transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2017-9-4-299-305transplantologiya-196Research ArticleПРОБЛЕМНЫЕ АСПЕКТЫPROBLEMATIC ASPECTSМаркеры воспаления и инфекционные осложнения в раннем послеоперационном периоде при проведении ортотопической трансплантации печениInflammatory markers and infectious complications in the early postoperative period in orthotopic liver transplantationЧугуноваО. А.ChugunovaO. A.

врач анестезиолог-реаниматолог отделения анестезиологии и реанимации № 2 РНПЦ трансплантации органов и тканей УЗ «9-я городская клиническая больница»

Минск

Anesthesiologist and Critical Care Physician of the Anesthesiology and Critical Care Department No. 2 at The Republican Scientific-Practical Center of Organ and Tissue Transplantation at the City Clinical Hospital No. 9, Minsk

gourvi@yahoo.comДзядзькоА. М.Dzyadz'koA. M.

Минск

Minsk

ЩербаА. Е.ShcherbaA. E.

Минск

Minsk

КатинМ. Л.KatinM. L.

Минск

Minsk

ЕфимовД. Ю.EfimovD. Yu.

Минск

Minsk

МиновА. Ф.MinovA. F.

Минск

Minsk

РНПЦ трансплантации органов и тканей УЗ «9-я городская клиническая больница»БеларусьThe Republican Scientific-Practical Center of Organ and Tissue Transplantation at the City Clinical Hospital No. 9Belarus20171812201794299305Copyright © Чугунова О.А., Дзядзько А.М., Щерба А.Е., Катин М.Л., Ефимов Д.Ю., Минов А.Ф., 20172017Чугунова О.А., Дзядзько А.М., Щерба А.Е., Катин М.Л., Ефимов Д.Ю., Минов А.Ф.Chugunova O.A., Dzyadz'ko A.M., Shcherba A.E., Katin M.L., Efimov D.Y., Minov A.F.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/196

Стандартными маркерами воспаления, используемыми для выявления инфекционных осложнений в периоперационном периоде, являются С-реактивный белок и прокальцитонин. Однако, согласно ряду исследований, данные лабораторные маркеры не всегда эффективны в распознавании инфекционных осложнений у пациентов после трансплантации печени в раннем послеоперационном периоде и их предиктивные возможности ограничены. Мы предположили, что в даннос случае более надежным и точным маркером развития инфекционных осложнений будет являться интерлейкин-6.

Procalcitonin and c-reactive protein are routine inflammatary markers used in the perioperative period to detect surgical infectious complications. However, a number of studies have demonstrated that these laboratory markers appear less effective in identifying infectious complications in the early postoperative period in patients after liver transplantation, and their predictive power is limited. We hypothesized, that interleukin-6 could be a more reliable and precise marker of the development of infectious complications in this patient population.

