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 Federation10.15825/1995-1191-2018-1-120-126vtio-863Research ArticleОбзор литературыLiterature ReviewsТРАНСПЛАНТАЦИЯ СЕРДЦА У РЕЦИПИЕНТОВ С САХАРНЫМ ДИАБЕТОМHEART TRANSPLANTATION IN DIABETIC RECIPIENTSПопцовВ. Н.PoptsovV. N.

Попцов Виталий Николаевич

123182, Москва, ул. Щукинская, д. 1

Poptsov Vitaly Nicolaevich

1, Shchukinskaya st., Moscow, 123182

poptsov_vit@mail.ruЗолотоваЕ. Н.ZolotovaE. N.ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияV.I. Shumakov National Medical Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationRussian Federation201824042018201120126Copyright © Попцов В.Н., Золотова Е.Н., 20182018Попцов В.Н., Золотова Е.Н.Poptsov V.N., Zolotova E.N.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/863

СД является одним из самых часто встречающихся хронических метаболических нарушений. Роль СД в посттрансплантационном течении после ТС не определена однозначно. Согласно некоторым авторам, СД повышает риск острого отторжения и инфекционных осложнений, вероятность прогрессирования болезни коронарных артерий сердца трансплантата и уменьшает выживаемость реципиентов. Другие исследования не подтверждают эти данные. Однако реципиенты с СД осложненного течения имеют выживаемость значительно худшую, чем реципиенты без СД. Пациенты, скомпенсированные по СД, имеют такую же выживаемость, как пациенты без СД. С другой стороны, у пациентов с осложненным СД выживаемость значительно ниже. Таким образом, изолированно СД не должен рассматриваться как противопоказание к ТС. В условиях нехватки донорских органов лучшие результаты в этой области могут быть достигнуты совершенствованием базисной терапии СД и использованием «альтернативного» листа ожидания.

Diabetes mellitus is one of the most prevalent chronic metabolic disorders. Its role in patients with heart transplantation is not unifi ed. According to some authors, post-transplantation diabetes mellitus increases the risk of acute rejections and infections, increases the incidence of coronary artery disease of the graft and reduces long-term survival of patients with heart transplantation. On the other hand other studies did not confi rm these fi ndings. However, when diabetic patients were stratifi ed by disease severity, recipients with less severe disease achieved better survival. Accordingly, posttransplant survival was not signifi cantly different between recipients with uncomplicated diabetes and nondiabetic recipients. Diabetes alone should not be a contraindication to heart transplantation. Well-selected diabetic patients achieve the same survival as nondiabetic patients. Conversely, patients with complicated diabetes have signifi cantly worse survival. Therefore, given the critical shortage of transplantable organs, maximal benefi t may be achieved by exploring alternative treatment options in individuals with severe diabetes. These include use of high-risk transplant lists and destination therapy.

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