The paper reviews the milestones and prerequisites in the history of the emergence and development of xenotransplantation. The currently existing barriers (immunological, infectious, genetic, ethical, and regulatory) to the development of this organ and tissue transplantation type have been studied. Available data on theoretical research and experimental studies have been reviewed. The prospects for performing xenotransplantation in various combination of species have been assessed. The forms and variants of the xenograft rejection reaction have been described. Genetic engineering approaches to overcoming xenoimmunological incompatibility are described. An assessment is made of ways to overcome existing barriers and prospects for the further development of xenotransplantation as a scientific section of transplantology.

The implementation of organ transplantation programs in our country is far from perfect. Many regions do not have transplantation centers, in many regions the work on organ donation is not carried out. Intensification of this vital work is of key importance – the need for organ transplantation remains unfulfilled in many regions of the Russian Federation by 70–90 %. The activity on organ donation must be realized with strict administrative control and administrative stimulation. It does not represent the sphere of interests of particular transplantologists. It is a strategically important task, the implementation of which should be carried out at the state level. The key importance in the implementation of organ transplantation program is the hospital where the potential donor is located, identified and accompanied. In the literature and daily practice the outdated term “donor base” is often used, the use of which we consider unacceptable. The donor hospital is a spring, a source of life, the work in which has a key, starting character.

A case of a long-term management of a patient with Kaposi’s sarcoma developed as presumably related to a “standard” immunosuppressive therapy after kidney transplantation has been described. Immunosuppressive therapy conversion to mTOR receptor inhibitors and administering chemotherapy with prospidium chloride allowed for a long-term remission of the disease and a satisfactory clinical outcome.

The moral and ethical aspects of organ donation for transplantation constitute a new section of the doctor's activity. The correct and motivated awareness of the answers to the main questions that may arise from members of the public, patients, members of their families, medical personnel, undoubtedly, is within the competence of the doctor. This work is devoted to the analysis of existing approaches to answering the main questions arising around the activity of preserving the organs of the deceased for transplantation. The work was done in the format of a catechism, questions and the answers offered to them. Answers are given as one of the options.