Treatment of Vascular Complications After Kidney Transplantation

Abstract

The aim of the study was to determine the frequency of occurrence and treatment methods of early vascular complications after kidney transplantation. Material and methods. A retrospective analysis comprised of 245 patients subjected to kidney transplantation during the period between 1998 and 2006 in our department. Of these, 236 patients received organs from deceased donors, while nine patients received organs from living donors. The occurrence of vascular complications and the diagnostic and treatment methods used were determined for each patient. Patients operated on during the period between 1998 and 2001 were compared to those operated on between 2002 and 2006. Results. Twenty-two patients presented with vascular complications after kidney transplantation. The following were observed: bleeding (6.1%), anastomotic stenosis (1.2%), renal vein thrombosis (0.81%), renal artery thrombosis (0.4%), and false aneurysm of the renal artery (0.4%). Nineteen patients underwent surgery, and two required intravascular procedures while one was subjected to conservative treatment. Good treatment results were obtained in 17 patients, while five patients had the transplanted kidney removed. Seventy-eight transplantations were performed in the first four years (1998)(1999)(2000)(2001). In that period, vascular complications occurred in 13 patients (17%). During the following four years (2002)(2003)(2004)(2005)(2006) we transplanted 167 patients, and vascular complications were observed in nine patients (5%). Statistical analysis showed a significant reduction (p=0.004-test chi 2 ) in the number of vascular complications during the latter period. Conclusions. As surgeons gain experience treating transplant recipients, the number of vascular complications decreases. Diagnostics and treatment depends on the early visualization of complications by means of Doppler ultrasound and angio-MRI examinations. The use of intravascular techniques could be an effective and safe therapeutic method in the case of vascular complications.

Adsorption and thermodynamic properties of the alumina–polyacrylic acid solution system

“…The same pH conditions are very essential for PAA because polyacrylic acid is the anionic polymer and its conformation at the interface depends on the solution pH. Our previous investigations [7] indicated that the rise of pH causes the decrease of PAA adsorption on the alumina surface and increase of thickness of its adsorption layers for all examined polymer molecular weights ( Table 2).…”

“…When the temperature rises, polymer coils become a more developing structure [7] in comparison to those at lower temperatures. As a consequence, at the highest examined temperature (35°C) the polymer adsorption layer at the interface is rich in tail and loop structures (Fig.…”

“…Moreover, it should be noted that at pH 6 PAA chains are fully dissociated and strong repulsion between charged macromolecules takes place. It probably results in the following situation: on the solid surface the compact layer of polymer coils is not created, but these coils are loosely tangled due to repulsion between carboxylic groups present in the same and neighboring macromolecules [7]. This situation is presented schematically in Fig.…”

“…The estimation of the free energy of adsorption of PAA segments on alumina is based on the adsorption-desorption measurements. These investigations are the continuation and supplement of our previous studies [6,7]. All measurements (adsorption-desorption, solid surface charge density, viscosity and spectrophotometric) were carried out in the temperature range 15-35°C.…”

Influences of polyacrylic acid adsorption and temperature on the alumina suspension stability

“…Additionally, at 25°C the suspension stability was determined using a spectrophotometer Specord M52 from the absorbance changes. This study is the continuation and kind of supplement of the previous studies concerning the temperature influence on the adsorbed amounts, polymer layer thicknesses and free energies of PAA adsorption on the alumina surface [5][6][7].…”