Objective: to assess the current status and development trends in organ donation and transplantation in the Russian Federation based on data from 2025.

Materials and methods. A survey was conducted among directors at transplant centers. Data were verified using the information accounting system of the Russian Ministry of Health. Comparative analyses were performed to assess trends over time, regional differences across Russia, and variations among transplant centers.

Results. According to the National Registry, 55 kidney, 40 liver, and 28 heart transplant programs were operating in Russia in 2025. The donor activity rate was 7.9 per million population (p.m.p.). Multi-organ procurement accounted for 82.9% of all procurements, with an average of 3.0 organs retrieved per effective donor. A total of 3,869 organ transplants were performed in 2025, including 2,190 kidney, 1,082 liver, and 522 heart transplants. This represents a 16.9% increase in the number of organ transplants compared to 2024. In Moscow, donor activity reached 34.4 p.m.p. Fourteen transplant centers in Moscow and Moscow Oblast collectively performed 50.6% of all kidney transplants and 63.3% of all extrarenal organ transplants nationwide. The number of people living with transplanted organs in Russia exceeded 169.4 p.m.p.

Conclusion. The network of transplant centers in Russia continues to expand, with eight new transplant programs launched in 2025. Over the past year, both the number of effective donors and the number of organ transplants increased. The resource potential of healthcare institutions has not yet been fully utilized, providing opportunities for further growth in transplant activity. Moscow remains the driving force of transplant medicine in Russia. The Shumakov National Medical Research Center of Transplantology and Artificial Organs (Shumakov Center) and its branch accounted for 26.2% of all organ transplants performed in the country. In 2025, new types of transplantation were introduced, including pancreatic islet transplant at the Shumakov Center and transplantation of the distal third of the upper limb, including the hand, at both the Shumakov Center and the Sklifosovsky Research Institute of Emergency Care. Advances were also made in the development of perfusion technologies for the rehabilitation of organs from suboptimal donors and in the use of long-term mechanical circulatory support systems as a bridge to heart transplant in children. Notable regional transplant programs include those in Ryazan Oblast, the Republic of Tatarstan, Kemerovo Oblast (Kuzbass), Novosibirsk Oblast, St. Petersburg and Leningrad Oblast, Volgograd Oblast, Arkhangelsk Oblast, Tyumen Oblast, and Krasnoyarsk Krai. The Russian Federation continues to prioritize the provision of pediatric transplant care.

Prognostic models have become an integral part of clinical practice in liver transplantation (LT), supporting decision-making throughout the patient’s clinical pathway – from assessment of the severity of underlying disease to postoperative monitoring of graft function. This review aims to systematize the principles of development, validation, and quality assessment of clinical prognostic models, with a particular focus on the scales used in LT. The review is based on an analysis of key publications on the methodology of prognostic modeling, international quality assessment standards (PROGRESS, TRIPOD+AI, and CHARMS), as well as original studies describing prognostic scoring systems in hepatology and transplant medicine. The main statistical approaches, including logistic regression, Cox proportional hazards regression, and machine learning algorithms, are discussed. A multilevel framework of prognostic models used in LT is presented, including preoperative tools for assessing recipient disease severity (CTP, MELD, MELD 3.0, and PELD), donor-related risk (DRI and BAR score), and postoperative criteria (EAD, SOFT, L-GrAFT, MEAF, and EASE). Of the entire array of scales, only three are applicable to pediatric practice: PELD, Pedi-SOFT, and ASPELT. The shortage of specialized pediatric prognostic tools persists and underscores the need for targeted multicenter studies.

Objective: to analyze the organizational strategies and clinical outcomes of the Organ Transplant Department at Botkin Hospital following the milestone of 1,000 solid organ transplants.

Materials and methods. A retrospective analysis of the center’s transplant activities was conducted for the period 2018–2025, covering kidney, liver, and heart transplants. Donor and recipient characteristics, perioperative variables, and short- and long-term clinical outcomes were examined. Particular attention was given to the development of an integrated patient care pathway and organizational solutions that ensured continuity of specialized care at every stage, from candidate selection and pretransplant preparation to transplantation, postoperative management, and long-term follow-up. Advanced technologies were implemented to expand the donor pool, optimize perioperative management, and reduce the incidence of transplant-related complications.

