"EX VIVO" MACHINE PRESERVATION OF THE ABDOMINAL ORGANS OF A PIG.

The aim of the study is to test the developed perfusion machine for long-term preservation of the liver, to evaluate the perfusion scheme that provides two different (arterial and venous) flows, and to evaluate hemodynamic of parallel perfusion of the liver together with the kidney. We have developed a perfusion machine to enable simultaneous perfusion of the liver and kidney, based on clinically proven constant flow blood pump. In the developed device, constant blood flow is converted into pulsed blood flow using a device of its own design - a pulsator.

Challenges and perspectives of surgical treatment of liver failure. Current status and last achievements in Georgia.

Liver transplantation is considered to be the last hope of treatment for irreversible liver failure caused by different diffuse and/or space-occupying lesions of this organ. The strict limitation of the donor organs stipulates for development of alternative approaches for the solving this problem. The presented review of literature and our experience aims to discuss the modern aspects of management of different hepatic pathologies causing liver failure with the view of creation of the auxiliary, bioengineer-based functional tissues and/or organs and innovative surgical interventions allowing to conduct the operations in cases, which were up to date considered as inoperable.

[IMPROVING THE PERFUSION FLOW OF BLOOD PUMPS].

Research in recent years has shown that pulsating flow during cardiopulmonary bypass can prevent the development of a number of perfusion complications inherent in continuous blood flow. On the other hand, attempts to pulsate with roller and centrifugal pumps, which are structurally DC pumps, are fraught with complications. However, these pumps are clinically tested and are successfully used for the implementation of direct blood flow.

MORPHOLOGICAL CHANGES IN THE LIVER AFTER 8 HOURS OF PRESERVATION BY MACHINE PERFUSION.

Patients with refractory cardiac arrest, who have undergone Extracorporeal Life Support (ECLS) for resuscitation, but have not achieved cardiac recovery, can be considered as potential donors (Cardiac Death Donors). In such cases, it takes time to notify and obtain the principle consent of the relatives and finalize the clinical and legal documents. During this time, prior to obtaining consent for the removal of organs, ECLS can be extended.

[PRESERVATION OF ORGANS VIABILITY BY THE HEART-LUNG BYPASS MACHINE IN THE NON-HEART-BEATING DONORS (REVIEW)].

In a wide range of acute, debatable problems of transplantology, the problem of donation should be highlighted. It includes the selection and management of the donors, ethical and religious aspects and issues on the prevention, treatment and rehabilitation of the organ before its transplantation. Among the many methods of organ preservation, in the last decade, machine perfusion methods are on the forefront.

[THEORETICAL BACKGROUND OF FINDING ORGANS FOR TRANSPLANTATION AMONG NON-HEART BEATING DONORS UNDER UNSUCCESSFUL EXTRACORPOREAL RESUSCITATION (LITERATURE REVIEW)].

The number of patients who are in the "Transplant Waiting List" is increasing each year. At the same time, as a result of the significant shortage of donor organs, part of the patients dies without waiting till surgery. According to the Maastricht classification for non-heart beating donors, the patients, who had cardiac arrest outside the hospital (in the uncontrolled by medical staff conditions) should be considered as a potential donors of category II.

Abdominal organ donation: surgical aspects and recommended practice guidelines for controlled donation of brain-dead donor.

The shortage of organ donors along with the increased number of waiting recipients have created the need for new strategies to expand the organ pool from donations after brain death. Organ procurement from brain-dead deceased donors is a complex task. Multiple, complicated operations are performed simultaneously.

Experimental liver autotransplantation with novel scheme of veno-venous bypass as a model of liver denervation and delymphatization.

The impact of denervation and delymphatization (DD) on liver tissue remains a topic of major interest in liver transplantation, as the organ or its part continues to function well. Various chemical and/or surgical interventions have been developed to achieve in situ liver denervation and delymphatization, but it is evident that DD can be achieved only through "ectomia", ie, complete isolation of the organ from adjacent and connected structures. This Study describes a liver DD model based on a technique of autotransplantation (replantation), maximally preventing ischemia in the transplanted (replanted) graft and dyscirculatory complications in the recipient.

New model of veno-venous bypass for management of anhepatic phase in experimental study on dogs.

