Compromised inferior vena cava (IVC) is a rare but life-threatening condition in low-birth-weight children who require kidney transplantation (KT) to survive.

Objective: to demonstrate a comprehensive approach to KT in children with IVC atresia.

Materials and methods. In the period from December 2019 to April 2024, 5 kidney transplants were performed in children with atresia or obliteration of the IVC at Shumakov National Medical Research Center of Transplantology and Artificial Organs. The average age of the children at transplantation was 4.6 ± 2.7 (from 1 to 8 years) years, body weight 13.5 ± 4 (from 8.3 to 19.5) kg.

Results. Vertical midline transperitoneal approach was performed, the right lobe of the liver, as well as the accessible part of the subhepatic IVC were partially mobilized. The renal graft was positioned on the right side with the formation of venous anastomosis with the accessible part of the subhepatic IVC. All the children had primary graft function. There were no acute rejection episodes at year 1 post-transplant. The average renal graft glomerular filtration rates in recipients at 3 months and at 1 year post-transplant were 95.9 ± 9.6 ml/min per 1.73 m² and 80.6 ± 26.2 ml/min per 1.73 m², respectively.

Conclusion. When the iliac veins and/or distal IVC are compromised, venous outflow into an accessible IVC segment is the preferred option. Transplantation in the left orthotopic position and other mentioned revascularization techniques are complex surgical techniques with a higher risk of thrombotic complications in the early postoperative period.

Objective: to use intraoperative fluorometry to assess the impact of renal allograft arterial blood flow on vascular complications.

Materials and methods. The study included 285 patients who underwent kidney transplantation (KT) at Shumakov National Medical Research Center of Transplantology and Artificial Organs (from May 2022 to July 2023). Patients were distributed into 2 comparison groups. Group 1 (49 patients, 17.2%) underwent intraoperative flowmetry, while group 2 (236 patients, 82.8%) did not. Following graft reperfusion, renal transplant arterial blood flow was measured in real time. Next, ureteroneocystostomy was performed, and then the graft was placed in the iliac fossa in its optimal position and the measurement was repeated.

Results. Intraoperative vascular complications occurred in 6 patients (12.2%) in the intraoperative flowmetry group. Those with vascular complications exhibited statistically significantly lower renal arterial volumetric blood flow (VBF) rate immediately after reperfusion (94 ± 93 vs. 291 ± 147; p = 0.002) and after reassessment at the end of ureteroneocystostomy (160 ± 88 vs. 349 ± 157; p = 0.006). A VBF of less than 120 mL/min contributed to the intraoperative decision to immediately revise the anastomosis. Following revision and reanastomosis of the arterial channel, there was no significant difference in VBF rate and PI values between recipients with the complications and the group without.

Conclusion. Prophylactic application of intraoperative fluorometry in KT allows to obtain objective data about the quality of vascular anastomosis and timely prevent irreversible vascular complications, thus preserving the renal graft in the postoperative period.

Objective: to analyze early outcomes of kidney transplantation (KT) in patients with type 1 diabetes mellitus (T1D) and stage 5 chronic kidney disease resulting from diabetic nephropathy.

Materials and methods. The study group included 145 T1D patients who underwent KT at the kidney and pancreas transplant department of Sklifosovsky Research Institute for Emergency Medicine between January 1, 2007 and December 31, 2023. Among them were 57 men (39.3%) and 88 women (60.7%), the median age was 41.5 [35–47] years. The median age at disease onset was 14.6 [9–17] years. Organ donors consisted of 100 (69%) men, 40 (27.6%) women, and there was no information on the sex of 5 donors (3.4%). Donor median age was 46 [35.5–53] years.

Results. Ninety-nine recipients (68.3%) had primary renal allograft function (PRAF), whereas 46 recipients (31.7%) had delayed function. The median time for azotemia to normalize was 6 [3; 6] days in PRAF patients and 20.5 [14; 27] days in those with delayed function. Overall, there were 9.7% (n = 14) surgical complications, 12.4% (n = 18) acute rejection crisis, and 9.7% (n = 14) infectious complications. Median serum creatinine and urea levels at discharge were 123 [99–164] μmol/L and 10 [7.4–14] mmol/L, respectively; median fasting blood glucose levels before transplantation and at discharge were 9.8 [7.8; 12] mmol/L and 8.1 [6.5; 10] mmol/L, respectively. A total of 125 patients (86.2%) were discharged with adequately functioning kidney graft, while 13 patients (9%) were discharged with graft dysfunction that did not require renal replacement therapy; one patient (0.7%) was transferred to the outpatient stage of treatment to continue dialysis therapy; however, renal allograft function was restored within 2 months post-transplant.

