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RISS 인기검색어
- 검색키워드
- 저자 : ( Nurbek Ilyassov ) (검색결과 3 건)
- 무료
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Risk Predictors of Infectious Complications after Liver Surgery
( Nurbek Ilyassov ),( Zhaksylyk Doskaliyev ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Introduction: Serious infectious complications such as blood stream infection pose a life-threatening condition in patients af ter liver surgery. Despite the development of modern medicine, infection remains one of the main problems in hepatic surgery that affects survival of patients. In recent studies researchers fo cused on immunological changes in patients with liver diseases which could be the important factors influencing the mortality associated with liver surgery. Materials and methods: Twenty-six patients who had under gone the liver surgery and had severe infectious complications at National Scientific Medical Research Center between January 2011 and December 2017 were enrolled in this study. We in cluded cases in which the infections had developed within 30 days after surgery where the immunostatus and blood culture tests were observed. All patients who underwent a segmental resection, left hepatectomy or trisectionectomy were included. Results: Rates of infectious complications varied significantly across primary procedures and ranged from 6.5% in segmental resection patients to 23% in trisectionectomy patients. No sta tistically significant differences in any preoperative characteris tics between patients with or without infectious complications were observed. There was no correlation between intraoper ative factors and infection episodes. The association between the changes in immunological components and infectious com plications were found in this study. Conclusion: These results can help identify the patients at risk of developing infectious complications and advance strategies to reduce the incidence of infections.
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Effect on Liver Transplant Success with Proper Management of Patients on a Waiting List
( Assemgul Doskali ),( Nurbek Ilyassov ),( Anuar Abdikarimov ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: For patients with severe and irreversible acute or chronic liver diseases with no alternative therapy, liver transplantation remains the main option for the treatment of such patients. However, between four main groups (by cause of disease) the appropriate time is difficult to choose the patients on the waiting waiting list for liver transplantation. The aim of this study was to observe the optimal timing for patients depends on categories of disease origin. Methods: From 2012 among patients who were registered on the waiting list for liver transplantation in the National Register Center of the Republic of Kazakhstan were reviewed in this study and divided for four categories depended on disease cause. Results: We found that in four major categories of causes such as cirrhosis, fulminant hepatitis, tumors of the liver and genetical damages the firstly the patients with fulmnant hepatitis should be considered for liver transplantation. According to patients with cirrhosis the optimal time when that patients have advanced major complications or coagulopathy. Even MELD score is the main tool to choose the appropriate time for liver transplantation, we found that patient survival was successful with lower MELD score than 15 and that patients could improve there quality of life. In case of patients with tumors the decision depended on the stage of the malignisation in all cases. Conclusions: The ideal timing for liver transplantation is the time when patient survival is in a high position and all available alternative therapies were not successful.
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Portal Vein Thrombosis after Liver Transplantation: Prevention and Treatment
( Zhaksylyk Doskaliyev ),( Marlen Doskali ),( Abay Baigenzhin ),( Nurbek Ilyassov ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Among complications after liver transplantation the vascular causes of graft dysfunction remains as a devastating complication and its challenging clinical condition requires a multidisciplinary approach for management. Methods: From January 2013 to January 2017, 38 LDLTs were performed in our center. Operation procedures were performed by standard methods in donor and recipients. In all donors right hepatectomies were performed. Risk factors and variables associated with the transplant and the post-transplant period were analyzed. Results: At a median follow up of 3 years, both the patient and graft survival were 82%. The main causes of transplantation were primary biliary cirrhosis (50%), viral hepatitis (30%) and other liver diseases. The median age of the recipients at the time of LDLT was 43.9±17.2 (19-65 years). Recipients average hospital stay was 30±5 days (23-38 days, median 30 days) found. Vascular and biliary complications were the leading cause of reoperation, graft loss and retransplantation. Conclusions: Portal vein thrombosis is an awkward problem to treat after liver transplantation because a different portal inflow is difficult to establish. We successfully applied the heparin-based treatment in 3 patients, but graft loss were found in 2 patients. It is reliable to use a local delivery of thrombolytic therapy compare to systemic therapy because of a high risk of systemic bleeding in post-liver transplant patients. Survival rate depends on presence of PVT in cirrhotic liver before surgery.
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