In the presented case, a patient who underwent liver transplant procedure for cirrhosis resulting from chronic hepatitis C was diagnosed with colorectal cancer 12 years after the operation. A combined treatment plan consisting of right hemicolectomy followed by nine cycles of adjuvant polychemotherapy using the FOLFOX6 regimen was performed. Seven months following the conclusion of treatment, 22×35 mm foci in segment 8 was detected as a sign of metastatic liver disease. The patient had a transplant hepatectomy. At present, the relapse-free survival is 22 months.

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.

Organ transplantation is an effective treatment for many end-stage diseases. However, reperfusion injury constitutes a major complication of transplantation, which is associated with microcirculatory disorders and aggregation of blood corpuscles. Red blood cells (RBC) play an essential role in maintaining hemodynamic and rheological properties of the blood. Moreover, the study of mechanisms of changes in RBC functional indices is an urgent task. The main indicator of RBC functioning is the stability of RBC membrane structure. The issue of RBC membrane modification in organ transplantation has not been studied so far. Objective: to study the protein composition of RBC membranes, their aggregation and electrokinetic parameters in liver and kidney recipients, as well as in related kidney and liver fragment donors before and after operation. Research materials. Blood of 12 kidney recipients and 5 related kidney donors, 8 liver recipients and 4 related liver fragment donors – 1–2 hours before surgery, 1 week, 1, 2, 7, 10, 12 months after surgery. The control group consisted of 8 healthy volunteers. Research methods. Protein separation was done by Laemmli electrophoresis. RBC electrophoretic mobility, which characterizes the electrokinetic properties of cells, was measured by microelectrophoresis. Aggregation was calculated microscopically by counting unaggregated RBCs. Obtained values were compared by Mann-Whitney U test. Results. Examination of the RBC membrane of kidney recipients revealed a significant decrease in the amount of Band 3 protein and glycophorin before and after transplantation. Band 3 protein levels reduced at 1 month, glycophorin reduced at 7 months after surgery, with a maximum decrease in these protein fractions by more than 50% by 7 days compared with control values. There was also a decrease in spectrin content for 2 months after surgery with a maximum decrease of 30% by 1 month. In liver recipients, analysis of RBC membrane proteins revealed a decrease in the amount of glycophorin before surgery and further decrease at 2 months of post-transplant period. The maximum decrease in this index was 72% by 7 days after surgery. In addition, there was a fall in spectrin and Band 3 protein levels at 1 month by more than 60% relative to the control values. In donors, there were changes in the protein fraction of RBC membranes in the long-term post-operative period: spectrin and Band 3 protein levels reduced by 2 times at month 2 in kidney donors, while glycophorin levels reduced by 2.3 times at month 1 after operation in liver donors. Similarly, both groups of donors had increased actin levels at month 1 after surgery. The revealed changes in protein levels in the protein phase of RBC membranes were combined with functional indices of RBCs. In kidney recipients, decreased RBC electrophoretic mobility and increased aggregation were detected at 2 months. In liver recipients, the changes in these indicators were at 1 month. A decrease in RBC electrophoretic mobility was detected in donors of both groups. Conclusion. Changes in RBC membrane electronegativity are associated with changes in glycophorin and Band 3 protein levels, whereas in RBC aggregation process in liver/kidney recipients, the structural and functional disorders in the interrelationships of such membrane proteins as spectrin, Band 3 protein, and glycophorin, are significant factors. Alteration of actin determines inhibition of RBC aggregation growth in donors.

Objective: to study the electrokinetic and aggregation properties, as well as the pro-oxidant and antioxidant processes in red blood cells following kidney transplantation in donors and in recipients in the postoperative period. Materials and methods. Blood from 12 recipients and 5 kidney donors over time – before transplantation, as well as at week 1, months 1, 2, 7, 10 and 12 after surgery, as well as from 8 healthy volunteers who formed the control group. We used microelectrophoresis to measure the electrophoretic mobility of red blood cells, characterizing the electrokinetic properties of cells. Aggregation was calculated microscopically by counting unaggregated red blood cells. Malondialdehyde concentration was measured spectrophotometrically at its absorbance maximum at 530 nm by reaction with thiobarbituric acid. Catalase activity was analyzed by reducing hydrogen peroxide in the sample spectrophotometrically at 240 nm wavelength. The obtained values were compared using the Mann–Whitney U test. Results. Decreased electrophoretic mobility of red blood cells within 2 months after transplantation was associated with increased malondialdehyde concentration and erythrocyte aggregation, decreased catalase activity in kidney recipients, followed by restoration of indicators to the control values. Electrophoretic mobility of red blood cells decreased, while malondialdehyde concentrations increased in donors after surgery. However, the increase was less pronounced than in recipients. The changes indicate that the postoperative period causes changes at the cellular level both in donors and in recipients. This is manifested by decreased stability of erythrocyte membrane structure, which is largely determined by lipid peroxidation processes. At the systemic level, a change in the electrophoretic mobility of red blood cells indicates a stress reaction before and after kidney transplantation in recipients within 2 months after surgery, and in donors in 1–2 months in the postoperative period with gradual increase in the body’s resistance. Conclusion. Kidney transplantation is manifested at the cellular and systemic levels. At the cellular level, there is decreased stability of the membrane structure, which is largely determined by lipid peroxidation processes. At the systemic level, a change in the electrophoretic mobility of red blood cells indicates a stress reaction with gradual increase in the body’s resistance. The data obtained demonstrate changes in the functional properties of red blood cells both in kidney transplant recipients and in donors. These changes need to be taken into account when carrying out therapeutic measures.

