[肝肾移植术后原发性恶性肿瘤的发展及治疗方法]。

W O Bechstein, K Dette, M Golling, Ch Wullstein
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引用次数: 0

摘要

实体器官移植后原发性恶性肿瘤的发生率是正常人群的三倍以上。原因包括免疫抑制的强度和持续时间、术前未被发现、受体存在隐匿的恶性或癌前病变、通过移植直接或间接的肿瘤传播以及环境因素。预防措施包括对有原发性eb病毒感染风险的个体进行抗病毒治疗和防止日晒。早期发现遵循一般医疗准则,此外,对某些危险患者群体进行选择性筛查。实体瘤的治疗遵循专业工作组的既定指导方针。移植后淋巴细胞增生性疾病通常可以用抗cd抗体(利妥昔单抗)治疗。抗增殖性免疫抑制剂如雷帕霉素在未来可能降低恶性肿瘤复发的发生率方面似乎很有希望。
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[Development of primary malignancies after liver and kidney transplantation and the treatment approach].

Primary malignancy after solid organ transplantation has a more than three-fold incidence compared to the normal population. Causes are intensity and duration of immunosuppression, pre-operatively undetected, occult malignancy or pre-cancerous lesions in the recipient, direct or indirect tumor transmission via the transplant and environmental factors. Measures for prevention comprise antiviral treatment of individuals at risk for primary EBV-infection and prevention of sun exposure. Early detection follows general medical guidelines and, in addition, selective screening of certain risk groups of patients. Treatment of solid tumors follows established guidelines of professional working parties. Post-transplant lymphoproliferative disorders can often be treated with anti-CD antibody (rituximab). Antiproliferative immunosuppressants like rapamycin may seem promising with regard to a possibly reduced incidence of de-novo malignancy in the future.

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