Pub Date : 2022-08-24DOI: 10.15825/1995-1191-2022-3-74-79
A. Goncharova, N. Koloskova, V. Poptsov, V. M. Zakharevich, N. P. Mojeiko, А. R. Zakiryanov, N. N. Sayfullina, K. S. Kiryakov, S. Gautier
Primary cardiac sarcoma is a rapidly progressive, aggressive cardiac tumor that is very rare in the general population. Conservative treatment for this tumor is not very effective. The only effective treatment is radical surgical removal of the malignancy. However, if sarcoma removal cannot be performed, heart transplantation (HT) becomes the only treatment option. The median survival of heart recipients with preoperative cardiac sarcoma is 8.5 months. Globally, such operations are performed in a small number of cases. This paper presents the first experience of HT for a patient with primary cardiac sarcoma in the Russian Federation.
{"title":"Heart transplantation for primary cardiac sarcoma","authors":"A. Goncharova, N. Koloskova, V. Poptsov, V. M. Zakharevich, N. P. Mojeiko, А. R. Zakiryanov, N. N. Sayfullina, K. S. Kiryakov, S. Gautier","doi":"10.15825/1995-1191-2022-3-74-79","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-74-79","url":null,"abstract":"Primary cardiac sarcoma is a rapidly progressive, aggressive cardiac tumor that is very rare in the general population. Conservative treatment for this tumor is not very effective. The only effective treatment is radical surgical removal of the malignancy. However, if sarcoma removal cannot be performed, heart transplantation (HT) becomes the only treatment option. The median survival of heart recipients with preoperative cardiac sarcoma is 8.5 months. Globally, such operations are performed in a small number of cases. This paper presents the first experience of HT for a patient with primary cardiac sarcoma in the Russian Federation.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78336063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-24DOI: 10.15825/1995-1191-2022-3-80-93
L. Antonova, E. Krivkina, M. Khanova, E. Velikanova, V. Matveeva, А. V. Mironov, A. Shabaev, Е. A. Senokosova, T. V. Glushkova, M. Sinitsky, R. Mukhamadiyarov, L. Barbarash
Surface modification of polymer vascular matrices is a promising development for preventing vascular graft thrombosis, improving long-term patency and accelerating remodeling. Objective: to study the outcomes of long-term patency of PHBV/PCL/GFmix grafts with iloprost (Ilo) and heparin (Hep) implanted into the carotid artery of sheep. Materials and methods. Matrices 04 mm were fabricated by electrospinning from a polymer composition of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and poly(s-caprolactone) (PCL) with incorporation of endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and chemoattractant molecule (SDF-1a). The fabricated matrices were then modified with Ilo and Hep by complexation via polyvinylpyrrolidone (PVP). Synthetic Gore-Tex grafts were used as a comparison group. The physical and mechanical properties of the studied matrix groups were evaluated, the surface structure of vascular grafts before and after implantation was assessed. Vascular grafts were implanted into the carotid artery of a sheep. The explanted samples were studied via histological and immunofluorescence analysis, the elemental composition of the obtained vascular graft samples was also assessed, and the gene expression profile was evaluated. Results. One day after implantation, the patency of PHBV/PCL/GFmixHep/n° vascular grafts was 62.5%, whereas synthetic Gore-Tex grafts had thrombosis in 100% of cases. At the same time, after 18 months of implantation, the patency of biodegradable PHBV/PCL/GFmixHep/n° vascular grafts decreased to 50%. Permeable drug-coated polymer grafts were completely reabsorbed after 18 months of implantation, and aneurysmally dilated newly-formed vascular tissue was formed in their place. Conclusion. Modification of the surface of PHBV/PCL/GFmix polymer grafts with Hep + Ilo coating improved long-term patency outcomes compared to synthetic Gore-Tex grafts.
