The article gives the second report of the Registry of Russian transplant society, taking into account donor and transplant activity in the Russian Federation in 2009. Data analysis proves once again that the only way of organ transplantation development over the country is the creation of regional donor infrastructures whose activities should be aimed at maximizing the donor pool (increasing the number of donor hospitals) and its intensive use (expansion of brain death verification and performance of multiorgan procurement). 

The aim of our work is to develop diagnostic criteria of liver ischemic injury according to needle biopsies of liver allograft using light microscopy. We studied 45 zero liver biopsies from cadaver donors with diagnosed brain death and 16 needle biopsies of liver allograft from 12 recipients 1 hour up to 1 month after operation. Grading to three stages of ischemic injury in liver allograft is based on clinical and morphological criteria. Ischemic injury of liver allograft is an acute alterative-inflammatory process i.e. there are hepatocyte degeneration and necrosis with following inflammation (exudation with edema, hemorrhage, neutrophil infiltration). In case of favorable outcome ischemic injury of liver allograft is a reversible process. 

Acute kidney injury (AKI) is a frequent complication after heart transplantation (HT). For the identification of risk factors of AKI and optimal modes of renal replacement therapy (RRT) 86 HT data was analyzed. AKI was observed in 37 cases. The main risk factors were renal failure before HT, heart transplant dysfunction and requirement in mechanical support. Continuous RRT was preferable due to the best control of patient’s volumes. The widening of indications for RRT was associated with better survival. In the cases of AKI occurrence the long-term (>10 years) prognosis was worsening significantly. 

In our department from December 1998 to 2009 have been performed 1028 operations with use of prosthesises «MedEng-2»: aortic valve replacement (AVR) – 494, mitral valve replacement (MVR) – 351 and double valves mitral and aortic replacement (DVR) – 183.
Remote results are tracked at 76% (719) patients. The 10-years survival rate has made 4532 patient-years of them 3146 pats.-years (86,4%) for AVR, 2530 (82,4%) for MVR and 836 (82,9%) for DVR. Mechanical dysfunctions of artificial valves were not. Freedom from a thrombosis, endocarditis and reoperations at AVR has made 98,7; 97,6; 97,1% accordingly. From embolism complications – 97,5%. For MVR freedom from thrombosis – 96,9%, endocarditis – 97,7%, from reoperations and embolism complications of 99,1 and 91,2%. Freedom from throm- bosis and endocarditis at DVR 100 and 97,4% accordingly. From embolism complications and reoperations – 97,5%.

The analysis of 10-years results of replacements prosthetics valves «MedEng-2» has shown its good haemody- namic qualities and satisfactory results both in the nearest, and in the remote terms after operation. 

Atrial fibrillation or flutter (AF) are frequent complication after replacement of cardiac valves including prosthe- tics of ascending aorta and/or aortic valve, and can cause the infringement of haemodynamics, development of thromboembolic complications, and also increase duration of hospitalisation and treatment cost. The work pur- pose was the attempt to define the most frequent reasons of development AF in early terms after ascending aorta and/or aortic valve replacement, and also medical and preventive tactics at occurrence of these complications. 

The aim of this article was to show possibilities, range of application and the diagnostic sensitivity 64-slice computed tomography (CT) of coronary artery in daily work of trasplantology clinic. CT coronary angiography was performed in 283 patients (190 men and 93 women; mean age 55,6 years). In 37 patients of this group CT coronary angiography was performed before any type of operation. Invasive coronary angiography performed in 45 patients after CT, has shown high diagnostic sensitivity of this technique. 

Left ventricular hypertrophy (LVH) is one of the main complication in patients on chronic haemodialysis.
We observed high left ventricular mass index (LVMI) – 175,8 ± 6,4 g/m2 – in patients with substantial (>8 L) overhydration at the beginning of dialysis treatment and its reduction to 112,0 ± 7,2 g/m2 after removing of excessive fluid. In stable dialysis patients LVMI correlated with interdialysis weight gain (r = 0,79). In patients with interdialysis overhydration more, than 5% body mass, worsening of LVH was observed. On the contrary, regression of LVMI was registered in patients with moderate overhydration (<4,5% body mass). Patients with adequate intravascular refilling during dialysis session (with minor decline of relative blood volume per one L of ultrafiltration) were noncompliant concerning fluid restriction more frequently. 

24 recipients after ortotopic liver transplantation (9 women and 5 men) 18–57 years aged were studied in 1–2 and then through 4–18 months following operation. Bone mineral density (BMD) in repeated estimation in 13 recipients was elevated on 14 ± 10,5% and in 11 recipients was decreased on 2,5 ± 2,56%. BMD elevation was associated with bone remodelling normalization. BMD lowering followed transplant dysfunction, glucocorticoid therapy, bone resorption increasing and bone formation suppression. 

This article presents preliminary results of complex clinical-psychological investigation of patients with autoim- mune liver diseases with cirrhosis waiting for liver transplant. The data discussed defense role of anxiety com- bined with other emotional affective disorders, psychological mechanisms in combination with coping strategies of stress-overcoming behavior in the state of disease and their involvement in formation of the clinical picture of the disease. It considers the need for differential diagnosis of the pathology using modern experimental- psychological methods in connection with further building of psychological aid to patients with autoimmune liver diseases. 

