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1
Mroviecová, Lenka. "Trh s ledvinami." Master's thesis, Vysoká škola ekonomická v Praze, 2014. http://www.nusl.cz/ntk/nusl-194264.
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This diploma thesis deals with the possible solution of the kidney shortage problem. Especially analyses effect of legislation system of registration to organ donation on count of kidney transplants and waiting time. The effect of the legislation system is analyzed with panel data of OECD countries. Using random effects method, the estimated result suggest that the countries using informed consent produce on average 7,49 kidney transplants per million population fewer and on average 1,95 years longer waiting time, than countries using presumed consent. Although model predicted positive impact of presumed consent system, empirical data from Chile didn't confirm this assumption. Based on the analysis, I suggest better solution of kidney shortage problem, than change of the registration system. Introduce of compensatory payments to living kidney donors.
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Hajšelová, Zuzana. "Fotoprotekce u pacientů po transplantaci ledvin." Master's thesis, 2020. http://www.nusl.cz/ntk/nusl-434393.
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Photoprotection in Patients after Kidney Transplantation Author: Zuzana Hajšelová Tutor: doc. PharmDr. Josef Malý, PhD. Consultant: Mgr. Barbora Vaňková Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradci Králové, Charles University Introduction and aims: Patients after kidney transplantation (KT) are in a higher risk of developing skin cancer as a result of lifelong immunosuppressive (IS) therapy. Thorough photoprotection is therefore recommended. The aim of this study was to determine patients' awareness and level of photoprotection and to analyse selected risk factors for skin cancer development in patients after KT. Methods: The cross-sectional study was undertaken from 15th April to 31st December 2019 at the Haemodialysis Centre in the Teaching Hospital Hradec Králové. Patients included in this study were above 18 years old, who visited Haemodialysis Centre in the defined period. The data was collected from the patients' medical documentation (e.g. occurrence of skin cancer and skin cancer type, current IS) and from the written version of questionnaires (e.g. phototype, sun exposure, photoprotection). The data was analysed using descriptive statistics. Results: There were 410 KT patients in regular care of the Haemodialysis Centre, 361 fulfilled the questionnaire (88.0...
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Moravcová, Lucie. "Transplantace ledvin - shoda mezi dárcem a příjemcem ve FN Hradec Králové." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-398657.
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8 ABSTRACT Author: Bc. Lucie Moravcová Supervisor: MUDr. Vít Řeháček Charles University, Faculty of Pharmacy in Hradec Králové Title of master's thesis: Kidney transplantation: donor-recipient pairing in University Hospital Hradec Králové Background: The aim of this study was to determine HLA, blood group, age and sex match in donor-recipient pairing in kidney transplantation. HLA alleles of deceased donors were typed in Transfusion Department of the University Hospital Hradec Králové. Methods: Donor's HLA-A*, HLA-B* and HLA-DRB1* alleles were typed by PCR - SSP method. Complex data evaluating and processing was then performed. Results: 97 deceased donors were tested between 2013 and 2018. A total of 98 kidneys received from them were subsequently transplanted to 98 recipients in University Hospital Hradec Králové. 60,2 % of the donors were men, 63,3 % of the recipients were men. Most of the donors, as well as the recipients, were 51-70 years old (50,0 % and 59,2 %, respectively). The most common diagnoses in the group of deceased donors were associated with brain damage (66,3 %), the most common cause of renal failure in the group of recipients was chronic inflammatory kidney disease (41,8 %). All 98 transplantations (100,0 %) were AB0 compatible. 74 transplantations (75,5 %) were RhD compatible. 5...
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Vaňková, Barbora. "Adherence k léčbě u pacientů po transplantaci ledvin." Master's thesis, 2017. http://www.nusl.cz/ntk/nusl-356243.
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Adherence to Treatment in Patients after Kidney Transplantation Author: Barbora Vaňková Tutor: PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Kateřina Ládová, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Kidney transplantation (KT) is the best treatment option for patients with end- stage renal disease. However, despite its numerous benefits it requires a lifelong medical regimen of immunosuppressive treatment (IS) with a special emphasis on a strict medication adherence (MA). The objective of our study was to analyse MA in KT outpatients. We also intended to analyse non- adherence as one of the drug-related problems. Furthemore, we focused on analysis of the main self- management tasks. Methods: The prospective cross-sectional study was undertaken in one year period from March 2016 to March 2017 at the Haemodialysis Centre in the Teaching Hospital Hradec Králové. Patients ≥ 18 years old and at least 3 weeks after KT were addressed within their regularly scheduled visit to the nephrologist. Structured interview was performed by pharmacist to determine patients' self-reported MA to IS using validated Czech version of Medication Adherence Report Scale (MARS-CZ). In addition, patients were interviewed about other...
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Sýsová, Alena. "Fyzická aktivita u jedinců po transplantaci ledvin." Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-300488.
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Introduction: Thanks to modern medicine people with chronic forms of the diseases can live longer than before. In this work we concerned with last stage of chronical kidney dinase, which is treated by dialysis or transplantation. Succesful renal transplantation leads to significant improvement in quality of life of patients, but after transplantation there are still some risk factors, which may influence health and physical condition of men. We can eliminace these risk factors with some non-pharmacological ways, for example with intervention program of regular physical activity and special nutrition, which can help to gain and increase patient`s physical condition. The main focus of research of this thesis was to evaluate physical condition and amount of physical aktivity of 4 groups of patients, each with another intervention, after renal transplant. We used the battery of motor tests "Senior Fitness Test Manual". Aim: Analyze, how regular physical activity, special nutrition and combination of both influence physical condition of patients after renal transplant. Methods: This research work is a part of the grant project IGA MZ CR 173 (NS-10518- 3/2009). We used 21 participants selected from patients of Nephrology Clinic TC IKEM in Prague for our solution. Physical fitness testing was performed...
