[Labilization of lysosomal and peroxisomal membranes in the kidneys preserved by transrenal gas perfusion]. / Labilizatsiia membran lizosom i peroksisom v pochkakh, konservirovannykh transorgannoi gazovoi perfuziei

The total, free and unprecipitated activity of lysosomal (acid DNAase, acid RNAase, acid phosphate, acid beta-galactosidase) and peroxisomal (catalase, oxidase of D-amino acids) enzymes were studied in dog kidney cortex during storage of the tissues in solution of rheopolyglucin and under conservation of the kidney tissue by transrenal gas perfusion in hypothermia within 3 and 7 days. Labilization of lysosomal and peroxisomal membranes was observed during storage both in unperfused and in oxygenated kidney. Mechanisms of formation and functional significance of the alterations observed in structure of lysosomes and peroxisomes are discussed.

[Storage of cadaver kidney by trans-organ oxygen insufflation]. / Konservirovanie trupnoi pochki transorgannoi kislorodnoi insuffliatsiei.

Transorganic oxygen preservation was used in storage of 87 cadaver kidneys. The kidneys were stored for 14 to 56 h (34 +/- 1.95 on the average). After storage, all organs were transplanted to 87 patients with chronic renal insufficiency in the terminal stage. The patients age ranged from 18 to 55 years. All recipients were divided into 3 groups according to the results of the operation. Group 1 (55 patients)-the function of the organ was restored immediately, blood creatinine normalized on the 5th-10th postoperative day; subsidiary hemodialysis was not needed. Group 2 (22 patients)-the function of the transplant was restored 14-21 days after the operation; 2 to 8 sessions of hemodialysis had to be conducted. Group 3 (10 patients)-the transplant did not function due to acute irreversible canalicular necrosis or irreversible rejection. No correlative dependence between restoration of the transplant function and the duration of storage was noted (r = 0.15). Our experience allows us to assert that transorganic oxygen perfusion can ensure long-term safe storage of cadaver kidneys.

[Local hemostasis in surgical practice]. / Mestnyi gemostaz v khirurgicheskoi praktike.

Results of experimental and clinical investigations of a new local highly effective hemostatic drug " Gelplastan " are presented. Gelplastan was found to increase blood coagulation, to have strong adhesive and prolonged antibacterial properties. It is well resolved in the tissues, is biologically intact, has no side effects.

[Substantiation and use of a new method of transorganic oxygen preservation of the kidneys]. / Obosnovanie i primenenie novogo sposoba transorgannoi kislorodnoi konservatsii pochek.

A new method has been developed for effective normobaric transorganic oxygen preservation of the kidneys. According to this method, oxygen is insufflated simultaneously through an artery, a vein and a ureter. A portable autonomously-operated device has been developed and used successfully for its clinical application. In experimental conditions, transorganic oxygen preservation ensures viability of the preserved kidney for up to 48 hours, with immediate post-transplantation recovery of renal function, and for 72 hours, with delayed functional recovery. The success of transorganic oxygen preservation was controlled by cellular metabolism assessment. Changes in adenylic acid components, lactic acid and lipid peroxidation products were measured in renal tissue. In clinical conditions, the outcome of transplantation could be predicted with high probability on the basis of intraoperative transplant hemodynamic studies. Two groups of patients were compared: 43 patients to whom a cadaver kidney, preserved by transorganic oxygenation for up to 52 hours, was transplanted, and recipients of contralateral kidneys, obtained from the same donors and preserved in Eurocollins solution for not more than 26 hours without perfusion. Preservation by transorganic oxygenation was shown to be preferable when clinical results were analysed.