Pub Date : 2023-06-19DOI: 10.23873/2074-0506-2023-15-2-158-167
V. L. Korobka, V. Pasechnikov, R. V. Korobka, E. Pak, A. M. Shapovalov, D. Pasechnikov, N. Sapronova, Y. Khoronko
Background. Saving lives and preventing patients from dropping out of the waiting list for liver transplantation due to the progression of portal hypertension and the development of complications is an urgent task of transplantology in conditions of a donor organ shortage, which causes long waiting times for this operation. Aim. To study the efficacy of endoscopic band ligation versus no intervention in the primary prevention of upper gastrointestinal bleeding and assess the impact on survival of patients with ascites listed in the liver transplantation waiting list. Material and methods. A retrospective comparative study was conducted in patients with decompensated liver diseases with severe ascites and varicose veins, without a history of bleeding, when included in the waiting list for liver transplantation. Primary prevention of bleeding from varices was carried out in patients by means of endoscopic ligation of varicose veins (n=92, group 1); this intervention was not performed in other patients (n=89, group 2). Results. The compared groups were comparable in demographics, clinical parameters, MELD and Child-TurcottePugh scores, or the incidence of severe ascites. The study groups of patients did not have significant differences in the numbers of medium-size and large varices. The incidence of bleeding was significantly lower in the group of patients with endoscopic band ligation as a method of primary prevention than in the group of patients without this intervention (23.9% and 78.7%, respectively, p=0.0001). Patient survival was significantly higher in the group of patients who underwent endoscopic band ligation than in the group of patients without interventions, which was established using the Kaplan-Meier method (Log Rank=0.0001). Conclusion. Primary prevention of bleeding from the upper digestive tract through endoscopic band ligation is an effective method of saving lives and preventing patients with ascites from dropping out of the liver transplantation waiting list in conditions of a donor organ shortageб which causes a long waiting period for surgery.
{"title":"The use of endoscopic band ligation in the primary prevention of bleeding in patients with ascites listed in the liver transplantation waiting list","authors":"V. L. Korobka, V. Pasechnikov, R. V. Korobka, E. Pak, A. M. Shapovalov, D. Pasechnikov, N. Sapronova, Y. Khoronko","doi":"10.23873/2074-0506-2023-15-2-158-167","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-2-158-167","url":null,"abstract":"Background. Saving lives and preventing patients from dropping out of the waiting list for liver transplantation due to the progression of portal hypertension and the development of complications is an urgent task of transplantology in conditions of a donor organ shortage, which causes long waiting times for this operation. Aim. To study the efficacy of endoscopic band ligation versus no intervention in the primary prevention of upper gastrointestinal bleeding and assess the impact on survival of patients with ascites listed in the liver transplantation waiting list. Material and methods. A retrospective comparative study was conducted in patients with decompensated liver diseases with severe ascites and varicose veins, without a history of bleeding, when included in the waiting list for liver transplantation. Primary prevention of bleeding from varices was carried out in patients by means of endoscopic ligation of varicose veins (n=92, group 1); this intervention was not performed in other patients (n=89, group 2). Results. The compared groups were comparable in demographics, clinical parameters, MELD and Child-TurcottePugh scores, or the incidence of severe ascites. The study groups of patients did not have significant differences in the numbers of medium-size and large varices. The incidence of bleeding was significantly lower in the group of patients with endoscopic band ligation as a method of primary prevention than in the group of patients without this intervention (23.9% and 78.7%, respectively, p=0.0001). Patient survival was significantly higher in the group of patients who underwent endoscopic band ligation than in the group of patients without interventions, which was established using the Kaplan-Meier method (Log Rank=0.0001). Conclusion. Primary prevention of bleeding from the upper digestive tract through endoscopic band ligation is an effective method of saving lives and preventing patients with ascites from dropping out of the liver transplantation waiting list in conditions of a donor organ shortageб which causes a long waiting period for surgery.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80680051","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 : 2023-03-21DOI: 10.23873/2074-0506-2023-15-1-127-140
S. Glyantsev
