Objective: to assess the current status and development trends in organ donation and transplantation in the Russian Federation based on data from the year 2024. Materials and methods. A survey was conducted among transplant center directors. The Russian Ministry of Health’s information accounting system was used for data verification. Comparative analysis was carried out to evaluate trends over time, differences across regions of the Russian Federation, and variations among transplant centers. Results. Based on data retrieved from the National Registry in 2024, there were 49 kidney transplant programs, 38 liver transplant programs, and 21 heart transplant programs operating in the Russian Federation. The donor activity rate was 6.7 per million population (p.m.p.). Multi-organ procurement accounted for 78.5% of cases, with an average of 3.0 organs retrieved per effective donor. A total of 3,307 organ transplants were performed in 2024, including 1,943 kidney transplants, 894 liver transplants, and 426 heart transplants. This represents an 8.2% increase in organ transplants compared to 2023. In Moscow, organ donation activity reached 31.6 p.m.p. A total of 12 transplant centers operated in Moscow and Moscow Oblast, collectively performing 54.0% of all kidney transplants and 67.3% of all extrarenal transplants nationwide. The number of patients living with transplanted organs in the Russian Federation exceeds 155.1 p.m.p. Conclusion. The network of transplant centers in the Russian Federation continues to expand, with three new transplant programs launched in 2024. Over the past year, both the number of effective donors and the volume of organ transplants have increased. The resource potential of medical institutions has not yet been fully utilized, allowing for further growth in transplant activity. Moscow remains the central driver of transplant medicine in Russia. Shumakov National Medical Research Center of Transplantology and Artificial Organs and its branch account for 27.1% of all organ transplants performed nationally. Successful regional transplant programs are also underway in the Republic of Tatarstan, Kemerovo Oblast (Kuzbass), St. Petersburg and Leningrad Oblast, Novosibirsk Oblast, and Krasnoyarsk Krai. Notably, the Russian Federation places a strong priority on providing pediatric transplant care.

This article explores the historical development of pediatric liver transplantation (LT), tracing its evolution from the first experimental procedures to modern high‑tech approaches. Throughout its history, LT in children has been a catalyst for innovation and novel surgical techniques. The earliest attempts at pediatric LT faced numerous technical and immunological challenges and were associated with extremely high mortality rates. A major breakthrough occurred in the 1980s with the introduction of cyclosporine A. During this period, pioneering advances such as reduced-size grafts, split-liver transplantation, and the first successful living-related donor procedures marked a new era. The 1990s witnessed further progress in surgical techniques, introduction of tacrolimus, and the development of right-lobe living donor transplantation. These innovations not only expanded the donor pool significantly but also improved surgical outcomes. Entering the 21st century, the field experienced further breakthroughs with the implementation of ABO-incompatible transplantation and the adoption of MELD and PELD scoring systems for organ allocation. In addition, the integration of minimally invasive laparoscopic and robot-assisted approaches reduced donor morbidity and improved postoperative recovery. Today, pediatric LT is recognized not only as a life-saving treatment for end-stage liver failure in children but also as a driving force of innovation in modern transplant practice. The article underscores the importance of continuous refinement of surgical techniques and personalization of immunosuppressive regimens as key strategies to improve long-term survival and enhance the quality of life in pediatric LT recipients.

Background. Liver transplantation (LT) is one of the most complex surgical procedures, presenting significant challenges in preoperative preparation, intraoperative management, and postoperative rehabilitation. These complexities make it demanding both technically and logistically. The introduction of enhanced recovery after surgery (ERAS) protocols has revolutionized perioperative care across numerous surgical disciplines, leading to improved patient outcomes and reduced healthcare costs. However, the application of ERAS protocols in LT remains limited and inconsistent, with considerable variation in implementation strategies across institutions. Objective: to summarize current knowledge and assess an overview of implementation and outcomes of ERAS protocols in LT recipients. Materials and methods. A structured literature search was conducted using the keywords «ERAS» and «liver transplantation» across major scientific databases. The review included a range of relevant publications, including review articles, clinical trials, observational studies, and case-control studies. Conclusion. ERAS protocols in LT are designed to optimize postoperative recovery, improve clinical outcomes, and minimize the risk of complications. Given the complexity and individuality of each LT case, ERAS pathways must be carefully tailored to the recipient’s clinical condition, donor characteristics, and intraoperative variables.

