Matevossian E.*, Snopok I.**, Doll D.***
Clinical aspects of kidney transplantation
*Technical University of Munich, University Hospital «rechts der Isar», Department of Surgery, Division of organ transplantation, Munich, Germany
**St.-Lucas Hospital, Department of Surgery, Sollingen, Germany
***Catholic Hospital Oldenburger Münsterland, Department of Surgery, St. Maria Hospital, Fechta, Germany
Vestnik VGMU. 2015;14(6):53-63.
Abstract.
Kidney transplantation (KT) is one of the first disciplines of the transplantational medicine, which has become firmly established in clinical practice as a treatment standard for patients with renal insufficiency at the terminal stage. Significant advantages of KT compared with hemodialysis from the viewpoint of life-span and life quality as well as from the economic angle turn it into the method of choice especially in relatively young patients. Positing the indications for KT is performed jointly by a surgeon-transplantologist and a nephrologist or an urologist (or/and a pediatrician). Such cases are as a rule chronic dialysis patients. After KT a one-year survival rate of a transplant makes up more than 95%, and the probability of its rejection during 3-6 months after transplantation is less than 7-10%. There are also possibilities of KT without or prior to hemodialysis – the so-called preventive transplantation of the kidney from a living donor. The advantages of this method are planned character of the surgical intervention and still better results with regard to the transplant function and survival rate. Transplantation of the kidney from a living relative donor significantly reduces the deficiency of donor organs. In addition recently the transplantation of the kidney from a living relative donor of a different group according to ABO system has been introduced into clinical practice. After KT immunosuppression treatment is selected which corresponds to the main and concomitant diseases of a recipient. Besides special attention is paid to nephroprotection. The elaboration of new less toxic and nondiabetogenic immunosuppression preparations, causing no side effects on the gastrointestinal tract is promising and important for further improvement of the treatment results in patients after KT.
Key words: transplantation, kidney, surgical technique, Eurotransplant, allocation, immunosuppression.
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Matevossian E. – Technical University of Munich, University Hospital «rechts of Isar», Department of Surgery, Division of organ transplantation, Munich, Germany;
Snopok I. – St.-Lucas Hospital, Department of Surgery, Sollingen, Germany;
Doll D. – Catholic Hospital Oldenburger Münsterland, Department of Surgery, St. Maria Hospital, Fechta, Germany.
Chirurg, Visceralchirurg, Chirurgische Klinik und Poliklinik, Transplantationszentrum München Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München. E-Mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Priv.-Doz. Dr. med. Edouard Matevossian.
