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Dialyse aktuell 2018; 22(07): 302-310
DOI: 10.1055/a-0668-5039
Schwerpunkt | Transplantation
© Georg Thieme Verlag KG Stuttgart · New York

Wann sollte man die Immunsuppression nach Ende der Nierentransplantatfunktion absetzen?

Eine allgemeingültige Empfehlung gibt es nicht
Markus Tölle
Medizinische Klinik mit Schwerpunkt Nephrologie, Charité – Universitätsmedizin Berlin
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Publication History

Publication Date:
10 September 2018 (online)

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Zusammenfassung

In den nächsten Jahren wird bei vielen Patienten über eine zweite, dritte oder auch vierte Nierentransplantation nachgedacht werden, da die initialen Transplantate nach längerer oder kürzerer Funktion nicht mehr ausreichend entgiften und damit erneut eine maschinelle Nierenersatztherapie notwendig ist. Auch wenn das transplantierte Organ nicht mehr ausreichend funktionstüchtig ist, bleibt es ein Fremdkörper, kann weiterhin vom Körper als ‚fremd‘ erkannt und damit auch abgestoßen werden. Dies wiederum kann massive Komplikationen für betroffene Patienten nach sich ziehen. Auf der anderen Seite ist eine Immunsuppression durchaus mit kardiovaskulären, infektiologischen, aber auch mit malignen Risiken für den Patienten unter einer maschinellen Nierenersatztherapie verbunden. Damit stellt sich dem behandelnden Arzt bei einem versagenden Transplantat immer die Frage, wie mittelfristig mit der verwendeten immunsuppressiven Behandlung umgegangen werden sollte.

 

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