Conclusion. Although T1D patients remain the most severe category of dialysis patients, our findings suggest that KT is an effective treatment option for them with high graft and recipient survival rates.

Background. Living-donor liver transplant (LDLT) is a life-saving procedure for patients with end-stage liver diseases.

Objective: to evaluate the outcomes of the first independent LDLT performed at the Department of Hepatobiliary Surgery, Vakhidov Republican Specialized Surgical Research and Practical Medical Center of Surgery, and to demonstrate that liver transplantation (LT) is a feasible procedure at our institution.

Materials and methods. From October 2021 to December 2023, 40 right lobe LDLTs were performed in our department. Short-term and long-term outcomes in recipients were assessed. The outcomes of transplant hepatectomy were also evaluated.

Results. Hepatic artery thrombosis developed in 1 case (2.5%); arterial anastomotic stenosis was detected in 3 cases (7.5%), which were repaired by endovascular balloon dilation; splenic artery steal syndrome was diagnosed in 3 cases (7.5%), which was resolved by endovascular splenic artery embolization. One patient (2.5%) developed portal vein thrombosis. Two patients (5%) had portal vein stenosis 10 months after transplantation; endovascular balloon angioplasty was performed with good clinical effect. Biliary complications accounted for 45%, of which 89% were biliary leaks and 11% were anastomotic biliary stricture. In-hospital mortality was 12.5%.

Conclusion. The results of our experience and analysis of post-transplant complications are comparable with those of the world literature and are acceptable at the stage of implementation of the LT program. Transplantation is feasible at our center, but it is necessary to improve surgical and conservative treatment techniques in order to minimize early and late postoperative complications.

This paper reviews the strategies for correcting ischemia-reperfusion injury (IRI) in kidneys during surgeries and transplantation, discussed and proposed in the current literature. The pathophysiological mechanisms of IRI and a wide range of proposed methods for reducing the severity of injury are considered. The use of such techniques as the combination of ischemic, pharmacological pre- and postconditioning is still being studied. It was observed that researchers were very interested in immunological and biological (stem cell) therapeutic strategies as a potential avenue to lessen the severity of IRI.

Renal cell carcinoma (RCC) in a kidney transplant is a rare condition as it occurs in the donor kidney of a recipient undergoing immunosuppressive therapy and differs exceptionally from a similar cancer that develops in the native kidney. Given the relative rarity, characteristic specificity of RCC in transplant recipients, and the difficulty in diagnosis and treatment, this type of tumor is less thoroughly studied than the «standard» RCC. However, as more transplants are performed and recipients are being detected with this pathology more frequently, the study of this tumor becomes significantly relevant.

In the presented case, a patient who underwent liver transplant procedure for cirrhosis resulting from chronic hepatitis C was diagnosed with colorectal cancer 12 years after the operation. A combined treatment plan consisting of right hemicolectomy followed by nine cycles of adjuvant polychemotherapy using the FOLFOX6 regimen was performed. Seven months following the conclusion of treatment, 22×35 mm foci in segment 8 was detected as a sign of metastatic liver disease. The patient had a transplant hepatectomy. At present, the relapse-free survival is 22 months.