Results. Over a 7-year period, more than 1,000 solid organ trans-plants were performed. Despite a steady increase in transplant volume, excellent short- and long-term clinical outcomes were consistently maintained. The majority of grafts were procured from deceased donors, including a substantial proportion from expanded-criteria donors. Most recipients presented with severe comorbidities. The implementation of a comprehensive multidisciplinary care model, integrating specialists from diverse medical disciplines within a single transplant department, ensured continuity of patient care. The adoption of modern techniques enhanced the efficiency of the transplant program, reduced the risk of graft dysfunction, and minimized the incidence of both transplant-specific and general postoperative complications.

Conclusion. The transplant program at Botkin Hospital represents a comprehensive model that integrates clinical activities, scientific research, and the training of young transplant specialists. Seven years of experience have demonstrated the effectiveness and sustainability of the developed strategies, the sustainability of achieved results, and their significant practical value for the continued advancement of transplant services within the national healthcare system.

We report two clinical cases of the humoral variant of graft-versus-host reaction – passenger lymphocyte syndrome – in recipients who underwent split liver transplant (LT) from a donor with minor AB0 incompatibility. Clinical and laboratory manifestations developed one week after transplantation. Following laboratory confirmation, both patients were successfully treated with intensified immunosuppressive therapy and multiple sessions of plasmapheresis, resulting in clinical stabilization, laboratory improvement, and elimination of anti-AB antibodies. The report describes the clinical features of the early and late postoperative periods and includes a review of the current literature.

Objective: to evaluate the outcomes of kidney transplants performed at Chelyabinsk Regional Clinical Hospital between 2015 and 2025.

Materials and methods. A retrospective analysis was conducted of 148 medical records of patients who underwent a kidney transplant (KT). The parameters assessed were recipient age and sex, duration of hemodialysis prior to transplantation, underlying cause of end-stage chronic kidney disease, duration of surgery and hospitalization, cold ischemia time, graft function, occurrence of acute rejection, surgical complications, graft survival, and patient survival.

Results. Delayed graft function occurred in 27.7% of recipients. The incidence of surgical complications was 16.2%, while immunological complications were observed in 10.1% of patients. Thirty-day graft and patient survival rates were 95.9% and 97.3%, respectively.

Conclusion. KT outcomes at our center, including the rates of surgical and immunological complications as well as in-hospital graft and patient survival, are consistent with those reported by leading transplant centers.

Kidney transplant (KT) is currently the optimal modality of renal replacement therapy. A well-functioning kidney graft can fully replace native renal function, resulting in substantial improvements in quality of life and life expectancy compared with dialysis-based therapies. However, the need for long-term immunosuppression remains a major limitation of transplantation, as it significantly increases the risk of infectious complications and malignancies, which often present with atypical clinical manifestations. Among post-transplant malignancies, Kaposi sarcoma is the most common in KT recipients. We report a clinical case of isolated visceral Kaposi sarcoma with multiple localizations. Establishing the diagnosis was particularly challenging because of the absence of characteristic cutaneous manifestations. Nevertheless, awareness of a previously reported case with a similar clinical presentation, the availability of advanced diagnostic modalities, and the timely involvement of multidisciplinary physicians enabled prompt diagnosis and appropriate treatment. Complete remission of Kaposi sarcoma was achieved, while kidney graft function remained stable throughout chemotherapy and conversion of the immunosuppressive regimen, with no evidence of allograft rejection.

2,8-Dihydroxyadeninuria (DHA) and dihydroxyadenine nephropathy are rare autosomal recessive disorders caused by mutations in the adenine phosphoribosyltransferase (APRT) gene, resulting in complete deficiency of APRT enzyme activity. The disease is characterized by crystal-induced nephropathy affecting both native and transplanted kidneys.

Objective: to increase awareness among physicians about this rare physician awareness of dihydroxyadenine nephropathy, a rare disorder, given that relapse and crystal deposition in kidney allografts are often more aggressive than in native kidneys.

Materials and methods. We present a clinical case of recurrent dihydroxyadenine nephropathy in a 46-year-old kidney transplant recipient with an APRT gene mutation and progressive allograft dysfunction, ultimately leading to rapid deterioration of graft function. The diagnosis was established by identifying dihydroxyadenine crystals in allograft biopsy specimens and was subsequently confirmed by molecular genetic testing.