Blood is shunted from the inferior vena cava and portal vein to the superior vena caval system to prevent congestion in the lower parts of the body during the anhepatic phase (AP) of liver transplantation. It leads to overload in the superior vena caval system retarding cranial outflow due to a nonphysiological blood redistribution. To overcome this problem, we developed a new bypass in dogs: blood is shunted from the inferior (caudal) vena cava and portal vein to the suprahepatic inferior (caudal) vena cava.

Gerontology research in Georgia.

Gerontology research carried out in different scientific centers of Georgia follows the basic directions of most work in this field: epidemiology, investigation of the mechanisms of aging, and finding ways to prevent senile pathologies and to prolong life. The genealogy and epidemiology of long-living peaple have been studied in areas with high occurrence of these people by considering the sex ratio and social status of the long-living, the influence of environmental factors, and the development of senile pathologies. According to the centrosome (centriole) model of aging, the centrosomes and the cytoskeleton, important structures in cellular differentiation and morphogenesis, may be involved in the initiation of the replication senescence mechanism.

[Optimization of the venous return during experimental hepatectomy in rabbits].

A traditional bypass pattern applied in hepatectomy (venous return in superior vena cava system) is frequently attended by blood congestion in cranial veins. The study objective is the maintenance of hemodynamic indices in normal physiological ranges via application of the new bypass scheme in the experimental model of the anhepatic period. 12 rabbits of Chinchilla breed were involved in the experiments, with weight ranging between 3,0-3,5 kg, which were divided into three groups (with 3 animals in each): I control group - hepatectomy under the condition of non-compulsory liver bypass with the return of the venous flow in brachiocephalic vein.

Experimental study of the new blood pump for the heart-lung bypass machine.

The functioning of the rolling pump in the system of artificial blood circulation is associated with a number of complications. For avoiding these complications, virtually new perfusion system is developed, in which the functions of a blood reservoir and a pump are united in hermetic cardiotomy reservoirs. The technical aspects of connecting this system to experimental animals are described.

[Use of Plaferon LB for cardiac preconditioning during experimental ischemia/reperfusion injury in rabbits].

The main goal of research was to study potential of Plaferon LB for cardiac preconditioning during experimental ischemia/reperfusion injury in rabbits. 30 rabbits (2.5-3.

[Effects of early vocational guidance of students at medical faculty of institute of higher education].

Despite the intensive clinical application of the scientific and technological innovations, the effect of the human factor in surgical intervention remains decisive. The existing model of training highly qualified specialists in the residency program does not always render positive results. For this reason, the issue of early orientation and specialization of prospective specialists, starting from the Bachelor's stage, has received considerable attention.

New type of pulsate flow system for artificial heart-lung bypass.

In the artificial system of heart-lung bypass, used during the surgery on stopped heart, a com-mon problem-causing device is a roller pump. Inexpensive, simple, yet dependable device is in the process of development, with characteristics maximally approximated to the physiologic parameters of the organism's natural heart. Substituting for the roller pumps, this device consists of two reservoirs.

Biventricular bypass: alternative to univentricular bypass and total artificial heart-bridge.

Left ventricular and biventricular bypasses (LVBs, BVBs) were performed in 102 experiments in sheep, goats, and donkeys. Biventricular bypass was performed in the assisted circulation mode or in the paracorporeal artificial heart bridge (PCAHB) mode when the natural heart fibrillates. During implantation of artificial ventricles instead of a heart-lung bypass, counterpulsation was used.

[Left-ventricular bypass: characteristics of homeostasis].

Experiments were conducted on donkeys to study the peculiarities of homeostasis in establishment of left ventricular bypass (LVB) by means of an artificial heart ventricle (AHV). Preliminary modelling of acute cardiac insufficiency makes the work of the AHV effective and ensures longer survival than that among intact animals. However, arterial hypertension and anemia accompanying prolonged work of the AHV and resulting from the interaction of the last named with the cardiovascular system sharply aggravate homeostasis and the course of LVB and lead to early death of the animals.

Long-term circulatory and respiratory support using two artificial ventricles and a fluorocarbon oxygenator.

Using a new heart-lung machine developed at our Institute, experiments were conducted on dogs, donkeys, and monkeys, providing complete and assisted artificial circulation, assisted oxygenation, and perfusion preservation of the heart. The new apparatus consists of two sequentially mounted artificial ventricles working in an antiphase mode; blood oxygenation is accomplished by a reusable oxygenator with a fluorocarbon preoxygenator. Experimental results indicate that clinical use of the apparatus is promising and deserves consideration.