Комбинированная последовательная ex vivo перфузия трансплантатов печени от доноров с расширенными критериями: современный взгляд на проблему

Несмотря на значительные изменения, произошедшие в области трансплантации печени (ТП) за последние 30 лет, «золотым стандартом» консервации аллографтов все это время оставалась статическая фармако- холодовая консервация. Интенсивно растущее несоответствие между потребностью в ТП и количеством органов вкупе со смертностью в листах ожидания вплоть до 20% вынуждает трансплантационное сооб- щество в значительной степени расширять критерии пригодности для доноров печени, что неминуемо сказывается на непосредственных и отдаленных результатах ТП. Динамическая консервация аллографтов печени уверенно демонстрирует положительные результаты в когорте доноров с расширенными крите- риями, в особенности в группе «высокого риска». За последнее десятилетие разрабатывались и активно изучались ряд методик, основанных на проведении перфузии в разных температурных режимах. Одним из важных направлений развития перфузионных технологий является комбинированная последовательная ex vivo перфузия, совмещающая несколько подходов. В данной работе описан современный опыт выпол- нения комбинированной последовательной машинной перфузии трансплантатов печени ex vivo с кратким освещением каждого из этапов, входящих в данный протокол.

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