Registry data analysis shows stabilization of indicators of donor and transplant activity in 2011 after continuous growth within five years, increase in a share of effective donors after brain death and multi-organ explantation, development of thoracic organs transplantation and living related donor kidney transplantation.
In the conditions of decentralization of organ donation and transplant programs it is necessary to develop coope- ration between transplant centers and to expand the practice of an interregional exchange of donor organs.

The federal law «About bases of health protection of citizens in the Russian Federation», accepted in 2011, creates a legal basis for development and acceptance of the new legislation in the sphere of organ donation and transplantation. 

We studied the long-term results of 532 deceased donor kidney transplantations to investigate the impact of HLA match on the survival of renal allograft. All transplants were performed in our center in 1996–2009 and moni- tored prospectively for 1–14 years. We found, the survival of 58 kidneys grafted with 0–2 mismatch for HLA- ABDR to be significantly better (Plogrank = 0,016) than the survival of the kidneys grafted with 3–6 HLA-ABDR mismatch. The full compatibility for HLA-A (n = 75) did not influence the long-term survival (Plogrank = 0,48). The absence of HLA-DR mismatch had a beneficial effect for survival of 68 kidneys (Plogrank = 0,07). Eighteen cases with the full HLA-B compatibility between graft and recipient demonstrated excellent long-term survival (Plogrank = 0,007). HLA-B compatibility influenced significantly (P = 0,042) the survival of transplanted kidney in the Cox regression model adjusted for donor and recipient age, panel-reactive antibody level, re-transplant, and immunosuppression protocol. The data obtained support the conclusion, that HLA compatibility should be one of the criteria of deceased donor kidney allocation. 

We studied 11 cases of HBV-infection de novo in patients after orthotopic liver transplantation performed because of non-viral cirrhosis. Serum НBeAg, was revedled in all patients. In most cases clinical course of HBV-infection was benign. Treatment with entecavir was more effective than lamivudin, and brought to НBsAg elimination in 4 patients. Treatment with lamivudin led to descrease viral load in all patients and HBsAg elimination in one case. 

End stage liver disease is often associated with growth retardation in children with congenital and hereditary diseases of hepatobiliary system. The aim was to investigate the serum growth hormone level before and after liver transplantation in 52 children with congenital and hereditary diseases of hepatobiliary system. Data of our research work revealed increased serum level of growth hormone in children with liver cirrhosis (3,32 ± 7,7 ng/ml vs. 1,16 ± 1,46 ng/ml in healthy children, p = 0,01), which correlates with PELD score (r = 0,62, p < 0,001). In a month after liver transplantation growth hormone concentration decreases (p < 0,001) and in a year after transplantation it doesn’t differ from healthy children. There wasn’t revealed any interaction between serum growth hormone level and anthropometric parameters before liver transplantation, but in a year after there was significant correlation between growth hormone concentration and height (r = 0,79, p = 0,01). Investigation of growth hormone level in children with liver cirrhosis and its evolution after liver transplantation is of interest as objective criterion of recovery of physical development regulation and as an additional parameter, which cor- relates with severity of end-stage liver disease. 

Cytomegalovirus infection may be associated with the development of acute cellular rejection – the most fre- quent and serious complication after heart transplantation, limiting long-term survival of recipients. Biomarkers of inflammation and thrombosis, one of which is the product of platelet activation – a soluble CD40 ligand (sCD40L), also play an important role in the immunopathology of acute rejection.

The aim of the study was to assess the risk of cardiovascular complications after heart transplantation under the combined effect of two factors – sCD40L and cytomegalovirus infection. We examined 64 heart recipients in the period of 12 years after heart transplantation. It was revealed that with the presence of elevated levels of sCD40L in combination with cytomegalovirus infection, risk of acute cellular rejection is higher. In recipients with low levels of sCD40L and without cytomegalovirus infection survival rate is significantly higher than in recipients with the presence of one or both of the studied risk factors. 

The article presents the 2-year results of prospective study, which included 67 heart transplantations for end-stage heart failure, performed in Krasnodar, in Clinical regional hospital No 1. Survival rate was 89,1% (59 patients). Causes of death were septic complications, thromboembolia of the pulmonary artery, severe pancreatonecrosis, and transplant rejection due to non-compliance with immunosuppression therapy, heart rhythm disturbances. The most common complications were pneumonia (19%), heart graft rejection (10%), steroid-induced diabe- tes (10%). In a year after heart transplantation chronic heart failure, II stage, was diagnosed in 29 patients (43%), I stage – in 30 (44%) patients. Monitoring and therapy are carried out by cardiologists domiciliary and by spe- cialists of polyclinic of Krasnodar clinical hospital. Orthotopic heart transplantation is an effective treatment for end – stage heart failure. It is possible to provide surgical treatment and further management of patients in multisectoral regional medical hospital. 

