Deficit of donor organs is the limiting factor in organ transplantation. One way of solving this problem is the use of donors with sudden irreversible circulatory arrest. Obtaining organs from this category of donors is pos- sible only through the use of normothermic extracorporal perfusion in situ (NECP) with oxygenation and leu- cocyte depletion. The article presents the implementation of NECP in 11 uncontrolled non heart beating donor (uNHBD) kidneys (age of 43,1 ± 2,98 years) and the results of transplantation in 22 recipients of such transplants in comparison with the results of the 20 recipients of kidney transplants from 20 donors to the death of the brain (age 45,65 ± 1,8 years). Despite the initially high rate of delayed function and more significant number of hemo- dialysis in uNHBD group (group of investigation), serum creatinine at 21st day was the same level as in BDD group (comparison group): 0,198 ± 0,002 mmol/L and 0,151 ± 0,002 mmol/L (p > 0,05). The use of NECP with oxygenation and leucocyte depletion is an effective practice for recovery kidney from donors with a sudden ir- reversible circulatory arrest with warm ischemic time one hour and more before the operation explantation. 

This is preliminary report about first clinical experience with early conversion to Everolimus based scheme of immunosupression for kidney transplant recipients receiving grafts from expanded criteria donors (ECDs). The indications were given in aspects of recommended pretransplant estimation of zero-biopsy results. Two groups of recipients received grafts form the same suboptimal donors, n = 20, and were divided according to different scheme of immunosupression. The recipients of the first one, comparative group, n = 17, received standard CNI- based three components scheme, the recipients of the other one, investigation group, n = 20, received Everoli- mus based scheme of immunosupression, with cancelled MMF and reduction of CNI in two times. The statistic differences of the serum creatinine level were 215,3 ± 53,38 in comparative group and 149 ± 53,9 mkmol/L in investigation group (р = 0,022). Despite the benefits of early conversion to Everolimus in recipients of grafts from ECDs which were shown by authors this protocol demands further investigation. 

Combined liver-pancreas transplantation is considered to be a reasonable treatment of patients with end-stage liver disease and concomitant insulin-dependent diabetes mellitus, so it may become a standard treatment of this category of patients. As known, diabetes mellitus negatively affects the long-term results of isolated liver transplantation and increases a risk of posttransplant complications. Notwithstanding the widening range of indi- cations for simultaneous liver-pancreas transplantation and advances of transplantology, this operation continues to be a rare event in world medical practice. In May 2010 in Academician V.I. Shumakov Federal Research Cen- ter of Transplantology and Artificial Organs there was performed a first in Russia simultaneous liver-pancreas transplantation to 17-years old recipient, suffering with liver cirrhosis (as a result of autoimmune hepatitis) and concomitant insulin-dependent diabetes mellitus.

In this article we give an overview of indications for simultaneous liver-pancreas transplantation, different ope- rative techniques, immunological aspects and immunosuppression regimes, as well as we describe the first in Russian experience of such transplantation. 

Sequence specific oligonucleotides typing was used to identify human leukocyte antigen (HLA)-A, B, DRB1 alleles from 705 recruited volunteers with Volga Federal District for unrelated hematopoietic stem cell registry and 155 of their number at locus HLA-C. 48 samples cannot be entered into the database because of ambiguities in the identification of allelic loci on HLA-class I – HLA-A, HLA-B. To resolution of ambiguity use reagents kits AlleleSEQR HLA Sequencing, which allowed to reveal the ambiguity of the locus HLA-A, 44% of cases, the loci HLA-B and HLA-C – 40% of cases. Application software HARPs Finder showed the possibility of resolution of all identified allelic ambiguities (with the exception of types of ambiguity – A*03/A*32 or A*74:13/A*32:04 and A*01/A*11 or A*36:04/A*11) with the addition of basic kits AlleleSEQR HLA Sequencing reagents kit Al- leleSEQR HARPs. 

