This study is provided to increase the efficiency of the treatment

This study is provided to increase the efficiency of the treatment of kidney transplant recipients by predicting the development of the late allotransplant dysfunction. in the blood as well as the concentration of protein in the urine in one year after kidney transplantation with the calculation of prognostic criterion predicts the loss of renal allotransplant function in 3 years after surgery. The advantages of the method are the possibility of quantitative forecasting of renal allotransplant losses which is BTZ038 based not only on its excretory function assessment but also on an assessment of other characteristics that may have important prognostic value and does not always directly correlate with changes in its excretory function. In order to assess the risk of death with a transplant functioning or return to the program hemodialysis the predictive model was implemented in tabular processor Excel. For the use of the model it is quite enough to input the value of the given indices. BTZ038 Calculation and prognosis will be automatically done in the electronic table (Figure 3). Figure 3 The interface of mathematical model for prognostication of kidney transplant function during the period of three years after the transplantation according to the results of investigation one year after the operation. The calculator designed by us has been patented (http://uapatents.com/4-68339-sposib-prognozuvannya-vtrati-funkci-nirkovogo-transplantata.html) and is available on the Internet (https://yadi.sk/i/w9DaT4YrsFRnZ). The accuracy of prediction of renal transplant function loss three years after transplantation was 92%. Progression of chronic renal dysfunction of the transplant is accompanied by the simultaneous loss of the benefits of a successful transplantation and the growth of problems due to immunosuppression. Based on a retrospective analysis of results of treatment of kidney transplant of the recipients with blood creatinine higher than 0.3?mmol/L we adhere to the following principles in the correction of immunosuppression which allow decreasing the rate of chronic dysfunction of the transplant development or decreasing the risk of complications in case of loss of its function. Do not prescribe high doses of steroids and do not have the steroid pulse therapy. Do not increase the dose of received cyclosporine or tacrolimus and stop medication if there is an increase in nephropathy. Continue immunosuppression with medicines of mycophenolic acid which are not nephrotoxic. Enhance monitoring of immunosuppression and prevention of infectious complications. Cancel immunosuppression at returning to hemodialysis treatment. Cancellation of steroids should be done gradually sometimes for several months. When the discomfort is associated with transplant (temperature pain in the projection of the transplanted kidney and hematuria) short courses of low doses of steroids administered orally or intravenously can be effective. According to plasma concentration of creatinine at the return to hemodialysis the patients were divided into 3 groups. In the BTZ038 first group the creatinine concentration in blood plasma was 0.5-0.69?mmol/L in the 2nd group concentration in blood plasma was 0.7-1.0?mmol/L and in the third group concentration in blood plasma was Rabbit Polyclonal to IRF-3 (phospho-Ser386). more than 1.0?mmol/L. Dates of the return of transplant recipients with delayed renal transplant dysfunction are largely dependent on the psychological state of the patient severity of depression the desire to ensure the irreversibility of the transplanted kidney dysfunction and fear that the dialysis will BTZ038 contribute to the deterioration of renal transplant function. The survival rate of patients of the first group after return to hemodialysis was 7.4 + 2.8 years and in the second and third groups it was BTZ038 respectively 5.3 ± 3.2 and 2.8 + 2.6 years. In general the noninvasive prediction of loss of renal transplant function based on quantitative criteria which diversely characterized the state of renal transplant enabled timely influence on modifiable risk factors for dysfunction of the transplanted kidney correct immunosuppression or return kidney transplant recipients to dialysis treatment. 5 Conclusions Our experience of renal transplantation confirms the principle possibility to achieve a guaranteed high level of patient’s rehabilitation. The quality of medical and social rehabilitation after kidney transplantation is comparable with healthy individuals and is much better than the patients being treated with hemodialysis. The results.