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 Federation10.15825/1995-1191-2015-4-33-39vtio-588Research ArticleКлиническая трансплантологияClinical TransplantologyСНИЖЕНИЕ ТЯЖЕСТИ ИШЕМИЧЕСКОГО И РЕПЕРФУЗИОННОГО ПОВРЕЖДЕНИЯ ПОЧЕЧНОГО ТРАНСПЛАНТАТА ПРИ ПОМОЩИ СОЧЕТАННОЙ ПЛАЗМОФИЛЬТРАЦИИ И АДСОРБЦИИREDUCING THE SEVERITY OF RENAL GRAFT ISCHEMIC AND REPERFUSION INJURY WITH COUPLED PLASMA FILTRATION AND ADSORPTIONВатазинА. В.VatazinA. V.ЗулькарнаевА. Б.ZulkarnaevA. B.ШаховН. Л.ShakhovN. L.КантарияР. О.KantariaR. O.ФаенкоА. П.FaenkoA. P.КрстичМ.KrstichM.БельскихЛ. В.BelskichL. V.ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского», Москва, Российская ФедерацияРоссияM.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russian FederationRussian Federation2015130120161743339Copyright © Ватазин А.В., Зулькарнаев А.Б., Шахов Н.Л., Кантария Р.О., Фаенко А.П., Крстич М., Бельских Л.В., 20162016Ватазин А.В., Зулькарнаев А.Б., Шахов Н.Л., Кантария Р.О., Фаенко А.П., Крстич М., Бельских Л.В.Vatazin A.V., Zulkarnaev A.B., Shakhov N.L., Kantaria R.O., Faenko A.P., Krstich M., Belskich L.V.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/588

Цель исследования: оценить эффективность сочетанной плазмофильтрации и адсорбции (СПФА) в снижении тяжести ишемического и реперфузионного повреждения почечного трансплантата. Материалы и методы: проанализированы ближайшие и отдаленные результаты трансплантации почки у 33 пар реципиентов. Пациенты разделены на две группы: у 33 реципиентов основной группы проводили СПФА в раннем послеоперационном периоде. У 33 реципиентов группы сравнения, получивших парные почки, СПФА не проводили. Результаты. Доли больных с хорошей начальной и отсроченной функцией трансплантата в двух группах не различались. У пациентов основной группы с отсроченной функцией трансплантата был отмечен значительно больший темп снижения уровня азотемии и роста скорости клубочковой фильтрации (СКФ), чем у больных группы сравнения. Среди больных с хорошей начальной функцией трансплантата различия между группами были не такими значительными. При анализе отдаленных результатов отмечено, что у больных, получивших СПФА в раннем послеоперационном периоде, через год после трансплантации функция трансплантата была лучше: ниже уровни азотемии и суточной протеинурии, выше СКФ. Таким образом, в результате применения СПФА в раннем послеоперационном периоде можно ожидать улучшения функции в долгосрочной перспективе и улучшения прогноза выживаемости трансплантата. 

Aim: to evaluate the effectiveness of coupled plasma filtration and adsorption (CPFA) in reducing the severity of the renal graft ischemic and reperfusion injury. Materials and methods: shortand long-term results of renal transplantation in 33 pairs of recipients were analyzed. The patients were divided into two groups: in 33 recipients of the study group we performed CPFA in the early postoperative period. In the comparison group in 33 recipients with paired grafts CPFA was not performed. Results. The proportion of patients with good initial and delayed graft functions in the two groups was the same. In patients with delayed graft function from the study group a significantly greater rate of creatinine and urea decrease and glomerular filtration rate (GFR) increase than in patients of the comparison group were observed. Among patients with good initial graft function the differences between the groups were not significant. We have also analyzed long-term results of the transplantations: patients who received CPFA in the early postoperative period had lower levels of creatinine, urea and daily proteinuria and higher GFR in 1 year time. Thus, as a result of CPFA in the early postoperative period the improvement of graft function and graft survival prognosis can be expected in the long-term. 

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