Prediction of Complication Development After Kidney Transplantation Using Blood Plasma Redox Potential Monitoring
A problem of great concern in transplantology is inability of reliable prediction of the initial function of the graft in the early postoperative period.
The aim of the investigation was to assess reliability of predicting complications in the early postoperative period after kidney transplantation on the basis of the data obtained by monitoring redox potential (RP) in blood plasma.
Materials and Methods. 60 patients were examined after kidney transplantation in the early postoperative period in N.V. Sklifosofsky Research Institute of Emergency Care (Moscow). Two groups were formed: group 1 without complications in the postoperative period (n=36) and group 2 with complications (n=24). A total of 982 analyses were performed. Graft condition was evaluated basing on clinical observations, laboratory findings, US examination and needle graft biopsy. Electrochemical measurements were performed using platinum microelectrode. Experimental data were analyzed by the software packages Statistica 6.0 (StatSoft), EViews 8.0 (IHS Global, Inc.) and Visual Basic 6.0 IDI (Microsoft).
Results. Prediction was made by assessing the probability of complication development as a function of statistical characteristics of clinical and laboratory parameters. Comparison of the mean RP values dynamics in the examined groups in the course of monitoring showed, that the difference between them has reached 12 mV already by day 5, and 18 mV by day 10. And even on day 25 the difference in the mean RP values remains not less than 10 mV. To assess the dependence of complication occurrence probability on the RP value in blood plasma probit analysis, which has been previously used only in toxicology, was applied. The normal character of distribution was proved with the help of five criteria of testing for symmetry and for excess value. The application of probit analysis enabled us to assess the probability of complication development depending on the RP value on a selected day of the postoperative period during the patient’s hospital stay.
Thus, application of RP monitoring proved to give a high probability of early prediction of complications in patients with transplanted kidney.
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