Pub Date : 2023-12-19DOI: 10.23873/2074-0506-2023-15-4-450-463
V. Syutkin, O. Olisov, A. Salienko, B. I. Yaremin, K. Magomedov, K. Lutsyk, M. Novruzbekov
Background. The terminal stages of chronic hepatitis C remain the main indication for liver transplantation in Russia and in the world.Aim. To retrospectively evaluate the changes in the waiting list of liver transplantation that occurred during 22 years of work of the Department for Liver Transplantation at N.V. Sklifosovsky Research Institute for Emergency Medicine in relation to patients with anti-HCV+; and to study the survival rate of anti-HCV+ after liver transplantation, and peculiarities of the course of recurrent HCV infection and virological outcomes of modern antiviral therapy.Material and methods. We analyzed the results of anti-HCV+ liver transplantations from a deceased donors (n=400) operated in the Department for Liver Transplantation at N.V. Sklifosovsky Research Institute for Emergency Medicine for 22 years. Changes in the Waiting List structure, recipient survival and antiviral therapy efficacy were studied.Results. The proportion of anti-HCV+ recipients decreased from 44.3% (period from 2007 to 2019) to 34.1% (from 2020 to 2022, p=0.0027). Survival of anti-HCV+ recipients without HCC is currently comparable to survival of non-infectious non-HCC recipients. The 5-year survival of anti-HCV+ recipients without HCC at the time of liver transplantation was 84%, and the 10-year survival was 76%. The 3and 5-year survival rates of recipients without HCC at the time of liver transplantation who had surgery before August 2016 were lower (80% and 77%, respectively) than the 3and 5-year survival rates (91%) of liver transplant recipients operated on later than this date (p=0.01). Before August 2016, recurrence of HCV infection occurred in > 90% of anti-HCV+ recipients with known HCV RNA status after liver transplantation. Spontaneous clearance of HCV RNA after liver transplantation was observed in 2.1% of cases. In recent years, the incidence of recurrent HCV infection after liver transplantation has decreased significantly (~25% in 2021–22). The use of modern direct acting antiviral regimens results in >95% viral eradication after the 1st course. The emergence of drug resistance polymorphisms in patients who have had unsuccessful experience of direct acting antiviral before liver transplantation is not an obstacle to the success of direct acting antiviral treatment after liver transplantation.Conclusion. The possibility of a rapid and safe cure for HCV infection against the backdrop of a shortage of donor organs necessitates a revision of the documents regulating organ donation, which should make organs from donors with antiHCV in the blood available for transplantation.
{"title":"Waiting list changes and follow-up of anti-HCV positive liver transplant recipients: an analysis of 400 cases out of 1000 transplantations","authors":"V. Syutkin, O. Olisov, A. Salienko, B. I. Yaremin, K. Magomedov, K. Lutsyk, M. Novruzbekov","doi":"10.23873/2074-0506-2023-15-4-450-463","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-4-450-463","url":null,"abstract":"Background. The terminal stages of chronic hepatitis C remain the main indication for liver transplantation in Russia and in the world.Aim. To retrospectively evaluate the changes in the waiting list of liver transplantation that occurred during 22 years of work of the Department for Liver Transplantation at N.V. Sklifosovsky Research Institute for Emergency Medicine in relation to patients with anti-HCV+; and to study the survival rate of anti-HCV+ after liver transplantation, and peculiarities of the course of recurrent HCV infection and virological outcomes of modern antiviral therapy.Material and methods. We analyzed the results of anti-HCV+ liver transplantations from a deceased donors (n=400) operated in the Department for Liver Transplantation at N.V. Sklifosovsky Research Institute for Emergency Medicine for 22 years. Changes in the Waiting List structure, recipient survival and antiviral therapy efficacy were studied.Results. The proportion of anti-HCV+ recipients decreased from 44.3% (period from 2007 to 2019) to 34.1% (from 2020 to 2022, p=0.0027). Survival of anti-HCV+ recipients without HCC is currently comparable to survival of non-infectious non-HCC recipients. The 5-year survival of anti-HCV+ recipients without HCC at the time of liver transplantation was 84%, and the 10-year survival was 76%. The 3and 5-year survival rates of recipients without HCC at the time of liver transplantation who had surgery before August 2016 were lower (80% and 77%, respectively) than the 3and 5-year survival rates (91%) of liver transplant recipients operated on later than this date (p=0.01). Before August 2016, recurrence of HCV infection occurred in > 90% of anti-HCV+ recipients with known HCV RNA status after liver transplantation. Spontaneous clearance of HCV RNA after liver transplantation was observed in 2.1% of cases. In recent years, the incidence of recurrent HCV infection after liver transplantation has decreased significantly (~25% in 2021–22). The use of modern direct acting antiviral regimens results in >95% viral eradication after the 1st course. The emergence of drug resistance polymorphisms in patients who have had unsuccessful experience of direct acting antiviral before liver transplantation is not an obstacle to the success of direct acting antiviral treatment after liver transplantation.Conclusion. The possibility of a rapid and safe cure for HCV infection against the backdrop of a shortage of donor organs necessitates a revision of the documents regulating organ donation, which should make organs from donors with antiHCV in the blood available for transplantation.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138962999","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 : 2023-06-23DOI: 10.23873/2074-0506-2023-15-2-226-237
A. A. Anisimov, A. Abdullina, A. T. Raimova, Yuri A Anisimov
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.