Objective: to identify specific psychological characteristics of individuals with end-stage renal disease (ESRD) who are undergoing evaluation for inclusion on the kidney transplant waiting list, as well as those already on the list. Materials and methods. The study was based on the hypothesis that individuals with ESRD exhibit a correlation between family-related anxiety and psychological traits such as weak personal boundaries, depressive symptoms, and difficulty recognizing and expressing emotions. To test this hypothesis, the following validated instruments were employed: Karpov’s Reflexivity Diagnostic Method, Beck Depression Inventory (BDI), the Sovereignty of Psychological Space Questionnaire – 2010, Toronto Alexithymia Scale (TAS-20) and Family Anxiety Analysis Questionnaire (FAA). The study sample included 60 people aged 18 to 71 years. The main group consisted of 30 respondents diagnosed with kidney failure, while the control group included 30 ESRD-free individuals. Statistical analysis was conducted using SPSS Statistics version 27.0. Results. The study found that patients with ESRD exhibited reduced levels of reflexivity compared to the control group (p ≤ 0.01). However, no statistically significant differences were observed between the groups in terms of depression levels, personal boundary preservation, or the ability to identify and describe emotions (p > 0.05). ESRD patients reported lower levels of family-related anxiety than the healthy individuals (p ≤ 0.05). Correlation analysis revealed a significant positive relationship between depression and the difficulty in recognizing and identifying emotions among ESRD patients (R = 0.491, p ≤ 0.01), as well as between depression and levels of anxiety (R = 0.418, p ≤ 0.05) and psychological tension (R = 0.640, p ≤ 0.01). An inverse correlation was found between the ability to recognize internal states and make informed decisions, and the perceived sense of security within one’s physical and psychological space (R = –0.385, p ≤ 0.05). Additionally, a direct correlation was identified between the level of depression and the duration of hemodialysis treatment in the ESRD population. Conclusion. The findings underscore the importance of considering psychological factors in the pre-transplant assessment and preparation of patients with kidney failure. Incorporating psychological evaluation into the transplant protocol may enhance both surgical outcomes and long-term adaptation to post-transplant life.

Background. Despite the effectiveness of modern immunosuppressive therapy protocols, acute rejection remains a significant challenge in liver transplantation (LT), occurring in up to 40% of cases. One promising strategy to improve graft tolerance and reduce rejection rates is the use of mesenchymal stem cells (MSCs). Administering MSCs directly into the regional circulation of the transplanted liver offers the potential to enhance the effects of standard immunosuppressive therapy by exerting a localized immunosuppressive effect at the graft site. Objective: to evaluate the clinical efficacy of intraportal administration of MSCs during the induction phase of immunosuppressive therapy in patients undergoing LT. Materials and methods. A randomized prospective study was conducted involving two groups of LT recipients. In the experimental group (n = 14), patients received an intraportal infusion of MSCs during transplantation at a dose of 20 × 106 cells. The control group (n = 14) underwent standard transplant reperfusion without MSC administration. The study assessed the safety of the MSC infusion procedure, graft function, incidence and severity of acute rejection, renal function, and tacrolimus levels. Additional assessments included histological and immunohistochemical analyses, as well as fluorescence in situ hybridization (FISH). Results. No complications associated with MSC administration were observed. The MSC group demonstrated faster restoration of graft function, with significantly lower levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) by postoperative day 4 (p < 0.05), and normalization of AST achieved by day 10. The incidence of acute rejection was lower in the MSC group (21%) compared to the control group (28%), with only mild to moderate rejection observed in the MSC group. Additionally, expression of matrix metalloproteinase-10 (MMP10) was significantly reduced in the MSC group (p = 0.01). Tacrolimus levels were lower in the MSC group, yet adequate immunosuppression was maintained. This correlated with faster renal function recovery, with serum creatinine levels on day 4 significantly lower in the MSC group compared to controls (80 vs 101 μmol/L, p < 0.05). FISH analysis confirmed the presence of MSCs within the liver graft tissue on postoperative day 7. Conclusion. Intraportal administration of MSCs during LT is a safe approach that enhances faster graft function recovery, reduces the severity of acute rejection, and mitigates tacrolimus-associated nephrotoxicity. These findings support the potential of MSC therapy as a valuable adjunct to standard immunosuppressive regimens in LT.

