vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2021-3-171-179vtio-1254Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSИммуносенесценция как причина индивидуализированной иммуносупрессивной терапии при трансплантации почкиImmunosenescence as a reason of individualizing immunosuppressive therapy in kidney transplantationФедулкинаВ. А.FedulkinaV. A.

Федулкина Вероника Андреевна, старший научный сотрудник хирургического отделения трансплантации почки, кандидат медицинских наук

129110, Москва, ул. Щепкина, д. 61/2, корп. 6

Veronika A. Fedulkina, Senior Researcher, Surgical Division of kidney transplantation

61/2, Schepkina str., Moscow, 129110

v.fedulkina@mail.ruВатазинА. В.VatazinA. V.

Ватазин Андрей Владимирович, руководитель хирургического отделения трансплантации почки, доктор медицинских наук, профессор

Москва

vatazin@yandex.ruКильдюшевскийА. В.KildyushevskiyA. V.

Кильдюшевский Александр Вадимович, заведующий курсом клинической трансфузиологии при кафедре анестезиологии и реанимации, доктор медицинских наук, профессор

Москва

Alexandr V. Kildyushevskiy, Head of the Clinical Transfusiology Course

Moscow

kildushev@yandex.ruЗулькарнаевА. Б.ZulkarnayevA. B.

Зулькарнаев Алексей Батыргараевич, главный научный сотрудник хирургического отделения трансплантации почки, доктор медицинских наук

Москва

Alexey B. Zulkarnayev, General researcher, Surgical Division of kidney transplantation

Moscow

7059899@gmail.comГубинаД. В.GubinaD. V.

Губина Дарья Владимирович, врач-нефролог хирургического отделения трансплантации почки

Москва

penzevadv@yandex.ruФедулкинаМ. П.FedulkinaM. P.

Федулкина Мария Павловна, клинический ординатор кафедры трансплантологии, нефрологии и хирургической гемокоррекции

Москва

Mariya P. Fedulkina, Resident

Moscow

fedulkinamasha@mail.ruГБУЗ Московской области «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского»РоссияVladimirsky Moscow Regional Research Clinical InstituteRussian Federation202117092021233171179Copyright © Федулкина В.А., Ватазин А.В., Кильдюшевский А.В., Зулькарнаев А.Б., Губина Д.В., Федулкина М.П., 20212021Федулкина В.А., Ватазин А.В., Кильдюшевский А.В., Зулькарнаев А.Б., Губина Д.В., Федулкина М.П.Fedulkina V.A., Vatazin A.V., Kildyushevskiy A.V., Zulkarnayev A.B., Gubina D.V., Fedulkina M.P.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/1254

Трансплантация пожилому реципиенту, очевидно, более сложна из-за существующих сопутствующих заболеваний, изменений фармакокинетики иммуносупрессивных препаратов, полипрагмазии и трансформации иммунореактивности (иммуносенесценции). В обзоре представлены данные о модификации адаптивного и врожденного иммунитета при старении и рассмотрена возможность как сокращенной, так и адаптированной иммуносупрессивной терапии у пожилых реципиентов почечных трансплантатов для достижения оптимального баланса между эффективностью и осложнениями.

Transplantation in elderly patients is obviously more challenging due to existing underlying diseases, changes in pharmacokinetics of immunosuppressive drugs, polypragmasy, and transformation of immunoreactivity (immunosenescence). Our review presents data on modification of adaptive and innate immunity during aging. It also considers the possibility of both reduced and adapted immunosuppressive therapy in elderly renal transplant recipients in achieving an optimal balance between efficacy and complications.

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