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Biodegradable film compositions based on natural biopolymer gelatin with immobilized colchicine were prepared and their efficiency in prevention of the adhesion process in the pericardium was evaluated on rabbit model of postoperative pericarditis. The use of gelatin-based biodegradable film compositions significantly reduced the intensity of adhesion formation in the pericardial cavity, while immobilization of anti-inflammatory drug colchicine amplified their anti-adhesion activity.

The study was performed in a group of 25 patients with acute necrotizing pancreatitis (mean age 46.2 ± 6.74 years). Gender differences of the hemostasis postagressive early response in the early stages of the disease were identified by comparing the procoagulant , anticoagulant and fibrinolytic blood activity of men and women suffering from pancreatitis. Compared to men, women showed higher concentrations of fibrinogen, D-dimer and VWF and smaller values marked trombokrit , antithrombin III, inhibitor of plasmin and protein C (p < 0.05). These results suggest a greater tendency to thrombi formation in women with acute pancreatitis; We believe that gender differences should be the subject of further research.

The article deals with the safety and efficiency of recombinant activated factor VII (Coagil VII, Russia) and prothrombin complex concentrate (protromplex-600, Baxter Austria) in the neonatal and pediatric cardiac surgery. The study included 56 children aged from 7 days to 5.5 years underwent surgery with cardiopulmonary bypass for congenital heart defects repair. Clinical and laboratory evidences suggest that Coagil VII and protromplex-600 effective for bleeding stop. The drugs have no negative impact on hemodynamics. We did not identify allergic reactions and thrombosis associated with the introduction of drugs in the pen operative period.

We measured the level of cardiac markers (high-sensitivity troponin T and MB fraction of creatine kinase) in children of the first year of life with congenital heart disease in the perioperative period. After cardiac surgery, plasma levels of the above markers exceed the reference limits in the examined children. The diagnosis of myocardial ischemia using biochemical markers in the postoperative period is possible only by dynamic monitoring of the cardiac marker level. The preoperative concentration of high-sensitivity troponin T in children of the first year of life with congenital heart disease can be regarded as a predictor of postoperative complications.

Cardiopulmonary bypass (CPB) reduces coagulation factor levels through hemodilution and consumption. Differences in CPB-induced alterations of factor XIII (FXIII) levels in children with cyanotic and acyanotic congenital heart defects (CHDs) are not well characterized. FXIII activity (determined by Berichrom assay), prothrombin index, activated partial thromboplastin time, and fibrinogen were measured before open heart surgery with CPB and 5 days postoperatively for children older than 3 years with acyanotic (n = 30) and cyanotic (n = 30) CHDs. The preoperative FXIII levels did not differ significantly among the children of the compared groups. The cyanotic patients showed a significantly longer duration of CPB (111.4 ± 45.8 vs 71.5 ± 33.6 min; p = 0.026) and aortic cross-clamp (68.0 ± 27.1 vs 45.4 ± 31.4 min; p = 0.034). The drop in FXIII levels after termination of CPB was more profound for the children with cyanotic CHDs (87.1 ± 13.4 to 49.1 ± 13.2 vs 81.5 ± 12.6 to 58.6 ± 11.1 %, respectively; p = 0.018). The cyanotc patients also were restored to their baseline FXIII levels later than the children with acyanotic CHDs (at 48 vs 24 h). The post-CPB dynamics of the majority of the other coagulation parameters in the compared groups of patients were similar. The cyanotic patients experienced significantly greater postoperative blood loss than the acyanotic patients (12.6 ± 4.9 vs 5.0 ± 2.1 mL/kg; p < 0.001) and were transfused with larger volumes of red blood cells (10.4 ± 6.5 vs 4.2 ± 2.5 mL/kg; p = 0.007). The decrease in FXIII levels after CPB is more profound and lasts longer in children with cyanotic CHDs than in acyanotic patients. The rational strategy of postoperative FXIII replacement therapy for these categories of patients needs to be determined.