Internal organ transplantation is a high-tech medical intervention that significantly improves patient survival and quality of life. However, infections remain the leading cause of mortality in organ transplant recipients. Invasive aspergillosis (IA) is the second most common invasive fungal infection in this population and is associated with high mortality rates, reaching up to 90%. This article presents a clinical case of IA following heart transplantation (HT), along with an analysis of registry data and institutional experience in managing this serious complication based on registry data. Between September 2010 and October 2024, 23 adult patients with IA following an internal organ transplantation were included in the institutional registry. Most IA cases occurred after heart transplantation (65%), followed by kidney transplantation (31%), and, less commonly, lung transplantation (4%). The lungs were the primary site of IA (96% of cases). Diagnosis was confirmed through direct microscopy of clinical samples, such as bronchoalveolar lavage (BAL) fluid and tissue biopsies, in 50% of patients, while fungal cultures yielded positive results in 35% of cases. The predominant pathogen was Aspergillus fumigatus (73%), followed by Aspergillus niger (18%) and Aspergillus flavus (9%). A positive galactomannan test in BAL was detected in 85% of patients. All patients received targeted antifungal therapy, primarily with voriconazole (87%), while echinocandins and itraconazole were used in 17% and 4% of cases, respectively. Overall 90-day patient survival was 78%. The literature review outlines the main approaches to the diagnosis and management of invasive infections associated with Aspergillus spp.

Objective: to evaluate the correlation between renal scan (RSc) and volumetric multislice computed tomography (perfusion CT) in living kidney donors, with the goal of identifying interchangeable functional parameters and optimizing the preoperative assessment of split renal function. Materials and methods. The study included 54 living kidney donors (totaling 108 kidneys). Split renal function was assessed using RSc with 99mTc-mercaptoacetyltriglycine (MAG3) and contrast-enhanced volumetric MSCT. Key parameters from nephroscintigraphy included renal plasma flow (RPF), time to maximum tracer accumulation (Tmax), and excretion half-life (T½). Single-photon emission computed tomography (SPECT) analysis included arterial flow (AF), blood volume (BV), extraction fraction (FE), and indexed extraction fraction (IFE). Correlation between modalities was analyzed using Pearson’s correlation coefficient and Bland–Altman plots. Results. Significant correlations were observed between RSc and volumetric MCT parameters. A strong negative correlation was found between Tmax and AF (r = –0.75, p < 0.001), indicating an inverse relationship between blood flow velocity and renal filtration capacity. Similarly, T½ showed a negative correlation with FE (r = –0.75, p < 0.01), suggesting that a shorter tracer half-life corresponds to more efficient renal extraction. A strong positive correlation between RPF and IFE (r = 0.79, p < 0.001) supports the feasibility of using indexed CT perfusion as a surrogate for assessing RPF. Bland-Altman analysis showed that differences between the two diagnostic methods remained within clinically acceptable limits, confirming their potential interchangeability in preoperative donor assessment. Conclusion. The study demonstrates the potential for partial interchangeability between RSc and volumetric CT perfusion in the preoperative assessment of kidney donors. While CT perfusion offers superior accuracy in assessing renal blood flow, nephroscintigraphy remains the method of choice for evaluating excretory function. The combined use of both modalities improves diagnostic accuracy and kidney donor selection, thereby improving the safety of kidney transplant programs.