{"title":"Results of preclinical trials in a sheep model of biodegradable small-diameter vascular grafts","authors":"L. Antonova, E. Krivkina, M. Khanova, E. Velikanova, V. Matveeva, А. V. Mironov, A. Shabaev, Е. A. Senokosova, T. V. Glushkova, M. Sinitsky, R. Mukhamadiyarov, L. Barbarash","doi":"10.15825/1995-1191-2022-3-80-93","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-80-93","url":null,"abstract":"Surface modification of polymer vascular matrices is a promising development for preventing vascular graft thrombosis, improving long-term patency and accelerating remodeling. Objective: to study the outcomes of long-term patency of PHBV/PCL/GFmix grafts with iloprost (Ilo) and heparin (Hep) implanted into the carotid artery of sheep. Materials and methods. Matrices 04 mm were fabricated by electrospinning from a polymer composition of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and poly(s-caprolactone) (PCL) with incorporation of endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and chemoattractant molecule (SDF-1a). The fabricated matrices were then modified with Ilo and Hep by complexation via polyvinylpyrrolidone (PVP). Synthetic Gore-Tex grafts were used as a comparison group. The physical and mechanical properties of the studied matrix groups were evaluated, the surface structure of vascular grafts before and after implantation was assessed. Vascular grafts were implanted into the carotid artery of a sheep. The explanted samples were studied via histological and immunofluorescence analysis, the elemental composition of the obtained vascular graft samples was also assessed, and the gene expression profile was evaluated. Results. One day after implantation, the patency of PHBV/PCL/GFmixHep/n° vascular grafts was 62.5%, whereas synthetic Gore-Tex grafts had thrombosis in 100% of cases. At the same time, after 18 months of implantation, the patency of biodegradable PHBV/PCL/GFmixHep/n° vascular grafts decreased to 50%. Permeable drug-coated polymer grafts were completely reabsorbed after 18 months of implantation, and aneurysmally dilated newly-formed vascular tissue was formed in their place. Conclusion. Modification of the surface of PHBV/PCL/GFmix polymer grafts with Hep + Ilo coating improved long-term patency outcomes compared to synthetic Gore-Tex grafts.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84537720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-24DOI: 10.15825/1995-1191-2022-3-111-120
M. Zhulkov, D. Sirota, I. Zykov, A. Sabetov, K. Agaeva, А. G. Makaev, D. Osintsev, A. P. Nadeev, V. Kliver, E. Kliver, A. Volkov, A. Tarkova, А. V. Fomichev, A. Chernyavsky
Objective: to evaluate the technical feasibility as well as functional, metabolic and structural integrity of donor heart myocardium after 4 hours of direct intracoronary oxygen persufflation in an experiment.Materials and methods. Mini-pig siblings aged 3 months with a body weight of23-36 kg were used as the experimental model. In the control group (n = 8), donor hearts were cold preserved by injecting 2 liters of Bretschneider cardioplegic solution (Custodiol®, Germany, HTK) into the aortic root. In the experimental group (n = 8), modified HTK solution (with 40 mg/L hyaluronidase added) was used to initiate cardioplegia, then moistened carbogen (95% O2, 5% CO2) was injected into the ascending aorta, maintaining 40-45 mm Hg aortic root pressure. The hearts were stored in an mHTK solution at 0-4 °С. After 3 hours of donor heart preservation, orthotopic heart transplantation (OHTx) was performed. In the post-transplant period, we studied central hemodynamic parameters, myocardial oxygen consumption, level of myocardial ischemia markers (troponin I, Tnl; creatine phosphokinase-MB, CPK-MB; lactate dehydrogenase, LDH), and histological signs of structural cellular injury.Results. Sixteen OHTx surgeries were performed during the study. At 120 minutes after restoration of spontaneous cardiac activity, cardiac output was 2.99 [4.85; 3.17] L/min and 2.48 [2.04; 2.92] L/min (p > 0.05) in the control and experimental groups, respectively. Changes in LDH, TnI and lactate levels in the blood flowing from the coronary sinus were significantly higher in the early reperfusion period. However, there was no statistically significant difference between the groups (p > 0.05). Myocardial oxygen consumption in the control and experimental groups was 8.2 [7.35; 9.35] ml-O2/min/100 g and 7.7 [6.75; 10.12] ml-O2/min/100 g, respectively (p > 0.05). Morphological examinations also showed no significant myocardial ischemia injury in the persufflation group compared to the control group.Conclusion. The experiment showed the technical feasibility and safety of direct intracoronary oxygen persufflation for 4 hours at the ex vivo donor heart conditioning stage. At the same time, experimental data showed no significant advantages of coronary persufflation over the standard protocol of cold preservation of donor heart with Bretschneider cardioplegic solution.
