Objectives: Kazakhstan is experiencing a high demand for liver transplants. More than 1000 patients have end-stage liver disease in the country, and liver transplant is the only viable option for their treatment. Conclusions: Our experience was insufficient to adequately assess morbidity and survival rates in patients for whom the longest follow-up was 25 months. However, no episodes of rejection were observed. Survival rates between living and deceased donor recipients were equivalent, although cadaveric-donor liver conditions were imperfect. This analysis demonstrates the necessity for timely diagnosis of surgical complications, which accounted for all mortality incidence in our series.

Background Liver transplantation is considered to be the best available treatment option for patients with liver failure. In Kazakhstan, the liver transplantation program was established a decade ago. In this study, we analyzed a low-volume transplant center experience of liver transplantation in Kazakhstan. Material/Methods Clinical data of the 64 consecutive liver transplantations from deceased and living donors between 2010 and 2020 were retrieved from electronic records. All data were retrospectively analyzed. Results A total of 64 liver transplantations, 11 from deceased donors and 53 from living donors, were carried out in our center between 2010 and 2020. The mean age of the recipient was 44 years, 53% were female, and 47% were male. Hepatitis B+hepatitis D infection was the most common cause of end-stage liver disease (21 cases; 32.8%). The overall patient survival rates for 1, 3, and 5 years were 75%, 69.5%, and 59.6%, respectively, for recipients of a liver transplant from a living donor and 54.5%, 45.5%, and 39% for recipients of a liver transplant from a deceased donor. Conclusions Our clinical outcomes had a high rate of biliary and vascular complications that led to a low survival rate of the recipients. Starting the transplant program in Kazakhstan faced various challenges. In the early period, most transplantations were performed in collaboration with or under the guidance of transplant teams from Russia, Turkey, and South Korea. Improving surgical techniques and protocols of pre- and posttransplantation management could reduce the complications after transplantation.

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Relevance: The introduction into clinical practice of new non-invasive, safe and effective methods of treatment of benign and malignant diseases is an urgent task. The purpose was to study literature sources on the experience of using MRI-guided focused ultrasound (MRgFUS) method of thermal ablation for its subsequent implementation and use at the East Kazakhstan Region Multidisciplinary Center of Oncology and Surgery of Ust-Kamenogorsk. Results: The proposed method is based on real-time MRI-guided thermal ablation by focused ultrasound. Numerous studies have shown its clinical and economic efficiency, safety, and convenience for patients with bone metastases, early-stage prostate cancer, and uterine myoma. Conclusions: MRgFUS ablation is a modern non-invasive technique that expands the ways to treat benign and malignant tumors. In certain cases, it can be a good alternative to invasive treatments. MRgFUS ablation can be used in combination with other treatments.

The aim of this study is to present our initial implementation experience in peritoneal carcinomatosis treatment and the technical details of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the light of current literature.Material and methods: Data of 7 consecutive patients who were treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis in the National Research Center for Oncology and Transplantology, between October 2016 and December 2018 were retrospectively reviewed. Treatment indication and management were evaluated at the multidisciplinary oncology council. All patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with the aim of complete cytoreduction. Patients with unresectable disease and/or palliative surgery were excluded from analysis. Perioperative complications were classified according to Clavien-Dindo classification, and hyperthermic intraperitoneal chemotherapyrelated side effects were identified using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) criteria. Demographic, clinical and histopathological data of the patients were analyzed.Results: The mean age was 47 (30-62). Three patients were female. The origin of peritoneal carcinomatosis was colorectal cancer in 3 patients, ovarian cancer in 2 patients and pseudomyxoma peritonei in 2 patients. The mean Peritoneal Carcinomatosis Index was 17 (3-32), with a mean operative time of 517 (366-710) minutes. Perioperative morbidity and mortality were observed in 2 (28,5%) and one patient (14.2%), respectively. During a mean follow up of 9,6 (3-26) months, overall and disease-free survival rates were 85,7% and 83,3%, respectively. One patient with colorectal cancer (after 12 months) had retroabdominal recurrence. The remaining patients are being followed-up without any recurrence.Conclusion: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have favorable results in the treatment of patients with peritoneal carcinomatosis. Compatible with the literature, surgical outcomes of the presented series are encouraging for this treatment modality. Careful perioperative evaluation, proper patient selection and multidisciplinary approach are essential for success in curative treatment of peritoneal carcinomatosis.