Background. Saving lives and preventing patients from dropping out of the waiting list for liver transplantation due to the progression of portal hypertension and the development of complications is an urgent task of transplantology in conditions of a donor organ shortage, which causes long waiting times for this operation.
Aim. To study the efficacy of endoscopic band ligation versus no intervention in the primary prevention of upper gastrointestinal bleeding and assess the impact on survival of patients with ascites listed in the liver transplantation waiting list.
Material and methods. A retrospective comparative study was conducted in patients with decompensated liver diseases with severe ascites and varicose veins, without a history of bleeding, when included in the waiting list for liver transplantation. Primary prevention of bleeding from varices was carried out in patients by means of endoscopic ligation of varicose veins (n=92, group 1); this intervention was not performed in other patients (n=89, group 2).
Results. The compared groups were comparable in demographics, clinical parameters, MELD and Child-TurcottePugh scores, or the incidence of severe ascites. The study groups of patients did not have significant differences in the numbers of medium-size and large varices. The incidence of bleeding was significantly lower in the group of patients with endoscopic band ligation as a method of primary prevention than in the group of patients without this intervention (23.9% and 78.7%, respectively, p=0.0001). Patient survival was significantly higher in the group of patients who underwent endoscopic band ligation than in the group of patients without interventions, which was established using the Kaplan-Meier method (Log Rank=0.0001).
Conclusion. Primary prevention of bleeding from the upper digestive tract through endoscopic band ligation is an effective method of saving lives and preventing patients with ascites from dropping out of the liver transplantation waiting list in conditions of a donor organ shortageб which causes a long waiting period for surgery.

Aim. To assess the safety and efficacy of percutaneous transluminal balloon angioplasty with stenting for renal graft artery stenosis.
Material and methods. From June 2018 to December 2022, 344 kidney transplants from a deceased donor were performed at the surgical clinic of City Clinical Hospital n.a. S.P. Botkin. The study group consisted of 220 men (63.9%) and 124 women (36.1%). The mean age was 46.46±11.74 (19–73) years. With a mean follow-up period of 20.05 (1-54) months, stenosis of the renal graft artery was diagnosed in 4 patients (1.16%). The mean time from transplantation to the diagnosis of stenosis was 4 (1–9) months. In addition, we diagnosed the development of this complication in 4 kidney transplant recipients operated in other centers. The mean time from transplantation to the diagnosis of stenosis in these patients was 103.25 (12–221) months. Thus, we have the experience in the treatment of renal transplant arterial strictures in 8 recipients: 4 men (50%) and 4 women (50%). The mean age was 48.25±11.97 (27–60) years. Stenosis was manifested by renal graft dysfunction with a progressive increase in urea and creatinine in 6 patients (75%), by arterial hypertension in 2 patients (25%). The mean, level of creatinine at the time of diagnosing stenosis was 290.75 (157–494) µmol/L, glomerular filtration rate was 22.87±12.19 (8–41) ml/min/1.73m² .
Results. In the early postoperative period, 1 complication was recorded in the form of pulsating hematoma of the common femoral artery, which required surgical intervention (complication class IIIA according to Clavien-Dindo). The mean hospital postoperative bed-days made 5.22 (4-8). The mean follow-up time was 22.75±7.4 (14–33) months. All recipients were alive throughout the whole follow-up period. In 7 of 8 recipients (87.5%), the graft was functioning, in 1 patient a progressive graft dysfunction was noted, for which chronic hemodialysis was started. Mean creatinine in recipients with a functioning graft was 156.71±33.4 (123–200) µmol/L; mean glomerular filtration rate was 41.57 ml/min/1.73m² .
Conclusions. Percutaneous transluminal balloon angioplasty with stenting is a safe and effective minimally invasive technique and should be considered as the operation of choice in the development of renal graft artery stenosis.