Emphysematous pyelonephritis (EPN) is a necrotizing infection of the renal parenchyma and its surrounding areas that causes gas accumulation around the renal parenchyma, collecting system and surrounding tissues in the process of vital activity of several microorganisms. EPN occurs nearly exclusively in people with diabetes. Treatment strategies for EPN have evolved over the past 20 years, with minimally invasive procedures replacing nephrectomy, which has resulted in lower mortality rates (12.5–13%). EPN is rare in kidney transplant (KT) recipients and is characterized by a severe, often fulminant course with a high rate of adverse outcomes, which is determined primarily by background immunosuppressive therapy. There is no universally accepted consensus on the radiographic classification of EPN in KT recipients and its management. We present the first description of EPN in transplanted kidney in a 45-year-old woman with post-transplant diabetes, obesity and recurrent urinary tract infections. Massive antibiotic therapy (ABT), percutaneous nephrostomy, transplantectomy, renal replacement therapy, selective cytokine adsorption, and ventilatory support were all administered on the patient after she was admitted to the hospital with increasing clinical symptoms of sepsis and multiple organ failure. Death occurred on the fourth day after disease onset. The article examines 38 clinical cases from the English-language segment of the medical literature from the late 1970s to the present. EPN in KT recipients is characterized by the predominance of male gender, including among the deceased, rapid development of sepsis and acute kidney injury. There was no statistically significant difference in the frequency of emergency transplantectomies among surviving and deceased patients. Mortality was 28%. The issue of EPN in transplanted kidney requires more research and the development of optimal therapeutic plans, including surgical strategies.

Kidney transplantation (KT) remains the best treatment for patients with chronic kidney disease (CKD) stage 4–5. It helps patients live longer, have better quality of life, and undergo improved medical and social rehabilitation. This paper examines the outcomes of KT performed between 2019 and 2023.

Materials and methods. There were 1,106 KTs deceased donor KTs performed between January 1, 2029, and December 31, 2023. The recipients had a median age of 45 (37–54) years, with 664 (60%) males and 442 (40%) females. Donors were mainly males (n = 706, 63.8%), with the median donor age being 50 (43–57) years. Induction immunosuppressive therapy (IST) with monoclonal antibodies was administered to 859 (77.7%) recipients, with polyclonal antibodies to 122 recipients (11%), and induction without antibodies to 125 recipients (11.3%). Triple-drug baseline IST consisted of a combination of calcineurin inhibitors, antimetabolites and glucocorticoids. Tacrolimus was the most often utilized calcineurin inhibitor (n = 961, 86.9%), while cyclosporine was used less often (n = 145, 13.1%). Mycophenolic acid (n = 1041, 94.1%) was used as the second medication in most recipients, while everolimus (n = 54, 4.9%) and azathioprine (n = 11, 1%) were used less often.

Results. Primary initial renal graft function was noted in 714 patients (64.6%) and delayed in 392 recipients (35.4%). Overall incidence of surgical complications was 11.6% (n = 130), and immunological complications 9.9% (n = 109). At hospital discharge, 768 recipients (69.4%) had satisfactory kidney allograft (KAG) function, while 276 recipients (25%) were discharged with graft dysfunction; median serum creatinine and blood urea levels were 158 (120–204) μmol/L and 11 (8–16) mmol/L, respectively. Twenty-six recipients (2.4%) were discharged to continue renal replacement therapy; 28 recipients (2.6%) underwent in-hospital graft nephrectomy. Twelve individuals passed away during the hospitalization phase. The cumulative uncensored in-hospital graft and recipient survival rates were 97.5% (n = 1078) and 98.9% (n = 1094), respectively.

Conclusion. KT is an effective and safe transplant modality for stage 4–5 CKD. Our KT outcomes are consistent with those of reputable transplant centers around the globe.

Objective: to analyze heart transplant (HT) outcomes in patients who suffered cardiac arrest requiring extracorporeal cardiopulmonary resuscitation (ECPR) by peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO).

Materials and methods. The study included 41 patients (14 (34.1%) women and 27 (65.9%) men, aged 42.6 ± 16.8 (40.0 [30.5; 54.0]) years with in-hospital cardiac arrest. The causes of cardiac arrest were acute decompensated heart failure (n = 19; 46.3%), irreversible graft dysfunction (n = 9; 22.0%), postcardiotomy acute heart failure (n = 5; 12.2%), acute myocardial infarction (n = 4; 9.8%), and acute graft rejection (n = 4; 9.8%).

