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Langzeitkomplikationen nach viszeraler Organtransplantation

Long-term complications after visceral transplantation

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Der Gastroenterologe Aims and scope

Zusammenfassung

Die Prävention und die Behandlung von Langzeitkomplikationen nach viszeraler Organtransplantation gewinnen im Kontext von Organmangel und steigenden Überlebensraten zunehmend an Bedeutung. Der vorliegende Artikel gibt eine Übersicht über die verfügbare Literatur, Leitlinien und Expertenempfehlungen zu diesem Thema. Die Rekurrenz der Grunderkrankung, Infektionen, maligne Erkrankungen und kardiovaskuläre Ereignisse stellen die Hauptursachen für eine erhöhte Mortalität im Langzeitverlauf nach viszeraler Organtransplantation dar. Erkrankungen wie Diabetes mellitus, arterielle Hypertonie, Adipositas und Hyperlipidämie treten im Vergleich zur Normalbevölkerung gehäuft auf. Weiterhin müssen Abstoßungsreaktionen in Betracht gezogen werden. Eine adäquate Evaluation vor Lebertransplantation sowie eine intensive postoperative Nachsorge mit regelmäßigem Screening auf Langzeitkomplikationen sowie deren Therapie ist notwendig, um das Langzeitüberleben nach viszeraler Organtransplantation zu optimieren.

Abstract

The impact of long-term complications after visceral transplantation is increasing due to organ shortage and improved survival. This article provides an overview of the literature, guidelines and expert opinions. Recurrence of the underlying disease, infections, malignancy and cardiovascular events are the main reasons for long-term mortality after visceral transplantation. Diabetes mellitus, arterial hypertension, obesity and hyperlipidemia are diagnosed more frequently compared to the general population. Furthermore, rejection episodes must be considered. Adequate evaluation before transplantation as well as intensive postoperative follow-up with screening for long-term complications and their therapy is necessary to optimize long-term survival after visceral transplantation.

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Authors and Affiliations

  1. I. Medizinische Klinik und Poliklinik, Gastroenterologie und Hepatologie, Interdisziplinäres Transplantationszentrum, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland

    F. Darstein &  T. Zimmermann MHBA

  2. Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsmedizin Mainz, Mainz, Deutschland

    H. Lang

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  1. F. Darstein
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Correspondence to T. Zimmermann MHBA.

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Interessenkonflikt

F. Darstein, T. Zimmermann und H. Lang geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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G. Gerken, Essen

S. Zeuzem, Frankfurt am Main

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Darstein, F., Zimmermann, T. & Lang, H. Langzeitkomplikationen nach viszeraler Organtransplantation. Gastroenterologe 14, 296–300 (2019). https://doi.org/10.1007/s11377-019-0360-3

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