Coronary artery disease remains a leading cause of graft failure after heart transplantation (HT). Because the transplanted heart is denervated, graft ischemia is typically asymptomatic, necessitating annual screening to detect cardiac allograft vasculopathy (CAV), monitor established coronary lesions, and evaluate in‑stent restenosis. The need for annual invasive coronary angiography, along with its associated risks, including potentially life-threatening complications, underscores the need for safer, yet equally effective, noninvasive diagnostic alternatives for evaluating coronary pathology in heart transplant recipients. Multislice computed tomography coronary angiography (MSCT–CAG) has been successfully employed in the diagnosis of ischemic heart disease (IHD) for many years and is well-established as a noninvasive alternative to conventional coronary angiography. This makes it particularly relevant to investigate its applicability and effectiveness in the post-transplant setting.

Heart transplantation (HT) is a cardiac surgical procedure involving the replacement of a recipient’s pathologically impaired heart with a functionally adequate donor organ. As with any major surgical intervention, HT comes with possible complications, one of which is primary graft dysfunction (PGD). This report presents our initial experience in the diagnosis and management of a patient who developed PGD, necessitating the use of mechanical circulatory support.

This study focuses on the evaluation of a modernized impeller for the RotaFlow centrifugal pump (Maquet, Germany), carried out as part of efforts to design a domestic counterpart. The proposed impeller features a combination of primary elongated blades, responsible for generating the majority of pressure, and secondary shortened blades. The investigation examined pump performance under extracorporeal membrane oxygenation (ECMO) therapy conditions at a pressure of 350 mmHg and flow rate of 5 L/min. Computational analyses were conducted to evaluate fluid flow parameters associated with hemolysis risk. The optimized impeller demonstrated a significant increase in low tangential stress zones (<10 Pa), reduced exposure time, and a lower hemolysis index. Comparative mathematical modeling and bench testing with donor blood confirmed the improved hemodynamic performance of the redesigned impeller over the original configuration.

As part of the development of a domestic counterpart, the impeller of the RotaFlow centrifugal pump (Maquet, Germany) was modernized within the framework of research into the operating conditions of centrifugal pumps used in extracorporeal membrane oxygenation (ECMO) therapy. A novel rotor impeller design was proposed, featuring two types of blades: the primary elongated blades responsible for generating most of the pressure, and secondary shortened auxiliary blades. A three-dimensional computational model of the RotaFlow pump was created incorporating the redesigned impeller. To evaluate the effectiveness of the modernization, the new design was compared to the original Maquet impeller. Computational simulations were conducted to analyze key fluid dynamics parameters, such as turbulence intensity and flow velocity, within the typical operating range of the pump (flow rates from 1 to 5 L/min at a pressure drop of 350 mmHg). Mathematical modeling demonstrated that the new blade configuration yields improved flow characteristics compared to the original design.

Objective: to conduct a comprehensive bibliometric analysis of publications from 2008 to 2024 on the problem of cell therapy for liver diseases using mesenchymal stem cells (MSCs) with stem-like properties, with the goal of identifying new ways to tackle this problem. Materials and methods. A bibliometric analysis was carried out using the Scopus electronic database. The search included article titles, abstracts, and keywords. The dataset was exported in BibTeX and CSV formats for compatibility with VOSviewer and R software. Data were analyzed using R (version 4.4.2) and visualized through the Bibliometrix online analytical platform and VOSviewer (version 1.6.20). Results. The analysis identified four distinct periods of publication activity reflecting the evolution of research into the use of MSCs for liver regeneration in cases of liver injury. Period 1 (2008–2012) – This phase was marked by exploratory studies investigating the therapeutic potential of MSCs derived from various sources, including bone marrow, adipose tissue, and umbilical cord cells. Early findings highlighted the promise of MSC-based therapy and underscored the need for more rigorous and targeted research. Period 2 (2013–2016) – During this period, research focused on elucidating the mechanisms underlying the regulatory and regenerative effects of MSCs on damaged organs. Significant progress was made in the field of tissue engineering, aimed at enhancing the survival and functional integration of apoptotic MSCs post-transplantation. Period 3 (2017–2020), and more notably period 4 (2021–2024), were marked by the expansion, deepening, and intensification of research into the properties of apoptotic MSCs. Particular emphasis was placed on the regulatory functions and therapeutic potential of their secreted paracrine and trophic factors – specifically exosomes, extracellular vesicles, and apoptotic bodies. Conclusion. This bibliometric analysis has outlined key directions for further research in the development and application of cell technologies, particularly the use of MSCs in regenerative medicine. Future studies will likely focus on identifying the most active paracrine and trophic factors, elucidating their chemical structures and biological functions, and subsequently manufacturing chemical and pharmaceutical agents with bioactive regenerative properties. Such advancements would help standardize the production of MSC-based therapeutics and increase their availability for clinical use. Moreover, the bibliometric approach applied in this study can serve as a valuable tool for tracking and forecasting trends in related biomedical research fields.