Conclusion. Early diagnosis and timely initiation of medical therapy prior to kidney transplantation are essential for minimizing the risk of disease recurrence in the kidney allograft. Treatment with xanthine oxidase inhibitors at adequate doses should be initiated several weeks or even months before transplantation to preserve graft function in patients with APRT gene mutations.

Background. The available literature contains relatively few studies investigating the role of anti-human leukocyte antigen (anti-HLA) antibodies – including pre-existing antibodies, de novo synthesized antibodies, and donor-specific antibodies (DSAs) – in the prevention, diagnosis, and treatment of acute kidney transplant (KT) rejection.

Materials and methods. We evaluated the prevalence and specificity of pre-existing anti-HLA antibodies, the incidence and specificity of de novo anti-HLA antibody synthesis (including DSAs), and their impact on treatment outcomes at a major national transplant center. A total of 1,663 KTs performed over an 8-year period (2016–2024) were analyzed. The study cohort comprised 962 men (57.8%) and 701 women (42.2%), with a median age of 46 years (interquartile range: 37–55 years). Prior to transplantation, 90.3% of recipients received dialysis-based renal replacement therapy, while 161 patients underwent pre-emptive KT.

Results. The presence of pre-existing anti-HLA antibodies was significantly associated with a higher incidence of acute rejection episodes (p < 0.001), increased need for treatment with polyclonal antibodies (p < 0.001), a greater frequency of nonfunctioning kidney grafts (p < 0.001), and higher in-hospital mortality rates (p < 0.001). Similarly, the de novo synthesis of anti-HLA antibodies was significantly associated with an increased incidence of acute rejection (p = 0.004), a greater need for plasmapheresis as part of rejection management (p < 0.001), and a lower likelihood of a functioning kidney graft at the time of hospital discharge (p = 0.037).

Conclusion. Despite the high efficacy of modern immunosuppressive regimens, acute rejection remains a major factor compromising kidney graft survival. Assessing the impact of anti-HLA antibodies on KT outcomes therefore remains a pressing issue in modern KT.

Objective: to evaluate the diagnostic value of preoperative multislice computed tomography (MSCT) angiography in planning arterial reconstruction strategies for multi-vessel renal transplants, and to assess the relationship between the selected surgical technique, intraoperative parameters, and clinical outcomes of kidney transplantation.

Materials and methods. A single-center observational study was conducted, including 120 kidney transplants from deceased donors. Of these, 78 grafts (65.0%) had multivessel arterial anatomy, while 42 grafts (35.0%) with single-artery and single-vein anatomy served as the control group. Preoperative planning was based on donor MSCT angiography, with assessment of the number of renal arteries, interostial distance, vessel diameter, presence of an inferior polar artery (IPA), and the feasibility of creating a single arterial ostium. In the multi-vessel group, arterial reconstruction techniques included Carrel patch reconstruction, pantaloon (fish-mouth) reconstruction, and separate arterial anastomoses. Evaluated parameters included the duration of extracorporeal arterial reconstruction, warm and cold ischemia times, incidence of delayed renal graft function (DGF), vascular and urological complications, and estimated glomerular filtration rate (eGFR) at 12 months post-transplant. The reproducibility of morphometric measurements derived from angiographic data was assessed using the intraclass correlation coefficient (ICC) and the Bland–Altman analysis.

Results. In the multi-vessel group, arterial reconstruction was performed using the pantaloon (fish-mouth) technique in 28 cases, Carrel patch reconstruction in 26 cases, and separate arterial anastomoses in 24 cases. The choice of reconstruction strategy was determined by arterial orifice configuration, the ratio of vessel diameters, the presence of a common aortic patch, and the presence of a clinically significant IPA. Warm ischemia time was significantly longer in the multi-vessel graft group compared with the control group and also differed among reconstruction techniques. The shortest warm ischemia time was observed with the pantaloon reconstruction, whereas the longest was recorded in cases with separate anastomoses. The incidence of DGF, as well as vascular and urological complications, did not differ significantly between the reconstruction options. In the subgroup with a clinically significant IPA, preservation of this vessel was associated with a lower rate of urological complications; however, this difference did not reach statistical significance. The reproducibility of morphometric measurements based on angiographic data was high, with an ICC of 0.92. Bland–Altman analysis demonstrated a mean bias of –0.14 mm, with limits of agreement ranging from –2.36 to 2.09 mm.

