Terminal Failure Research Articles

Inhibition of contact-mediated activation of factor XI protects baboons against S aureus–induced organ damage and death

AbstractStaphylococcus aureus infections can produce systemic bacteremia and inflammation in humans, which may progress to severe sepsis or septic shock, even with appropriate antibiotic treatment. Sepsis may be associated with disseminated intravascular coagulation and consumptive coagulopathy. In some types of mouse infection models, the plasma coagulation protein factor XI (FXI) contributes to the pathogenesis of sepsis. We hypothesize that FXI also contributes to the pathogenesis of sepsis in primates, and that pharmacological interference with FXI will alter the outcome of Staphylococcus aureus–induced lethality in a baboon model. Pretreatment of baboons with the anti-FXI antibody 3G3, a humanized variant of the murine monoclonal 14E11 that blocks FXI activation by FXIIa, substantially reduced the activation of coagulation, as reflected by clotting times and plasma complexes of coagulation proteases (FXIIa, FXIa, FIXa, FXa, FVIIa, and thrombin) with serpins (antithrombin or C1 inhibitor) following infusion of heat-inactivated S aureus. 3G3 treatment reduced fibrinogen and platelet consumption, fibrin deposition in tissues, neutrophil activation and accumulation in tissues, cytokine production, kininogen cleavage, cell death, and complement activation. Overall, 3G3 infusion protected the structure and function of multiple vital organs, including lung, heart, liver, and kidney. All treated animals reached the end point survival (7 days), whereas all nontreated animals developed terminal organ failure within 28 hours. We conclude that FXI plays a role in the pathogenesis of S aureus–induced disseminated intravascular coagulation and lethality in baboons. The results provide proof of concept for future therapeutic interventions that may prevent sepsis-induced organ failure and save lives in certain forms of sepsis.

The direct-current characteristics and surface repairing of a hydrogen-terminated free-standing polycrystalline diamond in aqueous solutions

As we know that more effective synthesis of diamond combined with physical and chemical properties of hydrogen termination in aqueous environment as well as device structure design can greatly facilitate the chemical and electrochemical applications of higher cost-performance diamond. For this purpose, the direct-current (DC) characteristics, surface reaction and reparation of a hydrogen-terminated DC arc jet plasma CVD polycrystalline diamond, which has a high cost-performance, were characterized by I-V experiments based on a FET-like structure device in multiple aqueous solutions. The variation trends of the I-V properties of device based on pH were similar in different aqueous solutions but could be affected by disparate ions (such as K+ ions) or organic molecules (such as citric acid radicals or a benzene ring). Especially, owing to the founded replacement of hydrogen termination with hydroxyl (OH), carboxyl radical (COOH) or carbon-oxygen bond (COC) in mixed solution, i.e., KHP + H2SO4 (and +NaOH) solutions, the resistance of the device was remarkably increased from 13.57 kΩ to 95.78 kΩ. However, the raised resistance of surface reacted diamond (SRD) can be reduced prominently by repairing hydrogen termination through negative potential sweeps (NPS) at a low negative potential (−1 to −3 V) if the SRD was introduced as an electrode in a strong inorganic acid. What's more, the NPS repaired device, which subsequently stored for four weeks, was more sensitive than the original hydrogen plasma-treated diamond in aqueous solution environments. This repaired result was coming out of NPS re-formed CH bonds with higher intensity. These findings will be the references of failure and reparation of diamond hydrogen termination in aqueous environment.

