A single center experience of first 100 liver transplantations (LTs) is summarized. Analysis of trends in cadaver donor population and waiting list status changes, and also of early and late postoperative complications are presented. 100 LTs were performed for 95 patients (pts), retransplantation – 4 pts; one patient received 3 liver transplants (female – 55 pts, male – 40 pts, mean age – 39.9 ± 12.1 years). Cumulative 1-year survival rate of pts by Kaplan–Meyer was 91%, 3-year – 83%. Biliary complications were revealed in 9% of pts during 2–9 months after LT. 77 pts have been regularly observed in outpatient clinic, mean age – 44 ± 9.2 years, male – 35, fema- le – 42, follow-up period – 1 months up to 13 years after LT. 3.9% remained invalid with limitation of ability to work, 61.8% have been working, 22.3% were capable to work, retirees were 10.5%. Development of preoperati- ve planning, adequate organ selection will allow to improve the results of LT. Study of hematopoietic stem cells role will expand tools of prognosis of posttransplant complications. 

Chronic rejection, especially cardiac allograft vasculopathy, is a major limiting factor for long-term transplant survival. This process affects not only the blood vessels, but also cardiomyocytes. However, there are extremely few reports on the evaluation of their macromolecular structure state. The aim of the study was to evaluate the structural proteins of cardiomyocytes (actin, myosin, troponin I, titin, desmin, vinculin) of heart allografts in different periods after the operation (from 6 days to 15 years). Major changes of macromolecular structure were revealed in late period after transplantation (6 months – 15 years). The contribution of humoral immune response in the process of chronic cardiac allograft rejection was observed: in eight of twelve recipients episodes of acute humoral rejection had been repeatedly registered; disorders of the expression of 5 proteins out of 6 characterized were found in recipients with recurrent and persistent antibody-mediated rejection. 

A bacteriological study of 105 patients after orthotopic liver transplantation was conducted. The frequency and etiology of infectious complications and antibacterial sensitivity were analyzed. We established that isolated or associated infectious reactions developed in 24.8% of the surveyed patients. The C. albicans fungus was found to be the agent which caused most of the early infectious complications. Late complications were induced by the multiresistant gram-negative bacteria. 

Objective: to evaluate the influence of endotoxin adsorption on graft function and mortality. Methods: we analy- zed the results of treatment of 90 patients with bacterial complications after renal transplantation and compared them with retrospective group of patients, who didn’t undergo endotoxin adsorption. Results: the use of endo- toxin adsorption led to significant improvement of graft function and intraorganic microcirculation in compa- rison with retrospective group, treated without endotoxin adsorption. Survival was higher in the intervention group. However, endotoxin adsorption did not affect patient survival when multiple organ failure developed. Conclusion: when infectious complications developed, endotoxin adsorption is able to improve the graft function and recipient survival significantly. The earliest application of this procedure is recommended. 

Blood cells involved in neovascularisation were studied with flow-cytometry in the cadaver liver transplant recipients. The signs of «turbulent» state of bone marrow reproductive activity were found and assessed as features of its progressive exhaustion. The oscillations of regenerative capacity of angiogenic progenitor cells and angiogenic lymphocytes are discussed and considered to be the essential limiting factor influencing liver transplantation results. Further study of temporal variability of personal state of hematopoiesis is required for the improvement of posttransplant therapy. 

The research plasma levels of homocysteine (Hcy) in 99 children with congenital and hereditary diseases of hepatobiliary system was performed before liver transplantation. 27% of patients had hyperhomocysteinemia. There was correlation between Hcy levels and sCD40L. High (≥5.1 μmol/L) pretransplant concentration of Hcy is one of the negative factors that affect function of the liver graft in the early post-transplant period. 

We present the study of outcomes of PCR-diagnostics directed on detection of DNA of herpes-family viruses in donor’s corneal tissues taken during penetrating keratoplasty (PK). In total, there were 46 patients, who under- went PKs. They were followed up from 14 days till 12 months. PCR-research of fragments of a donor cornea re- vealed existence of DNA in 21.7%. The retrospective analysis showed that in the presence of herpes-virus DNA in donor’s cornea is the risk factor of postoperative complications development and increases the rejection rate 2–3 times, reaching 100% – 70%. Thus the high risk of graft failures remains associated not only with the system immunosupressive therapy which is usually considered as the precondition of activization of chronic infections, but also in the absence of that. It gives the ground to conclude that preoperative preparation of a donor material, especially «fresh» corneas, should include expanded PCR-diagnostics on herpes-viruses and its obligatory dis- carding in cases of positive tests. 

Ballon angioplasty with coronary arteries stenting was performed in 56 renal allograft recipients (75 procedures). The influence of contrast media on renal graft function was investigated. Renal graft function was estimated by creatinine level 24 hour before and 48 hours after the intervention. Risk factors of contrast induced nephropathy (CIN) development at renal graft recipients are discussed. Mathematical approaches for calculation of risk of CIN development are analyzed. 

Newborn rabbit pancreatic cell monolayer was obtained as we described earlier.The cultivated epithelial cells were shown by immunofluorescence to express special ductal marker CK19 and were insulin-and glucagon- negative for 10–15 days. A few fusiforms of nestin-positive cells were found in monolayer. Over 2 weeks in serum-free medium the plaques of epithelial cells became crowded and formed 3-dimentional structures – islet- like clusters. Islet-like clusters contain some insulin- and glucagon-positive cells recognized by immunohysto- chemistry staining. Pancreatic endocrine cell generation in 3-dimentional structures is discussed. 