Results. Twenty-seven (65.9%) patients had cardiac arrest in the intensive care unit (ICU) and 14 (34.1%) outside ICU. The interval between femoral artery puncture and ECPR initiation was 4-17 (9 ± 5) minutes, while that between cardiopulmonary resuscitation (CPR) initiation and peripheral VA-ECMO was 26 ± 9 minutes. Atonic seizure developed in 11 (26.8%) of 41 patients while receiving VA-ECMO. Of the 41 patients, 30 (73.2%) had irreversible brain damage. Four (9.8%) patients were discharged from the hospital without neurological or multiple organ dysfunction. In 26 (63.4%) patients (10 (38.5%) women and 16 (61.5%) men) aged 14 to 63 (40.7 ± 15.8) years, ECPR and subsequent treatment resulted in survival to HT while receiving VA-ECMO (duration 1-11 (4.0 [1.5; 5.0]) days). The age of the heart donor (6 (23.1%) women and 20 (76.9%) men) was 44.0 ± 9.9 years, the cumulative Eurotransplant Heart Donor Score was 16.9 ± 2.7, the Donor Risk Index was 6.3 ± 1.5, and the estimated incidence of severe primary graft dysfunction (RADIAL scale) was 15.4 ± 3.7%. Graft ischemia lasted for 188 ± 72 (170.0 [141.25; 185.0]) minutes. Five (19.2%) recipients developed severe dysfunction, which required continuation of peripheral VA-ECMO in the postperfusion period. The cause of death (n = 4; 15.3%) in the early post-HT period was irreversible multiple organ dysfunction.

Conclusion. In-hospital survival after emergency HT in recipients who underwent ECPR before transplantation is 84.7%.

Background. Orthotopic heart transplantation (OHT) is the gold standard treatment for individuals with endstage heart failure (HF), providing the best survival and quality of life. In Russia, the number of OHT procedures and transplantation of other organs have significantly increased in recent years. At the same time, there is lower perioperative mortality and higher survival in the post-OHT long-period.

Objective: to analyze OHT outcomes in Kuzbass over a 10-year period.

Material and methods. From January 2013 to December 2023, 72 OHTs (36.7% of those included on the heart transplant waiting list (HTWL) over a 10-year period) were performed at the Research Institute for Complex Issues of Cardiovascular Diseases. Recipient median age was 56 [50.5; 61.0] years, which included 61 men and 11 women. Among the etiologic causes of end-stage HF, ischemic cardiomyopathy was predominant in 65.3% (n = 47) of recipients, whereas dilated cardiomyopathy was present in 25% (n = 18) of recipients. Other cardiomyopathies accounted for 9.7% (n = 7).

Results. A total of 196 patients with end-stage HF were included in the HTWL over a 10-year period; 74 (37.8%) of these did not live to get a transplant. The waitlist time was 173 days (5.77 months) – which is slightly longer than the average waiting time of 3.9 months for OHT according to data from European registries. Waitlist mortality was 19.6%. The 10-year average in-hospital mortality rates among patients after OHT were 16.7% and 1-year mortality was 15.3%. These rates are consistent with worldwide trends for this high-tech medical care. Cumulative survival at the end of 2023 was 51.4% (36 patients after OHT). Median length of stay in the hospital was 28 days, with 14 days spent in the intensive care unit. Donor heart anoxia time was 112 [85.25; 170.5] minutes, and cardiopulmonary bypass time was 145 [124; 169.5] minutes. Ten patients (13.9%) required extracorporeal membrane oxygenation, while 8.3% of cases required extracorporeal homeostasis correction.

Conclusion. The 10 years of successful experience at the Research Institute for Complex Issues of Cardiovascular Diseases validates the need to develop the OHT program in Kuzbass as a gold standard for treating end-stage HF.

Heart transplantation remains the gold standard treatment for end-stage heart failure. Lifelong immunosuppressive and adjuvant therapy requires constant medical follow-up in order to optimize treatment regimens and increase the adherence of heart recipients to treatment.

Objective: to study and adapt a method for systematic assessment of the complexity of treatment regimen using the MRCI index, and its link to long-term prognosis in heart recipients.

Materials and methods. Results of the study were obtained by analyzing the data of heart recipients observed at the Consultative & Diagnostic Department, Shumakov National Medical Research Center of Transplantology and Artificial Organs (Shumakov Center). The Medication Regimen Complexity Index (MRCI) was used to assess drug therapy. In our study, polypharmacy was defined as taking five or more medications, and high-risk polypharmacy was defined as the use of more than eight medications. The heart recipients were divided into two groups based on how many medications they received daily.

