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Authors
Runólfur Pálsson,Issue Date
2000-09-01
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Key issues concerning long-term management of transplant recipientsCitation
Læknablaðið 2000, 86(9):557-65Abstract
During the past 40 years, solid-organ transplantation has evolved into a routine clinical procedure for the management of end-stage heart, kidney, liver and lung disease as well as diabetes mellitus. This has mainly been accomplished through advances in understanding the molecular mechanisms involved in the rejection of allografts which has led to major improvements in immunosuppressive therapy. The discovery of the immunosuppressive drug cyclosporine which came into clinical use in the early eighties, revolutionized the field of transplantation. The short-term survival of allografts is now excellent but relentless loss of grafts over time due to chronic rejection remains a major problem. A number of complications can affect transplant recipients, most of which result from intensive immunosuppressive treatment. Among those are life-threatening infections and malignancies. The key issues concerning long-term management of transplant recipients are discussed.Á síðustu 40 árum hafa orðið miklar framfarir á sviði líffæraflutninga sem nú eru viðurkennd meðferð við lokastigssjúkdómi í hjarta, lifur, lungum og nýrum og við sykursýki. Stóraukinn skilningur á ónæmissvörun við ósamgena græðlingum hefur leitt til fjölbreyttari möguleika í ónæmisbælandi lyfjameðferð. Mestum straumhvörfum olli þó uppgötvun ónæmisbælandi lyfsins cýklósporíns sem farið var að nota við meðferð sjúklinga í upphafi níunda áratugarins. Skammtíma lifun ígræddra líffæra er nú mjög góð en hægfara tap græðlinga af völdum langvinnrar höfnunar er eitt stærsta vandamálið í dag. Margvíslegir fylgikvillar geta hrjáð líffæraþega og tengjast þeir flestir ónæmisbælandi lyfjameðferð. Meðal þeirra eru lífshættulegar sýkingar og krabbamein. Fjallað er um helstu atriði sem lúta að langtímameðferð líffæraþega.
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