Objective: to assess the impact of baseline pulmonary hypertension (PH) on early and long-term outcomes following heart transplantation (HT). Materials and methods. From January 2010 to December 2018, 112 HTs were carried out. Based on right heart catheterization results, all recipients were divided into 2 groups: Group 1 with PH (n = 76; mean pulmonary arterial pressure (mPAP) ≥25 mm Hg), Group 2 – without PH (n = 36; MPAP <25 mm Hg). The average age of Group 1 patients was 46.4 ± 14.9 years, baseline pulmonary vascular resistance (PVR) was 3.5 ± 1.5 Wood units, PVR after reversion test (nitric oxide – 80 ppm, iloprost 20 μg) – 2.8 ± 1.0 Wood units, systolic PAP (sPAP) – 50.1 ± 13.4 mm Hg. The average age in Group 2 was 47.3 ± 12.2 years, baseline PVR – 2.1 ± 0.8 Wood units, sPAP – 27.4 ± 5.3 mm Hg. The dynamics in indicators of early postoperative period (duration of mechanical ventilatory support, use of vasodilators and inotropic support and the length of stay in intensive care unit (ICU), 30-day mortality) and long-term post-HT echocardiography results were assessed. Results. Due to acute right-ventricular failure (RVF) developing after heart transplantation, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was done in 8 patients (11%) from Group 1 and one patient (3%) from Group 2. Presence of PH did not affect duration of mechanical ventilatory support, inotropic support, and length of stay in ICU. Levosimendan therapy in the early postoperative period was more often performed in Group 1 (n = 29) than in Group 2 (n = 6) (p = 0.048). Nitric oxide inhalation was also more often administered in Group 1 (n = 54); Group 2 (n = 7), (p = 0.003). Sildenafil therapy after HT was comparable in both groups Group 1 (n = 25); Group 2 (n = 6), (p = 0.048). In early post-HT stages, 14 patients died, 30-day mortality was comparable in both groups (p = 0.12). Six months after HT, no differences were found in the sPAP (p = 0.21) and PVR (p = 0.07) levels. Conclusion. Patients with baseline PH after HT have a more severe early postoperative period, including a higher RVF incidence, with the need for ECMO implantation. A PVR level >3.5 Wood units is not a threshold for HT. Patients with baseline PVR >3.5 Wood units following HT show comparable results with patients without baseline PH. This allows such patients (baseline PVR >3.5 Wood units) to be considered for inclusion in the heart transplant waiting list. In addition, 30-day mortality and duration of mechanical ventilatory support after HT in patients with and without baseline PH did not differ. Regardless of the baseline level of sPAP and PVR, all patients showed improvement in these parameters after HT. Six months after HT, no differences were found in sPAP and PVR levels in the patients, regardless of whether there was baseline PH or not.

Introduction. Heart transplantation (HT) is an extreme treatment for chronic congestive heart failure. One of the ways of reducing deficit of donor organs was to expand the criteria for selection of donors in favor of heart retrieval from older donors. This became one of the causes increasing the risk of donor-transmitted coronary atherosclerosis (DTCA). The impact of endovascular DTCA correction on postoperative survival of heart recipients remains poorly studied. Objective: to estimate the life expectancy of heart recipients with donor-transmitted coronary atherosclerosis. Materials and methods. The life expectancy of 518 heart recipients who underwent coronarography during the first week after HT was evaluated. When hemodynamically significant stenosis of the coronary arteries was detected, percutaneous coronary intervention (PCI) was performed as planned. The average age of recipients was 46.92 ± 1 year (10 to 72 years). 90% of them were men. Recipients’ initial UNOS status was distributed as follows: UNOS 1a – 217 people, UNOS 1b – 89 and UNOS 2 – 212. Two groups were formed based on coronary angiography results. Group 1 included patients with DTCA signs, Group 2 was the control group (without DTCA). The first group was divided into 2 subgroups – a subgroup with DTCA signs, but without hemodynamically significant lesions (without PCI), and a subgroup with DTCA, where PCI was performed (PCI). Results. The age of recipients in both groups (DTCA and without DTCA) did not differ – 47.54 ± 1.01 and 46.64 ± 0.64 years, respectively. Donors were older in the DTCA group (50.2 ± 0.7 years) than in the control group (41 ± 0.5 years) (p = 0.0005). Survival in the control group averaged 58.25 ± 1.17 months, and in the DTCA group – 53.16 ± 0.36 months (p = 0.033). The difference in life expectancy of patients who underwent PCI (51.18 ± 2.9 months) and patients of the control group (58.25 ± 1.17 months) was not statistically significant (p = 0.88). In the group where graft showed signs of atherosclerotic changes in the coronary arteries, the cause of donor brain death from cerebrovascular accident was more common than in the control group. Conclusion. The risk of DTCA is associated with the donor’s age and the death of the donor brain from vascular causes. Endovascular correction of atherosclerotic lesions of coronary arteries makes it possible to neutralize the impact of transplant coronary artery stenosis on long-term outcome of HT surgery.

