Medicina, Vol. 46 No. 4, 2010.
Pregledni rad
Complications after kidney transplantation
Stela Živčić-Ćosić
orcid.org/0000-0002-0770-8808
; Zavod za nefrologiju i dijalizu, Klinika za internu medicinu, Klinički bolnički centar Rijeka
Zlatko Trobonjača
; Zavod za fiziologiju i imunologiju, Medicinski fakultet Sveučilišta u Rijeci
Branka Sladoje-Martinović
; Zavod za nefrologiju i dijalizu, Klinika za internu medicinu, Klinički bolnički centar Rijeka
Lidija Orlić
; Zavod za nefrologiju i dijalizu, Klinika za internu medicinu, Klinički bolnički centar Rijeka
Sažetak
Renal transplantation is the best replacement therapy for renal failure in most patients,
but it is often associated with development of complications. The leading causes of
end-stage renal failure (diabetes mellitus, arterial hypertension and atherosclerosis), aging of
the population undergoing dialysis and widening of the acceptance criterias for both recipients
and donors, significantly increase morbidity. During the first year after transplantation,
most grafts are lost due to acute rejection, arterial thrombosis, primary graft non-function and
death. After the first year, most grafts are lost due to death from other causes, but with a functioning
graft, and chronic allograft nephropathy. According to the data collected in our institution
during the last twenty-five years, cardiovascular diseases caused death in 44.8 % recipients,
infection in 20.1 % and malignant tumors in 8.4 %, while in 17.5 % of cases, the cause of
death was unknown. This paper addresses the etiology of the most common complications after
renal transplantation. Acute allograft rejection is a significant cause of chronic nephropathy
and graft loss. With available immunosuppressive treatments, it occurs in less than 15 % of
patients, it is frequently asymptomatic and a rise in serum creatinine is a late and nonspecific
marker. For early diagnosis of rejection and causes of graft damage, several methods of immune
monitoring are investigated, including not only the determination of antibodies against
the allograft and markers of cell activation, but also gene profiling and determination of proteins
and metabolites in blood, urine and biopsy specimens. These methods could allow individualised
immunosuppressive treatments and timely treatment of complications, leading to
an improvement of results after renal transplantation.
Ključne riječi
acute rejection; immunologic monitoring; renal transplantation
Hrčak ID:
63066
URI
Datum izdavanja:
8.12.2010.
Posjeta: 7.183 *