In the article a complex technology of receiving a biological transplant with autologous mesenchymal stem cells from the adipose tissue is presented. Possibility of successful clinical performance of reconstruction of extensive defects of anterior belly wall with the use of a multicomponent biological transplant with autologous mesenchy- mal stem cells from the adipose tissue, differentiated in the fibroblast direction is shown. The use of the proposed method of plasticity promotes the improvement of quality of surgical treatment, expansies the scope of cellular technologies in practical health care, improves the patients quality of life in the postoperative period. 

Intradialytic hypotension (IDH) remains an important cause of morbidity and mortality in chronic hemodialysis (HD) patients and can be ameliorated by low temperature HD. Biofeed-back temperature-control device BTM® (Fresenius Medical Care, Germany) was used for precision temperature measurement and to deliver isothermic (ITD) or thermoneutral (TND) dialysis. At stage one 24 stable dialysis patients were studied in terms of inlet blood temperature (IBT) variation during sessions with normal (36,5 °С-ND) and cold dialysate (35 °С-CD). IBT was increasing in both cases however the increase was significantly lower in CD. At stage two, 18 patients underwent programmed cooling during two ITD and two TND sessions. In TND high correlation (r = 0.66; р < 0.05) was observed between IBT increase and ultrafiltration rate. Keeping IBT stable during ITD required cons- tant decrease of dialysate temperature to 34.9 ± 0.2 °С at the end of session. At stage three, 19 IDH-prone patients were displaced from regular dialysis program to ITD. As a result,the decrease overall rate of IDH from 36.2 ± 1.1% to 11.3 ± 4,6% was observed. Conclusions: 1. The main mechanism of body temperature raise during HD is heat retention secondary to the compensatory response to loss of plasma volume, resulting in increase of the total peripheral resistance. 2. CD is effective for IDH prevention. 3. ITD is the optimal version of CD. 

This article presents the results of a pilot study of experimental stent in comparison to traditionally used. Experi- ments were performed on 20 adult male rabbits weighing 4350–4580 grams. The main study group (10 animals) was performed an experimental unilateral implantation of the stent, as a control (10 animals) was performed a unilateral stent implantation «White-star standart» (Company Urotech, Germany), of the same diameter. The observation period was 1 month. There were performed laboratory tests of blood and urine, as well as morpholo- gical examination of the kidneys and ureters. We obtain statistically significant benefits of using an experimental stent. 

Clinical case of prolonged massive polyuria in patient after renal transplantation is represented in this article. Polyuria lasted for a forty days after kidney transplantation, the larges amount of urine output was 55 litres per day. Analysis of transplant biopsy revealed acute tubular necrosis, initial arteriolosclerosis and suspected acute rejection. Doppler ultrasound study and perfusion scintigraphy detected no pathology. At first we tried to decrease the volume of infusion and fluid intake. Also we performed pulse therapy with methylprednisolone. However, these efforts were not effective. Using of a large doses of «Minerin» (posterior pituitary antidiuretic factor) allowed to decrease and stabilize the volume of urine output. The patient was discharge from clinic on day 42 after transplantation. 

This review discusses issues related to intensive care in recipients of transplanted liver in the early postoperative period, with an emphasis on contemporary conditions and attitudes that are specific for this group of patients. Early allograft dysfunction (EAD) requires immediate diagnosis and appropriate treatment in case. The causes of the EAD and therapeutic tactics are discussed. Acute kidney injury (AKI) and renal failure are common in patients after transplantation. We consider etiology, risk factors, diagnosis and treatment guidelines for AKI. The negative impact of EAD and AKI on the grafts survival and recipients is demonstrated. 

Hepatitis E is enterically transmitted infection and is the cause of outbreaks and sporadic cases. Disease was originally registered only in the developing subtropical and tropical countries and has been connected with I or II genotypes of hepatitis E virus (HEV). Later sporadic hepatitis E has been registered in a number of the deve- loped countries of Western Europe, North America, South East Asia and Ocenia. These cases have been caused, as a rule, by III or IV genotypes of HEV. Until recently it was considered, that the disease is usually self-limited except pregnant women in which HEV infection is more severe, often leading to fulminant liver failure and death in a significant proportion of patients.

The current review represents the analysis of publications of the last years reflecting the facts that HEV infection may develop in immunosuppressed patients, in particular in liver transplant recipients, who may then serve as long-term carriers of the virus with progression to cirrhosis. The information on the first attempts of antiviral therapy in these patients is presented. 

In the review we present the world scientific literature data analysis of the results of ABO-incompatible liver transplantation in children and adults. Used previously and modern protocols of pre- and postoperative manage- ment of ABO-incompatible recipients from different transplant centers are described. While adult ABO-incom- patible liver transplantation is still linked with increased risk of immune complications, short and long-term results of ABO-incompatible liver transplantation in children are similar to those of ABO-compatible transplan- tation. We conclude that ABO-incompatible liver transplantation is reasonable in urgent cases for recipients of all age groups and for children without possible ABO-compatible living related donors.