The paper reviews the milestones and prerequisites in the history of the emergence and development of xenotransplantation. The currently existing barriers (immunological, infectious, genetic, ethical, and regulatory) to the development of this organ and tissue transplantation type have been studied. Available data on theoretical research and experimental studies have been reviewed. The prospects for performing xenotransplantation in various combination of species have been assessed. The forms and variants of the xenograft rejection reaction have been described. Genetic engineering approaches to overcoming xenoimmunological incompatibility are described. An assessment is made of ways to overcome existing barriers and prospects for the further development of xenotransplantation as a scientific section of transplantology.

Stem cell transplantation is a major tool of modern renegerative medicine. Stem cells can be obtained from the bone marrow (BM) of dead subjects. Objective: to provide a morphofunctional characterization of the cells obtained from the bone marrow of dead donor tissues by aspiration methods. Materials and methods. BM samples were taken from 17 adult cadaver subjects, who had suddenly died from myocardial infarction or pulmonary artery embolism, not later than 6 hours after sudden death. BM was simultaneously taken (from the iliac bones on different sides) in 10 donors by aspiration and aspiration-washing methods within an hour. In 7 donors, BM sampling was made by the aspiration method (for 30 min) and then by the aspiration-washing (Valeri Borisovich khvatov khvatov@yandex.ru) method (for the following 30 min). Results. The count of CD45lowCD34+-cells obtained by the aspiration and aspiration-washing methods for taking BM differs insignificantly. The morphological pattern of the BM taken from live donors and cadavers is similar. When the aspiration and aspiration-washing methods are concurrently used, the total yield of viable hematopoietic stem cells averaged 99.8±25.0 × 106 cells. Conclusion. BM sampling from donor tissues in the first 6 hours of death yields viable, functionally active hematopoietic stem cells. Both the aspiration method and the aspiration-washing one may be used to sample BM from dead donor tissues. The successive use of aspiration and aspiration-washing is most efficacious. This combination of the methods enables one to obtain a BM suspension containing the therapeutic dose of hematopoietic stem cells.

The data summarized in this review suggest that radionuclide studies are highly effective in the clinical situations that the structure and function of the liver should be simultaneously evaluated, which is in full measure appropriate for liver transplantation.

The paper analyzes current approaches to selecting heart transplantation (HT) recipients, namely, approaches to assessing the severity of heart failure since the latter is the most common indication for HT. The approaches to selecting patients will be refined as the availability of new types of therapy increases and the implantation of mechanical extracorporeal circulation devices is ranked as a more standard intervention. With allowance made for the shortage of donor organs, it is anticipated that the trend in the performance of HT will persist in the most critically ill patients who need long-term parenteral use of positive inotropic drugs and mechanical circulation support.

Experience of Institute of Emergency Medicine n.a. Sklifosovski in management of liver transplantation waiting list is analyzed. International protocols are described and applied to the treatment of 324 pts. with end stage liver diseases. Authors stressed the importance of dynamic evaluation of severity of liver disease as well as treatment of different complications such as resistant ascites, esophageal varicose, encephalopathy and gastrointestinal bleeding. Prophylactics and treatment of viral hepatitis takes important place in the management of liver transplant recipient pts.

Data on the efficiency of low-molecular peptide preparations, selected from cultivated stem cells of marrow, in the treatment of acute kidney insufficiency in experimental animals are resulted. It is demonstrated that the use of peptide preparations reliably promotes survivability of experimental animals suffering from acute kidney insufficiency.

Comment on the paper “Analysis of reasons for organ donor shortage and the main directions of its overcoming”.

Objective: to study the effect of selenium on the course of a postoperative period in patients after orthotopic liver transplantation (OLT). Subjects and methods. The prospective controlled randomized study enrolled 30 patients after OLT. Selenium (Selenase, Biosyn) was administered in Group 1 (n = 15) within 5 days operatively. The agent was not used in complex therapy in Group 2 (n = 15). Results. After OLT, the plasma levels of selenium were much more than the normal value. In Group 1, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly lower on day 3 after OLT and those of urea and creatinine significantly decreased by day 7. A significant difference was found in scores on day 7, as shown by the analysis of the patients' condition by the SOFA scale. The patients who needed venovenous hemodiafiltration (VVHDF) were more than in those who did not use selenium. Conclusion. Selenium levels considerably decrease after liver transplantation. Selenase has a hepatoprotective effect, alleviates the manifestations of a systemic inflammatory response, and reduces the frequency of VVHDF use.