Objective: to evaluate the incidence of de novo malignant neoplasms (MN) after liver transplantation (LT) and compare with indicators among the general Russian population. Materials and methods. The study included 182 patients who had at least a 6-month follow-up period after LT and had no extrahepatic malignancies before LT. All data were analyzed retrospectively. Statistical processing of the results was carried out using the Statistica program for Windows v.10. Results. MN incidence was 5.5% (10 of 182 patients). The average period from transplantation to diagnosis of de novo neoplasm was 47.8 months (8 to 144 months). The patients were 3 men and 7 women. Types of de novo tumors included digestive system tumor (2 out of 10), hematologic malignant tumor (3 out of 10), skin cancer – melanoma (1 out of 10), urologic cancer (1 out of 10), gynecological (2 out of 10) and base of tongue cancer (1 out of 10). Five patients (50.0%) died, mortality was higher than in other LT patients (Z = –2.6; p = 0.009). The average follow-up period after detection of neoplasms was 18.8 months. Incidence of malignant neoplasms following LT was 10 times higher than among the general Russian population. No significant differences were found in the incidence of late acute rejection between 10 patients with MN and other 172 patients (Z = 0.18, p = 0.8). Among surviving patients, 2 patients with lymphomas received tacrolimus immunosuppression monotherapy, while 3 had everolimus-based immunosuppression. Conclusion. Incidence of de novo extrahepatic malignancies after LT is significantly higher than in the general population. To reduce the incidence of neoplasms in the future, patients should undergo regular screening, proliferative signal blockers should be prescribed, although their effectiveness requires further research.

Objective: to identify predicting factors at the listing stage that could be associated with recompensation followed by patient’s delisting. Materials and methods. A prospective case-control study was conducted. The “case” cohort included 19 adult patients who initially were wait-listed as a result of decompensated liver diseases of various origin, but later were delisted due to recompensation. The “control” cohort consisted of 61 patients who were listed during the same period for decompensation and died in the waiting list. Results. A logistic regression model was used to determine independent predictors of delisting following recompensation. Plasma albumin concentration and white blood cell count at listing became significant predictors of recompensation (p = 0.024 and p = 0.019, respectively). ROC (Receiver Operating Characteristic) curve analysis was used to compare the predictability of identified predictors. The area under the ROC curve (AUC) for plasma albumin concentration was 0.938 [95% confidence interval (CI) 0.882–0.995; p < 0.001]. The AUC for the white blood cell count was 0.924 [95% CI 0.865–0.982; p < 0.001]. The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥3.1 × 10⁹/L, was 14.639 (95% CI 2.16–99.12). The odds ratio for recompensation outcome, if the plasma albumin concentration at listing was ≥39.1 g/L, was 3.06 (95% CI 1.58–5.95). Conclusion. Liver injury could be reversed after the factors leading to decompensation have ceased to exist. Independent predictors of recompensation and subsequent delisting of patients were: white blood cell count ≥3.1 × 10⁹/L and plasma albumin concentration ≥39.1 g/L at listing for liver transplantation.