We studied the outcomes of the operations for distal splenorenal venous anastomosis of 134 patients with type 1 diabetes mellitus. We have noticed the significant improvement of patient’s general condition due to spasmolytic effect of glucagon, bypassed to blood circulation without coming through liver and also a stabilization of glyce- mia because of a restoration of insulin-glucagon ratio in systemic circulation. The effect of a surgery depends on a stage of microangiopathy and nephrosclerosis. 

Morphological research of canine cardiac tissues after implantation several types of implants has been made. The first group consisted of animals with implanted «Eslan+Elasto-POB» implants, the second was after im- plantation of «Eslan» implants, and the third group after «Ftorex» implants. Fabrics were implanted on canine heart muscular tissue. Muscular tissue with implant were examined by light microscopy. There were no early or late deaths of animals, no infectious complications in any groups and terms. The reactions in muscular tissue in response to implantation of implants were defined as typical pathological processes and manifested by alterative, exudative reactions with edema, ill-defined hydropic degeneration and formation of inflammatory infiltration in the early terms (20 days). The formation of mature granulation tissue was accompanied its invasion between pores of implants and giant-cell reaction (20 days). After that thin layer of connective tissue was formed at the periphery of implant (30 and 60 days). Development of ill defined fibrosis was revealed in late postoperative terms at the circumference of implant (30 days – 60 days). There were no substantial differences in features of tissue’s responses to implantation of all types of implants. 

Organization of organ donation for transplantation is one of the most actual problems of Russian Transplantolo- gy. Organ shortage for transplantation is perceiving in Russia through the improvement of organizational system of organ donation. An analysis of efficiency of Russian Transplantology demonstrates that there are some parts in Russia showing very positive results in organ donation quite comparable to European data. But at the same time the potential of donor pool is realizing only partially for some reasons. Analysis of few of them is described in the paper. 

HLA molecules appear to be the principal target of immune allorecognition. The efficiency of transplant directly depends on coincidence of the data obtained by different HLA laboratories. This study discusses the results produced by 12 tissue typing labs in the framework of the initiative program for tissue typing quality control in 2009. 

We analyzed the dynamics of the interaction of rotary pump, connected to the scheme «the left ventricle – aor- ta», and left ventricle in norms and heart failure, using data obtained on the mock circulatory system. Adverse pumping states such as suction and regurgitation can be detected. These limits depend on the degree of cardiac failure, which confirms the need to control the speed of rotation of the impeller in the range of the cardiac failure from pathology to normal. It has been shown that the pulsating pressure at the inlet of the pump modulates the flow of the pump, making it a pulsating, what positively affects on the dynamics of cardiac output. 

Intravascular volume preservation is the first choice measure for the prevention of intradialysis hypotension. At present there are devices that allow continuous monitoring of relative blood volume (RBV) changes during haemodialysis (HD). The aim of this research was to investigate (i) the regularity of RBV curve during haemo- dialysis and (ii) the efficacy of some measures for intravascular volume preservation.

In patients with hyperhydration RBV curves were monotone; in all cases relation RBV/ ultrafiltration volume (UF) did not exceed 2,5%/L. In stable patients the RBV curve was immutable in the course of years. Patients with high RBV/UF ratio (>6%/L) formed a high risk group. In these patients stability of RBV was more im- portant and more useful. Isolated UF did not decrease RBV drop, as well as haemodiafiltration online. Albumin administration allows to decrease RBV/UF ratio. After bolus of hypertonic dextrose solution RBV increased for about half of hour. In patients with acute renal injury RBV monitoring was far from reliability in many cases. 

The literature data in modern transplantology concerning morphology of ischemic injury of liver allograft are analyzed in the article. Questions of pathogenesis of liver allograft ischemic injury, histological features that indicate the possibility of donor liver transplantation are discussed in detail, as well as the role of steatosis and its reverse is highlighted. We tried to systematize the morphological changes depending on severity of ischemic injury; also we focused on the questions of persistency of the ischemic injury in the liver allograft. 

It is known, transplantation of organs is accompanied by activation of adaptive immunity (cellular and humoral) and innate immunity in an organism of the recipient. Population of T-lymphocyte which includes some subpopu- lations of cells , such as Тcyt, Th1, Th2 and T-regulatory cells, first of all responsible for development of these forms of the immune answer. The actual problem of modern transplantology is working out of methods which would promote accumulation in an organism of recipient T-regulatory of cells with suppressive properties for formation the donor-specific immune tolerance into recipient`s organism. 

It was ascertained, that induction of transplantation tolerance are bound with the using of regulatory possibilities of donor’s bone marrow cells. Hemopoietical bone marrow stem cells may be used to induct the central tole- rance into organism of recipient. For inducing of the active peripheral tolerance may be used small-differentiated dendrite cells of bone marrow, which are able to take part in receiving of T-regulatory memory cells, which are preventing both acute and chronic allograft rejection.