Results. The study included patients observed at the Consultative & Diagnostic Department, Shumakov Center from January 2008 to December 2017. The number of drugs taken by the patient at year 5 of follow-up was 9.2 ± 4.2. During the conducted data analysis, the mean total MRCI score was 48.72 ± 19.15 (from 32 to 70); medications used to treat comorbidities accounted for 42.9% of the total MRCI score, and immunosuppressive therapy accounted for 28.7%. The total MRCI score in the high-risk polypharmacy group was 58.49 ± 17.41; medications used to treat comorbidities accounted for 50.27% of the total MRCI score. The analysis revealed a correlation between the total MRCI score and the frequency of hospitalizations.

Conclusions. Patient adherence to prescribed treatment is a predictor of favorable prognosis of event-free long-term survival, but low adherence and therapeutic inertness are associated with decreased quality of life, more frequent hospitalizations and higher risk of adverse events. With proper outpatient follow-up of this patient cohort, there were no significant differences in survival in the polypharmacy and high-risk polypharmacy group.

Objective: today, extracorporeal membrane oxygenation (ECMO) systems remain the main type of short-term circulatory support in various clinical situations. One of the main elements of this system is a blood pump. The objective of this study is to develop the first domestic centrifugal pump for use in ECMO systems.

Materials and methods. Based on a systematic literature review, the main medical and technical requirements for an extracorporeal centrifugal pump were formulated. To create 3D mathematical models of the outer casing of the pump and all its internal components, calculations were performed in CAD software package SolidWorks (SolidWorks Corp., USA). Hydrodynamic test benches were designed and developed to evaluate the performance of the centrifugal pump mockup. The pump was studied to obtain its head-capacity curve (HCC) and hemolytic characteristics.

Results. 3D modeling of geometrical parameters of the pump flow impeller was performed. Fluid flow was assessed in the rotor rotation range at speeds from 3000 to 7000 rpm. Hydrodynamic bench tests were performed under conditions simulating the resistance of the oxygenator and connecting cannulas. The HCC was obtained based on the given medical and technical requirements for the operating flow range from 1 to 5 l/min at pressure dropsof 200 to 400 mm Hg.

Conclusion. Based on results from the 3D modeling and bench experiments, a model of extracorporeal centrifugal pump was obtained, which showed its efficiency during the first trials. Further experimental studies will be conducted to obtain the energy and biological characteristics of the developed device.

Objective: to conduct a comparative study of the efficacy of Custodiol^® cardioplegia (Custodiol HTK, Dr. Franz Köhler Chemie GmbH, Bensheim, Germany) and normothermic autoperfusion of heart graft as a part of an ex vivo cardiopulmonary complex (CPC).

Methods. Landrace pigs weighing 50 ± 5 kg and aged 4–5 months (n = 10) were used as the model for a series of acute experiments. In the experimental group (n = 5), the CPC was conditioned by autoperfusion for 6 hours. In the control group, the heart’s pumping function was restored after a 6-hour cold preservation with Custodiol^®. The effectiveness of cardiac graft preservation methods was evaluated by measuring myocardial ischemic markers, endothelial synthetic function, and endothelial cell activation markers (E- and P-selectins, endothelial growth factor).

Results. Following cardiac graft reperfusion, the control group exhibited a statistically significant increase in the concentration of myocardial ischemia markers; also, there was a significant decrease in the synthesis of endothelium-derived relaxing factor in the Custodiol^® solution preservation group (378.5 [226.4; 539.7] vs. 542.1 [377.6; 853.2] μM/mL in the autoperfusion group, p < 0.05). The degree of coronary endothelial reperfusion injury/activation was several times higher in the control group than in the normothermic autoperfusion conditioning group. Moreover, cardiac output after a 6-hour graft conditioning was 0.63 [0.37; 0.80] and 0.37 [0.23; 0.37] L/min in the experimental and control groups, respectively (p < 0.05).

Conclusion. Normothermic autoperfusion showed a significant advantage in preserving the morphofunctional status of the donor heart compared with cold preservation with Custodiol^® during 6 hours of ex vivo graft conditioning.