Objective: to study the differences in the frequency of pathological processes in liver biopsy samples of donors older than 60 years (group 1) and donors currently recognized as “standard” by age – 60 years and younger (group 2). Material and methods. Of the total pool of 300 consecutive donors with brain death, there were 28 (9.3%) donors over 60 years old (61 to 73 years old; 19 men and 9 women). Results. The frequency of pathology is independent of gender in both groups (p > 0.05). In elderly donors, compared with “standard” donors, mild (p < 0.05) and significantly more often severe (p < 0.05) albuminous degeneration are significantly less frequent, and there is only a tendency (p > 0.05) to more frequent mild hepatic steatosis. Dystrophic processes are the result of more severe ischemic injury to the liver of elderly donors. Ischemic liver injury determines the risk of more frequent biliary complications, which require careful monitoring and maintenance at an optimal level of hemodynamics for donors in the intensive care unit. Based on other morphological parameters, the liver of donors above 60 years of age does not significantly differ (p > 0.05) from the liver of donors 60 years and younger. Conclusion. To expand the donor pool, age restrictions should be removed when selecting a liver for transplantation, thereby maximizing the use of donor potential.

Objective: to evaluate the dependence of the magnitude of convection flow in online hemodiafiltration (OLHDF) on ultrafiltration control method and patients’ individual characteristics. Materials and methods. The study included 36 stable dialysis patients (20 male and 16 female). The substitution rate was conducted manually based on transmembrane pressure (TMP). In some cases, devices with automatic filtration rate control unit AutoSub plus were used. The filtration rate (FR), TMP, blood flow rate (Qb), specific filtration rate (SFR, m/l/min/mm Hg^–1 ) were recorded. Results. The maximum SFR in various patients ranged from 0.51 to 0.80 ml/min/mm Hg^–1 ; average value was 0.62 ± 0.07 ml/min/mm Hg^–1 . There was significant correlation of SFR with hemoglobin level (r = –0.55). SFR reduced during hemodiafiltration (on average – by 23 ± 4%). SFR was significantly affected by Qb (r = 0.70). Maximum SFR was achieved with a TMP of 140–220 mm Hg; with TMP over 250 mm Hg, a decrease in SFR was noted, an increase in Qb was required for further increase in FR. Individual stability of SFR was noted during serial observations; fluctuations in a particular patient did not exceed 10%. Substitution volume for the HDF session was 18.0 ± 3.3 L, the FR/Qb ratio was 24.7 ± 5.2%. Substitution volume of 21 L was not achieved in 17 of 36 patients. The use of automatic FR adjustment system made it possible to increase the substitution volume (SV) by 12–18%. Conclusion. Achieving maximum convection volume in OLHDF requires individualizing treatment parameters. The use of FR automatic control allows maximum possible convection flow.

Introduction. Creation of a biomedical cell product – a bioengineered pancreatic construct – is hampered by problems associated with maintaining the viability of functionally active isolated islets of Langerhans (ILs). Both biopolymer and tissue-specific scaffolds can contribute to maintaining the structure and function of isolated ILs in vitro and in vivo. The most preferred tissue-specific scaffolds for cells can be obtained via decellularized pancreas matrix scaffold (DP matrix scaffold). Objective: to conduct a comparative analysis of the secretory function of isolated ILs of rats cultured in biopolymer-based collagen-containing hydrogel (BCH) and tissue-specific DP matrix scaffold, respectively. Materials and methods. ILs from rat pancreas was isolated using classical collagenase technique with some modifications. ILs were cultured in BCH and tissue-specific scaffold under standard conditions. Tissue-specific DP matrix scaffold was obtained through decellularization of rat pancreas. The DP matrix scaffold was examined for cytotoxicity and DNA presence; it was subjected to morphological study. The secretory function of ILs was studied through enzyme-linked immunosorbent assay (ELISA). Results. The secretory function of islets cultured in BCH and DP scaffolds is significantly higher than in the monoculture of islets. The advantage of using tissue-specific DP matrix scaffolds when creating bioengineered constructs of the pancreas over BCH matrix scaffolds was identified. Conclusion. BCH and tissue-specific DP scaffolds contribute not only to preserving the viability of isolated ILs, but also to prolonging their secretory capacity for 10 days, compared with ILs monoculture.

