Zusammenfassung
Die Immunsuppression, welche die Abstoßung der transplantierten Nieren verhindert, geht mit einem erhöhten Risiko für die Tumorentwicklung einher. Andere Langzeitkomplikationen nach Transplantation, wie die des kardiovaskulären Systems oder Infektionen, nehmen an Bedeutung ab, sodass Tumoren sich zur führenden Ursache der hohen Mortalität in dieser Bevölkerungsgruppe entwickeln werden. Eine Reihe von Faktoren ist neben der Menge an Immunsuppression für die Tumorentwicklung von Bedeutung, so u. a. die die genetische Disposition, Viren und maligne Vorerkrankungen. Die Reduktion der Immunsuppression sowie eine konsequente und dem spezifischen Risiko angepasste Tumorvorsorge sind gegenwärtig die wichtigsten Maßnahmen zur Reduktion des Risikos, solange neue Formen der Immunsuppression bzw. die Induktion immunologischer Toleranz gegenüber dem Transplantat noch nicht zur Verfügung stehen.
Abstract
The chronic use of immunosuppressive agents to prevent allograft rejection increases the long-term risk of malignancy. With improved management and better outcomes of post-transplant infectious and cardiovascular complications, it is plausible that in the future post-transplant cancer may become the leading cause of death for this population. Many factors are involved in the development of malignancies including previous malignant diseases, genetic predisposition, viruses and the immunosuppression therapy itself. Lowering the amount of immunosuppression as far as possible and consistent tumor screening before and after transplantation are the current recommendations until new forms of immunosuppression or clinically applicable methods for tolerance induction become available.
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Kunzendorf, U., Renders, L. Tumoren nach Nierentransplantation. Nephrologe 4, 230–238 (2009). https://doi.org/10.1007/s11560-008-0273-5
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DOI: https://doi.org/10.1007/s11560-008-0273-5