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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vtio</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник трансплантологии и искусственных органов</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Transplantology and Artificial Organs</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-1191</issn><publisher><publisher-name>Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15825/1995-1191-2025-2-189-211</article-id><article-id custom-type="elpub" pub-id-type="custom">vtio-1966</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Обзор литературы</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Literature Reviews</subject></subj-group></article-categories><title-group><article-title>Комбинированная последовательная ex vivo перфузия трансплантатов печени от доноров с расширенными критериями: современный взгляд на проблему</article-title><trans-title-group xml:lang="en"><trans-title>Combined sequential ex vivo perfusion of liver grafts from expanded criteria donors: a contemporary perspective</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Болдырев</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Boldyrev</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Болдырев Михаил Александрович</p><p>123182, Москва, ул. Щукинская, д. 1. </p></bio><bio xml:lang="en"><p>Mikhail А. Boldyrev</p><p>1, Shchukinskaya str., Moscow, 123182</p></bio><email xlink:type="simple">comex.ksb@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Грудинин</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Grudinin</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Грудинин Никита Владимирович</p><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">zbignev.religa@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Богданов</surname><given-names>В. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Bogdanov</surname><given-names>V. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Богданов Владимир Константинович</p><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">zbignev.religa@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Монахов</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Monakhov</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Монахов Артем Рашидович</p><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">zbignev.religa@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Готье</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gautier</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Готье Сергей Владимирович</p><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">zbignev.religa@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр трансплантологии&#13;
и искусственных органов имени академика В.И. Шумакова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Shumakov National Medical Research Center of Transplantology and Artificial Organs</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр трансплантологии&#13;
и искусственных органов имени академика В.И. Шумакова» Минздрава России;&#13;
ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Shumakov National Medical Research Center of Transplantology and Artificial Organs;&#13;
Sechenov University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>12</day><month>07</month><year>2025</year></pub-date><volume>27</volume><issue>2</issue><fpage>189</fpage><lpage>211</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Болдырев М.А., Грудинин Н.В., Богданов В.К., Монахов А.Р., Готье С.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Болдырев М.А., Грудинин Н.В., Богданов В.К., Монахов А.Р., Готье С.В.</copyright-holder><copyright-holder xml:lang="en">Boldyrev M.A., Grudinin V.N., Bogdanov V.K., Monakhov A.R., Gautier S.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.transpl.ru/vtio/article/view/1966">https://journal.transpl.ru/vtio/article/view/1966</self-uri><abstract><p>Несмотря на значительные изменения, произошедшие в области трансплантации печени (ТП) за последние 30 лет, «золотым стандартом» консервации аллографтов все это время оставалась статическая фармако- холодовая консервация. Интенсивно растущее несоответствие между потребностью в ТП и количеством органов вкупе со смертностью в листах ожидания вплоть до 20% вынуждает трансплантационное сооб- щество в значительной степени расширять критерии пригодности для доноров печени, что неминуемо сказывается на непосредственных и отдаленных результатах ТП. Динамическая консервация аллографтов печени уверенно демонстрирует положительные результаты в когорте доноров с расширенными крите- риями, в особенности в группе «высокого риска». За последнее десятилетие разрабатывались и активно изучались ряд методик, основанных на проведении перфузии в разных температурных режимах. Одним из важных направлений развития перфузионных технологий является комбинированная последовательная ex vivo перфузия, совмещающая несколько подходов. В данной работе описан современный опыт выпол- нения комбинированной последовательной машинной перфузии трансплантатов печени ex vivo с кратким освещением каждого из этапов, входящих в данный протокол.</p></abstract><trans-abstract xml:lang="en"><p>Despite significant advancements in the field of liver transplantation (LT) over the last 30 years, the gold standard for allograft preservation – static cold storage with pharmacological agents – has remained largely unchanged. The growing disparity between demand for liver transplants and shortage of donor livers, along with a high wai ting list mortality rate (potentially up to 20%), has forced transplant teams to broaden donor eligibility criteria. This expansion, however, has inevitably impacted both the immediate and long-term LT outcomes. Dynamiс preservation of liver allografts has shown consistently positive outcomes, particularly among expanded criteria donors, including those classified as high-risk donors» Over the past decade, several perfusion techniques, tegrating various temperature conditions, have been developed and are under active investigation. A significant advancement in this area is the emergence of combined sequential ex vivo machine perfusion, which integrates multiple perfusion strategies. This approach leverages the strengths of each method while mitigating their in- dividual limitations. This paper reviews current experience with combined sequential ex vivo perfusion of liver grafts, providing a concise overview of the key stages encompassed within this protocol.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ex vivo перфузия</kwd><kwd>перфузия печени</kwd><kwd>трансплантация печени</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ex vivo perfusion</kwd><kwd>liver perfusion</kwd><kwd>liver transplantation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kwong AJ, Kim WR, Lake JR, Schladt DP, Schnellinger EM, Gauntt K et al. OPTN/SRTR 2022 Annual Data Report: Liver. Am J Transplant. 2024 Feb; 24 (2S1): S176–S265. doi: 10.1016/j.ajt.2024.01.014. PMID: 38431359.</mixed-citation><mixed-citation xml:lang="en">Kwong AJ, Kim WR, Lake JR, Schladt DP, Schnellinger EM, Gauntt K et al. OPTN/SRTR 2022 Annual Data Report: Liver. 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