Body weight, absolute and relative heart weight, DNA-synthetic activity of cardiomyocytes, and number of nucleoli in cardiomyocyte nuclei were reduced in newborn albino rats exposed to antennal hypoxia. All these changes developed against the background of oxidative stress. In mature animals, the absolute and relative heart weights were decreased, but the ratio of mononuclear cardiomyocytes in both ventricles was higher than in the control. These changes were accompanied by an increase in the percent of collagen fibers in the myocardial stroma. In the right ventricle, an increase in the cardiomyocyte length to width ratio and a decrease in the number of nucleoli were found. The observed changes can probably induce heart function disturbances under pathological conditions.

Aim. To evaluate the long-term results of liver transplantation for hepatocellular carcinoma. To perform an analysis of risk factors for tumor recurrence.Materials and methods. A retrospective analysis of 63 deceased donor liver transplantations, which were performed from January 2010 to February 2020. Patients were divided into three groups according to the Milan and California criteria – within the Milan criteria, outside the Milan criteria, but within the California criteria, outside the California criteria.Results. There were 33 recipients within the Milan criteria, 5 within the California criteria, and 25 outside the California criteria. The 5-years recurrence rate was 9.1%, 40% and 52%, respectively (p = 0.002), five-year survival rate of – 93.2%, 66.7% and 54.7% (p = 0.041). Factors associated with an increased risk of recurrence: five and more tumor nodes (OR = 3.675; 95% CI (1.35–9.97); p = 0.011), macroscopic vascular invasion (OR = 5.97; 95% CI (2.06–17.31); p = 0.001) and inconsistency with California criteria (OR = 4.00; 95% CI (1.49–10.74); p = 0.006). The factors associated with a lower recurrence rate: one or two tumor nodes (p = 0.014 and 0.042, respectively), a high grade of histological differentiation (RR = 0.24; 95% CI (0.06–0.93); p = 0.039), compliance with Milanese criteria (RR = 0.18; 95% CI (0.06–0.58); p = 0.004).Conclusion. Liver transplantation can be performed in a number of patients beyond the Milan and California criteria. The morphological and biological characteristics of the tumor and a multidisciplinary differentiated approach to treatment have an important role in the success of treatment.

Background: Split liver transplantation is used worldwide and allows for an increase of donor organ pool, especially for pediatric recipients. Donor selection, some aspects of surgical techniques and long-term results remain to be important issues of split liver transplantation.Aim: To analyze our own clinical results of split liver transplantation, basic principles of deceased donor selection and specifics of surgical technique.Materials and methods: From May 2008 to December 2019, 32 cases of division of the deceased donor liver for transplantation to two recipients have been performed (64 split liver transplantations). Liver was divided into the left lateral section and the extended right lobe in 30 cases (“classical split”), and into the left lobe and right lobe in two cases (“full-split”). In 22 cases, the liver grafts were split in situ and in 10, ex-situ.Results: In the recipients of left-side transplants (left lateral section and whole left lobe), the one-, three-, and five-year survival rates were 80, 80, and 60%, respectively. In the right-sided transplant recipients (extended right lobe and right lobe), the one-, three-, and five-year survival rates were 93.3, 89.4, and 89.4%, respectively (p = 0.167). The most probable risk factors for mortality in the univariate analysis were liver retransplantation (p = 0.047) and patient’s weight (p = 0.04).Conclusion: For split transplantation, it is advisable to consider donors with a high-quality liver. This technique demonstrates satisfactory results and can be viewed as effective for patients with terminal liver diseases.

