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Disseminierte intravasculäre Gerinnung nach allogener Nierentransplantation. Diagnostische Bedeutung und therapeutische Konsequenzen

Disseminated intravascular coagulation following kidney allotransplantation. Diagnostic significance and therapeutic consequences

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Summary

Typical findings of disseminated intravascular coagulation (DIVC) could be detected in patients with allogeneic kidney transplants. A significant increase of fibrin-and/or fibrinogen split products in serum was found in these patients especially during rejection crises. This increase could be demonstrated several days before other symptoms of a rejection crisis became obvious and therefore is to be considered as an early indicator of impending rejection. The significance of heparin therapy is discussed in correlation to the findings of DIVC especially in patients with chronic rejections.

Zusammenfassung

In Untersuchungen an 9 allogenen nierentransplantierten Patienten, die unmittelbar nach und bis zu 1 Jahr nach der Transplantation gerinnungsanalytisch untersucht wurden, konnten Befunde einer disseminierten intravasculären Gerinnung durch den Nachweis von Fibrinmonomerkomplexen im Plasma und vor allem durch den Nachweis von Fibrin- bzw. Fibrinogenspaltprodukten im Serum dieser Patienten erbracht werden. Besonders auffällig sind ein signifikanter Anstieg der Fibrinogenspaltprodukto im Serum während Abstoßungsreaktionen. Es konnte aufgrund der Befunde eindeutig nachgewiesen werden, daß Fibrinogenspaltprodukte im Serum bedeutend früher als die üblichen klinischen Kriterien einer Abstoßungsreaktion erhoben werden können, so daß dieser Befund ein ausgesprochenes Frühkriterium einer drohenden Abstoßungsreaktion darstellt. Es wird ferner auf die Bedeutung der Heparin-Dauertherapie bei Patienten mit disseminierter intravasculärer Gerinnung und chronischer Abstoßungsreaktion eingegangen.

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  1. Klinik und Poliklinik für Allgemeinchirurgie und Medizinische Klinik der Universität Göttingen, Germany

    V. Zühlke, E. Quellhorst, E. Hierholzer & G. Mietzsch

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  1. V. Zühlke
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  2. E. Quellhorst
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  3. E. Hierholzer
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  4. G. Mietzsch
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Zühlke, V., Quellhorst, E., Hierholzer, E. et al. Disseminierte intravasculäre Gerinnung nach allogener Nierentransplantation. Diagnostische Bedeutung und therapeutische Konsequenzen. Klin Wochenschr 50, 370–378 (1972). https://doi.org/10.1007/BF01486833

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