The article presents an analysis of the current state of the problem antiviral therapy CMV-infection in patients undergoing liver transplantation. We retrospectively reviewed the experience of the Moscow Center for liver transplantation in the prevention of cytomegalovirus disease in liver recipients. We describe the clinical examples of different flow CMV-infection in patients after liver transplantation and therapy approaches.

Aim. To analyze the efficacy and safety of different induction therapy protocols experience based on depleting antibodies for kidney transplantation (ATGAM, Timoglobulin).

Material and methods. The study included 107 non-sensitized patients who underwent primary kidney allotransplantation in the period from January 2012 to March 2014. Patients were divided into 3 groups according to the ongoing induction immunosuppressive therapy. Group I, patients receiving the drug ATGAM (n = 67). Group II – Timoglobulin (n = 30). Group III, patients received a combination of the introduction of basiliximab and ATGAM (n = 10). All patients received basic triple immunosuppressive therapy: tacrolimus, mycophenolic acid, methylprednisolone tapering.

Results. The incidence of acute rejection in group I – 7,5% , in group II – 0%, in group III – 0% (p = 0,15). The incidence of severe thrombocytopenia in group I – 2,7%, in group II – 0% (p < 0,05), in group III – 10%. Incidence of CMV viremia in group I – 6,16%, in group II – 6,6%, in the group III – 10%, respectively (p > 0,05). In the 2-nd and 3-rd group registered one case of CMV pneumonia in the early postoperative period.

Conclusion. Use of exhaustible polyclonal antibodies as drugs of choice for renal transplantation induction therapy in primary unsensitized patients is warranted. Further research is needed for evaluation of 5- and 10-year results.

Abstract 

A brief history of kidney transplantation in experiment and clinic in Russia and in the world is presented. The role of Russian scientists in the solution of this problem and their research priorities are highlighted. Achievements of scientific school of academician B.V. Petrovskiy, who performed in 1965 the first successful kidney transplant in Russia, are showed. Attention is paid to current problems in the field of organ transplantation. Some results of kidney transplantation in Russia are given and perspectives of its applications are indicated.