Conclusion. Preoperative MSCT angiography enables objective assessment of the vascular anatomy of a renal graft and supports the use of standardized morphometric criteria in selecting an appropriate arterial reconstruction strategy. Differences between reconstruction techniques are primarily reflected in warm ischemia time and duration of arterial reconstruction. However, when an appropriate technique is selected and fundamental principles of vascular surgery are adhered to, these variations do not adversely affect early clinical outcomes.

Pancreas retransplantation is a technically complex surgical intervention. This article presents a case report of pancreaticoduodenal complex retransplantation in a female patient who lost her primary pancreas graft in the early postoperative period. This clinical case demonstrates that a personalized surgical approach, combined with a rational and appropriately tailored immunosuppressive regimen, can support successful graft function after retransplantation.

Objective: to compare the diagnostic efficacy of traditional radiological methods and volumetric computed to mography (CT) perfusion for assessing split renal function (SRF) in living kidney donors, and to justify the use of an integrated «one-stop-shop» or «single diagnostic window» protocol.

Materials and methods. A systematic review of publications indexed in PubMed, Scopus, Web of Science, and eLIBRARY databases was conducted to evaluate methods for assessing SRF, including radionuclide nephroscintigraphy, CT, and perfusion imaging techniques. Data on diagnostic accuracy, reproducibility, radiation exposure, and clinical applicability were analyzed.

Results. Radionuclide methods demonstrate high physiological validity; however, they are limited by low spatial resolution and susceptibility to geometric errors. Volumetric CT shows a strong correlation with SRF (r ≈ 0.95). Volumetric CT perfusion enables quantitative assessment of renal perfusion and filtration using kinetic models (including Patlak analysis) and facilitates the simultaneous acquisition of anatomical and functional data within a single study. Discrepancies compared with radionuclide methods generally do not exceed ±10%.

Conclusion. The integration of volumetric CT perfusion into the examination protocol for living kidney donors improves the accuracy of SRF assessment, reduces logistical burden, and supports implementation of the «one-stop-shop» concept as a promising standard for preoperative evaluation.

The use of hearts from expanded-criteria donors (ECDs) is one of the most effective strategies for increasing the number of heart transplants (HTs). At Shumakov National Medical Research Center of Transplantology and Artificial Organs (Shumakov Center), the implementation of an ECD program has enabled more rational utilization of standard-criteria donor hearts while contributing to improved early and long-term survival rates.

Objective: to evaluate the early and long-term outcomes of HT using hearts from different categories of ECDs and combinations thereof.

Materials and methods. An analysis of 1,500 HTs was performed, including 1,459 primary HTs (97.3%) and 41 retransplantations (2.7%), carried out at Shumakov Center between January 1, 2011, and December 31, 2021. The study population (n = 1,500) was divided into two groups: the study group, comprising recipients who underwent orthotopic heart transplantation (OHT) using hearts from ECDs (n = 1,060; 70.6%), and the control group, comprising recipients who underwent OHT using hearts from standard-criteria donors (SCDs) (n = 440; 29.4%).

Results. Between 2011 and 2021, the annual number and proportion of HTs using ECD hearts at Shumakov Center increased 1.8-fold, from 46.0% (n = 17) in 2011 to 84.8% (n = 106) in 2016. Overall, in-hospital mortality did not differ significantly between the study groups (p = 0.976). However, long-term mortality was significantly higher among recipients of ECD hearts (p < 0.005). To further investigate this finding, long-term mortality was analyzed according to the number of donor risk factors. No significant difference was observed in the subgroup of donors with a single risk factor (n = 324; p = 0.351). In contrast, in the largest subgroup, comprising donors with two risk factors (n = 428), long-term mortality was significantly higher following transplantation using ECD hearts (p = 0.004). Analysis of the impact of different combinations of expanded donor criteria on long-term survival showed significantly poorer outcomes following HT from donors with the combinations of «age and hypertrophy» (p = 0.025) and «age and donor–recipient weight mismatch» (p = 0.025).

Conclusion. The findings of this study demonstrate that hearts from selected categories of ECDs can be used effectively, thereby increasing the availability of HT.

Objective: to investigate the frequency and pattern of stress-induced cardiac arrhythmias (CA) in patients in the late period after orthotopic heart transplantation (OHT) and to assess their impact on quality of life (QoL).

