Pub Date : 2022-08-23DOI: 10.15825/1995-1191-2022-3-42-50
V. L. Korobka, V. D. Pasetchnikov, R. V. Korobka, E. Pak, A. Shapovalov
Objective: to conduct a comparative analysis of the effectiveness of two methods - endoscopic band ligation (EBL) alone and in combination with nonselective beta blockers (NSBB) - used for prevention of variceal bleeding (VB); to evaluate their impact on patient survival in severe ascites during long-term stay on the liver transplant waiting list (LTWL).Materials and methods. A retrospective comparative study of two groups of patients with decompensated liver disease, ascites and varices included in the LTWL, who received EBL (n = 41, group 1) and EBL + NSBB (n = 45, group 2).Results. The groups being compared did not differ in demographics, clinical parameters, MELD and Child-Turcotte-Pugh scores. There were no significant differences in the incidence of severe ascites, particularly diuretic-resistant ascites. The study groups did not differ in the incidence of medium-and large-sized varices. Incidence of bleeding did not differ in both groups. Overall mortality was significantly higher in the EBL + NSBB group than in the EBL group. Patient survival was lower, while mortality was higher in the EBL + NSBB group. The combined therapy group had a significantly higher number of acute kidney injury (AKI) than the EBL group.Conclusion. The compared methods are equivalently effective in preventing VB in patients with decompensated cirrhosis with a prolonged stay on the waiting list. Survival rate is significantly lower, while mortality is significantly higher in the EBL + NSBB group than in the EBL group.
{"title":"Use of endoscopic band ligation alone and in combination with nonselective beta blockers for prevention of variceal bleeding in ascites patients on the liver transplant waiting list","authors":"V. L. Korobka, V. D. Pasetchnikov, R. V. Korobka, E. Pak, A. Shapovalov","doi":"10.15825/1995-1191-2022-3-42-50","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-42-50","url":null,"abstract":"Objective: to conduct a comparative analysis of the effectiveness of two methods - endoscopic band ligation (EBL) alone and in combination with nonselective beta blockers (NSBB) - used for prevention of variceal bleeding (VB); to evaluate their impact on patient survival in severe ascites during long-term stay on the liver transplant waiting list (LTWL).Materials and methods. A retrospective comparative study of two groups of patients with decompensated liver disease, ascites and varices included in the LTWL, who received EBL (n = 41, group 1) and EBL + NSBB (n = 45, group 2).Results. The groups being compared did not differ in demographics, clinical parameters, MELD and Child-Turcotte-Pugh scores. There were no significant differences in the incidence of severe ascites, particularly diuretic-resistant ascites. The study groups did not differ in the incidence of medium-and large-sized varices. Incidence of bleeding did not differ in both groups. Overall mortality was significantly higher in the EBL + NSBB group than in the EBL group. Patient survival was lower, while mortality was higher in the EBL + NSBB group. The combined therapy group had a significantly higher number of acute kidney injury (AKI) than the EBL group.Conclusion. The compared methods are equivalently effective in preventing VB in patients with decompensated cirrhosis with a prolonged stay on the waiting list. Survival rate is significantly lower, while mortality is significantly higher in the EBL + NSBB group than in the EBL group.","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":"85228294","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: 10.15825/1995-1191-2022-3-51-56
A. M. Talyzin, S. Zhuravel, M. Khubutiya, E. Tarabrin, N. K. Kuznetsova
Objective: to demonstrate the experience of using complex hemodynamic monitoring by means of prepulmonary thermodilution (PPTD) and transpulmonary thermodilution (TPTD) - PiCCO - in lung transplantation (LTx).Materials and methods. Presented is a clinical case study of a 51-year-old patient with the following diagnosis: severe bronchiectasis and type 3 respiratory failure. Bilateral lung transplantation was performed at Sklifosovsky Research Institute for Emergency Medicine, Moscow. Intraoperative hemodynamic monitoring was performed using PPTD and TPTD techniques.Conclusion. The case study presented shows that simultaneous use of PPTD and TPTD for hemodynamic monitoring during lung transplantation achieves better treatment outcomes. This hemodynamics monitoring strategy is highly informative, allows for continuous measurement of necessary hemodynamic parameters and for timely and targeted correction of identified disorders by influencing the basic pathogenesis links of cardiovascular disease.