The paper presents the analysis of two publications written by two pioneers of heart transplantation in the USSR, A.A. Vishnevsky with co-authors and G.M. Solovyov, which covered the state of the organ transplantation issue in 1971–1973 and gave predictions for its future development. It is shown that the authors of those publications saw and formulated the main trends in the development of the problem in one and the same way. Meanwhile, G.M. Solovyov, being the Director of the specialized Institute of Organ and Tissue Transplantation of the USSR Academy of Medical Sciences saw the issues of organ transplantation more in depth than A.A. Vishnevsky who headed the A.V. Vishnevsky Institute of Surgery of the USSR Academy of Medical Sciences. In particular, this concerned immunological studies. Shortly after its establishment in 1969, the Institute of Organ and Tissue Transplantation arranged a powerful laboratory of immunogenetics on its base. The staff of that laboratory (L.V. Smirnova, Yu.M. Zaretskaya, L.P. Alekseev, V.I. Shkurko, A.M. Sochneva, I.V. Petrova, etc.) conducted world-class immunological studies, which results inspired certain optimism among surgeons. A more complicated situation was with the clinical issues of organ transplantation, with the solution of organizational, moral and ethical issues, where, in addition to doctors, the active participation of legislators, economists, and healthcare organizers was required. This paper presents comparative data on the state of political, economic, and organizational issues of organ transplantation in the Russian Federation between the 2010s and early 2020s. It is shown that the planned in the 2020s tendency of their positive solution and further development inspires certain optimism.
{"title":"PHENOMENON OF DEMIKHOV. Achievements and prospects of heart transplantation in the USSR in the early 1970s","authors":"S. Glyantsev","doi":"10.23873/2074-0506-2023-15-1-127-140","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-127-140","url":null,"abstract":"The paper presents the analysis of two publications written by two pioneers of heart transplantation in the USSR, A.A. Vishnevsky with co-authors and G.M. Solovyov, which covered the state of the organ transplantation issue in 1971–1973 and gave predictions for its future development. It is shown that the authors of those publications saw and formulated the main trends in the development of the problem in one and the same way. Meanwhile, G.M. Solovyov, being the Director of the specialized Institute of Organ and Tissue Transplantation of the USSR Academy of Medical Sciences saw the issues of organ transplantation more in depth than A.A. Vishnevsky who headed the A.V. Vishnevsky Institute of Surgery of the USSR Academy of Medical Sciences. In particular, this concerned immunological studies. Shortly after its establishment in 1969, the Institute of Organ and Tissue Transplantation arranged a powerful laboratory of immunogenetics on its base. The staff of that laboratory (L.V. Smirnova, Yu.M. Zaretskaya, L.P. Alekseev, V.I. Shkurko, A.M. Sochneva, I.V. Petrova, etc.) conducted world-class immunological studies, which results inspired certain optimism among surgeons. A more complicated situation was with the clinical issues of organ transplantation, with the solution of organizational, moral and ethical issues, where, in addition to doctors, the active participation of legislators, economists, and healthcare organizers was required. This paper presents comparative data on the state of political, economic, and organizational issues of organ transplantation in the Russian Federation between the 2010s and early 2020s. It is shown that the planned in the 2020s tendency of their positive solution and further development inspires certain optimism.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91421975","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 : 2023-03-21DOI: 10.23873/2074-0506-2023-15-1-118-126
E. Aksenova, N. Kamynina, K. Tarkhov
Background. Bibliographic analysis for the period 2017–2022 showed an extremely small number of literary sources (scientific publications) in both foreign and domestic periodicals, which would cover issues related to the consideration, study and/or analysis of any aspects of publication activity in the field of transplantology at the global, national and regional levels or in with respect to specific organizations, journals and authors. In Russian periodicals, the objects of research are often either various countries of the world (in comparative characteristics with Russia), or medical universities of the Russian Federation, or scientific medical organizations of federal designation, while there is a complete absence or a small number of publications devoted to the issues of publication activity of organizations at the level of the city of Moscow.Aim. Conducting a scientometric study to characterize, analyze and evaluate the publication activity of the Moscow Healthcare Department organizations in the subject area "Transplantation".Material and methods. The study was carried out for the subject area "Transplantation" using analytical platform SciVal for more than 10 quantitative and shared scientometric indicators (from 2019 to 2021) for 55 organizations from the categories of research institutes, scientific and practical centers and city clinical hospitals subordinated to the Moscow Healthcare Department.Results and discussion. The main scientometric indicators (in quantitative and fractional ratio) characterizing the publication activity over a three–year period – from 2019 to 2021 – in the subject area "Transplantation" in organizations subordinate to the Moscow Healthcare Department.Conclusion. It is shown that in the subject area "Transplantation" during the period under review, positive growth and changes in scientometric indicators such as the total number of publications, the number of publications in 1st–2nd quartiles, the number of publications in national and intraorganizational collaboration are observed for the Moscow Healthcare Department organizations.
