References

nogr

Экспериментальная и клиническая гастроэнтерология

Experimental and Clinical Gastroenterology

1682-8658

«Global Media Technologies»

10.31146/1682-8658-ecg-246-2-61-83

nogr-3394

Research Article

ОБЗОР

REVIEW

Особенности течения и терапевтической стратегии язвенного колита у реципиентов печени

Features of the course and therapeutic strategy of ulcerative colitis in liver transplant recipients

https://orcid.org/0009-0009-0242-5743

Смирнова

Т. О.

Smirnova

T. O.

fedorovato@mail.ru

https://orcid.org/0000-0001-8391-5211

Сюткин

В. Е.

Syutkin

V. E.

noemail@neicon.ru

https://orcid.org/0000-0003-2370-170X

Паринов

О. В.

Parinov

O. V.

noemail@neicon.ru

https://orcid.org/0000-0001-5691-5398

Восканян

С. Э.

Voskanyan

S. E.

noemail@neicon.ru

ФГБУ ГНЦ ФМБЦ им. А.И. Бурназяна ФМБА РоссииРоссияState Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencyRussian Federation

ФГБУ ГНЦ ФМБЦ им. А.И. Бурназяна ФМБА России; ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияState Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency; N.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation

2026

18072026

026183

2026

Смирнова Т.О., Сюткин В.Е., Паринов О.В., Восканян С.Э.

Smirnova T.O., Syutkin V.E., Parinov O.V., Voskanyan S.E.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nogr.org/jour/article/view/3394

Целью настоящего обзора является оценка предполагаемых механизмов патогенеза, лежащих в основе поддержания активности ЯК у реципиентов печени, а также эффективности и безопасности препаратов, предлагаемых для лечения ЯК в этой группе больных. Материалы и методы. Проведен обзор литературы, касающийся темы воспалительных заболеваний кишечника у реципиентов печени. Результаты. Воспалительные заболевания кишечника (ВЗК) часто сочетаются с такими заболеваниями печени как первичный склерозирующий холангит (ПСХ), аутоиммунный гепатит (АИГ), первичный билиарный холангит (ПБХ). До 80% пациентов с ПСХ имеют сопутствующие ВЗК. Напротив, среди больных ВЗК ПСХ выявляется лишь в 5% случаев. Наиболее частыми вариантами ВЗК являются язвенный колит (ЯК), который встречается у 50-80% пациентов с ПСХ и болезнь Крона (БК), встречающаяся в 20% случаев ПСХ. Пациенты с ПСХ и ЯК имеют особенности клинического течения и выделены в отдельный фенотип ВЗК, отличный от пациентов, страдающих только ЯК. Трансплантация печени (ТП) остается единственным радикальным способом лечения терминальных стадий хронических диффузных заболеваний печени. После ТП все реципиенты получают поддерживающую иммуносупрессивную терапию (ИСТ). Препараты, применяемые для ИСТ, приводят к изменению течения ЯК в данной группе больных. Согласно действующим клиническим рекомендациям, препаратами выбора в лечении ЯК являются средства, действие которых направлено преимущественно на подавление иммунного ответа в слизистой оболочке толстой кишки. Биологическая терапия произвела революцию в лечении ВЗК, однако контролируемых клинических испытаний, посвященных лечению ЯК у пациентов, перенесших ТП, не проводилось. Риски развития и особенности течения ЯК у реципиентов печени изучены недостаточно, а терапия ЯК у больных, получающих поддерживающую ИСТ, не разработана и не нашла отражения в действующих клинических рекомендациях.

The aim of this review is to assess the proposed mechanisms of pathogenesis underlying the maintenance of UC activity in liver recipients, as well as the efficacy and safety of drugs proposed for the treatment of UC in this group of patients. Materials and methods. A literature review concerning the topic of inflammatory bowel diseases in liver recipients was conducted. Results. Inflammatory bowel diseases (IBD) are often associated with liver diseases such as primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and primary biliary cholangitis (PBC). Up to 80% of patients with PSC have concomitant IBD. Conversely, only 5% of patients with IBD have PSC. The most common IBD variants are ulcerative colitis (UC), which occurs in 50-80% of patients with PSC, and Crohn’s disease (CD), which occurs in 20% of cases of PSC. Patients with PSC and UC have specific clinical features and are classified as a separate IBD phenotype, distinct from patients with UC alone. Liver transplantation (LT) remains the only radical treatment for advanced stages of chronic diffuse liver diseases. After TP, all recipients receive maintenance immunosuppressive therapy (IST). The drugs used for IST lead to a change in the course of UC in this group of patients. According to current clinical guidelines, the drugs.

трансплантация печениязвенный колитванкомицин

ulcerative colitisliver transplantationvancomycin

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