{"title":"Experience in the use of invasive hemodynamic monitoring using prepulmonary and transpulmonary thermodilution in lung transplantation","authors":"A. M. Talyzin, S. Zhuravel, M. Khubutiya, E. Tarabrin, N. K. Kuznetsova","doi":"10.15825/1995-1191-2022-3-51-56","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-3-51-56","url":null,"abstract":"Objective: to demonstrate the experience of using complex hemodynamic monitoring by means of prepulmonary thermodilution (PPTD) and transpulmonary thermodilution (TPTD) - PiCCO - in lung transplantation (LTx).Materials and methods. Presented is a clinical case study of a 51-year-old patient with the following diagnosis: severe bronchiectasis and type 3 respiratory failure. Bilateral lung transplantation was performed at Sklifosovsky Research Institute for Emergency Medicine, Moscow. Intraoperative hemodynamic monitoring was performed using PPTD and TPTD techniques.Conclusion. The case study presented shows that simultaneous use of PPTD and TPTD for hemodynamic monitoring during lung transplantation achieves better treatment outcomes. This hemodynamics monitoring strategy is highly informative, allows for continuous measurement of necessary hemodynamic parameters and for timely and targeted correction of identified disorders by influencing the basic pathogenesis links of cardiovascular disease.","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":"82504324","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 : 2022-08-09DOI: 10.15825/1995-1191-2022-4-85-93
N. A. Onishchenko, A. Nikolskaya, Z. Z. Gonikova, L. A. Kirsanova, M. Shagidulin, V. Sevastianov
Objective: to compare the efficiency of regenerative processes in the liver using apoptotic bone marrow-derived mononuclear cells (BMMCs) and intact BMMCs from healthy animals on an extended liver resection (ELR) model.Materials and methods. Male Wistar rats (n = 77) with an ELR model (70–75%) were divided into 3 groups: group 1 (control with a single intraperitoneal injection of saline), group 2 (single intraperitoneal injection of unsorted intact BMMCs at a dose of 30–35 × 106, and group 3 (single intraperitoneal injection of apoptotic BMMCs at the same dose). Restoration of biochemical parameters of liver function and mass, as well as the emerging microstructural changes in hepatocytes in histological preparations, were monitored by assessing hepatocyte mitotic activity (MA) during the first 7–10 days after ELR.Results. It was found that in groups 2 and 3, as compared with group 1, there was no death after ELR modeling, and that the biochemical parameters of liver function normalized more rapidly (at days 10–14). Hepatocyte MA in group 3 sharply increased as early as on day 1, and mitotic index (MI) averaged 14‰, reaching 20.9‰ in some experiments; MI in the control group remained at the baseline by this time, while in group 2, MI was only 3.2‰. In group 3, liver mass recovered more rapidly after ELR to baseline values already at days 8–10, whereas the recovery was at day 12–14 and day 17–20 in group 2 and group 1, respectively. It was suggested that the more pronounced increase in the efficiency of regenerative processes in the liver after ELR in group 3 after using apoptotic BMMCs was due to the release from these cells of a large spectrum of formed paracrine factors, including various classes of RNA molecules involved in the regeneration process.Conclusion. Apoptotic BMMNCs have a more effective adaptive and regulatory potential than intact BMMCs because reorganizations are rapidly formed in the damaged liver cells, providing an early and more powerful activation of the targeted regenerative program.