{"title":"Results of a study of the effectiveness of direct coronary oxygen persufflation as a donor heart conditioning method","authors":"M. Zhulkov, D. Sirota, I. Zykov, A. Sabetov, K. Agaeva, А. G. Makaev, D. Osintsev, A. P. Nadeev, V. Kliver, E. Kliver, A. Volkov, A. Tarkova, А. V. Fomichev, A. Chernyavsky","doi":"10.15825/1995-1191-2022-3-111-120","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-111-120","url":null,"abstract":"Objective: to evaluate the technical feasibility as well as functional, metabolic and structural integrity of donor heart myocardium after 4 hours of direct intracoronary oxygen persufflation in an experiment.Materials and methods. Mini-pig siblings aged 3 months with a body weight of23-36 kg were used as the experimental model. In the control group (n = 8), donor hearts were cold preserved by injecting 2 liters of Bretschneider cardioplegic solution (Custodiol®, Germany, HTK) into the aortic root. In the experimental group (n = 8), modified HTK solution (with 40 mg/L hyaluronidase added) was used to initiate cardioplegia, then moistened carbogen (95% O2, 5% CO2) was injected into the ascending aorta, maintaining 40-45 mm Hg aortic root pressure. The hearts were stored in an mHTK solution at 0-4 °С. After 3 hours of donor heart preservation, orthotopic heart transplantation (OHTx) was performed. In the post-transplant period, we studied central hemodynamic parameters, myocardial oxygen consumption, level of myocardial ischemia markers (troponin I, Tnl; creatine phosphokinase-MB, CPK-MB; lactate dehydrogenase, LDH), and histological signs of structural cellular injury.Results. Sixteen OHTx surgeries were performed during the study. At 120 minutes after restoration of spontaneous cardiac activity, cardiac output was 2.99 [4.85; 3.17] L/min and 2.48 [2.04; 2.92] L/min (p > 0.05) in the control and experimental groups, respectively. Changes in LDH, TnI and lactate levels in the blood flowing from the coronary sinus were significantly higher in the early reperfusion period. However, there was no statistically significant difference between the groups (p > 0.05). Myocardial oxygen consumption in the control and experimental groups was 8.2 [7.35; 9.35] ml-O2/min/100 g and 7.7 [6.75; 10.12] ml-O2/min/100 g, respectively (p > 0.05). Morphological examinations also showed no significant myocardial ischemia injury in the persufflation group compared to the control group.Conclusion. The experiment showed the technical feasibility and safety of direct intracoronary oxygen persufflation for 4 hours at the ex vivo donor heart conditioning stage. At the same time, experimental data showed no significant advantages of coronary persufflation over the standard protocol of cold preservation of donor heart with Bretschneider cardioplegic solution.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78062615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-24DOI: 10.15825/1995-1191-2022-3-64-73
V. Poptsov, V. M. Zakharevich, E. Spirina, N. Koloskova, V. V. Pchelnikov, V. M. Khatutskii, A. Skokova, A. Fomichev, E. Z. Aliev, V. Boronova, A. Bereznyak, A. K. Solodovnikova
Amidst the shortage in viable donor hearts, the use of hearts from expanded criteria donors, including those with prolonged ischemic time, remains one of the real ways to increase the donor pool and number of heart transplantations (HTx) performed. The study included 38 recipients (33 (86.8%) men and 5 (13.2%) women) aged 11 to 66 (44.7 ± 12.0 years, median 48.0 years), who underwent primary (n = 37; 97.4%) or repeat (n = 1; 2.6%) HTx (retransplantation). Donor hearts (n = 38) with ischemic time ranged from 362 (6 hours 2 minutes) to 571 (9 hours 31 minutes) or 407 ± 52 minutes (median 400 minutes). In 33 (86.8%) of 38 recipients, the early posttransplant period was characterized by satisfactory initial graft function. Five (13.1%) recipients developed severe primary graft dysfunction, requiring post-transplant venoarterial extracorporeal membrane oxygenation (VA-ECMO) (n = 4; 10.5%) or prolongation of pre-transplant VA-ECMO within 8 days of HTx (n = 1; 2.6%). In-hospital mortality was 7.9% (n = 3). Thirty-five (92.1%) of 38 recipients were discharged from the hospital. Three recipients died in the post-hospital period at day 734, 944, and 2146 after HTx. Thirty-two (84.2%) of the 38 recipients remained alive at the end of the study. Our own experience shows that HTx from donors with prolonged ischemic time could be effective.