The prosthesis ON-X carcas has advantages in implantation commodity and safety, effective orifice area. We pe- sent results of this prosthesis usage during perioud of 2006–2009 years. This time 792 operations with AC were completed. In mitral position were implanted 132 (91,7%) prostheses ON-X. Of them 80 (60,6%) valves were sutured with complete or partial preservation of posterior leaflet and 26 (19,7%) valves – with total MV preser- vation. In aortic position we implanted 76 (53,9%) valves ON-X. Only 3 cases needed posterior aortoplasty for the N 23 prosthesis implantation.

In perioperative and late postoperative periods we didn’t meet prostheses thrombosis or dysfunction. Reoperati- ons for high prosthesis gradients didn’t occur in postoperative period. Late postoperatively there were 3 (1,1%) cases of embolic events related to the incorrect anticoagulant treatment. 

Despite all successes of a modern heart surgery, anesthesiology and resuscitation till now actual there is a ques- tion of improvement of results of surgical treatment of patients with chronic left ventricle postinfarction aneu- risms. Аfter left ventricular reconstructive surgery preoperative risk factors of development heavy myocardial dysfunctions in the postoperative period aren’t defined accurately now. We have made the analysis of 168 similar operations and have defined preoperative risk factors of development of severe heart failure in the intraoperative and early postoperative period. We have suggested methods to improve the results of operations in these patients using mechanical and pharmacological support of blood circulation. Use our suggested methods of preoperative preparation (Intraaortic balloon counterpulsation (VABK) and VABK + levosimendan) had significantly impro- ved results and significantly reduce mortality in patients with high risk of surgical treatment. 

For correction and treatment of liver failure before liver transplantation were proposed severe methods such as: extracorporal devices, transplantation of hepatocytes and implanted tissue-engineering units. The function of healthy hepatocytes presumes to stabilize the state of patients with chronic liver diseases and to wait a donor organ transplantation. In this review the results of experimental and clinical therapy of liver diseases by method of hepatocyte transplantation were summarized. 

The nosocomial or hospital acquired infections is one of the most important medical and social problem. Mo- dern strategy of nosocomial infections prevention include prevention of nosocomial legionellosis. Epidemic outbreaks of nosocomial legionellosis with high mortality rate (20–40%) were recognized last years in different countries. The contaminated by Legionella hospital hot water supply system is a source of Legionella infection outbreaks. A risk reduction strategy of waterborne pathogens in hospital water system is important part of mo- dern conception of nosocomial infection prevention, especially among immune compromised patient including transplant patients. In revue discussed different aspects of epidemiology, laboratory diagnostic and prevention of nosocomial legionellosis. 

Successful donor’s programs have to base on the fundamental knowledge about brain death and principles of do- nor intensive care. In this article there is presented a comprehensive review of modern literature which highlights the main issues in donor care management. 

Clotting prevention is one of the key problems in renal replacement therapy. In this review traditional heparini- zation and its complications, low molecular weight heparins, which are wide used in programme haemodialysis, treatment without anticoagulants, regional citrate anticoagulantion, as well as new alternative anticoagulants are considered. 

The review article analyses the published literature for mobilization of CD34/CD45 positive bone marrow cells into peripheral blood after liver injury. Recent investigations of mechanism of bone marrow stem cells mobiliza- tion into peripheral blood, role of the stem cells in recovery of injured liver and clinical studies of hematopoietic stem cells mobilization after liver transplantation and resection are discussed in the review. Recently some stu- dies have demonstrated that bone marrow stem cells can participate in recovery of liver tissue and functions after its injury. Mobilization of bone marrow stem cells into peripheral blood after liver injury is one of the possible evidence of such participation. The mobilization of bone marrow stem cells was shown in experimental models and in clinical investigations. However the issue is still controversial as there are publications which failed to find mobilization of bone marrow stem cells into peripheral blood after liver transplantation or resection in pa- tients. In this review we investigate and summarize recent research of the topic.