{"title":"Apoptotic bone marrow-derived mononuclear cells accelerate liver regeneration after extended resection","authors":"N. A. Onishchenko, A. Nikolskaya, Z. Z. Gonikova, L. A. Kirsanova, M. Shagidulin, V. Sevastianov","doi":"10.15825/1995-1191-2022-4-85-93","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-85-93","url":null,"abstract":"Objective: to compare the efficiency of regenerative processes in the liver using apoptotic bone marrow-derived mononuclear cells (BMMCs) and intact BMMCs from healthy animals on an extended liver resection (ELR) model.Materials and methods. Male Wistar rats (n = 77) with an ELR model (70–75%) were divided into 3 groups: group 1 (control with a single intraperitoneal injection of saline), group 2 (single intraperitoneal injection of unsorted intact BMMCs at a dose of 30–35 × 106, and group 3 (single intraperitoneal injection of apoptotic BMMCs at the same dose). Restoration of biochemical parameters of liver function and mass, as well as the emerging microstructural changes in hepatocytes in histological preparations, were monitored by assessing hepatocyte mitotic activity (MA) during the first 7–10 days after ELR.Results. It was found that in groups 2 and 3, as compared with group 1, there was no death after ELR modeling, and that the biochemical parameters of liver function normalized more rapidly (at days 10–14). Hepatocyte MA in group 3 sharply increased as early as on day 1, and mitotic index (MI) averaged 14‰, reaching 20.9‰ in some experiments; MI in the control group remained at the baseline by this time, while in group 2, MI was only 3.2‰. In group 3, liver mass recovered more rapidly after ELR to baseline values already at days 8–10, whereas the recovery was at day 12–14 and day 17–20 in group 2 and group 1, respectively. It was suggested that the more pronounced increase in the efficiency of regenerative processes in the liver after ELR in group 3 after using apoptotic BMMCs was due to the release from these cells of a large spectrum of formed paracrine factors, including various classes of RNA molecules involved in the regeneration process.Conclusion. Apoptotic BMMNCs have a more effective adaptive and regulatory potential than intact BMMCs because reorganizations are rapidly formed in the damaged liver cells, providing an early and more powerful activation of the targeted regenerative program.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87614771","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 : 2022-08-09DOI: 10.15825/1995-1191-2022-4-60-72
M. Shagidulin, N. A. Onishchenko, A. Grechina, M. Krasheninnikov, A. Nikolskaya, E. Volkova, N. Mogeiko, N. A. Boiarinova, A. Lyundup, G. Piavchenko, L. Davydova, A. Arhipova, V. Bogush, S. Gautier
Objective: to study the effectiveness of correcting the morphofunctional characteristics of the liver in an experimental model of chronic liver disease (CLD), using implanted cell-engineered constructs (CECs).Materials and methods. Experiments were carried out on male Wistar rats (n = 80) aged 6–8 months with an initial weight of 230–250 g. CLD was modeled by inoculating the rats with 60% CCl4 oil solution for 42 days based on a modified scheme. Microgel based on recombinant spidroin rS1/9 was used as a matrix for CECs fabrication. Allogeneic liver cells (LCs) and multipotent bone marrow-derived mesenchymal stem cells (BM-MSCs) from a healthy donor were used as the cellular component of the CECs. The effectiveness of the corrective effect of the implanted CECs was assessed in an experimental CLD model (n = 60) in two groups of rats: Group 1 (control, n = 20, 1 mL of saline solution was injected into the damaged liver parenchyma) and Group 2 (experimental, n = 40, CECs containing allogenic LCs and BM-MSCs in a 5 : 1 ratio in a volume of 1 mL were implanted into the damaged liver parenchyma). For long-term monitoring of the CEC state, the CECs were labeled by additional inclusion in Cytodex-3. The effectiveness of the regulatory effect of CECs on regenerative processes in the liver was evaluated using biochemical, morphological and morphometric techniques, as well as by flow cytometry at 90 days after implantation.Results. In the control group, the mortality rate in CLD was 25%. There was no death in the experimental group with CLD after CEC implantation. The CECs were found to have a corrective effect on the biochemical and morphological parameters of the liver in CLD during 90 days of follow-up, with concomitant preservation of structural cellular homeostasis in the implanted CECs. Conclusion. Implantation of CECs in the liver facilitates effective correction of CLD by activating regenerative processes in the damaged liver, which is due to long-term preservation of structural cellular homeostasis in the CECs.
