The data summarized in this review suggest that radionuclide studies are highly effective in the clinical situations that the structure and function of the liver should be simultaneously evaluated, which is in full measure appropriate for liver transplantation.

The review of the historical development of pancreas transplantation worldwide with a detailed description of its state-of-the-art in Russia in the past decade is offered to the readers’ attention.

The paper describes a case of the rare complication of orthotopic liver transplantation - steal syndrome successfully controlled by interventional radiology techniques.

The purpose of the investigation was to study the informative and prognostic values of a dynamic hepatic function test using indocyanine green (ICG) in cirrhotic patients. The investigation covered 149 patients with hepatic cirrhosis (a study group) and 20 patients without signs of liver disease (a control group). The plasma ICG elimination rate (PICGER) was significantly lower in the study group (7.6±3.4 and 22.9±4.2% per min in the study and control groups, respectively; p < 0.001). With the progression of hepatocellular dysfunction revealed by the ChildPugh criteria, the indocyanine clearance values became progressively worse. In cirrhotic patients, PICGER correlated with the levels of total bilirubin (r = -0.501; p < 0.001), albumin (r = 0.494; p < 0.001), international normalized ratio (r = 0.475; p < 0.001), and the histological activity index of the necroinflammatory process in the hepatic parenchyma (r =-0.579; p < 0.001). In these patients, median survival was significantly higher in cases with prompter ICG elimination and, at a PICGER of > 7, 5 to 7, and <5% per min, it was 20, 11.5, and 6 months (χ2  = 51.9; p<0,001). Analysis of ROC curves demonstrated a greater prognostic value of the ICG clearance test than the Child-Pugh and MELD criteria (statisticPER, 0.852±0.032; c-statisticCHILD, 0.767±0.039, с-statisticMELD, 0.758±0.041; p < 0.001). The sensitivity and specificity of the clearance test in the prediction of annual survival were 86.5 and 76.8%, respectively. Thus, the determination of ICG clearance is a highly informative and specific dynamic test that estimates hepatic functional reserves. The inclusion of this criterion into the existing scales for rating the severity of hepatocellular dysfunction permits improvement of the diagnostic and prognostic efficiency of their use.

A method for identifying mixed infections, dysbioses, and inflammatory processes from specific markers (fatty acids, aldehydes, and sterols) by chromatographic mass spectrometry was used to study the microecological status of patients eligible for liver transplantation. Heterogeneous microorganisms (aerobes, anaerobes, actinobacteria, fungi, and viruses) were quantified from molecular markers in an experiment within 3 hours after the samples were sent to the laboratory. The examinees were found to have excessive growth of gram-positive anaerobes (Clostridia, eubacteria), actinobacteria of the genera Streptomyces, Nocardia, and Candida yeasts. Next were staphylococci, streptococci, and gram-negative microorganisms of the group Moraxella/Acinetobacter, Pseudomonas aeruginosa, Helicobacter pylory, and Fusobacterium/Haemophylus. Antibiotics and probiotics were chosen to correct dysbiosis and infection, by taking into account the data available in the literature. The speed and accuracy of the procedure ensure real-time monitoring of a treatment process under control of mass spectrometry.

As for now, liver transplantation is the only radical treatment in children with terminal stages of chronic liver diseases. In children under 3 years of age, transplantation of the liver from a living-related donor generally uses a left lateral hepatic section graft of the donor. Adequate graft venous outflow is crucial. The aim of the study was to define indications for the use of various methods for venous outflow reconstruction in young children. With this aim in mind, the results of living-related donor liver transplantation were studied in 22 children 6 months to 3 years of age and weighing < 3 kg. The paper describes the procedures of venous reconstruction of graft hepatic veins and the results of their use. Criteria for choosing this or that procedure are given.

The paper describes 2 cases of correction of portal vein stenosis after pediatric liver transplantation using interventional radiology techniques. Its long-term result is analyzed. X-ray endovascular correction of portal vein stenosis after left lateral liver bisegment transplantation demonstrates a high clinical efficiency, yielding good long-term results.

The review deals with anemia, one of the posttransplantation complications. To define the ways of preventing this complication in the posttransplantation period, the factors favors its development are analyzed. Anemia is shown to negatively affect autografted kidney function and actuarial survival in allokidney graft recipients. The current principles in the treatment of posttransplantation anemia are reflected.

The paper provides a case of foot replantation by the autotransplantation type after train run-over-inflicted injury, by shortening the limb by 12 cm, followed by distraction in the external fixation apparatus. The technical features of the procedure comprising the elements of autotransplantation and up-to-date orthopedic technology of bone elongation are described. A patient’s good rehabilitation is shown to be possible after replantation of a limb in severe injury generally resulting in its loss. The described procedure assures a high reliability and predictability of functional and aesthetic results that cannot be achieved via prosthesis replacement.

The paper provides a brief overview of the data available in the literature with the discussion of the basic principles of the diagnosis and treatment of a graft-versus-host reaction (GVHR). After orthotopic liver transplantation, the incidence of this complication is 1–3%, mortality is as high as 75%. The paper describes a case of GVHR after liver transplantation, the clinical picture of which shows a preponderance of skin manifestations. Timely diagnosis of this rare complication has allowed the patient to be effectively treated.

The paper shows the main stages of introduction and organization of liver transplantation in the Republic of Belarus, the procedure of examination of patients on the waiting list for liver transplantation, and the experience of the first 37 orthotopic liver transplantations made in the Republic of Belarus in April 3, 2008, to February 1, 2010.

Proceedings of the 2nd Conference of the Interregional Public Organization «Society of Transplantologists» (Report Abstracts).