{"title":"Publication activity indicators of the Moscow Healthcare Department organizations in the subject area \"Transplantation\"","authors":"E. Aksenova, N. Kamynina, K. Tarkhov","doi":"10.23873/2074-0506-2023-15-1-118-126","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-118-126","url":null,"abstract":"Background. Bibliographic analysis for the period 2017–2022 showed an extremely small number of literary sources (scientific publications) in both foreign and domestic periodicals, which would cover issues related to the consideration, study and/or analysis of any aspects of publication activity in the field of transplantology at the global, national and regional levels or in with respect to specific organizations, journals and authors. In Russian periodicals, the objects of research are often either various countries of the world (in comparative characteristics with Russia), or medical universities of the Russian Federation, or scientific medical organizations of federal designation, while there is a complete absence or a small number of publications devoted to the issues of publication activity of organizations at the level of the city of Moscow.Aim. Conducting a scientometric study to characterize, analyze and evaluate the publication activity of the Moscow Healthcare Department organizations in the subject area \"Transplantation\".Material and methods. The study was carried out for the subject area \"Transplantation\" using analytical platform SciVal for more than 10 quantitative and shared scientometric indicators (from 2019 to 2021) for 55 organizations from the categories of research institutes, scientific and practical centers and city clinical hospitals subordinated to the Moscow Healthcare Department.Results and discussion. The main scientometric indicators (in quantitative and fractional ratio) characterizing the publication activity over a three–year period – from 2019 to 2021 – in the subject area \"Transplantation\" in organizations subordinate to the Moscow Healthcare Department.Conclusion. It is shown that in the subject area \"Transplantation\" during the period under review, positive growth and changes in scientometric indicators such as the total number of publications, the number of publications in 1st–2nd quartiles, the number of publications in national and intraorganizational collaboration are observed for the Moscow Healthcare Department organizations.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85990936","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 : 2023-03-20DOI: 10.23873/2074-0506-2023-15-1-89-97
G. V. Bulava
Acute inflammation of the peritoneum – peritonitis – often develops after injury to hollow visceral organs, intestinal necrosis, failure of anastomosis, or tumor processes. Subsequent microbial contamination of the abdominal cavity leads to infection, in response to which immune mechanisms are activated. The pathogenesis of inflammatory processes in the abdominal cavity and their features are largely determined by the structure and function of the peritoneum, as well as its close connection with the omentum. An important point in resolving peritonitis is to maintain the balance of cytokines, the activity of immunocytes and complement functioning in the immune lymphoid clusters of the peritoneum and omentum, and their collaborative action during inflammation. The review presents data on the structure and function of the peritoneum and omentum, the role of neutrophil, macrophage, lymphocytic links of the immune system, as well as those of pro- and anti-inflammatory cytokines and complement in the development and cessation of acute inflammation in the abdominal cavity.
