1. VASCULAR RECONSTRUCTION DURING KIDNEY TRANSPLANTATION FOR PREVENTING COMPLICATIONS
Batsaikhan B ; Erdenesaikhan M ; Bayan-Undur D ; Nyamsuren D ; Jambaljav L ; Tumurbaatar B
Journal of Surgery 2016;20(2):50-55
Introduction: This article provides areview about techniques and pitfalls of arterialand venous reconstruction during kidneytransplantation. Main reasons of our clinicalstudy are to evaluate vascular variationsof kidney, posttransplantation vascularcomplication incidence and present status ofsurgery outcome.This retrospective researchbased on cross-sectional assessmentofconsecutive 102 kidney transplantation cases,which performed from 2006 to 2015 at theFirst Central Hospital of Mongolia.Materials and methods: Statisticalprocessing andanalysis on posttransplantionpatient history data are made byMicrosoftExcel, SPSS19.0software.Results: Despite rising technicaldifficulties caused by vascular variations,pelvic and inguinal morphology of recipientand the existence of multiple renal arterieskidney transplantation is a safe and highlyefficient procedure.On this article wereexplained 44 kidney transplantation caseswith reconstruction using microvasculartechniques to reconstruct renal arteriesand veins. About 10 different kinds ofreconstructions were done in our practice.Due to investigation of consecutive 102kidney transplanted recipients, 24,51% had avascular anatomical variations. And describedabout 44 vascular reconstructions used inour hospital in case of vascular variations.According to the lit., vascular complicationsranges from 1 to 16%. In our hospital,vascularcomplication of kidney transplantation withmultiple vessels is 4,0-12,0%. Also, incidenceof vascular complication in group with singlevessels from 1.3 to 2.6% and in group withmultiple vessel 4 to 12%.Even it is highcomparing with other international articles;it’s almost in same results. But lymphaticcomplication is higher than others; it showsneeds of careful and accurate dissection ofrecipient site anastomosing vessels.Conclusion: Multiple renal graft’sveselshave been associated with a higher rateof vascular complications, including arterialstenosis and lymphorrhea. It shows needs ofcareful and accurate dissection of recipientsite anastomosing vessels.
2.The evaluation of immunosuppressive regimens in kidney transplant Mongolian recipients
Sarantsetseg J ; Byambadorj B ; Byambadash B ; Munkhjargal B ; Tumurbaatar B ; Jambaljav L ; Bayan-Undur D ; Ganbold L ; Chuluunbaatar D ; Oyunbileg B ; Batbaatar G ; Munkhbat B ; Nyamsuren D
Health Laboratory 2019;9(1):21-27
Background:
However kidney transplantation has being performed in Mongolia since
2006, because of pre-transplant sensitization, ABO incompatibility, hepatitis B and C virus
activation many patients are taken kidney transplantation in abroad. The transplantation
centers use own immunosuppressive regimens.
Objective:
Our aim was to assess the immunosuppressive regimens efficacy and toxicity
in kidney transplant Mongolian recipients.
Methods:
We analyzed data from 96 adult kidney transplant recipients who had taken
kidney transplantation in different transplant centers from August 2006 through January
2014. There were 3 kinds of regimens Group I Simulect induction with standard triple
/FK506/CyA+MMF/AZA+steroid/, Group II Campath-1H induction with CNI monotherapy
and Group III Campath-1H induction with standard triple /FK506/CyA+MMF/AZA+steroid/.
We retrospectively collected the post-transplant first two years serum creatinine. The study
was performed in 2014. The questionnaire was taken and blood samples collected for
determination of tacrolimus through level and for other laboratory tests. The primary end
point was the first two years serum creatinine, the secondary end points included rejection
episodes, blood through level of tacrolimus and some laboratory findings.
Results:
The post-transplant first two years serum creatinine levels were significantly
different in 3 groups. Group III showed similar results compared to Group I. There was not
enough data of biopsy proven acute rejection episodes however group II said more
rejections occurred. However participants said that rejection occurred in 15 (15.6%) biopsy
was done only 3 (3.1%) cases. Blood through level of tacrolimus was significantly different
in three groups. Some laboratory findings showed different between three groups.
Conclusions
A regimen of Campath-1H induction with CNI monotherapy (Group II) may
be advantageous for short-term renal function and cost effective but there were more
rejection complications and increased creatinine. The regimen of Campath-1H induction
11 with standard triple (Group III) may be advantageous for long-term renal function, allograft
survival, but there should consider about infection complications and polycythemia.
Simulect induction with standard triple could be best choice but transplantations were
performed in experienced centers. The study enrolled few cases and cases which were
performed at the beginning of transplant program so many things could influence on the
result. The study was compared beginner transplant center with experienced centers.
Longitudinal cohort study needed in the future.