{"title":"Treatment of chronic liver disease using cell‑engineered constructs: morphofunctional characteristics","authors":"M. Shagidulin, N. A. Onishchenko, A. Grechina, M. Krasheninnikov, A. Nikolskaya, E. Volkova, N. Mogeiko, N. A. Boiarinova, A. Lyundup, G. Piavchenko, L. Davydova, A. Arhipova, V. Bogush, S. Gautier","doi":"10.15825/1995-1191-2022-4-60-72","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-60-72","url":null,"abstract":"Objective: to study the effectiveness of correcting the morphofunctional characteristics of the liver in an experimental model of chronic liver disease (CLD), using implanted cell-engineered constructs (CECs).Materials and methods. Experiments were carried out on male Wistar rats (n = 80) aged 6–8 months with an initial weight of 230–250 g. CLD was modeled by inoculating the rats with 60% CCl4 oil solution for 42 days based on a modified scheme. Microgel based on recombinant spidroin rS1/9 was used as a matrix for CECs fabrication. Allogeneic liver cells (LCs) and multipotent bone marrow-derived mesenchymal stem cells (BM-MSCs) from a healthy donor were used as the cellular component of the CECs. The effectiveness of the corrective effect of the implanted CECs was assessed in an experimental CLD model (n = 60) in two groups of rats: Group 1 (control, n = 20, 1 mL of saline solution was injected into the damaged liver parenchyma) and Group 2 (experimental, n = 40, CECs containing allogenic LCs and BM-MSCs in a 5 : 1 ratio in a volume of 1 mL were implanted into the damaged liver parenchyma). For long-term monitoring of the CEC state, the CECs were labeled by additional inclusion in Cytodex-3. The effectiveness of the regulatory effect of CECs on regenerative processes in the liver was evaluated using biochemical, morphological and morphometric techniques, as well as by flow cytometry at 90 days after implantation.Results. In the control group, the mortality rate in CLD was 25%. There was no death in the experimental group with CLD after CEC implantation. The CECs were found to have a corrective effect on the biochemical and morphological parameters of the liver in CLD during 90 days of follow-up, with concomitant preservation of structural cellular homeostasis in the implanted CECs. Conclusion. Implantation of CECs in the liver facilitates effective correction of CLD by activating regenerative processes in the damaged liver, which is due to long-term preservation of structural cellular homeostasis in the CECs.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85867939","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 : 2022-08-09DOI: 10.15825/1995-1191-2022-4-135-144
I. V. Rebrikova, E. Vorotelyak, O. Rogovaya, A. Polyakov, A. V. Mordovskiy, M. V. Ratushny, A. Kaprin, A. Vasiliev
After removal of metastatic malignant tumors of the hypopharynx and larynx, hypopharyngeal defects are formed. To restore the hypopharynx, a mucosa and a muscular component are needed.The objective of this study is to develop a hypopharyngeal reconstruction technique using prelaminated pectoralis major flap with mucosal epithelium analogue from autologous epithelial layers.Materials and methods. Nine patients underwent reconstruction of the hypopharynx using bioengineered prelaminated pectoralis major flaps. The mucosa was restored by tissue-engineered autologous epithelial cell layers that were obtained by culturing in vitro cells isolated from skin biopsies that were previously obtained from patients.Results. Oral nutrition was restored in all cases. Pharyngeal stenosis was detected in one (11%) patient. A stratified squamous epithelium on the pectoral fascia was revealed in 67% of cases at week 2 after prelamination, in 89% of cases at week 4 after reconstruction and in 100% of cases at month 3, 6, 12 and 24 after reconstruction.Conclusion. Reconstruction using prelaminated bioengineered flaps allows recreating the anatomical integrity and function of the hypopharynx.
{"title":"Hypopharyngeal reconstruction using prelaminated autologous bio-engineered pectoralis major flaps","authors":"I. V. Rebrikova, E. Vorotelyak, O. Rogovaya, A. Polyakov, A. V. Mordovskiy, M. V. Ratushny, A. Kaprin, A. Vasiliev","doi":"10.15825/1995-1191-2022-4-135-144","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-135-144","url":null,"abstract":"After removal of metastatic malignant tumors of the hypopharynx and larynx, hypopharyngeal defects are formed. To restore the hypopharynx, a mucosa and a muscular component are needed.The objective of this study is to develop a hypopharyngeal reconstruction technique using prelaminated pectoralis major flap with mucosal epithelium analogue from autologous epithelial layers.Materials and methods. Nine patients underwent reconstruction of the hypopharynx using bioengineered prelaminated pectoralis major flaps. The mucosa was restored by tissue-engineered autologous epithelial cell layers that were obtained by culturing in vitro cells isolated from skin biopsies that were previously obtained from patients.Results. Oral nutrition was restored in all cases. Pharyngeal stenosis was detected in one (11%) patient. A stratified squamous epithelium on the pectoral fascia was revealed in 67% of cases at week 2 after prelamination, in 89% of cases at week 4 after reconstruction and in 100% of cases at month 3, 6, 12 and 24 after reconstruction.Conclusion. Reconstruction using prelaminated bioengineered flaps allows recreating the anatomical integrity and function of the hypopharynx.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73785964","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 : 2022-08-09DOI: 10.15825/1995-1191-2022-4-94-108
L. Antonova, A. Mironov, A. Shabaev, V. Silnikov, E. Krivkina, V. Matveeva, E. Velikanova, E. A. Senokosova, M. Khanova, V. Sevostyanova, T. V. Glushkova, R. Mukhamadiyarov, L. Barbarash
