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Infektionen nach Organtransplantation

Infections after solid organ transplantation

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Zusammenfassung

Durch den Einsatz potenter Immunsuppressiva steigen die Raten erfolgreicher Organtransplantationen, allerdings auch die Infektionsrisiken. Die Pathogene können aus der Prätransplantationszeit mitgebracht (endogene Reaktivierung), durch das Spenderorgan übertragen oder neu erworben sein. Unter Immunsuppression kann sowohl eine milde klinische Symptomatik als auch eine atypische Laborkonstellation Infekte maskieren. Wichtig ist es, frühzeitig eine gezielte Diagnostik einzuleiten und an seltene Erreger zu denken, die mit mikrobiologischen Standardverfahren oft nicht erfasst werden.

Abstract

Potent immunosuppressive therapies increased the rate of successful solid organ transplantations, but are also associated with augmented risk for infections. The pathogens can originate from the pretransplant period (endogenous reactivation), donor-derived, or newly acquired. Immunosuppression can disguise infection by mild clinical symptoms and atypical laboratory constellation. Therefore, it is important to consider early in the process a systematic diagnostic workflow including rare pathogens which are sometimes not detectable by routine methods.

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Danksagung

Die Autoren danken Herrn PD Dr. med. Peter Hunold, Klinik für Radiologie und Nuklearmedizin und Frau Dr. med. Christiane Kümpers, Institut für Pathologie, UKSH, Campus Lübeck, für die freundliche Zur Verfügung Stellung der Abbildungen.

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Authors and Affiliations

  1. Medizinische Klinik I, Nephrologie und Transplantation, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    F. Cakiroglu & M. Nitschke

  2. Klinik für Infektiologie und Mikrobiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland

    J. Rupp

Authors
  1. F. Cakiroglu
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  2. J. Rupp
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  3. M. Nitschke
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Correspondence to F. Cakiroglu.

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Interessenkonflikt

F. Cakiroglu, J. Rupp und M. Nitschke geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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C. Dodt, München

C. Wrede, Berlin

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Cakiroglu, F., Rupp, J. & Nitschke, M. Infektionen nach Organtransplantation. Notfall Rettungsmed 20, 199–205 (2017). https://doi.org/10.1007/s10049-016-0241-y

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