Renal effects of exendin-4 in an animal model of brain death

Organ transplantation is the gold standard therapy for the majority of patients with terminal organ failure. However, it is still a limited treatment especially due to the low number of brain death (BD) donors in relation to the number of waiting list recipients. Strategies to increase the quantity and quality of donor organs have been studied, and the administration of exendin-4 (Ex-4) to the donor may be a promising approach. Male Wistar rats were randomized into 3 groups: (1) control, without central nervous system injury; (2) BD induced experimentally, and (3) BD induced experimentally + Ex-4 administered immediately after BD induction. After BD induction, animals were monitored for 6h before blood collection and kidney biopsy. Kidney function was assessed by biochemical quantification of plasma kidney markers. Gene and protein expressions of inflammation- and stress-related genes were evaluated by RT-qPCR and immunoblot analysis. Animals treated with Ex-4 had lower creatinine and urea levels compared with controls. BD induced oxidative stress in kidney tissue through increased expression of Ucp2, Sod2 and Inos, and Ex-4 administration reduced the expression of these genes. Ex-4 also induced increased expression of the anti-apoptotic Bcl2 gene. Nlrp3 and Tnf expressions were up-regulated in the BD group compared with controls, but Ex-4 treatment had no effect on these genes. Our findings suggest that Ex-4 administration in BD rats reduces BD-induced kidney damage by decreasing the expression of oxidative stress genes and increasing the expression of Bcl2.

Abnormal Calcium Leak from Cardiac Sarcoplasmic Reticulum: New Insights Offered by Statistical Physics

Heart muscle contraction is activated by a synchronized systolic Ca release from sarcoplasmic reticulum (SR) via Ca sparks. In disease, Ca sparks fail to terminate, causing a diastolic Ca leak that decreases contraction amplitude and increases the risk of arrhythmia. The mechanisms and treatment of the abnormal Ca leak remain unclear. We have recently shown that spark termination emerges as collective behavior (synchronized closings) of Ca release channels (RyRs) that is identical to synchronization of spin orientation in ferromagnets described by a phase transition in Ising model. We employed the Ising approach to investigate and classify mechanisms of spark termination failure and Ca leak. Methods and Results: The key parameters determining whether spark termination succeeds or fails are SR Ca and RyR opening/closing rates. They define analogues of magnetic field h and the inverse temperature (β) in Ising model. Sparks terminate via a phase transition known as “h polarity reversal” and the leak emerges when h fails to change its sign. This happens when the SR depletes insufficiently and RyR openings remained partially synchronized via Ca-induced-Ca-release, generating long-lasting sparks. Leak can also occur via β, known as Onsager's “order-disorder” transition. This happens at low SR Ca, reducing RyR current and RyRs interactions, resulting in independent RyR openings. The disorder leak is distinguished from synchronized leak by larger Peierls contour lengths reflecting degree of disorder. Abnormal leak results from either a probability imbalance during synchronized firing of RyRs or from disordered RyR firing. Each leak type requires different and balanced treatment to shift RyR operation towards normal spark termination.

External Validation of the MEESSI Acute Heart Failure Risk Score: A Cohort Study.

The MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF) score was developed to predict 30-day mortality in patients presenting with acute heart failure (AHF) to emergency departments (EDs) in Spain. Whether it performs well in other countries is unknown. To externally validate the MEESSI-AHF score in another country. Prospective cohort study. (ClinicalTrials.gov: NCT01831115). Multicenter recruitment of dyspneic patients presenting to the ED. The external validation cohort included 1572 patients with AHF. Calculation of the MEESSI-AHF score using an established model containing 12 independent risk factors. Among 1572 patients with adjudicated AHF, 1247 had complete data that allowed calculation of the MEESSI-AHF score. Of these, 102 (8.2%) died within 30 days. The score predicted 30-day mortality with excellent discrimination (c-statistic, 0.80). Assessment of cumulative mortality showed a steep gradient in 30-day mortality over 6 predefined risk groups (0 patients in the lowest-risk group vs. 35 [28.5%] in the highest-risk group). Risk was overestimated in the high-risk groups, resulting in a Hosmer-Lemeshow P value of 0.022. However, after adjustment of the intercept, the model showed good concordance between predicted risks and observed outcomes (P= 0.23). Findings were confirmed in sensitivity analyses that used multiple imputation for missing values in the overall cohort of 1572 patients. External validation was done using a reduced model. Findings are specific to patients with AHF who present to the ED and are clinically stable enough to provide informed consent. Performance in patients with terminal kidney failure who are receiving long-term dialysis cannot be commented on. External validation of the MEESSI-AHF risk score showed excellent discrimination. Recalibration may be needed when the score is introduced to new populations. The European Union, the Swiss National Science Foundation, the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, the University of Basel, and University Hospital Basel.