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Sidorová, Kristína. "Riziko kožních nádorů a lymfoproliferativních onemocnění u pacientů po transplantaci ledvin." Master's thesis, 2020. http://www.nusl.cz/ntk/nusl-434391.
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Risk of skin cancer and lymphoproliferative diseases in patients after kidney transplantation Author: Kristína Sidorová Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: Mgr. Barbora Vaňková Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Organ transplantations (Tx) are associated with the lifelong use of immunosuppressive therapy (IS), which carries with it, among other risks, an increased incidence of malignancies. The most common malignancies after Tx are skin tumors, post-transplant lymphoproliferative diseases (PTLD) are also more common in transplant patients. The aim of the study was to determine the incidence of skin tumors and PTLD in patients with kidney Tx within one transplant center and to analyze the risk factors associated with these diseases. Methods: Retrospective longitudinal study was conduted in the Teaching Hospital Hradec Králové. The study included patients from the age of 18 who had overcome kidney Tx until 24 April 2019, were registered in a transplant clinic in Hradec Králové and had a medical record in the hospital information system. Data collection from medical records took place from 15 April 2019 to 31 December 2019. Collected data included demographic characteristics, family history,...
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Čápová, Barbora. "Diferenciace lidských M2 monocytů/makrofágů a jejich úloha u transplantací ledvin." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-392932.
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The system of mononuclear phagocytes includes macrophages that modulate their phenotype based on microenvironmental signals. Their properties vary considerably in a differentiated stage. M1 macrophages, which are classically activated (typically by IFN-γ), are involved in phagocytosis and produce some pro-inflammatory cytokines, that can stimulate other immune cells. A phenotypically different cell population are M2 macrophages, which are alternatively activated by exposure by Th2 cytokines. M2 macrophages produce preferentially anti-inflammatory cytokines IL-10, TGF-β and participate in repair and tissue healing. The main aim of this study was to standardize a model of differentiation of THP-1 cells and human monocytes towards the M2 phenotyp using an in vitro model. This is represented in particular by increased expression of CD163 and CD206 molecules. The second aim was to assess the dynamics of expression (and co-expression) of CD163 and CD206 molecules in monocytes of patients after kidney transplantation. Expression of surface markers was determined by flow cytometry. Both THP-1 cells and human monocytes, isolated from buffy coat fraction, were stimulated by IL-4, TNF-α, TGF-β and IL-10. Changes in CD163 and CD206 expression were measured after day 1, day 3 and day 6 of stimulation. The most...
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Horníková, Dita. "Rozdíly v kvalitě života pacientů léčených hemodialýzou, peritoneální dialýzou a transplantací ledvin." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-380741.
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The literature indicates that treatment by means of elimination methods is extremely challenging for patients, bringing a fundamental change to their lives. The aim of the thesis was to identify and describe the challenges of treatment in patients with renal failure and how a given method of treatment affects the patient's quality of life and needs, as well as to understand the subjective difficulties and problems. A data collection method in the form of non-standardized semi-structured interviews was selected for qualitative research. The surveyed sample consisted of six patients of a dialysis centre. The respondents taking part in the qualitative research were informed in advance of the course, circumstances and ethical aspects of the research. The obtained data was analyzed, colour-coded and then sorted into subcategories. The results were interpreted using the "showdown" technique. The interviewed sample of respondents was subjected to multiple elimination methods in the treatment of their disease. Kidney transplant patients subjectively evaluated the quality of their lives as very high, talking about "a life of a normal man". Peritoneal dialysis patients also evaluated their quality of life as relatively high, highlighting a certain feeling of independence. Haemodialysis patients describe...
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Králová, Helena. "Kvalita života jedinců po transplantaci ledvin a možnosti jejího ovlivnění různými formami intervence." Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-299903.
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Title: Quality of life in renal transplant recipients and the possibilities of its affecting through different forms of intervention. Aims: 1) To evaluate quality of life in renal transplant recipients and compare it with that of the general population. 2) To analyze effects of a 6 months controlled intervention exercise program, special diet, combination of special diet and exercise program and control group on the health related quality of life and to compare results between groups. Methods: We studied a composite group of 21 patients (mean age 58,4 9,34 years) after renal transplantation. Patients were randomly divided into four groups, each group had different program, as described above. The assessment of the quality of life was performed twice, before and after six months of a regular intervention program. We used standardized questionnaires KDQOL-SFTM . We have also assessed the importance of individual dimensions of quality of life with questionnaire WHOQOL - 100. Results were analyzed using descriptive statistics, non-parametric Wilcoxon signed-rank test and non-parametric Kruskal Wallis test. Statistically significance was considered on p ≤ 0,05. Results: After the pre-test and evaluation of the quality of life we assessed, that from 8 dimensions there were 5 lower after the...
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Fořtová, Magdaléna. "Biomarkery časného poškození ledvin." Doctoral thesis, 2018. http://www.nusl.cz/ntk/nusl-391368.
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Aims: The thesis deals with the biomarkers of early renal injury, namely albuminuria and neutrophil gelatinase-associated lipocalin (NGAL). The aims in the case of albuminuria were the implementation of HPLC method, comparing HPLC with immunoturbidimetric (IT) method and monitoring the relationship to the diagnosis of diabetes mellitus. The aim of urinary NGAL (and eventually other markers) examination was to verify its reliability in the prediction of acute kidney injury (AKI). Methods: We investigated albuminuria in fresh urine samples in the groups of 636 diabetics and 456 nondiabetics using the HPLC method (Agilent 1200, Agilent Technologies, USA) and immunoturbidimetrically (Cobas Integra 400, Roche Diagnostics); we studied the correlations and relationships between albuminuria and glycated hemoglobin HbA1c. We investigated urinary NGAL by chemiluminescent microparticle immunoassay (Architect i4000, Abbott) in children's groups: 1) after renal transplantation (N = 15), 2) with acute or chronic kidney disease (N = 28); and in adult patient's groups: 1) after cardiac surgery (N = 10) and 2) post angiography (N = 41). Results: Albuminuria determined by HPLC was statistically significantly higher than albuminuria determined by IT. We excluded nonspecificity of the HPLC method. Results indicate...