Introduction. Biological grafts, including bone chips and collagen, are supposed to be promising in the treatment of bone tissue treatment. Nevertheless, manufacturing of these grafts still needs to be standardized.
Aim. To optimize methodology of osteoplastic material production, based on allogenic 1 type collagen and bone chips.
Material and methods. Osteoplastic material grafts were produced, using with allogeneic bone chips 180-800 µm and type 1 collagen solution in acidic acid. We studied total integrity of graft, collagen quality, morphofunctional properties of line M-22 human cells interacting with different type of osteoplastic material grafts.
Results. Procedures for manufacturing the osteoplastic material did not significantly affect the quality of collagen in its composition, while lyophilized grafts had pronounced acidogenic and toxic effects in cell culture. Soaking osteoplastic material in isotonic solution for 30 min or longer increased its biocompatibility in vitro. Adhesion properties of osteoplastic material widely varied depending on collagen concentration and bone chips size.
Conclusion. Osteoplastic material prepared with allogeneic bone chips of 180–800 µm and collagen solution in acidic acid had pronounced acidogenic and toxic effects in vitro that could be considerably reduced by soaking in isotonic solution. Varying the collagen concentration and the size of bone chips one could produce biocompatible osteoplastic material grafts with high and low adhesion properties.

Introduction. Kidney and pancreas transplantation is a surgical method for the treatment of patients with diabetes mellitus and terminal diabetic nephropathy. While waiting for surgical treatment, potential recipients receive maintenance hemodialysis. Dialysis initiates the loss of body fluid, which in turn can affect the state of the intraocular structures.
Aim. To study the effect of long-term hemodialysis therapy on ophthalmic parameters in patients with terminal diabetic nephropathy.
Material and methods. Sixty patients (120 eyes) were examined: group A included 30 patients with end-stage renal failure as a result of diabetic nephropathy, group B included 30 people without systemic and ocular pathologies. The ophthalmological status of group A was assessed at the stage of planned preparation for renal replacement therapy, at 3 and 6 months after the initiation of dialysis. Ophthalmological examination consisted of the use of traditional and special diagnostic methods (microperimetry, photorecording of the fundus, optical coherence tomography angiography).
Results. Within 6 months of hemodialysis courses, the following was recorded: a decrease in the thickness of the retina (Me: from 348.5 to 306.1 µm; p <0.05) and choroid (Me: from 330.3 to 294.9 µm; p <0.05), the improvement of retinal perfusion in eyes with diabetic macular edema (Me in the superficial capillary plexus: from 10.6 to 15.8% in the fovea, from 19.7 to 25.4% in the parafovea; in the deep capillary plexus: from 15.4 to 20.9% in the fovea, from 27.5 to 33.5% in the parafovea; p <0.05), a decrease in choroidal hemoperfusion (Me in the layer of choriocapillaries: from 59.0 to 54.2% in the fovea, from 59.3 to 54.7% in the parafovea; in the deep layer of the choroids: from 55.5 to 50.7% in the fovea, from 55.3 to 50.7% in the parafovea; p<0.05),an improvement in retinal photosensitivity (Me: from 16.7 to 20.3 dB in eyes with diabetic macular edema; from 21.1 to 24.2 dB in eyes without diabetic macular edema; p<0.05) and increased visual acuity in eyes with macular edema (Me: 0.1 to 0.3; p<0.05).
Conclusions. Against the background of maintenance hemodialysis hemodialysis in patients with terminal diabetic nephropathy, along with a decrease in hyperazotemia, there is an improvement in architectonics, hemodynamics of the retina and visual functions.

