transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2024-16-3-353-363transplantologiya-918Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCASE REPORTSРедкие случаи пересадки первично инфицированных трансплантатов почки с развитием гнойных осложненийRare cases of primarily infected kidney graft transplantation with the development of purulent complicationshttps://orcid.org/0000-0002-8199-905XШмаринаН. В.ShmarinaN. V.

Нонна Валерьевна Шмарина, канд. мед. наук, врач хирург, старший научный сотрудник отделения трансплантации почки и поджелудочной железы; доцент

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

117997, Москва, ул. Островитянова, д. 1 

Nonna V. Shmarina, Cand. Sci. (Med.), Surgeon, Senior Researcher, Department of Kidney and Pancreas Transplantation; Associate Professor

3 Bolshaya Sukharevskaya Sq., Moscow 129090  

1 Ostrovityanov St., Moscow 117997 

shmarinanv@sklif.mos.ruhttps://orcid.org/0000-0002-0473-9932ЛазареваК. Е.LazarevaK. E.

Ксения Евгеньевна Лазарева, канд. мед. наук, врач эндокринолог, научный сотрудник отделения трансплантации почки и поджелудочной железы; доцент

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

127006, Москва, Долгоруковская ул., д. 4 

Kseniya E. Lazareva, Cand. Sci. (Med.), Endocrinologist, Research Associate, Department of Kidney and Pancreas Transplantation; Associate Professor

3 Bolshaya Sukharevskaya Sq., Moscow 129090 

4 Dolgorukovskaya St., Moscow 127006 

lazarevake2@sklif.mos.ruhttps://orcid.org/0000-0002-5731-3310ДмитриевИ. В.DmitrievI. V.

Илья Викторович Дмитриев, д-р мед. наук, заведующий отделением трансплантации почки и поджелудочной железы; доцент

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

117997, Москва, ул. Островитянова, д. 1 

Ilya V. Dmitriev, Dr. Sci. (Med.), Head of the Department of Kidney and Pancreas Transplantation; Associate Professor

3 Bolshaya Sukharevskaya Sq., Moscow 129090  

1 Ostrovityanov St., Moscow 117997 

dmitrieviv@sklif.mos.ruhttps://orcid.org/0000-0002-1396-7048БалкаровА. Г.BalkarovA. G.

Аслан Галиевич Балкаров, канд. мед. наук, заведующий научным отделением трансплантации почки и поджелудочной железы; доцент; заведующий организационно-методическим отделом по трансплантологии

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

117997, Москва, ул. Островитянова, д. 1 

115184, Москва, Большая Татарская ул., д. 30 

Aslan G. Balkarov, Cand. Sci. (Med.), Head of the Scientific Department of Kidney and Pancreas Transplantation; Associate Professor; Head of the Organizational and Methodological Department for Transplantology

3 Bolshaya Sukharevskaya Sq., Moscow 129090  

1 Ostrovityanov St., Moscow 117997 

30 Bolshaya Tatarskaya St., Moscow 115184 

balkarovag@sklif.mos.ruhttps://orcid.org/0000-0002-2232-7296ЛоньшаковД. В.LonshakovD. V.

Денис Владимирович Лоньшаков, врач хирург отделения трансплантации почки и поджелудочной железы

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

Denis V. Lonshakov, Surgeon, Department of Kidney and Pancreas Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090 

lonshakovdv@sklif.mos.ruhttps://orcid.org/0000-0002-0156-2107ЖуравельН. С.ZhuravelN. S.

Никита Сергеевич Журавель, канд. мед. наук, врач хирург, младший научный сотрудник отделения трансплантации почки и поджелудочной железы; ассистент

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

127006, Москва, Долгоруковская ул., д. 4 

Nikita S. Zhuravel, Cand. Sci. (Med.), Surgeon, Junior Researcher, Department of Kidney and Pancreas Transplantation; Assistant

3 Bolshaya Sukharevskaya Sq., Moscow 129090 

4 Dolgorukovskaya St., Moscow 127006  

zhuravelns@gmail.comhttps://orcid.org/0009-0006-9621-520XСмирноваВ. В.SmirnovaV. V.