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Švagrová, Klára. "Vliv pohybové a nutriční a nutriční intervence na fyzickou zdatnost a QŽ jedinců v prvním roce po transplantaci ledviny." Doctoral thesis, 2013. http://www.nusl.cz/ntk/nusl-330390.
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UNIVERZITA KARLOVA V PRAZE FAKULTA TĚLESNÉ VÝCHOVY A SPORTU The effect of physical activity and nutrition interventions on physical fitness and quality of life during the first year after kidney transplantation Abstract of disertation Zpracovala: Mgr. Klára Švagrová Školitel: Prof. Ing. Václav Bunc, CSc. Školící pracoviště: Laboratoř sportovní motoriky Praha, 2012 ABSTRACT Kidney transplantation is the best known treatment of chronic kidney failure. However, it is often accompanied by a number of health complications. The transplantation itself positively affects both physical fitness and quality of life during the first year after the transplant surgery which are seriously diminished when compared to the healthy population. This improvement can be even enhanced by appropriate physical activity and nutrition interventions otherwise both the physical fitness and quality of life would start declining after the first post-transplant year again. The aim of this study was to confirm a positive effect of a long-term physical activity and nutrition interventions on health-related physical fitness and health-related quality of life in a representative sample of individuals in the first year after the kidney transplantation. At the same time it was fundamental to verify that the experimental trial can be...
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Turková, Sedláčková Terezie. "Změny metabolismu železa a jeho regulace u nemocných v konečné fázi onemocnění ledvin léčených hemodialýzou a transplantací ledviny." Doctoral thesis, 2013. http://www.nusl.cz/ntk/nusl-327439.
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Iron is a very important biogenous trace element, which is involved in many of cell processes in organism. For its character iron can be also involved in Fenton reaction, where a toxic hydroxyl radical is produced. The iron metabolism is very carefully regulated in order to avoid formation of hydroxyl radical. Iron Responsive Proteins-Iron Responsive Elements (IRPs-IREs) system is involved in the regulation of iron metabolism on cell level, small peptide hormon hepcidin is involved in the regulation on systemic level. Hepcidin was discovered in 2000 as a peptide with antimicrobial properties. It is a key regulator of iron metabolism, as was discovered later. The target of hepcidin is ferroportin-the only known iron cell exporter. The expression of hepcidin is downregulated by hypoxia and anemia and upregulated by iron overload and inflammation. Hemodialyzed patients suffer from anemia very often. This anemia is caused by many factors, e.g. inadequate production of erythropoietin, chronic inflammation, chronic oxidative stress, blood loss during hemodialysis process or lower lifetime of red blood cells. We realized three studies on the patients with end-stage renal disease in our laboratories. Our aim was to find a relationship of hepcidin and other parameters of iron metabolism, inflammation and...
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Reischig, Tomáš. "Cytomegalovirová infekce po transplantaci ledviny." Doctoral thesis, 2009. http://www.nusl.cz/ntk/nusl-278237.
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1 SUMMARY Cytomegalovirus (CMV) disease is a common infectious complication in patients after solid organ transplantation. The last decade witnessed major advances in CMV disease prevention. Use of universal prophylaxis or preemptive therapy resulted in a decrease in the incidence of CMV disease from 20-60% to 5-20%. However, the efficacy of preventive approaches in terms of indirect effects of CMV occurrence is problematic. Association with allograft rejection belongs to well documented and clinically extremely important indirect effects of CMV with a prolonged adverse impact on graft survival. Potential mechanisms include overexpression of major histocompatibility complex molecules, growth factors and cytokines, and upregulation of adhesion molecules. A number of questions remain to be answered in evaluating CMV as a risk factor for acute rejection. While CMV disease is associated with an increased incidence of acute rejection, data regarding the role of asymptomatic CMV viremia are controversial. In our research we evaluated the role of CMV in pathogenesis of allograft rejection in the era of modern immunosuppression and CMV prophylaxis as well as optimal preventive strategy to minimize impact of CMV. In the first trial, renal transplant (RTx) recipients were followed prospectively for 12 months to...
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Kačer, Martin. "Infekční komplikace po transplantaci ledviny." Doctoral thesis, 2016. http://www.nusl.cz/ntk/nusl-353599.
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3 Abstract Infectious complications after kidney transplantation In the general part of this work, the most common and typical infectious complications in renal transplant recipients are reviewed. The practical part presents results of our research on prevention of the most common infection in renal transplant recipients, cytomegalovirus infection. Globally, infection belongs amongst the main causes of morbidity of solid organ recipients and is the second leading cause of mortality in patients with a functioning kidney graft. In the first year post kidney transplant, approximately one half of recipients undergo a clinically apparent infectious complication and 20% of patients are hospitalized due to infection. Cytomegalovirus (CMV) is the most common viral infection in kidney transplant patients and its occurence is associated with serious negative consequences for both kidney and patient survival. Prevention of CMV is essential in renal transplant recipients. Valganciclovir, due to its efficacy and good bioavailability, is the most commonly used antiviral agent used in CMV prophylaxis. The only currently recommended alternative for the prevention of CMV in patients undergoing renal transplantation is valacyclovir. So far, studies comparing valacyclovir and valganciclovir for CMV prophylaxis in renal...
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Pacovský, Jaroslav. "Patogeneze lymfokély po transplantaci ledviny." Doctoral thesis, 2009. http://www.nusl.cz/ntk/nusl-281050.
