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肾移植患者的胃肠并发症

Gastroenterological complications in kidney transplant patients.

作者信息

Calogero Armando, Gallo Monica, Sica Antonello, Peluso Gaia, Scotti Alessandro, Tammaro Vincenzo, Carrano Rosa, Federico Stefano, Lionetti Ruggero, Amato Maurizio, Carlomagno Nicola, Dodaro Concetta Anna, Sagnelli Caterina, Santangelo Michele

机构信息

Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy.

出版信息

Open Med (Wars). 2020 Jul 11;15(1):623-634. doi: 10.1515/med-2020-0130. eCollection 2020.

Abstract

Kidney transplantation is the surgical operation by which one of the two original kidneys is replaced with another healthy one donated by a compatible individual. In most cases, donors are recently deceased. There is the possibility of withdrawing a kidney from a consenting living subject. Usually, living donors are direct family members, but they could be volunteers completely unrelated to the recipient. A much-feared complication in case of kidney transplantation is the appearance of infections. These tend to arise due to immune-suppressor drugs administered as anti-rejection therapy. In this review, we describe the gastrointestinal complications that can occur in subjects undergoing renal transplantation associated with secondary pathogenic microorganisms or due to mechanical injury during surgery or to metabolic or organic toxicity correlated to anti-rejection therapy. Some of these complications may compromise the quality of life or pose a significant risk of mortality; fortunately, many of them can be prevented and treated without the stopping the immunosuppression, thus avoiding the patient being exposed to the risk of rejection episodes.

摘要

肾脏移植是一种外科手术,通过该手术,将两个原始肾脏中的一个替换为另一个由匹配个体捐赠的健康肾脏。在大多数情况下,捐赠者是近期去世的人。也有可能从同意捐赠的活体供体身上获取肾脏。通常,活体供体是直系家庭成员,但也可能是与接受者完全无关的志愿者。肾脏移植中一个令人非常担忧的并发症是感染的出现。这些感染往往是由于作为抗排斥疗法使用的免疫抑制药物引起的。在本综述中,我们描述了肾移植受者可能出现的胃肠道并发症,这些并发症与继发致病微生物有关,或者是由于手术期间的机械损伤,或者是与抗排斥疗法相关的代谢或器官毒性。其中一些并发症可能会影响生活质量或带来重大死亡风险;幸运的是,它们中的许多可以在不停止免疫抑制的情况下得到预防和治疗,从而避免患者面临排斥反应发作的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b0/7712021/0f51fd963b5b/j_med-2020-0130-ga001.jpg

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