Carotid endarterectomy (CEA) with patch angioplasty is the most effective treatment for carotid artery stenosis. However, the use of existing vascular patches is often associated with thrombosis, restenosis, calcification and other complications.Objective: to develop biodegradable patches for arterial reconstruction, containing vascular endothelial growth factor (VEGF) or arginyl-glycyl-aspartic acid (RGD), and comparatively evaluate their biocompatibility and efficacy in in vitro experiments and during preclinical trials in large laboratory animal models.Materials and methods. Biodegradable patches, made from a mixture of poly(3-hydroxybutyrate-co-3- hydroxyvalerate (PHBV) and poly(ε-caprolactone) (PCL), were fabricated by electrospinning and modified with VEGF or the peptide sequence RGD in different configurations. In in vitro experiments, the surface structure, physicomechanical and hemocompatibility properties were evaluated. In in vivo experiments, we evaluated the effectiveness of the developed vascular patches for 6 months after implantation into the carotid artery of 12 sheep. The quality of remodeling was assessed using histological and immunofluorescence studies of explanted specimens.Results. The PHBV/PCL/VEGF patches had physicomechanical characteristics closer to those of native vessels and their biofunctionalization method resulted in the smallest drop in strength characteristics compared with their unmodified PHBV/PCL counterparts. Modification with RGD peptides reduced the strength of the polymer patches by a factor of 2 without affecting their stress-strain behavior. Incorporation of VEGF into polymer fibers reduced platelet aggregation upon contact with the surface of the PHBV/PCL/VEGF patches and did not increase erythrocyte hemolysis. At month 6 of implantation into the carotid artery of sheep, the PHBV/PCL/ VEGF patches formed a complete newly formed vascular tissue without signs of associated inflammation and calcification. This indicates the high efficiency of the VEGF incorporated into the patch. In contrast, the patches modified with different configurations of RGD peptides combined the presence of neointimal hyperplasia and chronic granulomatous inflammation present in the patch wall and developed during bioresorption of the polymer scaffold.Conclusion. PHBV/PCL/VEGF patches have better biocompatibility and are more suitable for vascular wall reconstruction than PHBV/PCL/RGD patches.
{"title":"Tissue-engineered vascular patches: comparative characteristics and preclinical test results in a sheep model","authors":"L. Antonova, A. Mironov, A. Shabaev, V. Silnikov, E. Krivkina, V. Matveeva, E. Velikanova, E. A. Senokosova, M. Khanova, V. Sevostyanova, T. V. Glushkova, R. Mukhamadiyarov, L. Barbarash","doi":"10.15825/1995-1191-2022-4-94-108","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-94-108","url":null,"abstract":"Carotid endarterectomy (CEA) with patch angioplasty is the most effective treatment for carotid artery stenosis. However, the use of existing vascular patches is often associated with thrombosis, restenosis, calcification and other complications.Objective: to develop biodegradable patches for arterial reconstruction, containing vascular endothelial growth factor (VEGF) or arginyl-glycyl-aspartic acid (RGD), and comparatively evaluate their biocompatibility and efficacy in in vitro experiments and during preclinical trials in large laboratory animal models.Materials and methods. Biodegradable patches, made from a mixture of poly(3-hydroxybutyrate-co-3- hydroxyvalerate (PHBV) and poly(ε-caprolactone) (PCL), were fabricated by electrospinning and modified with VEGF or the peptide sequence RGD in different configurations. In in vitro experiments, the surface structure, physicomechanical and hemocompatibility properties were evaluated. In in vivo experiments, we evaluated the effectiveness of the developed vascular patches for 6 months after implantation into the carotid artery of 12 sheep. The quality of remodeling was assessed using histological and immunofluorescence studies of explanted specimens.Results. The PHBV/PCL/VEGF patches had physicomechanical characteristics closer to those of native vessels and their biofunctionalization method resulted in the smallest drop in strength characteristics compared with their unmodified PHBV/PCL counterparts. Modification with RGD peptides reduced the strength of the polymer patches by a factor of 2 without affecting their stress-strain behavior. Incorporation of VEGF into polymer fibers reduced platelet aggregation upon contact with the surface of the PHBV/PCL/VEGF patches and did not increase erythrocyte hemolysis. At month 6 of implantation into the carotid artery of sheep, the PHBV/PCL/ VEGF patches formed a complete newly formed vascular tissue without signs of associated inflammation and calcification. This indicates the high efficiency of the VEGF incorporated into the patch. In contrast, the patches modified with different configurations of RGD peptides combined the presence of neointimal hyperplasia and chronic granulomatous inflammation present in the patch wall and developed during bioresorption of the polymer scaffold.Conclusion. PHBV/PCL/VEGF patches have better biocompatibility and are more suitable for vascular wall reconstruction than PHBV/PCL/RGD patches.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90723609","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 : 2022-07-29DOI: 10.15825/1995-1191-2022-4-39-45
R. Muratov, S. Babenko, M. N. Sorkomov
In recent years, cardiologists and cardiovascular surgeons are increasingly encountering radiation-induced heart disease (RIHD) in their practice. This complication is described in literature but is poorly understood and clinically challenging. Radiation therapy (RT) is widely used in the treatment of many cancers. Despite the considerable risk of RT complications, it is used in 20–55% of cancer patients. Radiation-associated cardiotoxicity appears to be delayed, typically 10 to 30 years following treatment. Mediastinal irradiation significantly increases the risk of non-ischemic cardiomyopathy. Recent reviews estimate the prevalence of radiation-induced cardiomyopathy at more than 10%. Therefore, it is important to understand the pathophysiology of RIHD, consider risk factors associated with radiation injury, and detect the condition early.
