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 Federation10.15825/1995-1191-2025-3-33-45vtio-2006Research ArticleКЛИНИЧЕСКАЯ ТРАНСПЛАНТОЛОГИЯCLINICAL TRANSPLANTOLOGYИстория педиатрической трансплантации печени: от истоков до современностиEvolution of pediatric liver transplant: from inception to modern practicehttps://orcid.org/0000-0002-3537-6601МонаховА. Р.MonakhovA. R.

Монахов Артем Рашидович - руководитель отделения трансплантации печени

123182, Москва, ул. Щукинская, д. 1

Тел. (906) 078-16-21

Artem R. Monakhov.

1, Shchukinskaya str., Moscow, 123182

Phone: (906) 078-16-21

a.r.monakhov@gmail.comhttps://orcid.org/0000-0003-0633-678XГотьеС. В.GautierS. V.

Готье Сергей Владимирович - доктор медицинских наук, профессор, академик РАН, Директор НМИЦ ТИО им. ак. В.И. Шумакова; заведующий кафедрой Трансплантологии и Искусственных Органов Первого МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет).

Москва

Moscow

gautier@list.ruhttps://orcid.org/0000-0003-3965-5277ЦирульниковаО. М.TsirulnikovaO. M.

Цирульникова Ольга Мартеновна - доктор медицинских наук, врач-гепатолог НМИЦ ТИО им. ак. В.И. Шумакова; профессор кафедры Трансплантологии и Искусственных Органов Первого МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет).

Москва

Moscow

tsiroulnikova@mail.ruФГБУ «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)РоссияShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityRussian Federation2025030920252733345Copyright © Монахов А.Р., Готье С.В., Цирульникова О.М., 20252025Монахов А.Р., Готье С.В., Цирульникова О.М.Monakhov A.R., Gautier S.V., Tsirulnikova O.M.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/2006

Статья посвящена историческим аспектам становления и развития педиатрической трансплантации печени, начиная с первых экспериментальных операций и завершая современными высокотехнологичными подходами. Трансплантация печени у детей на протяжении всего периода своего развития неоднократно становилась драйвером инноваций и новых хирургических методик. Первые попытки трансплантации печени у детей были сопряжены с многочисленными техническими и иммунологическими трудностями и характеризовались крайне высокой летальностью. Поворотным моментом стало внедрение циклоспорина А в 1980-е годы. В этот же период начали использоваться редуцированные трансплантаты, сплит-трансплантация и впервые были выполнены успешные операции от живых родственных доноров. 1990-е годы ознаменовались дальнейшим прогрессом в области хирургических техник, внедрением такролимуса и развитием технологии пересадки правой доли печени от живого донора, что существенно расширило донорский пул и улучшило результаты операций. В начале XXI века в практику вошли трансплантации при АВ0-несовместимости, новые системы аллокации органов, основанные на шкалах MELD и PELD. Кроме того, началось активное внедрение мини-инвазивных лапароскопических и робот-ассистированных технологий, позволяющих снизить травматичность операций у доноров. Педиатрическая трансплантация печени стала не только эффективным методом лечения терминальных стадий печеночной недостаточности у детей, но и значимым катализатором инноваций, продолжающим формировать новые направления современной трансплантологии. Отмечена важность дальнейшего совершенствования методик и индивидуализации иммуносупрессивной терапии с целью повышения долгосрочной выживаемости и качества жизни реципиентов.

This article explores the historical development of pediatric liver transplantation (LT), tracing its evolution from the first experimental procedures to modern high‑tech approaches. Throughout its history, LT in children has been a catalyst for innovation and novel surgical techniques. The earliest attempts at pediatric LT faced numerous technical and immunological challenges and were associated with extremely high mortality rates. A major breakthrough occurred in the 1980s with the introduction of cyclosporine A. During this period, pioneering advances such as reduced-size grafts, split-liver transplantation, and the first successful living-related donor procedures marked a new era. The 1990s witnessed further progress in surgical techniques, introduction of tacrolimus, and the development of right-lobe living donor transplantation. These innovations not only expanded the donor pool significantly but also improved surgical outcomes. Entering the 21st century, the field experienced further breakthroughs with the implementation of ABO-incompatible transplantation and the adoption of MELD and PELD scoring systems for organ allocation. In addition, the integration of minimally invasive laparoscopic and robot-assisted approaches reduced donor morbidity and improved postoperative recovery. Today, pediatric LT is recognized not only as a life-saving treatment for end-stage liver failure in children but also as a driving force of innovation in modern transplant practice. The article underscores the importance of continuous refinement of surgical techniques and personalization of immunosuppressive regimens as key strategies to improve long-term survival and enhance the quality of life in pediatric LT recipients.

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