nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1042Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESИнфекции после трансплантации почки (Обзор литературы)Infections after kidney transplantation ReviewКабулбаевК. А.KabulbayevK. A.kairat555@rambler.ruНациональный научный центр хирургии им. А.Н. Сызганова, г. Алматы, КазахстанРоссияA.N. Syzganov National Scientific Surgical Centre, Almaty, KazakhstanRussian Federation200919062025114293298Copyright © Кабулбаев К.А., 20252025Кабулбаев К.А.Kabulbayev K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1042

Инфекционные осложнения после трансплантации почки остаются серьезной проблемой, доля которых составляет в первый год после трансплантации 36%, а в первые 6 месяцев 52%. В данном литературном обзоре мы приводим современные представления о часто встречающихся инфекциях как в первый месяц после пересадки (инфекции мочевых путей), так и в последующие периоды (вирусные, оппортунистические инфекции). Определены предикторы развития инфекции после трансплантации почки, каковыми являются: гипоальбуминемия, низкая концентрация IgG1, снижение уровня CD4, лейкопения, очаги хронической инфекции, сахарный диабет, отсутствие антител к герпес-зостер-вирусу, ЦМВ-положительный статус, наличие у реципиента HBV и/или HCV. Придается значение определению уровня прокальцитонина для дифференциации инфекционных осложнений и реакции отторжения трансплантата. Среди профилактических мер, предотвращающих инфекции после трансплантации почки, отмечены как стандартные меры в виде приема котримоксазола-форте в течение 6–12 месяцев для всех пациентов, вальганцикловира в течение 3 месяцев при ЦМВ-положительном доноре вне зависимости от ЦМВ-статуса реципиента, так и необходимость ревизии статуса вакцинации.

Infectious complications after kidney transplantation occur in 36% of patients in the first year after transplantation and in in 52% of them in the first 6 months We review modern data concerning the infection appearance in the first month after kidney transplantation (mainly urinary tract infections) and those which are revealed later (viral and opportunistic infections). The predictors of the development of infections after kidney transplantation: hypoalbuminemia, low concentration of IgG1, decrease in the CD4 level, leucopenia, chronic infections, diabetes mellitus, the absence of antibodies to herpes-zoster-virus, CMV-positive status, HBV- and/or HCV are considered. The importance of the level of procalcitonin for differentiation of infectious complications and allograft rejection is emphasized. Standard measures for preventing infections after kidney transplantation: kotrimoksazol-forte for 6–12 months for all patients, valganciclovir for 3 first months for the CMV-positive donors independently on the CMV-status of the recipients and necessity of evaluation of the status of vaccination are discussed and evaluated.

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