46 protocol graft biopsies with the subsequent histological examination were performed in 39 patients after kidney transplantation. In 20 patients with stable graft function acute subclinical rejection were revealed in 12 (60%) with the following steroid therapy. In 19 patients with delayed kidney graft function acute rejection was revealed in 13 (68,4%). Treatment by steroids was successful and function renewed. Our results showed that protocol biopsy is a safe and reliable method that allows to recognize such kidney graft pathology as subclinical rejection and to perform its treatment in time. 

Active calcium and sodium reabsorption (ACR, SR) examination was performed in 125 renal recipients (RR) [78 with good renal function (GRF), 26 with chronic rejection(CR), 21 with cyclosporine nephrotoxity(CN)], 18 with bronchial asthma (36 estimation) receiving for a long time glucocorticoid therapy (EG) and 16 – with chronic renal disease in the initial stage of renal insufficiency (CRD). It was revealed elevated level of ACR in all patients being maximal in triple immunosupression therapy (cyclosporine, prednisolone, azathioprine) and minimal in double (prednisolone, azathioprine) therapy both in GRF and CR. There was reliable linear inversely proportional dependence between ACR and SR in all recipients receiving triple immunosupression and EG patients with analogous regression coefficient and free article. The latter was lower in group of health voluntaries. ACR value did not depend on parathyroid hormone level in all groups of patients. In summary elevated ACR in RR is the result of low SR and high glucocorticoid level in blood and did not depend on PTH. 

In the present study influence of contrast media on renal transplant function in patients with ischemic heart disease treated by coronary angioplasty and stenting waz estimated. Results are based on clinical and angiographic data, the analysis of amount of contrast media, average speed of it introduction, level of creatinine before and at the first 48 hours after coronary angioplasty in 42 patients with renal transplant. 

We present our first experience gained in use of polytetrafluoroethylene carbon-coated grafts for partial portosystemic shunting in three cirrhotic patients. The results obtained indicate that these grafts in mesocaval position can function as a long-term «bridge» to hepatic transplantation in patients with uncontrolled gastroesophageal varices. The different options of portal hypertension treatment and the current role of shunting procedures in the era of liver transplantation are discussed in short literature review. 

In patients with end stage renal failure it is vitally necessary to have permanent long functioning vascular access, providing all requirements of modern hemodialysis. Authors have evaluated the terms of functioning of arterio- venous fistulas after operations at 56 patients. Undertaking reconstructive operation on arteriovenous fistula allows to enlarge duration of the permanent vascular access function for two years in average. 

The new gel-sublimation technique for preparation porus biodegradable scaffolds (hydroxybutyrate-co-hydro- xyvalerate) is presented. The scaffolds with multi-mode internal structure have the of porus sizes varied from ~100 microns up to ~100 nanometers and the porosity in a range of 80–90%. A few techniques for modification of 3D scaffolds by gas discharge plasma are developed and optimized: the microsecond dielectric barrier dischar- ge, the semi-self-maintained discharge supported by an electron beam; the nanosecond dielectric barrier dischar- ge. Biological tests including red blood cell hemolysis and cytotoxicity analysis have shown the possibilities of scaffolds applications for cell-based technologies. 

SIMULTANEOUS INFRARENAL AORTIC PROSTHESIS IMPLANTATION AND RENAL TRANSPLANTATION IN PATIENT ON PERITONEAL DIALYSIS 

There are case report and literature review of the treatment recurrent bladder cancer after kidney transplantation. Radical cystectomy and Bricker ileal conduit was performed. Detailed operative technique is described. Radical cystectomy is an effective curative treatment for recurrent disease. Bricker ileal conduit is safe and feasible in renal transplant patients. 

Survival of renal transplants and renal transplants recipients has improved greatly last years, but long-term graft survival remains unchanged. Nephrotoxicity of calcineurin inhibitors is one of the main factors of late renal allograft disfunction. Everolimus, new proliferation signal inhibitor, can facilitate minimization cyclosporine A exposure and has antineoplastic activity. The paper reviews literature dates regarding to clinical aspects of everolimus use in de novo renal transplant recipients. 

The liver is an essential player in the pathway of coagulation in both primary and secondary hemostasis as it is the site of synthesis of all coagulation factors and their inhibitors. Liver diseases are associated with complex changes in coagulation and the delicate balance between pro and antithrombotic factors is preserved but reset to a lower level. There is growing evidence that portal and hepatic vein thrombosis is cause of disease progression in cirrhotic patients and worsens hemostatic abnormalities. These hemostatic abnormalities do not always lead to spontaneous bleeding, which may be triggered only by additional factors, such as infections. Usually therapy for coagulation disorders in liver disease is needed only during bleeding or before invasive procedures. In patients with end stage liver disease liver transplantation is the only treatment available, which can restore normal hemostasis, and correct genetic clotting defects. During liver transplantation hemorrhage may occur due to the pre-existing hypocoagulable state, the collateral circulation caused by portal hypertension and increased fibrinolysis. 

Acute renal failure is one of the most frequent and life-threatening complications after cardiac surgery, which determines the outcome. The priority is the development of preventive measures and best treatments, in the first place – renal replacement therapy (RRT). To date, any medicines with proven nephroprotective properties is unknown. According to some reports, the use of prophylactic dialysis reduces the need for postoperative RRT. Continuous and intermittent methods of RRT are complementary. Early or even prophylactic use of RRT with increasing effectiveness are the current trends. However, it is unclear where is the limit of extended indications for RRT and what it`s optimal dose. 

In this review the modern information about effectiveness of liver insufficiency treatment by stem/ progenitor cells of liver (oval cells) and bone marrow (hemopoietic cells and mesenchymal cells) was presented. It is shown that medical action of these cells is referred on normalization of liver cell interaction and reorganization of processes of a reparative regeneration in damaged liver. It is believed that application of mesenchymal stromal cells from an autological bone marrow is the most perspective strategy. However, for definitive judgement about regenerative possibilities of the autological bone marrow cells it is necessary to carry out large-scale double blind clinical researches.