transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2020-12-3-199-212transplantologiya-515Research ArticleАКТУАЛЬНЫЕ ВОПРОСЫ ТРАНСПЛАНТОЛОГИИACTUAL ISSUES OF TRANSPLANTATIONВнепеченочная онкологическая патология у реципиента печени от живого родственного донораExtrahepatic malignancies in a liver transplant recipient from a living related donorhttps://orcid.org/0000-0002-6254-130XКолышевИ. Ю.KolyshevI. Yu.

Илья Юрьевич Колышев, канд. мед. наук, заведующий хирургическим отделением № 1 Центра новых хирургических технологий

123098, Москва, ул. Маршала Новикова, д. 23

Ilya Yu. Kolyshev, Cand. Med. Sci., Head of Surgical Department № 1 Center for New Surgical Technologies; Surgery and Transplantology Center Surgeon

23 Marshal Novikov Str., Moscow 123098

diffdiagnoz@mail.ruhttps://orcid.org/0000-0001-5691-5398ВосканянС. Э.VoskanyanS. E.

Сергей Эдуардович Восканян, чл.-корр. РАН, проф., заведующий кафедрой хирургии с курсами онкохирургии, эндоскопии, хирургической патологии, клинической трансплантологии и органного донорства ИППО, заместитель главного врача по хирургической помощи, руководитель Центра хирургии и трансплантологии

123098, Москва, ул. Маршала Новикова, д. 23

Sergey E. Voskanyan, Corr. Member of RAS, Prof., Head of the Surgery Department with the Courses of Oncology, Anesthesiology and Resuscitation, Endoscopy, Surgical Pathology, Clinical Transplantation and Organ Donation, the Institute of Postgraduate Professional Education; Deputy Chief Doctor for Surgical Care, Head of the Center for Surgery and Transplantation

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0002-4527-0448ШабалинМ. В.ShabalinM. V.

 

123098, Москва, ул. Маршала Новикова, д. 23

Maksim V. Shabalin, Cand. Med. Sci., Surgeon, the Center for Surgery and Transplantation

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0002-1784-5945АртемьевА. И.ArtemyevA. I.

Алексей Игоревич Артемьев, канд. мед. наук, заведующий хирургическим отделением Центра хирургии и трансплантологии

123098, Москва, ул. Маршала Новикова, д. 23

Aleksey I. Artemyev, Cand. Med. Sci., Head of the Surgical Department, the Center for Surgery and Transplantation

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0002-3171-6621РудаковВ. С.RudakovV. S.

Владимир Сергеевич Рудаков, канд. мед. наук, врач-хирург Центра хирургии и трансплантологии

123098, Москва, ул. Маршала Новикова, д. 23

Vladimir S. Rudakov, Cand. Med. Sci., Surgeon, the Center for Surgery and Transplantation

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0003-1192-9598МальцеваА. П.MaltsevaA. P.

врач-хирург Центра хирургии и трансплантологии

123098, Москва, ул. Маршала Новикова, д. 23

Anna P. Maltseva, Surgeon

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0002-4560-6415БашковА. Н.BashkovA. N.

Андрей Николаевич Башков, канд. мед. наук, заведующий отделением лучевой и радиоизотопной диагностики

123098, Москва, ул. Маршала Новикова, д. 23

Andrey N. Bashkov, Cand. Med. Sci., Head of the Department for Diagnostic Radiology and Radionuclide Imaging

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0001-8391-5211СюткинВ. Е.SyutkinV. E.

Владимир Евгеньевич Сюткин, д-р мед. наук, ведущий научный сотрудник отделения трансплантации печени

129090, Москва, Большая Сухаревская площадь, д. 3

Vladimir E. Syutkin, Dr. Med. Sci., Leading Research Associate, Department for Liver Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0001-9006-163XГубаревК. К.GubarevK. K.

Константин Константинович Губарев, канд. мед. наук, заведующий хирургическим отделением по координации донорства органов и (или) тканей человека

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Konstantin K. Gubarev, Cand. Med. Sci., Head of the Surgical Department for the Coordination of Human Organ and(or) Tissue Donation

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0002-2274-6204СветлаковаД. С.SvetlakovaD. S.

врач-хирург хирургического отделения по координации донорства органов и (или) тканей человека

123098, Москва, ул. Маршала Новикова, д. 23

Darya S. Svetlakova, Surgeon of the Surgical Department for the Coordination of Human Organ and(or) Tissue Donation

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0002-6558-7143ПоповМ. В.PopovM. V.

врач по рентгенэндоваскулярным диагностике и лечению отделения рентгенохирургических методов диагностики и лечения

123098, Москва, ул. Маршала Новикова, д. 23

Maksim V. Popov, Endovascular Radiology Physician for Diagnosis and Treatment, the Department of Diagnostic and Treatment Techniques in Interventional Radiology

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0002-1561-6268СушковА. И.SushkovA. I.

