Donor organ shortage stimulated an active use of donors with expanded evaluation criteria. The main evaluation method was a histological examination of liver graft biopsy specimens before (time-zero biopsy) and after reperfusion (time-1 biopsy). Severe ischemic and reperfusion injuries among recipients who received a liver graft made 20.4% and 16.6% respectively. The study showed no impact of small droplet, medium droplet, or even large droplet steatosis (less than 50%) on graft reperfusion injury.

The article discusses the development of solid organ transplantation in the Krasnodar Region. The clinical efficacy of kidney, liver, and heart transplantation performed in the in the leading regional multidisciplinary clinic, the Research Institute – Regional Clinical Hospital No.1 n.a. Prof. S.V. Ochapovsky has been demonstrated. The authors have analyzed the changing trends in donor population structure and waiting list dynamics, and also the early and long-term postoperative outcomes in the Krasnodar Region.

The purpose was to determine the specific features of respiratory and intensive therapy of pulmonary infectious complications in acute and chronic kidney graft rejection. Material and methods. The results of treatment of 7 patients with pulmonary infectious complications against an acute and chronic kidney graft rejection were retrospectively studied. Results. The total number of pulmonary infection cases made 7 among 54 cases of kidney transplantation from living related donors. In all cases, bilateral interstitial pneumonia was diagnosed. Six patients had positive dynamics on receiving a respiratory therapy and intensive care.

Background. The verification and identification of the transplanted pancreas rejection type requires a morphological examination of the graft tissue. The pancreas graft transcutaneous biopsy procedure is associated with a high risk of surgical and infectious complications, and with the risk of the graft loss. Relatively safe is the biopsy of the donor duodenum mucosa.

Objective: to evaluate the efficacy of morphological examination of the donor duodenum mucosa in early diagnosis of an acute rejection crisis of pancreas graft.

Material and methods. The study presents a retrospective analysis of 35 donor duodenum mucosa biopsies performed in 19 recipients. In order to assess the correlation between clinical and morphological signs of rejection, the patients were divided into two groups. The first group included 6 patients with clinical signs of graft dysfunction; the second group included 7 patients without signs of rejection. Statistical processing of the study results was made using the descriptive statistics methods.

Results . The signs of immunological complications were identified in 18 donor duodenum mucosa biopsies (51.4%) in 12 recipients (63.2%). In most cases (n = 13; 72.2%), the histological signs of mild rejection were found, the signs of moderate and severe rejection were less frequent (n = 3; 16.6% and n = 2; 11.1%, respectively). Morphological signs of acute rejection were found in all the patients of the 1st group (n = 6), including the signs of mild rejection in 4 cases (66.6%), of medium and severe rejection in 1 case each (16.7%). In the 2nd group, morphological signs of mild rejection were found in 3 patients (42.9%). Differences between the groups in the incidence of immunological complications were statistically significant (p < 0.05).

Conclusions: the biopsy of donor duodenum mucosa is an important criterion in the diagnosis of an acute rejection crisis of the pancreatoduodenal complex, and also remains a safe method, even in the earliest postoperative period.

Humoral rejection belongs to severe complications of the post-transplant period. Mechanisms of humoral rejection proceed through antibody formation. Donor specific anti-HLA antibodies (anti-HLA DSAs) damage transplant tissues by activating the complement system, leading to the dysfunction and loss of the transplanted organ. This article describes the clinical case of humoral rejection development with the identification of anti-HLA DSAs, their impact on the risk of coronary artery disease of the transplanted heart, and the graft loss.

Hemophagocytic Syndrome (hemophagocytic lymphohistiocytosis, macrophage activation syndrome) is a rare form of systemic inflammatory response. It usually presents with nonspecific symptoms like fever, lymphoadenopathy, hepatosplenomegaly, cytopenia. Secondary hemophagocytic syndrome is usually associated with severe infection. We describe a clinical case of a patient after liver transplantation who developed hemophagocytic syndrome secondary to Epstein-Barr virus and Human Herpes virus Type 8. There had been 22 cases of hemophagocytic syndrome after liver transplantation described in literature by the moment of our observation. We found just 1 similar case of a patient suffered from hemophagocytic syndrome in combination with Kaposi sarcoma and Epstein Barr virus infection. Differential diagnostics of hemophagocytic syndrome is difficult as there are no specific symptoms. Rapid disease progression makes early diagnosis and treatment an actual problem.

On September 1, 1960, V.P. Demikhov was taken in the staff of the Sklifosovsky Research Institute for Emergency Medicine. But earlier, in the summer of that year, he talked at a meeting of the Academic Council of the Institute about his achievements in transplanting vital organs in warm-blooded animals in experiment, and outlined a plan for their implementation into clinical practice. In his opinion, the N.V.Sklifosovsky Institute for Emergency Medicine best suited for that purpose. However, the first months of his work in a new place showed that the Institute was neither morally nor organizationally ready to perform clinical organ transplantations. The his idea of mammarocoronary anastomosis developed in 1953 was not heard either.