РЕКУРРЕНТНЫЕ ЗАБОЛЕВАНИЯ В ПЕДИАТРИЧЕСКОЙ ПОЧЕЧНОЙ ТРАНСПЛАНТАЦИИ

Риск развития рекуррентного заболевания после трансплантации почки у детей относительно высокий и может привести к потере трансплантата в 7–8% случаев. Рецидив основного заболевания почек может быть связан с высоким риском потери трансплантата (фокальный и сегментарный гломерулосклероз, мембранопролиферативный гломерулонефрит, оксалоз, атипичный гемолитико-уремический синдром) или с низким риском потери трансплантата (IgA-нефропатия, СКВ, ANCA-ассоциировынный гломерулонефрит). Рецидив также может повышать отсроченный риск потери трансплантата при таких заболеваниях, как инсулин-зависимый сахарный диабет и серповидно-клеточная анемия. В связи с этим необходимо применять соответствующую стратегию, например, проводить претрансплантационное генотипирование, адекватный отбор доноров, использовать специфическую иммуносупрессию и/или биотерапию, сочетанную трансплантацию почки и печени, а также другие. Это позволит значительно расширить лист ожидания за счет существенного снижения исключения пациентов из-за высокого развития рецидива. В будущем проблема рекуррентных заболеваний после трансплантации почки может решиться благодаря альтернативным методам лечения.

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