Transplantologia最新文献

{"title":"Successful liver transplantation from a donor with occlusive portal vein thrombosis","authors":"M. S. Novruzbekov, O. D. Olisov, V. A. Gulyaev, K. N. Lutsyk, B. I. Yaremin, B. I. Kazymov, K. M. Magomedov, A. R. Akhmedov, K. F. Alekberov","doi":"10.23873/2074-0506-2023-15-3-334-340","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-3-334-340","url":null,"abstract":"Introduction . The shortage of donor organs has been and remains the basic problem of clinical transplantation and the expansion of the organ pool by using marginal donor organs has become one of its solutions. In this regard, every decision to use a \"non-standard\" or \"non ideal\" organ for transplantation should be made carefully. Aim . Demonstration of successful liver transplantation from a donor with brain death and occlusive thrombosis of the splanchnic venous system. Description . A 34-year-old donor without serious concomitant pathology was diagnosed with total portal thrombosis during liver procurement. After cold aortic perfusion, a thrombectomy from the portal vein was performed. At the “backtable” stage, an additional perfusion was made through the portal vein, the results of which confirmed the patency of the portal system. The liver graft was transplanted to a 33-year-old recipient; the postoperative period was uneventful, the patient was discharged on the 17-th postoperative day. Conclusions . Portal vein thrombosis in a donor liver is rare. A positive decision on liver transplantation from a donor with portal vein thrombosis should be based on the confirmed patency of the portal system. It is desirable that these data be supplemented by a histological examination of the donor liver. The donor organs shortage needs to expand the criteria for post-mortem organ donation. However, every decision should be made in the light of individual characteristics of the donor-recipient pair.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911000","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":"Peculiarities of orthotopic liver transplantation in patients with liver cirrhosis and severe hemophilia A","authors":"A. V. Shabunin, P. A. Drozdov, O. N. Levina, E. A. Lidzhievа","doi":"10.23873/2074-0506-2023-15-3-341-346","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-3-341-346","url":null,"abstract":"In the presented clinical case reports, patients with decompensated liver cirrhosis resulted from chronic viral hepatitis C, being stable responders to antiviral therapy and having severe hemophilia A, underwent orthotopic liver transplantation from a post-mortem donor. The volume of intraoperative blood loss and the course of the immediate postoperative period on the background of the replacement therapy with recombinant VIII coagulation factors did not differ from other liver transplant recipients of the City Clinical Hospital n.a. S.P. Botkin. In the late postoperative period, the level of coagulation factor VIII returned to normal in patients, which made it possible to cancel the replacement therapy.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911283","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":"Comparative analysis of models predicting the risks of early poor outcome of deceased-donor liver transplantation: a retrospective single-center study","authors":"A. I. Sushkov, M. V. Popov, V. S. Rudakov, D. S. Svetlakova, A. N. Pashkov, A. S. Lukianchikova, M. Muktarzhan, K. K. Gubarev, V. E. Syutkin, A. I. Artemyev, S. E. Voskanyan","doi":"10.23873/2074-0506-2023-15-3-312-333","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-3-312-333","url":null,"abstract":"Rationale . The risk of early graft loss determines the specifics and plan of anesthesiological assistance, intensive therapy, and overall the feasibility of liver transplantation. Various prognostic models and criteria have become widespread abroad; however, Russian transplant centers have not yet validated them. Objective . To evaluate the applicability and accuracy of the most common models predicting the risks of early adverse outcomes in liver transplantation from deceased donors. Material and methods . A retrospective single-center study included data on 131 liver transplantations from deceased donors performed between May 2012 and January 2023. For each observation, DRI, SOFT, D-MELD, BAR, MEAF, L-GrAFT, and EASE indices were calculated, and compliance with an early allograft dysfunction criteria was verified. Depending on the possibility of calculating the indicators and their values relative to known cutoff points, the study groups were formed, and 1-, 3-, 6-, and 12-month graft survival rates were calculated. The forecast was compared with the actual outcomes, and sensitivity, specificity, F1-score, and C-index were calculated. Results . When assessing the risk of 1- and 3-month graft loss, models using only preoperative