Materials and methods. Fifty-two patients who underwent OHT using the bicaval technique were examined. The median age was 46 (38–52) years. The post-transplant period was 1.2 (1.0–1.5) years. All patients under went a cardiopulmonary exercise test (CPET) with continuous electrocardiographic monitoring to detect CA. QoL was assessed using the SF-36 questionnaire. Univariate linear regression analysis was used to evaluate the association between CA during CPET and QoL domains in the late post-transplant period.

Results. During CPET, stress-induced arrhythmias in the form of premature ventricular contractions (PVCs) were detected in 28% of patients. Among these, 60% had isolated PVCs and 40% had paired PVCs. No spontaneous arrhythmias were recorded at rest in these patients. Univariate linear regression analysis demonstrated that the occurrence of stressinduced PVCs during CPET in the late post-OHT period negatively impacts physical functioning, as assessed by the SF-36 questionnaire.

Conclusion. Patients who have undergone a heart transplant are at a potential risk of developing stress-induced CA. In the late post-OHT period, PVCs were detected during CPET in 28% of patients despite the absence of arrhythmias at rest. The occurrence of PVCs during stress testing is associated with reduced physical functioning as assessed by the SF-36 questionnaire.

A centrifugal pump for an extracorporeal membrane oxygenation (ECMO) system is being modernized for use in devices based on the RotaFlow pump drive (Maquet, Germany). Previous research resulted in the development of an original rotor impeller for the RotaFlow pump. The aim of the present study is to optimize the rotor design, straightening vanes, and flow path elements to increase pressure generation and improve the pump’s head-capacity curve (H-Q curve) within a rotational speed range of up to 5000 rpm. These design modifications are intended to shift the pump operating point closer to the hemodynamic requirements of ECMO systems. The optimized design demonstrated improved flow stability and reduced mechanical stress on the blood.

This paper analyzes current evidence on the molecular and cellular mechanisms underlying skin wound healing. The key stages of the wound healing process are examined, including inflammation, proliferation, angiogenesis, and extracellular matrix remodeling, together with the genes regulating these processes. Particular attention is given to the phase-specific patterns of gene expression and their role in coordinating intercellular interactions. The major experimental models used to study wound healing are discussed, including in vitro, in vivo, and microfluidic systems, as well as methods for assessing tissue regeneration at the macroscopic, histological, and molecular levels. The findings demonstrate that the integrated use of these approaches enables a more comprehensive characterization of the dynamics of reparative processes and improves the reproducibility of experimental results. The evidence obtained highlights the critical role of molecular and genetic mechanisms in regulating wound healing and underscores their potential as biomarkers of regenerative efficacy and as therapeutic targets for the development of novel treatment strategies.

Objective: to investigate the dynamics of vascular endothelial growth factor A (VEGF-A), fibroblast growth factor (FGF), platelet-derived growth factor-BB (PDGF-BB), and transforming growth factor beta-1 (TGF-β1) during cellular cardiomyoplasty (CCM) in the treatment of coronary artery disease (CAD).

Material and methods. A retrospective analysis was conducted on medical records of 68 patients with CAD, grade 2–3 mitral regurgitation, and reduced left ventricular ejection fraction (LVEF, <30%). Patients underwent CCM using autologous bone marrow–derived mesenchymal stromal cells (auto BM-MSCs), administered transendomyocardially or intravenously at a dose of 50 million cells. Control groups included patients receiving optimal medical therapy and those receiving sham saline injections. Outcomes were assessed using echocardiography, electromechanical mapping (NOGA XP system), and the Seattle Angina Questionnaire (SAQ). Serum levels of VEGF-A, FGF, PDGF-BB, and TGF-β1 were measured by ELISA at baseline, 3 months, and 6 months post-procedure. Statistical analysis was performed using Microsoft Excel and StatTech 3.1.8 (Wilcoxon, Spearman, and other tests).

Results. Transendomyocardial administration of auto BM-MSCs resulted in significant improvement in LVEF, reduction in end-diastolic volume, and increased exercise tolerance (p < 0.01), with effects sustained up to 6 months. Intravenous administration was less effective. At 3 months, the transendomyocardial group showed a significant increase in VEGF-A (46%), FGF (142%), and PDGF-BB (83%), along with a decrease in TGF-β1 (27.5%) (p < 0.001). These changes were more pronounced and sustained at 6 months compared with other groups. Intravenous delivery produced weaker and less stable increase in growth factors.

