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 Federation10.15825/1995-1191-2022-3-64-73vtio-1510Research ArticleТрансплантация сердца и вспомогательное кровообращениеHeart Transplantation and Assisted CirculationПериоперационный период при трансплантации с экстремально длительным (более 6 часов) сроком ишемии донорского сердцаPerioperative period in heart transplantation with extremely prolonged ischemic times (>6 hours)ПопцовВ. Н.PoptsovV. N.

Попцов Виталий Николаевич

Адрес: 123182, Москва, ул. Щукинская, д. 1Тел. (963) 644-96-39

Vitaly Poptsov

Address: 1, Shchukinskaya str., Moscow, 123182Phone: (963) 644-96-39

poptsov_vit@mail.ruЗахаревичВ. М.ZakharevichV. M.

Москва

Moscow

СпиринаЕ. А.SpirinaE. A.

Москва

Moscow

КолосковаН. Н.KoloskovaN. N.

Москва

Moscow

ПчельниковВ. В.PchelnikovV. V.

Москва

Moscow

ХатуцкийВ. М.KhatutskiiV. M.

Москва

Moscow

СкоковаА. И.SkokovaA. I.

Москва

Moscow

ФомичевА. В.FomichevA. V.

Новосибирск

Novosibirsk

АлиевЭ. З.AlievE. Z.

Москва

Moscow

БороноваВ. В.BoronovaV. A.

Москва

Moscow

БерезнякА. В.BereznyakA. V.

Москва

Moscow

СолодовниковаА. К.SolodovnikovaA. K.

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 FederationФГБУ «Национальный медицинский исследовательский центр имени академика Е.Н. Мешалкина» Минздрава РоссииРоссияMeshalkin National Medical Research CenterRussian Federation2022240820222436473Copyright © Попцов В.Н., Захаревич В.М., Спирина Е.А., Колоскова Н.Н., Пчельников В.В., Хатуцкий В.М., Скокова А.И., Фомичев А.В., Алиев Э.З., Боронова В.В., Березняк А.В., Солодовникова А.К., 20222022Попцов В.Н., Захаревич В.М., Спирина Е.А., Колоскова Н.Н., Пчельников В.В., Хатуцкий В.М., Скокова А.И., Фомичев А.В., Алиев Э.З., Боронова В.В., Березняк А.В., Солодовникова А.К.Poptsov V.N., Zakharevich V.M., Spirina E.A., Koloskova N.N., Pchelnikov V.V., Khatutskii V.M., Skokova A.I., Fomichev A.V., Aliev E.Z., Boronova V.A., Bereznyak A.V., Solodovnikova A.K.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/1510

В условиях дефицита донорских сердец, отвечающих допустимым критериям, использование сердец от доноров с расширенными критериями, в том числе с длительным сроком ишемии, остается одним из реальных путей увеличения донорского пула и количества выполняемых трансплантаций сердца (ТС). В исследование включили 38 реципиентов – 33 (86,8%) мужчин и 5 (13,2%) женщин – в возрасте от 11 до 66 (44,7 ± 12,0, медиана 48,0) лет, которым была выполнена первичная (n = 37; 97,4%) или повторная (n = 1; 2,6%) ТС (ретрансплантация). Продолжительность ишемии сердечного трансплантата (n = 38) составила от 362 (6 ч 2 мин) до 571 (9 ч 31 мин), или 407 ± 52 мин (медиана 400 мин). У 33 (86,8%) из 38 реципиентов ранний посттрансплантационный период характеризовался удовлетворительной начальной функцией сердечного трансплантата. У 5 (13,1%) реципиентов развилась тяжелая первичная дисфункция сердечного трансплантата, потребовавшая посттрансплантационного применения ВА ЭКМО (n = 4; 10,5%) или пролонгирования предтрансплантационной ВА ЭКМО в течение 8 суток после ТС (n = 1; 2,6%). Госпитальная летальность составила 7,9% (n = 3); 35 (92,1%) из 38 реципиентов были выписаны из стационара; 3 реципиента умерли в постгоспитальном периоде на 734, 944 и 2146-й день после ТС; 32 (84,2%) из 38 реципиентов оставались живы на момент окончания исследования. Собственный опыт демонстрирует возможность результативного выполнения ТС от доноров с длительной ишемией сердечного трансплантата.

Amidst the shortage in viable donor hearts, the use of hearts from expanded criteria donors, including those with prolonged ischemic time, remains one of the real ways to increase the donor pool and number of heart transplantations (HTx) performed. The study included 38 recipients (33 (86.8%) men and 5 (13.2%) women) aged 11 to 66 (44.7 ± 12.0 years, median 48.0 years), who underwent primary (n = 37; 97.4%) or repeat (n = 1; 2.6%) HTx (retransplantation). Donor hearts (n = 38) with ischemic time ranged from 362 (6 hours 2 minutes) to 571 (9 hours 31 minutes) or 407 ± 52 minutes (median 400 minutes). In 33 (86.8%) of 38 recipients, the early posttransplant period was characterized by satisfactory initial graft function. Five (13.1%) recipients developed severe primary graft dysfunction, requiring post-transplant venoarterial extracorporeal membrane oxygenation (VA-ECMO) (n = 4; 10.5%) or prolongation of pre-transplant VA-ECMO within 8 days of HTx (n = 1; 2.6%). In-hospital mortality was 7.9% (n = 3). Thirty-five (92.1%) of 38 recipients were discharged from the hospital. Three recipients died in the post-hospital period at day 734, 944, and 2146 after HTx. Thirty-two (84.2%) of the 38 recipients remained alive at the end of the study. Our own experience shows that HTx from donors with prolonged ischemic time could be effective.

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