Introduction. Despite resounding success in treatment of patients with coronary heart disease (CHD), researchers are yet unable to significantly reduce mortality in this disease. With this in mind, there are ongoing studies everywhere, which are aimed at investigating new techniques in order to boost the efficiency of existing standards. One of such promising techniques is cell/regenerative therapy with autologous bone marrow mononuclear cells (ABMMCs). However, even though ABMMCs have been studied for more than 10 years, there are no unambiguous data yet on several issues. Objective: to evaluate the outcome of ABMMC transplantation during coronary artery bypass grafting (CABG) surgery in combined treatment of CHD. Materials and methods. The data of 408 patients admitted to the clinic from 2013 to 2016 for planned surgical treatment of CHD were analyzed. The work included 117 people based on the design of the study. Patients were randomized in 3 groups: Group 0 (control group) – CABG surgery and intramyocardial injection of 0.9% NaCl solution, Group 1 – CABG surgery and intramyocardial injection of ABMMCs, Group 2 – CABG surgery, intramyocardial and intra-graft injection of ABMMCs. The dynamics was assessed 12 months later – functional class of angina pectoris and heart failure, echocardiography, speckle tracking (assessment of the degree of myocardial deformation), treadmill test, 6-minute walk test, daily ECG monitoring, quality of life questionnaires, coronary angiography. Qualitative indicators were calculated using the Pearson’s chi-squared test and Fisher criteria. Quantitative indicators were calculated using the Kruskal–Wallis and Wilcoxon tests. Factor analysis was used to identify certain severity factors and to study data homogeneity. Discriminant analysis was performed to investigate the leading characteristics that determine differentiation between the groups. For analysis of variance, taking into account various factors, the model of variance analysis for dependent samples – Repeated Measures ANOVA – was used. Results. In the observation groups, an improvement in both systolic and diastolic myocardial function was universally noted. A six-minute walk test showed statistically significant increase in Groups 1 and 2 compared with the control Group 0 – 315.06 ± 17.6 (433.54 ± 20.6), Group 1 – 319.8 ± 24.5 (524.4 ± 28.7), Group 2 – 329.9 ± 25.3 (452.7 ± 29.7) meters. A significant decrease in the functional class of exertional angina pectoris in Groups 1 and 2 was noted unlike in the control group. The percentage of functioning coronary shunts after a 12-month follow-up period was 87.6% in Group 0. In Groups 1 and 2, this ratio was 96.2% and 97.3%, respectively. Predictors of overall effectiveness were identified: smoking, initial diastolic myocardial dysfunction, left ventricular ejection fraction. Conclusion. In addition to surgical treatment of coronary heart disease, ABMMC transplantation can improve myocardial contractility, boost exercise tolerance, and increase the duration of the functioning of coronary shunts at the follow-up period of 12 months. The study showed the need for stage-by-stage analytical calculations with the aim of possible correction of further work.

