Konstantin Semash
@bmtm.uz
Mini-invasive and transplant surgery department
National Children's Medical Center
EDUCATION
2012. Doctor of Medicine. First Moscow State Medical University. I. M. Sechenov. Moscow, Russia.
2014. Master of Surgery. First Moscow State Medical University. I. M. Sechenov. Moscow, Russia.
2016. General & Transplant Surgery Residency. V.I Shumakov National Medical Research Center of Transplantology and Artificial Organs, Moscow, Russia
2020. PhD in Transplant Medicine. Thesis defense on the topic «Living Donor Laparoscopic Left Lateral Sectionectomy»
RESEARCH, TEACHING, or OTHER INTERESTS
Transplantation, Hepatology, Surgery, Pediatrics
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
K. O. Semash, T. A. Dzhanbekov, and M. M. Akbarov
V.I. Shimakov Federal Research Center of Transplantology and Artificial Organs
Vascular complications (VCs) after liver transplantation (LT) are rare but are one of the most dreaded conditions that can potentially lead to graft loss and recipient death. This paper has analyzed the international experience in the early diagnosis of various VCs that can develop following LT, as well as the optimal timing and methods of treatment of these complications.
K. O. Semash and S. V. Gautier
V.I. Shimakov Federal Research Center of Transplantology and Artificial Organs
Living related liver transplantation has proved to be an effective, safe and radical method for treating end-stage liver diseases. In the last decade, a laparoscopic approach to donor hepatectomy has been gradually introduced into clinical practice. According to world literature, there are presently no uniform standards for performing la paroscopic liver resections in living donors. This literature review considers almost all methods for performing this surgery in living donors. These methods are described in transplant centers around the world.
S. V. Gautier, M. A. Voskanov, A. R. Monakhov, and K. O. Semash
V.I. Shimakov Federal Research Center of Transplantology and Artificial Organs
and innova tions in surgical techniques. These complications can lead to graft damage or even death, and they are caused by many factors. Although minimally invasive interventional radiology is an optional treatment for such post-liver transplant complications, there is little research on this method of treatment.
S. V. Gautier, A. R. Monakhov, O. M. Tsiroulnikova, R. A. Latypov, T. A. Dzhanbekov, S. V. Mescheryakov, K. O. Semash, S. I. Zubenko, Kh. M. Khizroev, and E. V. Chekletsova
Moscow Regional Research and Clinical Institute (MONIKI)
Background: Split liver transplantation is used worldwide and allows for an increase of donor organ pool, especially for pediatric recipients. Donor selection, some aspects of surgical techniques and long-term results remain to be important issues of split liver transplantation.Aim: To analyze our own clinical results of split liver transplantation, basic principles of deceased donor selection and specifics of surgical technique.Materials and methods: From May 2008 to December 2019, 32 cases of division of the deceased donor liver for transplantation to two recipients have been performed (64 split liver transplantations). Liver was divided into the left lateral section and the extended right lobe in 30 cases (“classical split”), and into the left lobe and right lobe in two cases (“full-split”). In 22 cases, the liver grafts were split in situ and in 10, ex-situ.Results: In the recipients of left-side transplants (left lateral section and whole left lobe), the one-, three-, and five-year survival rates were 80, 80, and 60%, respectively. In the right-sided transplant recipients (extended right lobe and right lobe), the one-, three-, and five-year survival rates were 93.3, 89.4, and 89.4%, respectively (p = 0.167). The most probable risk factors for mortality in the univariate analysis were liver retransplantation (p = 0.047) and patient’s weight (p = 0.04).Conclusion: For split transplantation, it is advisable to consider donors with a high-quality liver. This technique demonstrates satisfactory results and can be viewed as effective for patients with terminal liver diseases.
A. R. Monakhov, B. L. Mironkov, M. A. Voskanov, S. V. Meshcheryakov, E. T. Azoev, K. O. Semash, T. A. Dzhanbekov, O. V. Silina, and S. V. Gautier
V.I. Shimakov Federal Research Center of Transplantology and Artificial Organs
Many studies have shown that biliary complications after transplantation of the left lateral segment (LLS) of the liver reduce graft and recipient survival. Thus, timely correction of biliary complications, and strictures in particular, improves long-term outcomes in transplantation. Objective: to analyze our own experience in correcting biliary strictures in LLS graft transplantation. Materials and methods. From February 2014 to April 2020, 425 LLS grafts were transplanted in children. 19 (4.5%) patients were diagnosed with biliary strictures at different times after transplantation (from 0.2 to 97 months). Results. Biliary strictures were more often formed a year after transplantation (17.8 ± 23.9 months). In 14 out of the 19 patients, internal-external biliary drainage was successfully performed with phased replacement of the catheter with one that was larger in diameter (from 8.5 Fr to 14 Fr). The catheters were removed in 8 patients after completion of the treatment cycle. Restenosis was not observed during follow-up (13 ± 8.7 months) after the internal-external biliary drainage catheter had been removed. In 5 cases, antegrade passage of a guide wire through the stricture was unsuccessful. As a result, biliary reconstruction was performed in 4 (21.1%) patients and retransplantation was required in 1 (5.3%) patient. Conclusion. An antegrade minimally invasive approach can successfully eliminate biliary strictures in most children after liver LLS graft transplantation. The proposed technique is effective and safe.
