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Russian Journal of Transplantology and Artificial Organs

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Vol 11, No 3 (2009)
View or download the full issue PDF (Russian)
https://doi.org/10.15825/1995-1191-2009-3

Clinical Transplantology

8-16 885
Abstract

The article gives the first report of the Registry of Russian transplant society, taking into account donor and transplant activity in the Russian Federation for the period 2006–2008. Despite the inadequate provision of transplant assistance, it’s noted the positive trends. 

17-29 768
Abstract

The articleis is dedicated to the main problem of transplantology which is shortage of acceptable donors’ organs. The tendency of expanding the donor’s pool should include policy of prevention and reduction the ischemia- reperfusion trauma of donor’s organs. The crucial role of machine perfusion in pretransplantaion improving organs quality is highlighted. The large review of literature is listed in order to state several new approaches in modern preservation trend. The definition of organ preservation is given as well as new strategy in organ acceptance is grounded. 

30-36 728
Abstract

The aim of present study was to characterize immunohistological features of humoral (antibody-mediated rejection, AMR) by evaluating their manifestation, localization and distribution in endomiocardial biopsies (EMBs) from patients after heart transplantation. The role of AMR in the development of allograft vasculopathy is investigated widely. The examine of more than 1000 EMBs maid it possible to elaborate the diagnostic criteria of acute humoral rejection, to characterize immunomorfological peculiarities of long-term heart allograft and demonstrated the relation AMR with the early development of coronary artery diseases. 

37-41 924
Abstract

The purpose was to determine the possibilities of Multispiral computed tomography (MSCT) in evaluation of potential living liver related donors. A total of 104 potential donors were examined with «Siemens» Somatom «Sensation-64» MSCT-scanner. The technique provides comprehensive preharvest analyses of vascular anatomy and liver volumes in living family related liver donors. 

42-50 739
Abstract

To study therapeutic modalities of interventional radiology in patients (pts) before and after orthotopic liver trans- plantation (OLT). OLT was performed in 53 pts between 1998 and 2008. Endovascular treatments were performed in 20 pts. Pre-OLT interventional procedures included transcatheter arterial chemoembolization (5 patients) and TIPS (8 patients). Post-OLT procedures were: dilatation or/and stenting of biliary strictures (4), stenting of IVC (2), balloon dilatation of cava-caval anastomosis (1), partial splenic embolization (PSE) in steel syndrome (1). All IR procedures were technically successful. There was no mortality or serious complication. After chemoemboliza- tion, there was partial tumor response in all 5 patients with HCC; two successfully transplanted are alive without recurrence in 11 and 15 months. After TIPS, 3 pts underwent OLT. Satisfactory biliary passage was achieved in all pts with strictures. Clinical symptoms and liver function improved in three pts with venous strictures. After PSE, steal syndrome regressed rapidly. All pts are asymptomatic and well in 5–24 mo after IR treatment. IR procedures prolong long-term patient survival before OLT and may improve outcomes in pts after OLT. 

51-55 828
Abstract

Method for restoration of bile outflow in orthotopic transplantation of liver using cystic duct may find application in anatomic version characterised by parallel location of cystic and common liver ducts in donor. After cholecystectomy, at the level of bile ducts donor segment intersection, common reservoir is formed with application of common liver and cystic ducts by dissection or wedge-shaped excision of partition segment between them. Level of bile ducts donor segment intersection is selected so that diameter of common reservoir coincides with diameter of recipient bile duct, with which biliobiliary anastomosis is formed. Biliobiliary anastomosis is formed as «end to end». If there are mucous and muscular layers in composition of partition between liver and cystic ducts, they are dissected. Edges of mucous layer are sutured. If only mucous layer is present in composition of partition, it is dissected without further suturing. Such approach supply possibility to overcome discrepancy of sutured ducts diameters and provision of bile outflow from liver in the most physiological version with «end to end» anastomosis. 

56-61 1011
Abstract

An article presents the results of cadaveric kidney transplantation (KT) in patients with end-stage of renal disease (ESRD) before initiation of hemodialysis (n = 20) and in patients after prior hemodialysis (n = 33). Survival of the recipients and transplants in 3 years period after preemptive KT is 90 and 70% respectively, and 90,8 and 60,6% – in patients after prior hemodialysis (р < 0,05). A disturbance frequency of the lipid profile, phosphorus and calcium homeostasis as well as the level of the arterial hypertension and the number of hypotensive drugs were assessed in recipients before hemodialysis and after prior hemodialysis in 3 years period after KT. The received data showed an advantage of preemptive KT compared to KT after prior hemodialysis. 