Implantation of polymeric heart valves can solve the problems of existing valve substitutes – mechanical and biological. Objective: to comprehensively assess the hemocompatibility of styrene-isobutylene-styrene (SIBS) triblock copolymer, synthesized by controlled cationic polymerization in comparison with expanded polytetrafluoroethylene (ePTFE) used in clinical practice. Materials and methods. SIBS-based films were made by polymer solution casting method; in vitro biocompatibility assessment was performed using cell cultures, determining cell viability, cell adhesion and proliferation; tendency of materials to calcify was determined through in vitro accelerated calcification; in vivo biocompatibility assessment was performed by subcutaneous implantation of rat samples; hemocompatibility was determined ex vivo by assessing the degree of hemolysis, aggregation, and platelet adhesion. Results. The molecular weight of synthesized polymer was 33,000 g/mol with a polydispersity index of 1.3. When studying cell adhesion, no significant differences (p = 0.20) between the properties of the SIBS polymer (588 cells/mm²) and the properties of culture plastics (732 cells/mm²) were discovered. Cell adhesion for the ePTFE material was 212 cells/mm². Percentage of dead cells on SIBS and ePTFE samples was 4.40 and 4.72% (p = 0.93), respectively, for culture plastic – 1.16% (p < 0.05). Cell proliferation on the ePTFE surface (0.10%) was significantly lower (p < 0.05) than for the same parameters for SIBS and culture plastic (62.04 and 44.00%). Implantation results (60 days) showed the formation of fibrous capsules with average thicknesses of 42 μm (ePTFE) and 58 μm (SIBS). Calcium content in the explanted samples was 0.39 mg/g (SIBS), 1.25 mg/g (ePTFE) and 93.79 mg/g (GA-xenopericardium) (p < 0.05). Hemolysis level of red blood cells after contact with SIBS was 0.35%, ePTFE – 0.40%, which is below positive control (p < 0.05). Maximum platelet aggregation of intact platelet-rich blood plasma was 8.60%, in contact with SIBS polymer – 18.11%, with ePTFE – 22.74%. Conclusion. In terms of hemocompatibility properties, the investigated SIBS polymer is not inferior to ePTFE and can be used as a basis for development of polymeric prosthetic heart valves.

Despite advancements in modern surgery in the treatment of cutaneous injuries, the search for new methods of ensuring faster and more effective wound healing appears especially urgent today. Tissue engineering is undoubtedly of interest when it comes to developing such technologies. Objective: to determine the optimal protocol for obtaining a decellularized dermal matrix scaffold for subsequent development of tissue-engineered skin. Materials and methods. One Landrace piglet was used as the experimental animal. After preliminary skin treatment with dermatome, 0.3 cm thick samples were taken. Two decellularization protocols were considered: protocol No. 1 was based on the use of Triton X-100 and deoxycholate, protocol No. 2 was only based on deoxycholate. There were 5 processing cycles in total for the 2 protocols. After treatment, acellular matrix scaffolds were examined through histological analysis and quantitative determination of DNA concentration. Next, static recellarization of the matrix scaffolds was carried out with porcine dermal fibroblasts. After that, the matrix scaffolds were tested for cytotoxicity using XTT test and differential staining test to differentiate between live and dead cells. Results. Comparative analysis of the two protocols for porcine dermis decellularization showed that both protocols effectively remove cells and nuclear material, while maintaining the architectonics of the intercellular substance intact, since fibrous structures are not destroyed. But when assessing the biocompatibility of matrix scaffolds based on analysis of cell viability according to data obtained from XTT test and cell–matrix adhesion, the matrix scaffold processed under protocol No. 1, shows advantages. Conclusion. In this study, a decellularization protocol based on Triton X-100 and deoxycholate was noted. The results obtained mark the first stage towards developing a tissue-engineered skin.

Revitalization of decellularized or devitalized matrix scaffolds in tracheal tissue engineering typically involves seeding the autologous recipient cells or allogeneic cells under long-term cultivation. Objective: to study the capability of human nasal chondrocytes for colonization of devitalized scaffolds based on native human tracheal cartilage, with proinflammatory stimulation (cytokine) by adding Interleukin-1-beta (IL-1β) to the culture medium. Materials and methods. Scaffolds for tracheal tissue engineering were obtained from native human tracheal cartilage through devitalization and laser etching. The scaffold was revitalized by seeding the human nasal chondrocytes. Histological examination was performed after staining with hematoxylin and safranin-O, with further microscopy using a Nikon Eclipse L200 light microscope. X-ray microtomography was performed on a Phoenix nanotom m apparatus. Electron microscopy was performed on a Nova NanoSEM 230 setup. Results. There was statistically significant increase in the intensity of colonization (p = 0.0008) with nasal chondrocytes and stimulation of their migration activity (p < 0.0001) in the presence of IL-1β compared with the control groups. Conclusion. Addition of proinflammatory cytokine IL-1β (1 μg/ml) to the culture medium enhances volumetric seeding of devitalized cartilage scaffold with human nasal chondrocytes, allowing to create highly revitalized materials for tracheal tissue engineering.