Sergey Gautier, Artem Monakhov, Igor Miloserdov, Sergey Arzumanov, Olga Tsirulnikova, Konstantin Semash, and Timur Dzhanbekov
Elsevier BV
With the presence of organ shortage, living donors remain important sources of grafts, especially for pediatric recipients. Laparoscopic nephrectomy has become the gold standard for living donors. Additionally, laparoscopic partial liver procurement in living donors has proven its safety and feasibility in the latest studies. We have combined both approaches to perform a simultaneous liver‐kidney transplantation in a pediatric patient from the same living donor. Our experience of laparoscopic left lateral sectionectomy and laparoscopic nephrectomy in living donors was the basis for adapting to this procedure. A 29‐year‐old mother was an ABO‐incompatible (ABOi) donor for the left lateral section (LLS) of the liver and left kidney for her 2‐year‐old son. The postoperative period was uneventful. Two sessions of plasmapheresis and rituximab induction were necessary to prepare for ABOi transplantation. The donor and recipient were discharged on postoperative days 5 and 28, respectively. Simultaneous laparoscopic left lateral sectionectomy and nephrectomy in the same living donor is feasible for transplantation from the parent to the child with advanced laparoscopic expertise.
Sergey Gautier, Artem Monakhov, Eduard Gallyamov, Olga Tsirulnikova, Evgeny Zagaynov, Timur Dzhanbekov, Konstantin Semash, Khizry Khizroev, Denis Oleshkevich, and Elena Chekletsova
Wiley
AbstractBackgroundLaparoscopic living donor liver procurement for transplantation has increased in popularity over the past decade. The purpose of this study was to compare the laparoscopic and open approaches in living donor left lateral sectionectomy (LLS) and to assess the safety and feasibility of this laparoscopic approach.MethodsA total of 103 living donor LLSs were performed at our center from May 2016 to December 2017. Of these, 35 were completely laparoscopic procedures, which represented the subject of this study. An additional 68 open living donor LLSs performed during the same period were studied as a comparison group. To overcome selection bias, LLS donors were balanced on a 1:1 ratio (laparoscopic [n = 35]: open [n = 35]) according to covariates with similar values. The PSM was based on the operation date, recipient age, diagnosis, recipient weight, and donor age.ResultsThere were significant differences between the laparoscopic and open LLS groups (P < 0.001) in terms of blood loss (96.8 ± 16.5 vs 155.8 ± 17.8 mL) as well as the duration of hospital stay (4 ± 0.4 vs 6.9 ± 0.5 days).ConclusionLaparoscopic LLS is a feasible and efficacious in the setting of a developed program with advanced laparoscopic expertise.
A. R. Monakhov, B. L. Mironkov, T. A. Dzhanbekov, K. O. Semash, Kh. M. Khizroev, and S. V. Gautier
V.I. Shimakov Federal Research Center of Transplantology and Artificial Organs
Introduction. Liver transplantation is a multi-component and complex type of operative treatment. Patients undergoing such a treatment sometimes are getting various complications. One of these complications is a portal hypertension associated with portal vein stenosis.Materials and methods. In 6 years after the left lateral section transplantation from living donor in a pediatric patient the signs of portal hypertension were observed. Stenosis of the portal vein was revealed. Due to this fact percutaneous transhepatic correction of portal vein stenosis was performed.Results. As a result of the correction of portal blood flow in the patient a positive trend was noted. According to the laboratory and instrumental methods of examination the graft had a normal function, portal blood flow was adequate. In order to control the stent patency Doppler ultrasound and MSCT of the abdominal cavity with intravenous bolus contrasting were performed. Due to these examinations the stent function was good, the rate of blood flow in the portal vein due to Doppler data has reached 80 cm/sec, and a decrease of the spleen size was noted.Conclusion. Diagnosis and timely detection of portal vein stenosis in patients after liver transplantation are very important for the preservation of graft function and for the prevention of portal hypertension. In order to do that, ultrasound Doppler fluorimetry examination needs to be performed to each patient after liver transplantation. In cases of violation of the blood flow in the portal vein CT angiography performance is needed. Percutaneous transhepatic stenting of portal vein is a minimally invasive and highly effective method of correction of portal hypertension. Antiplatelet therapy and platelet aggregation control are the prerequisites for successful stent function.