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- 저자 : Aibolat Smagulov (검색결과 2 건)
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Features of Care the Pregnant Woman after Liver Transplantation
( Aibolat Smagulov ),( Doskali Marlen ),( Rysmakhanov Myltykbai ),( Taganova Aliya ),( Kulmaganbetov Aidos ),( Seidakhmetov Akhmet ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: As known the first case of pregnancy after liver transplantation has been in 1978 (Armenti VT1 et. al., Liver Transpl. 2000). During three years 127 living donor liver transplantations has carried out in Kazakhstan and our report represents the first successful pregnancy and childbirth after liver transplantation. Methods: Our patient is 27 years old for long period suffered from liver cirrhosis caused by autoimmune hepatitis. In December 2013 orthotopic transplantation of right liver lobe from a living related donor was performed. The donor was her elder brother. Results: In postoperative period it was portal vein thrombosis which treated by heparin monotherapy. No other complications found in late period after transplantation. The standard third-component immunosuppressive therapy (CI + MMF + GCS) was applied during the first year after transplantation. One year later it was suddenly known that patient is pregnant and it was 2 week of pregnancy when MMF application was canceled. First signs of liver rejection was appeared on 18-20 weeks where sensitization of HLA class 1 was 0% and HLA class 2 consisted 91%. As a main therapy pulse therapy with GCS and plasmapheresis were performed. During observation all signs of rejection and laboratory data decreased in 4 weeks and patientperformed a screening of fetus where no pathological alterations were found. On 40 weeks delivery was successfully done by Cesarean section. The child was male with weight - 2830 g, and height - 54.3 cm and without no visible any defects. Conclusions: In our case, it was an acceptable outcome for both mother and baby, although considered a high risk pregnancy. Regarding our data there is no evidence of specific structural malformations among children born to female liver transplant recipients, but it is still under observation when it should be decided with immunosuppressive therapy alterations.
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Retrograde reperfusion of renal grafts to reduce ischemic-reperfusion injury
Myltykbay Rysmakhanov,Aibolat Smagulov,Nadiar Mussin,Asset Kaliyev,Bazylbek Zhakiyev,Yerlan Sultangereyev,Gani Kuttymuratov 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.4
Background: During transplantation, a kidney graft undergoes a cascade of pathological changes, referred to as ischemia-reperfusion injury (IRI), as it is incorporated into the bloodstream. Various studies have reported that retrograde reperfusion (RRP) leads to improved myocardial recovery and could reduce IRI in liver transplantation. This study investigated the effect of RRP in renal transplantation with a focus on reduction of kidney IRI. Methods: Between December 2019 and July 2022, 15 consecutive kidney transplants were performed with retrograde venous reperfusion. To conduct a comparative study and to recruit a control group, 15 kidney transplants that had been performed in the same center by the same two surgeons were retrospectively analyzed. Differences between the two groups were considered statistically significant at P<0.05. Results: The baseline characteristics of the two groups were statistically comparable (P>0.05). The surgical technique for kidney transplantation was the same in both groups. On the first postoperative day, polyuria was less pronounced in the RRP group (P<0.01). Serum creatinine and urea levels and estimated glomerular filtration rates on postoperative days 1, 4, 7, and 30 were lower in the RRP group (P<0.05). Conclusions: Retrograde venous reperfusion of a kidney transplant, preceding antegrade arterial reperfusion, reduced the effects of renal parenchyma IRI. To validate the results of this study, it is necessary to conduct further studies on a larger cohort of patients with a longer follow-up period.
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