{"title":"Immune mechanisms in the pathogenesis of acute peritonitis G.V. Bulava","authors":"G. V. Bulava","doi":"10.23873/2074-0506-2023-15-1-89-97","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-89-97","url":null,"abstract":"Acute inflammation of the peritoneum – peritonitis – often develops after injury to hollow visceral organs, intestinal necrosis, failure of anastomosis, or tumor processes. Subsequent microbial contamination of the abdominal cavity leads to infection, in response to which immune mechanisms are activated. The pathogenesis of inflammatory processes in the abdominal cavity and their features are largely determined by the structure and function of the peritoneum, as well as its close connection with the omentum. An important point in resolving peritonitis is to maintain the balance of cytokines, the activity of immunocytes and complement functioning in the immune lymphoid clusters of the peritoneum and omentum, and their collaborative action during inflammation. The review presents data on the structure and function of the peritoneum and omentum, the role of neutrophil, macrophage, lymphocytic links of the immune system, as well as those of pro- and anti-inflammatory cytokines and complement in the development and cessation of acute inflammation in the abdominal cavity.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80923626","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 : 2023-03-19DOI: 10.23873/2074-0506-2023-15-1-61-71
D. Perlin, I. Dymkov, A. Terentyev, A. Perlina, I. V. Alexandrov
Introduction. Long-term results of renal transplantation from living donors are much better than the results of cadaveric transplantations. Recently, because of the shortage of living donors, some centers have started using kidneys from living donors with asymptomatic stones as a potential solution for the problem. However, the optimal surgical solution for such situations has not yet been developed.Aim. To evaluate our obtained transplantation results of using the kidneys from living donors with nephrolithiasis and compare them with the literature data.Material and methods. In the period from 2012-2021, renal transplantations in our clinic were done in three patients from related donors with stones in the kidney. One donor underwent mini-percutaneous lithotripsy one month prior to nephrectomy. The other two underwent simultaneous retrograde lithotripsy and laparoscopic donor nephrectomy. In these cases a holmium or thulium laser was used for the destruction of calculi. All donors underwent laparoscopic retroperitoneal nephrectomy.Results. All stones were successfully removed. There were no surgical complications in donors during and after procedures. Warm ischemia time did not exceed 3.5 minutes. The general length of hospital stay was 10 days in case of predonation stone removal surgery and 6 and 4 days in the cases of simultaneous procedures, respectively. All grafts were transplanted to related recipients. One of the recipients was treated with hemodialysis before transplantation, the other one with peritoneal dialysis. The third recipient underwent preemptive transplantation (before the start of dialysis). The graft function in all cases was immediate. During the follow-up period (9-57 months), no signs of nephrolithiasis were seen in either donors, or recipients.Conclusions. Consideration of potential donors with stones in one kidney might increase the number of living donor renal transplantation. Simultaneous RIRS and laparoscopic donor nephrectomy can be considered as an alternative to sequential operations or ex vivo stone extraction. The presented technique is reproducible, safe and was not associated with an increased length of hospital stay.
{"title":"Nephrolithiasis in related kidney donors","authors":"D. Perlin, I. Dymkov, A. Terentyev, A. Perlina, I. V. Alexandrov","doi":"10.23873/2074-0506-2023-15-1-61-71","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-61-71","url":null,"abstract":"Introduction. Long-term results of renal transplantation from living donors are much better than the results of cadaveric transplantations. Recently, because of the shortage of living donors, some centers have started using kidneys from living donors with asymptomatic stones as a potential solution for the problem. However, the optimal surgical solution for such situations has not yet been developed.Aim. To evaluate our obtained transplantation results of using the kidneys from living donors with nephrolithiasis and compare them with the literature data.Material and methods. In the period from 2012-2021, renal transplantations in our clinic were done in three patients from related donors with stones in the kidney. One donor underwent mini-percutaneous lithotripsy one month prior to nephrectomy. The other two underwent simultaneous retrograde lithotripsy and laparoscopic donor nephrectomy. In these cases a holmium or thulium laser was used for the destruction of calculi. All donors underwent laparoscopic retroperitoneal nephrectomy.Results. All stones were successfully removed. There were no surgical complications in donors during and after procedures. Warm ischemia time did not exceed 3.5 minutes. The general length of hospital stay was 10 days in case of predonation stone removal surgery and 6 and 4 days in the cases of simultaneous procedures, respectively. All grafts were transplanted to related recipients. One of the recipients was treated with hemodialysis before transplantation, the other one with peritoneal dialysis. The third recipient underwent preemptive transplantation (before the start of dialysis). The graft function in all cases was immediate. During the follow-up period (9-57 months), no signs of nephrolithiasis were seen in either donors, or recipients.Conclusions. Consideration of potential donors with stones in one kidney might increase the number of living donor renal transplantation. Simultaneous RIRS and laparoscopic donor nephrectomy can be considered as an alternative to sequential operations or ex vivo stone extraction. The presented technique is reproducible, safe and was not associated with an increased length of hospital stay.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81136188","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 : 2023-03-19DOI: 10.23873/2074-0506-2023-15-1-72-78
S. V. Romanov, O. Pauzina, V. M. Kukosh, S. Vasenin, M. S. Murtazalieva, O. P. Abaeva, K. V. Evdokimova
The patient's anamnesis, the peculiarities of the course of pregnancy, delivery in a kidney and pancreas recipient have been described. The results of the patient's follow-up for nine months after delivery are presented. The authors emphasize that the management of pregnancy in a woman after organ transplantation is possible only with the effective interaction of obstetricians, gynecologists, and transplantologists.
