[Long-term problems after kidney transplantations].
Allogenic kidney transplantation is a widely established treatment option for patients with end-stage renal disease to gain independency from dialysis and recovery of excretory and hormonal functions. Transplantation is superior to dialysis with respect to quality of life, morbidity and mortality. Improvements in one-year graft survival have become evident during the last decades, but long-term outcome is not yet satisfying. The most common form of late transplant failure is chronic rejection or chronic allograft nephropathy, and as a consequence of higher ages of transplant recipients death of patients with functioning grafts. The histological hallmark of chronic rejection is intimal thickening of small arteries and arterioles, but the involved pathomechanisms are not well understood. Strict normalization of blood pressure and hyperlipidemia by drugs aims to prevent vascular alterations of chronic allograft nephropathy. In addition, in this overview some other late complications of renal transplant recipients are addressed which are associated to chronic immunosuppression, such as viral or malignant diseases.
Heidenreich
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Medizinische Klinik D, Westfälischen Wilhelms-Universität Münster. heidenr@uni-muenster.de
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D000367:Age Factors; D002908:Chronic Disease; D006084:Graft Rejection / Q000503:physiopathology*; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control; D006973:Hypertension / Q000517:prevention & control; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000503:physiopathology* / Q000517:prevention & control*; D012307:Risk Factors; D055502:Secondary Prevention
D007166:Immunosuppressive Agents
Langzeitprobleme bei nierentransplantierten Patienten.