Transplantologiya. The Russian Journal of Transplantation

Journal Information
ISSN / EISSN : 2074-0506 / 2542-0909
Current Publisher: IPO Association of Transplantologists (10.23873)
Total articles ≅ 101
Current Coverage
DOAJ
Archived in
SHERPA/ROMEO
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I. V. Abdulyanov, I. M. Rakhimullin, M. R. Gaysin, R. R. Khamzin
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-4-301-310

Abstract:
Introduction. The number of surgically treated cases of heart failure by means of orthotopic heart transplantation is increasing every year. At the same time, there is a shortage of optimal donors for heart transplantation, being a factor that leads to a primary graft dysfunction in the intra- and immediate postoperative period. In order to reduce the risk of complications and increase patient survival rates in primary heart graft dysfunction, a number of transplant centers resort to the choice of the treatment by means of mechanical circulatory support, such as extracorporeal membrane oxygenation. Clinical case. In the early postoperative period after heart transplantation, the patient was diagnosed with developing primary graft dysfunction. The clinical response to medication support of hemodynamics was unsatisfactory. Venoarterial extracorporeal membrane oxygenation was performed. On the 4th day, the regional contractility of the left ventricle restored, the ejection fraction of both ventricles increased, their systolic function improved. The patient was discharged on the 21st day in a satisfactory condition. Conclusion. Mechanical circulatory support modalities, such as venoarterial extracorporeal membrane oxygenation, can compensate for the emerging primary myocardial dysfunction in recipients. The efficiency of the extracorporeal membrane oxygenation is achieved not only by knowledge of current clinical recommendations, but also depends on the implementation of other clinics' experience as well as technical readiness of the center and medical personnel' qualification.
M. V. Gurin, A. A. Venediktov
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-4-286-294

Abstract:
Introduction. Ligaments play a critical role in the body, linking bones together. Ligament ruptures are the most common manifestations of serious musculoskeletal injuries. This is especially true for the anterior cruciate ligament of the knee joint. In trauma surgery, orthopedics, the ligament functional recovery can be achieved by using tissue autografting, synthetic and biological prostheses. Of great interest to surgeons is the use of prostheses made of biological tissues of animal origin, since they are easily available and, when high-quality processing is achieved, they are safe, retaining their natural structure and strength. Purpose of the study. To decellularize the bovine tendon according to our originally developed technique and to investigate its efficacy in terms of the presence of cellular elements and physical and mechanical parameters of the material. Material and methods. To manufacture the prototype of the ligament prosthesis product, we developed the technique for processing the bovine tendon, as the most similar material by structure, including its mechanical processing, chemical and physical processing methods and a special treatment with supercritical carbon dioxide fluid containing nonionic surfactant Tween-80 for decellularization and extraction of organic components in addition to collagen framework, while maintaining strength properties. Histological studies were performed to check for the residues of cellular elements, and the measurements of the physical and mechanical properties of the material were made. Results. Histological examination of the material showed that after processing, 0–2 cells in the field of view were found in the material. The strength properties of the material were 503 kgf/mm2 before processing and 605 kgf/mm2 after processing. Conclusion. The data obtained in the study confirmed that the processing performed qualitatively affected the elimination of cells, did not worsen but even increased the mechanical strength of the material. Further study of the biocompatible properties of the material is required.
V. L. Korobka, M. Yu. Kostrykin, O. V. Kotov, R. O. Dabliz, E. S. Pak
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-4-295-300

Abstract:
The clinical case of liver revascularization in a recipient using the technique of selective thrombolysis of the hepatic artery and its stenting at the arterial anastomosis site has been reported. The applied technique allowed a quick elimination of thrombosis and stenosis of the arterial anastomosis, providing a long-term effect, preventing more severe consequences for the recipient, and saving the liver graft. The presented case showed that the combined technique of endovascular intervention might be a good alternative to the reconstruction of arterial anastomosis by re-exploration and by liver retransplantation.
S. E. Voskanyan, V. E. Syutkin, M. V. Shabalin, A. I. Artemyev, I. Yu. Kolyshev, A. N. Bashkov, A. M. Borbat, K. K. Gubarev, M. V. Popov, A. P. Maltseva
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-4-319-331