Aim. To evaluate the intersystemic (between the myocardium of the left coronary artery system and the right coronary artery system redistribution mechanisms of perfusion in the myocardium after revascularization in patients with coronary artery disease with focal cardiosclerosis using gated single photon emission computed tomography. Сardiosclerosis foci were initially identified by magnetic resonance imaging.
Material and Methods. The study included 17 patients with coronary artery disease with multivessel coronary disease and large-focal cardiosclerosis according to the results of magnetic resonance imaging with contrast; the diagnosis of left ventricular aneurysm was established in 14 patients, the focal subendocardial cardiosclerosis was diagnosed in 3 patients. For various reasons, all patients underwent myocardial revascularization without the left ventricle reconstruction (coronary artery bypass grafting in 10 patients, percutaneous coronary intervention in 7 patients). Magnetic resonance imaging was used as the gold standard for focal cardiosclerosis before revascularization. All patients before and after revascularization underwent gated single photon emission computed tomography with MIBI scan. During the initial analysis of peaks on the profile slices of coronal and transversal midsections passing along the lateral walls of the left and right ventricles, we did not notice a clear visualization of in 8 patients (group 1), while an increased MIBI scan accumulation in the right ventricle myocardium was clearly visualized in 9 patients (group 2). Based on the peaks height of profile curves, we compared changes in the maxima of radiopharmaceutical accumulation before and after revascularization in the lateral walls of the left ventricle and right ventricle. All studies were performed using the original Cardiac Functional Imaging medical program in order to obtain quantitative information about the myocardial function of both the left ventricle, and also the right ventricle. This program made it possible to highlight the right ventricle area even in the case of its weak visualization through the initial formation of parametric images, where the right ventricle area was visualized.
Results. When comparing the revascularization results of the two groups, we noted that the left ventricle ejection fraction increased significantly only in patients without initial visualization of the right ventricular myocardium. Left ventricle ejection fraction did not change after revascularization in patients with initially increased accumulation of the radiopharmaceutical in the right ventricle. Globally, only an improvement in the diastolic function of the left and right ventricles was noted in the latter group of patients. In addition, an increase in the right ventricular uptake level was noted for patients with focal cardiosclerosis and the initially increased uptake in the right ventricle after the maximum possible complete myocardial revascularization, which may indicate a redistribution of perfusion in favor of a more intact right ventricular myocardium.
Conclusions. 1. In patients without signs of increased visualization of the right ventricle (group 1) after revascularization, we revealed a statistically significant increase in the left ventricle ejection fraction (p-value=0.024), a decrease in the end-systolic volume (p-value=0.024), an increase in the motion in segments corresponding to the peri-infarct scar zone (p-value=0.016), and a change in systolic thickening in the segment of the basal parts of the anterolateral wall (p-value=0.046). 2. Initially increased visualization of the right ventricle in patients with extensive focal cardiosclerosis in the myocardium of the left ventricle suggests the absence of the left ventricle ejection fraction increase after myocardial revascularization. 3. An increase in the visualization of the right ventricle after complete myocardial revascularization indicates an intersystemic redistribution of perfusion in favor of the preserved myocardium of this part of the heart.

Introduction. Infectious complications contribute to a significant decrease in graft and recipient survival rates. The article describes a case report of transplantation of the primary infected kidney transplant.
Material and methods. A 33-year-old patient with type 1 diabetes mellitus and end-stage renal disease underwent kidney transplantation. The deceased donor was a 46-year-old man with a confirmed brain death as a result of acute cerebrovascular accident.
Results. The early postoperative period was complicated by the development of primary infection of kidney transplant. Despite the ongoing treatment aimed at preserving the transplant, we had to remove it in order to prevent the development of further complications.
Conclusion. Kidney transplantation improves the quality of life of patients with end-stage renal disease. In case of uncontrolled course of the infectious process after primary infected graft transplantation, it is necessary to perform transplantectomy in a timely manner in order to save the recipient’s life, since the graft itself is the source of infection.

Rationale. In developed countries, public service announcement has long been a universal tool for diagnosing and correcting social behavior, including the donor activity increase. Considering the existing organ donation popularization inertia in Russia, the review of positive foreign public service announcement examples has a high scientific and practical relevance.
Aim. To study the world examples of organ donation public service announcement.
Material and methods. We reviewed public service announcement products of donor organizations from Spain, Portugal, Italy, the Vatican, Belgium, Argentina, Brazil, France, Germany, Singapore, and Japan. We assessed the popularization of organ donation in Russia and highlighted the ways for its improvement.
Conclusion. Organ donation public service announcement are widely used both in "Opt In" and "Opt Out" countries and have a high potential for forming a positive public opinion in the Russian Federation. In Russia, the activities aimed at promoting organ donation are insufficient, there is a need to scale it up. In this regard, independent non-profit organizations with the necessary professional staff and marketing competencies can be considered as reliable partners for the government in conducting educational work on organ donation, in particular, in the public service announcement implementation.