Green peas protein hydrolyzed by bromelain in simple procedure to improve kidney function in cisplatin-induced rats

Context: Chronic kidney disease (CKD) can lead to terminal kidney failure. Previous study has shown that protein hydrolysate in yellow peas (Pisum sativum L.) can be used as a natural remedy for CKD. Aims: To obtain hydrolysate protein that is most effective in improving kidney function of cisplatin (CP)-induced Wistar rats, based on urea, creatinine, atrial natriuretic peptide (ANP), cyclooxygenase-1 (COX-1), and renin levels of CP-induced nephrotoxicity Wistar rats. Materials and Methods: Methods of Kjeldahl, Bradford, Kunitz, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis were used to determine the content of the eight types of protein hydrolysates. In in vivo experiment, the samples were administered to CP-induced nephrotoxicity Wistar rats, with urea, creatinine, ANP, COX-1, and renin as parameters. Results: Total neutrase activity was 40.65 U/mg, and bromelain was 35.77 U/mg. Total specific activities of both enzymes were almost identical. Protein hydrolyzed using bromelain had small fractions (<14.4 kDa). On the 30th day of treatment, urea and creatinine levels of all groups of treatment were significantly different from CP control (P < 0.01). The lowest level was shown by the group which was treated with bromelain-hydrolyzed green pea protein. Among ANP, COX-1, and renin measurements, only the result of COX-1 showed the promising result. Conclusions: Green peas protein hydrolysate hydrolyzed by bromelain are suggested as the most effective in improving kidney function based on urea, creatinine, and COX-1 levels of CP-induced nephrotoxicity Wistar rats.

Eksplorasi Perubahan Fisik dan Gejolak Emosional pada Pasien Gagal Ginjal Kronis yang Menjalani Hemodialisis: Pendekatan Kualitatif

Pasien dengan gagal ginjal kronis melaporkan keterbatasan dan perubahan fisik, fungsi psikologis, dan kelemahan yang berdampak negatif pada status kesehatan dan penurunan kelangsungan hidup. Kemajuan teknologi cuci darah dan penanganan penyakit masih banyak menimbulkan keluhan baik fisik maupun psikis dengan meningkatkan angka kematian pasien yang menjalani hemodialisis. Pada tahun 2008, terdapat sekitar 1,75 juta pasien di seluruh dunia yang rutin menerima terapi penggantian ginjal berupa dialisis, sekitar 1,55 (89%) juta menjalani hemodialisis (HD) dan sekitar 197.000 (11%) menggunakan peritoneal dialysis (PD). Penelitian ini mengeksplorasi pengalaman pasien hemodialisis pada perubahan fisik dan gejolak emosi yang mempengaruhi pola perilaku hidup pasien dari aspek seksualitas. Hasil penelitian menemukan dua kategori tema, yaitu (1) perubahan fisik dan keluhan fisik: kulit wajah menghitam, gigi rusak, badan kurus, badan lemah, dan cepat lelah; (2) perasaan dan gejolak emosi yang dirasakan: tidak menerima dan takut mati, merasa tidak berdaya dan tidak berguna, meminta maaf dan menganjurkan agar pasangan menikah lagi. Pengalaman eksplorasi perubahan fisik dan gejolak emosi pasien hemodialisis dipengaruhi oleh aspek fisik, fisiologis, psikologis, sosial dan spiritual serta nilai-nilai budaya yang ada dalam kehidupan peserta.