A unique operon structure has been identified in the genomes of several plant- and insect-associated bacteria. The distinguishing feature of this operon is the presence of tandem hilA and hilB genes encoding dioxygenases belonging to the PF13640 and PF10014 (BsmA) Pfam families, respectively. The genes encoding HilA and HilB from Pantoea ananatis AJ13355 were cloned and expressed in Escherichia coli. The culturing of E. coli cells expressing hilA (E. coli-HilA) or both hilA and hilB (E. coli-HilAB) in the presence of l-isoleucine resulted in the conversion of l-isoleucine into two novel biogenic compounds: l-4'-isoleucine and l-4,4'-dihydroxyisoleucine, respectively. In parallel, two novel enzymatic activities were detected in the crude cell lysates of the E. coli-HilA and E. coli-HilAB strains: l-isoleucine, 2-oxoglutarate: oxygen oxidoreductase (4'-hydroxylating) (HilA) and l-4'-hydroxyisoleucine, 2-oxoglutarate: oxygen oxidoreductase (4-hydroxylating) (HilB), respectively. Two hypotheses regarding the physiological significance of C-4(4')-hydroxylation of l-isoleucine in bacteria are also discussed. According to first hypothesis, the l-isoleucine dihydroxylation cascade is involved in synthesis of dipeptide antibiotic in P. ananatis. Another unifying hypothesis is that the C-4(4')-hydroxylation of l-isoleucine in bacteria could result in the synthesis of signal molecules belonging to two classes: 2(5H)-furanones and analogs of N-acyl homoserine lactone., (© 2013 The Authors. Microbiology Open published by John Wiley & Sons Ltd.)

Medical technologies development and recent approaches in management of patients with septic complications during the early postoperative period present new obstacles to the laboratory service. Endotoxin is a main agent in the systemic inflammatory cascade and plays important role in sepsis pathogenesis. Recent express methods of diagnostics allow determining blood activity of endotoxin during 30-50 min. 55 ICU patients with clinical and laboratory signs of systemic inflammatory response syndrome (SIRS) after cardiac surgery were studied in the single-center prospective research. Endotoxaemia was diagnosed by express tests. Level of endotoxaemia was assessed before and after sorption in 15 patients receiving complex intensive care with selective lipopolysaccharide (LPS) adsorption. Endotoxaemia level assessment allows to define indications for different programs of intensive care in time and to assess its efficiency. Test systems for assessment endotoxin level based on the principle of interaction antigen - antibody (EAA and MACH-endotox spp.) is a most efficient for express diagnostics of endotoxaemia.

4-Hydroxyisoleucine (HIL) found in fenugreek seeds has insulinotropic and anti-obesity effects and is expected to be a novel orally active drug for insulin-independent diabetes. Here, we show that the newly isolated strain Bacillus thuringiensis 2e2 and the closely related strain B. thuringiensis ATCC 35646 operate a novel metabolic pathway for L-isoleucine (L-Ile) via HIL and 2-amino-3-methyl-4-ketopentanoic acid (AMKP). The HIL synthesis was catalyzed stereoselectively by an α-ketoglutaric acid-dependent dioxygenase and to be useful for efficient production of a naturally occurring HIL isomer, (2S,3R,4S)-HIL. The (2S,3R,4S)-HIL was oxidized to (2S,3R)-AMKP by a NAD(+)-dependent dehydrogenase. The metabolic pathway functions as an effective bypass pathway that compensates for the incomplete tricarboxylic acid (TCA) cycle in Bacillus species and also explains how AMKP, a vitamin B(12) antimetabolite with antibiotic activity, is synthesized. These novel findings pave a new way for the commercial production of HIL and also for AMKP.

Results of combined radiosurgical treatment with larynx preservation, and pre- and postoperative distant external irradiation, were evaluated. Forty-eight patients with locally advanced laryngeal cancer received single-step individually-tailored tissue application, followed by high-dose brachytherapy. Discriminative function of the larynx was restored in all patients within 2 days involving swallowing disturbances in 8%. Breathing function was restored in 98% within 2 days to 6 months after completion of treatment. Three-year relapse-free survival was 95.8%.

The stereo-specific L-isoleucine-4-hydroxylase (L-isoleucine dioxygenase (IDO)) was cloned and expressed in an Escherichia coli 2Δ strain lacking the activities of α-ketoglutarate dehydrogenase (EC 1.2.4.2), isocitrate liase (EC 4.1.3.1), and isocitrate dehydrogenase kinase/phosphatase (EC 2.7.11.5). The 2Δ strain could not grow in a minimal-salt/glucose/glycerol medium due to the blockage of TCA during succinate synthesis. The IDO activity in the 2Δ strain was able to "shunt" destroyed TCA, thereby coupling L-isoleucine hydroxylation and cell growth. Using this strain, we performed the direct biotransformation of L-isoleucine into 4-HIL with an 82% yield.