This article is presented in form of a current literature review on bacterial complications of the early post-liver transplantation period and promising areas for studying the effect of bacterial flora in patients after liver transplantation. The paper describes the problem of the emergence, spread, and pathogenesis of various bacterial complications, as well as current concepts of various bacterial complication’s impact on the results of liver transplantation. The results of ventilatorassociated pneumonia in patients after liver transplantation are given. A theoretical analysis of bacterial complications from the standpoint of microbiota effects on the biliary tree was carried out. The review also highlights a relatively new conceptual approach in examining the results of scientific research using the "Machine Learning Method”. The so-called CDC “Big Four” was chosen as the main infectious nomenclature in this article. However, catheter-associated bacterial complications, which pathogenesis has been sufficiently studied to date, have been replaced by a relatively new group of complications – bacteriobilia. This review also contains a brief statistical data collected in the frames of the NCT04281797 study. Own cohort data consisted of 57 patients who underwent orthotopic liver transplantation from a post-mortem donor. Surgical site infection was the most common bacterial complication of the early postoperative period. The most common causative agent of bacterial infection was Klebsiella pneumonia and Enterococcus.

Aim. To reveal the significance of the major histocompatibility complex and the human leukocyte antigen evolutionary divergence in transplantation of allogeneic hematopoietic stem cells.
The article traces the evolution of the major histocompatibility complex and discusses the reasons for its formation on the example of the recognition system of invertebrates, plants, jawed vertebrates and humans. The concepts of immunopeptidome and human leukocyte antigen evolutionary divergence have been defined; and the data on their impact on the therapy outcomes in patients with hemoblastosis have been presented. The impact of the major histocompatibility complex incompatibility on transplantation outcomes has been disclosed.

In 2023, the medical community of Russia is celebrating two closely related significant historical events. They are the 115th anniversary from the birth of B.V. Petrovsky, an outstanding personality in Russian medicine, Academician of the Russian Academy of Sciences, and the 60th anniversary from the foundation of Petrovsky National Research Center of Surgery.The article presents little-known materials related to the cultural heritage of B.V. Petrovsky and keeping the historical memory of him. The paper esteems B.V. Petrovsky's activity as the founder of the Russian Scientific Center for Surgery and a reformer of higher medical education.

Having reviewed the archival documents, we enlightened the results of research performed by V.P. Demikhov and the employees of the Organ Transplantation Laboratory at the N.V. Sklifosovsky Research Institute, as well as V.P. Demikhov’s life and work in 1971–1972. During those years he continued to conduct the research required, as he believed, for practical healthcare. In 1971, together with M.M. Razgulov, he proposed a method for connecting blood vessels, a method for transplanting an upper limb together with a scapula, repeated experiments previously carried out on dogs, on human corpses (revitalization of a cadaveric heart, monitoring its activity using electrocardiography, implanting an additional heart into the cadaver’s chest in order to implement the technique in clinic for the treatment of heart failure), presented the results of his research at the X International Congress on Cardiovascular Diseases. We have also shown that in 1971–1972 V.P. Demikhov performed 76 experimental interventions, most of which were aimed at the development of a technique for transplanting an isolated cardiopulmonary complex and heart, as well as the technique for their revitalization. It should be noted that all the methods of organ transplantation developed by him were intended for implementation in clinic. However, no method was introduced into clinic during his lifetime. The fact is that the studies of V.P. Demikhov in the field of organ transplantation could not be adequately supplied from the material, technical and economic point, since they did not correspond to the main trends of the scientific and practical activities of the N.V. Sklifosovsky Institute – to improve the organizing system of rendering an emergency and urgent care to the population of Moscow in acute diseases and injuries.