Giant-cell granuloma: 2 case reports

Introduction: Giant-cell granuloma (GCG) is a benign tumor occurring almost exclusively in the jaws. These lesions remain rare but can sometime have an aggressive behavior. In this article, we will describe and follow two cases of GCG. Observations: The first case is a referred female patient, who presents a mandibular swelling. Its clinical and radiological aspects lead us to do a biopsy, with a histological result of GCG. The second case is a patient with a terminal kidney failure, referred for a buccal swelling in the upper left jaw. The cone-beam computed tomography X-ray shows a compartmentalized lesion with blurry limits. An excisional biopsy is performed and the histological diagnosis is a GCG. Discussion: Although the first patient suffers from no systemic disease, the second one presents a terminal kidney failure resulting in a chronic hyperparathyroidism. Hyperparathyroidism can activate osteoclastic resorption and create bone lesions such as brown tumors. Conclusion: The slow and asymptomatic growth of these lesions often result in a late diagnosis. It should be kept in mind as a differential diagnosis when dealing with an osteolytic lesion of the jaws with no clear etiology, especially if hyperparathyroidism or kidney failure is associated.

Consistent success in life-supporting porcine cardiac xenotransplantation.

Heart transplantation is the only cure for patients with terminal cardiac failure, but the supply of allogeneic donor organs falls far short of the clinical need1-3. Xenotransplantation of genetically modified pig hearts has been discussed as a potential alternative4. Genetically multi-modified pig hearts that lack galactose-α1,3-galactose epitopes (α1,3-galactosyltransferase knockout) and express a human membrane cofactor protein (CD46) and human thrombomodulin have survived for up to 945days after heterotopic abdominal transplantation in baboons5. This model demonstrated long-term acceptance of discordant xenografts with safe immunosuppression but did not predict their life-supporting function. Despite 25years of extensive research, the maximum survival of a baboon after heart replacement with a porcine xenograft was only 57days and this was achieved, to our knowledge, only once6. Here we show that α1,3-galactosyltransferase-knockout pig hearts that express human CD46 and thrombomodulin require non-ischaemic preservation with continuous perfusion and control of post-transplantation growth to ensure long-term orthotopic function of the xenograft in baboons, the most stringent preclinical xenotransplantation model. Consistent life-supporting function of xenografted hearts for up to 195days is a milestone on the way to clinical cardiac xenotransplantation7.

Particle Tracking of Microelectromechanical System Performance and Reliability.

Microelectromechanical systems (MEMS) that require contact of moving parts to implement complex functions exhibit limits to their performance and reliability. Here, we advance our particle tracking method to measure MEMS motion in operando at nanometer, microradian, and millisecond scales. We test a torsional ratcheting actuator and observe dynamic behavior ranging from nearly perfect repeatability, to transient feedback and stiction, to terminal failure. This new measurement capability will help to understand and improve MEMS motion.

Label-Free Quantitative Proteomics in a Methylmalonyl-CoA Mutase-Silenced Neuroblastoma Cell Line.

Methylmalonic acidemias (MMAs) are inborn errors of metabolism due to the deficient activity of methylmalonyl-CoA mutase (MUT). MUT catalyzes the formation of succinyl-CoA from methylmalonyl-CoA, produced from propionyl-CoA catabolism and derived from odd chain fatty acids β-oxidation, cholesterol, and branched-chain amino acids degradation. Increased methylmalonyl-CoA levels allow for the presymptomatic diagnosis of the disease, even though no approved therapies exist. MMA patients show hyperammonemia, ketoacidosis, lethargy, respiratory distress, cognitive impairment, and hepatomegaly. The long-term consequences concern neurologic damage and terminal kidney failure, with little chance of survival. The cellular pathways affected by MUT deficiency were investigated using a quantitative proteomics approach on a cellular model of MUT knockdown. Currently, a consistent reduction of the MUT protein expression was obtained in the neuroblastoma cell line (SH-SY5Y) by using small-interfering RNA (siRNA) directed against an MUT transcript (MUT siRNA). The MUT absence did not affect the cell viability and apoptotic process in SH-SY5Y. In the present study, we evaluate and quantify the alterations in the protein expression profile as a consequence of MUT-silencing by a mass spectrometry-based label-free quantitative analysis, using two different quantitative strategies. Both quantitative methods allowed us to observe that the expression of the proteins involved in mitochondrial oxido-reductive homeostasis balance was affected by MUT deficiency. The alterated functional mitochondrial activity was observed in siRNA_MUT cells cultured with a propionate-supplemented medium. Finally, alterations in the levels of proteins involved in the metabolic pathways, like carbohydrate metabolism and lipid metabolism, were found.

