[Selection of donors for heart transplantation]. / Selektsiia donora dlia transplantatsii serdtsa.

The article discusses the first clinical experience of the donor maintenance of the program of heart transplantation. Under analysis are etiology and terms of the process of death of the brain in 65 potential donors. The authors propose a scheme of the three-stages assessment of fitness of his heart for transplantation. Specific features of intensive therapy of the donors are considered. Twenty donors were used for clinical transplantations of the heart, in 18 cases (90%) satisfactory recovery of functions of the transplanted heart was noted.

[Comparative evaluation of various methods of initial hypothermic perfusion of donor kidneys]. / Sravnitel'naia otsenka razlichnykh sposobov initsial'noi gipo- termicheskoi perfuzii donorskikh pochek.

The authors discuss three various methods of initial hypothermic perfusion applied in 160 donors. The function of the donor kidneys was evaluated according to the results of clinical transplantation. The advantage of high-current perfusion in situ is shown, it allows the number of donor kidneys which are unfit for transplantation to be reduced to minimum. The method of in situ perfusion of organs in multiorganic collection ensures the most adequate antiischemic protection of all organs removed for transplantation, particularly in donors after circulatory arrest.

[HLA-associated predisposition to dilated cardiomyopathy]. / Assotsirovannaia s HLA predraspolozhennost' k dilatatsionnoi kardiomiopatii.

HLA-antigens grade I and II were studied by tissue typing in 60 Russians and 40 Georgians suffering from dilated cardiomyopathy (DCMP), and 40 Georgians with virus myocarditis. 267 test-donors Russians and 579 Georgians served as control. Markers of DCMP predisposition were found different for Russians and Georgians: DR4 (relative risk 2.96) and A11 (RR = 3.07), R12 (RR = 5.5), respectively. Georgians have a marker of resistance to DCMP--B35 (RR = 0.15). Antigen B12 marks a severe DCMP course in Georgians. Markers of virus myocarditis predisposition were distinct from those of DCMP: A1 (RR = 3.78) and B27 (RR = 3.62). This shows different etiology of the two diseases. The conclusion is made on nonidentical genetic markers of predisposition and resistance to the same disease in various populations.

[The first clinical experience with heart transplantation]. / Pervyi klinicheskii opyt transplantatsii serdtsa.

The article analyses the first clinical experience in orthotopic allotransplantation of the heart at the Scientific Research Institute of Transplantology and Artificial Organs, USSR Ministry of Health, in the period from October, 1986 to July, 1989 (26 transplantations of the heart and one two-stage transplantation of the heart with the use of "Poisk-10M" artificial heart for 3.5 days in the first stage). Eleven patients are alive. Follow-up periods: maximum over 2.5 years, minimum 3 months. Sixteen patients died in different periods (up to 12 months). Three-component therapy (cyclosporine A, methylprednisolone, azathioprine) was applied for immunosuppression. The authors analyse the problems of the selection of potential recipients (indications and contraindications) and donor, the optimum surgical techniques, complications of immunosuppressive therapy, and infectious complications. The first clinical experience in two-stage transplantation of the heart is analysed. The first experience in transplantation of the heart in patients allows the conclusion that the use of this method for the management of the terminal stage of congestive cardiac insufficiency is a reality.

Effect of bezafibrate on lipoprotein secretion by cultured human hepatocytes.

The secretion of newly synthesized very low density lipoprotein and low density lipoprotein (VLDL + LDL) and high density lipoprotein (HDL) in cultured human hepatocytes in the presence or absence of bezafibrate added to the culture medium has been evaluated. The content of triacylglycerol, apolipoprotein B, 3H-labeled proteins and 14C-labeled lipids accumulated in a culture medium increased linearly for periods up to 18 h. During incubation, cellular triacylglycerol content was unchanged. This hypolipidemic agent, at a concentration of 10 microM, inhibited secretion of the several VLDL + LDL [3H]apolipoproteins and the VLDL + LDL [14C]lipids, suggesting it can affect the processes of biosynthesis and secretion. The secretion of total [3H]apolipoproteins in the HDL fraction and [3H]protein (d greater than 1.21 g/ml) was unchanged after an exposure to bezafibrate (10 microM). Incubation in the presence of 10 microM bezafibrate resulted also in decreases in both total VLDL neutral lipids and apolipoprotein B secreted into the medium. These results indicate that bezafibrate might exert its plasma lipid-lowering effect by suppressing the VLDL production in liver and reducing the secretion of VLDL into the circulation.

[Immunologic typing of splenic lymphocytes from human fetuses--donors of pancreatic islet cell cultures]. / Immunologicheskoe tipirovanie limfotsitov selezenki vnutriutrobnykh plodov cheloveka--donorov kul'tur ostrovkovykh kletok

To determine the HLA-phenotype of a potential donor of pancreatic islet cells, use was made of lymphocytes from 18-25-week-old human fetuses. The HLA-phenotype was clearly established in 39 out of 52 cases. In 13 cases, the authors failed to reveal histocompatibility antigens because of low viability of lymphocytes. The relationship was ascertained between the detectability of HLA-antigens in fetal donors and cytophysiological characteristics of islet cell cultures prepared from the pancreas.

Factors responsible for fluctuations in human NK cell activity in vitro.

The activity of NK cells in 12 healthy male donors was studied after 4, 8, 12, 16 and 20 h incubation of killer (mononuclear) cells with K562 target cells; a modification of the standard 3-5 h NK assay was used without preliminary centrifugation of the plates. The results indicated that 4 or 8 h incubation of killer and target cells (ratio 50:1) did not achieve maximum activity of NK cells. A significant increase in activity was found up to 12 h incubation. It was noted that variation in values decreased as the incubation time increased. The optimal incubation period was 16 h at which time maximum 51Cr release and least variation were registered. Longer incubation of K562 cells also contributed to their higher sensitivity to NK cells. The experimental data revealed in vitro factors responsible for fluctuations in the level of lytic NK activity in repeated assays in the same healthy donors.