Isolated islet transplantation offers a safer and less invasive alternative to whole pancreas transplantation for patients with complicated type 1 diabetes mellitus. However, the procedure faces significant challenges, including the loss of vascularization, innervation, and extracellular matrix (ECM) support. Additionally, factors such as hypoxia, oxidative stress, inflammatory responses, and the cytotoxic effects of immunosuppressive therapy compromise islet viability significantly and limit long-term graft function. Tissue engineering and regenerative medicine strategies aim to address these challenges. A central objective is the development of biocompatible, biomimetic ECM scaffolds (frameworks, carriers, or matrices) that can provide both mechanical support and a suitable microenvironment for islet cells in vitro and in vivo. This review aims to systematize current data on the use of biomimetic ECMs in the creation of stable, tissue-engineered pancreatic constructs.

Cardiovascular disease (CVD) remains the leading cause of mortality in patients with end-stage renal disease (ESRD). The risk factors for CVD in this population can be categorized into three main groups: traditional (nonmodifiable factors such as male gender, age over 65 years in men and over 75 years in women, and a family history of cardiovascular disease; modifiable factors encompass hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, and physical inactivity), renal-specific (anemia, chronic fluid overload, mineral and bone disorders, chronic inflammation, electrolyte imbalances, and oxidative stress), and transplant-specific (immunosuppressive therapy and graft dysfunction). Risk factors related to renal pathology and immunosuppressive therapy following kidney transplantation play a role comparable in significance to traditional CVD risk factors. Early detection and management of these factors are critical for reducing CVD incidence in this patient population.

Objective: to establish and conduct annual monitoring of the status and development trends in nephrology care across the federal subjects of the Russian Federation for the year 2024. Materials and methods. A comprehensive set of indicators was developed, and a structured survey was administered among leading freelance nephrology specialists across the regions. The collected data were systematically analyzed. Results. In 2024, the Russian Federation operated 706 hemodialysis (HD) centers and 49 kidney transplant (KT) centers. A total of 73,483 patients were receiving renal replacement therapy (RRT), of whom 76.6% were on HD, 2.7% on peritoneal dialysis (PD), and 20.6% were being monitored with a functioning kidney transplant. During the year, 1,943 KTs were performed across 49 centers in 38 regions. The overall RRT availability in the Russian Federation was 503.2 patients per million population (pmp), with HD at 385.7 pmp, PD at 13.7 pmp, and KT at 103.8 pmp. Among patients receiving HD in 2024, 81.9% were treated via arteriovenous fistula, 12.1% through permanent central venous catheter, 3.6% via temporary catheter, and 2.4% using vascular prostheses. In 2024, the Russian Federation had 537 nephrology outpatient offices, staffed by 690 physicians providing specialized care. The ratio of outpatient nephrologists to the population was 0.24 per 50,000, significantly below the recommended standard for medical personnel. Inpatient care for patients with pre-dialysis stages of chronic kidney disease (CKD) was delivered through 263 departments, comprising a total of 5,039 beds (equivalent to 0.35 beds per 10,000 population). Morphological evaluation of kidney biopsies – an important indicator of inpatient nephrological care – was independently conducted in 38 regions. Kidney biopsies were performed in 2.5% of patients hospitalized in inpatient facilities, translating to an average of 32.8 biopsies per million population. Conclusion. An annual monitoring framework has been successfully developed, with active collaboration established across regional centers, enabling the collection of up-to-date data on nephrological care in the Russian Federation for 2024. There is no current shortage of dialysis facilities, and a significant proportion of patients receive RRT via HD, an approach that places considerable financial burden on the national healthcare system. The high proportion of working-age individuals (62.4%) among HD patients underscores the substantial socio-economic impact of CKD and its treatment on both the state and society. Although the number of KTs continues to rise annually, current transplant volumes remain insufficient to fully meet demand and only partially offset the growing costs associated with RRT. Expanding the use of PD, particularly in sparsely populated regions, may offer advantages over HD. Nonetheless, KT remains the optimal treatment modality for patients with end-stage CKD, supporting the need to further expand transplant infrastructure and increase access to this intervention. The continuation of annual monitoring across all stages of CKD will allow for data-driven improvements in care delivery, incorporating emerging recommendations and regional insights.

