Cardiac transplantation (CTX) remains the gold standard for treatment of terminal forms of heart failure. Nevertheless, all over the world shortage of donors and postoperative complications leads to search of alternative therapeutic strategy. Cardiac resynchronization therapy is discussed alternative CTX. Besides, now it is not clear, whether it is possible to prevent CRT CTX in long-term prospect. Thus, we aspired to estimate long-term clinical results in the big group of candidates to CTX which have received CRT-systems in Institute of Transplantation last years. In total 70 patients are operated, from them 5 patients in connection with condition deterioration heart transplantation has been executed. The received experience shows that at patients with left ventricular dissinhroniсity, which are in a waiting list to heart transplantation, application of method CRT may to prevent or delay necessity for heart transplantation, or to become a link as «bridge» to transplantation. 

The selection of recipients for the orthotopic heart transplantation is of great importance. In 2006–2009 we examined 25 tests on reversibility of pulmonary hypertension, i.e. in 14 patients with dilated cardiomyopathy (DCM) (11 males and 3 females aged 41,1 ± 9,3) and in 11 patients with coronary artery disease (CAD) (all males aged 50 ± 4.9). Initial pulmonary vascular resistance (PVR) was 3,61 ± 1,02 and 3,59 ± 0,98 respectively. Alprostadil was infused to all the patients. Pulmonary hypertension was irreversible in 4 (28,5%) DCM patients and in 2 (18%) CAD patients. Initial PVR in those patients was 6,27 ± 3,2 and 5,7 ± 2,4 respectively. The average alprostadil dose necessary for the reverse of pulmonary hypertension was 0,054 ± 0,027 μg/kg/min in DCM patients, and 0,047 ± 0,022 μg/kg/min in CAD patients. Thus, the application of alprostadil for the pharmacological correction of pulmonary vascular resistance is most effective in patients with moderate pulmonary hypertension according to Rich classification. 

The article focuses on the results of the investigation of peripheral blood lymphocyte morphofunctional status in healthy volunteers and renal allograft recipients for early postoperative period. Working out noninvasive tests for diagnosis of acute renal allograft rejection based on the measuring of cell morphometric parameters by method of coherent phase microscopy (CPM). It was found out that the lymphocyte phase height was proportional cell image density and its geometrical thickness. Our results showed that the variations of immunocompetent cell morphometric indicants can be in advance the dynamics of blood creatine increasing and answer for early criteria of acute renal allograft rejection. 

Quality of life analysis of kidney graft recipients includes complex assessment of physical, psychological and social status and also certain laboratory and clinical studies. However we suppose that significance of the study might increase considerably if it would be multicenter. The objective of the present publication is to organize such a multicenter study. Obviously, quality of life of recipients with functioning transplanted kidney is undoubtedly of scientific interest and needs further extended studies that might contribute to better interpretation of long-term results after kidney transplantation. 

Patients with dissecting aortic aneurysm and associated acute aortic insufficiency form a group of seriously ill patients with significant cardiac failure, generally involving other organs and systems. It justifies an attempt to reduce a surgical risk, by using more sparing procedures, including supracoronary replacement of the ascending aorta with its root reconstruction.

The latter has been performed in 27 patients (mean 54,5 ± 2,1 years) with dissecting aortic aneurysm and aortic valvular insufficiency in 1996 to 2009. The major etiological factor was atherosclerosis (88%)/ Seventeen (63%), 6 (22,2%) and 4 (16%) had types I, IIA and II dissection, respectively. Overall hospital mortality was 11%. In late period, progressive aneurysm dissection needed reinterventions in 2 cases. The competence of the reconstructed aortic valve was satisfactory both just after surgery and throughout the follow-up. Indications for this option of chronic correction, surgical techniques, and immediate and long-term results are outlined. 

Taking into consideration the treatment of 227 patients suffering from diabetes of I type on early stage, we consider a distal venous splenorenal anastomosis (DVSRA) to be an appropriate treatment method. Changing hormone regulation and influencing on metabolic processes, the given treatment is based on the research results. 2-nd (with nephritic syndrome) and 3-d (with progressive diabetic nephropathy) stages of diabetic nephropathy is the indication for kidney transplantation (KT). Combined KT and DVSRA proved to additionally improve a diabetes mellitus. GFR and creatinine level is not the only indication for KT, cardiovascular system failure, preliminary, is a major risk factor. 

The computerized system to control depth of anesthesia during surgical operation was developed in our research center. The depth of anesthesia is regulated by controlled intravenous infusion of propofol. The varied propofol rate is controlled by the closed-loop propofol system (CLPS) with mean arterial pressure (MAP) controller. MAP is used in the CLPS as input parameter and indicator of anesthesia depth. CLPS consists PC, invasive blood pressure (BP) sensor and Graseby 3400 infusion pump. The C language computer program sets the propofol infusion rate based on empirical algorithm including proportional component to maintain the measured MAP more closely to the target MAP (85% of patient standard MAP). The propofol concentrations are calculated by Runge–Kutta’s method PK/PD model differential equations solving with Marsh’s microconstants and Kazama’s BIS effect site microconstant and age depended BP effect site microconstants every 30 s. The designed CLPS was effective and useful for anesthesia maintenance during open-heart surgery, especially for early extubation. 

