Dieser Artikel soll einen Überblick über den Einsatz und
mögliche Probleme der immunsuppressiven Therapie nach solider
Organtransplantation (SOT) geben. Für einige Immunsuppressiva sind
andere Empfehlungen bezüglich der angestrebten Talblutspiegel angegeben,
als dies in der Fachinformation empfohlen ist. Wir möchten
ausdrücklich darauf hinweisen, dass es sich hierbei um die
persönliche Meinung der Autor*innen handelt.
Abstract
Patients who have undergone a transplantation have a significantly increased risk
of developing a malignancy compared to the normal population. The risk of tumour
development depends mainly on the type of the transplanted organ, the dose and
duration of immunosuppression, as well as the patient’s medical history,
and may require individualised pre-transplant and post-transplant care. Standard
immunosuppression is usually based on a combination of tacrolimus with
mycophenolic acid/enteric-coated mycophenolic acid or, more rarely, a
mTor inhibitor. Induction therapy may allow baseline immunosuppression to be
delayed and/or started at a reduced dose. The most frequent long-term
complications after liver transplantation include calcineurin
inhibitor-associated nephrotoxicity; in addition, transplanted patients have an
increased cardiovascular (kidney transplantation), infection and tumour risk
(liver, kidney transplantation), depending on the time course after
transplantation and the type of immunosuppression. To minimise long-term
complications, individualised immunosuppression is recommended, taking
comorbidities into account.
Schlüsselwörter
Immunsystem - Transplantation - Immunsuppressiva - Organempfänger - Abstoßungsreaktion
Key words
immune system - transplantation - immunosuppressants - organ recipient - rejection
reaction