Old and New Treatments for Pediatric Autoimmune Hepatitis.

Autoimmune hepatitis is a rare inflammatory disease of the liver that most frequently affects children and young adults. It is a multifactorial disease of unknown etiology, characteristically progressive in nature, and if left untreated, may lead to cirrhosis and terminal liver failure. It has been known for several decades now that immunosuppressive treatment convincingly alters the outcome of most patients with autoimmune hepatitis and as such it should be started as soon as diagnosis is made. Primary goals of treatment are: normalization of hepatocellular function, extinction of the hepatic necroinflammatory process, and maintenance of a stable remission, thus preventing progression to cirrhosis and its complications. This article aims to review old and new treatments for this rare chronic disorder, from the oldest and most frequently used treatment consisting of the association of prednisone and azathioprine, to alternative medical treatments, liver transplant and promising medical strategies currently under investigation. The review will focus on the efficacy and safety profile of each drug, as well as on the published clinical experience with them in pediatric patients with autoimmune hepatitis.

TINGKAT KEPATUHAN PASIEN GAGAL GINJAL KRONIK DALAM MENJALANI HEMODIALISA

Background: Chronic Kidney Failure is one of the important health problems in Indonesia and the world community. In Indonesia, according to data from Penetri (Persatuan Nefrologi Indonesia) the number of patients with kidney failure is estimated at 4500 people, but those detected suffering from terminal stage chronic kidney failure from those undergoing dialysis (hemodialysis) are only around 4 thousand - 5 thousand people. Cases of kidney failure in Indonesia are still relatively high every year, because there are still many Indonesian people not maintaining their diet and health. This means that chronic kidney failure ranks as one of the highest rates of disease causing death. The purpose of this study was to describe the level of adherence to patients with chronic kidney failure in undergoing a hemodialysis program in the hemodialysis room at Sanjiwani Hospital in Gianyar. Methods: This research is a descriptive observational type. This study uses a sampling technique that is purposive sampling with a total sample of 30 people. Results: In this study the results of the rate of compliance of CRF patients with hemodialysis were 27 respondents (90%) who were obedient and non-adherent as many as 3 respondents (10%). Thus most patients with chronic renal failure adhere to undergoing hemodialysis in the hemodialysis room of Sanjiwani Hospital in Gianyar. Conclusions: The conclusion of this study is that patients with chronic renal failure are expected to seek treatment regularly in accordance with the rules set by health workers. Delay of dialysis causes pulmonary complications, seizures, decreased consciousness, severe electrolyte disturbances, heart failure, which can cause death. Keywords : Chronic Kidney Failure; Hemodialysis, Compliance

Prognostication and Risk Factors for Cystic Fibrosis via Automated Machine Learning

