mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/2072-3180-2023-4-88-95mossj-730Research ArticleЛИТЕРАТУРНЫЕ ОБЗОРЫLITERARY REVIEWSТрансплантация легких: состояние вопроса и перспективыLung transplantation: the state of the issue and prospectshttps://orcid.org/0000-0003-4204-8865ШумаковД. В.ShumakovD. V.

Шумаков Дмитрий Валерьевич – член-корр. РАН, д.м.н., профессор, руководитель отдела хирургии сердца и сосудов

129110, Москва, ул. Щепкина, д. 61/2

Shumakov Dmitry Valerievich – MD, PhD, professor, corresponding member RAS, Head of the Department of Cardiac and Vascular Surgery of the MONIKI named after M.F. Vladimirskii

Schepkina str., 61/2, Moscow, 129110

sdvtranspl@rambler.ruhttps://orcid.org/0000-0001-7087-5441ЗыбинД. И.ZybinD. I.

Зыбин Дмитрий Игоревич – к.м.н., руководитель отделения кардиохирургии

129110, Москва, ул. Щепкина, д. 61/2

Zybin Dmitry Igorevich – MD, PhD, Department head of the Cardiac Surgery of the MONIKI named after M.F. Vladimirskii

Schepkina str., 61/2, Moscow, 129110

poison1983@inbox.ruhttps://orcid.org/0000-0001-6898-5393ГоловинскийС. В.GolovinskyS. V.

Головинский Сергей Владимирович – старший научный сотрудник

115682, Москва, Ореховый бульвар, д. 28

Golovinskiy Sergey Vladimirovich – MD, Researcher of the Department Federal State Budgetary Institution «Research Institute of Pulmonology» of the Federal Medical and Biological Agency of Russif

115682 Moscow

lungtranspl@gmail.comhttps://orcid.org/0000-0002-0316-8410ПоповМ. А.PopovM. A.

Попов Михаил Александрович – к.м.н., старший научный сотрудник отделения кардиохирургии

129110, Москва, ул. Щепкина, д. 61/2

Popov Mikhail Alexandrovich – MD, PhD, Senior Researcher of the Department of Cardiac Surgery of the MONIKI named after M.F. Vladimirskii

Schepkina str., 61/2, Moscow, 129110

popovcardio88@mail.ruhttps://orcid.org/0000-0002-6074-1201АгафоновЕ. Г.AgafonovE. G.

Агафонов Евгений Геннадьевич – научный сотрудник отделения кардиохирургии

129110, Москва, ул. Щепкина, д. 61/2

Agafonov Evgeniy Gennadevich – MD, Researcher of the Department of Cardiac Surgery of the MONIKI named after M.F. Vladimirskii

Schepkina str., 61/2, Moscow, 129110

agafonov.cardiacsurger@mail.ruГБУЗ МО МОНИКИ им. М.Ф. ВладимирскогоРоссияMoscow Regional Research and Clinical Institute n.a. M.F. VladimirskiyRussian FederationФГБУ «НИИ Пульмонологии ФМБА России»РоссияFederal State Budgetary Institution «Research Institute of Pulmonology» of the Federal Medical and Biological AgencyRussian Federation202320122023048895Copyright © Шумаков Д.В., Зыбин Д.И., Головинский С.В., Попов М.А., Агафонов Е.Г., 20232023Шумаков Д.В., Зыбин Д.И., Головинский С.В., Попов М.А., Агафонов Е.Г.Shumakov D.V., Zybin D.I., Golovinsky S.V., Popov M.A., Agafonov E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/730

Введение. На сегодняшний день, несмотря на достижения в консервативной терапии, единственным методом лечения заболевания легких в терминальной стадии является трансплантация легких, которая улучшает качество и увеличивает продолжительность жизни пациента. В мире неуклонно растет количество трансплантаций легких, однако доступность донорских органов ограничена, что приводит к высокой летальности пациентов в листе ожидания. В этой связи постоянно идет дискуссия о донорах с расширенными критериями, ведутся работы по улучшению консервации донорских легких, идет поиск новых решений по сохранению трансплантата перед операцией и выращиванию биоинженерных органов. Наряду с этим, последние достижения в посттрансплантационной терапии, направленные на борьбу с ранним и поздним отторжением, дисфункцией трансплантата, а также профилактику инфекционных осложнений, способствуют увеличению выживаемости у данной категории пациентов.Цель исследования. Изучить состояние вопроса и перспектив трансплантации легких.Материалы и методы исследования. Проведен обзор литературных источников среди отечественных и англоязычных публикаций. Использованы базы данных Pubmed, Web of Science, РИНЦ.Заключение. На сегодняшний день трансплантация легких является единственным эффективным методом лечения для пациентов с заболеванием легких в терминальной стадии. В последние годы отмечается большой скачок в области трансплантации легких, увеличивается клинический опыт и посттрансплантационное ведение больных, все больше пациентов выживают с трансплантатами, которые несколько десятилетий назад считались непригодными. Не смотря на большой скачек в области трансплантации, главной проблемой развития трансплантации легких является ограниченная доступность донорских органов. Для решения проблемы нехватки донорских органов внедряются новые технологии (EVLP, биоинженерные легкие) и расширяются критерии использования донорских органов после остановки кровообращения.

