Bugallo-Carrera Cesar, Facal David, Domínguez-Lenogue Cristina, Álvarez-Vidal Vanessa, Gandoy-Crego Manuel, Caamaño-Ponte José
Asociación de Familiares de Enfermos de Alzheimer de Fisterra e Soneira-Afafes. Cee, 15270 A Coruña, Spain.
Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
Brain Sci. 2022 Dec 16;12(12):1721. doi: 10.3390/brainsci12121721.
The development of immunosuppressants has been key for the advancement of solid organ transplant surgery. Specifically, cyclosporine, tacrolimus, or everolimus have significantly increased the survival rate of patients by reducing the risk of a rejection of the transplanted organ and limiting graft-versus-host disease. We report the case of a 65-year-old man who, after undergoing a liver transplantation and receiving an immunosuppressive treatment with cyclosporine and everolimus, presented severe obsessive, psychotic, and behavioral symptoms over the past three years, and describe the pharmacological and non-pharmacological interventions implemented against these symptoms. In this case, the immunosuppressants used have been cyclosporine and, preferably, everolimus. On the other hand, potential adverse reactions to the treatment have been observed, including neuropsychiatric symptoms such as tremor, anxiety, dysthymia, psychosis, and behavioral disorders, which make it necessary to use corrective psychoactive drugs such as benzodiazepines, antidepressants, and antipsychotics, combined with non-pharmacological interventions. A transversal approach, from the medical and psychosocial disciplines, facilitates success in managing neuropsychiatric symptoms after soft organ transplants.
免疫抑制剂的发展是实体器官移植手术取得进展的关键。具体而言，环孢素、他克莫司或依维莫司通过降低移植器官排斥风险和限制移植物抗宿主病，显著提高了患者的生存率。我们报告了一例65岁男性患者的病例，该患者在接受肝移植并接受环孢素和依维莫司免疫抑制治疗后，在过去三年中出现了严重的强迫、精神和行为症状，并描述了针对这些症状实施的药物和非药物干预措施。在该病例中，使用的免疫抑制剂为环孢素，优选依维莫司。另一方面，已观察到该治疗的潜在不良反应，包括神经精神症状，如震颤、焦虑、心境恶劣、精神病和行为障碍，这使得有必要使用苯二氮䓬类、抗抑郁药和抗精神病药等矫正性精神活性药物，并结合非药物干预措施。从医学和社会心理学科采取横向方法，有助于成功管理软组织器官移植后的神经精神症状。