Accurate prediction of survival for cystic fibrosis (CF) patients is instrumental in establishing the optimal timing for referring patients with terminal respiratory failure for lung transplantation (LT). Current practice considers referring patients for LT evaluation once the forced expiratory volume (FEV1) drops below 30% of its predicted nominal value. While FEV1 is indeed a strong predictor of CF-related mortality, we hypothesized that the survival behavior of CF patients exhibits a lot more heterogeneity. To this end, we developed an algorithmic framework, which we call AutoPrognosis, that leverages the power of machine learning to automate the process of constructing clinical prognostic models, and used it to build a prognostic model for CF using data from a contemporary cohort that involved 99% of the CF population in the UK. AutoPrognosis uses Bayesian optimization techniques to automate the process of configuring ensembles of machine learning pipelines, which involve imputation, feature processing, classification and calibration algorithms. Because it is automated, it can be used by clinical researchers to build prognostic models without the need for in-depth knowledge of machine learning. Our experiments revealed that the accuracy of the model learned by AutoPrognosis is superior to that of existing guidelines and other competing models.

Ferric Gluconate Complex in Elderly Hospital Inpatients without Terminal Kidney Failure

Anemia is a common health issue for elderly patients. For patients with iron deficiency who cannot tolerate iron supplementation by the oral route, the parenteral route may be used. Options for parenteral iron supplementation include ferric gluconate complex (FGC). To evaluate the safety of FGC in elderly patients without terminal kidney failure and to assess its efficacy in treating iron-deficiency anemia. An observational chart review was conducted at a tertiary care university health centre. Patients included in the study were 65 years of age or older, had received at least 1 dose of FGC between January 1, 2014, and December 31, 2015, and had a hemoglobin count of less than 130 g/L (men) or less than 120 g/L (women) at baseline. For each patient, the observation period began when the first dose of FGC was administered and ended 60 days after the last dose. The main safety outcome (occurrence of any adverse reaction) was evaluated for every patient, with the efficacy analysis being limited to patients with a diagnosis of iron-deficiency anemia. A total of 144 patients were included in the study, of whom 76 had iron-deficiency anemia. No serious, life-threatening adverse reactions were reported. The most commonly reported adverse reactions were nausea and vomiting. The mean increase in hemoglobin count was 13.5 g/L, a statistically significant change from baseline. These results show that FGC is safe for use in elderly patients, with very few mild adverse reactions. Use of FGC led to increased hemoglobin count within 60 days. Of the 3 options for parenteral iron supplementation available in Canada, iron sucrose has not been studied in elderly patients, and iron dextran has a higher incidence of anaphylaxis, whereas FGC appears to be a safe alternative for patients with intolerance to oral iron.

Association of signal transducer and activator of transcription, interleukin-6, and interleukin-10 positivity with antiviral treatment in cirrhotic liver samples from patients with the hepatitis B or C virus

Objective: Terminal liver disease due to viral hepatitis infections is an important health problem. This study aimed to compare the expression of members of the signal transducer and activator of transcription (STAT) family (STAT-1, -2, -3, -5a, and -5b) and interleukin (IL)-6 and IL-10 in hepatectomy material from patients who received antiviral treatment and underwent a liver transplantation due to terminal liver failure. Methods: The study consisted of 45 patients who underwent a liver transplantation due to chronic liver failure associated with viral hepatitis (hepatitis C virus [HCV] or hepatitis B virus [HBV]). The patients were divided into three groups according to the drug treatments they received prior to the liver transplantation: Group A: lamivudine, Group B: adefovir, and Group C: interferon or interferon + ribavirin. Results: In the study population, 9 (20%) patients were females and 36 (80%) were males. The mean age was 45.7 (29–69) years. STAT-2, -3, and IL-6 expression were significantly higher in hepatocytes in Group A (p&amp;lt;0.05). Conclusion: High STAT-3, high IL-6, and low STAT-1 expression were associated with optimum hepatocyte regeneration and liver metabolic function. In this regard, lamivudine was the most effective drug in the present study.

Serious somatic disease as a limit-experience: clinical aspect of end-stage renal disease

Terminal kidney failure is a serious and irreversible somatic condition. The ordeal of the disease can undermine the internal identity markers of patients, prey to unbearable anxieties, exposing them to formlessness and a vacillating identity.