Introduction. To date, despite advances in conservative therapy, the only method of treating end-stage lung disease is lung transplantation, which improves the quality and increases the patient's life expectancy. The number of lung transplants is steadily increasing in the world, however, the availability of donor organs is limited, which leads to a high mortality rate of patients on the waiting list. In this regard, there is a constant discussion about donors with expanded criteria, work is underway to improve the preservation of donor lungs, new solutions are being sought for the preservation of the transplant before surgery and the cultivation of bioengineered organs. Along with this, recent advances in post-transplant therapy aimed at combating early and late rejection, graft dysfunction, as well as prevention of infectious complications, contribute to an increase in survival in this category of patients.The purpose of the study. To study the state of the issue and prospects of lung transplantation.Materials and methods of research. A review of literary sources among domestic and English-language publications is carried out. Pubmed, Web of Science, RSCI databases were used.Conclusion. To date, lung transplantation is the only effective treatment method for patients with terminal lung disease. In recent years, there has been a big leap in the field of lung transplantation, clinical experience and post-transplant management of patients are increasing, more and more patients are surviving with transplants that were considered unsuitable several decades ago. Despite the big leap in the field of transplantation, the main problem of the development of lung transplantation is the limited availability of donor organs. To solve the problem of the shortage of donor organs, new technologies (EVLP, bioengineered lungs) are being introduced and criteria for the use of donor organs after circulatory arrest are being expanded.