{"title":"Current view on radiation-induced heart disease and methods of its diagnosis","authors":"R. Muratov, S. Babenko, M. N. Sorkomov","doi":"10.15825/1995-1191-2022-4-39-45","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-39-45","url":null,"abstract":"In recent years, cardiologists and cardiovascular surgeons are increasingly encountering radiation-induced heart disease (RIHD) in their practice. This complication is described in literature but is poorly understood and clinically challenging. Radiation therapy (RT) is widely used in the treatment of many cancers. Despite the considerable risk of RT complications, it is used in 20–55% of cancer patients. Radiation-associated cardiotoxicity appears to be delayed, typically 10 to 30 years following treatment. Mediastinal irradiation significantly increases the risk of non-ischemic cardiomyopathy. Recent reviews estimate the prevalence of radiation-induced cardiomyopathy at more than 10%. Therefore, it is important to understand the pathophysiology of RIHD, consider risk factors associated with radiation injury, and detect the condition early.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85428054","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 : 2022-07-29DOI: 10.15825/1995-1191-2022-4-15-23
E. Prokopenko, V. Guryeva, V. Petrukhin, K. Krasnopol’skaya, F. Burumkulova, D. V. Gubina
Kidney transplantation (KT), the optimal treatment for stage 5 chronic kidney disease (CKD), restores impaired fertility in most women of reproductive age. However, infertility occurs in some patients after successful KT. We present our own experience of overcoming secondary tubal infertility by in vitro fertilization (IVF). The patient was a 36-year-old with a transplanted kidney, who had lost two pregnancies in the past due to severe preeclampsia (PE). After the second attempt on cryo-thawed embryo transfer against the background of hormone replacement therapy, one embryo was transferred into the uterus, resulting in pregnancy. Gestational diabetes mellitus (GDM) was diagnosed in the first trimester, and a diet was prescribed. Immunosuppression with tacrolimus, azathioprine and methylprednisolone, prophylaxis of PE with low molecular weight heparin and antiplatelet drugs were administered during pregnancy. Elective cesarean section was performed at 37–38 weeks and a healthy boy was born, weighing 2760 g (25th percentile), 48 cm tall (36th percentile). A stay in the neonatal intensive care unit was not required. The baby is growing and developing normally, the mother’s renal graft function is satisfactory. So, IVF can be successfully used in post-KT patients with infertility issues, provided that the IVF program is carefully controlled, and the pregnancy is managed in a multidisciplinary manner.
