Russian Journal of Transplantology and Artificial Organs最新文献

{"title":"Risks and ways of preventing kidney dysfunction in drug-induced immunosuppression in solid organ recipients","authors":"S. R. Galeev, S. Gautier","doi":"10.15825/1995-1191-2022-4-24-38","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-24-38","url":null,"abstract":"Immunosuppressive therapy (IMT) is the cornerstone of treatment after transplantation. The goal of immunosuppression is to prevent acute and chronic rejection while maximizing patient survival and long-term graft function. However, the expected effects of IMT must be balanced against the major adverse effects of these drugs and their toxicity. The purpose of this review is to summarize world experience on current immunosuppressive strategies and to assess their effects on renal function.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74401028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanized lymphatic drainage in acute decompensated heart failure. A study on a hydrodynamic test bench","authors":"A. Buchnev, G. Itkin, A. Drobyshev, A. P. Kuleshov, O. Y. Esipova, A. I. Syrbu","doi":"10.15825/1995-1191-2022-4-54-59","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-54-59","url":null,"abstract":"Objective: to investigate the effectiveness of a new mechanized lymphatic drainage method in acute decompensated heart failure (ADHF) modeling through local reduction in venous pressure in the site of lymphatic drainage from the thoracic duct.Materials and methods. Main components of the device are a catheter with built-in inlet and outlet mechanical valves designed for insertion into the left brachiocephalic vein through the left internal jugular vein. It comes with an extracorporeal drive system made as a valveless pulsator pump with a 10 ml shock discharge and a controller ensuring preset frequency and pressure/rarefaction duty cycle. The operating principle of the device is based on local reduction of venous pressure in the site of lymphatic drainage from the thoracic duct (in the junction of the left internal jugular and subclavian veins).Results. When modeling hydrodynamics under ADHF conditions on a hydrodynamic test bench, the upper venous flow through the left brachiocephalic vein was 0.4 l/min, the pressure in the site of lymphatic drainage from the thoracic duct, was decreased from 20–25 mmHg to 0–5 mmHg due to operation of the mechanized drainage device with suction/injection phase duration ratio 0.2/0.8 and pulsator pump operating frequency from 30 to 60 beats/min.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74366001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of hepatic steatosis in living liver donors","authors":"M. Minina, D. Voronov, A. A. Nevredimov, E. A. Tenchurina","doi":"10.15825/1995-1191-2022-4-118-123","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-118-123","url":null,"abstract":"Fatty liver disease (steatosis) is considered a risk factor in donor liver transplantation (LT). Macrosteatosis (>50%) is associated with primary graft dysfunction and may reduce long-term recipient survival.Objective: to identify predictors of macrovesicular steatosis (>50%) by analyzing donor characteristics.Materials and methods. The retrospective study included 525 potential liver donors between January 1, 2019 and December 31, 2020. Clinical and morphological characteristics of donors were studied using logistic regression and receiver operating characteristic (ROC) analysis. Threshold values of parameters demonstrating statistical significance in multivariate analysis as predictors of >50% hepatic steatosis were obtained by ROC analysis based on calculation of the optimal cutoff point.Results. Diabetes mellitus (DM), cause of donor’s death (traumatic brain injury), alanine transaminase (ALT) >90 units/L and aspartate transaminase (AST) >110 units/L were predictors of >50% steatosis, revealed by time-zero biopsy in the donor. Almost identical sensitivity and specificity indicators were determined in ROC analysis for liver enzymes – ALT and AST – which were 69.1 and 80.6; 72.2 and 81.1, respectively. Given the obtained values, we can say that with elevated levels of liver enzymes in the donor’s blood, there is a high degree of probability of liver parenchymal damage, but low sensitivity indicates possible multifactoriality of liver damage, and fatty liver disease may be one of the factors, but there may also be no damage to the liver parenchyma. At the same time, the rather high specificity revealed in ROC analysis for liver enzymes is a reliable sign of the absence of fatty liver disease at enzyme values less than the threshold.Conclusion. The thresholds established for ALT and AST and their corresponding levels of sensitivity and specificity indicate that these parameters have a relatively low predictive level in the context of the presence of severe fatty liver disease in a donor. This allows, nevertheless, to use models built on their basis as screening models in the primary evaluation of liver donors.