RETRACTED ARTICLE: COMPANY FINANCIAL PATH ANALYSIS USING FUZZY C-MEANS AND ITS APPLICATION IN FINANCIAL FAILURE PREDICTION

This study investigates the dynamic process of the company’s financial status over years and proposes to design financial path using fuzzy c-means (FCM) approach. FCM is firstly used to quantize company financial paths of behavior over consecutive years. Financial paths are deployed to depict different patterns of failure and to understand the dynamics of financial failure. Then financial failure prediction model is built based on the proposed financial path (FP) approach. Empirical experiment is carried out with data samples of Chinese listed companies. Through analyzing financial path, it is found that there are mainly four patterns of process to terminal failure. Besides, in order to validate the prediction performance of the financial path prediction model, four prevalent financial failure prediction models, logistic regression (LR), support vector machine (SVM), decision tree (DT), and neural network (NN), are deployed to compare with the proposed model respectively. Experimental results show that FP has significantly better financial failure performance than other four models in terms of accuracy, type I error, and type II error. Therefore, the financial path monitors the change of financial status and acts as a prediction tool for financial failure prediction, which is a significant determinant of the financial success. Managers can recognize the financial failure signal in advance and understand their evolution trend on the future. In addition, the financial path prediction model is also an effective supplement to the research field of financial failure analysis and prediction.

RESULTS OF KIDNEY TRANSPLANTATION IN AKTOBE REGION OF KAZAKHSTAN

Aim:to analyse the results of the initial experience of kidney transplantation of the regional hospital of the Republic of Kazakhstan.Materials and methods.The results of kidney transplantations which were performed to 31 patients in the Aktobe Medical Center (AMC, Aktobesity) for the period from November 2014 to 2017 are presented. Kidney transplantations were performed in compliance with clinical protocols according to the generally accepted methodology. In 25 cases transplantation performed from a living donor, in 6 cases – from deceased donors. The most of living donors underwent laparoscopic nephroureterectomy with manual assistance (70.8%).Results.After nephrectomy operations complications were not observed in donors, all patients were discharged in a satisfactory state on the 5th–8th postoperative day. The following complications were observed in recipients in the early postoperative period: acute tubular necrosis – 1, postoperative bleeding (retroperitoneal hematoma) – 2, lymphorrhagia – 2, urinary leakages – 2. One recipient was died in the late postoperative period after infection complications and the development of sepsis.Conclusions.Kidney transplantation is undoubtedly effective method for treating patients with terminal chronic kidney failure. The results of the initial experience of kidney transplantation in the Aktobe regional hospital of the Republic of Kazakhstan are not differ from the average results of leading domestic and other foreign transplant clinics.

Factores que inciden en la cultura de donación de órganos en Morelia, Michoacán: hacia una propuesta de política pública

&lt;p align="justify"&gt;El trasplante de órganos es un procedimiento médico que se realiza de rutina en más de cien países, pues representa la única posibilidad para miles de pacientes con insuficiencia terminal de algún órgano. La problemática de la escasez de trasplantes es proporcional; por ello, la mayoría de la población se encuentra a favor de la donación de órganos, pero sus preferencias no se llevan a la práctica, y el número de donaciones es muy limitado. La cultura de donación de órganos es determinante en las actitudes de la población, pues se traduce en la aceptación o rechazo de esta práctica. Por ello, determinaremos las variables que influyen en la cultura de donación de órganos en Morelia. La finalidad es contar con una teoría causal que permita diseñar estrategias de política pública para consolidar dicha cultura. Para ello, se aplicó un cuestionario a una muestra de 400 personas mayores de 15 años, en la ciudad. Los principales factores de influencia son la educación, el ingreso, el conocimiento del concepto de muerte cerebral, el tratamiento del tema con la familia y el conocimiento de lugares que brindan información sobre donación. &lt;/p&gt;