parameters demonstrated relatively low prognostic significance: DRI (F1-score: 0.16; C-index: 0.54), SOFT (F1-score: 0.42; C-index: 0.64), D-MELD (F1-score: 0.30; C-index: 0.58), and BAR (F1-score: 0.23; C-index: 0.57). Postoperative indices of MEAF (F1- score: 0.44; C-index: 0.74) and L-GrAFT (F1-score: 0.32; C-index: 0.65) were applicable in 96%, those of ABC (F1-score: 0.29; C-index: 0.71) in 91%, and EASE (F1-score: 0.26; C-index: 0.80) in 89% of cases. The relative risk of 30-days graft loss in case of EAD was 5.2 (95% CI: 3.4-8.1; p<0.0001), F1-score: 0.64, and C-index: 0.84. Using locally established cutoff values for SOFT (11 points) and L-GrAFT (-0.87) scores increased their prognostic significance: F1-score: 0.46 and 0.63, C-index: 0.69 and 0.87, respectively. Conclusion . The analyzed models can be used to assess the risks of early liver graft loss; however, their prognostic significance is not high. Developing a new model in a multicenter Russian study, as well as searching for new objective methods to assess the state of the donor liver are promising directions for future work.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911144","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":"Phenomenon of Demikhov. At N.V. Sklifosovsky Institute (1960–1986). V.P. Demikhov and his experiments in the field of organ transplantation in 1968–1973","authors":"S. P. Glyantsev","doi":"10.23873/2074-0506-2023-15-3-397-408","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-3-397-408","url":null,"abstract":"The article analyzes the experimental studies of V.P. Demikhov conducted by him in 1968-1973, by studying the content of his report on the work done during this period of time and presented at the Meeting of the Academic Council of N.V. Sklifosovsky Institute in July 1973 for the re-election for the position of the Head of the Organ Transplantation Laboratory for a new 5-year term. It follows from the analyzed document that the extent of the research made by V.P. Demikhov and his staff significantly exceeded the data that were presented in the Institute's reporting documents for 1973, in the Research Plans for 1974, and the plans for implementing the research results in healthcare practice in 1974. The Table that illustrated the report indicated that in 1968–1973 V.P. Demikhov conducted more than 485 different experiments, including transplantation of vital organs, experiments on perfusion of isolated organs, resuscitation of cadaveric hearts, and heterogeneous blood transfusion. He actively collaborated with surgeons from many clinical institutions in Moscow (Institute of Tuberculosis, S.P. Botkin Hospital, Hospitals of the Moscow Military District) and other cities of the country (Frunze, Tyumen), conducting joint experimental and clinical studies with them. However, attempts to introduce the methods developed by him into clinical practice were futile. Of all his achievements in different years, the method of upper limb reimplantation was successfully applied in clinic in 1971 by Professor B.D. Komarov.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911137","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":"The possibilities of using the inhibitors of matrix metalloproteinases for keratoplasty","authors":"K. V. Sirotkina, E. V. Chentsova","doi":"10.23873/2074-0506-2023-15-2-347-358","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-347-358","url":null,"abstract":"Introduction . The review is devoted to the actual problem of treating patients with keratolysis. The role of matrix metalloproteinases in the pathogenesis of cornea and corneal graft melting is discussed as well as the practical experience of using synthetic metalloproteinase inhibitors in various branches of medicine and in ophthalmology, in particular. In the field of eye diseases, the search for effective methods for the treatment of corneal injuries of various origins, as well as its post-transplant complications, has been underway for a long time. Recent studies have shown that local imbalance of matrix metalloproteinases and their inhibitors system, as well as the immune system status, may play the main role in the outcome of urgent keratoplasty, and the use of synthetic metalloproteinase inhibitors can significantly improve the biological result of the donor cornea transplant. The role of platelets in the regulation of the proteolytic system has not been fully studied. However, some literature data on the platelet-associated inhibitor of metalloproteinases and the use of platelet-rich plasma to correct the collagenolytic activity of enzymes are of great interest to ophthalmologists, due to therapeutic efficacy and simple method of producing its production the autologous platelet-rich plasma.The present brief literature review covers the pathogenesis and clinical features of keratolysis, factors which can affect the outcome of urgent keratoplasty, describes the features of matrix metalloproteinases, their inhibitors, and the plateletrich plasma as a potential endogenous source of a tissue inhibitor of matrix metalloproteinases. Aim . To evaluate the possibility of using inhibitors of matrix metalloproteinases for keratoplasty based on a literature review. Material and methods . To write the review article, we have made the search in the homeland eLibrary.RU database and in the PubMed resource database to select the articles on the topic published in the period from 1985 to 2022.