{"title":"Perioperative period in heart transplantation with extremely prolonged ischemic times (>6 hours)","authors":"V. Poptsov, V. M. Zakharevich, E. Spirina, N. Koloskova, V. V. Pchelnikov, V. M. Khatutskii, A. Skokova, A. Fomichev, E. Z. Aliev, V. Boronova, A. Bereznyak, A. K. Solodovnikova","doi":"10.15825/1995-1191-2022-3-64-73","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-64-73","url":null,"abstract":"Amidst the shortage in viable donor hearts, the use of hearts from expanded criteria donors, including those with prolonged ischemic time, remains one of the real ways to increase the donor pool and number of heart transplantations (HTx) performed. The study included 38 recipients (33 (86.8%) men and 5 (13.2%) women) aged 11 to 66 (44.7 ± 12.0 years, median 48.0 years), who underwent primary (n = 37; 97.4%) or repeat (n = 1; 2.6%) HTx (retransplantation). Donor hearts (n = 38) with ischemic time ranged from 362 (6 hours 2 minutes) to 571 (9 hours 31 minutes) or 407 ± 52 minutes (median 400 minutes). In 33 (86.8%) of 38 recipients, the early posttransplant period was characterized by satisfactory initial graft function. Five (13.1%) recipients developed severe primary graft dysfunction, requiring post-transplant venoarterial extracorporeal membrane oxygenation (VA-ECMO) (n = 4; 10.5%) or prolongation of pre-transplant VA-ECMO within 8 days of HTx (n = 1; 2.6%). In-hospital mortality was 7.9% (n = 3). Thirty-five (92.1%) of 38 recipients were discharged from the hospital. Three recipients died in the post-hospital period at day 734, 944, and 2146 after HTx. Thirty-two (84.2%) of the 38 recipients remained alive at the end of the study. Our own experience shows that HTx from donors with prolonged ischemic time could be effective.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78228486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-24DOI: 10.15825/1995-1191-2022-3-102-110
M. Minina, D. Voronov, E. A. Tenchurina
The objective of the study was to investigate the evolution and trends in liver donation in the city of Moscow, with special focus on the expansion of liver donor selection criteria for transplantation.Materials and methods. The study included 1,548 effective donors (EDs) in the period from January 1, 2012 to December 31, 2020. Their basic characteristics - age and cause of death - are presented. The dynamics of changes in the age groups of donors and the dynamics of the number of >60-year-old liver donors were studied. The influence of expanded liver donor selection criteria over the dynamics of the number of transplant surgeries and patient flow on the waiting list was assessed.Results. During the study period, the number of effective liver donors (ELDs) in Moscow increased 4.7-fold. The average age of ELDs increased from 37.1 in 2012 to 48.8 in 2020. There was an absolute prevalence of donors who died from cerebrovascular accident compared with donors who died from traumatic causes, 83.4% vs 16.6%, respectively. Since 2016, there has been a progressive increase in >60-year-old liver donors; the number of such donors in 2020 reached 39, accounting for 13.6% of the total pool of EDs. The progressive growth in the number of liver transplants has significantly influenced patient movement on the waiting list. In 2012, there was a 25.2% increase in the number of liver transplants per 100 patients on the waiting list; by 2020, it had reached 86.6%.Conclusion. The results reasonably indicate an increase in liver donation and liver transplantation (LTx) in Moscow. Comparison of Russian data with those of leading foreign donor programs shows that the trends in the donor pool in the context of older age, including >60-year-old donors, and shifting causes of donor death towards cerebrovascular diseases are similar. An overall increase in donor activity and expansion of liver donor criteria contributed to an increase in the number of transplants performed per 100 patients on the waiting list, which, in turn, reduced the waiting time for a donor organ and increased the intensity of patient flow on the waiting list.
