In the period from 2005 to December 2015, 37 transplantations of vascularized composite facial tissue allografts (VCAs) were performed in the world. A vascularized composite tissue allotransplantation has been recognized as a solid organ transplantation rather than a special kind of tissue transplantation. The recent classification of composite tissue allografts into the category of donor organs gave rise to a number of organizational, ethical, legal, technical, and economic problems. In May 2015, the first successful transplantation of a composite facial tissue allograft was performed in Russia. The article describes our experience of multiple team interactions at donor management stage when involved in the identification, conditioning, harvesting, and delivering donor organs to various hospitals. A man, aged 51 years old, diagnosed with traumatic brain injury became a donor after the diagnosis of brain death
had been made, his death had been ascertained, and the requested consent for organ donation had been obtained from relatives. At donor management stage, a tracheostomy was performed and a posthumous facial mask was molded. The "face first, concurrent completion" algorithm was chosen for organ harvesting and facial VCA procurement; meanwhile, the facial allograft was procured as the "full face" category. The total surgery duration from the incision to completing the procurement (including that of solid organs) made 8 hours 20 minutes. Immediately after the procurement, the facial VCA complex was sent to the St. Petersburg clinic by medical aircraft transportation, and was there transplanted 9 hours later. Donor kidneys were transported to Moscow by
civil aviation and transplanted 17 and 20 hours later. The authors believe that this clinical case report demonstrates the feasibility and safety of multiple harvesting of solid organs and a vascularized composite facial tissue allograft. However, this kind of surgery requires an essential multidisciplinary approach. Establishing of facial VCA transplantation Program is a complicated process for transplant centers and can hardly be implemented without a properly organized post-mortem organ donation system at a national level. Today these criteria are met only by the Coordination Center for Organ Donation at FMBA of Russia.

Abstract. Using a steatotic graft in liver transplantation (LT) can lead to a poor function and high mortality. The role of the rapid liver graft biopsy processing was studied. The liver grafts of potential donors were assessed for hepatic steatosis.
Material and methods. The study included 341 cases of cadaveric donor liver transplantations. Patients were divided in two groups: the study group where the rapid graft biopsy processing was performed (n=163) and the comparison group (n=178) without biopsy processing. Livers with macrosteatosis of over 50% of graft parenchyma or with severe necrosis and structural damage were discarded.
Results. The rates of ischemic reperfusion injury (IRI), initial poor graft function (IPGF), and primary graft nonfunction (PNF) were significantly lower in the study group. There were no significant differences between two groups in cold ischemia time.
Conclusion: rapid histological examination provides a useful tool to avoid life threatening LT complications such as severe IRI, IPGF, and PNF.

Introduction: the prognostic significance of microvascular inflammation (MVI) in the absence of donor-specific antibodies (DSA) in kidney allotransplantation (KTx) is not well defined, and the predictors of such immune conflict type remain unclear.
The study was aimed to define the long-term prognosis of MVI and to identify clinical factors associated with MVI.
Material and methods. Two hundred eighty four kidney allograft (KA) recipients were enrolled into the study according to inclusion criteria (AB0-compatibility, negative cytotoxic crossmatch, and at least one KA biopsy in posttransplant period). One hundred fifty patients had MVI. The control group included 134 KTx recipients without MVI. The following clinical parameters were registered: he recipient’s gender and age, donor age, cadaveric/alive donor, cold/warm ischemia time, renal replacement therapy duration, last donor creatinine level, a delayed graft function (DGF), an immunological risk (IR) (number of HLAmm, panel-reactive antibodies, previous KTx), the level of creatinine
and proteinuria at the time of biopsy. The long-term KA survival was estimated by Kaplan–Meier analysis. The combined end-point was determined as the return to dialysis or the estimated glomerular filtration rate 15 mL/min/1,73m2 or less. Multivariate Cox regression analysis was used for the evaluation of independent risk factors associated with the presence of MVI and risk of KA loss.
Results. According to MVI phenotypes, the patients were distributed into the following groups: MVI+DSA+ cases (n=31) that met criteria for antibody-mediated rejection (Banff 2013); MVI+DSA- (n=62); and MVI+DSA? cases (n=57) with undetermined DSA. In MVI+DSA- group, 28 recipients had an isolated MVI, while MVI was accompanied with
T-cell mediated rejection (TCMR) in 34 cases. The median follow-up was 52 (23; 85) months from KTx and 39 (13; 77) months from the biopsy. KA survival in all MVI groups was significantly lower compared with controls. In the adjusted multivariable Cox regression model, MVI was associated with the relative risk of KA loss (Exp(

We have analyzed the foreign experience of organ transplantation from donors infected with blood-borne viruses (BBVIs). Lifting of the ban on the transplantation of organs positive for BBVI markers contributes to the expansion of the donor pool and reduces time spent on Waiting lists. At the same time, the use of donor organs positive for BBVI markers is often associated with an increased risk of complications and deaths among recipients.

This literature review presents an immune system disorder in end-stage renal disease (ESRD), emphasizing the specific role of uremia and related changes. Finally, on the basis of new relationships between the changes in the immune system of ESRD patients, it emphasizes the potential role of the immune dysfunction as the main cause of the high
mortality in this patient population and the need for further research in this area.

In experiments on rats, the efficacy of the extract of Daigo lactic acid bacteria fermentation was investigated as the means for the prophylaxis and correction of an impaired microflora composition, and small intestine motor activity changes at dysbiosis. Experimental dysbiosis induced by a 7-day oral administration of antimicrobials (Amoxycillinum and Metronidazolum) was manifested by considerable disturbances in qualitative and  quantitative composition of the jejunum and cecum microflora. A preventive administration of Daigo prior to the exposure to antimicrobials eliminated the dysbiosis signs. Daygo administration after modeling the dysbiosis led to the recovery of intestinal motor function,
normalized the numbers of conditionally-pathogenic microorganisms in a jejunum, and decreased the numbers of opportunistic microorganisms in the cecum.