World Bulletin of Public Health (WBPH)

Available Online at: https://www.scholarexpress.net

Volume-22, May 2023
ISSN: 2749-3644

MAINTAINING VITAL SIGNS OF THE TRANSPLANTED KIDNEY.

Ismoilov Ibodjon Imomjonovich
Bukhara State Medical Institute.
Article history: Abstract:
Received: March 1st 2023 Treatment of chronic renal failure is one of the medical and social
Accepted: April 4th 2023 problems for modern modern medicine. There are now a growing number of
Published: May 6th 2023 methods for the kidney and its maintenance, for example: Temporary renal
hemodialysis, as well as kidney transplantation, which leads to an increase in the
life expectancy of patients. But not always. At present, the number of patients in
need of kidney transplantation and the number of transplant options are
increasing. This is primarily due to acute and chronic renal failure, and secondly,
due to the increased number of transplants.
Keywords: organ transplant, acute rejection, immunological tolerance, chronic renal failure

Kidney transplantation is the treatment of choice the presence of uremia, neutropenia, anemia,
in patients with end-stage chronic renal failure (CRF). hypoprotsinemia, hyperglycemia, and damage to the
All over the world, there is a constant increase in the skin (4). Infections are not only one of the most
number of such patients. More than 370,000 patients frequent complications of the post-transplant period,
receive renal replacement therapy in the United States. but are often characterized by a severe course,
In 2002, more than 11 thousand kidney transplants unusual symptoms, which complicates the diagnosis
were performed in the countries of the European and choice of treatment tactics. Unfortunately, so far
Union, and in the USA - more than 12 thousand kidney there are no immunosuppressive drugs that are
transplants. Even more urgent is the problem of absolutely free from infectious complications. The
treating end-stage chronic renal failure for our search continues for the most effective and at the
country, where the provision of patients with end- same time safe regimens of immunosuppression after
stage chronic renal failure with renal replacement kidney transplantation (13,15). However, the incidence
therapy is insufficient. More than 10,800 patients are of infections with new immunosuppressive protocols is
currently receiving treatment with hemodialysis and not fully understood. For example, there is still
peritoneal dialysis in Russia, more than 2,500 patients insufficient data on the frequency and nature of
with a functioning renal transplant are observed, infectious complications when a new and already
however, the real need for renal replacement therapy widely used drug mycophenolate mycophenolate
is much higher (9). Kidney transplantation makes it mofetil (cellsept) is included in the immunosuppression
possible not only to achieve a high quality of life for protocol.
patients with end-stage chronic renal failure, but also Of particular importance after organ
to provide specialized care to a large number of transplantation are viral infections, most often caused
patients in conditions of a shortage of dialysis sites. by herpes viruses, primarily cygomegalovirus, Herpes
However, a number of important problems still simplex (type 1, 2), Herpes zoster, Epstein Barr
remain in clinical transplantation, one of which is the viruses, as well as hepatitis B, C, D viruses (11). It has
problem of infectious complications after kidney been established that viruses are the cause of at least
transplantation. 50% of all infectious complications in renal transplant
It was found that during the first year after LT, recipients. The clinical significance of these infections
among all fatal complications, infections are the most is determined not only by the primary damage to
significant, the proportion of which is at least 1/3 (10). organs and systems, but also by their
Subsequently, infectious complications recede into immunomodulatory effect, which creates the
second place after cardiovascular complications, but preconditions for the development of severe
they continue to remain the most important cause of superinfections, including aspergillosis,
morbidity and mortality in patients with kidney pneumocystosis, and mycoplasmosis.
transplants. The development of infectious A special place in clinical transplantation is
complications after transplantation depends on the occupied by cytomegalovirus infection (CMV infection),
immunological status and the epidemiological the causative agent of which is a virus from the beta-
environment. Immunological status is determined by herpesvirus family. This is due to the high incidence of
the type of immunosuppressive therapy used, doses active CMV infection in the post-transplant period -
and sequence of drugs used, and the duration of from 20 to 60% in various transplant centers and a
treatment. An important influence is also exerted by
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 World Bulletin of Public Health (WBPH)
Available Online at: https://www.scholarexpress.net
Volume-22, May 2023
ISSN: 2749-3644

