Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)134010.18786/2072-0505-2020-48-038REVIEW ARTICLEОБЗОРPreservation and perfusion rehabilitation of donor organs: achievements of the last decadeСохранение и перфузионная реабилитация донорских органов: достижения последнего десятилетияhttps://orcid.org/0000-0003-2770-1432ReznikO. N.РезникО. Н.
Russian Federation

Oleg N. Reznik – MD, PhD, Head of Department of Transplantology and Organ Donation; Professor, Chair of Cardiovascular Surgery, Surgery Faculty; Head of Department of Transplantology, Scientific Research Institute of Surgery and Emergency Medicine

3A Budapeshtskaya ul., Saint Petersburg, 192242, tel.: +7 (921) 935 51 91;

41 Kirochnaya ul., Saint Petersburg, 191015;

6–8 L'va Tolstogo ul., Saint Petersburg, 197022

Резник Олег Николаевич – д-р мед. наук, руководитель отдела трансплантологии и органного донорства; профессор кафедры сердечно-сосудистой хирургии хирургического факультета; руководитель отдела трансплантологии Научно-исследовательского института хирургии и неотложной медицины

192242, г. Санкт-Петербург, ул. Будапештская, 3А, тел.: +7 (921) 935 51 91;

191015, г. Санкт-Петербург, ул. Кирочная, 41;

197022, г. Санкт-Петербург, ул. Льва Толстого, 6–8

onreznik@gmail.comhttps://orcid.org/0000-0001-5205-0331SkvortsovA. E.СкворцовА. Е.
Russian Federation

Andrey E. Skvortsov – MD, PhD, Surgeon, Research Fellow, Department of Transplantology and Organ Donation; Assistant, Chair of Cardiovascular Surgery, Surgery Faculty

3A Budapeshtskaya ul., Saint Petersburg, 192242;

41 Kirochnaya ul., Saint Petersburg, 191015

Скворцов Андрей Евгениевич – канд. мед. наук, врач-хирург, науч. сотр. отдела трансплантологии и органного донорства; ассистент кафедры сердечно-сосудистой хирургии хирургического факультета

192242, г. Санкт-Петербург, ул. Будапештская, 3А;

191015, г. Санкт-Петербург, ул. Кирочная, 41

https://orcid.org/0000-0002-0002-9183MoysyukYa. G.МойсюкЯ. Г.
Russian Federation

Yan G. Moysyuk – MD, PhD, Professor, Head of Department of Transplantology

61/2 Shchepkina ul., Moscow, 129110

Мойсюк Ян Геннадиевич – д-р мед. наук, профессор, руководитель отдела трансплантологии

129110, г. Москва, ул. Щепкина, 61/2

Saint-Petersburg I.I. Dzhanelidze Research Institute of Emergency MedicineГБУ «Санкт-Петербургский научно-исследовательский институт скорой помощи им. И.И. Джанелидзе»North-Western State Medical University named after I.I. MechnikovФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава РоссииAcademician I.P. Pavlov First St. Petersburg State Medical UniversityФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» Минздрава РоссииMoscow Regional Research and Clinical Institute (MONIKI)ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»051020204831932061609202016092020Copyright ©; 2020, Reznik O.N., Skvortsov A.E., Moysyuk Y.G.Copyright ©; 2020, Резник О.Н., Скворцов А.Е., Мойсюк Я.Г.2020Reznik O.N., Skvortsov A.E., Moysyuk Y.G.Резник О.Н., Скворцов А.Е., Мойсюк Я.Г.https://creativecommons.org/licenses/by/4.0https://almclinmed.ru/jour/article/view/1340

At present, it is widely recognized that machine perfusion allows for a decreased rate of delayed function of the renal graft and of the risk of liver graft early dysfunction. The aim of the review is to present the actual changes of the donor pool related to prevailing numbers of donors by expanded criteria, to determine the prospects of expanding of the available donor pool based on their selection, as well as development of functional rehabilitation and modification at tissue, cell and molecular levels with the help of perfusion technologies. The article presents the state-of-the art view on the mechanisms of ischemic-reperfusion injury of donor organs, delineates the trends in the maintenance of their viability, and gives the literature data on the role and outlook of perfusion methods in organ transplantation. The authors provide the rationale for a comprehensive systemic approach to the assessment of the functional status of a donor organ with any baseline parameters and discuss a number of theoretical provisions on the implementation of a personalized perfusion approach to ensure the availability of transplantation care.

В настоящее время общепризнано, что аппаратная перфузия позволяет снизить частоту отсроченной функции почечного трансплантата, риск ранней дисфункции печеночного трансплантата. Цель обзора – представить актуальные изменения донорского пула, связанные с превалированием доноров с расширенными критериями; определить направления максимального использования доступных донорских органов за счет их селекции, функциональной реабилитации и модификации на тканевом, клеточном и молекулярном уровне с помощью перфузионных технологий. В статье изложены современные взгляды на механизмы ишемической/реперфузионной травмы донорских органов, обозначены тенденции в решении вопросов сохранения жизнеспособности донорских органов, приведены данные литературы о роли и перспективах перфузионных методов в трансплантации органов. Обосновывается целесообразность комплексного системного подхода к оценке функционального состояния донорского органа с любыми исходными параметрами, дается ряд теоретических положений о внедрении в практику персонифицированного перфузионного подхода для обеспечения доступности трансплантационной помощи.

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