{"title":"IVF pregnancy after kidney transplantation: clinical case and literature review","authors":"E. Prokopenko, V. Guryeva, V. Petrukhin, K. Krasnopol’skaya, F. Burumkulova, D. V. Gubina","doi":"10.15825/1995-1191-2022-4-15-23","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-15-23","url":null,"abstract":"Kidney transplantation (KT), the optimal treatment for stage 5 chronic kidney disease (CKD), restores impaired fertility in most women of reproductive age. However, infertility occurs in some patients after successful KT. We present our own experience of overcoming secondary tubal infertility by in vitro fertilization (IVF). The patient was a 36-year-old with a transplanted kidney, who had lost two pregnancies in the past due to severe preeclampsia (PE). After the second attempt on cryo-thawed embryo transfer against the background of hormone replacement therapy, one embryo was transferred into the uterus, resulting in pregnancy. Gestational diabetes mellitus (GDM) was diagnosed in the first trimester, and a diet was prescribed. Immunosuppression with tacrolimus, azathioprine and methylprednisolone, prophylaxis of PE with low molecular weight heparin and antiplatelet drugs were administered during pregnancy. Elective cesarean section was performed at 37–38 weeks and a healthy boy was born, weighing 2760 g (25th percentile), 48 cm tall (36th percentile). A stay in the neonatal intensive care unit was not required. The baby is growing and developing normally, the mother’s renal graft function is satisfactory. So, IVF can be successfully used in post-KT patients with infertility issues, provided that the IVF program is carefully controlled, and the pregnancy is managed in a multidisciplinary manner.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90360402","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 : 2022-07-29DOI: 10.15825/1995-1191-2022-4-73-84
E. A. Nemets, A. E. Lazhko, A. Grigoriev, Y. Basok, A. Kirillova, V. Sevastianov
In contrast to decellularization of soft tissues for use as tissue-specific matrices in the creation of tissue-engineered constructs, decellularization of cartilage tissue requires several processing techniques, which can negatively affect the biocompatibility and functional properties of the native extracellular matrix (ECM).Objective: to study the biocompatible and functional properties of microdispersed tissue-specific 3D matrix from a porcine cartilage that is decellularized by sequential use of chemical, physical and enzymatic techniques.Materials and methods. For decellularization, microdispersed cartilage particles (MCPs), obtained by cryomilling, were incubated in detergent solutions (sodium dodecyl sulfate and Triton X-100), then treated with supercritical carbon dioxide (scCO2) with 10% ethanol and DNase I. The Ames test (Salmonella typhimurium reverse mutation assay) was used to determine the genotoxicity of decellularized microdispersed cartilage particles (dMCPs). Local and general toxic effects, as well as resorption of dMCPs were studied in vivo on sexually mature outbred rats. Decellularized MCP specimens (10 mg) were implanted into the thigh muscle tissue. Viability of human adipose-derived mesenchymal stem/stromal cells (hAdMSCs), when cultured on dMCPs, was analyzed by in vivo microscopy, stained with fluorescent Calcein AM dye. Cell metabolic activity was assessed using PrestoBlue™ Cell Viability Reagent.Results. It has been proven that porcine dMCPs implanted in rat muscle after treatment with scCO2 do not exhibit local and general toxic effects, and do not show genotoxicity and negative effects on the reproductive system of animals. After 6 months of in vivo experiment, most (87%) of the implanted decellularized cartilage was resorbed. It was shown that the resulting matrices are able to support adhesion and proliferation of hAdMSCs. Conclusion. Porcine dMCP specimens are suitable for biocompatible medical products in terms of local and general toxic effects, genotoxicity and reproductive toxicity, and can be used as a matrix for creating cell- and tissue-engineered cartilage constructs.
{"title":"Biocompatible and functional properties of a microdispersed tissue-specific 3D matrix from decellularized porcine cartilage","authors":"E. A. Nemets, A. E. Lazhko, A. Grigoriev, Y. Basok, A. Kirillova, V. Sevastianov","doi":"10.15825/1995-1191-2022-4-73-84","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-4-73-84","url":null,"abstract":"In contrast to decellularization of soft tissues for use as tissue-specific matrices in the creation of tissue-engineered constructs, decellularization of cartilage tissue requires several processing techniques, which can negatively affect the biocompatibility and functional properties of the native extracellular matrix (ECM).Objective: to study the biocompatible and functional properties of microdispersed tissue-specific 3D matrix from a porcine cartilage that is decellularized by sequential use of chemical, physical and enzymatic techniques.Materials and methods. For decellularization, microdispersed cartilage particles (MCPs), obtained by cryomilling, were incubated in detergent solutions (sodium dodecyl sulfate and Triton X-100), then treated with supercritical carbon dioxide (scCO2) with 10% ethanol and DNase I. The Ames test (Salmonella typhimurium reverse mutation assay) was used to determine the genotoxicity of decellularized microdispersed cartilage particles (dMCPs). Local and general toxic effects, as well as resorption of dMCPs were studied in vivo on sexually mature outbred rats. Decellularized MCP specimens (10 mg) were implanted into the thigh muscle tissue. Viability of