трансплантация легкихдонорреципиентlung transplantationdonorrecipientReferencesSalerno C.T., Burdine J., Perry E.H., Kshettry V.R., Hertz M.I., Bolman R.M., 3rd. Donor-derived antibodies and hemolysis after ABO-compatible but nonidentical heart-lung and lung transplantation. Transplantation, 1998, № 65(2), рр. 261–264. https://doi.org/10.1097/00007890-199801270-00021Salerno C.T., Burdine J., Perry E.H., Kshettry V.R., Hertz M.I., Bolman R.M., 3rd. Donor-derived antibodies and hemolysis after ABO-compatible but nonidentical heart-lung and lung transplantation. Transplantation, 1998, № 65(2), рр. 261–264. https://doi.org/10.1097/00007890-199801270-00021Wagner W.R., Griffith B.P. Reconstructing the lung. Science, 2010, № 329(5991), рр. 520–522. https://doi.org/10.1126/science.1194087Wagner W.R., Griffith B.P. Reconstructing the lung. Science, 2010, № 329(5991), рр. 520–522. https://doi.org/10.1126/science.1194087Yeung JCKS.Overview of clinical lung transplantation. Cold Spring Harbor Perspect Med., 2014, № 4(1), рр. a015628. https://doi.org/10.1101/cshperspect.a015628Yeung JCKS.Overview of clinical lung transplantation. Cold Spring Harbor Perspect Med., 2014, № 4(1), рр. a015628. https://doi.org/10.1101/cshperspect.a015628Lund L., Khush K., Cherikh W., Goldfarb S.., Kucheryavaya A, Levvey B. et al. The registry of the international society for heart and lung transplantation: thirty-fourth adult heart transplantation report-2017; focus theme: allograft ischemic time. J Heart Lung Transpl., 2017., № 36(10), рр. 1037–1046. https://doi.org/10.1016/j.healun.2017.07.019Lund L., Khush K., Cherikh W., Goldfarb S.., Kucheryavaya A, Levvey B. et al. The registry of the international society for heart and lung transplantation: thirty-fourth adult heart transplantation report-2017; focus theme: allograft ischemic time. J Heart Lung Transpl., 2017., № 36(10), рр. 1037–1046. https://doi.org/10.1016/j.healun.2017.07.019Valapour M., Skeans M.A., Heubner B.M. OPTN/SRTR 2013 annual data report: lung. Am J Transplant., 2015, № 15(Suppl 2), рр. 1–28. https://doi.org/10.1111/ajt.13200Valapour M., Skeans M.A., Heubner B.M. OPTN/SRTR 2013 annual data report: lung. Am J Transplant., 2015, № 15(Suppl 2), рр. 1–28. https://doi.org/10.1111/ajt.13200Weill D. Access to lung transplantation. The long and short of it. Am J RespirCrit Care Med., 2016, № 193(6), рр. 605–606. https://doi.org/10.1164/rccm.201511-2257EDWeill D. Access to lung transplantation. The long and short of it. Am J RespirCrit Care Med., 2016, № 193(6), рр. 605–606. https://doi.org/10.1164/rccm.201511-2257EDCharles E.J., Huerter M.E., Wagner C.E. Donation after circulatory death lungs transplantable up to six hours after ex vivo lung perfusion. Ann Thorac Surg., 2016, № 102(6), рр. 1845–1853. https://doi.org/10.1016/j.атораксур.2016.06.043Charles E.J., Huerter M.E., Wagner C.E. Donation after circulatory death lungs transplantable up to six hours after ex vivo lung perfusion. Ann Thorac Surg., 2016, № 102(6), рр. 1845–1853. https://doi.org/10.1016/j.атораксур.2016.06.043Reeb J., Keshavjee S., Cypel M. Expanding the lung donor pool. Curr Opin Organ Transplant., 2015, № 20(5), рр. 498–505. https://doi.org/10.1097/MOT.0000000000000233Reeb J., Keshavjee S., Cypel M. Expanding the lung donor pool. Curr Opin Organ Transplant., 2015, № 20(5), рр. 498–505. https://doi.org/10.1097/MOT.0000000000000233Krutsinger D, Reed RM, Blevins A. Lung transplantation from donation after cardiocirculatory death: a systematic review and meta-analysis. J Heart Lung Transplant. 2015;34(5):675–684. https://doi.org/10.1016/j.healun.2014.11.009Krutsinger D, Reed RM, Blevins A. Lung transplantation from donation after cardiocirculatory death: a systematic review and meta-analysis. J Heart Lung Transplant. 