References

vtio

Вестник трансплантологии и искусственных органов

Russian Journal of Transplantology and Artificial Organs

1995-1191

Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation

10.15825/1995-1191-2009-3-114-122

vtio-254

Research Article

Новые технологии

Advanced technology

ПОЗДНЯЯ ДИСФУНКЦИЯ ТРАНСПЛАНТИРОВАННОЙ ПОЧКИ: ПРИЧИНЫ, МОРФОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА, ПОДХОДЫ К ПРОФИЛАКТИКЕ И ЛЕЧЕНИЮ

LATE DYSFUNCTION OF THE GRAFTED KIDNEY: CAUSES, MORPHOLOGICAL STRUCTURE, PROPHYLAXIS AND TREATMENT

Столяревич

Е. С.

Stolyarevich

E. S.

Томилина

Н. А.

Tomilina

N. A.

natomilina@yandex.ru

ФГУ «Федеральный научный центр трансплантологии и искусственных органов им. академика В.И. Шумакова» Минздравсоцразвития РФ, МоскваРоссияAcademician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, MoscowRussian Federation

2009

03062014

113

ВЕСТНИК ТРАНСПЛАНТОЛОГИИ И ИСКУССТВЕННЫХ ОРГАНОВ том XI No 3–2009

114122

2009

Столяревич Е.С., Томилина Н.А.

Stolyarevich E.S., Tomilina N.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/254

В статье приводятся морфологические характеристики основных причин поздней дисфункции транс- плантированной почки, таких как острое и хроническое отторжение, нефротоксичность ингибиторов кальцинейрина и неспецифический фиброз интерстиция и атрофия канальцев, а также рассматривают- ся возможные подходы к их профилактике и лечению путем модуляции иммуносупрессивной терапии (ИСТ). В частности, анализируются литературные данные об эффективности конверсии с циклоспорина на такролимус при остром позднем отторжении, а также перехода на ИСТ на базе ингибиторов проли- феративного сигнала (сиролимус, эверолимус) при нефротоксичности, индуцированной ингибиторами кальцинейрина.

The most important causes of late renal graft dysfunction (late acute rejection, chronic rejection, chronic neph- rotoxicity induced by calcineurin inhibitors (CNI) and nonspecific nephrosclerosis), their morphological charac- teristics and the current approaches to their treatment are considered. One of the ways to influence the prevention and the course of late acute rejection which is under discussion in literature is the conversion from cyclosporine A to tacrolimus. The switch from standart to low dosage cyclosporine in combination with proliferative signal in- hibitors (sirolimus, everolimus) is considered as a way to prevent the progression of nephrosclerosis due to CNI- nephrotoxicity. In cases where the main cause of the late kidney graft dysfunction is nonspecific nephrosclerosis the treatment with ACE-inhibitors and optimization with CNI-dosage may be recommended.

трансплантация почкипоздняя дисфункция трансплантатаиммуносупрессивная терапия

kidney transplantationlate graft dysfunctionimmunosupression

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