{"title":"Public service announcement as a tool for building trust in organ donation","authors":"A. A. Anisimov, A. Abdullina, A. T. Raimova, Yuri A Anisimov","doi":"10.23873/2074-0506-2023-15-2-226-237","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-226-237","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90637173","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 : 2023-06-23DOI: 10.23873/2074-0506-2023-15-2-238-250
U. R. Salimov, A. Shcherba, O. Rummo
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.
{"title":"Bacterial complications after liver transplantation. Promising directions for further research","authors":"U. R. Salimov, A. Shcherba, O. Rummo","doi":"10.23873/2074-0506-2023-15-2-238-250","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-238-250","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80603847","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 : 2023-06-23DOI: 10.23873/2074-0506-2023-15-2-216-225
M. Khubutiya, D. Lonshakov, A. Balkarov, Y. Anisimov, N. Shmarina, N. V. Zagorodnikova, V. O. Aleksandrova, I. V. Dmitriev
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.
{"title":"Experience in the treatment of a primary infected kidney transplant","authors":"M. Khubutiya, D. Lonshakov, A. Balkarov, Y. Anisimov, N. Shmarina, N. V. Zagorodnikova, V. O. Aleksandrova, I. V. Dmitriev","doi":"10.23873/2074-0506-2023-15-2-216-225","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-216-225","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79678942","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 : 2023-06-23DOI: 10.23873/2074-0506-2023-15-2-251-265
F. Omarova, M. Drokov, E. Khamaganova
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.
{"title":"Major histocompatibility complex: history of discovery, evolution, structure, significance in transplantation of allogeneic hematopoietic stem cells","authors":"F. Omarova, M. Drokov, E. Khamaganova","doi":"10.23873/2074-0506-2023-15-2-251-265","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-251-265","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74457895","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 : 2023-06-23DOI: 10.23873/2074-0506-2023-15-2-266-278
K. Kotenko, M. Khubutiya, S. Kabanova, Y. Goldfarb
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.
{"title":"Academician B.V. Petrovsky: cultural heritage, historical memory","authors":"K. Kotenko, M. Khubutiya, S. Kabanova, Y. Goldfarb","doi":"10.23873/2074-0506-2023-15-2-266-278","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-266-278","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89668836","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 : 2023-06-21DOI: 10.23873/2074-0506-2023-15-2-200-215
E. N. Ostroumov, E. V. Migunova, E. Kotina, E. B. Leonova, I. Kuzmina, M. V. Parkhomenko, S. Y. Kambarov, M. A. Sagirov
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, w
{"title":"Right ventricular visualization at SPECT perfusion imaging before and after revascularization in patients with postinfarction cardiosclerosis","authors":"E. N. Ostroumov, E. V. Migunova, E. Kotina, E. B. Leonova, I. Kuzmina, M. V. Parkhomenko, S. Y. Kambarov, M. A. Sagirov","doi":"10.23873/2074-0506-2023-15-2-200-215","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-200-215","url":null,"abstract":"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, w","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84909958","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 : 2023-06-21DOI: 10.23873/2074-0506-2023-15-2-177-187
A. A. Ofitserov, M. Makarov, M. V. Storozheva, N. V. Borovkova, I. N. Ponomarev
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.
{"title":"Optimization of the technique for manufacturing the osteoplastic material based on type 1 human collagen and allogeneic bone chips","authors":"A. A. Ofitserov, M. Makarov, M. V. Storozheva, N. V. Borovkova, I. N. Ponomarev","doi":"10.23873/2074-0506-2023-15-2-177-187","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-177-187","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79744780","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 : 2023-06-21DOI: 10.23873/2074-0506-2023-15-2-188-199
I. Vorobyeva, E. Bulava, A. Balkarov, I. Dmitriev
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.
{"title":"Results of studying the diabetic retinopathy course in potential kidney and pancreatic recipients while on hemodialysis","authors":"I. Vorobyeva, E. Bulava, A. Balkarov, I. Dmitriev","doi":"10.23873/2074-0506-2023-15-2-188-199","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-188-199","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72752108","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 : 2023-06-20DOI: 10.23873/2074-0506-2023-15-2-168-176
A. Shabunin, P. Drozdov, V. Tsurkan, I. Nesterenko, D. A. Makeev, O. S. Zhuravel, S. А. Astapovich, I. A. Zyablikov
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.
{"title":"Immediate and long-term results of the use of balloon angioplasty with stenting in the treatment of renal graft arterial stenosis","authors":"A. Shabunin, P. Drozdov, V. Tsurkan, I. Nesterenko, D. A. Makeev, O. S. Zhuravel, S. А. Astapovich, I. A. Zyablikov","doi":"10.23873/2074-0506-2023-15-2-168-176","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-168-176","url":null,"abstract":"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.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74749705","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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