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The lymphocele is a surgical transplant complication resulting from lymphatic vessels injury. This injury is background of the lymphocele pathogenesis, no lymphocele cannot become into existence without this step. On the other hand, the all organ procurement and transplantation procedures are associated with any rate of this injury at all time. Our results present proteins as a very important factor influencing interstitial fluids transport. The colloid osmotic pressure of the proteins controls interstitial fluids flow even across the vessel walls. Lymph fluid flow is also under the osmotic pressure control. The proteins play serious role in the second phase post-transplant lymphocele pathogenesis. At first, proteins control return of the leaked lymph back into the lymphatic vessels. Finally, inflammatory proteins participate on development of the fibrous lymphocele capsule. Postoperative care for protein metabolism seems to be very important in the protection against the post-transplant lymphocele formation. Carefully metabolic care for patient after renal transplantation should help to decline risk of lymphocele. The knowledge of the pre-transplant protein level and its fractions is very useful for relevant estimation of the risk of the post-transplant lymphocele formation. Calculation of the...
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Krepsová, Eva. "Markery transplantační tolerance po transplantaci ledviny." Doctoral thesis, 2016. http://www.nusl.cz/ntk/nusl-348093.
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Long-term renal graft acceptance still requires long-term immunosuppressive therapy, which is accompanied by many adverse effects. Contrarily insufficient immunosuppression could lead to graft rejection and its failure. Therefore, research continues for biomarkers that reflect a patient's immunological status and thus allowing for individualized immunosuppressive therapy. In our study we showed lower incidence of acute rejection in kidney transplant recipients treated with rabbit anti-thymocyte globulin (rATG) or basiliximab induction within the first three months after transplantation. The rATG induction caused profound decrease of recipient's peripheral blood T and NK cells, as well as transcripts that are exclusively expressed by these cell types together with expansion of regulatory T cells (Tregs) among CD4+ T cells. In rATG group the increase of two transcripts associated with rejection (MAN1A1 and TLR5) was also observed in early post-transplant period. After the basiliximab induction we transiently detected CD4+CD25low/-FoxP3+ cell population along with disappearance of CD4+CD25+FoxP3+ Tregs. Basiliximab induction resulted in a transient increase in CD4+FoxP3+ Tregs, accompanied by the highest peripheral expression levels of markers associated with operational tolerance (FOXP3 and TCAIM)....
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Francová, Lidmila. "Rizikové faktory kardiovaskulárních onemocnění po transplantaci ledviny." Master's thesis, 2010. http://www.nusl.cz/ntk/nusl-285108.
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Risk factors of cardiovascular disease after renal transplantation This study which explores conventional and new markers of cardiovascular diseases after a renal transplantation. We have paid main attention to new markers such as PAPP-A (pregnancy-associated plasma protein-A), AGEs (Advanced Glycation End Products) and matrix metalloproteinases (MMP-2 and MMP-9). All of them are involved in the pathogenesis of atherosclerosis and the plaque destabilization. The serum levels of new markers were measured by an enzyme-like immunosorbent assay. The renal function is determined as inulin clearance in ml/s/1.73 m.We have used Excel and MedCal programs for the evaluation of the statistic data. New markers were evaluated by t-test. We have used 21 healthy controls. We have had 142 patients, who have undergone renal transplantation within a period of one year between April 2007 and April 2008. The most numerous age was 60-70 years (31%), follows 50-60 years (28%). From 142 patients there were 98 men (96%) and 44 women (31%). At the time of the study 25% of the patients were smokers, 49% of them never smoke and 26% stopped smoking. The normal body mass index was found out in 39% of the patients, 58% was overweight . The average time of dialysis was 12-18 months. Only 8% of the patients had a basal diagnosis made by...
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Girmanová, Eva. "BK virová infekce u pacientů po transplantaci ledviny." Doctoral thesis, 2020. http://www.nusl.cz/ntk/nusl-410799.
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Polyoma BK virus is associated with graft dysfunction leading to BK viral nephropathy (BKVN) in 1-10% of kidney transplant recipients, moreover 30-80% of kidney transplant recipients experience asymptomatic reactivation of the virus that does not result in BKV associated damage of the renal allograft. The first aim of this study was to introduce monitoring of BK virus replication in the blood and urine of patients within first year after transplantation. Risk factors were evaluated and limit values for viremia and viruria for BKVN development was established. Positive BK viruria >107 copies/ml and positive BK viremia >104 copies/ml occurred in 25.8% and 5%; respectively. 3 patients out of monitoring study developed BKVN. Using ROC analysis, limit values for the development of BKVN were set at 103 copies/ml serum for BK viremia and 6.7x107 copies/ml BK viruria. The second objective was to determine the expression profile of the immune genes in kidney biopsies in three groups of patients with varying degrees of reactivation of the BK virus (without virus reactivation, with asymptomatic viruria, BKVN). 90 genes of immune response were measured by the TaqMan® low density array RT-qPCR. The analysis of biopsies from patients with non-signalling viruses led to the identification of 5 differentially...
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Rybáková, Kateřina. "Metodika ELISpot a predikce rejekce po transplantaci ledviny." Master's thesis, 2014. http://www.nusl.cz/ntk/nusl-332199.
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Transplantation is the best therapeutic solution for patients with chronic renal failure. Due to the great advances in immunosuppressive therapy in the last decades, graft and patient survival have improved significantly. On the other hand, immunosuppressive therapy has serious side effects - too strong immunosuppression may lead to infection or malignancies, conversely insufficient immunosuppression may lead to graft rejection. Due to the grave consequences of acute rejection, the main goal of cooperation of clinicians and transplant immunologists is to stratify patients into groups with low, moderate and high risk of rejection based on the evaluation of various immunologic risk factors. There are reports in the literature that the numbers (frequencies) of interferon gamma (IFNγ) producing cells before transplantation may be helpful to identify patients with high risk of acute cellular rejection and to predict long-term survival of the graft. In this retrospective study we determined the pre-transplant frequencies of activated donor specific T lymphocytes producing IFNγ after short stimulation (24 hrs) by ELISpot (Enzyme-linked immunosorbent spot assay). The results were correlated with the incidence of acute cellular (ACR) and antibody-mediated (AMR) rejection and with other risk factors. In our...
