In 25 cases transplantation performed from a living donor, in 6 cases – from deceased donors. The most of living donors underwent laparoscopic nephroureterectomy with manual assistance (70.8%).Results. After nephrectomy operations complications were not observed in donors, all patients were discharged in a satisfactory state on the 5th–8th postoperative day. The following complications were observed in recipients in the early postoperative period: acute tubular necrosis – 1, postoperative bleeding (retroperitoneal hematoma) – 2, lymphorrhagia – 2, urinary leakages – 2. One recipient was died in the late postoperative period after infection complications and the development of sepsis.Conclusions. Kidney transplantation is undoubtedly effective method for treating patients with terminal chronic kidney failure. The results of the initial experience of kidney transplantation in the Aktobe regional hospital of the Republic of Kazakhstan are not differ from the average results of leading domestic and other foreign transplant clinics