{"title":"Evolution of liver donation in Moscow. Movement towards expanded donor selection criteria","authors":"M. Minina, D. Voronov, E. A. Tenchurina","doi":"10.15825/1995-1191-2022-3-102-110","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-102-110","url":null,"abstract":"The objective of the study was to investigate the evolution and trends in liver donation in the city of Moscow, with special focus on the expansion of liver donor selection criteria for transplantation.Materials and methods. The study included 1,548 effective donors (EDs) in the period from January 1, 2012 to December 31, 2020. Their basic characteristics - age and cause of death - are presented. The dynamics of changes in the age groups of donors and the dynamics of the number of >60-year-old liver donors were studied. The influence of expanded liver donor selection criteria over the dynamics of the number of transplant surgeries and patient flow on the waiting list was assessed.Results. During the study period, the number of effective liver donors (ELDs) in Moscow increased 4.7-fold. The average age of ELDs increased from 37.1 in 2012 to 48.8 in 2020. There was an absolute prevalence of donors who died from cerebrovascular accident compared with donors who died from traumatic causes, 83.4% vs 16.6%, respectively. Since 2016, there has been a progressive increase in >60-year-old liver donors; the number of such donors in 2020 reached 39, accounting for 13.6% of the total pool of EDs. The progressive growth in the number of liver transplants has significantly influenced patient movement on the waiting list. In 2012, there was a 25.2% increase in the number of liver transplants per 100 patients on the waiting list; by 2020, it had reached 86.6%.Conclusion. The results reasonably indicate an increase in liver donation and liver transplantation (LTx) in Moscow. Comparison of Russian data with those of leading foreign donor programs shows that the trends in the donor pool in the context of older age, including >60-year-old donors, and shifting causes of donor death towards cerebrovascular diseases are similar. An overall increase in donor activity and expansion of liver donor criteria contributed to an increase in the number of transplants performed per 100 patients on the waiting list, which, in turn, reduced the waiting time for a donor organ and increased the intensity of patient flow on the waiting list.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78168645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-24DOI: 10.15825/1995-1191-2022-3-121-129
D. M. Bondarenko, A. G. Sdvigova, G. A. Akopov, A. Ivanov, M. K. Lugovskii, А. F. Afanasiev, R. Bangarov
Dissecting aortic aneurysm is one of the most dangerous diseases of the aorta, often leading to severe complications or death. Currently, due to the increased level of diagnosis and the speed of care for patients with aortic diseases, there is now a need to improve approaches to the treatment of this condition. This paper presents the outcomes of a technique developed at our center, Shumakov National Medical Research Center of Transplantology and Artificial Organs, for selective antegrade cerebral perfusion (SACP) when performing prosthetic replacement of the aortic arch under circulatory arrest. Surgical treatment is performed on an emergency basis. During these surgeries, we focused on preventing neurological complications. Analysis of the efficacy and safety of our SACP technique shows that we obtained positive outcomes. In the analysis of 10 cases of aortic arch replacement, there was no evidence indicating the presence of any neurological complication. This technique allows for more adequate monitoring of perfusion during reconstructive interventions on the ascending aorta and aortic arch than the classical perfusion technique.