The methods of the prevention, diagnosis, and correction of hemostatic disorders are discussed in cardiosurgical patients. Prevention of hemorrhages requires hemostatic history data collection that allows identification of patients with concomitant hemophilia and those, taking antithrombotic drugs. The benefits of an extended study of blood coagulation disorders are shown in neonates and babies of the first year of life due to the physiological features of the hemostatic system and the pattern of heart disease. Algorithms are proposed for the diagnosis and treatment of hemorrhagic diathesis in the early postoperative period; a complex of minor signs of surgical hemorrhage is formulated, which makes it possible to timely perform rethoracotomy and to reduce blood transfusion. Efficiency evaluation and exclusion criteria for the use of recombinant factor VIIa are given. The efficiency of using the Russian drug tranexam versus epsilon-aminocapronic acid and aprotinin in the perioperative period was evaluated. The blood coagulative system was monitored in the treatment of disseminated intravascular coagulation in multiple organ dysfunction and sepsis, which promoted the timely use of recombinant human activated protein C and human antithrombin III. A diagnostic and treatment algorithm for replacement therapy of congenital heart disease concurrent with hemophilia A is given.

The paper describes and analyzes the initial period in the formation of cardiac resuscitation service at the A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, from the first heart operation performed in the USSR to the setting up of the resuscitation-anesthesiology department. On September 24, 1948, A. N. Bakulev was the first in the USSR to make an operation for congenital heart disease, the successful outcome of which predetermined anesthetic maintenance and antishock measures as well. On May 1959, the Institute of Thoracic Surgery, U.S.S.R. Academy of Medical Sciences, began performing heart operations under extracorporeal circulation. The number of postoperative complications has increased due to the higher severity of diseases and the complexity of open heart surgery. This has made the rehabilitative period require that vital function recovery specialists should participate more frequently (Smirenskaya Ye. M.), which ultimately give birth to a resuscitation department in January 1967 (Levant A. D.) and its transformation to a resuscitation-anesthesiology department on October 31, 1973 (Malyshev V. D.).

The unique function of 4-hydroxyisoleucine (4-HIL) is to stimulate glucose-induced insulin secretion in a glucose-dependent manner. 4-HIL is distributed only in certain kinds of plants and mushrooms, but the biosynthetic mechanism of 4-HIL has not been elucidated. Moreover, 4-HIL-producing microorganisms have not been reported. l-isoleucine (l-Ile) hydroxylating activity producing 4-HIL was detected in a cell lysate of Bacillus thuringiensis strain 2e2 AKU 0251 obtained from the mid-late exponential phase of growth. Properties of the purified hydroxylase demonstrated that it is a alpha-ketoglutaric acid (alpha-KG) dependent l-Ile dioxygenase (IDO) and requires alpha-KG, ferric ion, and ascorbic acid for its maximum activity. IDO showed high stereoselectivity in l-Ile hydroxylation producing only (2S,3R,4S)-4-HIL. The N-terminal 22 amino acids sequence revealed high homology to a hypothetical protein (GenBank ID: RBTH&#95;06809) in B. thuringiensis serovar israelensis ATCC 35646. The histidine motif, which is conserved in alpha-KG dependent dioxygenases, is found in RBTH&#95;06809.

Early in the new millennium, sepsis remains one of the most urgent problems of modern medicine as before in view of a steady tendency for a rise of morbidity rates and for stably high mortality rates in patients (from 30 to 70%). The endotoxin lipopolysaccharide (LPS) of the cell wall of gram-negative bacteria plays the most important role in the pathogenesis of sepsis. This paper assesses the first experience in using endotoxin-selective sorption technologies within complex intensive care of critically ill patients with infectious and septic complications after cardiac surgery. Group 1 comprised 6 patients undergoing Alteco LPS adsorption procedures. Group 2 included 5 patients having hemoperfusion using Polymixin B-based Toraymyxin columns. The authors'first experience in clinically using LPS adsorption suggests that it is absolutely expedient to include extracorporeal selective hemoperfusion into the complex intensive care for infectious and septic complications in patients after operations on the heart and vessels.

