The origin of the recipient is one of the recipient-related factors that statistically significantly affects the outcomes of kidney transplantation, but this factor is not so relevant in our country. The article presents the first experience of kidney transplantation in a patient of African descent at the N.I. N.V. Sklifosovsky.Material and methods. Allogeneic renal graft transplantation from a post-mortem donor was performed in a 60-year-old African male patient with stage 5 chronic kidney disease as a result of hypertensive nephroangiosclerosis.Results. The early postoperative period was complicated by the development of acute cellular graft rejection grade 1a-b according to Banff. Anti-crisis therapy was performed with some positive effect, however, in the late postoperative period, a loss of renal graft function was noted, and the patient was returned to renal replacement therapy with program hemodialysis.Conclusion. Patients of African ancestry are at increased risk of adverse outcomes due to immunological causes and require more careful immunological selection of a donor organ, an enhanced immunosuppressive regimen, and close monitoring after transplantation.

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Введение: в нашей стране использование стандартизированных опросников у пациентов после трансплантации органов с целью оценки качества жизни не получило широкого распространения. Цель: оценка качества жизни пациентов после сочетанной трансплантации почки и поджелудочной железы с применением опросника SF-36. Материал и методы. Были обследованы 35 пациентов с сахарным диабетом 1-го типа, осложненным терминальной хронической почечной недостаточностью. Среди них было 16 женщин (45,7%) и 19 мужчин (54,3%). Медиана возраста составила 36 [33;45] лет. В зависимости от типа трансплантации пациенты были разделены на две группы: группа I была представлена пациентами, перенесшими изолированную трансплантацию почки, группа II-сочетанную трансплантацию почки и поджелудочной железы. Качество жизни больных оценивали с использованием опросника SF-36. Результаты: у пациентов группы II статистически значимо выше физическое функционирование, общее состояние здоровья и жизненная активность. Вывод: у больных, страдающих сахарным диабетом 1-го типа, сочетанная трансплантация почки и поджелудочной железы является операцией, значительно повышающей качество их жизни. Ключевые слова: сахарный диабет 1-го типа, качество жизни, сочетанная трансплантация почки и поджелудочной железы, изолированная трансплантация почки

Introduction. Despite the improvements in immunosuppressive therapy, the growing number of repeat kidney transplantations and associated risks of acute rejection make it relevant to assess the impact of early acute rejection on a long-term kidney graft survival.Objective. The aim of the study was to evaluate the rate, the clinical aspects of early acute rejection after repeat kidney transplantation and the outcomes of its treatment, to perform the assessment of the impact of rejection episodes on a long-term kidney graft survival.Material and methods. We carried out the retrospective analysis of kidney graft survival after 121 repeat kidney transplantations performed in N.V. Sklifosovsky Research Institute for Emergency Medicine in the period from 2007 to 2018. Group I included 96 recipients after kidney transplantation without acute rejection in postoperative period. Group II consisted of 25 patients with early acute rejection after kidney transplantation. We performed the assessment of the impact of early acute rejection on the kidney graft survival in comparison with recipients with uncomplicated postoperative period. Statistical processing was carried out by nonparametric methods. Survival was assessed using the Kaplan–Meier curves.Results. 1-year and 3-year kidney graft survival rates amounted to 90.3% (95%, confidence interval 85–95) and 85.4% (95%, CI 79–91), respectively, in recipients of Group I; and 72% (95%, CI 58–86) and 60% (95%, CI 46–76) in patients of Group II. Significant differences in 1-year and 3-year kidney graft survival between patients of Group I and II have been noticed (P=0.0022 and P=0.0065, respectively).Conclusions. Patients with early acute rejection after kidney transplantation had poorer kidney graft survival in comparison with patients without rejection episodes in postoperative period.