[Extracorporeal use of a donor spleen in the treatment of patients with urinary tract infection].
Ten sessions of extracorporeal connection to a xenous (pig) spleen were conducted as part of combined treatment in 7 patients with urosepsis in combination with severe renal failure. The session lasted for 40 to 90 minutes. The blood volume, required to fill the spleen and the main vessels, was below 100-150 ml with 7500-10,000 units of heparin spent. There was a marked clinical effect, manifested in reduced fever, better spirits, sleep and appetite, and a greater urinary output. Encephalopathy diminished. The connection to a xenous spleen had virtually no effect on urea, creatinin, electrolytes, bilirubin, transaminases, protein and acid-base values. There is evidence of mechanical withdrawal of compounds that are markers of septic intoxication: mean molecular levels dropped by an average of 20%, total spermine, spermidine and putrescine levels dropped by 35-40%, and blood became sterile. Circulating immune complexes decreased by 30-60%. The T-RFC count increased by 30-50%, largely owing to the helper cells. Leucocyte counts increased by 25%. FHA-induced blast transformation increased by 15-20%. Four (57%) of the 7 patients died. With hemodialysis alone, the mortality rate was 85% in this category of patients. Therefore, extracorporeal connection to a xenous spleen is indicated in cases of urosepsis as an effective as well as sparing method of biosorption and immunity activation in septic intoxication.
Serniak
P S
PS
Denisov
V K
VK
Guba
G B
GB
Oleshchenko
N D
ND
Frolov
S G
SG
D000328:Adult; D000818:Animals; D005260:Female; D006464:Hemoperfusion / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D013154:Spleen / Q000098:blood supply*; D013552:Swine; D014552:Urinary Tract Infections / Q000628:therapy*
Ekstrakorporal'noe podkliuchenie donorskoĭ selezenki v lechenii bol'nykh urosepsisom.