Abstract:
We present an uncommon case of liver graft dysfunction caused by seronegative hepatitis C-related fibrosing cholestatic hepatitis after cadaver liver transplantation for unresectable liver metastases of neuroendocrine small intestine cancer followed by living relation donor liver fragment retransplantation for primary graft nonfunction. Early postoperative period was complicated by hepatic artery thrombosis, cerebral hemorrhage, acute cellular rejection, bilateral polysegmental pneumonia, bleeding into neck soft tissues, severe surgical site infection, and sepsis. Anticoagulant therapy, as well as the absence of Hepatitis C Virus antibodies made difficult early diagnostics of fibrosing cholestatic hepatitis. A present-day antiviral therapy produced a complete clinical and virological response. At control examination performed at 240 days after surgery, there were neither signs of cancer progression no graft dysfunction. Liver transplantation in that case was an example of radical and effective treatment method for unresectable liver metastases of neuroendocrine small intestine cancer. Timely diagnosis and proper treatment of fibrosing cholestatic hepatitis made it possible to save the liver graft and patient's life.
A. V. Shabunin, , D. A. Eremin, I. V. Nesterenko, D. A. Makeev, O. S. Zhuravel, S. A. Astapovich
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-4-278-285

Abstract:
Background. Urological complications are currently one of the main causes of the renal graft loss and the death of the recipient in the early and late periods after surgery. Objective. To reduce the risk of developing infectious complications after kidney transplantation by early removal of the internal ureteral stent. Material and methods. From June 2018 to March 2020, the Department of Organ and/or Tissue Transplantation of the City Clinical Hospital n.a. S.P. Botkin performed 89 deseased-donor kidney transplantations with the placement of an internal ureteral stent. Depending on the timing of stent removal, the patients were divided into 2 groups: the first group included 54 patients who had the stent removed on day 21, and the second group included 35 patients who had the stent removed on day 14. Results. No urological complications were recorded in both groups. Urinary tract infection was recorded in 8 patients (15%) in the first group, and in 1 patient (3%) in the second group (p = 0.01). Conclusion. Removal of the internal ureteral stent on the 14th day after kidney transplantation safely and reliably reduces the risk of a urinary tract infection development, improving the immediate results of the operation.
, B. M. Gorelik, A. Werner
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-4-332-352

Abstract:
Having studied the available printed, visual, and verbal sources from Russia, South Africa, the USA, and Germany, we have identified and reviewed in the article the facts of face-to-face and correspondence communication between V.P. Demikhov, the "father" of experimental heart transplantation (Moscow, USSR), and C.N. Barnard, a pioneer of clinical heart transplantation (Cape Town, South Africa). We have shown that C.N. Barnard mastered the heart surgery techniques, including those under conditions of artificial circulation, in the USA in 1956-1958, and later improved them in his homeland both in clinic (heart surgery for cardiac defects), and in the experiment (heart transplantation). The main events preceding the first world human heart transplant performed by C.N. Barnard on December 3, 1967, were his trip to the United States in August 1967 to study immunosuppression techniques, and the kidney transplantation he had performed in Cape Town in September, 1967. Prior to that time, C.N. Barnard had visited the USSR only once, in May 1960, as a delegate to the XXVII All-Union Congress of Surgeons. In the Soviet Union, he visited a number of clinics dealing with heart surgery and tissue and organ transplantation, including the N.V. Sklifosovsky Institute for Emergency Medicine, where he met V.P. Demikhov, but C.N. Barnard could neither talk to him personally, nor watch his operations. In December 1967, V.P. Demikhov spoke with C.N. Barnard on the phone, but the conversation was highly professional. This paper has shown different approaches of V.P. Demikhov and C.N. Barnard to the transplantation problem: the Soviet surgeon paid more attention to the transplantation technique, meanwhile, the South African surgeon considered the solution of immunological problems to be the basis of success. Nevertheless, C.N. Barnard knew about V.P. Demikhov's scientific achievements and used some of them in his surgical practice. The authors have substantiated the interaction between V.P. Demikhov and C.N. Barnard as between an ideological mentor and a student (in a broad sense) rather than as a teacher and a student (in a narrow sense). Therefore, in a broad, philosophical sense, the Soviet surgeon can be considered one of the inspirers of the world's first heart transplantation, which, in turn, proved that his ascetic work was not in vain.
S. A. Prozorov
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-4-311-318

