Background. Identification of patients at risk for kidney allograft (KAG) failure beyond the first posttransplant year is an unmet need. We aimed to determine whether serum beta-2-microglobulin (β2MG) in the late posttransplant period could predict a decline in KAG function. Methods. We assessed a value of single measurement of serum β2MG at one to seventeen years after transplantation in predicting the estimated glomerular filtration rate (eGFR) and the decline in eGFR over a period of two years in 79 recipients of KAG. Results. At baseline serum β2MG concentration was higher (P = 0.011) in patients with allograft dysfunction: 8.67 ± 2.48 µg/mL versus those with satisfactory graft function: 6.67 ± 2.13 µg/mL. Higher β2MG independently predicted the lower eGFR, the drop in eGFR by ≥25% after one and two years, and the value of negative eGFR slope. When combined with proteinuria and acute rejection, serum β2MG had excellent power in predicting certain drop in eGFR after one year (AUC = 0.910). In conjunction with posttransplant time serum β2MG had good accuracy in predicting certain eGFR drop after two years (AUC = 0.821). Conclusions. Elevated serum β2MG in the late posttransplant period is useful in identifying patients at risk for rapid loss of graft function.

Заболевания сердечно-сосудистой системы (ЗССС) – одна из самых острых медицинских и социальных проблем современного общества. В настоящее время установлено, что в прогрессировании ишемической болезни сердца (ИБС) и ее осложнений существенное значение имеет повышение уровня гомоцистеина. Однако в медицинских публикациях недостаточно освещены вопросы влияния гипергомоцистеинемии (ГГЦ) на течение атеросклероза и функциональное состояние миокарда, что требует более детального изучения этой проблемы. Цель исследования – изучить функциональное состояние миокарда в зависимости от степени ГГЦ у больных ИБС, требующих хирургического вмешательства. В исследовании был проведен анализ лабораторных данных 30 пациентов, страдающих атеросклерозом. Указанные изменения сократительной способности миокарда были более выражены у пациентов с гипергомоцистеинемией и мультифокальным атеросклерозом, что требует более тщательной медикаментозной коррекции после вмешательств на коронарных и сонных артериях.

To date, it has been established that in the progression of cardiovascular (CV) disorders, an increase in the level of homocysteine (HC) and hypovitaminosis D play an important role. According to the latest recommendations, the modern clinician should consider risk factors not as a diagnostic sign, but as a prognostic, contributing factor, which to some extent can lead to destructive changes in the vascular wall. The aim. To study the morphological changes of the vascular wall depending on the degree of hyperhomocysteinemia and hypovitaminosis D. Materials and methods. We analyzed data from 54 patients who, in addition to determining the level of HC and vitamin D, underwent morphological studies of fragments of the great saphenous vein and aorta. Samples were obtained during coronary artery bypass grafting. Depending on the degree of hyperhomocysteinemia and the level of vitamin D, the patients were divided into 3 groups. Results. Morphological examination of the great saphenous vein and aorta showed normal structure of the vascular wall in patients with normal levels of HC and vitamin D (78.5% and 71.4%, respectively). Patients from the groups 2 and 3 with hyperhomocysteinemia had more pronounced changes in the venous wall, regardless of the level of vitamin D. These data suggest a probable association of HC levels with the changes in the vascular wall. It was also noted that the patients of group 3 had more pronounced inflammatory infiltration of the vascular wall. Conclusions. Hyperhomocysteinemia and hypovitaminosis D are independent predictors of CV disorders and have a detrimental effect on the vascular wall and blood coagulation system, creating conditions for the progression of atherosclerosis. The higher is the level of HC, the more pronounced are morphological changes in the vascular wall of the vein, leading to hypertrophy of all layers, regardless of the level of vitamin D.

This review describes the present day state of organ and cell transplantation services in Ukraine. Established have been the main challenges of their development and ways of overcoming. The creation of the National Agency on the transplantation and donation would give an opportunity to determine a single structure responsible for the development of all directions of transplantation service and would allow provide functioning of public health care and research institutions extremely necessary for institute of transplantation coordinators. Some kinds of activity need updating and elaboration of new normative documents. It is only clear-cut regulations and control over activities of organ transplantation that would prevent possible legal infringements in this sphere, thus allowing medical professionals in the field of organ transplantation service in Ukraine work on good international standards.