ENDOTOXIN ADSORPTION IN TREATMENT OF SELECTIVE SEPTIC COMPLICATIONS IN PATIENTS WITH UROLOGICAL DISEASES AFTER RENAL TRANSPLANTATION

Abstract

Aim. Treatment of urosepsis in patients after renal transplantation is very dif fi cult. Currently selective endotoxin adsorption is a perspective method of treatment. Works devoted to the study of the effectiveness of this method in patients with renal transplant are extremely rare. Materials and methods. 94 recipients were included in study: 54 in prospective main group and 40 – in retrospective comparison group. For each patient of the main group we performed 2 sessions of selective endotoxin adsorption. Patients of comparison group were not trea- ted with sorption of endotoxin. We investigated the dynamics of APACHE II score, the concentration of IL-6, IL-8, TNF-alpha, procalcitonin and endotoxin. Results. As a result of endotoxin adsorption there was noted more pronounced decrease in the APACHE II score in patients of the main group, than in the comparison group. There was a decrease in activity of the systemic in fl ammatory response, and that was re fl ected in the decrease in the concentration of proin fl ammatory cytokines and procalcitonin in patients of the main group. Application of endotoxin adsorption resulted in a signi fi cant increase in survival in patients of the main group. Conclusion. Sorption of endotoxin is very effective and safe procedure that affects the pathogenesis of sepsis. Application of this procedure can signi fi cantly improve the condition of patients and survival.