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肾移植后的胃肠道并发症。

Gastrointestinal complications after kidney transplantation.

机构信息

General Surgery Unit, University Hospital of Catania, Catania 95123, Italy.

Department of Biomedical and Biotechnological Sciences, University of Catania, Catania 95123, Italy.

出版信息

World J Gastroenterol. 2020 Oct 14;26(38):5797-5811. doi: 10.3748/wjg.v26.i38.5797.

Abstract

Gastrointestinal complications are common after renal transplantation, and they have a wide clinical spectrum, varying from diarrhoea to post-transplant inflammatory bowel disease (IBD). Chronic immunosuppression may increase the risk of post-transplant infection and medication-related injury and may also be responsible for IBD in kidney transplant re-cipients despite immunosuppression. Differentiating the various forms of post-transplant colitis is challenging, since most have similar clinical and histological features. Drug-related colitis are the most frequently encountered colitis after kidney transplantation, particularly those related to the chronic use of mycophenolate mofetil, while IBDs are quite rare. This review will explore colitis after kidney transplantation, with a particular focus on different clinical and histological features, attempting to clearly identify the right treatment, thereby improving the final outcome of patients.

摘要

胃肠道并发症在肾移植后很常见,其临床表现广泛,从腹泻到移植后炎症性肠病(IBD)不等。慢性免疫抑制可能会增加移植后感染和药物相关损伤的风险,并且即使在免疫抑制的情况下,也可能导致肾移植受者的 IBD。区分各种类型的移植后结肠炎具有挑战性,因为大多数结肠炎具有相似的临床和组织学特征。肾移植后最常发生的结肠炎是与药物相关的结肠炎,特别是与长期使用霉酚酸酯有关的结肠炎,而 IBD 则相当罕见。这篇综述将探讨肾移植后的结肠炎,特别关注不同的临床和组织学特征,试图明确确定正确的治疗方法,从而改善患者的最终结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/846c/7579754/0e0bf4e849d2/WJG-26-5797-g001.jpg

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