This review addresses a key issue in establishing vascular access for maintenance hemodialysis: the implantation of tunneled central venous catheters (TCVCs). Advances in catheter design and imaging technologies in recent years have significantly reduced the risk of complications associated with TCVC placement. Nevertheless, certain complex clinical scenarios still require individualized approaches during implantation. This review highlights the indications and contraindications for TCVC placement, examines the various catheter types and potential insertion sites, and discusses patient preparation, intraoperative considerations, and postoperative care. It also reviews early and late complications, along with strategies for their management. The use of additional imaging modalities to facilitate catheter placement is also presented. Currently, a standardized approach to TCVC implantation is employed, encapsulated in a standard operating procedure (SOP), which ensures adherence to aseptic techniques and provides a structured framework for training new clinical staff.

Objective: to compare the effectiveness of extended heart preservation (up to 6 hours) at a temperature of +4 to +8 °C with the standard method. Materials and methods. The study was conducted using male Landrace pigs weighing 40–60 kg (n = 6). The experimental group (n = 3) underwent heart preservation at an optimized temperature of +4 to +8 °C for 6 hours prior to transplantation. In the control group (n = 3), hearts were preserved using the standard method for the same duration. Following preservation, coronary perfusion was restored ex vivo, cardiac activity was reinitiated, and myocardial function was evaluated alongside biochemical markers of cardiac tissue injury. Results. Following the resumption of blood supply and cardiac activity, both groups showed a reduction in superoxide dismutase (SOD) and malondialdehyde (MDA) levels. In the experimental group (preserved at +4–8 °C), SOD and MDA levels decreased from 12.31 to 8.85 ng/mL per 1 g of protein, while in the control group (standard method), levels declined from 12.04 to 9.23 ng/mL per 1 g of protein. In the experimental group, the level of heart-type fatty acid-binding protein (H-FABP) remained stable, whereas in the control group, it declined from 1.42 to 1.06 ng/mL per 1 g of protein. After prolonged preservation, receptor-interacting protein (RIP) kinase concentrations increased more markedly in the control group (from 0.071 to 0.086 ng/mL) than in the experimental group (from 0.024 to 0.028 ng/mL per 1 g of protein). Additionally, caspase-8 levels in the experimental group significantly decreased from 0.04 to 0.013 ng/mL per 1 g of protein. No significant differences were observed in von Willebrand factor levels between the two groups. However, histological analysis in the control group revealed muscle fiber fragmentation and widespread coagulopathy in myocardial tissue following standard cold («ice») preservation. Conclusion. This pilot experimental study indicates that long-term preservation of donor hearts at a controlled temperature of +4–8 °C is both effective and safe when compared to the conventional preservation method.

