SU1748836A1 - Method for treating the cases of acute and chronic rejection of liver allograft - Google Patents

Abstract

Usage: in clinical transplantology. The goal is to reduce the side effects. Summary of the invention: against the background of immunosuppressive therapy, the area of the graft is exposed to radiation from a pulsed light source in the visible spectral range with optical radiation of the above-mentioned area 2-5 mm overlapping, exposure time 30 s - 30 min, power density 10 W / cm2 - 200 kW / cm2 per pulse with a duration of 1-3 µs, with a dose of 0.2-30 J / cm2 in the amount of three to four irradiation sessions per course, a defocused laser is used as the source of irradiation. Positive effect: improved function of the transplanted kidney in the shortest possible time.

Description

The invention relates to medicine, namely transplantology.

The aim of the invention is to reduce the side effects of immunosuppressive therapy.

The method is carried out as follows.

The radiation from the source of electromagnetic radiation in the spectral range (of the defocused laser) is directed through the fiber to the area of the intended irradiation. This area was the surface of the skin above the graft site. In order to reduce the perifocal inflammation, the above region was covered by defocused laser radiation from 2 to 5 mm. Pre-graft sizes are determined by ultrasound. Exposure takes 30 seconds to 30 minutes. The defocused laser radiation had a pulse power density of 10 W / cm - 200 kW / cm2, a pulse duration of 1-3 μs. The dose ranged from 0.2 to 30 J / cm2. During one course of therapy, 3-4 sessions were performed.

Example 1. Ill R., 42 years old. He was admitted with a diagnosis of chronic glomerulo-nephritis (CGN), a terminal stage of chronic renal failure (CRF), allografting of a cadaveric kidney into the right iliac region. The postoperative course was complicated by the crisis of rejection. A 4-fold irradiation of the graft area with defocused laser radiation with a exposure time of 30 s at a dose of 30 J / cm2 was performed with overlapping of the graft area by optical radiation by 5 mm and a power density of 200 kW / cm pulse with a duration of 1 μs. As a result, graft function indicators significantly

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improved, decreased perifocal inflammation, decreased infiltration and edema of the interstitial allograft kidney, which was confirmed by a decrease in the thickness of the kidney and cortical layer, a decrease in the venous wave and skin temperature over the graft. Blood creatinine decreased from 16.8 mg% to 6.4 mg%, club filtration and minute diuresis increased from 0.9 to 5.2 ml / min and from 0.1 to 2.4 ml / min, respectively. K in blood decreased from 6.9 to 5.3 meq / l, leukocytosis decreased from 14.3 to 6.4 thousand / mm, the leukocyte formula shift to the left disappeared, and the transplant density decreased by palpation.

Example 2. Patient A., 44 years old, about CGN, CKD, performed allotransplantation of a cadaveric kidney in the right iliac region.

Received with a crisis of rejection. After three sessions of therapy with a defocused laser with an exposure time of 30 min at a dose of 0.2 J / cm2, optical grating overlapping the graft area by 2 mm, a power density of 4 kW / cm2 pulse duration of 3 μs, a progressive improvement in graft function indicators was registered: a decrease in urea and creatinine in the blood from 190 mg% to 83 mg% and from 4.6 mg% to 1: 2 mg%, respectively, the concentration of urea in the urine increased from 1198 to 2094 mg%, minute diuresis and glomerular filtration increased from 1.04 to 1 , 87 ml / min and from 28.8 to 14.41 ml / min, respectively.

Example Patient 5., 38 years old. In connection with the deterioration of the function of the transplanted kidney due to chronic rejection

an irradiation of a defocused laser with a power density of 10 W / cm2 of a pulse with a duration of 3 µs with an exposure time of 2 min at a dose of 5 J / cm2 was performed. After 4 sessions, the dynamics are positive: a decrease in the thickness of the kidney, cortical layer and pelvis according to ultrasound data, a decrease in the reografic index, a decrease in the concentration of urea and creatinine in the blood from 66 to 45 mg% and from 1.9 to 1.5 mg% accordingly, an increase in minute diuresis and glomerular filtration from 0.41 to 0.83 ml / min and from 12.56 to 29 ml / min, respectively. The patient was discharged with an adequate diuresis and prekastically normal indicators of the function of the transplanted kidney.

The proposed method makes it possible in the shortest possible time to achieve a progressive improvement in the function of a transplanted kidney without significantly increasing the doses of immunosuppressive therapy, which prevented the side effects of the latter, shortened the length of stay of patients in the hospital.

The method is recommended for treating a crisis of rejection of renal allograft.

Claims (1)

Invention Formula A method of treating acute and chronic renal allograft rejection, including background immunosuppressive therapy, characterized in that, in order to reduce side effects, the graft is affected by a defocused laser beam in a pulse mode of 1-3 μs duration at a dose of 0.2-30 J / cm for a course of 3-4 sessions, with the irradiation zone exceeding the graft area per mm.