2015;34(5):675–684. https://doi.org/10.1016/j.healun.2014.11.009Kootstra G., Daemen J.H., Oomen A.P. “Categories of non-heartbeating donors”. Transplantation Proceedings, 1995, № 27(5), рр. 2893–2894. https://doi.org/10.1016/j.nephro.2007.06.017Kootstra G., Daemen J.H., Oomen A.P. “Categories of non-heartbeating donors”. Transplantation Proceedings, 1995, № 27(5), рр. 2893–2894. https://doi.org/10.1016/j.nephro.2007.06.017Aigner C., Winkler G., Jaksch P. Extended donor criteria for lung transplantation—a clinical reality. Eur J Cardiothorac Surg., 2005, № 27(5), рр. 757–761. https://doi.org/10.1016/j.ejcts.2005.01.024Aigner C., Winkler G., Jaksch P. Extended donor criteria for lung transplantation—a clinical reality. Eur J Cardiothorac Surg., 2005, № 27(5), рр. 757–761. https://doi.org/10.1016/j.ejcts.2005.01.024Tikkanen J.M., Cypel M., Machuca T.N. Functional outcomes and quality of life after normothermic ex vivo lung perfusion lung transplantation. J Heart Lung Transplant., 2015, № 34(4), рр. 547–556. https://doi.org/10.1016/j.healun.2014.09.044Tikkanen J.M., Cypel M., Machuca T.N. Functional outcomes and quality of life after normothermic ex vivo lung perfusion lung transplantation. J Heart Lung Transplant., 2015, № 34(4), рр. 547–556. https://doi.org/10.1016/j.healun.2014.09.044Somers J., Ruttens D., Verleden S.E. A decade of extended-criteria lung donors in a single center: Was it justified? Transpl Int., 2015, № 28(2), рр. 170–179. https://doi.org/10.1111/tri.12470Somers J., Ruttens D., Verleden S.E. A decade of extended-criteria lung donors in a single center: Was it justified? Transpl Int., 2015, № 28(2), рр. 170–179. https://doi.org/10.1111/tri.12470Dorrello N.V., Guenthart B.A., O’Neill J.D. Functional vascularized lung grafts for lung bioengineering. Sci Adv., 2017, № 3(8), рр. e1700521. https://doi.org/10.1126/sciadv.1700521Dorrello N.V., Guenthart B.A., O’Neill J.D. Functional vascularized lung grafts for lung bioengineering. Sci Adv., 2017, № 3(8), рр. e1700521. https://doi.org/10.1126/sciadv.1700521Meers C., Van Raemdonck D., Verleden G.M. The number of lung transplants can be safely doubled using extended criteria donors; a single-center review. Transpl Int., 2010, № 23(6), рр. 628–635. https://doi.org/10.1111/j.1432-2277.2009.01033Meers C., Van Raemdonck D., Verleden G.M. The number of lung transplants can be safely doubled using extended criteria donors; a single-center review. Transpl Int., 2010, № 23(6), рр. 628–635. https://doi.org/10.1111/j.1432-2277.2009.01033Sommer W., Kühn C., Tudorache I. Extended criteria donor lungs and clinical outcome: results of an alternative allocation algorithm. J Heart Lung Transplant., 2013, № 32(11), рр. 1065–1072. https://doi.org/10.1016/j.healun.2013.06.021Sommer W., Kühn C., Tudorache I. Extended criteria donor lungs and clinical outcome: results of an alternative allocation algorithm. J Heart Lung Transplant., 2013, № 32(11), рр. 1065–1072. https://doi.org/10.1016/j.healun.2013.06.021Taaning E, Morling N, Mortensen SA, Pettersson G, Simonsen AC. Severe hemolysis caused by graft-derived anti-B production after lung transplantation. J Heart Lung Transpl. 1996;15(8):850–851.Taaning E, Morling N, Mortensen SA, Pettersson G, Simonsen AC. Severe hemolysis caused by graft-derived anti-B production after lung transplantation. J Heart Lung Transpl. 1996;15(8):850–851.DemirA., Coosemans W., Decaluwe H., De Leyn .P, Nafteux P., Van Veer H. et al. Donor-recipient matching in lung transplantation: which variables are important? Eur J Cardiothorac Surg., 2015, № 47(6), рр. 974–983. https://doi.org/10.1093/ejcts/ezu340DemirA., Coosemans W., Decaluwe H., De Leyn .P, Nafteux P., Van Veer H. et al. Donor-recipient matching in lung transplantation: which variables are important? Eur J Cardiothorac Surg., 2015, № 47(6), рр. 974–983. https://doi.org/10.1093/ejcts/ezu340Fakhro M. ABO-identical matching has no superiority in long-term survival in comparison to ABO-compatible matching in lung transplantation. J Cardiothorac Surg., 2019, № 14, рр. 24. https://doi.org/10.1186/s13019-019-0846-6Fakhro M. ABO-identical matching has no superiority in long-term survival in comparison to ABO-compatible matching in lung transplantation. J Cardiothorac Surg., 2019, № 14, рр. 24. https://doi.org/10.1186/s13019-019-0846-6Bonser R.S., Taylor R., Collett D., Thomas H.L., Dark J.H., Neuberger J. Effect of donor smoking on survival after lung transplantation: a cohort study of a prospective registry. Lancet, 2012, № 380(9843), рр. 747–755. https://doi.org/10.1016/S0140-6736(12)60160-3Bonser R.S., Taylor R., Collett D., Thomas H.L., Dark J.H., Neuberger J. Effect of donor smoking on survival after lung transplantation: a cohort study of a prospective registry. Lancet, 2012, № 380(9843), рр. 747–755. https://doi.org/10.1016/S0140-6736(12)60160-3Munshi L., Keshavjee S., Cypel M. Donor management and lung preservation for lung transplantation. Lancet Respir Med., 2013, № 1(4), рр. 318–328. https://doi.org/10.1016/S2213-2600(12)70064-4Munshi L., Keshavjee S., Cypel M. Donor management and lung