{"title":"Favorable outcome of pregnancy in a kidney and pancreas recipient","authors":"S. V. Romanov, O. Pauzina, V. M. Kukosh, S. Vasenin, M. S. Murtazalieva, O. P. Abaeva, K. V. Evdokimova","doi":"10.23873/2074-0506-2023-15-1-72-78","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-72-78","url":null,"abstract":"The patient's anamnesis, the peculiarities of the course of pregnancy, delivery in a kidney and pancreas recipient have been described. The results of the patient's follow-up for nine months after delivery are presented. The authors emphasize that the management of pregnancy in a woman after organ transplantation is possible only with the effective interaction of obstetricians, gynecologists, and transplantologists.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91223165","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 : 2023-03-19DOI: 10.23873/2074-0506-2023-15-1-79-88
A. M. Polstianoy, K. Gubarev, O. Y. Polstianaya, I. Rendashkin
The absolute uterine factor infertility is a non-treatable cause of female infertility. Surrogacy has become the only option that allows this group of patients to achieve genetic, although biological motherhood. According to statistics there are more than 30 thousand women of fertile age in Russia who cannot get pregnant due to the absolute uterine factor infertility. The recently emerged possibility of uterine transplantation has become the only treatment for this kind of female infertility.Prior to the very first clinical study of human uterine transplantation which was carried out in 2013 in Sweden, scientists had conducted systematic studies in animals (rodents, pigs, cattle and primates). The first clinical trial with the uterine transplantation performed resulted in a live birth in September 2014. Currently, cases of successful uterine transplantation in humans have been reported in Sweden, Brazil, USA and Italy. Experience and practice in animal research played a key role in the success of the first clinical study on uterine transplantation. The application of this method is fundamental in the introduction of the scientifically grounded technology of uterine transplantation in Russia.Aim. Analysis of the problems of the clinical application of the uterine transplantation based on a literature review.