{"title":"Shumakov National Medical Research Center of Transplantology and Artificial Organs","authors":"D. M. Bondarenko, A. G. Sdvigova, G. A. Akopov, A. Ivanov, M. K. Lugovskii, А. F. Afanasiev, R. Bangarov","doi":"10.15825/1995-1191-2022-3-121-129","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-121-129","url":null,"abstract":"Dissecting aortic aneurysm is one of the most dangerous diseases of the aorta, often leading to severe complications or death. Currently, due to the increased level of diagnosis and the speed of care for patients with aortic diseases, there is now a need to improve approaches to the treatment of this condition. This paper presents the outcomes of a technique developed at our center, Shumakov National Medical Research Center of Transplantology and Artificial Organs, for selective antegrade cerebral perfusion (SACP) when performing prosthetic replacement of the aortic arch under circulatory arrest. Surgical treatment is performed on an emergency basis. During these surgeries, we focused on preventing neurological complications. Analysis of the efficacy and safety of our SACP technique shows that we obtained positive outcomes. In the analysis of 10 cases of aortic arch replacement, there was no evidence indicating the presence of any neurological complication. This technique allows for more adequate monitoring of perfusion during reconstructive interventions on the ascending aorta and aortic arch than the classical perfusion technique.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87393411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-24DOI: 10.15825/1995-1191-2022-3-133-138
S. R. Galeev, R. E. Shulgin, S. Y. Bizhiev, D. M. Gadaborshev
The paper presents the clinical case of successful treatment of giant oleogranuloma of the external genitalia in a kidney recipient. The relevance of the problem, which has not diminished over time due to identification of new cases, is presented. Stages involving pathological tissue removal and reconstructive plastic surgical intervention to restore the anatomical form and functionality of the penis are described and illustrated in detail. The authors conclude that reconstructive plastic intervention for penile oleogranuloma can be effectively performed in a patient with end-stage chronic renal disease treated via renal transplant and who is receiving triple immunosuppressive therapy.
{"title":"Two-stage reconstructive plastic surgery for giant oleogranuloma of the external genitalia in a kidney recipient","authors":"S. R. Galeev, R. E. Shulgin, S. Y. Bizhiev, D. M. Gadaborshev","doi":"10.15825/1995-1191-2022-3-133-138","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-133-138","url":null,"abstract":"The paper presents the clinical case of successful treatment of giant oleogranuloma of the external genitalia in a kidney recipient. The relevance of the problem, which has not diminished over time due to identification of new cases, is presented. Stages involving pathological tissue removal and reconstructive plastic surgical intervention to restore the anatomical form and functionality of the penis are described and illustrated in detail. The authors conclude that reconstructive plastic intervention for penile oleogranuloma can be effectively performed in a patient with end-stage chronic renal disease treated via renal transplant and who is receiving triple immunosuppressive therapy.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81586421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-23DOI: 10.15825/1995-1191-2022-3-32-36
V. V. Borovik, A. Polikarpov, D. Granov
Objective: to evaluate the possible influence of neoadjuvant transarterial chemoembolization (TACE) on development of early arterial complications after orthotopic liver transplantation (OLTx).Materials and methods. The work is based on treatment-related data of 250 recipients. The analyzed group included 21 patients with hepatocellular carcinoma (HCC). In all recipients who underwent primary transplantation (n = 228), possible negative factors influencing the development of early arterial complications were analyzed, such as degree of allograft steatosis, cold and warm ischemia time, revascularization duration, blood pressure level after arterial reconstruction, and exchange transfusion volume.Results. The degree of allograft steatosis did not differ between HCC patients and the general sample (95% CI, p = 0.25). No early arterial complications were revealed during TACE. There was no significant difference in preservation parameters, arterial revascularization time, systolic blood pressure level at blood flow start, and exchange transfusion volume (CI 95%, p > 0.05). The incidence of early vascular complications in the study group was 16.7%, it did not differ from the entire sample (95% CI, p = 0.96).Conclusion. The incidence of early arterial complications of OLTx in patients who underwent TACE does not significantly increase both according to the literature and our own findings. When vascular complications of OLTx occur, image-guided endovascular intervention is the method of choice for treatment.