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85313422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors in deceased donor liver transplantation: a single centre experience","authors":"S. Zubenko, A. Monakhov, M. Boldyrev, V. R. Salimov, A. D. Smolianinova, S. Gautier","doi":"10.15825/1995-1191-2022-4-7-14","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-7-14","url":null,"abstract":"Deceased brain-dead donor liver transplantation (LT) is a high-risk intervention. The outcome depends on a large number of modifiable and non-modifiable factors. Objective: to analyze our own experience and identify preoperative and perioperative prognostic factors for poor outcomes in LT. Materials and methods. The study included 301 liver transplants performed between January 2016 and December 2021. Donor and recipient characteristics, intraoperative data, perioperative characteristics including laboratory test data, and the nature and frequency of complications were used for the analysis. Results. The 1-, 3- and 5-year recipient survival rates were 91.8%, 85.1%, and 77.9%, respectively; graft survival rates were 90.4%, 83.7%, and 76.7%, respectively. The most significant predictors of poor outcome of LT on the recipient side were biliary stents (HR 7.203, p < 0.01), acutely decompensated cirrhosis (HR 2.52, p = 0.02); in the postoperative period, non-surgical infectious complications (HR 4.592, p < 0.01) and number of reoperations (HR 4.063, p < 0.01). Donor creatinine level (HR 1.004, p = 0.01, one factor analysis; HR 1.004, p = 0.016, multivariate analysis) was the only reliable prognostic negative factor. Conclusion. LT taking into account established risk factors will improve surgery outcomes and help personalize the therapy for each patient.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83840892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of polyclonal antibodies in brain-dead donors in kidney transplantation","authors":"D. Kuzmin, V. Manukovsky, S. Bagnenko, O. Reznik, A. Ananiev, O. Vorobyeva, S. Vorobyev, D. V. Gogolev, V. S. Daineko, A. A. Kutenkov, N. A. Chichagova, I. V. Uliankina","doi":"10.15825/1995-1191-2022-4-124-134","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-124-134","url":null,"abstract":"Objective. The objective of this study is to develop a therapeutic strategy for protecting grafts in order to improve the efficiency of kidney transplantation (KT) using polyclonal antibodies (pAbs) through elimination of activated forms of neutrophils, chemo- and cytokines from the donor’s bloodstream, and a decrease in the level of expression of adhesion molecules on the renal vascular endothelium at the pre-transplant stage.Materials and methods. In 2017, we developed and for the first time applied a therapeutic strategy for ischemia-reperfusion injury (IRI) in a brain-dead donor (BDD). Given the limited time interval after brain death has been diagnosed, Timoglobulin (Sanofi Genzyme, France) was administered to the donor at a dose of 8 mg/kg intravenously for 6 hours. Before drug administration and immediately before the start of cold perfusion, a complete blood count and renal transplant biopsy were performed. The study group included 10 BDDs (mean age 39.3 ± 4.4 years) who received anti-thymocyte globulin (ATG). The comparison group included 10 BDDs (mean age 38.5 ± 4.3 years) who did not undergo the new strategy. Donor kidneys were transplanted to 40 recipients (average age 47.5 ± 4.3 years), who were also divided into 2 groups, depending on the graft received (with and without ATG). At the organ donation center, a biobank of specimens from donors of various categories, including those using the IRI therapeutic strategy and recipients for retrospective assessment of the effectiveness of pAbs, was formed.Results. Clinical blood test results show that in the ATG group, there was stable leukopenia (neutropenia and lymphopenia) of 1.46 ± 0.18x109/l. Fifteen (75%) recipients of kidneys obtained from donors with ATG had immediate graft function; in the control group – 10 (50%) recipients.Conclusion. Data obtained testify to the prospects of implementing the proposed strategy in clinical practice, which will improve the quality of the resulting grafts and their suitability for subsequent transplantation, prolong graft functioning due to elimination of leukocytes as a factor of IRI, prevention of early allograft nephropathy, increase in the donor pool by using expanded criteria donors (ECDs).","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80787128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a cannula device for gas fraction removal in surgical drains","authors":"A. P. Kuleshov, A. Buchnev, A. Drobyshev, O. Y. Esipova, G. Itkin","doi":"10.15825/1995-1191-2022-4-46-53","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-46-53","url":null,"abstract":"The development of low-traumatic surgical drains aimed at maximum possible separation of blood and air, is an important trend in modern medicine. The objective of this work is to create an inexpensive, user-friendly and low-traumatic dynamic blood aspiration system (DBAS). The system allows effective separation of blood and air when drawing blood from a wound under vacuum conditions required for blood aspiration. The operating principle of the system is to separate liquid and gas fractions of the blood-air mixture by modifying the blood intake cannula. The effect is achieved by applying the principles of centrifugal forces of a rotating blood-air flow combined with Archimedes lift forces.