34 patients (23 male, 11 female) in the age of 41–77 years (mean age 59,7 ± 4,2 years) with 2 type hepatorenal syndrome were included in the study. All patients were divided in 3 groups. The 1st group (n = 15) was treated by medical treatment, the 2nd group (n = 12) was treated by medical treatment and hemodiafiltration and the 3rd group (n = 7) – combined treatment with MARS therapy. Outcomes showed that combined therapy with addition of MARS provides positive results in treatment of the patients with 2 type hepatorenal syndrome. 

The study has shown that early diagnosis of the type and degree of immune disturbances in preparation for the operation and the first signs of multiorgan failure and septic complications in the postoperative period in cardiac surgery patients were the rationale for the earlier substitution immunocorrection by immunomodulators of cytokine nature and intravenous immunoglobulin. It allowed increasing the efficiency of the treatment of postoperative complications and lower mortality after operations with artificial and assist circulation. 

Sodium reabsorption and sodium consumption (daily sodium excretion) were studied in 63 health volunteers and 100 recipients of kidney allografts. We elaborated the nomogramm for definition of sodium reabsorption with confidence interval 95% and proposed to use T-score CNa/GFR for a quantitative estimation of sodium reabsorption. There was a direct line dependence between sodium fractional excretion (CNa/GFR) and T-score CNa/GFR in kidney allograft recipients with good function and chronic rejection of kidney allograft (R = 0,86; р < 0,01; Yx = 0,593 + 0,64x; R = 0,97; р < 0,01; Yx = 0,147 + 1,146х and R = 0,97; р < 0,01; Yx = 0,21 + 0,69х, respectively). In recipients with good function of kidney allograft the regression coefficient was significantly higher, than in health volunteers (р < 0,01). In the group of recipients with chronic transplant rejection a free member of regression equation was significantly higher, than in health volunteers (р < 0,01). Consequently, exactness of sodium reabsorption estimation after kidney transplantation is not sufficient without calculation of sodium consumption. 

The morphofunctional status of peripheral blood platelets from 16 recipients, 16 optimal and 16 marginal donors renal allograft were investigated by method of vital computer phase morphometry (phase-interference microscope «Cytoscan»). The abnormality of platelet hemostasis was found out in recipients and potential renal allograft donors. Such hemostasis damages can promote the thrombotic complications and failure of microcirculation in renal parenchymatous tissue. 

The purpose of the present work was the experimental substantiation of application of new biodegraded materials: gel implant «Sfero®Gel» and a film membrane of «ElastoPOB»® a domestic production, in surgery of defeats of peripheral nerves. Experimental researches carried out on females of nonlinear rats, is powerful 200–250 gramme. In experience 10 animals are used, 20 operative interventions on sciatic nerves are executed. Morphological studying of the received material in 101 days after operation was carried out. At application of a membrane «ElastoPOB»® it was defined delimitin of peripheral nerves from surrounding tissue. A film membrane of «ElastoPOB»® is perspective to apply at traumas of a nervous fabric for the purpose of formation of a friable hem in a damage zone. On the basis of the received experimental data it is possible to make the conclusion about possibility and expediency of application of biodegraded materials in surgical treatment of defeats of peripheral nervous system. 

There were studied the use of donor pool in intensive care unit (ICU) at Moscow Clinical Hospital No 7 as a typical general ICU during the period of 2005–2008. If ICU receives the number of patients a year, equal to 1500–1700, mortality rate is 30% (463–532 died per year). Nevertheless, the actual percentage of potential donors is 5,8–8,6%. Thus, patients dying in ICU during the first 24 hours represent additional opportunities to increase the donor pool. The real way to improve the situation should be considered an introduction of transplant coordinators into hospital staff. 

The positions of the national and international Office for intellectual property on the questions of providing the legal protection in the capacity of innovations to the methods of diagnostics, therapy, disease prevention (further medical methods) are considered in this work. The inability of arguments, which prove the exclusion of the medical methods out of the legal protection is described. The author analyses legislative possibilities of regulation of the innovation usage, referred to the medical methods from the side of the Government. 

The high mortality and morbidity of patients in terminal heart failure are a therapeutic challenge to modern medicine. Surgically, cardiac transplantation is an excellent treatment for many patients. However, lack of donors combined with an increasing number of patients has led to the search for other surgical strategies. Although other common surgical methods’, such as Batista operation or dynamic cardiac myoplasty has a favorable outcome in selected patients, those method’s is currently not recommended for treatment of heart failure because of high surgical failure rates. The present paper reviews some of the relevant literature regarding surgical left ventricular remodeling in heart failure. 

In this review the modern conception of induction of immune tolerance was presented. Possibilities of immune tolerance induction after organs transplantation by allogenic bone marrow cells were considered. 

The article reflects the use of special schemes of immunosupression in recipients who received kidneys from expanded criteria donors. The reduction of traditional doses of cyclosporine A is discussed in old patients. The data of literature is reviewed about immunosupression schemes including inhibitors of proliferative signal, especially everolimus. 

The paper describes the modern approaches in treatment of hepatitis B virus (HBV)-infected patients who underwent liver transplantation. The patients with HBV liver cirrhosis and waiting for orthotopic liver transplantation (OLT) have to receive long-term therapy with nucleos(t)ide analogs right up to liver transplantation. The paper discuss the different schemes of prophylaxis of recurrent HBV infection during post-transplantation and specific treatment of HBV infection after liver transplantation as well as possibilities of orthotopic liver transplantation for patients with liver cancer.