The review includes results of retrospective and prospective clinical studies (foreign and national) and guidelines on the use of transplantation technologies for treatment of type 1 diabetes and pancreatogenic diabetes in chronic pancreatitis and pancreatic conditions. Modern data on prevalence of diabetes and modern insulin delivery methods are presented. Results of transplantation of pancreas and islets of Langerhans in primary insulin-dependent conditions are considered. Analysis of the technology for isolation and autotransplantation of islets after pancreatectomy in chronic pancreatitis and benign tumor diseases are given.

Aim . To improve the efficiency of treatment of advanced liver alveococcosis using modern surgical techniques including transplantation. Material and Methods. It was analyzed surgical treatment of 25 patients with advanced liver alveococcosis for the period 2008–2014. Operations were performed in 21 cases. Lung metastasis were diagnosed in two of them. Long-term obstructive jaundice was observed in 5, portal hypertension – in 2. 1 patient with associated HBV had liver cirrhosis. Results . Surgical interventions had extended volume and included liver resection “in situ” in 16 cases, orthotopic liver transplantation (OLT) in 3 patients. Invasion into IVC was detected in 9 cases. In 6 patients IVA was made a prosthetic appliance using PTFE-prosthesis including 1 case with left hepatic vein orifice repair and 3 cases with partial resection. Resection and reconstruction of portal vein were required in 6 cases. 9 patients underwent resection of the extrahepatic bile ducts. Resection of the right dome of the diaphragm was made in 4 cases. In one case explorative laparotomy was performed. All patients after surgery receive antiparasitic therapy. There was 1 death in the early postoperative period due to multiple organ failure. There were no recurrences within 7-year follow-up. Antiparasitic therapy after liver transplantation did not require adjustment of immunosuppressive therapy. Conclusion . Surgical interventions for liver alveococcosis have advanced volume and are combined with reconstruction of great vessels and bile ducts. Maximum tendency to resection is caused by potential risk of immunosuppressive therapy after transplantation for the progression of the disease, that justifies difficult resections “ex situ”.

Pathological and physiological processes in living tissues are usually accompanied by variation of their electrodynamic parameters; hence study of dielectric permittivity and conductivity of bio-objects is of considerable interest for various medical applications. Diagnostics of skin pathologies without using the hystomorphologic method is required in dermatology. Tissue sampling (biopsy) refers to minor operations and is often undesirable for patients with abnormality in carbohydrate metabolism, vascular pathology, and eruption on unclothed parts of the body (face, neck, and hands). The estimation of viability of organs in vivo in the case of acute pathology and organs conserved for their further transplantation is necessary in surgery. The processes of tissue ischemia and reperfusion complications are the result of violation of the fine cellular mechanisms, diagnostics of which cannot be carried out by the known diagnostic techniques (Xray, ultrasound). These processes can be recognized only by means of biopsy with further optical or electron microscopic analysis; this procedure is timeconsuming, whereas a clinician does not have much time at his disposal. The aim of the study is to consider the opportunities of resonance near-field microwave sounding for estimation of viability of parenchymal organs in critical states, determination of pathologic processes, differential diagnostics of various dermatoses, and control of medical maintenance. The method of resonance near-field microwave probing can be explained as follows. The area of a medium located in the near field of a probing electrically small antenna affects its impedance. This feature enables one to provide high spatial resolution. If the antenna is connected to the resonance system as a load, the resonance frequency shift and the Q-factor variation can be used to estimate the electromagnetic parameters of the medium and then the state of the examined object. Diagnostic probes for passive measurements of the electrodynamic features of parenchymal organs and sensors for investigation of skin of dermatologic patients have been developed. A high-Q microwave resonator placed on a segment of the coaxial line is employed as a resonance system. The eigen frequencies of the sensors are 0  2  800 MHz and the Qfactor is Q0 150. The spatial resolution and the sensitivity are determined by the design and sizes of the electrically small antenna. If Z0 is the internal impedance of the antenna, Zmedium is the impedance of the antenna contacting with the medium, and Zmedium < ( is the wave resistance of the coaxial resonator), according to [1] one can obtain the equation of the resonance curve Ures(ω) of the sensor

There have been analyzed the results of surgical treatment of 128 patients with metastases of colorectal cancer in the liver operated in the Privolzhsky district medical center of Federal Medico-Biologic agency of Russia (Nizhny Novgorod). There has been carried out the comparative assessment of the results processed by means of international register LiverMetSurvey (www.livermetsurvey.org) with collective data of the project published. All main aspects were compared. Age, primary tumour localization, the number, size and localization of hepatic metastases, the presence of associated pathologies, as well as the volume of surgeries performed in the compared groups had differences representing the work of Regional Hepatology Centre. The main difference was in postoperative survival of such patients: according to International register, two-year survival amounts to 76%, and in our centre - 57%. The obtained results of the analysis show the approaches to the treatment of this difficult group of patients in the Privolzhsky district medical center correspond to the international protocol.