We modified the method of retroperitoneoscopic live donor nephrectomy and evaluated results of first 10 pro- cedures. We performed four left- and six right-sided donor nephrectomy. There were no conversions to open or hand-assisted surgery. All organs have been successfully transplanted. Retroperitoneoscopic live donor nephrec- tomy is safe and feasible. The method has three main advantages over conventional laparoscopic nephrectomy: the absence of contact with bowel, spleen, liver and other intra-abdominal structures, more comfortable access to the renal artery, absence of intraperitoneal pressure elevation. 

The study is devoted to analysis of microflora spectrum in various biological materials in patients after renal transplantation. The character of the flora is strongly dependent on the infectious process localization. Gram- positive and gram-negative bacteria are found in approximately equal proportions with a slight predominance of gram-positive flora. Isolated bacteria in most cases had pronounced polyvalent antibiotic resistance. The performed analysis substantiated recommendations for rational antibiotic therapy of various bacterial infections. 

The decision to install cardiac resynchronization device in patients may be associated not with the apparent clini- cal effectiveness, but for other reasons that require medical consultation. This may be due to the need to create a «bridge» to heart transplantation (HT), for example. In order to predict the outcome of CRT, we observed 54 pa- tients with HF, III–IV functional class NYHA, on the waiting list for HT. Cardiomyopathy was diagnosed in 36 patients, various forms of ischemic heart disease was diagnosed in 17 patients, all with the ECG determined left bundle branch block with QRS complex duration of less than 120 ms. All patients performed gated SPECT before and after CRT with standard methods of research. LVEF at baseline did not exceed 35%. Monitoring was continued for 2 years after the start of the CRT. The results were divided into two groups. Group 1 consisted of patients who need HT for 2 years, in spite of the CRT (11 patients). Group 2 consisted of patients who have an increase in LVEF of at least 10% after CRT (28 patients). When comparing the initial and final performance with the help of the Main- Whitney in both groups, most significant differences were found in the assessment of myocardial perfusion relation- ships lateral walls of LV and RV. The decrease in the ratio between the level of perfusion of the lateral walls of LV and RV < 2,0 reduces the effectiveness of CRT, and within two years, there occured a need for a heart transplant. 

Biliary atresia is an inflammatory fibrosing process, which invades both extrahepatic and intrahepatic bile ducts. There are two forms of biliary atresia: embryonic form, associated with another visceral malformations, and perinatal form, which is an isolated disease. Biliary atresia is a heterogeinc disease which may appear as a result of different etiological factors, the most important of them are genetics, viral infection, vascular factors, toxins and disregulation of immune system. The characteristic morphological features of biliaryatresia are: intracellular and ductular cholestasis, ductular proliferation, giant cell transformation, portal and perilobular oedema and/or fibrosis. As the patalogical process progresses, ductopenia appears, and fibrosis turns to cirrhosis. Embryonic form mophologically manifests with ductal plate malformation is, what is an important diagnostic criterion. Pro- gnosis of biliary atresia depends on form of disease, age of patient and type of surgical operation. Today surgical treatment includes two steps: palliative portoenterostomia, performed in neonatal period and further liver trans- plantation. However liver transplantation is more preferable as first and single-step treatment. 

The article presents analysis of scientific literature of the last 20 years about medicamental immunosupression in early age pediatric liver recipients in view of immune response characteristics and immunosuppressive drugs pharmacokinetics in such patients. The modern concept of immunosuppressive therapy protocol choice in pedia- tric liver recipients depending on complications development (nephrotoxicity, arterial hypertension and neuroto- xicity, the high risk of infectious complications, post-transplant proliferative disorders, metabolic and cosmetic side effects) is presented. Different opportunities of early steroid withdrawal, calcineurin inhibitor minimization in pediatric liver allograft recipients are covered. 

The review presents data on the role of biofilms formation by opportunistic microbes in surgery. It gives in- formation about the microbial structure of biofilms, their architecture and physiology. The attention was payed to significal importance of microbial communities, which form biofilms in surgery. Mechanisms of increased resistance of biofilms bacteria are compared with plankton. The review includes literature data on the process of formation biofilms on intravascular catheters and methods of inhibition and protection. Methods of studing formation and inhibition of biofilms in vitro and in vivo are presented. Different biotechnology methods, based on using antiadhesive, antiseptic, biophysical resources and biomaterials are discussed.