Schutz der transplantierten Niere nach Nierentransplantation

Mario Schiffer

doi:10.1055/a-2538-1460

Nephrologie aktuell, Table of Contents

Nephrologie aktuell 2025; 29(06): 287-293
DOI: 10.1055/a-2538-1460

Schwerpunkt

Transplantation

Schutz der transplantierten Niere nach Nierentransplantation

Behandlungsstrategien, um die Transplantatdysfunktion zu verhindern

Mario Schiffer

Medizinische Klinik 4, Nephrologie und Hypertensiologie, Uniklinikum Erlangen, Erlangen

› Author Affiliations

Abstract

Zusammenfassung

Die Mechanismen des Nephronverlustes, die zu einer Transplantatdysfunktion führen, sind mannigfaltig und beinhalten sowohl immunologische Faktoren wie akute und chronische antikörper- oder T-Zell-vermittelte Abstoßungen, als auch nicht immunologische Faktoren. Dazu gehören, neben Schädigungen in der Peritransplantphase durch kalte und warme Ischämiezeiten, die typischen kardiovaskulären Risikofaktoren wie arterielle Hypertonie, Hyperlipidämie und vorbestehender Diabetes mellitus bzw. das Auftreten eines Post-Transplantations-Diabetes mellitus (PTDM). Weitere relevante Faktoren, die zu einem progredienten Verlust an Nierenmasse führen, ist die akute bzw. chronische Nephrotoxizität, die durch Calcineurininhibitoren (CNIs) ausgelöst wird. Rekurrierende Infekte und Virusinfektionen sind ebenfalls entscheidende Faktoren, die zu einem Transplantatverlust führen können. Dieser Artikel gibt eine Übersicht über die immunvermittelten Schädigungen und die nichtimmunologisch vermittelten Ursachen der Transplantatdysfunktion.

Full Text

References

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