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 Federation10.15825/1995-1191-2009-3-42-50vtio-244Research ArticleКлиническая трансплантологияClinical TransplantologyОРТОТОПИЧЕСКАЯ ТРАНСПЛАНТАЦИЯ ПЕЧЕНИ: РОЛЬ ИНТЕРВЕНЦИОННОЙ РАДИОЛОГИИORTHOTOPIC LIVER TRANSPLANTATION: ROLE OF INTERVENTIONAL RADIOLOGYТаразовП. Г.TarazovP. G.tarazovp@mail.ruГрановД. A.GranovD. A.ПоликарповА. А.PolikarpovA. A.ГенераловМ. И.GeneralovM. I.ЖеребцовФ. К.ZherebtsovF. K.КротоваО. А.KrotovaO. A.ГерасимоваО. А.GerasimovaO. A.МайстренкоД. Н.MaystrenkoD. N.КозловА. В.KozlovA. V.РуткинИ. О.RutkinI. O.ФГУ «Российский научный центр радиологии и хирургических технологий» Федерального агентства по высокотехнологичной медицинской помощи, Санкт-ПетербургРоссияFederal State Institution «Russian Research Centre of Radiology and Surgical Tehnologies» of the Federal Agency on High Technique Medical Care, Saint-PetersburgRussian Federation200903062014113ВЕСТНИК ТРАНСПЛАНТОЛОГИИ И ИСКУССТВЕННЫХ ОРГАНОВ том XI No 3–20094250Copyright © Таразов П.Г., Гранов Д.A., Поликарпов А.А., Генералов М.И., Жеребцов Ф.К., Кротова О.А., Герасимова О.А., Майстренко Д.Н., Козлов А.В., Руткин И.О., 20092009Таразов П.Г., Гранов Д.A., Поликарпов А.А., Генералов М.И., Жеребцов Ф.К., Кротова О.А., Герасимова О.А., Майстренко Д.Н., Козлов А.В., Руткин И.О.Tarazov P.G., Granov D.A., Polikarpov A.A., Generalov M.I., Zherebtsov F.K., Krotova O.A., Gerasimova O.A., Maystrenko D.N., Kozlov A.V., Rutkin I.O.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/244

В работе обсуждается эффективность интервенционных радиологических процедур у больных перед и после ортотопической трансплантации печени (ОТП). За период 1998–2008 гг. ОТП выполнена 53 паци- ентам. Лечебные эндоваскулярные вмешательства осуществлены у 20 из этих больных. Предоперацион- ные процедуры выполнены у 13 пациентов: масляная химиоэмболизация печеночной артерии (МХЭПА, n = 5), наложение внутрипеченочного портокавального шунта (TIPS, n = 8). У 7 больных произведены 8 послеоперационных вмешательств: дренирование и/или стентирование желчных протоков (n = 4), ре- канализация и стентирование стеноза/окклюзии нижней полой вены (НПВ, n = 2), баллонная дилатация кава-кавального анастомоза (n = 1), эмболизация селезеночной артерии (n = 1). После МХЭПА отмечено уменьшение злокачественной опухоли или замедление ее роста у всех 5 пациентов, ОТП к настоящему времени осуществлена у 3 из них. В результате TIPS снижение портальной гипертензии произошло у всех больных, ОТП выполнена в 3 наблюдениях. Все послеоперационные процедуры были также технически и клинически успешны. Методы интервенционной радиологии позволяют продлить время ожидания до- норской печени у больных, которым требуется ОТП. Рентгеноэндоваскулярные вмешательства позволяют устранить послеоперационные билиарные и сосудистые стриктуры, а также другие осложнения ОТП. 

To study therapeutic modalities of interventional radiology in patients (pts) before and after orthotopic liver trans- plantation (OLT). OLT was performed in 53 pts between 1998 and 2008. Endovascular treatments were performed in 20 pts. Pre-OLT interventional procedures included transcatheter arterial chemoembolization (5 patients) and TIPS (8 patients). Post-OLT procedures were: dilatation or/and stenting of biliary strictures (4), stenting of IVC (2), balloon dilatation of cava-caval anastomosis (1), partial splenic embolization (PSE) in steel syndrome (1). All IR procedures were technically successful. There was no mortality or serious complication. After chemoemboliza- tion, there was partial tumor response in all 5 patients with HCC; two successfully transplanted are alive without recurrence in 11 and 15 months. After TIPS, 3 pts underwent OLT. Satisfactory biliary passage was achieved in all pts with strictures. Clinical symptoms and liver function improved in three pts with venous strictures. After PSE, steal syndrome regressed rapidly. All pts are asymptomatic and well in 5–24 mo after IR treatment. IR procedures prolong long-term patient survival before OLT and may improve outcomes in pts after OLT. 

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