Intensivmedizin und Notfallmedizin

, Volume 44, Issue 3, pp 129–141 | Cite as

Intensivmedizinische Betreuung von Patienten nach Stammzelltransplantation

  • C. E. Wrede
  • E. Holler
ÜBERSICHT
  • 53 Downloads

Zusammenfassung

Innerhalb der hämatologischen Therapieverfahren stellen Stammzelltransplantationen (SZT) den umfassendsten Eingriff dar. In verschiedenen Phasen der Transplantation haben diese Patienten erhöhte Risiken für unterschiedliche bakterielle und virale Infektionen sowie Pilzinfektionen. Insbesondere bei allogen transplantierten Patienten ist die Abgrenzung nichtinfektiöser, überwiegend immunologischer Komplikationen, z. B. Graft-versus-Host-Reaktionen oder eine VOD (Veno-occlusive Disease) notwendig, was oft eine diagnostische Herausforderung darstellt. Eine adäquate intensivmedizinische Therapie solcher Patienten kann nur unter Kenntnis der spezifischen Komplikationen nach SZT erfolgen. Diese Zusammenstellung gibt zunächst einen Überblick über die verschiedenen Phasen der SZT mit den entsprechenden infektiösen und nichtinfektiösen Komplikationen, und geht anschließend einzeln auf die organspezifischen pulmonalen, renalen, kardialen, gastrointestinalen, hepatischen und neurologischen Komplikationen nach SZT ein.

Schlüsselwörter

Intensivmedizin Stammzelltransplantation allogen autolog Graft versus Host 

Intensive care support of patients after stem cell transplantation

Abstract

Within the hematologic therapy procedures, stem cell transplantation (SCT) represents the most extensive and invasive intervention. Those patients have certain risks for several bacterial, viral, as well as fungal infections during the different stages of transplantation. Especially in allogenic transplantation, discrimination of non-infectious, mostly immunologic complications like graft-versus-host reactions or VOD (veno-occlusive disease) is crucial, and often represents a therapeutic challenge. An adequate intensive care therapy of these patients can only be achieved with the knowledge of the specific complications of SCT. This review starts with an overview of the SCT stages with their corresponding infectious and noninfectious complications, followed by the discussion of organ specific pulmonary, renal, cardiac, gastrointestinal, hepatic and neurological complications of stem cell transplantation.

Key words

intensive care stem cell transplantation allogen autolog graft versus host 

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Copyright information

© Steinkopff-Verlag 2007

Authors and Affiliations

  • C. E. Wrede
    • 1
  • E. Holler
    • 2
  1. 1.Klinik und Poliklinik für Innere Medizin IKlinikum der Universität RegensburgRegensburgGermany
  2. 2.Abteilung für Hämatologie und internistische OnkologieKlinikum der Universität RegensburgRegensburgGermany

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