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0,65 (0,36-0,73) vs 1,05 (0,67-1,4) % и 0,039 (0,028-0,056) vs 0,063 (0,049-0,076) × 10 9 кл./л соответственно (р = 0,0009, р = 0,003), а также относительной и абсолютной численности плазмоцитоидных дендритных клеток -0,055 (0,04-0,085) vs 0,09 (0,05-0,12) % и 0,0038 (0,0021-0,0054) vs 0,005 (0,0035-0,007) × 10 9 кл./л соответственно (р = 0,0197, р = 0,0414 Introduction. Diagnosis of the kidney transplant cellular rejection in the long-term after transplantation remains a challenge. Usual surrogate markers are not enough sensitive and specific. Rejection is an immune reaction to donor alloantigens. The kidney transplant biopsy to diagnose a dysfunction is an invasive procedure with the incidence of complications about 12.6% and can lead to transplant loss. In this regard, the search of immunological biomarkers for early noninvasive and accurate diagnosis of kidney transplant rejection is an actual task. Material and methods. This is a report of the observational retrospective single-center, comparative case-control study in two groups involving 44 patients who underwent kidney transplantation. The first group (REJ) included the patients with the chronic graft dysfunction caused by a biopsy-confirmed late cellular rejection (22 patients). The second group (STA) included the recipients who had no dysfunction in the posttransplant period (22 patients). Flow cytometry of peripheral blood cells was performed to identify immunophenotyping markers of late cellular rejection after kidney transplantation (we determined subpopulations of T, B lymphocytes, and dendritic cells).Results. As a result of our work, we found significant differences in the absolute count of effector memory T cells making (0.36-0.73) vs. 1.05 (0.67-1.4) % and 0.039 (0.028-0.056) vs. 0.063 (0.049-0.076 , respectively (р = 0.0009, р = 0.003). The numbers of plasmacytoid dendritic cells were also different between the study groups: 0.0038 (0.0021-0.0054) vs. 0.005 (0.0035-0.007) × 10 9 cell/L for an absolute count (р = 0.0414), and 0.055 (0.04-0.085) vs. 0.09 (0.05-0.12

Background: Infectious complications are a major problem in transplantology of today. Soluble urokinase-type plasminogen activator receptor (suPAR) could be one of the markers of infection in kidney transplant recipients. Aim: To determine the potential of suPAR implementation into clinical practice to choose the management strategy in kidney graft recipients with infectious complications.Materials and methods: We conducted a single center, open-label pilot trial in 30 kidney graft recipients aged above 18 years, with clinical signs of infection (body temperature above 37.5 °С, dysuria or respiratory manifestations). Patients with diabetes mellitus, focal segmental glomerulosclerosis, chronic heart failure and cancer, as well as those with glomerular filtration rate below 15 mL/min/1.73 m2 were excluded. The patients were divided into 2 groups: those who were hospitalized to the nephrology department and those who were treated as outpatients.Results: There was no difference in suPAR levels between the in- and out-patients with kidney transplant and infectious complications (12.8 [10.4; 15] and 10.8 [7.6; 14.5] ng/mL, respectively, р = 0.194). The mean duration of hospitalization for infectious complications was 17.9 ± 10 days. SuPAR levels in the patients with a short in-hospital stay was 12.35 [9.6; 15] ng/mL, being not significantly different from that in the patients who required prolonged hospitalization (15 [10.4; 15] ng/mL, р = 0.347).Conclusion: We have made the first attempt to use the permeability factor suPAR in kidney transplant patients with clinical signs of infections at an out-patient visit to decide if they should be hospitalized to the nephrology department for in-patient treatment. The results obtained indicate that the stratification of the risk of death and unfavorable disease course, as well as the recommendations for patient managements developed for the general population, are not applicable to kidney transplant recipients. The results of this pilot trial have shown that high suPAR levels are not always indicative of severe status in the patients with kidney transplant and infectious complications. The predictive value of the marker for unfavorable disease course and death in this patient category remains vague.

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Objectives: The aim of this study was to identify new predictors of kidney graft primary dysfunction from results of metabolic, electrolyte composition, and preservation solution effluent osmolality analyses of kidneys from deceased donors. Materials and Methods: Samples of left renal veins in Custodiol preservation solution (produced by Dr. F. Köhler, Chemie, Bensheim, Germany) from kidney explants and from back table surgical procedures were obtained from 55 deceased donors. We compared metabolic parameters (glucose and lactate levels), electrolyte composition (potassium, sodium, calcium, chlorine), and effluent osmolality of kidney samples from donors whose recipients had satisfactory initial graft function (n = 44) and dysfunction (n = 22). Values are shown as median and interquartile ranges between the 25th and 75th percentiles. We used the Mann-Whitney U test to compare quantitative variables. Results: Statistically significant differences were observed in effluent osmolality results between kidneys that resulted in satisfactory graft function (median, 85; interquartile range, 65.5-97.1) and those that did not result in satisfactory graft function (median, 103.25; interquartile range, 78.7-125.75) (P = .045). We also observed a trend toward significance in sodium ion levels (P = .073) and lactate levels (P = .09). No statistically significant differences were shown in samples obtained from the back table surgical procedure. Conclusions: As a predictor of an initially satisfactory functioning deceased-donor kidney graft, it is possible to use the level of osmolality in Custodiol solution effluent obtained at explant.