{"title":"Issues of preparation for implementing uterine transplantation in clinical practice","authors":"A. M. Polstianoy, K. Gubarev, O. Y. Polstianaya, I. Rendashkin","doi":"10.23873/2074-0506-2023-15-1-79-88","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-79-88","url":null,"abstract":"The absolute uterine factor infertility is a non-treatable cause of female infertility. Surrogacy has become the only option that allows this group of patients to achieve genetic, although biological motherhood. According to statistics there are more than 30 thousand women of fertile age in Russia who cannot get pregnant due to the absolute uterine factor infertility. The recently emerged possibility of uterine transplantation has become the only treatment for this kind of female infertility.Prior to the very first clinical study of human uterine transplantation which was carried out in 2013 in Sweden, scientists had conducted systematic studies in animals (rodents, pigs, cattle and primates). The first clinical trial with the uterine transplantation performed resulted in a live birth in September 2014. Currently, cases of successful uterine transplantation in humans have been reported in Sweden, Brazil, USA and Italy. Experience and practice in animal research played a key role in the success of the first clinical study on uterine transplantation. The application of this method is fundamental in the introduction of the scientifically grounded technology of uterine transplantation in Russia.Aim. Analysis of the problems of the clinical application of the uterine transplantation based on a literature review.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77533912","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 : 2023-03-18DOI: 10.23873/2074-0506-2023-15-1-46-60
N. M. Bikbova, M. Mazanov, M. A. Sagirov, N. I. Kharitonova, A. A. Baranov, I. A. Argir, I. R. Mingalimova, S. Y. Kambarov
Ischemic heart disease holds the leading position in the structure of cardiovascular diseases. Early reperfusion therapy for acute myocardial infarction led to a decrease in mortality and severe complications of coronary artery disease. Despite advances in the treatment of coronary artery disease, dilatation and remodeling of the left ventricle develop in 20% of patients who have had a heart attack, leading to mitral insufficiency and systolic dysfunction of the left ventricle. Aneurysm of the left ventricle is a delayed severe complication of myocardial infarction, which significantly worsens the prognosis. Large aneurysms of the left ventricle cause progressive dilatation of the left ventricle, its volumetric overload with an increase in wall tension in the non-infarction zone, decreased functional characteristics of the left ventricle, thrombosis in the aneurysm cavity, life-threatening arrhythmias, and sudden death. Postinfarction left ventricular remodeling can lead to secondary mitral regurgitation, which is an independent predictor of mortality in the longterm period. Surgical treatment of coronary heart disease and its complications is one of the main problems of modern cardiovascular surgery.
{"title":"Giant postinfarction posterolateral left ventricular aneurysm, complicated by mitral insufficiency","authors":"N. M. Bikbova, M. Mazanov, M. A. Sagirov, N. I. Kharitonova, A. A. Baranov, I. A. Argir, I. R. Mingalimova, S. Y. Kambarov","doi":"10.23873/2074-0506-2023-15-1-46-60","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-46-60","url":null,"abstract":"Ischemic heart disease holds the leading position in the structure of cardiovascular diseases. Early reperfusion therapy for acute myocardial infarction led to a decrease in mortality and severe complications of coronary artery disease. Despite advances in the treatment of coronary artery disease, dilatation and remodeling of the left ventricle develop in 20% of patients who have had a heart attack, leading to mitral insufficiency and systolic dysfunction of the left ventricle. Aneurysm of the left ventricle is a delayed severe complication of myocardial infarction, which significantly worsens the prognosis. Large aneurysms of the left ventricle cause progressive dilatation of the left ventricle, its volumetric overload with an increase in wall tension in the non-infarction zone, decreased functional characteristics of the left ventricle, thrombosis in the aneurysm cavity, life-threatening arrhythmias, and sudden death. Postinfarction left ventricular remodeling can lead to secondary mitral regurgitation, which is an independent predictor of mortality in the longterm period. Surgical treatment of coronary heart disease and its complications is one of the main problems of modern cardiovascular surgery.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89607237","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 : 2023-03-18DOI: 10.23873/2074-0506-2023-15-1-34-45
A. Kostyunin, M. Rezvova, T. Glushkova, D. Shishkova, A. Kutikhin, T. Akentieva, E. Ovcharenko