The aim of the investigation is to estimate shortand long-term results of the treatment of ductal adenocarcinoma of the head of pancreas after conventional and extensive pancreatoduodenal resection. Materials and methods. There were performed total 27 conventional and 27 extensive interventions. The groups under study were comparable by sex, age, and the degree of tumour differentiation. Mean time of surgery, the volume of blood loss and hemotransfusion, the frequency of postoperative complications, and mortality did not differ significantly. Results. After extensive pancreatoduodenal resection, local recurrence occurred significantly more rarely (7.4 versus 33.3% after conventional surgery). Broadened lymphadenectomy in ductal adenocarcinoma of the head of pancreas did not lead to the increase of postoperative complications, mortality and overall survival. In the meantime, extensive gastropancreatoduodenoal resection enables to decrease significantly recurrence rate.

There have been analyzed the results of surgical treatment of 128 patients with metastases of colorectal cancer in the liver operated in the Privolzhsky district medical center of Federal Medico-Biologic agency of Russia (Nizhny Novgorod). There has been carried out the comparative assessment of the results processed by means of international register LiverMetSurvey (www.livermetsurvey.org) with collective data of the project published. All main aspects were compared. Age, primary tumour localization, the number, size and localization of hepatic metastases, the presence of associated pathologies, as well as the volume of surgeries performed in the compared groups had differences representing the work of Regional Hepatology Centre. The main difference was in postoperative survival of such patients: according to International register, two-year survival amounts to 76%, and in our centre 57%. The obtained results of the analysis show the approaches to the treatment of this difficult group of patients in the Privolzhsky district medical center correspond to the international protocol...

The aim of the investigation is to estimate short-and long-term results of the treatment of ductal adenocarcinoma of the head of pancreas after conventional and extensive pancreatoduodenal resection.Materials and methods. There were performed total 27 conventional and 27 extensive interventions. The groups under study were comparable by sex, age, and the degree of tumour differentiation. Mean time of surgery, the volume of blood loss and hemotransfusion, the frequency of postoperative complications, and mortality did not differ significantly.Results. After extensive pancreatoduodenal resection, local recurrence occurred significantly more rarely (7.4 versus 33.3% after conventional surgery). Broadened lymphadenectomy in ductal adenocarcinoma of the head of pancreas did not lead to the increase of postoperative complications, mortality and overall survival. In the meantime, extensive gastropancreatoduodenoal resection enables to decrease significantly recurrence rate.

The aim of the investigation is to develop pathologic criteria to estimate the condition of the liver in potential multi-organ donors with brain death to decrease the subjectivity when excluding donor's organs.Materials and Methods. There has been carried out the histological study of 30 effective liver biopsy samples and 30 non-effective biopsy material of potential postmortal donors. Liver tissue sections were stained by hematoxylin and eosin, using Masson's Trichrome staining, and PAS stain. To analyze histological material there have been used the computer quantitative morphometry system and statistical techniques.Results. The protocol of morphological estimation of the liver of potential postmortal donor was developed. According to the protocol, donors' liver pathology is to be estimated by eight histological criteria (steatosis, proteinosis and necrosis of hepatocytes; enotheliitis of central veins; endarteritis; phlebitis and inflammatory infiltration in portal tracts; hepatic fibrosis). Effective donors compared to non-effective ones were stated to have statistically significantly lower percentage of statosis (p<0.001), proteinosis (p<0.001) and necrosis of hepatocytes (p<0.001); and there were less expressed the degree of inflammatory infiltration (p<0.001), phlebitis (p=0.028) and endarteritis (p=0.028) in portal tracts and the degree of hepatic fibrosis (p<0.001).

Domestic device for destruction of tumors by microwave power was designed. Initial series of laboratory experiments were performed with microwave liver ablation. Primary series of patients with colorectal cancer metastases to the liver demonstrate positive results. Short-term exposure, programmable shapes and sizes of ablative zones are the distinctive advantages of microwave thermoablation (MTA). 329 patients underwent liver resections during 2005-2010 years.108 patients had colorectal cancer metastases to the liver. 52 (48,14%) patients had bilobar liver lesions. Among them 11 patients underwent liver resection combined with MTA of contralateral liver lesions. Reliable differences in survival rates among patients with monolobar and bilobar metastatic lesions were not observed. Median of survival rate amounted 22.8 months in patients operated for metastatic colorectal cancer. Variants of surgical treatment are proposed.

A method of the liver tumor destruction is elaborated according to experimental investigations of a domestic device. It is used for a contact thermal destruction of tumors by the SHF energy local effect and applied in the clinic. The method of the tumor hyperthermia by a local SHF-effect has demonstrated a high effectiveness due to a short period of effect and the ability program the form and the size of the destruction area. Specific zones of the tumor tissue destruction are revealed.