Padilla M L, Schilero G J, Teirstein A S
Mount Sinai Medical Center, Department of Medicine, New York, N.Y. 10029, USA.
Sarcoidosis Vasc Diffuse Lung Dis. 1997 Mar;14(1):16-22.
Organ transplantation is an accepted treatment for patients with end-stage organ failure. There is limited information about transplantation in patients with sarcoidosis. While there has been no systematic study of transplantation in sarcoidosis, there have been several reports of patients with sarcoidosis undergoing organ transplantation. The purpose of this review is to analyze the available literature.
We reviewed the literature regarding transplantation of kidney, liver, heart, heart-lung and lung in patients with sarcoidosis with attention to survival, complications and the incidence of recurrence of sarcoidosis in the transplanted organ and at distant sites.
Survival and complication rates are similar to those of patients undergoing transplantation for other indications. Recurrence of pulmonary sarcoidosis has been estimated to be 47% following lung transplantation. The published cases represent a fraction of the patients reported to the International Registry maintained by the United Network of Organ Sharing (UNOS).
Transplantation can be carried out safely in patients with sarcoidosis. Recurrence is frequent, often asymptomatic, and does not compromise graft function or patient survival. Radiographic abnormalities or symptoms associated with recurrence are responsive to increased adrenocorticosteroid therapy. Exacerbation of sarcoidosis in transplant recipients occurs in the setting of intense immunosuppression.
器官移植是终末期器官衰竭患者公认的治疗方法。关于结节病患者移植的信息有限。虽然尚未对结节病患者的移植进行系统研究，但已有数例结节病患者接受器官移植的报告。本综述的目的是分析现有文献。
我们回顾了关于结节病患者肾、肝、心、心肺及肺移植的文献，重点关注移植后的生存率、并发症以及移植器官和远处部位结节病复发的发生率。
生存率和并发症发生率与因其他适应证接受移植的患者相似。据估计，肺移植后肺结节病的复发率为47%。已发表的病例只是向器官共享联合网络（UNOS）维护的国际登记处报告的患者中的一部分。
结节病患者可以安全地进行移植。复发很常见，通常无症状，且不影响移植功能或患者生存。与复发相关的影像学异常或症状对增加肾上腺皮质激素治疗有反应。移植受者的结节病在强烈免疫抑制的情况下会加重。
