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Folgeerkrankungen nach Organtransplantation

Sequelae of organ transplantation

  • Schwerpunkt: Folgeerkrankungen
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Die Transplantationsmedizin hat die Prognose terminaler Organerkrankungen entscheidend verändert und sich von einem experimentellen Ansatz zur Standardtherapie für viele Leber-, Nieren- und kardiovaskuläre Erkrankungen entwickelt. Sie verbindet den operativen Organersatz mit dem Management schwer erkrankter Patienten vor der Transplantation und eine lebenslange Nachsorge von Organempfängern. 10-Jahres-Überlebensraten von 65% bis über 90% lassen die Zahl transplantierter Patienten in der Regelversorgung ständig steigen und bilden eine Herausforderung für die internistische Versorgung. Neben den organspezifischen Folgen einer Transplantation sind es insbesondere infektiologische, mit der Immunsuppression assoziierte und Stoffwechselfolgen, welche die Morbidität und Mortalität nach Transplantation prägen. Hierzu zählen Virusinfektreaktivierungen, Organabstoßung, Anastomosenveränderungen aber v. a. allgemeine Mortalitätsfaktoren wie Diabetes, Niereninsuffizienz und Hypertonus, die entscheidend das Langzeitüberleben beeinflussen. Die konsequente Erkennung und Behandlung dieser Folgeerkrankungen in der internistischen Praxis sichert daher maßgeblich die langfristigen Erfolge der Transplantationsmedizin.

Abstract

Transplant medicine has significantly changed the prognosis of diseases leading to terminal organ failure. It has evolved from an experimental procedure to standard therapy for liver, kidney and cardio-vascular diseases. Transplant medicine combines operative organ replacement with the management of severely ill patients before transplantation, as well as life-long follow-up of organ graft recipients. Ten year survival rates of 65% to over 90% have led to a steady increase of transplanted patients seen by general medical care providers which represents a challenge for practicing internists. Apart from organ-specific conditions, infectious, immunosuppressant-associated and metabolic consequences determine long-term survival. These include virus reactivation, graft rejection, anastomotic problems but more importantly general mortality determining factors such as diabetes, renal insufficiency and hypertension, which are often a consequence of immunosuppressant administration. They directly impact long-term survival. The awareness and treatment of these secondary conditions of organ transplantation in routine medical practice contributes significantly to secure the long term success of transplant medicine.

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Authors and Affiliations

  1. Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover

    S. Ciesek, M. P. Manns &  C. P. Strassburg

  2. Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule, Carl-Neuberg-Straße 1, 30625, Hannover

    C. P. Strassburg

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  1. S. Ciesek
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  2. M. P. Manns
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  3. C. P. Strassburg
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Correspondence to C. P. Strassburg.

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Ciesek, S., Manns, M.P. & Strassburg, C.P. Folgeerkrankungen nach Organtransplantation. Internist 47, 252–265 (2006). https://doi.org/10.1007/s00108-006-1583-1

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  • DOI: https://doi.org/10.1007/s00108-006-1583-1

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