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Školová, Lucie. "Funkční poruchy pohybového systému u jedinců po transplantaci ledviny." Master's thesis, 2012. http://www.nusl.cz/ntk/nusl-310791.
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Title: Functional disorders of the musculoskeletal system on individuals after kindey transplantation Defining of the problem: Renal transplantation is a method to treat patients with renal failure,which is associated to a prolonged survival of patients compared to a dialysis method (Viklický et al., 2008). After a successful renal transplantation the renal function is restored and complications caused by dialysis treatment disappear . However, complications due to the transplant, not only in terms of surgical intervention, but also from the point of a lifelong immunosuppressive therapy remain at risk. Functional changes on the locomotor system can occur as a concequence of a long-term renal disease or kidney transplant. This could further reduce the quality of life on patients due to self-sufficiency, being the main role of the locomotor system. Objectives: The aim of this study is to valuate functional disorders of the musculoskeletal system on individuals after kindey transplantation up to one year after a transplant. Methods: This thesis is elaborated in the form of an analytical - experimental study in which 2 groups of selected individuals were tested. Testing was conducted by using suitable tests focused on functional disorders of the locomotor system and parameters in each group and time...
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Bandúr, Štěpán. "Varianty vybraných kandidátních genů ve vztahu k výsledkům transplantace ledviny." Doctoral thesis, 2013. http://www.nusl.cz/ntk/nusl-326936.
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6 Abstract: Renal transplantation outcomes might be influenced by genetic determinants, genes encoding structural and regulatory proteins involved in respective pathophysiological and immunological pathways. CYP3A4/CYP3A5 and ABCB1/MDR1 genes encoding cytochrome P450IIIA and P-glycoprotein, proteins determining bioavailability of immunosuppressants- calcineurin inhibitors and mTOR inhibitors, play important role. Polymorphisms in these genes have been suggested to influence immunosuppressants pharmacokinetics and renal transplant outcomes. The association of CYP3A4 -288A>G, CYP3A5 +6986G>A, ABCB1/MDR1 +1236C>T, +2677G>T>A and +3435C>T polymorphisms with clinical and laboratory endpoints was assessed by using haplotype analysis approach in 1016 patients. Except of HLA-DR mismatch, delayed graft function and kidney graft donor age, [ABCB1/MDR1+1236C;+2677G;+3435T] haplotype was independent predictor of acute rejection, but did not influence kidney graft survival. Homozygotes for the [CYP3A4- 288A;CYP3A5+6986G] haplotype had higher bioavailability of tacrolimus at week one. ABCB1/MDR1 haplotypes did not influence pharmacokinetics, but modified the risk of acute rejection, suggesting that allelic arrangement of the genetic loci was a stronger regulator of P- glycoprotein activity than single polymorphisms....
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Krásová, Martina. "Riziko zhoubných novotvarů u příjemců transplantátů ledvin: Asociace mezi transplantací a výskytem kožních nádorů." Doctoral thesis, 2016. http://www.nusl.cz/ntk/nusl-353445.
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Aims: To determine the incidence of skin cancer and other malignancies in renal transplant recipients (RTRs) transplanted in the largest transplant center in the Czech Republic. To identify the distribution of risk factors involved in the skin cancer development and to derive the optimal strategy for dermatological screening in the Czech transplant population. Materials and methods: A cohort study was performed on the group of 797 patients after kidney transplantation, who were referred for dermatological examination in the time period from January 2013 to January 2016. Standardized morbidity ration (SMR) was analyzed and calculated for different types of cancer developed in the posttransplant period. Results: 192 cases of malignancies were diagnosed in 86 RTRs (10,8 %). Nonmelanoma skin cancer (NMSC) was the most frequent type of cancer with SMR = 6,42 (P = 0,000), followed by renal cancer with SMR = 5,9 (P = 0,000), malignant melanoma with SMR = 2,59 (P = 0,080) and prostate cancer with SMR = 1,21 (P = 0,593). The risk to develop NMSC was significantly higher in the group where cyclosporine has been used besides tacrolimus, mycophenolatemophetil and steroids as well as in the group treated with the combination without cyclosporine (SMR = 9,62, P = 0,001 and SMR = 5,18, P = 0,000). Furthermore,...
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Pidhorodetská, Halyna. "Chemokiny u transplantace ledviny a jejich tvorba lidskými makrofágy a renálním epitelem." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-380400.
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One of the main effects of pro-inflammatory cytokines is the induction of chemokines and the expression of adhesive molecules that regulate the migration of immune cells to the center of the damage. Chemoattractant gradient also provides a physiological delivery of cells to tissues and lymphatic organs under normal circumstances. Chemokines are chemotactic cytokines that form a very large and diverse group of secreted proteins that have many functions both in processes that maintain homeostasis but also in inflammatory states. Production of some chemokines also has a major effect on graft rejection. Further understanding of the mechanisms involved in the acute rejection chemokine could contribute to improving treatment steps in transplantology. In this diploma thesis, serum chemokine levels were monitored in renal transplant patients, but these measurements did not show significant dynamics. Furthermore, the effect of pro- inflammatory cytokines on the release of chemokines from renal epithelial cells and monocytes was studied. Experiments were performed to monitor the levels of individual chemokines such as ENA-78, IL-8, MCP-1, MIP-1β, RANTES, GRO-α, THP-1 (monocyte/macrophage cell line), RPTEC (renal epithelial cells of proximal tubules) and RA (renal cell tumor lines). TNF-α had an effect on the...
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Švábová, Markéta. "Vliv fyzické aktivity na posturální stabilitu u jedinců po transplantaci ledviny." Master's thesis, 2012. http://www.nusl.cz/ntk/nusl-308200.