Александр Игоревич Сушков, канд. мед. наук, заведующий лабораторией новых хирургических технологий

123098, Москва, ул. Маршала Новикова, д. 23

Aleksandr I. Sushkov, Cand. Med. Sci., Head of the Laboratory for Novel Surgical Technologies

23 Marshal Novikov Str., Moscow 123098

https://orcid.org/0000-0001-9594-7966СадыховЗ. А.SadykhovZ. A.

Замин Афлатун-оглы Садыхов, аспирант кафедры хирургии с курсами онкохирургии, эндоскопии, хирургической патологии, клинической трансплантологии и органного донорства ИППО

123098, Москва, ул. Маршала Новикова, д. 23

Zamin A.О. Sadykhov, Postgraduate Fellow of the Department of Surgery with the courses in Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantation, and Organ Donation, the Institute of Postgraduate Professional Education

23 Marshal Novikov Str., Moscow 123098

ФГБУ ГНЦ ФМБЦ им. А.И. Бурназяна ФМБА РоссииРоссияState Research Center – Burnasyan Federal Medical Biophysical Center of Medico-Biological Agency of the Russian Federation (FMBA)Russian FederationГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202010092020123199212Copyright © Колышев И.Ю., Восканян С.Э., Шабалин М.В., Артемьев А.И., Рудаков В.С., Мальцева А.П., Башков А.Н., Сюткин В.Е., Губарев К.К., Светлакова Д.С., Попов М.В., Сушков А.И., Садыхов З.А., 20202020Колышев И.Ю., Восканян С.Э., Шабалин М.В., Артемьев А.И., Рудаков В.С., Мальцева А.П., Башков А.Н., Сюткин В.Е., Губарев К.К., Светлакова Д.С., Попов М.В., Сушков А.И., Садыхов З.А.Kolyshev I.Y., Voskanyan S.E., Shabalin M.V., Artemyev A.I., Rudakov V.S., Maltseva A.P., Bashkov A.N., Syutkin V.E., Gubarev K.K., Svetlakova D.S., Popov M.V., Sushkov A.I., Sadykhov Z.A.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/515

Актуальность. Онкологическая патология у больных, перенесших трансплантацию печени, отличается прогрессивным развитием, что требует незамедлительного начала специализированного лечения и коррекции дозы иммуносупрессивной терапии. Цель. Уточнить закономерности развития, факторы риска онкологической патологии у больных, перенесших трансплантацию печени от живого родственного донора. Материал и методы. В ФГБУ ГНЦ ФМБЦ им. А.И. Бурназяна с 2010 по 2020 г. проведено 275 трансплантаций печени от живого родственного донора. Из них 42 пациента (15,27%) были прооперированы по поводу гепатоцеллюлярного рака печени. Проведены оценка медианы времени развития новообразований после трансплантации и сравнение частоты развития онкологических заболеваний в общей популяции и у пациентов после трансплантации печени. Результаты. У 9 пациентов (3,27%) зарегистрировано появление не выявленных ранее новообразований. Непосредственно злокачественная патология выявлена в 8 случаях (2,90%). Медиана развития онкологических процессов составила 48 мес. 1-, 3- и 5-летняя общая выживаемость пациентов после трансплантации составила соответственно 97%, 96%, 94%. 1-, 3- и 5-летняя выживаемость пациентов после трансплантации по поводу гепатоцеллюлярного рака составила соответственно 97%, 91%, 91%. Выживаемость в группе пациентов с онкологической патологией De-novo, развившейся после трансплантации, составила 90%. Вывод. Реципиенты трансплантата печени от живого родственного донора имеют повышенный риск развития онкологического заболевания, что требует проведения более частых всесторонних скрининговых мероприятий.

Background. Cancer occurring in recipients of living donor liver transplantation may be characterized by a progressive course requiring an immediate specialized treatment initiation and adjustment of immunosuppression regimen. Aim. To specify the malignancy development mechanisms and risk factors in the recipients of living donor liver transplantation. Material and methods: 275 living donor liver transplantations were made in Burnasyan Federal Medical Biophysical Center of FMBA from 2010 to 2020. Forty two (15.27 %) patients underwent surgery for hepatocellular carcinoma. The median time to the onset of malignancy development was estimated. The incidence of malignancy in general population and in recipients of living donor liver transplantation was compared. Results. The development of neoplastic lesion was registered in 9 cases (3.27%). Malignances were detected in 8 cases (2.90%). Median time to the onset of malignancy development was 48 months. 1, 3, and 5 year overall survival rates were 97%, 96%, 94%;respectively; 1, 3, and 5 year survival rates after transplantation for hepatocellular cancer were 97%, 91%, 91% respectively. Survival rate of patients with De-novo malignancy was 90%. Conclusion. Recipients of living donor liver transplantation have an increased risk of malignancy development that requires a close long-term follow-up.

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