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"213 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911001","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":"Features of the myocardial infarction course in convalescents of the new coronavirus infection COVID-19","authors":"N. A. Muradyan, I. M. Kuzmina, T. R. Gvindzhiliya, V. M. Balanyan, K. A. Popugaev","doi":"10.23873/2074-0506-2023-15-3-390-396","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-3-390-396","url":null,"abstract":"Acute myocardial injury is one of the possible complications of the new coronavirus infection COVID-19 and can be diagnosed both in the acute phase of the infection, and also after stabilization or clinical improvement of the patient's condition. This review is devoted to the actual problem of the acute myocardial infarction development during the period of COVID-19 convalescence. The pathophysiological mechanisms of acute myocardial infarction during recovery from COVID-19 are diverse. The key role belongs to the state of hypercoagulation and the systemic inflammatory response, which can provoke destabilization and rupture of unstable atherosclerotic cardiac plaques. Type 2 acute myocardial infarction is most often diagnosed in COVID-19 convalescents against the background of intact coronary arteries. In this case, acute myocardial infarction develops due to an imbalance between increased myocardial oxygen demand (increased levels of cytokines in the blood, hypercatecholaminemia, hyperthermia and tachycardia) and a decrease in oxygen supply to cardiomyocytes due to hypoxemia and hypotension. Subclinical myocardial injury may be present despite normal coronary arteries on angiography and intact left ventricular ejection fraction. There is no clear relationship between the development of acute myocardial infarction during the period of COVID-19 convalescence and the severity of the infection, the time from the initial diagnosis, and the presence of traditional risk factors for cardiovascular diseases in the patient. Cardiac complaints in COVID-19 convalescents are often interpreted as a post-COVID syndrome, especially given the absence of a history of coronary heart disease in many patients, which can lead to late diagnosis. Further study of the features of acute myocardial infarction during the period of COVID-19 convalescence is needed.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911286","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":"Transplantation of solid organs during the pandemic of a new coronavirus infection","authors":"D. V. Shumakov, D. I. Zybin, A. B. Zulkarnaev, V. V. Dontsov, E. G. Agafonov, M. A. Popov","doi":"10.23873/2074-0506-2023-15-3-376-389","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-3-376-389","url":null,"abstract":"The end-stage stage of chronic diseases of solid organs is rather significant in the structure of morbidity and mortality among patients worldwide. To date, there are more than six million patients in this status worldwide. Heart, liver and kidney transplantation is the gold standard of treatment for these patients. The number of transplants is growing every year.At the end of 2019, the world faced a new type of viral infection – SARS-CoV-2 – a highly contagious systemic respiratory disease transmitted by airborne droplets, which in three months led to a pandemic and killed hundreds of thousands of people. The pandemic has made adjustments to the structure of planned medical care. The number of planned operations has decreased significantly, and the number of the infection-associated complications has increased.Patients with end-stage chronic diseases initially have weakened immunity and represent the category most susceptible to the infection. At the moment, the question of patient management tactics remains open. There is no consensus on the patient management tactics before surgery and in the posttransplantation period for patients at the end-stage chronic disease of different organs. This topic requires further study and the development of treatment algorithms for such patients.