Kidney Transplantation de Tamaz J. Shioshvili

Kidney Transplantation

Tamaz J. Shioshvili

The described material is very important for the clinical and scientific transplantation, because it shows that the atrophy and functional depression of the transplanted kidney is caused not only by immune rejection, but also by non-specific factors of transplantation(denervation, warm ischemia). By means of evidence based reliable data the book confirms the necessity of an artificial surgical re-innervation and relevant hypothermia support of a transplanted kidney which ensures its full value and long-time function.

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Cuprins

Preface; Survey of the literature; Consequences of kidney denervation in situ; The methods of kidney denervation; The functional state of the kidney after denervation in situ; The influence of a transplantation denervation on the kidney; The morophologic state of the kidney after the denervation in situ; The influence of a transplantation denervation on the kidney; The functional state of an auto-transplanted kidney; The morphologic state of the autotransplanted kidney; First attempts of surgical reinnervation of the kidney and other inner organs; Discussion of information about denervation and reinnervation of the kidney; Material and methods; The influence of surgical reinnervation on the functional state of denervated in situ and auto-transplanted kidneys; Radiological functional examinations; Partial and common excretion renal functions; Discussion of results of kidney functional investigations; Results of investigation of bio-potentials of the renal nerve; Discussion of results; The morophologic state of denervated and auto-transplanted kidneys by spontaneous and surgical reinnervation; The surgical reinnervation of the transplanted kidney: is it needed?; The influence of an ischemia on the kidney: survey of literature; The cooling of a kidney in experiments and clinics; Material and methods; Ischemia and hypothermic protection of the kidney; Radiologic evaluation of functional changes in kidneys after 2 hour ischemia in various temperature regimes; The discussion of kidney functional examination results ure conditions; The influence of a normothermic ischemia on the kidney; The influence of ischemia and hypothermia +4+7C on the kidney; The influence of ischemia and hypothermia +10+15C on the kidney; The influence of ischemia and hypothermia +20+25C on the kidney; Results of examinations of kidneys in the control animal group; Discussion of kidneys morphologic investigation results; The kidney transplant cooling; Results of a practical application of apparatus for the local renal hypothermia in experiments and clinics; Employment of apparatus in organ transplantations; Employment of apparatus for local renal hypothermia in experiments and by nephrotomy and partial resection of a "dry" kidney in the clinic; Discussion of clinical results; Conclusions; Index.