Conclusion. The therapeutic effects of auto BM-MSCs in CAD are largely mediated by paracrine mechanisms involving activation of angiogenic growth factors (VEGF-A, FGF, PDGF-BB) and modulation of anti-inflammatory and profibrotic cytokine TGF-β1. Transendomyocardial delivery is significantly more effective and durable than intravenous administration in both biochemical and clinical outcomes. CCM may serve as a stabilizing therapeutic strategy in patients with severely reduced ejection fraction prior to definitive surgical intervention.

Objective: to evaluate the effect of the molecular weight of hydrophilic plasticizers on the surface properties and cytocompatibility of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) copolymer films.

Materials and me thods. PHBV copolymer films were prepared with the incorporation of hydrophilic plasticizers having molecular weights ranging from 1,500 to 15,000 Da. Surface hydrophilicity was assessed by contact angle measurements, while surface topography and roughness were analyzed using atomic force microscopy. Cytocompatibility was evaluated in vitro using human dermal fibroblast cultures based on cell adhesion and proliferation parameters.

Results. The molecular weight of the plasticizer significantly influenced the surface properties of the PHBV films. The most pronounced effect was observed following the incorporation of a simple polyester with a molecular weight of 8,000 Da, resulting in increased surface hydrophilicity and the formation of a more favorable microtopography. These changes were associated with enhanced adhesion and proliferation of human dermal fibroblasts.

Conclusion. Modifying PHBV films with hydrophilic plasticizers is an effective approach for selectively tuning their surface properties. The use of a simple polyester with a molecular weight of 8,000 Da appears particularly promising for the development of bioresorbable matrices intended for applications in regenerative medicine.

This study evaluated changes in free hemoglobin levels in a developed model of an axial pump designed for implantation in patients with small anthropometric parameters under pulsatile flow conditions generated by a pneumatic drive system previously developed by the authors. Experimental conditions were selected to replicate pulsatile flow regimes produced by the axial pump operating at a constant rotational speed, including steady flow conditions (2.5 L/min at 85 mmHg without pulsation) and pulsatile conditions (20 mmHg and 30 mmHg pulse pressure). In a series of experiments, increasing pulsation intensity was associated with a 3–4-fold rise in free hemoglobin levels. The normalized index of hemolysis (NIH) and modified index of hemolysis (MIH) increased throughout the 6-hour test period under both continuous and pulsatile modes; however, values remained within acceptable limits. Bench tests to determine free hemoglobin levels were conducted in accordance with the international standard ASTM F1841-19 and its 2025 update, ASTM F1841-25. Parameters were compared using the method for evaluating hemolysis indices.

The potential for chemical modification of the surface of matrices composed of various natural and synthetic polymers using cationic amphiphiles remains insufficiently studied.

Objective: to evaluate the biocompatibility and antimicrobial properties of polyurethaneand silk fibroin-based matrices modified with 1,4-diazabicyclo[2.2.2] octane (DABCO) attached to the surface via sorption mediated by hydrophobic or electrostatic interactions.

Materials and methods. Surface modification of non-woven matrices based on an 8% polyurethane solution and a 5% regenerated silk fibroin solution was performed by sorption of DABCO through hydrophobic interactions (variant 0) or electrostatic interactions (variants 1 and 2). The minimum inhibitory concentration (MIC) of the cationic amphiphile was determined using serial dilution in 96-well plates against Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Salmonella enterica ATCC 14028, Citrobacter freundii ATCC 8090, and Pseudomonas aeruginosa ATCC 9027. The amount of DABCO adsorbed on scaffold surfaces was determined by ultraviolet spectroscopy based on its residual concentration in the initial solutions. Surface structure, physicomechanical properties, antimicrobial activity, and biocompatibility of the scaffolds were assessed before and after modification. The obtained data were processed using GraphPad Prism 8.

Results. The MIC of DABCO ranged from 2 to 8 μM. Modification variant 0 preserved scaffold surface structure and physicomechanical properties. Variants 1 and 2 improved scaffold surface hemocompatibility but made the scaffolds rigid and brittle. All modification variants demonstrated comparable antibacterial activity and biocompatibility.

Conclusion. Surface modification of polyurethane and silk fibroin scaffolds with the cationic amphiphile DABCO via sorption mediated by hydrophobic or electrostatic interactions is suitable for imparting antibacterial properties to scaffolds.

