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Том 12 №3 2010 год - Нефрология и диализ

Полиомавирус (BKV) у реципиентов с трансплантированной почкой (Обзор литературы)


Горбатенко Е.В. Момыналиев К.Т. Грибанов О.Г. Бабенко Н.Н. Каабак М.М.

Аннотация: Трансплантация почки является методом лечения пациентов с терминальной стадией хронической почечной недостаточности. Выживаемость реципиентов и трансплантата в последнее время значительно увеличилась за счет разработки новых протоколов иммуносупрессии, которые позволяют снизить количество случаев острого отторжения трансплантированного органа, однако на этом фоне большое значение приобретают пост-трансплантационные инфекции. Наибольшее значение в последнее время приобрел полиомавирус (BKV), который ассоциирован с нефропaтией (BKVAN). Приблизительно у 30-60% пациентов с BKV нефропатией наблюдаются потеря трансплантата. Диагноз BK инфекции базируется на комбинации показателей: обнаружения клеток с вирусными включениями («decoy cells») в моче, вируса в моче/крови и типичных гистологических изменений при интерстициальном нефрите. Лечение BKV нефропатий состоит в снижении доз иммуносупрессивной терапии и антивирусной терапии − цидофовиром или лефлуномидом или их комбинации. Раннее выявление полиомавируса и соответствующее снижение иммуносупрессивной терапии обеспечивает лучшую выживаемость почечного трансплантата.

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Ключевые слова: Полиомавирус, трансплантация, нефропатия, иммуносупрессия, диагностика, polyoma virus BKV, transplantation, BKV-associated nephropathy, immunosuppression, diagnostic tools

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