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Title: The influence of physical activity on postural stability in individuals after renal transplantation Objectives: The aim of this study was to evaluate the current state of postural stability on individuals up to one year after renal transplantation. And then the results relate to the current state of health of the patient, his habitual physical activity and intervention program. Methods: On our pilot study, 12 probands participated, 5 women with an average age of 58 ± 2,88 years and 7 men with an average age of 64 ± 5,67 years post-transplant, who were included in the experimental group (n=12). These took part on a three-month exercise intervention that included group and individual exercises. The influence of physical activity on the quality of postural stability was objectified by a posturography, where a pressure plate Footscan was used, on the premises of the Clinic of Nephrology TC IKEM in Prague. The results were compared with parameters of postural stability in the control group (n=12) without renal disease, homogeneous age and gender. Results: When comparing individual tests and their results with the control group, there were apparent differences in the sense of deterioration in the experimental group. However, when comparing between the input and output measurements in the...
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Mindlová, Martina. "BK-polyomavirová infekce u pacientů po kombinované transplantaci ledviny a pankreatu." Doctoral thesis, 2011. http://www.nusl.cz/ntk/nusl-311363.
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Introduction. The aim of the study was to introduce a new BKV PCR protocol in our centre and to verify its accuracy as well as to assess the prevalence, risk factors of BK virus replication, course of BKV infection and therapeutic approaches in simultaneous pancreas and kidney (SPK) recipients in order to design a screening protocol. Methods. The results analysed by both Affigene® and Transplantation Virology, Basel PCR protocols were compared. Thereafter 183 SPK patients were examined to assess the prevalence of BK viremia, viruria and BKVN and to identify the risk factors of BKV replication. The cases of retransplantation after a graft loss due to BKVN were retrospectively described. Results. 100 of results were analysed according to the Affigene ® and Transplantation Virology, Basel PCR protocols with the accordance of 95%, Rho = 0,946, 95% CI: 0.920 - 0.963, P<0,0001, Bland-Altman plot analyses: bias Basel PCR protocol/Affigene® BKV trender: -0,1 (mean) *±1.96 SD: -1,6 - 1,3] for both methods. Point-prevalence was assessed in 183 patients; Viruria found in 17,3 %, viremia in 3.8% of patients. High-level viruria >107 copies/mL detected in 3,7% of patiets, high-level virémia >104 in 1,6% of patients simultaneously with high-level viruria. BKVN was found in 0,5% of patients. Diabetes duration...
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Nová, Michaela. "Alternativní postupy v terapii pooperační bolesti u pacientů po transplantaci ledviny od žijícího dárce." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-404203.
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The main criteria for managing good postoperative care include the effective and appropriate choice of pain therapy. Experiencing pain is a purely individual feeling for each of us, so it is very important to have adequate and sufficient analgesia during this period. Modern management of post-operative pain therapy uses preparations of various pharmacological groups that potentiate and thereby more effectively reduce pain. By this mechanism, we can reduce the total dose of analgesics given, and more particularly, reduce the dose of opioids that have a higher risk of side effects. In this project i want to show how the analgesic catheter could be useful as alternative possibility in algorithm therapy of postoperative pain. Analgesic catheter enable continual local anesthetics administration, exactly 0,5% bupivacaine, which is operating in surgical wound. Main goal of the study is to find out and verify if analgesic catheter is method which provides continual analgesia strong enough to results in lower use of opioids. The research data will be determined by quantitative research using a questionnaire survey. Non standardized self-production questionnaire. will be given in a paper form to non-medical healthcare staff, who perform nursing activities The spectrum of patients is very specific; they are...
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Valhová, Šárka. "Humorální rejekce po transplantaci ledviny a vyšetřování protilátek proti HLA a non-HLA antigenům." Master's thesis, 2013. http://www.nusl.cz/ntk/nusl-321057.
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Kidney transplantation is the treatment of choice for patients with end stage renal failure and is associated with prolonged survival of patients and better quality of life than long-term dialysis. Simultaneously, however, transplantation carries the risk of immunological complications leading to graft rejection. A serious problem in patients after organ transplantation is the development of humoral rejection, which is most often associated with the presence of antibodies specific to HLA antigens, particularly against mismatched HLA antigens of the organ donor. In certain cases antibodies may be specific to antigens expressed on endothelial cells, not on lymphocytes, like MICA, MICB, ICAM, and up till now unidentified tissue-specific antigens. Humoral rejection has significantly worse prognosis for the transplanted kidney than cellular rejection, and therefore its timely diagnosis is of great importance for the subsequent choice of appropriate therapy. The diagnosis of humoral rejection is based on the simultaneous detection of C4d deposits in the peritubular capillaries of the transplanted kidney and the finding of antibodies specific to the mismatched antigens of the donor (donor specific antibodies, DSA). The aim of our retrospective study was to contribute to improvement of the diagnosis of acute and...
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Šilhová, Markéta. "Určení dárcovsky specifické T buněčné aloreaktivity u pacientů po transplantaci ledviny s diagnózou hraničních změn." Master's thesis, 2020. http://www.nusl.cz/ntk/nusl-416113.
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After kidney transplantation the recipient's immune system responds to the donor's antigens and the graft rejection occurs. Borderline changes are a frequent diagnosis after kidney transplantation, representing only mild rejection signs. Some patients with borderline changes undergo progression to rejection. The identification of these at- risk patients by biomarkers will allow enhanced treatment and help to prevent the development of rejection. The aim of my work was to verify biomarkers of rejection in patients with borderline changes. Chemokines CXCL9, CXCL10 and CCL17 in urine/serum of 40 patients with subclinical borderline changes at 3 months and in 25 patients with early borderline changes were determined by ELISA. At 3 months, the higher CXCL10 level predicted rejection with AUC=0.749, p=0.024. High levels of CXL10 had also been found in patients with BKV infection. We did not confirm the relationship between rejection and the CXCL9 and CCL17. In the early posttransplant period the levels of CXCL10 and CXCL9 were elevated in all patients and therefore couldn't be used to predict rejection. The alloreactivity was examined using IFN-γ ELISPOT (n=38). No association between the frequency of IFN-γ producing cells after stimulation with donor cells or CMV peptides and the development of...