Information got at the analysis of basic reanimation performance indicators of multifunction hospitals of Moscow Department of Health Protection included in the program of organ donorship (15 hospitals) for 7 years (2004-2010) is resulted. Findings testify to high donor potential, however reanimation material well-being of below existent requirement in the most of hospitals does not allow to provide the decline of level of insufficiency of donors.

Обнаружена электрохимическая активность суспензии эритроцитов человека при потенциалах больше +0,4 В, а также линейная зависимость величины предельных токов электроокисления от концентрации клеток в суспензии. Электрохимическая активность суспензии эритроцитов сопровождается обратимым изменением морфологии клеток только в небуферных средах.

This review focuses on the nutritional status of patients with cystic fibrosis, systematic approach to monitoring and nutritional intervention in undernourished patients, and the maintenance of nutritional status before/after lung transplantation.

The intestine is an extremely sensitive organ with regard to ischemia/reperfusion damage (I/R) because of its high oxygen reguirement. The aim of this study is to investigate the effects of Peroxiredoxin VI (Prx VI) on preservation of the small intestine after the intestinal ischemia/reperfusion injury in strangulation ileum model. Intestinal ischemia/ reperfusion injury in strangulation model was produced by occlusion of the distal ileum loop and mesentery with its blood vessels for 60 min followed by a 120-min reperfusion period. A group of animals received intravenous injections of 10 mg/kg Prx VI 15 min prior to the intestinal ischemia/reperfusion in the strangulation model. After surgery, part of the intestine was collected for histological analysis. In I/R group a breakdown in the integrity of villi and crypts was revealed, as well as infiltration of lymphocytes, oxidative damage with serious mucosal loss. Prx VI pretreatment to rats with ischemia/reperfusion injury protected the intestine from ischemia/reperfusion injury by reducing oxidative damage and preserving intestinal mucosal composition. These results demonstrated that Prx VI possessed advantageous antioxidant effects as well as effectively attenuated ischemia-reperfusion trauma of the strangulated intestine segment.

Today, in connection with the development of surgical techniques, one of the main tasks is minimization of surgical trauma, reduction of postoperative complications and mortality, as well as the timing of hospital treatment of patients with maintained quality of surgical care. The widespread adoption of endoscopic surgery techniques into daily practice may help achieve the goal. Annually, we perform more than 450 laparoscopic surgeries for acute surgical diseases at the Institute, and we have performed more than 6,000 interventions since 2000. however, the laparoscopic method of surgery is not a priority, there are strict indications and contraindications, which we followed and thus avoided the development of iatrogenic complications associated with the use of this method for urgent diseases. Today, the laparoscopic technique is used in acute appendicitis, perforated gastric ulcer and duodenal ulcer, acute cholecystitis, strangulated hernia of the anterior abdominal wall, intestinal obstruction, as well as in patients with abdominal trauma. The use of the laparoscopic method in emergency abdominal surgery improves the quality of diagnosis and treatment, reduces the number of postoperative complications and mortality, as well as the time of treatment.

Clinical experience of anesthetic management of orthotopic heart transplantation (OHT) gained at the N.V. Sklifosofsky Research Institute for Emergency Medicine up to date, gives every reason to conclude that combining the knowledge and skills acquired through everyday cardioanesthetic activities, with protocols previously developed in leading transplant clinics, could allow to successfully master the anesthetic management of OHT and make this transplant surgery the standard treatment option. We believe that the use of protocols adapted to our own experience and the latest developments in the field of intensive therapy will allow us to successfully implement the OHT program in a multidisciplinary hospital.

The article reveals some little known facts of emergence the idea, development of the problem, and features of introduction of cadaveric blood transfusion method into clinical practice and the history of its development since the 20-ies of twentieth century to the present.

This article describes the risk and incidence of fungal infections in the early period after liver transplantation, their diagnosis, treatment and prevention. After liver transplant patients have a higher risk of developing invasive fungal infection. The presence of high - risk factors is an absolute indication for prophylactic antifungal medicine.

We have analyzed the foreign experience of organ transplantation from donors infected with blood-borne viruses (BBVIs). Lifting of the ban on the transplantation of organs positive for BBVI markers contributes to the expansion of the donor pool and reduces time spent on Waiting lists. At the same time, the use of donor organs positive for BBVI markers is often associated with an increased risk of complications and deaths among recipients.