The review presents data on the recent change in the spectrum of bacterial and fungal infectious complications in the early posttransplantation period. It discusses some reasons for this change. The emergence of multidrug-resistant strains of infectious complications requires epidemiological studies of the spectrum of nosocomial pathogens at the specific organ transplant centers and health care facilities where potential organ donors are present. Peritransplantation antibiotic prophylaxis and empiric antibiotic therapy should be based on either the results of these studies or the combined use of antibiotics that overlap the spectrum of the most dangerous causative agents.

The review discusses whether antiviral therapy for recurrent hepatitis C virus (HCV) infection may be used following liver transplantation. It analyzes the concepts of pre-emptive therapy initiated within the first weeks after the transplantation, as well as therapy for histologically verified active hepatitis and/or liver fibrosis. Capabilities and limits in the use of pegylated interferons and ribavirin as monotherapy or combination therapy are considered. Particular emphasis is placed on the role of viral kinetics in the determination of the duration of further therapy, including the possibility of its prolongation up to > 12 months. There are arguments in favor of a better course of recurrent HCV infection in patients receiving cyclosporine versus those taking tacrolimus.

Echinococcosis also remains a serious problem today. Highly informative diagnostic methods allow hepatic echinococcosis to be diagnosed at its early stage. This brings mini-invasive, saving operations under ultrasound, X-ray, TV, and endoscopic guidance up to a new level. The accumulated experience suggests that the current high-tech operations that are an alternative to traditional access surgery can be extensively used. However, only strict observance of a protocol for saving operations, their performance in specialized hospitals, and compulsory antiparasitic therapy with albendazole will be of benefit to mini-invasive surgery for hepatic echinococcosis.

The paper describes the use of the artificial pancreatic analogue – a cybernetic complex of insulin therapy – to correct carbohydrate metabolism in patients with diabetes mellitus in the early postoperative period after cadaveric renal allotransplantation.

The authors provide the results of colloid hepatic scintigraphy and whole body studies, by determining the hepatic and splenic uptake of the radiotracer in 105 patients with hepatic cirrhosis (HC) of different etiology. The results obtained in the groups of patients with varying HC according to the Child-Pugh classification and in the group of 11 healthy volunteers were compared. The results were analyzed in 17 patients prior to and following liver transplantation. In the Child-Pugh B-C groups, the liver showed a tendency to be reduced along with progressive splenic enlargement and radiocolloid redistribution towards the spleen and bone marrow with the most significant differences in the relative splenic and bone marrow uptake of the radiotracer (p < 0.005) and its hepatic capture in percentage of the whole body (p < 0.001). One-six months after surgery, there was a significant improvement of all parameters with obvious regression of the signs of portal hypertension in the patients who had undergone liver transplantation. Colloid hepatic scintigraphy has been shown to be a highly informative technique in assessing liver function in patients with HC; it also permits evaluation of the regression of symptoms of portal hypertension and the functional state of a liver graft in the postoperative period.

The paper considers an approach to solving a problem in the recovery of the cervical esophagus and in the closure of fenestrated tracheal defects in modern reconstructive thoracic surgery. It describes the clinical observation of a patient with postnecrotic cervical esophageal defect, extensive cicatricial stenosis and defect of the trachea. Methods for esophageal segmental plasty using a small intestine autograft, prefabrication, and movement of a graft on the basis of the pectoralis major muscle and free costal cartilages are depicted.