Nieru transplantācija no donoriem pēc sirdsdarbības apstāšanās

The doctoral thesis “Kidney transplantation from donors after cardiocirculatory death” has been developed in Rīga Stradiņšs University Transplant laboratory and Latvian Transplant Center. The aim of thesis to improve kidney transplant results from donors after cardiac death. The use of the kidneys from donors after cardiac arrest are associated with substantial changes in the algorythm in evaluation of some factors affecting graft function in post-transplant period. Additional difficulties appear also in assessing warm ischemia and cold preservation time and their impact on graft functionality. This doctoral thesis try to ansver the main question – which factor have the main effect on functionality of kidney grafts and how the functionality of transplanted kidneys vary depending on the presence or absence of hemodynamic during the organ procurement. Another important issue was to analyse the use of clinical, biochemical and morphological criteria for the determination of graft functional condition from donors after cardiac arrest, in order to improve the use of kidneys from donors after cardiocirculatory death. In this thesis was performed analysis of functional efficiencies of kidney transplants retrieved from donors after cardiac arrest and donors after diagnosed brain death, the use of some biomarkers for evaluation of kidney transplant function, the role pre-transplantation biopsy in predictions of kidney transplantation outcomes. Detected risk factors and criteria were used to establish forecasting formula to predict early post-transplant outcomes.