transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologiststransplantologiya-139Research ArticleАКТУАЛЬНЫЕ ВОПРОСЫ ТРАНСПЛАНТОЛОГИИACTUAL ISSUES OF TRANSPLANTATIONМорфологическая оценка трансплантата печени: роль экспресс-биопсииThe role of hepatic biopsy in liver graft evaluation during liver procurementНоврузбековМ. С.NovruzbekovM. S.N.M.S@bk.ruОлисовО. Д.OlisovO. D.face@neicon.ruГуляевВ. А.GulyaevV. A.face@neicon.ruЛуцыкК. Н.LutsykK. N.face@neicon.ruРябоштановаЕ. И.RyaboshtanovaE. I.face@neicon.ruТертычныйА. С.TertychnyyA. S.face@neicon.ruВостриковаО. Ф.VostrikovaO. F.face@neicon.ruРоженковА. С.RozhenkovA. S.face@neicon.ruГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation201613122016041926Copyright © Новрузбеков М.С., Олисов О.Д., Гуляев В.А., Луцык К.Н., Рябоштанова Е.И., Тертычный А.С., Вострикова О.Ф., Роженков А.С., 20162016Новрузбеков М.С., Олисов О.Д., Гуляев В.А., Луцык К.Н., Рябоштанова Е.И., Тертычный А.С., Вострикова О.Ф., Роженков А.С.Novruzbekov M.S., Olisov O.D., Gulyaev V.A., Lutsyk K.N., Ryaboshtanova E.I., Tertychnyy A.S., Vostrikova O.F., Rozhenkov A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/139

Резюме. Трансплантация печени с распространенным стеатозом чревата тяжелой печеночной недостаточностью и высокой летальностью. Изучена роль экспресс-биопсии в дооперационной оценке печеночного трансплантата.Материал и методы. Исследование основано на результатах 341 ортотопической трансплантации печени (ОТП). Пациенты были распределены на две группы: первая группа – 163 реципиента, у которых была выполнена экспресс-биопсия печени; вторая группа (сравнения) – 178 больных, у которых срочное гистологическоеисследование не проводили. Критерием отказа от трансплантата были макростеатоз более 50% паренхимы трансплантата, грубые структурные изменения печени и наличие массивных некрозов.Результаты. Частота тяжелого ишемического реперфузионного повреждения (ИРП), первичной тяжелой дисфункции трансплантата и первичный нефункционирующий трансплантат в первой группе встречались статистически значимо реже, чем в группе сравнения. Статистически значимых различий в группах по продолжительности холодовой ишемии трансплантата не выявлено.Выводы: срочное гистологическое исследование позволяет предотвратить возникновение таких жизнеугрожающих осложнений ОТП, как тяжелое ИРП и первично нефункционирующий или плохо функционирующий трансплантат.

Abstract. Using a steatotic graft in liver transplantation (LT) can lead to a poor function and high mortality. The role of the rapid liver graft biopsy processing was studied. The liver grafts of potential donors were assessed for hepatic steatosis.Material and methods. The study included 341 cases of cadaveric donor liver transplantations. Patients were divided in two groups: the study group where the rapid graft biopsy processing was performed (n=163) and the comparison group (n=178) without biopsy processing. Livers with macrosteatosis of over 50% of graft parenchyma or with severe necrosis and structural damage were discarded.Results. The rates of ischemic reperfusion injury (IRI), initial poor graft function (IPGF), and primary graft nonfunction (PNF) were significantly lower in the study group. There were no significant differences between two groups in cold ischemia time.Conclusion: rapid histological examination provides a useful tool to avoid life threatening LT complications such as severe IRI, IPGF, and PNF.

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