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90684036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro effect of bioscaffolds on viability and insulin‑producing function of human islets of Langerhans","authors":"A. S. Ponomareva, N. Baranova, I. Miloserdov, V. Sevastianov","doi":"10.15825/1995-1191-2022-4-109-117","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-109-117","url":null,"abstract":"The culture of islets of Langerhans with bioscaffolds – extracellular matrix (ECM) mimetics – can provide a native microenvironment suitable for islets. This is one of the main conditions for creating a pancreatic tissue equivalent.Objective: to compare the secretory capacity of viable human pancreatic islets in monoculture (control group) and cultured in the presence of two bioscaffolds: biopolymer collagen-based hydrogel scaffold (experimental group 1) and tissue-specific scaffold from decellularized deceased donor pancreas (experimental group 2).Materials and methods. Islets of Langerhans were isolated from the caudal pancreas using a collagenase technique. The viability of cultured islets was accessed by vital fluorescence staining, while secretory capacity was evaluated by enzyme-linked immunosorbent assay (ELISA).Results. Pancreatic islets cultured with bioscaffolds showed no signs of degradation and fragmentation, they remained viable throughout the entire period of observation (7 days). The monoculture of islets showed significant destructive changes during this period. Basal insulin levels in experimental groups 1 and 2 increased by 18.8% and 39.5% on day 1 of culture compared to the control group, by 72.8% and 102.7% on day 4 of incubation, and by 146.4% and 174.6% on day 7, respectively. The insulin secretion level of islets with tissue-specific scaffolds was 17.4% higher than that when cultured with biopolymer collagen-based scaffolds.Conclusion. Biopolymer and tissue-specific ECM mimetics contribute not only to preservation of the viability of isolated islets of Langerhans but also maintain their insulin secretion capacity for 7 days at a higher level in comparison with monoculture. The experiments revealed that the use of a tissue-specific scaffold for the creation of a pancreatic tissue equivalent has slight potential advantage over biopolymer scaffold.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86288325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Сoronary paradox","authors":"V. V. Chestukhin, F. A. Blyakhman","doi":"10.15825/1995-1191-2022-4-145-151","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-145-151","url":null,"abstract":"This work is a scientific and educational analytical review intended for practicing cardiologists. The purpose of the review is to draw physicians’ attention to the role of myocardial contractility in the regulation of coronary circulation. We consider the fundamental phenomenon of arterial compression (squeezing) in the left ventricular (LV) wall, creating an obstruction to blood flow during cardiac systole. This phenomenon formally resembles functional coronary artery stenosis. Based on a review of the literature, the positive role of arterial compression in coronary hemodynamics is interpreted. Understanding the mechanical relationship between the contractile and coronary systems in the cardiac wall may be useful for practicing physicians when choosing treatment tactics for patients, optimizing LV bypass during heart surgeries, and improving the efficiency of adaptation of the transplanted heart.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75187346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decellularized homograft for aortic valve replacement two years after lung transplantation","authors":"P. Iablonskii, F. Ius, I. Tudorache, A. Martens, S. Sarikouch, J. Salman, A. Haverich, S. Cebotari","doi":"10.15825/1995-1191-2022-3-130-132","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-130-132","url":null,"abstract":"Cardiac valvular surgery in patients after lung transplantation is a challenging procedure, reports are scarce. We report a 29-year-old patient who underwent concomitant mitral valve reconstruction and implantation of a decellularized aortic homograft two years after bilateral lung transplantation.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85191190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of renal transplant fibrosis","authors":"O. R. Bystrova, E. Stakhanova, M. I. Ilchuk, A. A. Ulybysheva, O. Gichkun, D. A. Saydulaev, O. Shevchenko","doi":"10.15825/1995-1191-2022-3-94-101","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-94-101","url":null,"abstract":"Fibrosis is one of the causes of kidney allograft loss, especially late after transplantation (up to 65% incidence after 2 years). The purpose of this literature review is to analyze studies examining noninvasive monitoring techniques for renal graft fibrosis.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87920823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}