Objective: to evaluate the effectiveness of lung preservation in donation after circulatory death (DCD) using a non-perfusion-based preservation method. Materials and methods. The study was conducted on eight healthy male Landrace pigs (weight range: 40–60 kg), divided into three groups based on the preservation solution used: Celsior group (n = 3), lungs preserved using a solution prepared according to the Celsior formulation.; NewSolution group (n = 3), lungs preserved using a custom-formulated solution developed in-house; NaCl group (n = 2), lungs preserved using saline (control group). Results. In the study groups (Celsior and NewSolution), the oxygenation index after reperfusion exceeded 350, while the control group (NaCl) exhibited an oxygenation index of less than 350. Conclusions. The method described for evaluating the effectiveness of new lung preservation solutions is technically simple and cost-effective, as it enables rapid experimentation with a sufficiently large number of observations. While this approach may not address all challenges in experimental transplantology, it provides a practical and efficient tool for preliminary screening of lung preservation strategies.

Elevated C-reactive protein (CRP) levels in brain-dead donors (BDDs) may indicate an underlying infectious process or may be related to the pathogenesis of the primary disease and brain death (BD) itself. The objective of this study was to assess the prognostic value of CRP levels in detecting infectious complications in BDDs prior to organ and/or tissue procurement. Materials and methods. This prospective pilot study included 345 BDDs. Median donor age was 54 years (IQR: 47–62); 218 (63.2%) were men and 127 (36.8%) women. The primary diagnoses leading to BD were: non-traumatic intracranial hemorrhage (n = 220; 63.8%), ischemic brain injury (n = 68; 19.7%), and traumatic brain injury (n = 57; 16.5%). Results. CRP levels measured after the first medical examination by the BD consultation were already significantly elevated above reference values, with a median of 176.2 mg/L (IQR: 100.5–276.4) after 18–24 hours. Following the second examination and confirmation of brain death, CRP levels increased further to a median of 271.1 (IQR: 174.1–365.0) mg/L (χ² = 35.79, p < 0.00001). The most frequently diagnosed infection during donor conditioning was pneumonia, observed in 79 donors (22.9%). Receiver operating characteristic (ROC) analysis was conducted to evaluate the predictive value of CRP levels for pneumonia in potential donors: at stage 1, AUC = 0.633 (SE = 0.04; 95% CI: 0.57–0.69; p = 0.001), with a cutoff point of 295 mg/L (sensitivity 36.9%, specificity 86.3%). At stage 3, AUC = 0.630 (SE = 0.05; 95% CI: 0.55–0.71; p = 0.01), with a cutoff value of 348.6 mg/L (sensitivity 47.7%, specificity 79%). Conclusion. Analysis of CRP levels provides a useful tool for detecting pulmonary infections in potential BDDs.

Objective: to review the current outcomes and future prospects of using sodium fumarate (SF) for the prevention of ischemia–reperfusion injury in renal surgery. Materials and methods. The drug used in the study was Konfumin, whose active ingredient is SF. The experimental sample consisted of 78 female Wistar rats. Renal warm ischemia (RWI) and reperfusion injury were modeled, involving either unilateral or bilateral kidney preservation. SF, administered as an infusion solution, was used to evaluate the effectiveness of infusion therapy in this renal injury model. It was administered as an intravenous infusion at doses of 1 mL/kg or 2 mL/kg. The infusion protocol included five administrations: one day prior to warm ischemia, on the day of the procedure, and over the subsequent three days. Clinical observation was then carried out. Results. Experimental therapy with SF led to a marked reduction in inflammation in the ischemic kidneys of rats, as evidenced by significant improvements in key markers of nephron function. The treatment also contributed to favorable pathomorphological changes associated with acute ischemia–reperfusion injury (IRI). Data from experimental models involving warm ischemia and reperfusion of a single kidney, as well as models with an intact contralateral kidney, demonstrated that SF, administered intravenously at doses ranging from 1 to 2.5 mL/kg, exerted a nephroprotective effect. This protective effect was reflected in the positive remodeling of ischemic renal infarction and its consequences, involving improvements across vascular, glomerular, tubular, and interstitial components of the renal parenchyma. Conclusion. SF, administered intravenously at doses of 1–2.5 mL/kg, demonstrated a clear nephroprotective effect. This was evidenced by favorable pathomorphological changes in ischemic renal infarction and its sequelae.