For more than 70 years, short-term mechanical circulatory support devices, as well as methods and skills for their implantation, have been continuously developed and improved. An in-depth study of each of the existing devices is important not only to optimize patient outcomes, but also to create a safer, more effective, smallersized new device. This review considers existing temporary circulatory support devices, as well as oxygenators, that supplement the system to protect lung function. Their main technical characteristics and the peculiarities of their application in clinical practice are given. Based on the literature review, we formulated the main directions of extracorporeal membrane oxygenation evolution in Russia.

Silk is becoming one of the key materials in contemporary bioengineering and medicine due to its unique physicochemical and biological properties. This review article discusses the main components of silk, fibroin and sericin, their structure and functional characteristics, as well as their importance in the production of biocompatible and biodegradable materials. Modern methods of modifying silk to enhance its mechanical and biological properties are considered, including physical, chemical, and genetic manipulation. The use of silk in tissue engineering, development of medical implants, controlled drug delivery systems, and biosensors is given particular consideration. In conclusion, the prospects for further silk research targeted at creating innovative biomaterials for medical applications are discussed.

Objective: to examine the relationship between native liver fibrosis and TGFB1 gene polymorphism in pediatric liver recipients.

Materials and methods. Fibrosis of varying severity was diagnosed (METAVIR scale) based on histological analysis of the native liver of children (45 boys and 62 girls aged 3 to 73 months). Genomic DNA was genotyped by real-time polymerase chain reaction using TaqMan probes.

Results. The prevalence of the TGFB1 single nucleotide polymorphisms (SNPs) rs1800469, rs1800470, and rs1800471 was examined in both children with liver fibrosis of varying severity and in healthy individuals. The distribution of rs1800470 in children with fibrosis was 50% homozygotes of major allele, 29% heterozygotes and 21% homozygotes of minor allele. This distribution was not consistent with the Hardy–Weinberg principle (p = 0.00026).

Conclusion. Liver fibrosis in pediatric liver recipients is linked to the rs1800470 polymorphism of the TGFB1 gene. Carriage of the heterozygous rs1800470 genotype may be a protective factor against liver fibrosis in children with liver failure.

Objective: to assess if normothermic ex vivo machine perfusion (NMP) of a kidney from an expanded criteria donor (ECD) is feasible and safe.

Materials and methods. NMP of the right kidney from an ECD was performed on a device developed at Botkin Hospital. A solution based on donor’s blood with the addition of Ringer’s lactate solution and human albumin was used for perfusion. The temperature in the circuit was maintained at 37 °C. Perfusion lasted for 203 minutes, after which the renal resistive index was almost halved from 0.33 to 0.16. 120 ml of urine was obtained.

Results. The right kidney was successfully transplanted after perfusion. There was immediate function of the right renal graft in the postoperative period. The recipient’s serum creatinine level was 530 μmol/L on day 1 following transplantation and 170 μmol/L on day 14 of discharge. The left kidney was preserved by static cold storage and further transplanted to the recipient.

Conclusion. The use of NMP to preserve grafts obtained from ECDs is safe and feasible in clinical practice. Further studies are required to determine the clear indications for its use and to formulate an optimal procedure for its implementation.

Objective: to ascertain the prevalence and risk factors for bacterial translocation (BT) in brain-dead donors (BDDs) during organ and tissue retrieval in health care facilities.

Materials and methods. The study included 62 BDDs, featuring 44 males (71%) and 18 females (29%), aged 17 to 64 years. Organ was retrieved in healthcare institutions located in Gomel Oblast in 2019–2022. Bacteriological examination of biopsy material taken from different parts of the intestine, mesenteric lymph nodes (MLNs) and spleen was carried out. The presence of BT was validated when bacterial growth was obtained from homogenized MLNs and(or) spleen by isolating an identical strain from the intestinal lumen. The anthropometric characteristics of BDDs, hematologic, biochemical parameters, and the length of stay in the intensive care unit (ICU) were assessed.

