Introduction. To prevent post-transplant complications associated with unbalanced immunosuppression, objective indicators reflecting the state of the immune system and associated with the immunosuppressant dose are required. In pediatric liver transplantation, an important indicator of hepatocellular function and restoration of anthropometric characteristics is insulin-like growth factor 1 (IGF-1), which exhibits both nonspecific and selective immunomodulator properties.Objective: to assess the correlation between growth hormone and IGF-1 levels and tacrolimus dose and blood concentrations in pediatric liver recipients and to determine the possibility of using the IGF-1 level in selecting the drug dose required to achieve its target concentration in the blood. Materials and methods. We examined 156 children aged from 2 to 105 (median – 8) months with liver cirrhosis of various etiology, who received liver from a living related donor. The concentration of growth hormone and IGF-1 was determined in blood plasma before, one month, and one year after transplantation using the enzyme-linked immunosorbent assay. Tacrolimus residual concentration was measured in the patient’s whole blood by immunochemical method.Results. Growth hormone levels in the blood of pediatric liver recipients did not correlate with the dose or concentration of immunosuppressant tacrolimus one month or one year after transplantation, whereas the IGF-1 content was directly related to tacrolimus dose one year later (r = 0.41, p = 0.001), but not a month after surgery. The correlation coefficient was higher in uncomplicated post-transplant recipients (r = 0.51, p = 0.002) than in those with complications (r = 0.26, p = 0.17). The diagnostic efficiency of the IGF-1 level as an objective criterion for selecting the tacrolimus dose required to achieve its target blood concentration was 0.80 ± 0.11; 95% CI [0.58–1.00] (p = 0.007). In recipients with blood IGF-1 levels ≥115.7 ng/mL, the probability of prescribing a tacrolimus dose ≥0.25 mg/kg/day was 14 times higher than in children with lower blood IGF-1 levels. The estimated accuracy of the test was 83%, positive predictive value was 71%, and negative predictive value was 85%.Conclusion. The IGF-1 level was found to correlate with tacrolimus dose in liver transplant recipients one year after transplantation. The diagnostic efficiency of IGF-1 as a potential indicator for choosing the tacrolimus dose required to achieve its target blood concentration is 80%, which suggests further study of the test to assess the effectiveness of immunosuppression and selection of an individual immunosuppressant dose.

The development of patient-oriented means of interaction between citizens and organizations of the participants of the modern “digital interaction” system is a current trend in the field of medical information technology. The formed principles of digital transformation of healthcare, which are carried out within the framework of the federal project “Creation of a unified digital contour in healthcare based on the unified state health information system (UGISZ) ”. National Project “Health Care”, provide ample opportunities for designing and developing new applied solutions in terms of requests from medical organizations for modern domestic IT tools for “communication” with patients. The aim of the article is to analyze and describe the current level of development of patient-oriented software products and methods of their development. As a result, the software “Personal account of the patient “Interin LC”, developed on the basis of research and running on a stack of freely distributed software, is described.

Management of solid organ recipients requires a significant amount of research and observation throughout the recipient’s life. This is associated with accumulation of large amounts of information that requires structuring and subsequent analysis. Information technologies such as machine learning, neural networks and other artificial intelligence tools make it possible to analyze the so-called ‘big data’. Machine learning technologies are based on the concept of a machine that mimics human intelligence and and makes it possible to identify patterns that are inaccessible to traditional methods. There are still few examples of the use of artificial intelligence programs in transplantology. However, their number has increased markedly in recent years. A review of modern literature on the use of artificial intelligence systems in transplantology is presented.

The article is devoted to the automation of the process of planning and management of operational activities in a multidisciplinary hospital – the basic principles and features, parameters and factors affecting the formation of the operation plan are formulated, the model of the business process is described and criteria for its effectiveness are given, the methodological foundations for organizing the planning of operational activities are shown – shown the leading role of the relationship between the plan of operations and the plan of hospitalizations, the role of the medical information system in the automation of operational activities is determined. All identified methods of increasing the efficiency of the operational activity of medical institutions by means of MIS were tested on the example of using MIS Interin PROMIS Alpha at the Federal Research and Clinical Center of the FMBA of Russia. The results that were achieved as a result of the practical application of these methods with the use of MIS in the organization of the daily process of the activities of surgeons in the Federal Research Center of the Federal Medical and Biological Agency of the Federal Medical and Biological Agency of Russia are considered.