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 Federation10.15825/1995-1191-2018-3-80-86vtio-916Research ArticleКлинические наблюденияClinical CasesКлеточное отторжение панкреатодуоденального трансплантатаCellular rejection of pancreaticoduodenal graftПинчукА. В.PinchukA. V.СторожевР. В.StorozhevR. V.

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storojevrv@sklif.mos.ruДмитриевИ. В.DmitrievI. V.ШмаринаН. В.ShmarinaN. V.НефедоваГ. А.NefedovaG. A.МуслимовР. Ш.MuslimovR. Sh.ТетеринЮ. С.TeterinYu. S.ГБУЗ «Научно-исследовательский институт скорой помощи имени Н.В. Склифосовского Департамента здравоохранения города Москвы»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation2018170920182038086Copyright © Пинчук А.В., Сторожев Р.В., Дмитриев И.В., Шмарина Н.В., Нефедова Г.А., Муслимов Р.Ш., Тетерин Ю.С., 20182018Пинчук А.В., Сторожев Р.В., Дмитриев И.В., Шмарина Н.В., Нефедова Г.А., Муслимов Р.Ш., Тетерин Ю.С.Pinchuk A.V., Storozhev R.V., Dmitriev I.V., Shmarina N.V., Nefedova G.A., Muslimov R.S., Teterin Y.S.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/916Цель исследования

Цель исследования. Оценка значимости морфологического исследования слизистой оболочки донорской двенадцатиперстной кишки в диагностике отторжения панкреатодуоденального трансплантата.

Материалы и методы

Материалы и методы. Пациенту 35 лет с терминальной стадией диабетической нефропатии была произведена сочетанная забрюшинная пересадка почки и поджелудочной железы с  кишечным вариантом отведения панкреатического сока через междуоденальный анастомоз.  Спустя 2 года при проведении эзофагогастро-дуоденоскопии мы выполнили гистологическое  исследование слизистого слоя двенадцатиперстной кишки трансплантата.

Результаты

Результаты. Была диагностирована и морфологически верифицирована тяжелая степень клеточного отторжения панкреатодуоденального трансплантата. Обосновано и  успешно проведено патогенетическое противокризовое лечение – пульс-терапия  преднизолоном, с положительным клиническим эффектом.

Заключение

Заключение. На клиническом примере показана эффективность гистологического исследования слизистой оболочки двенадцатиперстной кишки панкреатодуоденального  трансплантата в диагностике отторжения, возможность обосновать и успешно провести противокризовую терапию.

Aim

Aim. The evaluation of donor’s duodenum histological examination in diagnosis of pancreaticoduodenal graft rejection.

Materials and methods

Materials and methods. The 35-yo patient with terminal diabetic nephropathy undergone simultaneous retroperitoneal kidney and pancreas transplantation  with enteric exocrine drainage of the graft via inter-duodenal anastomosis. When performing the esophagogastroduodenoscopy 2 years posttransplant we  implemented histologic examination of the duodenum of the graft.

Results

Results. We diagnosed and verified severe cellular rejection of pancreaticoduodenal graft. Successful etiopathogenetic treatment of acute  rejection of the graft (pulse therapy with glucocorticoids) was performed.

Discussion

Discussion. The diagnostic value of donor’s duodenum morphological examination in the diagnosis of pancreaticoduodenal graft  rejection, the efficacy of anti-rejection treatment were performed in this case.

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