Виктория Владимировна Смирнова, врач хирург, младший научный сотрудник отделения трансплантации почки и поджелудочной железы

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

Viktoriya V. Smirnova, Surgeon, Junior Researcher, Department of Kidney and Pancreas Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090 

smirnovavv@sklif.mos.ruГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ» ; Кафедра трансплантологии искусственных органов ФДПО ИНОПР ФГАОУ ВО РНИМУ им. Н.И. Пирогова МЗ РФРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine ; Department of Transplantology and Artificial Organs, N.I. Pirogov Russian National Research Medical UniversityRussian FederationГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ» ; Кафедра трансплантологии и искусственных органов Научно-образовательного института «Высшая школа клинической медицины им. Н.А. Семашко» ФГБУ ВО «Российский университет медицины» МЗ РФРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine ; Department of Transplantology and Artificial Organs of the Scientific and Educational Institute "N.A. Semashko Higher School of Clinical Medicine", Russian University of MedicineRussian FederationГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ» ; Кафедра трансплантологии искусственных органов ФДПО ИНОПР ФГАОУ ВО РНИМУ им. Н.И. Пирогова МЗ РФ ; ГБУ «НИИ организации здравоохранения и медицинского менеджмента ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine ; Department of Transplantology and Artificial Organs, N.I. Pirogov Russian National Research Medical University ; Research Institute for Healthcare Organization and Medical ManagementRussian FederationГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202417092024163353363Copyright © Шмарина Н.В., Лазарева К.Е., Дмитриев И.В., Балкаров А.Г., Лоньшаков Д.В., Журавель Н.С., Смирнова В.В., 20242024Шмарина Н.В., Лазарева К.Е., Дмитриев И.В., Балкаров А.Г., Лоньшаков Д.В., Журавель Н.С., Смирнова В.В.Shmarina N.V., Lazareva K.E., Dmitriev I.V., Balkarov A.G., Lonshakov D.V., Zhuravel N.S., Smirnova V.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/918Актуальность

Актуальность. Непредвиденная передача возбудителя инфекционного заболевания с донорским органом реципиенту является редким событием, однако она связана со значительной заболеваемостью и смертностью, особенно при воздействии бактерий с множественной лекарственной устойчивостью, которые не были устранены с помощью стандартной антибиотикопрофилактики.

Цель

Цель. Демонстрация необходимости незамедлительного удаления первично инфицированного трансплантата почки при прогрессировании локальной инфекции в связи с высокой вероятностью развития синдрома полиорганной недостаточности и сепсиса у пациентов на иммуносупрессии.

Результаты

Результаты. Представлена картина клинического течения инфекционного процесса у двух реципиентов почки при трансплантации первично инфицированных трансплантатов от одного донора в зависимости от времени проведения трансплантатэктомии и результаты лечения.

Вывод

Вывод. Представленные наблюдения показывают необходимость немедленного проведения трансплантатэктомии у реципиента почки при выявлении местных гнойных осложнений при подтвержденном первичном инфицировании трансплантата в связи с быстрым развитием сепсиса и угрозы жизни.

Background

Background. Unexpected transmission of an infectious disease agent with a kidney graft to a recipient is a rare event but it is associated with significant morbidity and mortality, especially when exposed to multidrug-resistant bacteria that have not been eliminated by standard antibiotic prophylaxis.

Objective

Objective. To demonstrate the need for immediate removal of a primary infected kidney graft in the event of local purulent complications due to the rapid development of sepsis in immunocompromised patients.

Results

Results. The paper describes a clinical course of the infectious process in two kidney recipients each of whom underwent transplantation of a primary infected graft from a single donor, taking into consideration the transplantectomy timing and the treatment outcomes.

Conclusion

Conclusion. The Case Report shows the need for immediate transplantectomy in a kidney graft recipient when local purulent complications are detected with confirmed primary infection of the graft due to a high risk of the rapid development of sepsis and threat to life.

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