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Том 10 №2 2008 год - Нефрология и диализ

Использование маргинальных трупных доноров в клинической трансплантации почки (Обзор литературы)


Нестеренко И.В. Филипцев П.Я. Ватазин А.В. Янковой А.Г.

Аннотация: Трансплантация является общепризнанным методом лечения пациентов с терминальной стадией хронической почечной недостаточности. Однолетняя и 5-летняя выживаемость почечных трансплантатов достигает 95 и 80% соответственно. По данным The United Network for Organ Sharing (UNOS), несмотря на все возрастающее количество пересадок почек, только с 1988 по 2002 гг. количество больных, находящихся в листе ожидания на трансплантацию почки в США, возросло с 13 943 до 51 753 пациентов [17]. При этом значительный дефицит донорских органов приводит к тому, что часть пациентов умирает, так и не дождавшись операции. Определение критериев смерти мозга, опубликованных в Гарварде в 1968 г. как эквивалента смерти человека, сделали возможным получение органов от доноров, находящихся на искусственной вентиляции с бьющимся сердцем (ДБС) [35]. Использование органов для трансплантации, полученных от ДБС, стало настолько широко распространенным, что значительно сократило количество трансплантатов, полученных от доноров с небьющимся сердцем (ДНС) - самый распространенный источник донорских почек в 1960-е годы. Использование органов, полученных от ДНС, вновь стало актуальным приблизительно в 1990-е годы прошлого века, когда увеличилось общее количество трансплантаций и стал нарастать дефицит донорских органов [28]. Совершенствование протокола ДНС (Питсбург, 1993 г.), данные, представленные на международном симпозиуме в Маастрихте (1995 г.), а также публикации Американского Института Медицины (1997), посвященные трупному донорству, дали дальнейший стимул использованию ДНС во всем мире [12, 35, 50, 51, 57].

Для цитирования: Нестеренко И.В., Филипцев П.Я., Ватазин А.В., Янковой А.Г. Использование маргинальных трупных доноров в клинической трансплантации почки (Обзор литературы). Нефрология и диализ. 2008. 10(2):94-168. doi:


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Ключевые слова: трансплантация почки, маргинальные доноры, субоптимальные доноры, гломерулосклероз, выживаемость реципиентов и трансплантатов

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