Background. Around half of bioprosthetic heart valves become dysfunctional 15 years postimplantation because of structural valve deterioration notable for the degradation and calcification of the prosthetic tissue. Protection of bioprosthetic heart valves from structural valve deterioration requires innovative materials, science approaches including enveloping of the bioprosthetic heart valves into the polymer sheath.Aim. To develop a polyvinyl alcohol sheath for improving resistance of bioprosthetic heart valves to calcification.Material and methods. Bovine pericardium fixed with ethylene glycol diglycidyl ether was incubated with distinct concentrations of polyvinyl alcohol (5, 10, 12, or 15%) with the following freezing and thawing to perform cryotropic gelation. Surface and structure of unmodified and polyvinyl alcohol-modified bovine pericardium have been investigated by fluorescence microscopy and scanning electron microscopy, whilst tensile testing was carried out by uniaxial tension test. Haemocompatibility was assessed through the measurements of haemolysis and platelet aggregation/adhesion upon the contact of donor blood with the samples. Resistance to calcification was tested by incubation of the samples in calcium and phosphate supersaturated (10 µmol/L) cell culture medium for 3 and 6 weeks with the following tissue lysis and colorimetric measurement of Ca2+ ions.Results. Using cryotropic gelation, we obtained a polyvinyl alcohol-coated and filled bovine pericardium matrix. Out of all polyvinyl alcohol concentrations, 12% polyvinyl alcohol solution sealed pores and hollows within the bovine pericardium (what was not achieved using 5% or 10% polyvinyl alcohol solutions) and demonstrated the best processability as compared to 15% polyvinyl alcohol solution. Cryotropic gelation did not deteriorate durability, elasticity, or haemocompatibility of bovine pericardium. After 3 and 6 weeks of the incubation in calcium-supersaturated solution, polyvinyl alcoholmodified bovine pericardium contained 5- and 3-fold reduced amount of calcium compared to unmodified bovine pericardium.Conclusions. Enveloping of bovine pericardium into polyvinyl alcohol increases its calcification resistance, retains its tensile properties and haemocompatibility, and can be considered as a promising approach for the modification of bovine pericardium during the manufacturing of bioprosthetic heart valves.
{"title":"Polyvinyl alcohol improves resistance of epoxy-treated bovine pericardium to calcification in vitro","authors":"A. Kostyunin, M. Rezvova, T. Glushkova, D. Shishkova, A. Kutikhin, T. Akentieva, E. Ovcharenko","doi":"10.23873/2074-0506-2023-15-1-34-45","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-34-45","url":null,"abstract":"Background. Around half of bioprosthetic heart valves become dysfunctional 15 years postimplantation because of structural valve deterioration notable for the degradation and calcification of the prosthetic tissue. Protection of bioprosthetic heart valves from structural valve deterioration requires innovative materials, science approaches including enveloping of the bioprosthetic heart valves into the polymer sheath.Aim. To develop a polyvinyl alcohol sheath for improving resistance of bioprosthetic heart valves to calcification.Material and methods. Bovine pericardium fixed with ethylene glycol diglycidyl ether was incubated with distinct concentrations of polyvinyl alcohol (5, 10, 12, or 15%) with the following freezing and thawing to perform cryotropic gelation. Surface and structure of unmodified and polyvinyl alcohol-modified bovine pericardium have been investigated by fluorescence microscopy and scanning electron microscopy, whilst tensile testing was carried out by uniaxial tension test. Haemocompatibility was assessed through the measurements of haemolysis and platelet aggregation/adhesion upon the contact of donor blood with the samples. Resistance to calcification was tested by incubation of the samples in calcium and phosphate supersaturated (10 µmol/L) cell culture medium for 3 and 6 weeks with the following tissue lysis and colorimetric measurement of Ca2+ ions.Results. Using cryotropic gelation, we obtained a polyvinyl alcohol-coated and filled bovine pericardium matrix. Out of all polyvinyl alcohol concentrations, 12% polyvinyl alcohol solution sealed pores and hollows within the bovine pericardium (what was not achieved using 5% or 10% polyvinyl alcohol solutions) and demonstrated the best processability as compared to 15% polyvinyl alcohol solution. Cryotropic gelation did not deteriorate durability, elasticity, or haemocompatibility of bovine pericardium. After 3 and 6 weeks of the incubation in calcium-supersaturated solution, polyvinyl alcoholmodified bovine pericardium contained 5- and 3-fold reduced amount of calcium compared to unmodified bovine pericardium.Conclusions. Enveloping of bovine pericardium into polyvinyl alcohol increases its calcification resistance, retains its tensile properties and haemocompatibility, and can be considered as a promising approach for the modification of bovine pericardium during the manufacturing of bioprosthetic heart valves.","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77549187","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 : 2023-03-17DOI: 10.23873/2074-0506-2023-15-1-23-33