目的:探讨新辅助经动脉化疗栓塞(TACE)对原位肝移植术后早期动脉并发症发生的可能影响。材料和方法。这项工作是基于250名接受者的治疗相关数据。分析组包括21例肝细胞癌患者。对所有接受首次移植的受者(228例)，分析可能影响早期动脉并发症发生的不利因素，如异体移植脂肪变性程度、冷热缺血时间、血运重建时间、动脉重建后血压水平、换血量等。同种异体移植脂肪变性的程度在HCC患者和一般样本之间没有差异(95% CI, p = 0.25)。TACE期间未发现早期动脉并发症。两组保存参数、动脉血运重建时间、血流开始时收缩压水平、换血量差异无统计学意义(CI 95%， p > 0.05)。研究组早期血管并发症的发生率为16.7%，与整个样本没有差异(95% CI, p = 0.96)。根据文献和我们自己的研究结果，接受TACE的患者早期OLTx动脉并发症的发生率并没有显著增加。当OLTx发生血管并发症时，图像引导的血管内介入治疗是治疗的首选方法。
{"title":"Transarterial chemoembolization and early arterial complications after liver transplantation for hepatocellular carcinoma","authors":"V. V. Borovik, A. Polikarpov, D. Granov","doi":"10.15825/1995-1191-2022-3-32-36","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-32-36","url":null,"abstract":"Objective: to evaluate the possible influence of neoadjuvant transarterial chemoembolization (TACE) on development of early arterial complications after orthotopic liver transplantation (OLTx).Materials and methods. The work is based on treatment-related data of 250 recipients. The analyzed group included 21 patients with hepatocellular carcinoma (HCC). In all recipients who underwent primary transplantation (n = 228), possible negative factors influencing the development of early arterial complications were analyzed, such as degree of allograft steatosis, cold and warm ischemia time, revascularization duration, blood pressure level after arterial reconstruction, and exchange transfusion volume.Results. The degree of allograft steatosis did not differ between HCC patients and the general sample (95% CI, p = 0.25). No early arterial complications were revealed during TACE. There was no significant difference in preservation parameters, arterial revascularization time, systolic blood pressure level at blood flow start, and exchange transfusion volume (CI 95%, p > 0.05). The incidence of early vascular complications in the study group was 16.7%, it did not differ from the entire sample (95% CI, p = 0.96).Conclusion. The incidence of early arterial complications of OLTx in patients who underwent TACE does not significantly increase both according to the literature and our own findings. When vascular complications of OLTx occur, image-guided endovascular intervention is the method of choice for treatment.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90462104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-23DOI: 10.15825/1995-1191-2022-3-37-41
A. Nikogosova, D. Umrik, O. Tsirulnikova
De novo hepatitis B virus (HBV) infection developing after liver transplantation (LTx) is the development of infection in a patient with liver disease etiologically unrelated to HBV infection and who had no preoperative HBV markers.Objective: to analyze the clinical features and characteristics of de novo HBV infection and evaluate the efficacy of nucleos(t)ide analogue therapy in liver transplant recipients.Materials and methods. The study involved 247 adult patients who underwent deceased donor LTx from 2016 to 2022 at Shumakov National Medical Research Center of Transplantology and Artificial Organs and who had no pre-transplant HBV markers.Results. Twenty-two (7%) of 247 patients had de novo HBV markers from 5 to 69 months. At the time HBV DNA was detected, the mean alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in the patients was 53.3 ± 36.4 IU/L and 54.5 ± 33.0 IU/L, respectively. All patients received nucleos(t)ide analogues (NAs). The therapy led to a statistically significant decrease in the mean ALT level to 31.5 ± 24.2 IU/L (p = 0.049) and AST to 33.33 ± 21.5 IU/L (p = 0.025). In most cases (18 persons, 81%), no serum HBV DNA was detected after treatment (6 ± 3 months).Conclusion. Timely detection of de novo HBV risk factors, early diagnosis and immediate treatment can prevent severe graft damage.