human adipose-derived mesenchymal stem/stromal cells (hAdMSCs), when cultured on dMCPs, was analyzed by in vivo microscopy, stained with fluorescent Calcein AM dye. Cell metabolic activity was assessed using PrestoBlue™ Cell Viability Reagent.Results. It has been proven that porcine dMCPs implanted in rat muscle after treatment with scCO2 do not exhibit local and general toxic effects, and do not show genotoxicity and negative effects on the reproductive system of animals. After 6 months of in vivo experiment, most (87%) of the implanted decellularized cartilage was resorbed. It was shown that the resulting matrices are able to support adhesion and proliferation of hAdMSCs. Conclusion. Porcine dMCP specimens are suitable for biocompatible medical products in terms of local and general toxic effects, genotoxicity and reproductive toxicity, and can be used as a matrix for creating cell- and tissue-engineered cartilage constructs.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91067527","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 : 2022-05-31DOI: 10.15825/1995-1191-2022-2-108-118
E. Karakulina, S. Khomyakov, O. Aleksandrova, I. V. Lysikov, S. V. Shedenko, S. Gautier
Over the past 10 years, significant breakthroughs have been achieved in Russian transplantology in the field of regulatory legal framework. During this period, the powers of government authorities in the field of healthcare on organization of transplant care and organ donation have been defined, and sources and mechanisms for target financing of medical activities related to organ donation for transplantation purposes have been identified. The procedure for providing medical care under surgery (human organ and/or tissue transplantation) has been adopted, and a state registry system for donor organs, donors and recipients has been created. Measures on organ donation and transplantation in the Russian Federation have been approved within the «Healthcare Development», a framework of the state program of the Russian Federation. The Shumakov National Medical Research Center of Transplantology and Artificial Organs (Shumakov Center) has also been identified as the core institution that coordinates the activities of the entire transplant industry in the Russian Federation. Transplant medical care is currently being provided by specialist physicians trained in human organ and tissue transplantation, in collaboration with other specialist physicians. The Nomenclature of Specialties of Specialists with Higher Medical and Pharmaceutical Education, approved by the Russian Ministry of Health via Order No. 700n of October 7, 2015, does not contain a separate specialty related to human organ and tissue transplantation activities, and this is quite justified. However, in order to improve the legal regulation of transplantation activities, it is necessary to unify the requirements for specialists providing medical care in human organ/tissue transplantation. This can be achieved by developing uniform approaches to the definition of labor functions in the professional standards of specialist doctors involved in transplantation.
{"title":"Ways of improving the legal regulation of human organ and tissue transplantation in the Russian Federation","authors":"E. Karakulina, S. Khomyakov, O. Aleksandrova, I. V. Lysikov, S. V. Shedenko, S. Gautier","doi":"10.15825/1995-1191-2022-2-108-118","DOIUrl":"https://doi.org/10.15825/1995-1191-2022-2-108-118","url":null,"abstract":"Over the past 10 years, significant breakthroughs have been achieved in Russian transplantology in the field of regulatory legal framework. During this period, the powers of government authorities in the field of healthcare on organization of transplant care and organ donation have been defined, and sources and mechanisms for target financing of medical activities related to organ donation for transplantation purposes have been identified. The procedure for providing medical care under surgery (human organ and/or tissue transplantation) has been adopted, and a state registry system for donor organs, donors and recipients has been created. Measures on organ donation and transplantation in the Russian Federation have been approved within the «Healthcare Development», a framework of the state program of the Russian Federation. The Shumakov National Medical Research Center of Transplantology and Artificial Organs (Shumakov Center) has also been identified as the core institution that coordinates the activities of the entire transplant industry in the Russian Federation. Transplant medical care is currently being provided by specialist physicians trained in human organ and tissue transplantation, in collaboration with other specialist physicians. The Nomenclature of Specialties of Specialists with Higher Medical and Pharmaceutical Education, approved by the Russian Ministry of Health via Order No. 700n of October 7, 2015, does not contain a separate specialty related to human organ and tissue transplantation activities, and this is quite justified. However, in order to improve the legal regulation of transplantation activities, it is necessary to unify the requirements for specialists providing medical care in human organ/tissue transplantation. This can be achieved by developing uniform approaches to the definition of labor functions in the professional standards of specialist doctors involved in transplantation.","PeriodicalId":21400,"journal":{"name":"Russian Journal of Transplantology and Artificial Organs","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74780598","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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