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Sekerková, Zuzana. "Role BAFF cytokinu v transplantačních reakcích." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-343142.
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Current immunogenetic tests before organ transplantation include HLA typing and detection of HLA-specific antibodies. However, these tests do not provide information about the B cells participating in the humoral response against the transplanted organ. BAFF (B activating factor) plays an important role in the proliferation, maturation and differentiation of B cells. A soluble form of the cytokine arises after splicing the membrane form of BAFF. The soluble cytokine binds to three types of receptors - TACI, BCMA and BCMA. Some recent studies suggest that BAFF could serve as a marker or predictor of antibody-mediated (humoral) rejection in kidney transplant recipients. Our study consists of two parts. The first part is focused on the detection of soluble BAFF levels in patients after renal transplantation. The aim of our study was therefore to correlate levels of soluble BAFF cytokine in patients before and after transplantation with the clinical course and incidence of rejection after transplantation. The study included 92 kidney recipients. Humoral rejection was diagnosed on the basis of a positive finding of C4d deposits in peritubular capillaries (imunoflorescenční detection), and the presence of donor- specific antibodies. BAFF levels were determined using Xmap methodology by the Luminex method...
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Karasová, Alexandra. "HLA neshody u pacientů po opakované transplantaci ledviny a incidence akutní buněčné a protilátkami zprostředkované rejekce." Master's thesis, 2014. http://www.nusl.cz/ntk/nusl-337594.
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Kidney transplantation is the most appropriate treatment for end-stage kidney failure. The risk of graft failure in retransplanted patients is generally higher than in first-transplant patients due to immunological and non-immunological reasons. An important risk factor to consider for retransplant patients is their sensitization, i.e. the presence of antibodies directed to HLA antigens of previous donor(s). For that reason, a project called Forbidden (Non-acceptable) Antigens was launched by IKEM with the aim of reducing the incidence of acute cellular and antibody-mediated rejection in retransplant patients. Work on the project was carried out between the years 2011-2013. Forbidden antigens were defined as mismatched HLA antigens of previous kidney donor(s) against which patients waiting for retransplantation produced antibodies. The aim of this diploma thesis is to evaluate whether the incidence of rejection is lower in patients with forbidden HLA antigens in comparison with a control cohort, where no forbidden antigens are defined. 234 patients (162 males and 72 females) were included in the study. Almost all tested patients were producing HLA antibodies (90.2%) and forbidden antigens were determined in 71.4% of patients. In a control group of 267 patients waiting for their first transplantation, the...
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Wohlfahrtová, Mariana. "Predikce časného rozvoje funkce a rejekce transplanované ledviny." Doctoral thesis, 2015. http://www.nusl.cz/ntk/nusl-336144.
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Improving the short-term results of kidney transplantation did not result in improving the long-term function and survival of kidney allograft. Organ shortage and increasing number of marginal donors remains the key problem in transplant today. The quality of donor organ is critical for graft function development and survival. The aim is to improve understanding to ischemia/reperfusion injury and its consequences, predict delayed graft function and rejection, improve organ allocation strategy and identify patients suitable for safe drug minimization or complete withdrawal of immunosuppressive therapy. Analysis of donor kidneys identified poor tubular cell quality and low survival factor, Netrin-1 expression levels, to be associated with delayed graft function. We confirmed that reperfusion phase of ischemia/reperfusion injury leads to minimal morphological but significant molecular abnormalities. Dissociation observed in histology and molecular pathology finding calls for an integrated approach in donor quality organ evaluation and allocation for transplantation. Significant heterogeneity within donors with expanded criteria was shown and subgroup of organs at low risk of delayed graft function was identified. We suggested donor biopsies to be performed as a routine praxis in all kidneys...
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Opatrný, Václav. "Možnosti zlepšení vlastnostní ledvinných štěpů od nebijících dárců pomocí ihned zahájené mechanické pulzatilní perfuze." Doctoral thesis, 2018. http://www.nusl.cz/ntk/nusl-450442.
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Immediately started pulsatile machine perfusion of a kidney graft from a DCD (donor after cardiac death) as a way to improve its properties Opatrný V. Department of Surgery, University Hospital in Pilsen and Faculty of Medicine in Pilsen, Charles University in Prague Introduction: The number of kidneys available for transplantation still does not match the number of patients on the waiting list, which gets longer every year. At the same time, kidney transplantation is the only chance for the long-term survival of patients with good quality of life. Therefore, organs from marginal donors, including donors after cardiac death (DCD), have recently been used. The most common cause of death of these donors is severe trauma, especially craniocerebral trauma, or sudden cardiac arrest, followed by unsuccessful resuscitation. Kidneys can be harvested once an individual is declared dead according to the exact criteria. This involves initial washing of the grafts in the donor's body using a perfusion solution, followed by their removal and storage using selected preservation method. Mechanical pulsatile perfusion using special instrumentation is the most frequently used technique in the area of DCD. Despite of good long-term outcomes of grafts from DCDs, this group is burdened by a greater number of delayed graft...
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Marada, Tomáš. "Ovlivnění funkce ischemicky poškozených orgánů použitím perfluorocarbonu (PFC) jako konzervačního roztoku při experimentální transplantaci pankreatu, ledviny a Langerhansových ostrůvků." Doctoral thesis, 2013. http://www.nusl.cz/ntk/nusl-322185.