Results. Evidence of bacterial translocation was detected in 22 BDDs (35.5%, 95% CI 24.7–48.0). Growth in MLNs and in spleen biopsies was noted in 21 (95.5%) and 7 (31.8%) patients, respectively. The BDDs were categorized into two groups depending on the presence of BT, and the main characteristics were compared. ROC analysis was used to determine the prognostic significance of the main parameters. Risk factors for BT were serum sodium level >144 mmol/L (AUC = 0.759) at the time of retrieval, weight >89 kg (AUC = 0.756), BMI >27.5 (AUC = 0.709), decreased hemoglobin <126 g/L (AUC = 0.665), and ICU stay >2 days (AUC = 0.656).

Conclusion. Bacterial translocation is found in 35.5% of BDD cases, and it is accompanied by penetration of bacteria and yeast-like fungi into the MLNs and spleen. Bacterial translocation is linked to excess body weight, hypernatremia, prolonged ICU stay, and decreased hemoglobin levels at the time of retrieval. These factors should be taken into account in the medical management of brain-dead donors (organ donor conditioning).

Transplantation helps to save the lives of patients with end-stage diseases of the liver, heart, lungs, and kidney.

Objective: to study the strategies for advancing the idea of organ donation in the Russian Federation.

Materials and methods. Scholarly publications by Russian researchers on the issue at hand. The study’s methodology was based on application of general and specific scientific methods of theoretical analysis.

Results. An assessment of how opportunities were used to legitimately promote the idea of donation was conducted.

Conclusion. Modern ways and methods of promoting the idea of organ donation will help to introduce into public attention the importance of organ donation for transplantation.

Background. Organ shortage remains an unsolved issue in the field of transplantology. It is particularly severe in such a progressive area as lung transplantation. The creation of extracorporeal systems for rehabilitation of donor organs has been made possible by perfusion techniques; however, the search for the best perfusion and preservation solutions remains important.

Objective: to evaluate the efficacy of the developed solution for preservation and normothermic ex vivo lung perfusion (EVLP), as well as to conduct a comparative analysis with the standard perfusion solution for EVLP.

Materials and methods. Experimental studies on small animal models were conducted. All animals were divided into 2 groups – control and experimental. The study stages consisted of: procurement of donor lungs, static cold storage, EVLP and orthotopic left lung transplantation. In the experimental group, the lungs were preserved using an experimental solution, while in the control group, they were preserved in PERFADEX^® Plus (XVIVO, Sweden). Static cold storage lasted for 10 hours. Orthotopic left lung transplantation was performed after EVLP. The follow-up period was 2 hours, after which blood samples and sections of the transplanted lung were taken for morphological examination. Upon completion of the experiment, the animal was removed from the experiment by exsanguination.

Results. Respiratory index at the end of perfusion was statistically significantly higher in the experimental group (434 mmHg) than that of the control group (394 mmHg). Pulmonary vascular resistance (PVR) in both groups had a downward trend, which is a good prognostic sign of the efficacy of perfusion agents. PVR was lower in the experimental group compared to the control group – 36 versus 89 dynes/sec/cm^–5.

Conclusion. The developed combined dextran-40-based solution showed its effectiveness as a preservation agent for static cold storage and as a perfusion solution for EVLP.

Objective: to conduct a pilot study of the effect of bioprosthetic heart valve leaflet calcification on biomechanics and to identify the «stress in the material – dysfunction» relationship.

Materials and methods. The study’s focus was on two commercially available UniLine bioprosthetic mitral valves sized 26 and 30 (NeoCor, Russia). The samples were subjected to microcomputer tomographic scanning in order to reconstruct calcium volumes. The resulting 3D models were correlated with prostheses of corresponding sizes and projected to the volume of the locking element in the Abaqus/CAE engineering analysis software (Dassault Systemes, France).

Results. According to numerical modeling, the maximum principal stresses increased significantly to 90.8 MPa in the samples, the opening decreased qualitatively, and impact on the prosthetic frame increased. Comparison of stress diagrams of numerical simulation with samples demonstrates the relationship between peak amplitude and rupture and thinning localizations in the flap apparatus.

Conclusion. The work presented demonstrated the findings of a pilot study of the connection between biomechanics in a patient-specific calcified mitral prosthetic heart valve UniLine and macroscopic characterization of explanted samples. The comparative stage showed that stress values correlate with localization of leaflet dysfunction.