IMMUNOLOGICAL FOUNDATIONS AND CHALLENGES IN ORGAN TRANSPLANTATION

Аннотация

Compared to transplantation of other organs, such a direction as kidney transplantation has more than half a century of history. During this period, tremendous experience has been accumulated regarding the modernization of surgical techniques, organ preservation, improvement and optimization of immunosuppression protocols, as well as postoperative management of patients. By the end of the 90s, modern survival rates for renal transplants and recipients had been achieved. The success of kidney transplantation, however, has led to the fact that "waiting lists" for the operation are growing steadily every year around the world. Keywords. Immunosuppression, hemodialysis, allogeneic transplant, immune response. One of the essential factors determining the success of organ transplantation is the immunological compatibility of donor and recipient tissues. Achievements of the last decade of the last century in the field of fundamental immunogenistics, which made it possible to concretize the mechanisms of the implementation of the main functions of proteins. The gene-encoded immune response, as well as the transition from the study of genes of the human immune response from serological to molecular-genetic, have not only opened up fundamentally new possibilities for introducing these advances into medicine, but have made it possible to put them into practice with unprecedented speed [4]. Thanks to these advances, the effectiveness of kidney transplants (based on the results of the annual survival rate in the centers that switched to donor selection based on molecular genetic typing) increased by https://scientific-jl.org/obr 9 Выпуск журнала №-70 Часть–2_ Мая –2025 ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ 2181-3187 twenty%. At the same time, the remaining indicators of the functional graft significantly improved. Treatment of end-stage chronic renal failure is one of the most pressing modern medical and social problems. Existing methods of renal replacement therapy for end- stage chronic renal failure: hemodialysis. Perntoneal dialysis and allotransplants of the kidneys are constantly being improved, which leads to an increase in the life expectancy of patients, but not always - in quality. At the same time, the number of patients requiring renal replacement therapy is constantly increasing, which complicates the availability of J10. Today, kidney transplantation is considered as the optimal method of renal replacement therapy, since it increases the duration and quality of life of patients to a greater extent than perntoneal and hemodialysis. In addition, it is known that kidney transplantation provides a higher quality of life for patients, and is also the most preferred by the method of renal replacement therapy from an economic point of view [5], The discovery and use of modern methods of immunosuppressin made it possible to reduce the likelihood of developing an acute rejection reaction and to increase the graft survival rate during the first year after the operation, leaving the long-term survival rates of the rsial allatran graft unsatisfactory. In connection with this, methods of predicting the conflict "donor bale-recipient" are being actively developed. The interest of researchers in the study of immunological parameters in organ transplantation and kidney transplantation in particular has always remained at a high level, but the opportunity to study the delicate relationship between the recipient's organism and the donor organ has appeared in the last twenty years. This is associated with a number of important discoveries in the field of fundamental immunology. This entailed the introduction into wide practice of new reliable and highly sensitive research methods, modern instruments and diagnostic systems [2]. The use of new complex methods requires clinical understanding. So, in particular, after the introduction into practice of the molecular genetic approach to typing HLA genes, it became necessary to conduct a comparative analysis https://scientific-jl.org/obr 1 0 Выпуск журнала №-70 Часть–2_ Мая –2025 ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ 2181-3187 of the results obtained by both methods. Such studies were carried out by many laboratories around the world that are engaged in histotyping [1]. The data obtained revealed serious discrepancies in the typing results. Therefore, similar works aimed, ultimately, at the optimization of imunophenotinning continue and remain relevant. Treatment of chronic renal failure is one of the medical and social problems for modern modern medicine. There are now a growing number of methods for the kidney and its maintenance, for example: Temporary renal hemodialysis, in addition to kidney transplantation, which increases the life expectancy of patients. But not always. Currently, the number of patients in need of kidney transplantation and the number of transplant options is increasing. Renal transplantation, renal complications, impaired adaptation of the d