Background. Every year the number of patients with chronic renal failure is steadily increasing. Allogeneic kidney transplantation from a post-mortem donor is a radical method to cope with chronic renal failure, improving the quality and life expectancy of patients. Currently available inhalation anesthetics make it easy to control the depth of anesthesia; they are excreted by the lungs unchanged, providing a quick emergence from anesthesia and easy waking up of the patient. An “ideal” inhalation anesthetic used for kidney transplantation should have a minimal amount of adverse effects.

The aim was to compare the efficacy of inhaled anesthetics used for allogeneic kidney transplantation from a posthumous donor.

Material and methods. A randomized, prospective, single-center study included 62 patients with end-stage chronic renal failure. The subjects were divided into three groups depending on the type of the inhalation anesthetic used. The first group included patients who underwent low-flow inhalation anesthesia with desflurane, the second and third groups were comparator groups where patients received sevoflurane or isoflurane, respectively, as an inhalation anesthetic. When assessing hemodynamic parameters, most episodes of hemodynamic instability were seen in the isoflurane group; the most stable statistically significant values were observed in the sevoflurane group, and desflurane took an intermediate position.

Results. The use of desflurane as an inhalation anesthetic in a kidney transplant provided a quicker recovery of consciousness and early extubation of the patient after anesthesia compared to the sevoflurane or isoflurane use. So desflurane proved to be the most efficient of the three studied inhalation anesthetics.

Conclusion. Desflurane is the optimal inhalation anesthetic used in kidney transplantation.

Introduction. The development of invasive candidiasis leads to high mortality after liver transplantation. Choosing an effective prophylaxis is an important task.

The study purpose was to compare the results  of invasive candidiasis prevention with anidulafungin vs. the lipid formulation of amphotericin B in high-risk patients in the early postoperative period after liver transplantation.

Material and methods. The study included 80 patients with risk factors for the development of invasive mycosis who underwent liver transplantation. Patients were divided into 2 groups. In the first group (n = 40), anidulafungin was prescribed for prophylaxis; in the 2nd group (n = 40), the lipid complex of amphotericin B was used.

Results. The most common of Candida spp. isolated in the patients of our study, as expected, was Candida albicans accounting for 31.2%, significantly less than a half. Neither fungal infection breakthrough nor invasive mycosis development were reported in any patient. In group 2, renal replacement therapy was significantly more frequently used. In two cases, the amphotericin B lipid complex was canceled and the conversion to echinocandin was undertaken due to the occurrence of adverse events (chills and fever) associated, in our opinion, with the drug used.

Conclusions. 1. Patients after liver transplantation with 2 or more risk factors have absolute indications to invasive mycosis prevention. 2. Anidulafungin and the lipid formulation of amphotericin B are effective for prophylaxis and prevention of fungal infection breakthrough. 3. Anidulafungin has an advantage in safety over the lipid formulation of amphotericin B. 

According to the recent WHO data, 39 million people in the world are blind. In developing countries cornea diseases are the second most common cause of blindness. Cornea transplantation remains the only radical method to regain lost vision for many blind people around the world. However, according to literature reports, cadaveric donor corneas pose a potential risk of herpes virus transmission to the recipient during penetrating keratoplasty. It is known that herpes simplex virus-1 persisting in the donor cornea can adversely affect graft survival up to causing the graft failure reaction. The latent herpes simplex virus may be reactivated by a number of factors, most of them occurring with penetrating keratoplasty. One of these factors is immunosuppressive therapy, an essential element of the pharmacological graft protection. Antiviral agents are strongly recommended in order to inhibit the replicating herpes simplex virus in the cornea graft. The most common antiviral agents are interferons with their inducers and acyclic nucleosides. Viral decontamination during cornea storage would prevent the donor-to-recipient transmission of herpes simplex virus in relation to keratoplasty.

Introduction. We reviewed the literature data on clinical and laboratory parameters that allow predicting the development of operational tolerance in liver transplant recipients after their complete weaning from immunosuppressive therapy.

The aim was to identify possible biomarkers of tolerance in liver transplant recipients with the successful complete weaning from immunosuppression for subsequent implementation in routine clinical practice. The cellular, humoral, and molecular markers of the liver transplant recipients who were completely withdrawn from immunosuppressive therapy without the development of graft dysfunction were estimated. The authors underlined the necessity of clinical trials for identifying biomarkers of the operational tolerance development. 

Changes in current scientific literature and regulatory documents related to the issues of infectious safety in organ and tissue donation have been analyzed. The suggestions have been given for changing the existing practices to meet new challenges. Data on threats to the safety of organ and tissue donation associated with the COVID-19 pandemic have been presented.

The article covers V.P. Demikhov work and activities at N.V. Sklifosovsky Research Institute for Emergency Medicine in 1964-1965. On May 28, 1964, V.P. Demikhov defended his Thesis for the Degree of the Candidate of Biological Sciences at the Biology Faculty of Moscow State University. But on the proposal of his opponents, Professor P.I. Androsov and Professor A.E. Gurvich, he was awarded the Degree of the Doctor of Biological Sciences at a second vote. On September 12, 1964, V.P. Demikhov was approved to the assignment of the sought Academic Degree by the Higher Attestation Commission at the Ministry of Higher and Secondary Special Education of the USSR. Unfortunately, the archival file of the Higher Attestation Commission on V.P. Demikhov's defending the Thesis has been lost. The present paper contains the recollections of M.M. Razgulov, an eyewitness of this Thesis defence, as well as the inexplicable facts on the missing information in the Academic Council documents of N.V. Sklifosovsky Institute for 1964-1965 about V.P. Demikhov's work and the activities of the Organ Transplantation Laboratory he headed in the Institute. It has shown that clinical transplantology in the USSR began on April 15, 1965, when the group of surgeons headed by B.V. Petrovsky performed a successful kidney transplant surgery in a human for the first time in this country. V.P. Demikhov did not participate in those events. In 1965, he was engaged in developing the problem of establishing a bank of functioning organs connected to a living organism.