Coupled plasma filtration adsorption in the treatment of severe sepsis in patients after kidney transplantation


A.V. Vatazin, A.B. Zul'karnaev, M. Krstich, R.O. Kantarija

SBIH MR “Moscow's regional research clinical institute n.a. M.F. Vladimirskiy”, the Surgical Department of Transplantology and Dialysis
Post-transplant septic complications remain a major problem in organ transplantation. Treatment of sepsis in renal transplant recipients is a particularly challenging task due to the long-term use of immunosuppressive medications. According to modern concepts, the key role in the sepsis progression plays an uncontrolled systemic inflammatory response.
One of the promising treatment modalities able to suppress the systemic inflammatory response is a coupled plasma filtration adsorption (CPFA). However, there have been no studies examining the effectiveness of this technique for the sepsis in the kidney transplant patients, which emphasie the relevance of this study. We conducted a comparative assessment of the effects of hemofiltration (HF) and CPFA on the changes in the mean arterial pressure and the PaO2/FiO2 coefficient in septic patients after kidney transplantation. The study group patients were treated with CPFA in combination with HF while the patients of the comparison group received only HF. The combination of CPFA and HF was found to increase the mean arterial pressure and the PaO2/FiO2 coefficient, as well as to reduce the need for sympathomimetic agent administration.
In conclusion, additional sorption removal of circulating inflammatory mediators reduces the activity of the systemic inflammatory response, thus significantly improving the effectiveness of the therapy.

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About the Autors


Author Information:
A.V. Vatazin – Ph.D., Prof., Head of the Department of Transplantology, Nephrology and Surgical Hemocorrection, Head of the Department of Transplantology, Nephrology and Artificial Organs of FAME of SBIH MR “MRRCI”, the Honored Scientist of Russia
A.B. Zul'karnaev – Ph.D., Associate Professor of the Department of Transplantology, Nephrology and Artificial Organs; e-mail: 7059899@gmail.com
M. Krstich – Ph.D., Research Scientist of the Surgical Department of Organ Donation
R.O. Kantarija – Ph.D., Nephrologist of the Surgical Department of Transplantology and Dialysis


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