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(English) Perfluorocarbons (PFC) are hydrocarbons in which some or all of the hydrogen atoms are replaced with fluorine. PFC have a very high capacity for dissolving oxygen. They are chemically and biologically inert. The most successful clinical application of PFC is the "two-layer method" for pancreas preservation before islet isolation. The two-layer organ preservation method (TLM) is based on oxygenated perfluorocarbon overlaid with University of Wisconsin (UW) solution. In experiment it has been successfully used for heart and intestine transplantation. We tested whether this technique would prevent tissue damage and improve results of kidney, pancreas and islets of Langerhans transplantation with prolonged ischemia time in an experimental model of syngenic rats. In kidney and islets of Langerhanse transplantation model we used TLM preservation method. In pancreas transplantation model we used perfluorohexyloctane (PFH) as a new generation of less lipophilic PFC. 1. Kidneys were stored for 24 hours either in UW solution (n = 16), with TLM (n = 16) or transplanted immediately (control group, n = 12). In half of the animals, survival was observed and in the other animals grafts were procured for semiquantitative histological scoring and TUNEL apoptosis assessment 24 h after transplantation....
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Rousová, Martina. "Vliv pohybové aktivity Nordic Walking na tělesné složení a na kardiorespirační parametry u jedinců po transplantaci ledviny a u dialyzovaného jedince." Master's thesis, 2013. http://www.nusl.cz/ntk/nusl-341880.
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Title: Effect of physical activity Nordic Walking on body composition and cardiorespiratory parameters in individuals after kidney transplantation and dialysis individual. Objective: The aim of the study was to determine the effect of physical activity Nordic Walking on body composition and cardiorespiratory parameters in individuals after kidney transplantation and dialysis individual. Method: This thesis has been prepared in the form of a qualitative case study. The study involved 9 probands at the beginning, but only 5 probands completed the study. It was done the input examination before the intervention. The intervention was made from 20 lessons of Nordic Walking which should take 60 minutes each of them. Then were probands tested again like the output examination. During these both examination were measured specific values of body composition, anthropometric values (height, weight, age, circuit level), as well as the distribution of muscle and fat mass in the body, the value of physical fitness, respectively. cardiorespiratory parameters of the individual, for which was used the spiroergometric test within a modified Balke's walking test. For to detect the quality of life was used before and after intervention standardized questionnaire assessing quality of life WHOQOL-BREF. Last but not...
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Pavlova, Yelena. "Genetické a molekulární faktory ovlivňující výsledky transplantací solidních orgánů." Doctoral thesis, 2014. http://www.nusl.cz/ntk/nusl-326158.
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Since its beginning, graft rejection remains the key problem of solid organ transplantation. This reaction of the recipient's immune system against mismatched antigens of the transplanted organ causes graft damage and consequently loss of its function. Rejection involves cellular (lymphocyte mediated) and humoral (antibody mediated) mechanisms. Among the genetic factors which may have a prognostic value in rejection risk evaluation are the Human Leukocyte Antigens (HLA) genotype, the Killer Immunoglobuline-like Receptor (KIR) gene repertoir, cytokine and other gene polymorphisms. These factors could be screened for before transplantation to find the best possible combination of genetic characteristics of the donor and recipient and to reveal patients with "risky" genotypes, who may need more intensive immunosuppression and more careful post-transplant follow-up. Molecular factors, such as HLA and non-HLA antibodies, soluble CD30 molecule (sCD30), Hepatocyte Growth Factor (HGF) and other cytokines, measured before and/or after transplantation in the recipient's blood may be helpful for rejection risk estimation and may also be used as post-transplant rejection onset markers. In our study, we focused on some of the above mentioned factors. We found that ethnicity plays a significant role in the...
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Brožová, Jitka. "Role B buněk v transplantačních reakcích." Master's thesis, 2014. http://www.nusl.cz/ntk/nusl-337615.
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Kidney transplantation is the best treatment for patients with end-stage renal failure. The main problem of kidney transplantation is however the development of a cellular and antibody-mediated (humoral) rejection. During the last decade, thanks to the advanced immunosuppression, prognosis of survival and function of transplanted organs has significantly improved. Nevertheless, humoral rejection remains very serious obstacle in high-risk patients, because it can permanently damage the graft. Therefore, before transplantation it is necessary to stratify patients into high and low risk groups for development of antibody-mediated rejection. Current immunogenetic tests performed before transplantation include, in addition to HLA typing, detection of panel-reactive antibodies. However, this test does not provide information about B cells which participate in the humoral response of the kidney recipient. Therefore, in the presented thesis we studied B cell reactivity and its regulation in transplanted patients. In this retrospective analysis we measured levels of the B cell activating factor, a cytokine regulating the function of B lymphocytes (BAFF). Current reports suggest that BAFF could serve as a marker of humoral rejection. Furthermore, we focused on B lymphocytes and their capacity to produce...
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Thieme, Filip. "Chirurgické modely studia proinflamačního vlivu tukové tkáně v rozvoji aterosklerózy." Doctoral thesis, 2021. http://www.nusl.cz/ntk/nusl-446812.
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Univerzita Karlova v Praze 1. lékařská fakulta Doktorský studijní program Studijní obor: Experimentální chirurgie MUDr. Filip Thieme Název závěrečné práce Chirurgické modely studia proinflamačního vlivu tukové tkáně v rozvoji aterosklerózy Title Surgical models of the study of the pro-inflammatory effect of adipose tissue in the development of atherosclerosis Typ závěrečné práce Disertační Školitel: doc. MUDr. Jiří Froněk, Ph.D., FRSC Konzultant doc. MUDr. Libor Janoušek, Ph.D. Klinika transplantační chirurgie, IKEM Praha, 2021 Abstract Background: Atherosclerosis is a serious inflammatory systemic disease. Surgery mainly addresses its vascular complications. Conversely, surgery may also lead to the development and acceleration of atherosclerosis, e.g., in a living kidney donor. This would especially be the case in a donor who meets internationally recognized donation criteria but suffers from metabolic syndrome. The effort to refine assessments of living kidney donors in terms of eliminating the risk of developing atherosclerosis is a long-term project. Our aim is to determine risk factors for living kidney donors and to prevent long-term complications after donation. Collecting tissue from a living donor involves not oly subcutaneous tissue (SCAT) but also visceral (VAT) and perivascular tissue (PVAT),...