A two-step enzymatic synthesis process of 4-hydroxyisoleucine is suggested. In the first step, the aldol condensation of acetaldehyde and alpha-ketobutyrate catalyzed by specific aldolase results in the formation of 4-hydroxy-3-methyl-2-keto-pentanoate (HMKP). In the second step, amination of HMKP by the branched-chain amino acid aminotransferase leads to synthesis of 4-hydroxyisoleucine. An enzyme possessing HMKP aldolase activity (asHPAL) was purified 2500-fold from a crude extract of Arthrobacter simplex strain AKU 626. Sequencing of the asHPAL structural gene showed that the purified enzyme belongs to the HpcH/HpaI aldolase family. The 4-hydroxyisoleucine was synthesized in vitro from acetaldehyde, alpha-ketobutyrate and l-glutamate using a coupled aldolase/branched-chain amino acid aminotransferase bienzymatic reaction.

Arthrobacter simplex AKU 626 was found to synthesize 4-hydroxyisoleucine from acetaldehyde, alpha-ketobutyrate, and L-glutamate in the presence of Escherichia coli harboring the branched chain amino acid transaminase gene (ilvE) from E. coli K12 substrain MG1655. By using resting cells of A. simplex AKU 626 and E. coli BL21(DE3)/pET-15b-ilvE, 3.2 mM 4-hydroxyisoleucine was produced from 250 mM acetaldehyde, 75 mM alpha-ketobutyrate, and 100 mM L-glutamate with a molar yield to alpha-ketobutyrate of 4.3% in 50 mM Tris-HCl buffer (pH 7.5) containing 2 mM MnCl(2) x 4H(2)O at 28 degrees C for 2 h. An aldolase that catalyzes the aldol condensation of acetaldehyde and alpha-ketobutyrate was purified from A. simplex AKU 626. Mn(2+) and pyridoxal 5'-monophosphate were effective in stabilizing the enzyme. The native and subunit molecular masses of the purified aldolase were about 180 and 32 kDa respectively. The N-terminal amino acid sequence of the purified enzyme showed no significant homology to known aldolases.

Prothrombin time (PT) is usually measured in citrated venous blood. This test is undesirable in pediatric practice and in patients taking anticoagulants due to frequent venepunctures. Capillary blood PT test has no adverse impact. The authors have developed a standardized modified method for PT measurement in capillary blood. The adequacy of the test is due to the fact that analyzed test packed cell volumes are kept in mind. The modified test has shown that the values of normal plasma PT may be used to calculate an international normalized ratio (INR). It makes it possible to determine capillary blood PT in the range of packed cell volumes from 0.15 to 0.7 in the examinees and to monitor anticoagulant therapy. The results of the modified test closely correlated with those when determining PT and INR in venous plasma (r = 0.99) and applying the CoaguChek test (r = 0.97).

Surgical treatment of complex congenital heart disease under extracorporeal circulation is accompanied by a systemic inflammatory reaction occurring in neonatal infants and babies. There were drastic increases in the concentration of tumor necrosis factor, interleukin-8, neutrophilic elastase and a predominance of a proinflammatory response over an inflammatory one at the warming stages and after administration of protamine sulfate. The rate of an inflammatory response depended on the duration of extracorporeal circulation. Modified ultrafiltration could remove cytokines; however, their concentration in the body remains high. A relationship was found between the course of a postoperative period and the rate of a developing reaction to extracorporeal circulation in the surgical treatment of congenital heart diseases.

The present study comparatively analyzed the clinical effects of three solutions used to fill an extracorporeal circulatory circuit (ECCC). The arterial and venous blood samples taken from patients operated on for valvular disease and coronary heart disease were studied. All patients (n = 61) were divided into 3 groups according to the basic component of the primary volume of ECCC filling: 1) Ringer's crystalloid solution; 2) gelofusin; 3) the hydroxyethyl starch 130/0.4 Voluven. The resultant samples were examined for the following parameters: a) hematological: the levels of formed blood elements, hemoglobin, erythrocytic hemoglobin, and free hemoglobin and the histograms of leukocytes, erythrocytes, and platelets; b) physicochemical: arterial and venous blood pH, pO2, pCO2, SatO2; c) biochemical: blood electrolytic balance and lactate levels. The values of hemoglobin, hematocrit, and blood gas composition were used to calculate oxygen consumption (ml/min x m2). The parameters of central hemodynamics and the temperatures in the rectum, esophagus, and venous oxygenator port were continuously monitored during extracorporeal circulation (EC). At its end, overall diuresis and water balance were determined. The plasma-substituting effect of Voluven was found to be highly effective during a clinical study. The found beneficial properties of the agent may be particularly attractive while applying EC to the surgery of acquired heat diseases when the duration of an operation and, accordingly, extracorporeal support forces the physician to administer large solution doses many times.

