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Вестник трансплантологии и искусственных органов

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Новые тенденции в исследовании острого повреждения почек после трансплантации печени

https://doi.org/10.15825/1995-1191-2019-4-108-120

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Аннотация

Проблема острого повреждения почек (ОПП) после трансплантации печени (ТП) является актуальной и остается в центре внимания многих исследователей. Этиология ОПП многофакторная, но главным является ишемическое и реперфузионное повреждение печеночного трансплантата. Развитию ОПП способствуют многочисленные дооперационные, интраоперационные и послеоперационные факторы риска. Использование стандартных классификаций AKIN, RIFLE и KDIGO способствовало улучшению диагностики ОПП после ТП. Однако определение уровня креатинина в сыворотке крови позволяет диагностировать ОПП только в поздние сроки развития этого синдрома. Поэтому в настоящее время исследования проводят по поиску путей ранней диагностики ОПП с помощью биомаркеров. Переход на молекулярный уровень не только повышает точность, но и обеспечивает раннюю диагностику ОПП. В настоящее время наиболее изучены диагностические возможности липокалина, ассоциированного с нейтрофильной желатиназой (NGAL). До настоящего времени не известны меры профилактики ОПП после ТП, а лечение этого синдрома нельзя признать удовлетворительным. Даже легкая форма ОПП после ТП может привести к летальному исходу, а при тяжелой форме, при которой используют заместительную почечную терапию, является риском смерти в реанимации. Более чем у половины пациентов с ОПП развивается хроническая болезнь почек, требующая проведения хронического гемодиализа.

Об авторах

И. М. Ильинский
ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России
Россия

Ильинский Игорь Михайлович

123182, Москва, ул. Щукинская, д. 1
Тел. (999) 877-60-95 



О. М. Цирульникова
ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России
Россия
Москва


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Ильинский И.М., Цирульникова О.М. Новые тенденции в исследовании острого повреждения почек после трансплантации печени. Вестник трансплантологии и искусственных органов. 2019;21(4):108-120. https://doi.org/10.15825/1995-1191-2019-4-108-120

For citation:


Iljinsky I.M., Tsirulnikova O.M. New trends in the study of post-transplant acute kidney injury after liver transplantation. Russian Journal of Transplantology and Artificial Organs. 2019;21(4):108-120. (In Russ.) https://doi.org/10.15825/1995-1191-2019-4-108-120

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ISSN 1995-1191 (Print)
ISSN 2412-6160 (Online)