Machine learning is used to develop predictive models to diagnose different diseases, particularly kidney transplant survival prediction. The paper used the collected dataset of patients’ individual parameters to predict the critical risk factors associated with early graft rejection. Our study shows the high pairwise correlation between a massive subset of the parameters listed in the dataset. Hence the proper feature selection is needed to increase the quality of a prediction model. Several methods are used for feature selection, and results are summarized using hard voting. Modeling the onset of critical events for the elements of a particular set is made based on the Kapplan-Meier method. Four novel ensembles of machine learning models are built on selected features for the classification task. Proposed stacking allows obtaining an accuracy, sensitivity, and specifity of more than 0.9. Further research will include the development of a two-stage predictor.

The aim —  to analyze results of reconstructive operations on pedal arteries in patients with critical limb ischemia (CLI).Materials and methods. From January 2008 to September 2017 in the Department of Vascular Surgery of Lviv Regional Clinical Hospital reconstructions of pedal arteries were performed in 41 patients with CLI. Middle age was 65 years (62, 97 %), male patients prevailed — 34 (83 %), female patients — 7 (17 %) respectively. During the period of supervision major amputations were performed in 5 (12.2 %) cases, in 28 (68.3 %) tissue loss was limited to the necrectomies and minor amputations.Results and discussion. Limb salvage was in 36 (87.8 %) patients. Using of popliteal artery as inflow provided better cumulative bypass patency comparatively with femoral artery bypass, the dependency of bypass and distal anastomosis localization was not statistically significant.Conclusions. Reconstructive operations on pedal arteries are an efficient method of CLI management in patients with distal occlusive stenotic damages and often remain as only chance to avoid amputation in patients with CLI. Better bypass flow is observed when popliteal artery is used as an inflow, the dependency on distal anastamosis localization was not defined.

Резюме. Обов'язком нащадків є збереження пам'яті про своїх попередників. У ретроспективному огляді викладено етапи історії пересадки органів в Україні та згадані особистості, які творили ці події. Викладено популярні та маловідомі факти з життя засновників української трансплантології та результати їх професійної діяльності.

Objective. Improvement the surgical management for cavoatrial tumor thrombosis due to renal cell carcinoma. Methods. The results of complex clinical, laboratory, instrumental examination, intraoperative observations and morphological studies were analyzed in 62 patients with renal cell carcinoma, complicated by cavoatrial tumor thrombosis, hospitalized to the vascular surgery department of Lviv regional clinical hospital for the period 1993-2019. Surgical treatment included radical nephrectomy, thrombectomy from inferior vena cava and right atrium. Kaplan-Meier method was used to evaluate the long-term survival of patients. Results. The postoperative complications included: posthemorrhagic anemia - 22 (38,6%), acute renal failure - 15 (26,3%), pulmonary embolism - 4 (7,0%), acute liver failure - 3 (5,3%), phlebothrombosis - 3 (5,3%), pneumonia - 3 (5,3%), stroke - 2 (3,5%), wound сomplications - 5 (8,8%) cases. Perioperative mortality was 11,3%. The causes of death included: hemorrhagic shock - 4 (6,5%), pulmonary embolism - 3 (4,8%), stroke - 1 (1,6%) cases. Long-term survival indicators were evaluated among 53 patients. The median follow-up was 36,9±13,3 months. The cumulative 2-, 5-, and 10-year survival rates were 53,5%; 38,2% and 17,2%, in 32 patients without metastases - 58,7%; 43,1% and 18,5% respectively. There was no significant difference іin survival among patients with atrial and retrohepatic venous tumor thrombosis versus infrahepatic and cavarenal venous tumor thrombosis (p>0,05). Conclusion. The accurate preoperative assessment of the level of neoprocess involvement, improvement of surgical tactics, effective prevention of thromboembolic and hemorrhagic complications make it possible to provide acceptable survival rates for patients with renal cell carcinoma, complicated by cavoatrial tumor thrombosis. What this paper adds The role of intraoperative blood reinfusion in the aspect of oncological safety in patients with renal cell carcinoma, complicated by invasion of inferior vena cava and right atrium, was first determined. Based on the results of cytological examination of tumor contamination of blood sediment material from the operating field during the cavatomy and washed autoerythrocytes it has been established that intraoperative reinfusion can provide necessary ablastics and doesn’t pose an additional risk of tumor dissemination during radical nephrectomy and inferior vena cava thrombectomy. The use of combined mini-invasive approaches in the surgical treatment of supradiaphragmatic level of intracaval invasion due to renal cell carcinoma is proposed, which will reduce the volume, trauma and duration of surgery, as well as provide reliable pulmonary embolism prevention. For the first time in Ukraine the immediate and long-term results of surgical treatment of patients with renal cell carcinoma, complicated by invasion of inferior vena cava and right atrium, during the last three decades were analyzed.