Background: Oral anticoagulant therapy is monitored by a prothrombin time (PT) assay. The PT is standardised by the International Normalised Ratio (INR). The purpose of this study was to work out a modified method of PT/INR measurement in capillary blood for monitoring anticoagulation treatment., Methods: Healthy donors, subjects with high or low haematocrit values, and oral anticoagulant-treated patients were included in the study. Plasma and capillary blood PT/INRs were determined by the standard Quick clotting assay, by the modified approach and with the CoaguChek S analyser., Results: The performance characteristics of the developed method were accuracy, due to taking into account whole capillary blood haematocrit values, and precision, due to a decrease in the viscosity of the analysed samples. Implementation of the modified method showed that it is possible to use PT values of normal plasma for capillary blood INR calculation. The developed method allowed the determination of PT in capillary blood within the haematocrit value range from 0.15 up to 0.7. For capillary blood, the results of the modified method closely correlated with PT/INR values determined by the reference Quick method in venous plasma (r=0.99) and with the CoaguChek S analyser (r=0.97)., Conclusions: The modified method of capillary blood PT/INR determination could be recommended for oral anticoagulant therapy monitoring.

Gamma-aminobutyraldehyde dehydrogenase (ABALDH) from wild-type E. coli K12 was purified to apparent homogeneity and identified as YdcW by MS-analysis. YdcW exists as a tetramer of 202+/-29 kDa in the native state, a molecular mass of one subunit was determined as 51+/-3 kDa. Km parameters of YdcW for gamma-aminobutyraldehyde, NAD+ and NADP+ were 41+/-7, 54+/-10 and 484+/-72 microM, respectively. YdcW is the unique ABALDH in E. coli K12. A coupling action of E. coli YgjG putrescine transaminase and YdcW dehydrogenase in vitro resulted in conversion of putrescine into gamma-aminobutyric acid.

Background: Putrescine is the intermediate product of arginine decarboxylase pathway in Escherichia coli which can be used as an alternative nitrogen source. Transaminase and dehydrogenase enzymes seem to be implicated in the degradative pathway of putrescine, in which this compound is converted into gamma-aminobutyrate. But genes coding for these enzymes have not been identified so far., Results: The 1.8-kbp DNA fragment containing E. coli K12 ygjG gene with aer-ygjG intergenic region was examined. It was found that the fragment contains sigma54-depended open reading frame (ORF) of 1,380 nucleotides encoding a 459-amino acid polypeptide of approximately 49.6 kDa. The cytidine (C) residue localized 10 bp downstream of the sigma54 promoter sequence was identified as the first mRNA base. The UUG translation initiation codon is situated 36 nucleotides downstream of the mRNA start. The YgjG was expressed as a his6-tag fused protein and purified to homogeneity. The protein catalyzed putrescine:2-oxoglutaric acid (2-OG) aminotransferase reaction (PATase, EC 2.6.1.29). The Km values for putrescine and 2-OG were found to be 9.2 mM and 19.0 mM, respectively. The recombinant enzyme also was able to transaminate cadaverine and, in lower extent, spermidine, and gave maximum activity at pH 9.0., Conclusion: Expression of E. coli K12 ygjG coding region revealed sigma54-depended ORF which encodes a 459-amino acid protein with putrescine:2-OG aminotransferase activity. The enzyme also was able to transaminate cadaverine and, in lower extent, spermidine.

Patients with congenital heart diseases (CHD) aged 4 months to 12 years, hospitalized for surgical treatment, were examined. Complex viscosity of the blood and the constituents of this parameter (dynamic viscosity and elastic component) were evaluated in the range of shift strain corresponding to the range of shift velocities 0.37-500 s-1 at a frequency of 2 Hz. The threshold blood fluidity was estimated for evaluating the conditions under which erythrocyte disaggregation begins. The relationship between blood rheology and morphofunctional characteristics of blood cells was evaluated. In accordance with the findings, the patients were divided into 3 groups with different suspension stability of the blood. In group 1 the threshold fluidity approximated the norm. In group 2 with normal blood rheology the shifts were compensated and regulation of rheology was in general intact. In group 3 the hematocrit values, mean erythrocyte volume, mean concentration of hemoglobin in erythrocyte, leukocyte counts, and complex viscosity of the blood were the highest, while the suspension stability was the lowest, which indicates depletion of the adaptive potential of the organism. Hence, blood rheology in patients with CHD differs by the type of regulation, mechanisms and compensation of changes, and depend largely on the mean erythrocyte volume, mean hemoglobin concentration in erythrocytes, and leukocyte counts.

