PHENOMENON OF DEMIKHOV. At N.V. Sklifosovsky Institute (1960–1986). Paradigm shift in homologous organ transplantation: from overcoming biological incompatibility to artificial immunological tolerance (1960–1970)

The analysis of literature on experimental and clinical transplantation for the period of the 1968–1969 demonstrated that in the period from 1960 to 1970 the world transplantation saw a paradigm change in the field of homoorgan transplant: instead of overcoming the incompatibility between the donor organ and the recipient's body by using biological and physiological methods to influence the organ, which V.P. Demikhov had been dealing with for many years; surgeons and scientists, first abroad, and then in the USSR started developing and applying the creation of artificial immunological tolerance by using various physical, chemical and biological methods to impact recipient's body. The change of paradigms significantly influenced the implementation of organ transplantation techniques in clinic, including those of vital organs, and the further development of clinical transplantology. The data on the first heart transplants in 1968 and lung transplants in 1963–1970 have been presented.

Prospects for the use of artificial neural networks for problem solving in clinical transplantation

Management of solid organ recipients requires a significant amount of research and observation throughout the recipient’s life. This is associated with accumulation of large amounts of information that requires structuring and subsequent analysis. Information technologies such as machine learning, neural networks and other artificial intelligence tools make it possible to analyze the so-called ‘big data’. Machine learning technologies are based on the concept of a machine that mimics human intelligence and and makes it possible to identify patterns that are inaccessible to traditional methods. There are still few examples of the use of artificial intelligence programs in transplantology. However, their number has increased markedly in recent years. A review of modern literature on the use of artificial intelligence systems in transplantology is presented.

Macrophage Proinflammatory Responses to Microorganisms and Transplanted Organs

Tissue-resident macrophages and those conscripted from the blood/bone marrow are professional phagocytes. They play a role in tissue homeostasis, replacement, and healing, and are the first-line responders to microbial (viral, bacterial, and fungi) infections. Intrinsic ameboid-type motility allows non-resident macrophages to move to the site of inflammation or injury, where, in response to the inflammatory milieu they perform the anti-microbial and/or tissue repair functions. Depending on the need and the signaling from the surrounding tissue and other immune cells, macrophages acquire morphologically and functionally different phenotypes, which allow them to play either pro-inflammatory or anti-inflammatory functions. As such, the macrophages are also the major players in the rejection of the transplanted organs making an excellent target for the novel anti-rejection therapies in clinical transplantation. In this review, we describe some of the less covered aspects of macrophage response to microbial infection and organ transplantation.