preservation for lung transplantation. Lancet Respir Med., 2013, № 1(4), рр. 318–328. https://doi.org/10.1016/S2213-2600(12)70064-4Gomez-de-Antonio D., Campo-Cañaveral J.L., Crowley S. Clinical lung transplantation from uncontrolled non–heart-beating donors revisited. J Heart Lung Transplant., 2012, № 31(4), рр. 349–353. https://doi.org/10.1016/j.healun.2011.12.007.Gomez-de-Antonio D., Campo-Cañaveral J.L., Crowley S. Clinical lung transplantation from uncontrolled non–heart-beating donors revisited. J Heart Lung Transplant., 2012, № 31(4), рр. 349–353. https://doi.org/10.1016/j.healun.2011.12.007.Meneses J.C., Gámez P., Mariscal A. Development of a non–heart-beating donor program and results after the first year. Transplant Proc., 2012, № 44(7), рр. 2047–2049. https://doi.org/10.1016/j.transproceed.2012.07.092Meneses J.C., Gámez P., Mariscal A. Development of a non–heart-beating donor program and results after the first year. Transplant Proc., 2012, № 44(7), рр. 2047–2049. https://doi.org/10.1016/j.transproceed.2012.07.092Machuca T.N., Cypel M. Ex vivo lung perfusion. J Thorac Dis., 2014, № 6(8), р. 1054–1062. https://doi.org/10.3978/j.issn.2072-1439.2014.07.12Machuca T.N., Cypel M. Ex vivo lung perfusion. J Thorac Dis., 2014, № 6(8), р. 1054–1062. https://doi.org/10.3978/j.issn.2072-1439.2014.07.12Ware L.B., Wang Y., Fang X., Warnock M., Sakuma T., Hall T.S. et al. Assessment of lungs rejected for transplantation and implications for donor selection. Lancet, 2002, № 360, рр. 619–620. https://doi.org/10.1016/s0140-6736(02)09774-xWare L.B., Wang Y., Fang X., Warnock M., Sakuma T., Hall T.S. et al. Assessment of lungs rejected for transplantation and implications for donor selection. Lancet, 2002, № 360, рр. 619–620. https://doi.org/10.1016/s0140-6736(02)09774-xHozain A.E., Tipograf Yu., Pinezich M.R., O’Neill J.D., Vunjak-Novakovic G., Bacchetta M. Multiday maintenance of extracorporeal lungs using cross-circulation with conscious swine. Thoracic: Lung Transplantation, 2020, № 159(4). https://doi.org/10.1016/j.jtcvs.2019.09.121Hozain A.E., Tipograf Yu., Pinezich M.R., O’Neill J.D., Vunjak-Novakovic G., Bacchetta M. Multiday maintenance of extracorporeal lungs using cross-circulation with conscious swine. Thoracic: Lung Transplantation, 2020, № 159(4). https://doi.org/10.1016/j.jtcvs.2019.09.121Boffini M., Ricci D., Bonato R., Fanelli V., Attisani M., Ribezzo M. et al. Incidence and severity of primary graft dysfunction after lung transplantation using rejected grafts reconditioned with ex vivo lung perfusion. Eur J Cardiothorac Surg., 2014, № 46, рр. 789–793. https://doi.org/10.1093/ejcts/ezu239Boffini M., Ricci D., Bonato R., Fanelli V., Attisani M., Ribezzo M. et al. Incidence and severity of primary graft dysfunction after lung transplantation using rejected grafts reconditioned with ex vivo lung perfusion. Eur J Cardiothorac Surg., 2014, № 46, рр. 789–793. https://doi.org/10.1093/ejcts/ezu239Kugler C., Gottlieb J., Warnecke G., Schwarz A., Weissenborn K., Barg-Hock H. et al. Health-related quality of life after solid organ transplantation: a prospective, multiorgan cohort study. Transplant J., 2013, № 96, рр. 316–323. https://doi.org/10.1097/TP.0b013e31829853ebKugler C., Gottlieb J., Warnecke G., Schwarz A., Weissenborn K., Barg-Hock H. et al. Health-related quality of life after solid organ transplantation: a prospective, multiorgan cohort study. Transplant J., 2013, № 96, рр. 316–323. https://doi.org/10.1097/TP.0b013e31829853ebWobma H., Vunjak-Novakovic G. Tissue engineering and regenerative medicine 2015: a year in review. Tissue Eng Part B Rev., 2016, № 22(2), рр. 101–113. https://doi.org/10.1089/ten.TEB.2015.0535Wobma H., Vunjak-Novakovic G. Tissue engineering and regenerative medicine 2015: a year in review. Tissue Eng Part B Rev., 2016, № 22(2), рр. 101–113. https://doi.org/10.1089/ten.TEB.2015.0535Nichols J.E., La Francesca S., Niles J.A., Vega S.P., Argueta L.B., Frank L. et.al. Production and transplantation of bioengineered lung into a large-animal model. Science Translational Medicine, 2018, № 10(452). https://doi.org/10.1126/scitranslmed.aao3926Nichols J.E., La Francesca S., Niles J.A., Vega S.P., Argueta L.B., Frank L. et.al. Production and transplantation of bioengineered lung into a large-animal model. Science Translational Medicine, 2018, № 10(452). https://doi.org/10.1126/scitranslmed.aao3926

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