[Indocyanine green in liver transplantation]. / Primenenie indotsianina zelenogo (ICG) pri transplantatsii pecheni.

The purpose of this study was to evaluate the first own experience of using indocyanine green (ICG) in liver transplantation compared to literature data and to determine its potential for clinical practice. Liver transplantation is an effective option for patients with end-stage disease, but this procedure is associated with many problems such as graft rejection, graft dysfunction, surgical risk and postoperative management. Modern methods for assessing graft function have their limitations, so a more efficient method is needed. According to this review, ICG fluorescence is valuable for effective intraoperative blood flow control, assessment of graft function, intraoperative and postoperative monitoring of clinical status. ICG fluorescence can also predict clinical status of patients at all stages of liver transplantation. Routine ICG fluorescence method is advisable in liver transplantation to improve outcomes and optimize treatment process.

[Diagnostic and Prognostic Possibilities of the Redox-Potential Electrochemical Measurements in Blood Plasma].

AIMS: Determination of operating characteristics of the test based on blood plasma redox potential monitoring in patients with different patho- logical conditions associated with impaired oxygen metabolism during treatment in postoperative period and expanding the range of parameters of the developed method of investigation of blood plasma redox potential. METHODS: It were examined healthy volunteers group as following group (n = 63), groups of patients with transplanted liver (n = 64), kidney (n = 59), and lungs (n = 7). Redox potential measurements were done by platinum electrode, reference electrode was silver-chlorine one. Potentiostate IPC-ProL was used to registrate and record a dependence redox potential via time. Time of measurement was 15 min. RESULTS: statistically significant differencees of redox potentials ranges was found in healthy volunteers and patients with transplanted kidney and liver. Ratio of measured redox potentials coincident with the values within the confidence interval in healthy volunteers was 12% in patients with transplanted kidney and 10% in patients with transplanted liver. We observed significant differences in the nature of changes of blood plasma's redox potential values in course of monitoring of subgroups of patients with and without complications after liver transplantation. It was found that sensitivity of electrochemical method was 85%, selectivity--69.8%, precision--85.2%. CONCLUSION: we discovered value ranges of blood plasma redox potential typicalfor different pathological states; we detected an interaction between the effect of treatment and quantitative changes in the values of the blood plasma redox potentials; criterion for early predicition of complications in patients with transplanted liver was proposed basing on redox potential monitoring during postoperative period.

[Endoscopic hemostasis in patients with portal hypertension tumor genesis].

AIM OF THE STUDY: to assess the results of using endoscopic techniques to achieve hemostasis for the control of bleeding and the prevention of recurrent bleeding from esophageal and gastric varices in the patients with primary liver cancer and metastatic liver lesions. MATERIALS AND METHODS: in the period of 2009-2011,7 patients with primary liver cancer or metastatic liver lesions complicated by gastro-esophageal bleeding were treated in the Sklifosovsky Clinical and Research Institute for Emergency Medicine. The sources of bleeding were esophageal varices in 6 patients, gastric varices in 1. RESULTS: a diagnostic esophagogastroduodenoscopy (EGDS) revealed, besides the varices, an erosive hemorrhagic gastritis in 4 patients, a ruptured mucosa of cardio-esophageal transition in 1, an erosive hemorrhagic gastritis and a liver tumour invasion in the stomach antrum in 1. The hemostasis achieved by means of paravasal injections with a 20% glucose solution was efficient in 2 of 3 patients. The endoscopic ligations of esophageal varices were performed in 3 patients. Five patients died from the underlying disease progressing. In one of them, the cause of death was a recurrent bleeding from esophageal varices. CONCLUSIONS: in the patients with primary liver cancer and metastatic liver lesions, the use of mini-invasive endoscopic techniques is more appropriate, because the surgical treatment of this patient population carries a very high risk.