transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2022-14-4-421-431transplantologiya-704Research ArticleАКТУАЛЬНЫЕ ВОПРОСЫ ТРАНСПЛАНТОЛОГИИACTUAL ISSUES OF TRANSPLANTATIONВозврат аутоиммунных болезней после трансплантации печениRelapse of autoimmune diseases after liver transplantationhttps://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 пл., д. 3

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

3 Bolshaya Sukharevskaya Sq., Moscow 129090

SyutkinVE@sklif.mos.ruhttps://orcid.org/0000-0002-2732-684XСалиенкоА. А.SalienkoA. A.

Анастасия Александровна Салиенко, врач-хирург, научный сотрудник отделения трансплантации печени

129090, Москва, Большая Сухаревская пл., д. 3

Anastasiya A. Salienko, Surgeon, Researcher of the Department for Liver Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090

SalienkoAA@sklif.mos.ruhttps://orcid.org/0000-0002-0691-5581ОлисовО. Д.OlisovO. D.

Олег Даниелович Олисов, канд. мед. наук, старший научный сотрудник отделения трансплантации печени

129090, Москва, Большая Сухаревская пл., д. 3

Oleg D. Olisov, Cand. Sci. (Med.), Senior Researcher of the Department for Liver Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090

OlisovOD@sklif.mos.ruhttps://orcid.org/0000-0002-6362-7914НоврузбековМ. С.NovruzbekovM. S.

Мурад Сафтарович Новрузбеков, д-р мед. наук, заведующий научным отделением трансплантации печени

129090, Москва, Большая Сухаревская пл., д. 3

Murad S. Novruzbekov, Dr. Sci. (Med.), Head of the Scientific Department for Liver Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090

NovruzbekovMS@sklif.mos.ruГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202219122022144421431Copyright © Сюткин В.Е., Салиенко А.А., Олисов О.Д., Новрузбеков М.С., 20222022Сюткин В.Е., Салиенко А.А., Олисов О.Д., Новрузбеков М.С.Syutkin V.E., Salienko A.A., Olisov O.D., Novruzbekov M.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/704

Актуальность. Возврат аутоиммунных болезней печени может привести к снижению выживаемости реципиентов и трансплантатов.Цель. Изучить частоту и влияние на выживаемость трансплантатов рецидивов аутоиммунных болезней печени; влияние поддерживающей иммуносупрессии на возврат аутоиммунных болезней в трансплантате печени.Материал и методы. Ретроспективно проанализированы исходы трансплантаций у 111 реципиентов: 21 реципиент, оперированный по поводу аутоиммунного гепатита, 50 реципиентов, оперированных по поводу первичного билиарного цирроза и 40 реципиентов, оперированных по поводу первичного склерозирующего холангита.Результаты. После трансплантации печени возврат аутоиммунного гепатита наблюдается у 5% пациентов; первичного билиарного цирроза – у 10% и первичного склерозирующего холангита – у 17%. Среди пациентов с рецидивом аутоиммунных болезней мужчины составляли 54%, в то время как в подгруппе пациентов без рецидива – только 31% (p=0,004). Длительность наблюдения за реципиентами с рецидивом (64,5 (42,8;82,0) месяца) была сопоставима с длительностью наблюдения за реципиентами без рецидива (46,5 (17,9;103,5) месяца, p=0,54). Десятилетняя выживаемость трансплантатов была значительно ниже в группе реципиентов с возвратом аутоиммунных болезней по сравнению с реципиентами без рецидива (p<0,0001)Выводы. Возврат аутоиммунных болезней приводит к снижению выживаемости трансплантатов. Влияния компонентов иммуносупрессии на риск развития рецидива аутоиммунных болезней в трансплантате не установлено.

Background. The recurrence of autoimmune liver diseases can lead to reduced survival of recipients and grafts.Aim. To study the incidence and impact of the recurrence of autoimmune liver diseases on graft survival; the effect of maintenance immunosuppression on the recurrence of autoimmune diseases in liver transplant recipientsMaterial and methods. Transplantation outcomes in 111 recipients (21 recipients operated on for autoimmune hepatitis, 50 recipients operated on for primary biliary cirrhosis, and 40 recipients operated on for primary sclerosing cholangitis) were analyzed retrospectively.Results. The recurrence of autoimmune hepatitis is observed in 5%, the recurrence of primary biliary cirrhosis is in 10%, and the recurrence of primary sclerosing cholangitis is in 17% of cases. Among patients with recurrence of autoimmune diseases, men accounted for 54%, while for only 31% in the subgroup of patients without relapse (p=0.004). The followup for recipients with relapse (64.5 (42.8;82.0) months) was comparable to the follow-up for recipients without relapse (46.5 (17.9;103.5) months, p=0.54). A ten-year graft survival was significantly higher in the group of recipients with recurrent autoimmune diseases compared with recipients without autoimmune diseases recurrence (p<0.0001).Conclusions. The recurrence of autoimmune diseases leads to a decrease in graft survival. The effect of immunosuppression components on the risk of recurrence of autoimmune diseases in the graft has not been established.

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