COUPLED PLASMAFILTRATION AND ADSORPTION IN SEPTIC COMPLICATIONS IN RENAL TRANSPLANT RECIPIENTS

Abstract

In the article fi rst experience with the usage of coupled plasma fi ltration and adsorption in the treatment of sepsis in patients after kidney transplantation has been presented. Aim: to make a comparative assessment of the impact of hemo fi ltration and coupled plasma fi ltration and adsorption (CPFA) on systemic hemodynamics and alveolar-capillary diffusion, as well as the dynamics of the pro- and antiin fl ammatory cytokines in patients with sepsis after renal transplantation. Methods and results. The study included 24 recipients. In the main group (n = 14), we used a combination of CPFA and hemo fi ltration. The patients of the comparison group (n = 10) we used an isolated hemo fi ltration. In patients of both groups we observed improvement of hemodynamics and lung function. In doing so by the fi fth day after the second procedure in patients of the main group the results were signi fi cantly better. This effect we mainly associate with a reduction in the activity of the systemic in fl ammatory response and the rate of progression of sepsis. This is con fi rmed by the fact that circulating pro- and anti-in fl ammatory cytokines were expressly removed during the CPFA. Conclusion. As a result of the CPFA and the hemo fi ltration we observed an increase in mean arterial blood pres- sure, improving gas exchange in the lungs, as well as reducing the need for vasopressor support. In this case, the additional sorption removal of circulating in fl ammatory mediators reduces the activity of the systemic in fl am- matory response, which can signi fi cantly increase the effectiveness of the therapy.