METHOD OF GLOBULAR BLOOD VOLUME CONTROL AND IMMUNOMODULATION ACCOMPANYING TRANSPLANTATION Russian patent published in 2012 - IPC A61M5/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely transplantology, anesthesiology, resuscitation and transfusion medicine, and is applicable for the purpose of intraoperative and early postoperative compensation of acute profuse blood loss accompanying transplantation. That is ensured by preoperative recovery of multi-organ brain-death donor organs combined with blood banking from an inferior vena cava system. It is preceded by the intravenous introduction of heparin 25000-50000 units to the donor according to body weight. An aorta is cannulated through one of iliac arteries. Two ligatures are introduced under an infrarenal inferior vena cava with a vessel notched in between. A blood sample cannula is introduced in a distal direction through a vein orifice, and exhaustion 5-10 mm Hg makes blood arriving the distal inferior vena cava into the sterile container of a continuous autotransfusion system. In a proximal direction, a silicone tube is introduced in the inferior vena cava to remove mixed blood and preserving agent. Loss of systolic blood pressure 80 mm Hg and lower requires ligaturing the aorta above an arterial trunk. Through the aortic cannula, the preserving agent custadiol for cold perfusion is introduced. Another iliac artery is ligatured. Venous blood collected in the sterile container, exposed to cell separated in a sparing mode - 3 washing cycles at erythromass rate 30-70 ml/min. It is followed by cell concentration to packed cell volume 65-75 vl % with using the apparatus Cell Saver; the prepared product is marked as 'a cell blood component of donor organs' (CBCDO). The prepared CBCDO volume within 500 to 1500 ml contains: 3,9-12,0×10¹² red blood cells or 1.7-5.4 standard red blood cell doses; 57-171×10⁹ platelets or 0.2-0.6 standard therapeutic platelet concentrate doses; 48-81×10⁶ CD34+ haematopoietic stem cells and 100-264×10⁶ CD105+ multipotent mesenchymal stromal cells. The CBCDO is shifted with a reflux pump into a blood transfusion container and introduced intravenously in the patient with using a disposable system.

EFFECT: method provides adequate globular volume control in acute profuse blood loss, combined with prevention of developing a rejection episode due to involvement in the complex infusion-transfusion therapy of a cell blood component of donor providing particularly intensified immunosuppressive action on multipotent mesenchymal stromal cells on the recipient's immune system.

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