Donor organs shortage leads to extending criteria for deceased liver donation in the whole world.Aim:to compare results of deceased donor liver transplantation (DDLT) depending of donor age over 60 years old.Materials and methods:the study includes 390 DDLT from January 2010 to November 2017. All liver donors separated by age for two groups: I – 60 years and older (n = 26); II – younger than 60 years (n = 364). All donors were standardized by demographic, laboratory fi ndings and inotropic drug requirement. Results:no difference between both groups in severity of ischemia-reperfusion injury, ICU or in-hospital staying (median 2 and 7,5 days respectively) was found. There is also no difference between biliary or vascular complication rate. 5-year actuarial survival rate found no difference between both groups (I: 70%: II: 76%, p = 0,54).Conclusion.Using grafts from donors older than 60 years don’t worsen early and late results of DDLT. Care should be taken to avoid other risk factors (cold ischemia time, warm ischemia time).

Orthotopic liver transplantation is the only way to cure chronic liver failure and certain liver tumors. Deceased donor organs are the prevailing source in most transplantation centers. However, there is an organ shortage because of the increasing number of patients in need of transplantation. Using expanded criteria deceased donors is a routine way to overcome organ shortage. The majority of transplantation centers take older donors depending on the local rules. Successful liver transplantation from 73-year-old deceased donor. Recipient suffered from liver neuroendocrine tumor without signs of extrahepatic spread. Liver function is adequate during 90-day follow-up. Liver transplantation from older deceased donors has good outcome according to world experience. Careful donor-recipient selection is the key to success. The first positive trial in our center enlightens the way for further practice.

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Introduction. Liver transplant (LT) is a widely accepted treatment for hepatocellular carcinoma (HCC). The role of neoadjuvant (NAT) is still under debate.The aim of the work is to assess the effect of NAT on relapse-free survival (RFS) and overall survival (OS) in patients with HCC who underwent LT.Methods and materials. 63 patients diagnosed with HCC were observed at Blokhin National Medical Research Center of Oncology from October 2010 to January 2020. Of these, 28 patients did not receive any type of treatment before transplantation, 35 patients received various types of NAT. Two groups had similar patient and tumour characteristics at baseline. A significant number of patients with decompensated cirrhosis were observed in the non-NAT group (n = 14; 50%), while no patients with CP-C liver cirrhosis were observed in the NAT group (n = 0; 0%; p = 0.000). The average wait for a liver transplant was 10.3 months in the NAT group and 6.8 months in the NAT-free group (p = 0.561).Results. In the bridging subgroup, the tumour progression was detected in 29% of patients, stable disease in 47% of patients, partial response was achieved in 14% of patients, complete tumour response was observed in 5%. For 5% of patients, it was not possible to estimate the effect of the therapy due to the lack of appropriate data archives. In the subgroup of downstaging therapy, the tumour progression was detected in 23% of patients, stable disease in 41% of patients, a partial response was achieved in 12% of patients, a complete tumour response was observed in 6%. The treatment allowed the Milan criteria to be fulfilled in 18% of patients.Conclusion. There was no difference in overall survival (OS) or disease-free survival (DFS) between the NAT and control groups.

The purpose of the study is to summarize the first experience of liver transplants. Material and methods. Liver transplantation was performed at the Regional Clinical Hospital. 5 liver transplants from a posthumous donor were performed. Based on the available data, the analysis was carried out according to the following criteria: gender, age, MELD- Na index, cause of liver cirrhosis, method of liver transplantation, duration of surgery, postoperative complications, average bed-day, outcome. Results. In total, 5 liver transplants were performed from a posthumous donor. Among the patients there was 1 man and 4 women. The age of men is 41 years, women are 55.4 ± 9.2 years on average. The MELD- Na index is from 15 to 28, on average 17.8 ± 5.1. When transplanting a cadaveric liver, the method of classical orthotopic liver transplantation was used in 4 cases, in one the piggyback technique was used. The duration of surgical intervention in minutes averaged 394 ± 17.4. Postoperative complications on the Clavien-Dindo scale ranged from I to IIIb. The average bed-day of the patient’s stay in the hospital is 20.2 ± 8.9, including 6.2 ± 1.7 days in the intensive care unit. In all 5 cases, the outcome of liver transplantation is satisfactory. Conclusion. The first results of liver transplantation on the basis of the Regional Clinical Hospital showed that performing such a level of operations is possible in a multidisciplinary medical institution.