Personalization of immunosuppressive therapy based on the recipient’s genetic profile remains a major challenge in transplant medicine, with important implications for reducing adverse effects associated with immunosuppressive drugs. Optimization of immunosuppressive regimens is largely focused on determining the appropriate dose of the calcineurin inhibitor tacrolimus (Tac), which serves as a key component of maintenance immunosuppressive therapy. A promising approach to this challenge is the identification of novel biomarkers associated with Тac response, among which transforming growth factor-β1 (TGF-β1), a key immunoregulatory cytokine, has attracted considerable attention. It has been established that the development of post-transplant complications, such as graft rejection, graft fibrosis, infectious complications, and nephrotoxicity, is associated with TGF-β1 expression levels. TGF-β1 production in the body is regulated by multiple factors, including genetic polymorphisms in the TGFB1 gene encoding this cytokine. This review analyzes current evidence regarding the role of TGFB1 gene polymorphisms in the development of post-transplant complications and their potential impact on calcineurin inhibitor dosing to optimize immunosuppressive therapy in solid organ transplant recipients.

Objective: to present data from the annual monitoring of the current status and development trends in nephrology care in the federal subjects (also referred to as «regions») of the Russian Federation in 2025 and to compare them with nephrology care indicators for 2024.

Materials and methods. A survey of leading freelance nephrology specialists across the federal subjects of Russia was conducted using a set of key indicators of nephrology care. The collected data were analyzed.

Results. In 2025, 843 hemodialysis centers and 55 kidney transplant (KT) centers were operating in the Russian Federation. A total of 77,817 patients with stage 5 chronic kidney disease (CKD) were receiving renal replacement therapy (RRT), including 59,792 (76.8%) receiving hemodialysis, 1,919 (2.5%) receiving peritoneal dialysis, and 16,106 (20.7%) living with a functioning KT. Thus, both the number of patients on hemodialysis and the number of KT recipients continued to increase. In 2025, 2,190 KTs were performed at 55 transplant centers in 36 regions of the Russian Federation. The overall RRT coverage rate in  the Russian Federation was 532.9 patients per million population (p.m.p.), including 409.5 p.m.p. for hemodi alysis, 13.1 p.m.p. for peritoneal dialysis, and 110.3 p.m.p. for KT. Compared with 2024, the coverage rates for hemodialysis and KT increased. In 2025, 80.7% of patients receiving hemodialysis were dialyzed through an arteriovenous fistula, 14.3% through a permanent vascular catheter, and 2.8% through a vascular prosthesis. The proportion of patients receiving dialysis through a temporary central venous catheter decreased to 2.2%, compared with 3.6% in 2024. In 2025, 598 nephrology practices were operating in the Russian Federation, representing an 11.4% increase compared with 2024. The number of nephrologists providing outpatient care also increased to 731 (+5.9% compared with 2024); however, the availability of outpatient nephrologists remained low at 0.25 specialists per 50,000 people. Inpatient care for patients with predialysis stages of CKD was provided by 255 departments (–3%) with a total capacity of 5,250 beds (+4.2%). Consequently, the overall availability of nephrology beds in the Russia was 0.36 per 10,000 population, essentially unchanged from 2024. The number of kidney biopsies performed in the Russian Federation also increased. In 2025, kidney biopsies were performed in 4,417 inpatients across 80 regions, corresponding to an average of 40.4 biopsies per million population, compared with 32.8 per million in 2024.

Conclusion. According to the results of the annual monitoring program developed at Shumakov National Medical Research Center of Transplantology and Artificial Organs, nephrology care in the Russian in 2025 demonstrated positive trends in several areas, including increases in the number of nephrology practices, kidney biopsies, and dialysis centers, as well as continued development of KT services. However, significant challenges persist, including a shortage of outpatient nephrologists, the absence of registries for patients with predialysis stages of CKD in many regions, and unequal access to kidney biopsy. The number of kidney transplant recipients continued to increase; however, the number of patients receiving hemodialysis, including those of working age, also continued to rise, indicating that CKD will remain a heavy burden on the healthcare system. Priority areas for nephrology include the use of digital technologies to identify and monitor patients with CKD, further expansion of KT, increasing the number of outpatient nephrologists, improving access to kidney biopsy, and establishing patient education programs. Monitoring of nephrology care and renal replacement therapy in Russia will continue, with ongoing assessment of key indicators of medical care provided to patients at all stages of CKD and analysis of changes over time.