62-68 831
Abstract

Humoral rejection of the cardiac allograft is still a challenging problem associated with high incidence of graft loss and patient mortality. These episodes of rejection are often more severe, and more difficult to treat, than classical acute cellular rejection. Hemodynamic compromise, in the absence of acute cellular rejection, called biopsy-negative rejection occurs in 10 to 20% of cardiac allograft recipients. The assessment of hemodynamic compromise can provide functional data in transplant patients that is complementary to myocardial biopsies if the biopsy can miss significant rejection. We present three cases of the biopsy-negative rejection. All patients have studied with gated SPECT phase analysis. 

Transplantomics

88-95 1125
Abstract

In transplanted hearts, peri- and postoperative ischemic and alloimmune stimuli may be interpreted as inadequate tissue perfusion leading to activation of angiogenic signaling. Placenta growth factor (PLGF) is a marker of neoangiogenesis, belonge to vascular endothelial growth factors (VEGF) family. It has been shown that PLGF serum levels are elevated during acute rejection and decrease after immunosuppressive therapy in pediatric heart transplant recipients. The study was aimed to investigate clinical and prognostic significance of PLGF in heart transplant recipients. 34 patients (pts) (42,5 ± 8,5 years, 29 men and 5 women, 21 patient with dilated cardiomyopathy, 13 – with ischemic heart disease) underwent heart transplantation (HTx) and were examined before and after HTx. Our results showed that pretransplant PLGF is a marker of posttransplant cardiovascular risk. Revealing PLGF plasma level in recipients during the first year after HTx also has prognostic value concerning development of cardiovascular complications. In the remote terms (1–16 years) after HTx PLGF plasma levels were significantly higher in recipients with TxCAD than in recipients without TxCAD. These findings confirm participation of PLGF in damage of the transplanted heart vessels. 

96-102 1230
Abstract

Patients with terminal stage of chronic renal failure (CRF), treated by chronic hemodialysis, constitute severe group of patients whose cardiac valve replacement represents a separate problem. This article focuses on analysis of experience of 28 operations of cardiac valves replacement at the patients, suffering terminal stage of CRF taking into account international studies data. Isolated one valvular (mitral or aortic) replacement was performed in 22 cases, including one repeated mitral valve replacement; in 4 cases – two valvular replacement, including in a combination with coronary artery bypass grafting in 1 case, and in 2 cases replacement of the ascending aorta and aortic valve. At the hospital 2 patients (7,4%) died. In the remote period from the valve dependent complications 1 (3,7%) patient died, and 4 (14,8%) – from the non cardiac reasons. In 6 cases soon after operation kidney transplantation with good function of a transplant was performed, and in 4 cases transplantation of a kidney preceded heart operation. 

103-106 1049
Abstract

This report presents retrospective analysis of using artificial pacemaker in 16 heart transplanted patients because of developmented bradiarithmic disfunctions in the early and later posttransplanted periods. DDDR or SSIR regimens are recommended for persistened disfuncion of sinus node. DDDR regimen is recommened to prevent atrio-ventricular conduction. 

Editorial

Advanced technology

107-113 1016
Abstract

The aim of this work was developing of elements of the precise three-dimensional positioning technology of one or several micron and submicron size biological objects. Thereto a laboratory unit of hardware-software complex of optical femtosecond laser tweezers-scalpel was developed and constructed in the Joint institute for high temperatures RAS using material resources of Russia. Experimental data concerning a maximal manipulation speed of CHO and cells, produced from mammalian spinal ganglia (using protocols for producing pure culture of Schwann cells) was received. Besides facts of interaction of laser radiation with intracellular structures that lead to unexpected behavior of cell in the zone of optical trap and change of maximal speed of cell manipulation were determined. 

114-122 1013
Abstract

The most important causes of late renal graft dysfunction (late acute rejection, chronic rejection, chronic neph- rotoxicity induced by calcineurin inhibitors (CNI) and nonspecific nephrosclerosis), their morphological charac- teristics and the current approaches to their treatment are considered. One of the ways to influence the prevention and the course of late acute rejection which is under discussion in literature is the conversion from cyclosporine A to tacrolimus. The switch from standart to low dosage cyclosporine in combination with proliferative signal in- hibitors (sirolimus, everolimus) is considered as a way to prevent the progression of nephrosclerosis due to CNI- nephrotoxicity. In cases where the main cause of the late kidney graft dysfunction is nonspecific nephrosclerosis the treatment with ACE-inhibitors and optimization with CNI-dosage may be recommended. 

Implants and Artificial Organs

69-80 1568
Abstract

The paper presents the main fundamental and applied results obtained by The Center (Department) for Biomaterials Research for duration of time from 1999 to 2009. 

81-87 966
Abstract

The article briefly describes the history of the non-pulsating type blood pumps for ventricular assist circulation and heart-lung machine. Disclosed the main advantages of these pumps before pulsating type, especially for implantable systems development. However, disadvantages of these pumps and the directions of minimize or eliminate ones have shown. Specific examples of our implantable centrifugal and axial pump developments are presented. Declare the ways to further improve the pumps. 

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ISSN 1995-1191 (Print)