Faculty of Medicine
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Item type:Publication, Covid infection as devastating post-transplant complication(Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs, 2020); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, А PREVALENCE AND RISK FACTORS FOR INSULIN RESISTANCE AND DYSGLYCEMIA AFTER KIDNEY TRANSPLANTATION IN PATIENTS ON CYCLOSPORINE-A BASED IMMUNOSUPPRESSION(Macedonian Association of Anatomists, 2022); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Challenges of Deceased Kidney Transplantation in a Patient with Iliac Vein Thrombosis:(Incorporating Proceedings of the BANTAO Association, 2021); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SUCCESSFUL KIDNEY TRANSPLANTATION IN A PATIENT WITH MULTIPLE PERIOPERATIVE RENAL TRANSPLANT COMPLICATIONS. CASE REPORT(Macedonian Academy of Sciences and Arts / Sciendo, 2016-11-01); ; Josifov AleksandarKidney transplantations have become common surgical procedures that are associated with high success rates. Nevertheless, the detection, accurate diagnosis and timely management of the perioperative surgical complications sometimes require multidisciplinary team approach for some of the complications may result in significant morbidity, risk of graft loss and/or mortality of the recipient. A case of a 24-year old male patient that developed a number of different surgical complications is reported. The complications included venous graft thrombosis, urinary fistula, wound infection, wound dehiscence and a completely exteriorized transplanted kidney. Despite the various complications and, accordingly, a couple of revisions, finally the patient was discharged with a regular kidney function. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, POSTOPERATIVE SERUM CREATININ LEVEL IN TWO DIFERENT HYDRATION REGIMES IN LIVING DONOR KYDNEY TRANSPLANATATION(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2017-04); ; ; Introduction: Early graft function is very important and can be achieved with adequate intraopeartive perfusion characteristics of the graft and urine output. The goal of this study was to examine the influence of targeting central venous pressure (CVP) on early graft function. Material and methods: After approval of Ethical committee of the Medical Faculty-Skopje, we obtained inform consent of 60 patients, ASA 2-3 undergoing renal transplantation of livingrelated person in the Clinic of Urology – Skopje. A prospective clinical study was performed in the period of 2 years. Patients were divided into 2 groups of thirty patients : group A receiving normal saline intraoperatively targeting for CVP to 15 mmHg until vascular clamps were off and group B receiving normal saline 10ml/kg/h. We recorded lactate at the end of the surgery, onset of diuresis and total urine output from unclamping the renal vessels to the end of the surgery in both groups and postoperative serum creatinine in 3times (3, 12, 36 hours). Results: The onset of diuresis in seconds was insignificantly longer in group B p>0,05 (p=o,31). The average value of postoperative levels of the lactate showed that in group B the levels of the lactate were significantly higher for Z=-5,79 and p<0,001 (p=0,000). We didn’t find any statistical differences in postoperative serum creatinine in both groups. Conclusion: Our study didn’t show any benefit from targeting CVP to 15 mmHg. We couldn’t find any significant difference on onset of diuresis and urine output after the unclamping the vessels. However, in the constant infusion group (group B) the level of the lactate was higher CVP. In postoperative biochemical parameters we had no statistical difference between the average values of serum cratinine. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The impact of intraoperative targeting of the central venous pressure on the onset of diuresis in living donor kidney transplantation(Macedonian Association of Anatomists and Morphologists, 2016); ; ; Introduction: Early graft function is very important and can be achieved with an adequate intraoperative perfusion characteristics of the graft and urine output. The goal of this study was to examine the influence of targeting CVP on the onset of diuresis in kidney transplantation. Material and methods: The patients were divided in 2 groups of thirty patients: group A receiving normal saline intraoperatively, targeting for CVP 15 mmHg until vascular clamps were off and group B receiving normal saline 10ml/kg/h. The hemodynamic changes were recorded as systolic, diastolic and mean arterial pressure in 4 times: T0 before the induction, T1 after induction, T2 before the clamping the vessels and T3 after unclamping. We also recorded the duration of surgery, the duration of cold and warm ischemia, and the amount of normal saline until the unclamping of the vessels, lactates at the end of the surgery and total urine output from unclamping the renal vessels to the end of the surgery in both groups. We were monitoring the administration of plasma expander, dopamine and furosemide (if higher than 40mg) and we were inspecting if any tissue edema occurred. Results: There were no statistically significant differences in intraoperative hemodynamic parameters between both groups. The onset of diuresis in seconds was insignificantly longer in group B p>0.05 (p=0.31). The average value of postoperative levels of the lactate showed that in group B the level of the lactate were significantly higher for Z=-5.79 and p<0.001 (p=0.000). Conclusion: CVP as a guide for volume substitution is still highly recommended in kidney transplantation. The fact that in group B (the constant infusion group) we had 5 (16.7%) patients in whom we didn’t achieved urine output at the end of the surgery and the level of lactate was higher in group B gives us the right to conclude that targeting higher CVP, promotes diuresis and better urine output at the end of the surgery.