References

vtio

Вестник трансплантологии и искусственных органов

Russian Journal of Transplantology and Artificial Organs

1995-1191

Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation

10.15825/1995-1191-2019-4-108-120

vtio-1112

Research Article

ОБЗОРЫ ЛИТЕРАТУРЫ

LITERATURE REVIEWS

Новые тенденции в исследовании острого повреждения почек после трансплантации печени

New trends in the study of post-transplant acute kidney injury after liver transplantation

Ильинский

И. М.

Iljinsky

I. M.

Ильинский Игорь Михайлович

123182, Москва, ул. Щукинская, д. 1Тел. (999) 877-60-95

Iljinsky Igor Mihajlovich

1, Shchukinskaya str., Moscow, 123182Теl. (999) 877-60-95

iiljinsky@mail.ru

Цирульникова

О. М.

Tsirulnikova

O. M.

Москва

Moscow

ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияShumakov National Medical Research Center of Transplantology and Artificial OrgansRussian Federation

2019

02022020

214108120

2020

Ильинский И.М., Цирульникова О.М.

Iljinsky I.M., Tsirulnikova O.M.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.transpl.ru/vtio/article/view/1112

Проблема острого повреждения почек (ОПП) после трансплантации печени (ТП) является актуальной и остается в центре внимания многих исследователей. Этиология ОПП многофакторная, но главным является ишемическое и реперфузионное повреждение печеночного трансплантата. Развитию ОПП способствуют многочисленные дооперационные, интраоперационные и послеоперационные факторы риска. Использование стандартных классификаций AKIN, RIFLE и KDIGO способствовало улучшению диагностики ОПП после ТП. Однако определение уровня креатинина в сыворотке крови позволяет диагностировать ОПП только в поздние сроки развития этого синдрома. Поэтому в настоящее время исследования проводят по поиску путей ранней диагностики ОПП с помощью биомаркеров. Переход на молекулярный уровень не только повышает точность, но и обеспечивает раннюю диагностику ОПП. В настоящее время наиболее изучены диагностические возможности липокалина, ассоциированного с нейтрофильной желатиназой (NGAL). До настоящего времени не известны меры профилактики ОПП после ТП, а лечение этого синдрома нельзя признать удовлетворительным. Даже легкая форма ОПП после ТП может привести к летальному исходу, а при тяжелой форме, при которой используют заместительную почечную терапию, является риском смерти в реанимации. Более чем у половины пациентов с ОПП развивается хроническая болезнь почек, требующая проведения хронического гемодиализа.

Acute kidney injury (AKI) after liver transplantation (LT) is a pressing issue and remains the focus of many researchers. The etiology of AKI is multifactorial, but the main one is ischemia-reperfusion injury to the liver transplant. Numerous preoperative, intraoperative and postoperative risk factors contribute to the development of AKI. The use of standard classifications, such as AKIN, RIFLE and KDIGO, has improved post-transplant AKI diagnosis. However, determination of creatinine levels in the blood enables AKI diagnosis only in the later stages of this syndrome. Therefore, studies are currently underway to find ways of early diagnosis of AKI using biomarkers. Transition to a molecular level not only improves accuracy but also facilitates early diagnosis of AKI. Currently, the diagnostic capabilities of neutrophil gelatinase-associated lipocalin (NGAL) are the most investigated. To date, there are no known measures of preventing post-transplant AKI. Moreover, treatment of this condition cannot be considered satisfactory. Even a mild post-transplant AKI can be fatal. In severe AKI, where renal replacement therapy is used, there is a risk of death in the intensive care unit. More than half of AKI patients develop chronic kidney disease requiring chronic hemodialysis.

острое повреждение почектрансплантация печенифакторы рискапредикторыбиомаркеры

acute kidney injuryliver transplantationrisk factorspredictorsbiomarkers

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The authors declare that there are no conflicts of interest present.