Objective: to study the viability of a tissue-engineered graft (TEG) based on a devitalized tracheal scaffold (DTS) seeded with mesenchymal stromal and epithelial cells in an experiment on rabbits with assessment of cytocompatibility and biocompatibility in vivo. Materials and methods. Syngeneic mesenchymal stromal bone marrow cells (MSBMCs) and syngeneic lung epithelial cells of rabbit were obtained. The morphology and phenotype of the MSBMC culture were confirmed via immunofluorescence staining for CD90 and CD271 markers. Pulmonary epithelial cells obtained by enzymatic treatment of minced rabbit lung tissue were stained with CKPan, CK8/18 and CK14 markers characteristic of epithelial cells. The donor trachea was devitalized in three successive freezethawing cycles. Double-layer cell seeding of DTS was performed under static and dynamic culturing. Orthotopic implantation of TEGs was performed at the site of the anterolateral wall defect in the rabbit that was formed as a result of tracheal resection over four rings. Results were evaluated by computed tomography, histological and immunohistochemical analyzes. Results. A TEG implant, based on DTS, with bilayer colonization by cell cultures of rabbit MSBMC and epithelial cells was obtained. Three months after implantation, TEG engraftment was noted, no tracheal wall stenosis was observed. However, slight narrowing of the lumen in the implantation site was noted. Six months after implantation, viability of TEG was confirmed by histological method. Epithelialization and vascularization of the tracheal wall, absence of signs of purulent inflammation and aseptic necrosis were shown. The small narrowing of the lumen of trachea was found to have been caused by chronic inflammation due to irritation of the mucous membrane with suture material. Conclusion. A new model for assessing the viability of a tissue engineering implant when closing a critical airway defect was created. The developed TEG – based on DTS seeded (bilayer) by lung epithelial cells and BMSCs – was successfully used to replace non-extended tracheal defects in an in vivo experiment. The use of tracheal tissue-engineered graft for orthotopic implantation showed biocompatibility with minimal tissue response.

Acute kidney injury (AKI) after liver transplantation (LT) is a pressing issue and remains the focus of many researchers. The etiology of AKI is multifactorial, but the main one is ischemia-reperfusion injury to the liver transplant. Numerous preoperative, intraoperative and postoperative risk factors contribute to the development of AKI. The use of standard classifications, such as AKIN, RIFLE and KDIGO, has improved post-transplant AKI diagnosis. However, determination of creatinine levels in the blood enables AKI diagnosis only in the later stages of this syndrome. Therefore, studies are currently underway to find ways of early diagnosis of AKI using biomarkers. Transition to a molecular level not only improves accuracy but also facilitates early diagnosis of AKI. Currently, the diagnostic capabilities of neutrophil gelatinase-associated lipocalin (NGAL) are the most investigated. To date, there are no known measures of preventing post-transplant AKI. Moreover, treatment of this condition cannot be considered satisfactory. Even a mild post-transplant AKI can be fatal. In severe AKI, where renal replacement therapy is used, there is a risk of death in the intensive care unit. More than half of AKI patients develop chronic kidney disease requiring chronic hemodialysis.

Currently, kidney transplantation and hemodialysis are the primary therapies for end-stage renal disease. High mortality, mostly caused by cardiovascular disease, remains the main challenge in the treatment of this category of patients. It has been shown that in patients with end-stage chronic kidney disease undergoing hemodialysis, the risk of mortality due to cardiovascular disease is up to 20 times higher than in the sex- and age-matched general population. The indicated data determined the appropriateness of isolating cardiorenal relationships into a single cardiorenal syndrome (CRS). Due to the facts mentioned above, intravascular imaging methods, notably optical coherence tomography (OCT), are particularly important in diagnosing coronary artery lesions. This review analyses the data published to date on the features and capabilities of OCT in CRS patients.

