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 Federation10.15825/1995-1191-2011-2-21-28vtio-370Research ArticleТрансплантомикаTransplantomicsОПЫТ АВО-НЕСОВМЕСТИМЫХ ТРАНСПЛАНТАЦИЙ ПЕЧЕНИSINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATIONГотьеС. В.GautierS. V.ЦирульниковаО. М.TsirulnikovaO. M.АммосовА. А.AmmosovA. A.ЛурьеЮ. Э.LurieY. E.yulialurie@yahoo.comМойсюкЯ. Г.MoysyukY. G.ПопцовВ. Н.PoptsovV. N.ПогребниченкоИ. В.PogrebnichenkoI. V.ПоруноваА. К.PorunovaA. C.ОбразцоваН. П.ObraztsovaN. P.ЦирульниковаИ. Е.TsirulnikovaI. E.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 Federation201116062014132ВЕСТНИК ТРАНСПЛАНТОЛОГИИ И ИСКУССТВЕННЫХ ОРГАНОВ том XIII No 2–20112128Copyright © Готье С.В., Цирульникова О.М., Аммосов А.А., Лурье Ю.Э., Мойсюк Я.Г., Попцов В.Н., Погребниченко И.В., Порунова А.К., Образцова Н.П., Цирульникова И.Е., 20112011Готье С.В., Цирульникова О.М., Аммосов А.А., Лурье Ю.Э., Мойсюк Я.Г., Попцов В.Н., Погребниченко И.В., Порунова А.К., Образцова Н.П., Цирульникова И.Е.Gautier S.V., Tsirulnikova O.M., Ammosov A.A., Lurie Y.E., Moysyuk Y.G., Poptsov V.N., Pogrebnichenko I.V., Porunova A.C., Obraztsova N.P., Tsirulnikova I.E.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/370

Опыт АВО-несовместимых трансплантаций печени, выполненных в ФГУ «ФНЦТИО им. акад. В.И. Шумакова» за период с 2008-го по 2010 г., включает 8 случаев, из них была одна экстренная АВО- несовместимая трансплантация трупной печени, выполненная взрослой пациентке по витальным пока- заниям, и 7 АВО-несовместимых родственных трансплантаций части печени, выполненных детям ранне- го возраста. Собственный и мировой опыт подтверждает, что барьер АВО-несовместимости может быть с большим успехом преодолен при трансплантации печени, особенно у детей, по сравнению с результа- тами АВО-несовместимых трансплантаций других солидных органов. Хорошие результаты могут быть получены даже при неагрессивных протоколах медикаментозной иммуносупрессивной терапии. Предва- рительная подготовка реципиента к АВО-несовместимой трансплантации печени значительно улучшает прогноз таких операций, но, как показал собственный опыт, у детей данная подготовка может не потре- боваться, так как анти-АВО-антитела у них в большинстве случаев были в низком титре или вообще от- сутствовали до трансплантации и не повышались после нее. Таким образом, АВО-несовместимая трансплантация печени является целесообразной в ургентных си- туациях, когда экстренно требуется трансплантация печени, и у детей, для которых пул потенциальных родственных доноров части печени ограничен. 

Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

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