U. Maslikova, E. G. Khamaganova, M. Drokov, I. Y. Urybin, E. Mikhaltsova, L. Kuzmina, E. Parovichnikova
Introduction. Natural killers are the "first line" of antitumor and antiviral protection in the early stages after аllogeneic hematopoietic stem cell transplantation. Quantitative characteristics reach normal values already in the first month after the infusion of blood stem cells to the recipient. Self-tolerance of natural killers is achieved due to many receptors on their surface, but killer immunoglobulin-like receptors play a key role. Their role is to recognize "self" cells and block signals aimed at destroying their own cells. Knowledge of the functional activity of natural killers urged to studying the impact of mismatches between the inhibitory receptor gene and the ligand on the development of allogeneic hematopoietic stem cell transplant failure.The aim of research was to study the probability of the graft failure development in allogeneic hematopoietic stem cell transplantation depending on the recipient's killer immunoglobulin-like receptor genotype.Material and methods. Genotyping of killer-cell immunoglobulin-like receptors in 66 recipients of blood stem cells by the polymerase chain reaction method was performed in the study. Using an online calculator, receptors were classified as "best", "better" and "neutral" depending on the genotype. The end point of the assessment was the development of graft failure in the presence of different genotypes of immunoglobulin-like receptors in the recipient.Results. According to the data obtained, the presence of the “best” and "better" killer-cell immunoglobulin-like receptor genotype in the recipient significantly increased the risks of developing various forms of graft failure.Conclusion. The presence of the KIR2DL3 genotype in a recipient of hematopoietic stem cells significantly (by 3 times) reduces the likelihood of primary graft failure. This result is of great prognostic significance, although at present no ways of influencing it have been developed. The presence of the “best” killer immunoglobulin-like receptors genotype in the recipient increases the likelihood of developing graft failure by more than 3 times compared to the best and neutral genotype (44.4% vs. 13.4%).
{"title":"Probability of allogeneic hematopoietic stem cell transplant failure depending on the recipient's killer immunoglobulin-like receptor genotype","authors":"U. Maslikova, E. G. Khamaganova, M. Drokov, I. Y. Urybin, E. Mikhaltsova, L. Kuzmina, E. Parovichnikova","doi":"10.23873/2074-0506-2023-15-1-23-33","DOIUrl":"https://doi.org/10.23873/2074-0506-2023-15-1-23-33","url":null,"abstract":"Introduction. Natural killers are the \"first line\" of antitumor and antiviral protection in the early stages after аllogeneic hematopoietic stem cell transplantation. Quantitative characteristics reach normal values already in the first month after the infusion of blood stem cells to the recipient. Self-tolerance of natural killers is achieved due to many receptors on their surface, but killer immunoglobulin-like receptors play a key role. Their role is to recognize \"self\" cells and block signals aimed at destroying their own cells. Knowledge of the functional activity of natural killers urged to studying the impact of mismatches between the inhibitory receptor gene and the ligand on the development of allogeneic hematopoietic stem cell transplant failure.The aim of research was to study the probability of the graft failure development in allogeneic hematopoietic stem cell transplantation depending on the recipient's killer immunoglobulin-like receptor genotype.Material and methods. Genotyping of killer-cell immunoglobulin-like receptors in 66 recipients of blood stem cells by the polymerase chain reaction method was performed in the study. Using an online calculator, receptors were classified as \"best\", \"better\" and \"neutral\" depending on the genotype. The end point of the assessment was the development of graft failure in the presence of different genotypes of immunoglobulin-like receptors in the recipient.Results. According to the data obtained, the presence of the “best” and \"better\" killer-cell immunoglobulin-like receptor genotype in the recipient significantly increased the risks of developing various forms of graft failure.Conclusion. The presence of the KIR2DL3 genotype in a recipient of hematopoietic stem cells significantly (by 3 times) reduces the likelihood of primary graft failure. This result is of great prognostic significance, although at present no ways of influencing it have been developed. The presence of the “best” killer immunoglobulin-like receptors genotype in the recipient increases the likelihood of developing graft failure by more than 3 times compared to the best and neutral genotype (44.4% vs. 13.4%).","PeriodicalId":23229,"journal":{"name":"Transplantologiya. The Russian Journal of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87749914","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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