transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2009-0-2-25-31transplantologiya-260Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSКлинико-лабораторные аспекты монокомпонентной иммуносупрессии при трансплантации печениClinical laboratory aspects of one-component immunosuppression during liver transplantationХубутияМ. Ш.KhubutiaM. Sh.

кафедра трансплантологии и искусственных органов

Department of Transplantology and Artificial Organs

НикулинаВ. П.NikulinaV. P.

кафедра трансплантологии и искусственных органов

Валентина Петровна Никулина 

Department of Transplantology and Artificial Organs

sa-to@yandex.ruГодковМ. А.GodkovM. A.

кафедра трансплантологии и искусственных органов

Department of Transplantology and Artificial Organs

СюткинВ. Е.SyutkinV. E.

кафедра трансплантологии и искусственных органов

Department of Transplantology and Artificial Organs

АндрейцеваО. И.AndreitsevaO. I.

кафедра трансплантологии и искусственных органов

Department of Transplantology and Artificial Organs

ЧжаоА. В.ChzhaoA. V.

кафедра трансплантологии и искусственных органов

Department of Transplantology and Artificial Organs

Московский городской центр трансплантации печени НИИ скорой помощи им. Н.В. Склифосовского; МГСМУРоссияMoscow City Center of Liver Transplantation, N.V. Sklifosovsky Research Institute of Emergency Care; Moscow State University of Medicine and DentistryRussian Federation200917082018022531Copyright © Хубутия М.Ш., Никулина В.П., Годков М.А., Сюткин В.Е., Андрейцева О.И., Чжао А.В., 20182018Хубутия М.Ш., Никулина В.П., Годков М.А., Сюткин В.Е., Андрейцева О.И., Чжао А.В.Khubutia M.S., Nikulina V.P., Godkov M.A., Syutkin V.E., Andreitseva O.I., Chzhao A.V.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/260

Проведен анализ клинико-лабораторных результатов у пациентов, находящихся на монокомпонентной и 2-компонентной иммуносупрессии в отдаленный период после трансплантации печени.

Цель исследования — изучение влияния монокомпонентной иммуносупрессии кальциневриновыми ингибиторами на клинико-лабораторные показатели в отдаленные сроки после трансплантации печени.

Материал и методы

Материал и методы. Обследованы клинически, проведены биохимические и иммунологические исследования периферической крови пациентов 3 групп с различной иммуносупрессивной терапией: в 1-й группе (n=15) получали циклоспорин, во 2-й группе (n=10) — такролимус, в 3-й группе (n=8) — ингибитор кальциневрина и препарат микофеноловой кислоты.

Результаты

Результаты. Гипергликемия была выявлена у 5 (38,5%) получавших такролимус и у 3 (15%) больных, получавших циклоспорин. Артериальная гипертензия наблюдалась у 11 (55%) пациентов на фоне приема циклоспорина и у 3 (23%) принимавших такролимус. Вышеуказанные осложнения имели 50% пациентов с 2-компонентной иммуносупрессией. Было диагностировано 2 криза отторжения — в 1-й (6,7%) и 3-й (12,5%) группах. Наиболее выраженные изменения биохимических и иммунологических параметров отмечены в группе с 2-компонентной иммуносупрессией.

Выводы

Выводы. Применение монокомпонентной иммуносупрессии ингибиторами кальциневрина у пациентов после трансплантации печени эффективно и достаточно, однако при переводе на моносупрессию необходимо учитывать этиологию цирроза печени.

Clinical laboratory results were analyzed in patients on one- and two-component suppression in the late period after liver transplantation.

Objective

Objective: to study the impact of one-component immunosuppression with calcineurin inhibitors on clinical laboratory parameters in the late period after liver transplantation.

Subjects and methods

Subjects and methods. Examinations were made in 3 groups of patients receiving various immunosuppressive therapy regimens: 1) 15 took cyclosporine; 2) 10 had tacrolimus; 3) 8 received a calcineurin inhibitor and a mycophenolic acid preparation. Their peripheral blood samples were biochemically and immunologically studied.

Results

Results. Hyperglycemia was detected in 5 (38.5%) patients receiving tacrolimus and 3 (15%) patients taking cyclosporine. Hypertension was observed in 11 (55%) patients on cyclosporine and in 3 (23%) on tacrolimus. The above complications were seen in 50% of the patients on two-component immunosuppression. Two cases of acute rejection were noted in Groups 1 (6.7%) and 3 (12.5%). The most pronounced biochemical and immunological changes were observed in the two-component immunosuppression group.

Conclusion

Conclusion. The use of one-component immunosuppression with calcineurin inhibitors in patients after liver transplantation is effective and adequate; however, the etiology of liver cirrhosis should be taken into account on switching to one-component suppression.

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