Ìåòà. Ïîêðàùåííÿ ðåçóëüòàò³â õ³ðóð´³÷íîãî ë³êóâàííÿ ïóõëèííîãî òðîìáîçó íèaeíüî¿ ïîðîaeíèñòî¿ âåíè òà ïðàâîãî ïåðåäñåðäÿ ó õâîðèõ íà íèðêîâî-êë³òèííèé ðàê. Ìàòåð³àë ³ ìåòîäè. Ïðîàíàë³çîâàíî ðåçóëüòàòè êë³-í³÷íîãî îáñòåaeåííÿ, ëàáîðàòîðíèõ ïîêàçíèê³â, ³íñòðóìåíòàëüíèõ, ³íòðàîïåðàö³éíèõ ñïîñòåðåaeåíü òà ìîðôîëî´³÷íèõ äîñë³äaeåíü ó 83 õâîðèõ íà íèðêîâî-êë³òèííèé ðàê, óñêëàäíåíèé ïóõëèííèì âåíîçíèì òðîìáîçîì, ÿê³ ïåðåáóâàëè íà ñòàö³îíàðíîìó ë³êóâàí-í³ ó â³ää³ëåíí³ õ³ðó𴳿 ñóäèí Ëüâ³âñüêî¿ îáëàñíî¿ êë³-í³÷íî¿ ë³êàðí³ çà ïåð³îä ç 1993 ïî 2018 ðîêè. Äëÿ ïî-ð³âíÿëüíîãî àíàë³çó õâîðèõ ïîä³ëåíî íà äâ³ ãðóïè. Äî ïåðøî¿ ãðóïè, îñíîâíî¿, âêëþ÷èëè 61 õâîðîãî íà íèðêîâî-êë³òèííèé ðàê (39 ÷îëîâ³ê³â òà 20 ae³íîê, ñåðåä-í³ì â³êîì 58,1±2,7 ðîê³â; äâîº ä³òåé, â³êîì 5 òà 9 ðî-ê³â), óñêëàäíåíèé ïóõëèííèì òðîìáîçîì íèaeíüî¿ ïî-ðîaeíèñòî¿ âåíè òà ïðàâîãî ïåðåäñåðäÿ. Äî äðóãî¿ ãðóïè, êîíòðîëüíî¿, âêëþ÷èëè 22 õâîðèõ íà íèðêîâî-êë³òèííèé ðàê (19 ÷îëîâ³ê³â òà 3 ae³íîê, ñåðåäí³ì â³êîì 58,3±4,3 ðîêè), ó ÿêèõ ð³âåíü òðîìáîòè÷íî¿ ³íâà糿 áóâ îáìåaeåíèé íèðêîâîþ âåíîþ. Äëÿ îáñòåaeåííÿ õâîðèõ âèêîðèñòîâóâàëè ëàáîðàòîðí³ ìåòîäè äîñë³äaeåííÿ, à òàêîae ³íñòðóìåíòàëüí³: óëüòðàçâóêîâå äîñë³äaeåííÿ, ñï³ðàëüíó êîìï'þòåðíó ÷è ìà´í³òíî-ðåçîíàíñíó òîìî´ðàô³þ ç âíóòð³øíüîâåííèì êîíòðàñòíèì ï³äñèëåííÿì îð´àí³â ÷åðåâíî¿ ïîðîaeíèíè, ãðóäíî¿ êë³òêè, åêñêðåòîðíó óðî´ðàô³þ, Åõî-êàðä³î´ðàô³þ, âåíîêàâà-ðàô³þ çà ïîêàçàííÿìè. Äëÿ îö³íêè êóìóëÿòèâíîãî âèaeèâàííÿ õâîðèõ íà íèðêîâî-êë³òèííèé ðàê, óñêëàäíåíèé ïóõëèííèì âåíîçíèì òðîìáîçîì, âèêîðèñòîâóâàëè ìåòîä Êàïëàíà-Ìåéåðà. Ðåçóëüòàòè é îáãîâîðåííÿ. Îïåðàö³éíå ë³êóâàííÿ âêëþ÷àëî ïðîâåäåííÿ ðàäèêàëüíî¿ íåôðåêòî쳿 â êîì-á³íàö³¿ ç ìåòàòðîìáåêòî쳺þ ç íèaeíüî¿ ïîðîaeíèñ-òî¿ âåíè òà ïðàâîãî ïåðåäñåðäÿ. Çàñòîñóâàííÿ îáëàäíàííÿ "Cell-Saver Plus" äîçâîëèëî ñóòòºâî çìåíøèòè ïîòðåáó â äîíîðñüê³é êðîâ³. Íåçâàaeàþ÷è íà çíà÷íèé îá'ºì ³ òðàâìàòè÷í³ñòü õ³ðóð´³÷íèõ âòðó÷àíü ó õâîðèõ ïåðøî¿ ãðóïè, ðèçèê á³ëüøîñò³ ï³ñëÿîïåðà-ö³éíèõ óñêëàäíåíü íå ïåðåâàaeàâ â îáîõ ãðóïàõ. ³ä-äàëåí³ ðåçóëüòàòè îö³íþâàëè ñåðåä 76 ïàö³ºíò³â íà íèðêîâî-êë³òèííèé ðàê, óñêëàäíåíèé âåíîçíîþ ³íâà-糺þ-ó 55 õâîðèõ ïåðøî¿ òà 21 õâîðîãî äðóãî¿ ãðóï. Ñåðåäí³é ïåð³îä ñïîñòåðåaeåííÿ ñòàíîâèâ 53,2 ì³ñ. Ìåä³àíà âèaeèâàííÿ äëÿ õâîðèõ ïåðøî¿ ãðóïè ñêëàëà