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 Federation10.15825/1995-1191-2021-4-47-61vtio-1426Research ArticleТрансплантация сердца и вспомогательное кровообращениеHeart Transplantation and Assisted CirculationАнтителоопосредованное отторжение трансплантата сердцаAntibody-mediated rejection in heart transplantationКванВ. С.KvanV. S.

Кван Вера Сергеевна

123182, ул. Щукинская, д. 1

Тел. (966) 326-28-24

Vera Kvan

1, Shchukinskaya str., Moscow, 123182, Russian Federation

Phone: (966) 326-28-24

vergy2008@mail.ruКолосковаН. Н.KoloskovaN. N.

Москва

Moscow

КачановаЮ. А.KachanovaYu. A.

Москва

Moscow

СайфуллинаН. Н.SayfullinaN. N.

Москва

Moscow

ГончароваА. Ю.GoncharovaA. Yu.

Москва

Moscow

КруглыйЛ. Б.KruglyL. B.

Москва

Moscow

ШевченкоА. О.ShevchenkoA. O.

Москва

Moscow

face@neicon.comФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияShumakov National Medical Research Center of Transplantology and Artificial OrgansRussian FederationФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России; ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский университет); ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииРоссияShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov University; Pirogov Russian National Research Medical UniversityRussian Federation2021121120212344761Copyright © Кван В.С., Колоскова Н.Н., Качанова Ю.А., Сайфуллина Н.Н., Гончарова А.Ю., Круглый Л.Б., Шевченко А.О., 20222022Кван В.С., Колоскова Н.Н., Качанова Ю.А., Сайфуллина Н.Н., Гончарова А.Ю., Круглый Л.Б., Шевченко А.О.Kvan V.S., Koloskova N.N., Kachanova Y.A., Sayfullina N.N., Goncharova A.Y., Krugly L.B., Shevchenko A.O.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/1426

Роль антителоопосредованного отторжения в прогнозе выживаемости реципиентов сердца изучается в клинической трансплантологии более 20 лет. Данный патологический процесс выступает значимым фактором риска развития сердечной недостаточности и васкулопатии трансплантата. Антителоопосредованное отторжение является результатом активации гуморального иммунного звена и выработки донорспецифических антител, которые вызывают повреждение миокарда за счет системы комплемента. Наличие донор-специфических антител связано с более низкой выживаемостью аллотрансплантата. Лечение антителоопосредованного отторжения должно проводиться с учетом степени отторжения и наличия или отсутствия дисфункции трансплантата. Основной принцип лечения заключается в ингибировании системы гуморального иммунитета на разных уровнях. В настоящее время в мировой клинической практике достигнуты значительные успехи в изучении данного вопроса, однако требуются дальнейшие исследования для определения и разработки оптимальных схем лечения пациентов с гуморальным отторжением трансплантата сердца.

The role of antibody-mediated rejection in predicting survival among heart recipients has been studied in clinical transplantology for over 20 years. This condition is a significant risk factor for heart failure and graft vasculopathy. Antibody-mediated rejection results from activation of the humoral immune system and production of donorspecific antibodies that cause myocardial injury through the complement system. The presence of donor-specific antibodies is associated with lower allograft survival. Treatment of antibody-mediated rejection should take into account the rejection category and the presence or absence of graft dysfunction. The main principle of treatment is to suppress humoral immunity at different levels. World clinical practice has made significant inroads into the study of this issue. However, further research is required to identify and develop optimal treatment regimens for patients with humoral rejection in cardiac transplantation.

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