интерлейкин-6С-реактивный белокпрокальцитонинтрансплантация печениинфекционные осложненияпослеоперационный периодinterleukin-6c-reactive proteinprocalcitoninliver transplantationinfectious complicationspostoperative periodReferencesMaddrey W.C., Schiff E.R., Sorrell M.F. Transplantation of the liver. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2001.Maddrey W.C., Schiff E.R., Sorrell M.F. Transplantation of the liver. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2001.Журавель С.В., Кузнецова Н.К., Черненькая Т.В., Уткина И.И. Передача инфекционных возбудителей от донора органов реципиенту. Нужны ли изменения в оценке рисков? Трансплантология. 2015;(1):7–12.Zhuravel' S.V., Kuznetsova N.K., Chernen'kaya T.V., Utkina I.I. Transmission of infectious agents from the donor to the recipient. Do we need change in the risk assessment? Transplantologiya. 2015;(1):7–12. (In Russian).Jalan R., Fernandez J., Wiest R., et al. Bacterial infections in cirrhosis: A position statement based on the Conference 2013. J. Hepatol. 2014;60(6):1310–1324. PMID:24530646 DOI:10.1016/j.jhep.2014.01.024Jalan R., Fernandez J., Wiest R., et al. Bacterial infections in cirrhosis: A position statement based on the Conference 2013. J Hepatol. 2014;60(6):1310– 1324. PMID:24530646 DOI:10.1016/j.jhep.2014.01.024Eyraud D., Ayed S., Tanguy M. L., et al. Procalcitonin in liver transplantation: are high levels due to donors or recipients? Critical Care. 2008;12:R85. DOI:10.1186/cc6942Eyraud D., Ayed S., Tanguy M. L., et al. Procalcitonin in liver transplantation: are high levels due to donors or recipients? Critical Care. 2008;12:R85. DOI:10.1186/cc6942Dembic Z. The Cytokines of the Immune System:The Role of Cytokines in Disease Related to Immune Response. Сhapter 6: Cytokines of the Immune System: Interleukins. – Elsevier, Academic press. 2015: 143-239.Dembic Z. The Cytokines of the Immune System: The Role of Cytokines in Disease Related to Immune Response. Chapter 6: Cytokines of the Immune System: Interleukins. Elsevier, Academic press. 2015: 143–239.Jani A., Chen P. Infections After Solid Organ Transplantation. Electronic resource. Medscape. URL: https://emedicine.medscape.com/article/430550-overviewJani A., Chen P. Infections After Solid Organ Transplantation. Medscape. Available at: https://emedicine.medscape.com/article/430550-overviewBone R.C., Balk R.A., Cerra F.B., et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101(6):1644–1655. PMID:1303622 DOI:10.1378/chest.101.6.1644Bone R.C., Balk R.A., Cerra F.B., et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/ SCCM Consensus Conference Committee. American College of Chest Physicians/ Society of Critical Care Medicine. Chest. 1992;101(6):1644–1655. PMID:1303622 DOI:10.1378/chest.101.6.1644Levy M.M., Fink M.P., Marshall J.C., et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit. Care Med. 2003;31(4):1250–1256. PMID:12682500 DOI:10.1097/01.CCM.0000050454.01978.3BLevy M.M., Fink M.P., Marshall J.C., et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31(4):1250–1256. PMID:12682500 DOI:10.1097/01.CCM.0000050454.01978.3BRhodes A., Evans L.E., Alhazzani W., et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43(3):304–377. PMID:28101605 DOI:10.1007/s00134-017-4683-6Rhodes A., Evans L.E., Alhazzani W., et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43(3):304–377. PMID:28101605 DOI:10.1007/s00134-017-4683-6Mokart D., Merlin M., Sannini A., et al. Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery. Br J Anaest. 2005;94(6):767–773. PMID:15849208 DOI:10.1093/bja/aei143Mokart D., Merlin M., Sannini A., et al. Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery. Br J Anaest. 2005;94(6):767–773. PMID:15849208 DOI:10.1093/bja/aei143Qu J., L X., Liu Y., Wang X. Evaluation of procalcitonin, c-reactive protein, interleukin 6 and serum amyloid as diagnostic biomarkers of bacterial infection in febrile patients. Indian J. Med. Res. 2015;141(3):315–321. PMID:25963492Qu J., L X., Liu Y., Wang X. Evaluation of procalcitonin, c-reactive protein, interleukin 6 and serum amyloid as diagnostic biomarkers of bacterial infection in febrile patients. Indian J Med Res. 2015;141(3):315–321. PMID:25963492Lin S, Zhu Y, Huang Z, et al. Interleukin-6 as an early diagnostic marker for bacterial sepsis in patient with liver cirrhosis. J. Critical Care. 2015;30(4):732–738. PMID:25891645 DOI:10.1016/j.jcrc.2015.03.031Lin S, Zhu Y, Huang Z, et al. Interleukin-6 as an early diagnostic marker for bacterial sepsis in patient with liver cirrhosis. J Critical Care. 2015;30(4):732–738. PMID:25891645 DOI:10.1016/j.jcrc.2015.03.031Zant R., Melter M., Knoppke B., et al. Kinetics of Interleukin-6, procalcitonin and c-reactive protein after pediatric liver transplantation. Transplant. Proc. 2014;46(10):3507-3510. PMID:25498081 DOI:10.1016/j.transproceed.2014.08.048Zant R., Melter M., Knoppke B., et al. Kinetics of Interleukin-6, procalcitonin and c-reactive protein after pediatric liver transplantation. Transplant Proc. 2014;46(10):3507–3510. PMID:25498081 DOI:10.1016/j.transproceed.2014.08.048Дзядзько А.М., Щерба А.Е., Руммо О.О., и др. Парадокс: печеночная недостаточность «защищает» больного? Трансплантология. 2017;(1):52–70. DOI:10.23873/2074-0506-2017-9-1-52-70Dzyadz'ko A.M., Shcherba A.E., Rummo O.O., et al. Paradox: Does liver insufficiency protect the patient? A hypothesis. Transplantologiya. 2017;(1):52–70. (In Russian). DOI:10.23873/2074-0506-2017-9-1-52-70Takeuchi O., Akira S. Pattern recognition receptors and inflammation. Cell. 2010;140(6):805–820. PMID:20303872 DOI:10.1016/j.cell.2010.01.022Takeuchi O., Akira S. Pattern recognition receptors and inflammation. Cell. 2010;140(6):805–820. PMID:20303872 DOI:10.1016/j.cell.2010.01.022Olthoff K.M., Kulik L., Samstain B., et al. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver transplant. 2010;16(8):943–949. PMID:20677285 DOI:10.1002/lt.22091Olthoff K.M., Kulik L., Samstain B., et al. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver transplant. 2010.16(8):943–949. PMID:20677285 DOI:10.1002/lt.22091

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