Abstract:
Introduction. Vascular complications after transplant nephrectomy are rather rare. The aim of this article is to analyze the effectiveness of the stent-graft implantation in the treatment of pseudoaneurysm after transplant nephrectomy. Clinical case. In the previous 23 years, a 50-year-old patient underwent 3 kidney transplantations from a cadaveric donor and 2 transplant nephrectomies. At 12 years after the left transplant nephrectomy he complained of abdominal pain and was admitted for a pulsating mass in his left pelvic region. Computed tomography angiography, ultrasonography, and arteriography were performed and showed a large pseudoaneurysm arising from the left external iliac artery. The stentgraft implantation solved the problem providing successful clinical and radiological results. Conclusion. Treatment options in this case were open or endovascular techniques. Surgical revision associated with high risk of complications. Endovascular treatment had the benefits of a minimally invasive approach with low blood loss.
E. V. Parabina, B. I. Yaremin,
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-3-213-219

Abstract:
A case of a long-term management of a patient with Kaposi’s sarcoma developed as presumably related to a “standard” immunosuppressive therapy after kidney transplantation has been described. Immunosuppressive therapy conversion to mTOR receptor inhibitors and administering chemotherapy with prospidium chloride allowed for a long-term remission of the disease and a satisfactory clinical outcome.
, , V. N. Martinkov
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-3-189-198

Abstract:
Introduction. One of the main problems in transplantology is the detection of simple, reliable and non-invasive markers that could predict adverse immune reactions and adjust immune suppressive therapy in allograft recipients in a timely manner. Objective. To determine the immunological criteria for the prediction of a graft dysfunction. Material and methods. We have examined 197 recipients who underwent kidney transplantation. All of them were immunologically examined with the identification of more than 40 subpopulations of leukocytes. Allograft function was assessed on day 7 with the division of patients into two groups: with either primary or graft dysfunction. Simple and multiple logistic regressions were used to predict a graft dysfunction. Preliminary statistical analysis was performed using nonparametric statistics. Results and discussion. A scoring system to predict the graft function has been worked out. At CD19+IgD+CD27- 72.7%. At CD3+CD8+CD69+>9.7% score 1 is assigned, and 0 score is given at CD3+CD8+CD69+1 predicts a graft dysfunction. This scoring system has the sensitivity of 91.9%, еру specificity of 100%, еру accuracy of 94.9%, positive predictive value of 1 and negative predictive value of 0.877. Conclusions. 1. Percentage of CD19+IgD+CD27- and CD3+CD8+CD69+ subpopulations can be used to predict a graft dysfunction. 2. At values of CD19+IgD+CD27- not exceeding 72.7% and CD3+CD8+CD69+ more than 9.7%, the development of a graft dysfunction can be anticipated.
M. Sh. Khubutiya, S. E. Voskanyan, V. E. Syutkin, V. P. Chulanov, M. S. Novruzbekov, V. D. Pasechnikov, V. L. Korobka, O. O. Rummo, E. N. Bessonova, S. F. Bagnenko, et al.
Transplantologiya. The Russian Journal of Transplantation, Volume 12; doi:10.23873/2074-0506-2020-12-3-231-244

Abstract:
Рекомендации по профилактике и лечению инфекций вирусами гепатита В и С у больных, находящихся в Листе ожидания трансплантации печени, и реципиентов печени
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