Ишемически-реперфузионное повреждение печени

А.Е. Щерба, С.В. Коротков, А.Ф. Минов, М.М. Савчук, А.М. Дзядзько, О.О. Руммо РНПЦ « Трансплантации органов и тканей» УЗ «9-я ГКБ» г. Минска, ГУО «Белорусская медицинская академия последипломного образования»

2013 №1 | Клинический обзор

Аннотация

Список литературы

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Обзорная статья посвящена актуальной проблеме трансплантологии-использованию маргинальных трансплантатов печени, что связано с постоянно увеличивающимся количеством пациентов листа ожиданий и нехваткой донорских органов, отвечающим стандартным критериям. Однако использование маргинальных трансплантатов связано с риском развития первичной дисфункции трансплантата, в основе которого лежит ишемически – реперфузионное повреждение. Коллективом авторов на основе анализа мировой литературы выделены группы критериев маргинальности печеночного трансплантата, их пороговые значения, требующие применения лечебных технологий, направленных на улучшение послеоперационной функции печени. Также определены фармакологические агенты, которые могут быть использованы для коррекции ишемически – реперфузионных повреждений маргинальных трансплантатов печени и в экспериментальном исследовании.

Ключевые слова:

ишемически-реперфузионное повреждение, маргинальный трансплантат, севофлюран, ацетилцистеин

Ischemia reperfusion injury of liver

This review deals with the problem of transplantology — the usage of marginal liver grafts. It's associated with the ever-increasing number of patients in the waiting lists and the shortage of eligible donor organs. However the use of marginal grafts is associated with the risk of primary graft dysfunction based on ischemia reperfusion injury. The collective of authors pointed out the criteria groups of liver graft marginality, their threshold levels, that require curative technology aimed at improvement of postoperative liver function. Moreover the pharmacologic agents that may be used in the ischemia reperfusion injury correction of marginal liver grafts and that are useful for experimental studies have been defined.

Keywords

ischemia reperfusion injury, marginal liver graft, sevoflurane, acetylcysteine

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