Objective : to provide guidelines on how to improve the quality of health care in transplantation services for Russian regions; the recommendations were prepared by the Shumakov National Medical Research Center of Transplantology and Artificial Organs (Shumakov Center) based on field trips made by Shumakov Center from 2018 to 2019 in order to assess the status and development prospects of organ donation and organ transplantation in various regions of the Russian Federation. Materials and methods. Based on the over 40 field trips made by the Center, analytical reports, as well as recommendations were prepared by the Ministry of Health of Russia for regional health authorities and transplant centers. Guidelines were selected from these recommendations to address the most significant and common gaps and errors inherent in organ donation and organ transplantation in the regions. On the basis of the analytical reports, guidelines for the roadmap (plan) for organ donation and transplantation in the region were prepared. Results . A methodological framework for solving a wide range of managerial challenges on organ donation and organ transplantation is proposed for heads and experts at healthcare institutions and medical organizations. Conclusion. Organ donation and organ transplantation should be developed for the regions using the roadmap (plan) prepared and approved by the regional health authority. This approach brings stability and consistency to the development process, creates a resource base for development, and provides coordination and oversight.

Aim. To carry out monitoring of the organization and development of the organ donation and transplantation in theRussian Federationaccording to 2015. Materials and methods. Questioning of heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics by years, between certain regions of theRussian Federation, the transplantation centers is done. Results. According to the register in2015 inthe Russian Federation 36 centers of renal transplantation, 17 centers of liver transplantation and 10 centers of heart transplantation were functioning. The waiting list of kidney transplantation in 2015 included 4167 potential recipients that make 13% of the total number of the patients (31 500) receiving a dialysis. The rate of donor activity in 2015 made 3.0 pmp. Efficiency of donor programs in 2015 continues to increase: the share of multiorgan retrievals made 57.8%, average number of organs, received from one effective donor, made 2.7. In 2015 the rate of kidney transplantation made 6.5 pmp; the rate of liver transplantation made 2.2 pmp; the rate of heart transplantation made 1.2 pmp. The number of transplantations of liver and heart in theRussian Federationcontinues to increase. The number of transplantations of kidney remains approximately at one level in the range of 950–1050.Moscowcapital region continues to be the center of stability and development of the organ donation and transplantation in the country, in which 10 centers of transplantation are functioning and nearly a half from all kidney transplantations and more than 65% of all liver and heart transplantations are carried out. Conclusion. The potential for further development of the transplantation care in theRussian Federationcontinues to persist. In particular, at the expense of increasing efficiency of regional donation programs, expanding practices of multiorgan recuperation and transplantations of extrarenal organs, through interregional transplant coordination. It is critical to keep the volumes of the state order to deliver transplantological medical care to the population and to implement federal funding to conduct donation programs.

Monitoring of a condition and prospects of organ donation and transplantation development in Russia in the form of the National Registry is carried out under the auspices of the Pro fi le commission on transplantology of Minis- try of Health of Russia and the Russian Transplant Society. According to the registry in 2012 the indicator of do- nor activity decreased, but the indicator of transplant activity remained at the level of the last years. Decrease the number of deceased donors managed to be compensated by means of increase of ef fi ciency of donor programs: by increase of the number of donors after brain death and multi-organ explantation, by increase in average of the organs received from one deceased donor. In 2012 the number of transplantations of heart and liver increased. The main funding mechanism for organs transplantation in Russia is the state task to the transplant centers (fede- ral fi nancing), its role increases. For increase of stability of donor providing it is necessary to continue to develop legal base in the organ donation and transplantation sphere.

The article presents the third report of the Registry of Russian transplant society, taking into account donor and transplant activity in the Russian Federation in 2006–2010. Data analysis proves clear positive trends during the last 5 years. The further progress is possible through the creation and modernization of regional donor infra- structures whose activities should be aimed at increasing of the number of donor hospitals and its rational use by expansion of brain death veri fi cation and performance of multiorgan procurement.