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Tumor und Transplantation

Tumor and transplantation

  • Chirurgie und Forschung
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Zusammenfassung

Tumortherapie und Transplantation, verbunden mit der zwangsläufig notwendigen Immunsuppression, scheinen unüberbrückbare Gegensätze zu sein. Die klinische Realität zeigt jedoch, dass die Transplantation bei vielen primären Lebertumoren im frühen Stadium wohl die effektivste Therapie darstellt. Die nach jeder Transplantation notwendige Immunsuppression kann jedoch die Bildung von Tumorrezidiven begünstigen. Die Immunsuppression führt auch zu einer deutlich erhöhten Rate von De-novo-Tumoren bei allen Transplantatempfängern. Aber längst nicht alle Immunsuppressiva haben den gleichen Effekt auf Tumoren. Die Klasse der mTOR-Inhibitoren zeigt im experimentellen, aber auch im klinischen Setting, ausgeprägte antitumorale Wirkungen und empfiehlt sich so als Immunsuppressivum der Wahl bei Patienten mit einem erhöhten Tumorrisiko. Diese Übersichtsarbeit soll den wissenschaftlichen Hintergrund für das klinische Problem von Tumoren und Transplantation darstellen.

Abstract

Tumor treatment and transplantation—associated with unavoidable mandatory immunosuppression—appear to be unreconcilable opposites. The clinical reality shows, however, that transplantation in many early stage primary tumors is the most effective treatment. The essential immunosuppression after transplantation can however promote tumor recurrence. Immunosuppression also leads to a significant increased rate of de novo tumors—in all organ transplant recipients. However, not all immunosuppressant drugs have the same effect on tumors. In experimental and clinical settings, the class of mTOR inhibitors has a clear antitumoral effect and is recommended as the immunosuppression treatment of choice in patients with increased tumor risk. The purpose of this review is to provide the reader with the scientific background regarding the clinical problem of tumors and transplantation.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Guba, J. Andrassy, M. Angele und C. Bruns geben an, dass kein Interessenkonflikt besteht. Das vorliegende Manuskript enthält keine Studien an Menschen oder Tieren.

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  1. Klinik für Allgemeine-, Viszeral-, Transplantations-, Gefäß- und Thoraxchirurgie, Klinikum der Universität München, Campus Grosshadern, Marchioninistr. 15, 81377, München, Deutschland

    M. Guba, J. Andrassy, M. Angele & C. Bruns

  2. Transplantationszentrum München, Klinikum der Universität München, München, Deutschland

    M. Guba & J. Andrassy

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  1. M. Guba
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  2. J. Andrassy
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  3. M. Angele
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  4. C. Bruns
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Correspondence to M. Guba.

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Guba, M., Andrassy, J., Angele, M. et al. Tumor und Transplantation. Chirurg 84, 690–697 (2013). https://doi.org/10.1007/s00104-012-2426-3

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