Apart from its main electrolytes – sodium, potassium, calcium and magnesium – a dialysis fluid (DF) contains a buffer for correction of acidosis. A small amount of acid is added to the DF to prevent calcium and magnesium precipitation. Acetic acid has traditionally been used for this purpose. Several studies have shown that acetate ion, even in small concentrations, can cause a number of adverse events, such as low blood pressure, production of proinflammatory cytokines, etc. This literature review aims at considering alternative acidic components of DF, such as citric, hydrochloric, and succinic acids, as well as their advantages, possibilities and features of their use in wide clinical practice.

Spermatogonial stem cells, which are already present at birth in the testicles, are the progenitors of male gametes. These cells cannot produce mature sperm before puberty due to their dependence on hormonal stimuli. This feature of the reproductive system limits preservation of fertility only to males who can produce an ejaculate. Therefore, the use of cancer treatment which can lead to fertility loss has made sperm cryopreservation a standard practice. Prepubertal cancer boys – who are prescribed chemotherapy that is toxic to their reproductive system – are deprived of this fertility management procedure. This review focuses on the problem of obtaining and preserving spermatogonial stem cells for future transplantation to restore spermatogenesis. Development of these methods is becoming increasingly urgent due to higher survival rates in childhood cancer over the past decades thanks to improvements in diagnosis and effective treatment. Restoring and preserving fertility using spermatogonial stem cells may be the only option for such patients.

Patients with drug refractory end-stage heart failure fall into the severe category of cardiological patients. Numerous studies have shown the superior efficacy of heart transplantation over other treatments for end-stage chronic heart failure. However, despite decades of achievements in transplantology, shortage of donor organs remains a pressing and unresolved issue. The only way to reduce shortage of donor organs is to use donors with advanced criteria, which requires the use of latest technologies in organ resuscitation and conditioning.

This paper is dedicated to Sergei Brukhonenko (1890–1960), a physiologist and inventor of the world’s first heartlung machine. His immense contributions to the development of modern science and technology are investigated. Brukhonenko’s invention is seen as modern biotechnology that has attracted an all-round strong public interest. A philosophical analysis of the differences between the concepts “technique” and “technology” is presented. The paper discusses the sociocultural impact of biotechnology on the society and culture.

Aim: Nurses, especially nurses in ICUs play an important role in organ donation; their performance in relation to their role is more affected by their attitude in this regard, identification of effective factors on the positive attitude of nurses towards organ donation is essential. This study was conducted aimed to determine the empathy and altruism with the nurses’ attitudes in intensive care unit towards organ donation and brain death. Methods. In this cross-sectional study, which was conducted in 2019, 222 nurses from intensive care unit were selected by stratified random sampling. For collecting data the questionnaires of altruism, empathy and attitude toward organ donation were completed by nurses. Data was analyzed using pearson correlation, multiple linear regression. Results. There was a significant correlation between altruism (p < 0.001, r = 0.24) and its components (anonymous prosocial behaviors (r = 0.33, p < 0.001), emotional prosocial behaviors (r = 0.14, p = 0.03), dire prosocial behaviors (r = 0.14, p = 0.03) and compliant prosocial behaviors (r = 0.21 and p = 0.001)) with attitudes and also between empathy (r = 0.04, r = 0.13), perspective taking component (p = 0.02, r = 0.152) and imaginary empathy (r = 0.14, p = 0.03) with nurses’ attitudes. The components of anonymous prosocial behaviors in altruism (p < 0.0001), gender (p = 0.007) and having organ donation card (p = 0.012) are positive predictors of nurses’ attitudes towards organ donation. Conclusion. The results showed that altruism and having organ donation card were two of the most important factors in the tendency of nurses to organ donation. Therefore, the implementation of educational programs regarding changing nurse’s attitude in order to increase the sense of altruism and empathy about organ donation is necessary. By strengthening the sense of altruism and empathy in the family of brain death patients, they can be helped to decide on donate their patient’s organ with more certainty.