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134910998","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":"Liver allograft pathology in the late post-transplant period","authors":"S. E. Voskanyan, V. E. Syutkin, A. I. Sushkov, Yu. V. Voskanyan, A. Yu. Veselkova","doi":"10.23873/2074-0506-2023-15-3-359-375","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-3-359-375","url":null,"abstract":"Annually increasing quantity of liver transplants and the growing population of long-survived recipients determine the relevance of late allograft dysfunction study. Variety of morphological and functional disorders of the transplanted liver complicates their timely diagnostics. Moreover, in some patients, serious graft damage may proceed for a long time without clinical manifestations and laboratory abnormalities.The review summarizes the structure, prevalence, risk factors and prognostic value of different liver allograft pathology determined by histological examination in the long term after transplantation.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911148","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":"Phenomenon of Demikhov. At N.V. Sklifosovsky Institute (1960–1986). V.P. Demikhov and his experiments in the field of organ transplantation in 1971–1972","authors":"S. P. Glyantsev, Yu. A. Shabunts","doi":"10.23873/2074-0506-2023-15-2-279-294","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-279-294","url":null,"abstract":"Having reviewed the archival documents, we enlightened the results of research performed by V.P. Demikhov and the employees of the Organ Transplantation Laboratory at the N.V. Sklifosovsky Research Institute, as well as V.P. Demikhov’s life and work in 1971–1972. During those years he continued to conduct the research required, as he believed, for practical healthcare. In 1971, together with M.M. Razgulov, he proposed a method for connecting blood vessels, a method for transplanting an upper limb together with a scapula, repeated experiments previously carried out on dogs, on human corpses (revitalization of a cadaveric heart, monitoring its activity using electrocardiography, implanting an additional heart into the cadaver’s chest in order to implement the technique in clinic for the treatment of heart failure), presented the results of his research at the X International Congress on Cardiovascular Diseases. We have also shown that in 1971–1972 V.P. Demikhov performed 76 experimental interventions, most of which were aimed at the development of a technique for transplanting an isolated cardiopulmonary complex and heart, as well as the technique for their revitalization. It should be noted that all the methods of organ transplantation developed by him were intended for implementation in clinic. However, no method was introduced into clinic during his lifetime. The fact is that the studies of V.P. Demikhov in the field of organ transplantation could not be adequately supplied from the material, technical and economic point, since they did not correspond to the main trends of the scientific and practical activities of the N.V. Sklifosovsky Institute – to improve the organizing system of rendering an emergency and urgent care to the population of Moscow in acute diseases and injuries.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135904714","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":"Easy to say, hard to do. To the anniversary of two fundamental discoveries. Part 3","authors":"A. Yu. Anisimov","doi":"10.23873/2074-0506-2023-15-1-98-117","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-98-117","url":null,"abstract":"On the eve of the anniversaries of two historical events: the 145th anniversary of the experiments in which Eck's fistula was performed and the 55th anniversary of the successful clinical approbation of the selective distal splenorenal anastomosis, a retrospective analysis of the key historical stages in the development of portal hypertension surgery was performed: from the first attempts to describe the anatomy of the hepatic vascular system, explaining its purpose in the body, the development of direct portacaval anastomosis, and the widespread use of selective splenorenal anastomoses, to the Transjugular Intrahepatic Portosystemic Shunt procedure and orthotopic liver transplantation. Meantime, the emphasis has been focused on the most colorful characters of researchers and clinicians who passed this path. The expediency of an integrated approach in solving the problems of portal hypertension with the development of both fundamental and applied clinical and organizational aspects has been substantiated. It is shown that the discoveries born from summarizing the results achieved by numerous researchers have contributed to a better understanding of this field of medicine, have become a solid foundation for what we have today and are a reliable platform for a successful start into the future.","PeriodicalId":31706,"journal":{"name":"Transplantologia","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135135664","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}