Hematological status of infants with congenital heart disease (CHD) was evaluated by automated systems. Blood analyses were carried out in 40 infants with the pale type and in 20 with the blue type CHD. Increased erythrocyte count and hematocrit were detected in the blue type CHD. Evaluation of the leukocytic formula showed correlation of the results of automated analysis and microscopic analysis of a blood smear. Automated method is preferable for estimating platelet count. Platelet count was decreased and the cells were larger in patients with the blue type disease in comparison with the pale type group. Hence, automated analyzer gives a wide spectrum of blood values with high accuracy and productivity and helps evaluate hemopoiesis in patients with CHD.

Expression plasmids containing the synthetic gene hil-4 delta 2 was constructed to produce human interleukin-4 in Escherichia coli cells. Strains TG1 (pBTIL-4 delta 2) and BL21 (DE3) (pETIL-4 delta 2) produced the recombinant protein as inclusion bodies, and its production level was up to 30% of the total cell protein. The renatured hIL-4 delta 2 inhibited IL-4-stimulated T cell proliferation, and this effect was enhanced by cyclosporin A.

Modified ultrafiltration (MUF) was used in radical correction of complex congenital heart disease in 61 newborns and infants. The children were divided into 2 groups: group 1, 46 patients subjected to MUF, and group 2, 15 children operated on without MUF. Hemodynamic, hematological, biochemical, and immunological parameters were monitored. MUF in the newborns and infants helped adequately correct the hemohydrobalance due to ultrafiltration in the patient and hemoconcentration of the remaining volume in artificial ventilation device; it normalized the hematocrit values without additional infusion of donor blood. Elimination of inflammation mediators and cytokines recommends MUF for the treatment of newborns and infants.

Autohemotransfusion is one of the perspective methods of transfusion used in cardiosurgery. Intraoperative autohemotransfusion was used in surgical correction of congenital heart diseases in patients of various age groups, including children aged 6 to 8. The exfusion volume made up 300-600 ml, depending on the patient's body mass and the hematologic parameters. Clinical follow-up and assessment of the laboratory parameters have proved the possibility of blood exfusion in the patients with the blue congenital heart disease. Autoblood infusion was performed directly after artificial circulation switch-off, this providing a better hemostasis stabilization and correction of the patient's hemogram. Autoblood volume in blood substitution made up 30% on an average, this saving donor blood.

Ultraviolet (UV) blood irradiation has been performed in 11 patients with postoperative sepsis. UV blood irradiation was not accompanied by blood cell damage and stress reaction to irradiation. Already after the first session all the patients demonstrated a decrease in the maximum daily body temperature. Most patients revealed improvement in their somatic condition. Positive clinical effect was observed in 8 patients, 4 patients recovered completely. UV blood irradiation in combination with conventional therapeutic techniques may be used in the management of postoperative septic complications in cardiosurgical patients.

Results of differentiated administration of blood components to cardiac surgical patients are presented. Frozen washed erythrocytes and erythromass were successively used in the perfusate and postoperatively. A transfusion pattern for patients with rare A2B blood group has been elaborated. The feasibility of prevention of artificial-circulation-induced thrombocytopenia by introduction of large quantities of platelet components right after AC is demonstrated. The necessity of the ACT-test for adequate blood heparinisation and neutralisation during the AC is established. Results of successful autohemotransfusion in cardiac surgery and application of fibrinolytic blood and its components are discussed.

On the basis of an analysis of immunological and hematological indices the authors have shown the role of activation of physiological hemolysis, immunization of the organism by erythrocyte antigens, inhibition of erythropoiesis due to intoxication and massive hemotransfusions in the development of early and late anemias after operations for congenital and acquired heart diseases under conditions of the artificial blood circulation. The authors propose recommendations for the prevention of such anemias.