serious prognosis if specific therapy is not prescribed but specifically prevent damage to allogeneic tissues,
on time (12). is of paramount importance for the future of transplant
Treatment of patients with wound, pulmonary medicine. Induction of immunological tolerance will
and urinary infections after kidney transplantation eliminate the need to take medications without
often becomes a difficult task due to the constantly rejection and associated side effects [2].
changing sensitivity to antibiotics of pathogens of To achieve a state of tolerance, researchers have
bacterial infections with a tendency to develop drug focused on studying the regulation of the immune
resistance, immunosuppressive status of patients (13). response as the cornerstone of modern clinical
It is necessary to search for new strategies for the transplantation. Observations in veterinary medicine of
treatment and prevention of bacterial complications. induced hematopoietic chimeras [3] and the
There is no information in the available literature on pioneering work of M. Hasek and V. Demikhov, carried
the use of such a promising approach to the treatment out back in the 50s. XX century, allowed to come
of infectious-purulent complications as the use of closer to understanding this issue [4, 5].
bacteriophages in transplantation. At the same time,
interest in phage therapy has revived in general GRAFT REJECTION REACTION
surgical practice, oncology, and pediatrics (Perepanova It is known that a graft transplanted to a recipient
T.S. et al., 1995; Lakhno V.M., Bordunovsky V.N., from a genetically foreign donor does not take root
2001). and is inevitably rejected. At the same time, genetic
One of the most challenging tasks for differences between donor and recipient tissues play a
transplantologists and nephrologists is the key role in the development of allogeneic transplant
management of renal transplant recipients with fever rejection. Antigens providing intraspecific differences
of unknown origin. The list of possible causes of this are designated as tissue compatibility
condition is very large, and the clinical picture does not (histocompatibility) antigens and belong to the major
have characteristic features that allow a nosological histocompatibility gene complex (MHC) [6]. In
diagnosis to be established without the use of complex humans, the MHC is called HLA (human leukocyte
laboratory methods of examination. Creation of an antigen). The biological significance of MHC lies in
algorithm for examination and treatment of renal ensuring the interaction of body cells, recognizing its
transplant recipients with fever of unknown origin can own, foreign and altered own cells, triggering and
shorten the diagnosis time and improve the quality of implementing an immune response against carriers of
treatment for this group of patients. foreign information, positive and negative selection of
One of the greatest achievements of the twentieth T-cell clones, presentation of the targets of the
century is organ transplantation, which has stepped immune response.
into medicine as a therapeutic alternative for organ The immunological nature of graft rejection was
failure and allows many patients to be saved from demonstrated by Peter Medawar in an experiment on
death for whom other options for survival do not exist. the transplantation of a genetically alien skin graft in
Over 106,000 organ transplants were performed rabbits [7]. Both humoral and cellular mechanisms
worldwide in 2010, and this is an indicator of the level play a role in transplant rejection. Cellular rejection
of development of medicine in the state. Over the past mechanisms cause T-lymphocytes to become
three decades, the one-year survival rate of sensitized to the transplanted antigens. These
transplanted organs has reached 90% (kidneys, liver), lymphocytes cause damage to cells of foreign tissue by
but the duration of their functioning due to the either direct cytotoxicity or secretion of lymphokines. T
development of chronic transplant rejection has cell damage is characterized by parenchymal cell
changed insignificantly. Acute rejection even after liver necrosis, lymphocytic infiltration, and fibrosis. Humoral
transplantation was noted in 1/3 of patients. In most mechanisms are mediated by antibodies that may be
cases, it is dealt with using only traditional therapy, present in the serum of the recipient before
but in case of treatment-resistant rejection or transplantation or develop after transplantation of
contraindications to such treatment, it is necessary to foreign tissue. Humoral factors damage the
use other means [1]. Prevention and therapy of acute transplanted tissue through reactions that are
rejection are effective, but are associated with equivalent to type II and III hypersensitivity reactions.
significant risks, including opportunistic infections, The interaction of antibodies with the antigen on the
recipient intoxication, metabolic disorders, and surface of the transplanted cells leads to cell necrosis,
malignant neoplasms. The development of new and the accumulation of immune complexes in the
therapies that do not compromise the immune system, blood vessels activates complement, which leads to

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 World Bulletin of Public Health (WBPH)
Available Online at: https://www.scholarexpress.net
Volume-22, May 2023
ISSN: 2749-3644

the development of acute necrotizing vasculitis or 8. Nasullaevna H. N. Characteristic features of

chronic fibrosis of the intima with vasoconstriction. free-radical processes and antioxidant
protection in the oral cavity during chronic
CONCLUSION. Renal transplantation, renal transplant recurrent aphthous stomatitis //European
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with the immunogenesis of the individual organism. 9. Nasullaevna, H. N., & Vohidovna, O. D.
Changes in the physiological activity of class T (2021). The efficiency of glossalgia and
lymphocytes in the body after kidney transplantation stomatalgia complex treatmenT. Биология и
are accompanied by changes in all immunogenetic интегративная медицина, (6 (53)), 374-379.
conditions in the body, which leads to a decrease in 10. Khabibova N. N. Evaluation of vascular tissue
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decreased vital signs of renal transplantation within reduced preparative atphosis //Proceedings of
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