Summary Respiratory complications can be the cause of graft dysfunction after lung transplantation (LTx). MicroRNAs are small regulatory molecules—potential biomarkers of respiratory diseases and post‐transplant complications. Galectin‐3 is highly expressed in fibrosis of transplanted solid organs. The aim was to evaluate the expression of plasma miR‐339 and galectin‐3 concentrations in lung recipients including with airway obstruction after LTx. The study included 57 lung recipients (34 men and 23 women aged 10 to 74 years) were followed up to 5 years after LTx. The plasma microRNAs were detected by real‐time PCR; galectin‐3 levels were measured by ELISA. During follow‐up in 30 recipients, post‐transplant complications were detected: 12 (40.0%) cases of airway obstruction. The levels of miR‐339 and galectin‐3 were significantly higher in recipients with airway obstruction compare with 27 (47.3%) recipients without any complications (P = 0.036 and P = 0.014, resp.). Increasing miR‐339 (above the 0.02 fold change) and galectin‐3 (above the 11.7 ng/ml) threshold plasma levels in lung recipients is associated with high risk (RR = 7.14 ± 0.97 [95% CI 1.05–48.60], P = 0.045) of airway obstruction after LTx. A measurement of miR‐339 expression in combination with galectin‐3 level might be perspective to identify recipients at risk of airway obstruction after LTx.

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Трансплантация легких -единственный радикальный метод лечения заболеваний легких в терминальной стадии дыхательной недостаточности. К 2019 году в мире выполнено 63 530 трансплантаций легких [13]. В силу многообразия заболеваний, приводящих пациентов к пересадке легких, существует широкий спектр различных осложнений и состояний, которые подлежат индивидуальному клиническому подходу для определения тактики лечения. Каждый случай представляет огромный интерес с клинической точки зрения в силу небольшого количества данных операций и сложности послеоперационной реабилитации, требующей мультидисциплинарного подхода [12]. Мы представляем клиническое наблюдение хирургического лечения экспираторного стеноза трахеи в сочетании с бронхоэктатической болезнью у пациента после трансплантации легких.

ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация Трансплантация легких является последним возможным вариантом терапии терминальных стадий заболеваний легких в случае неэффективности консервативной терапии. Согласно регистру Международного общества трансплантации сердца и легких, в мире выполнено более 60 000 трансплантаций легких. Тяжесть послеоперационного периода обусловлена высокой частой послеоперационных осложнений. Осложнения послеоперационного периода могут быть разделены на несколько групп: хирургические осложнения, первичная дисфункция трансплантата и острое отторжение, сердечно-сосудистые, абдоминальные и почечные осложнения. Цель данного обзора литературы-анализ основных осложнений в раннем послеоперационном периоде после трансплантации легких в мировой практике.

медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация 2 ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский университет), Москва, Российская ФедерацияСиндром исчезающего промежуточного бронха -это разновидность периферических бронхиальных стенозов, развивающихся у реципиентов донорских легких в сроки от 2 до 9 месяцев после трансплантации. Отсутствие своевременной диагностики и эффективного лечения приводит к снижению продолжительности и качества жизни. Представленное клиническое наблюдение демонстрирует успешное продолжительное лечение синдрома исчезающего промежуточного бронха у пациента после трансплантации донорских легких с применением методов интервенционной бронхологии.

Objective: to evaluate the expression levels of miRNA (miR-27, miR-101, miR-142, miR-339 and miR-424) and its relationship with clinical and laboratory parameters in lung transplant recipients. Materials and methods. The study included 57 lung recipients aged 10 to 74 years (35 ± 15), including six children (9%) – four boys 10, 12, 13 and 17 years and girls 13 and 14 years old – and 51 adult recipients, including 30 men (62.5%). The control group was made up of 14 healthy individuals that were not significantly different by gender and age. Expression levels of the microRNAs studied in blood plasma were determined via quantitative polymerase chain reaction (PCR). Correlations of miRNA expression levels with complete blood count and biochemical blood test indicators were analyzed. Results. Patients with end-stage chronic respiratory failure (potential lung recipients) were found to have significantly higher expression levels of miR-27, miR-101 and miR-339 in plasma than the healthy individuals (p = 0.02, p = 0.03 and p = 0.01, respectively). The expression level of miR-339 correlated with the age of potential lung recipients (p = 0.04). It was a negative correlation (r = –0.46). The expression levels of the other four miRNAs were age independent. The average expression level of miR-424 in lung recipients in the long-term period after lung transplant was higher than in waitlisted patients (p = 0.03). Analysis of the relationship between miRNA expression levels and external respiration function in the long-term post-transplant period showed that miR-142 expression level (r = 0.61; p = 0.04) positively correlates with the Tiffeneau-Pinelli index. This strong correlation, which exceeds 85%, indicates the presence of restrictive lung diseases. A year and more after transplantation, it was found that in the recipients, there were close positive correlations between miR-27, miR-142, miR-424 expression levels and blood leukocyte concentration, as well as between the miR-142 expression level and the sCD40L concentration during this period. Conclusion. A comparative study of the expression level of miRNAs (miR-27, miR-101, miR-142, miR-339 and miR-424) in the blood plasma of patients suffering from end-stage chronic lung diseases of various origin and in lung recipients enables us to conclude that further studies of the miRNA panels are needed in order to assess their effectiveness as potential molecular and genetic markers of post-transplant complications.

Bronchial complications are among the main causes of impairing postoperative period and thansplant failure. Severe bronchial complications are very rare but have a high mortality rate. Light forms decrease transplant function and while progressing can leads to life-threatening conditions without required treatment. Nowadays there is a huge necessity in classification of diagnostic and bronchial complications treatment on different terms after lung transplantation. Methods of observation bronchoscopy and interventional bronchology are allowing us to realize prevention, diagnostic and treatment bronchial complications.

Lung cancer remains the leading cause of cancer mortality worldwide. Solid organ transplant recipients are at risk of developing malignant tumors, including lung cancer, due to long-term use of immunosuppressive drugs. Development of cancer, including lung cancer, in this patient cohort, has a number of peculiarities. Moreover, malignant tumors in these patients are difficult to treat and have a poorer prognosis. This review presents a study of the issues concerning the mechanisms of lung cancer development, screening methods and treatment in solid organ transplant recipients.