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 Federation10.15825/1995-1191-2023-3-57-63vtio-1620Research ArticleКлиническая трансплантологияClinical TransplantologyЭффективность дистанционной ударно-волновой литотрипсии камней трансплантированной почки. Надежда или разочарование?Efficacy of extracorporeal shock wave lithotripsy for post-transplant kidney stones. Hope or Disappointment?ПоповС. В.PopovS. V.

Санкт-Петербург

St. Petersburg

info@lucaclinic.ruГусейновР. Г.HuseynovR. G.

Санкт-Петербург

St. Petersburg

info@lucaclinic.ruМилосердовИ. А.MiloserdovI. A.

Москва

Moscow

info@lucaclinic.ruКисильЮ В.KisilYu. V.

Санкт-Петербург

St. Petersburg

info@lucaclinic.ruСайдулаевД. А.SaydulaevD. A.

Москва

Moscow

priemtranspl@yandex.ruСадовниковС. В.SadovnikovS. V.

Москва

Moscow

priemtranspl@yandex.ruСивакК. В.SivakK. V.

Санкт-Петербург

St. Petersburg

kvsivak@gmail.comБуненковН. С.BunenkovN. S.

Санкт-Петербург

St. Petersburg

bunenkov2006@gmail.comПерепелицаВ. В.PerepelitsaV. V.

Санкт-Петербург

St. Petersburg

perepelitsa_vit@mail.ruЛелявинаТ. А.LelyavinaT. A.

Лелявина Татьяна Александровна,

197341, Санкт-Петербург, ул. Аккуратова, д. 2

St. Petersburg

tatianalelyavina@mail.ruСПб ГБУЗ «Клиническая больница Святителя Луки»РоссияSt. Luke’s Clinical HospitalRussian FederationСПб ГБУЗ «Клиническая больница Святителя Луки»; Санкт-Петербургский государственный университетРоссияSt. Luke’s Clinical Hospital; St. Petersburg State UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияShumakov National Medical Research Center of Transplantology and Artificial OrgansRussian FederationСПб ГБУЗ «Клиническая больница Святителя Луки»; ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени И.П. Павлова»; ФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Минздрава РоссииРоссияSt. Luke’s Clinical Hospital; Pavlov University; Almazov National Medical Research CentreRussian Federation2023050620232535763Copyright © Попов С.В., Гусейнов Р.Г., Милосердов И.А., Кисиль Ю.В., Сайдулаев Д.А., Садовников С.В., Сивак К.В., Буненков Н.С., Перепелица В.В., Лелявина Т.А., 20232023Попов С.В., Гусейнов Р.Г., Милосердов И.А., Кисиль Ю.В., Сайдулаев Д.А., Садовников С.В., Сивак К.В., Буненков Н.С., Перепелица В.В., Лелявина Т.А.Popov S.V., Huseynov R.G., Miloserdov I.A., Kisil Y.V., Saydulaev D.A., Sadovnikov S.V., Sivak K.V., Bunenkov N.S., Perepelitsa V.V., Lelyavina T.A.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/1620

Нефролитиаз почечного трансплантата является важной медико-социальной проблемой. Наличие конкрементов может длительное время не проявляться клинически вследствие особенностей оперативного пособия при трансплантации органа. Развитие хронической инфекции мочевыводящих путей и ухудшение функциональной способности почечного трансплантата при наличии камней может приводить к его гибели, что несет непосредственную угрозу жизни пациента. В существующих российских руководствах по лечению мочекаменной болезни на сегодняшний день отсутствует четкая стратегия ведения больных с пересаженной почкой.

Цель

Цель: систематизировать литературные данные по анализу результатов выполнения дистанционной ударно-волновой литотрипсии (ДУВЛ) и других методов у пациентов с наличием камней трансплантированной почки.

Результаты

Результаты. Было отобрано 35 публикаций по теме исследования. Обобщены сведения о различных вариантах терапии пациентов с конкрементами в трансплантате почки: эндоурологический подход, ДУВЛ, перкутанная (чрескожная) нефролитотрипсия (ПНЛТ), открытое хирургическое лечение (нефростомия, пиелолитотомия). Приведен современный зарубежный алгоритм тактики ведения пациентов с камнями в трансплантированной почке в зависимости от выраженности обструкции с сепсисом и размера конкремента.

Заключение

Заключение. 1. Наличие конкрементов в почечном трансплантате является клинической ситуацией, которая требует хирургического лечения. 2. В клинической практике могут быть использованы разные методы лечения: открытое вмешательство, ДУВЛ, ПНЛТ, ретроградные трансуретральные манипуляции. 3. В большинстве случаев тактика ведения пациентов определяется клинической картиной (наличие/отсутствие обструкции) и размерами конкремента. 4. Применение ДУВЛ как наиболее часто используемого метода свидетельствует о его эффективности и малотравматичности.

Nephrolithiasis in a transplanted kidney is an important medical and social problem. The presence of renal calculi may not manifest clinically for a long time due to the peculiarities of the surgical intervention during organ transplantation. Development of chronic urinary tract infection and deterioration of the functional ability of the renal transplant in the presence of kidney stones can lead to graft death, which is an immediate threat to the patient’s life. Existing Russian guidelines on the treatment of urolithiasis currently lack a clear strategy for the management of kidney transplant recipients.

Objective

Objective: to systematize literature data on analysis of the outcomes of extracorporeal shock wave lithotripsy (ESWL) and other methods in patients with post-transplant kidney stones.

Results

Results. Thirty-five publications on the research topic were selected. We summarized the information on various therapy options for patients with stones in transplanted kidney: endourological approach, ESWL, percutaneous nephrolithotripsy (PCNL), open surgical treatment (nephrostomy, pyelolithotomy). A modern foreign algorithm for the management of patients with post-transplant kidney stones depending on the severity of obstruction with sepsis and the size of the renal calculi is presented.

Conclusion

Conclusion. 1. The presence of stones in a kidney graft is a clinical situation that requires surgical treatment. 2. In clinical practice, different methods of treatment can be used, such as open intervention, ESWL, PCNL, retrograde transurethral manipulations. 3. In most cases, patient management tactics depend on the clinical picture (presence/absence of obstruction) and the size of the calculi. 4. The use of ESWL, as the most frequently used method, testifies to its efficiency and low-traumatic effect.

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