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 Federation10.15825/1995-1191-2024-3-43-55vtio-1738Research ArticleКлиническая трансплантологияClinical TransplantologyВзаимосвязь режимов перфузионной подготовки аллографта и частоты развития артериальных и билиарных осложнений при ортотопической трансплантации печениRelationship between allograft perfusion preparation variations and rate of arterial and biliary complications in orthotopic liver transplantationБоровикВ. В.BorovikV. V.

Боровик Владимир Владимирович - ведущий научный сотрудник, врач-хирург

197758, Санкт-Петербург, ул. Ленинградская, 70

Vladimir V. Borovik

70, Leningradskaya str., St. Petersburg, 197758

 

borovik1968@yandex.ruТилеубергеновИ. И.TileubergenovI. I.

Тилеубергенов Инхат Ибрагимович

Санкт-Петербург

St. Petersburg

inkhat@mail.ruМоисеенкоА. В.MoiseenkoA. V.

Моисеенко Андрей Викторович

Санкт-Петербург

St. Petersburg

med_moiseenko@mail.ruМайстренкоД. Н.MaystrenkoD. N.

Майстренко Дмитрий Николаевич

Санкт-Петербург

St. Petersburg

may64@inbox.ruГрановД. А.GranovD. A.

Гранов Дмитрий Анатольевич

Санкт-Петербург

St. Petersburg

dmitriigranov@gmail.comФГБУ «Российский Научный Центр Радиологии и Хирургических Технологий им. академика А.М. Гранова» МЗ РФРоссияRussian Research Center of Radiology and Surgical TechnologiesRussian Federation2024100420242634355Copyright © Боровик В.В., Тилеубергенов И.И., Моисеенко А.В., Майстренко Д.Н., Гранов Д.А., 20242024Боровик В.В., Тилеубергенов И.И., Моисеенко А.В., Майстренко Д.Н., Гранов Д.А.Borovik V.V., Tileubergenov I.I., Moiseenko A.V., Maystrenko D.N., Granov D.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/1738Цель

Цель: оценить возможное влияние различных режимов перфузионной подготовки трансплантата на частоту развития билиарных и сосудистых осложнений ортотопической трансплантации печени (ОТП).

Материалы и методы

Материалы и методы. Обработаны данные 287 трансплантаций полноразмерной печени от доноров с установленным диагнозом «смерть мозга» и бьющимся сердцем. Число первичных и повторных ОТП составило 262 и 25 соответственно. Перед завершением формирования портального анастомоза и включением в системный кровоток проводили перфузию трансплантата гипо- (группа 2) и изотермическим (группа 4) физиологическим раствором с целью минимизации гемодинамических нарушений.

Результаты

Результаты. Отмечена статистически достоверная разница между группами 2 и 4 в развитии поздних (р = 0,04) и кумулятивных билиарных осложнений (р = 0,01). Установлена связь между наличием этих осложнений и типом перфузии (точный критерий Фишера = 0,02). Разница в частоте развития тромбозов в исследуемых группах не получена.

Заключение

Заключение. Проведенный анализ приводит к мнению о нецелесообразности использования гипотермических растворов при перфузионной подготовке трансплантата печени перед запуском в системный кровоток.

Objective

Objective: to evaluate the possible influence of different graft perfusion preparation variations on the incidence of biliary and vascular complications of orthotopic liver transplantation (OLT).

Materials and methods

Materials and methods. Data on 287 full-size liver transplants from donors with brain death and beating heart were processed. There were 262 and 25 primary and repeat OLTs, respectively. Before completion of portal anastomosis formation and inclusion into systemic blood flow, the graft was perfused with hypo- (group 2) and isotonic (group 4) saline in order to minimize hemodynamic disorders.

Results

Results. There was a statistically significant difference between groups 2 and 4 in the development of late (p = 0.04) and cumulative biliary complications (p = 0.01). The presence of these complications and the perfusion type were found to be associated (Fisher’s exact test = 0.02). There were no differences in incidence of thrombosis in the studied groups.

Conclusion

Conclusion. The conducted analysis suggests that it is inexpedient to use hypothermic solutions when preparing a liver transplant for perfusion before introducing it into systemic circulation.

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