{"title":"De novo hepatitis b virus infection after liver transplantation","authors":"A. Nikogosova, D. Umrik, O. Tsirulnikova","doi":"10.15825/1995-1191-2022-3-37-41","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-37-41","url":null,"abstract":"De novo hepatitis B virus (HBV) infection developing after liver transplantation (LTx) is the development of infection in a patient with liver disease etiologically unrelated to HBV infection and who had no preoperative HBV markers.Objective: to analyze the clinical features and characteristics of de novo HBV infection and evaluate the efficacy of nucleos(t)ide analogue therapy in liver transplant recipients.Materials and methods. The study involved 247 adult patients who underwent deceased donor LTx from 2016 to 2022 at Shumakov National Medical Research Center of Transplantology and Artificial Organs and who had no pre-transplant HBV markers.Results. Twenty-two (7%) of 247 patients had de novo HBV markers from 5 to 69 months. At the time HBV DNA was detected, the mean alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in the patients was 53.3 ± 36.4 IU/L and 54.5 ± 33.0 IU/L, respectively. All patients received nucleos(t)ide analogues (NAs). The therapy led to a statistically significant decrease in the mean ALT level to 31.5 ± 24.2 IU/L (p = 0.049) and AST to 33.33 ± 21.5 IU/L (p = 0.025). In most cases (18 persons, 81%), no serum HBV DNA was detected after treatment (6 ± 3 months).Conclusion. Timely detection of de novo HBV risk factors, early diagnosis and immediate treatment can prevent severe graft damage.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74052155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-23DOI: 10.15825/1995-1191-2022-3-57-63
A. Kirshin, A. Y. Teregulov, A. R. Kirshina
Objective: to study the incidence of splenic artery steal syndrome (SASS) in our own series of liver transplant surgeries and to determine diagnostic and therapeutic tactics.Materials and Methods. During the 3.5 years of existence of the liver transplant program in the Republic of Tatarstan, 77 cadaveric liver transplantations (LTx) have been performed. Postoperative SASS occurred in 4 cases (5.2%). Among the patients were 3 women and 1 man; mean age was 38 years. Doppler ultrasonography of the liver vessels and celiacography were used for diagnosis. Proximal splenic embolization was used as a way to correct the syndrome.Results. In all clinical cases, SASS was timely diagnosed and corrected by endovascular image-guided intervention. The patients were discharged with good hepatic graft function. The complication did not affect the length of hospital stay.Conclusion. SASS remains a severe vascular complication of LTx, which can lead to graft dysfunction and possible loss. Timely detection and treatment prevent severe consequences for the liver recipient.
{"title":"Early diagnosis and treatment of splenio artery steal syndrome after liver transplantation","authors":"A. Kirshin, A. Y. Teregulov, A. R. Kirshina","doi":"10.15825/1995-1191-2022-3-57-63","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-57-63","url":null,"abstract":"Objective: to study the incidence of splenic artery steal syndrome (SASS) in our own series of liver transplant surgeries and to determine diagnostic and therapeutic tactics.Materials and Methods. During the 3.5 years of existence of the liver transplant program in the Republic of Tatarstan, 77 cadaveric liver transplantations (LTx) have been performed. Postoperative SASS occurred in 4 cases (5.2%). Among the patients were 3 women and 1 man; mean age was 38 years. Doppler ultrasonography of the liver vessels and celiacography were used for diagnosis. Proximal splenic embolization was used as a way to correct the syndrome.Results. In all clinical cases, SASS was timely diagnosed and corrected by endovascular image-guided intervention. The patients were discharged with good hepatic graft function. The complication did not affect the length of hospital stay.Conclusion. SASS remains a severe vascular complication of LTx, which can lead to graft dysfunction and possible loss. Timely detection and treatment prevent severe consequences for the liver recipient.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74300475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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