Abdominalchirurgie trifft Nephrologie: Wichtige nephrologische Aspekte vor und nach Nieren- bzw. Lebertransplantation

Zusammenfassung

Bei chronischer Niereninsuffizienz ist die erfolgreiche Nierentransplantation (NTx) die Methode der Wahl, um Gesundheit, Wohlbefinden und körperliche Leistungsfähigkeit der Patienten wiederherzustellen. Sowohl für die Vorbereitung der entsprechenden Patienten als auch für deren postoperative Versorgung ist eine intensive interdisziplinäre Zusammenarbeit zwischen Nephrologen und Abdominalchirurgen unabdingbar. Ähnliches gilt für die Betreuung der Patienten vor und nach Lebertransplantation (LTx). Hier ist der Nephrologe häufig involviert bei prä- und postoperativer Dialysepflicht, aber auch bei der Entscheidung über eine kombinierte Listung zur Leber- und Nierentransplantation. In dieser Übersicht werden nephrologische Aspekte, die bei der Patientenbehandlung vor und nach Nieren- bzw. Lebertransplantation eine Rolle spielen, diskutiert.

Abstract

In cases of chronic renal insufficiency, successful kidney transplantation is the method of choice to restore patientsʼ health, well-being and physical fitness. The interdisciplinary collaboration of nephrologists and transplant surgeons has always been a prerequisite for the successful pre-, peri- and post-transplant care of renal transplant patients. The same holds true for liver transplant patients. Here the nephrologist is often involved in cases requiring pre- or post-transplant dialysis as well as in decision making for combined liver-kidney transplantation. This review focuses on nephrological aspects in patient care before and after kidney and liver transplantation.

Schlüsselwörter

Niere - Leber - Transplantation

Key words

kidney - liver - transplantation

• Literatur

• 1 Opelz G, Wujciak T, Döhler B. et al. HLA compatibility and organ transplant survival. Collaborative Transplant Study. Rev Immunogenet 1999; 1: 334-342
• 2 Opelz G, Döhler B. Effect of human leukocyte antigen compatibility on kidney graft survival: comparative analysis of two decades. Transplantation 2007; 84: 137-143
• 3 Becker LE, Susal C, Morath C. Kidney transplantation across HLA and ABO antibody barriers. Curr Opin Organ Transplant 2013; 18: 445-454
• 4 Ponticelli CE. The impact of cold ischemia time on renal transplant outcome. Kidney Int 2015; 87: 272-275
• 5 Mikhalski D, Wissing KM, Ghisdal L. et al. Cold ischemia is a major determinant of acute rejection and renal graft survival in the modern era of immunosuppression. Transplantation 2008; 85: S3-S9
• 6 Casey MJ, Wen X, Rehman S. et al. Rethinking the advantage of zero-HLA mismatches in unrelated living donor kidney transplantation: implications on kidney paired donation. Transpl Int 2015; 28: 401-409
• 7 Ford ML, Kirk AD, Larsen CP. Donor-reactive T-cell stimulation history and precursor frequency: barriers to tolerance induction. Transplantation 2009; 87: S69-S74
• 8 Brehm MA, Markees TG, Daniels KA. et al. Direct visualization of cross-reactive effector and memory allo-specific CD8 T cells generated in response to viral infections. J Immunol 2003; 170: 4077-4086
• 9 Page AJ, Ford ML, Kirk AD. Memory T-cell-specific therapeutics in organ transplantation. Curr Opin Organ Transplant 2009; 14: 643-649
• 10 Schwinzer R, Siefken R. CD45RA+ and CD45RO+ T cells differ in susceptibility to cyclosporin A mediated inhibition of interleukin-2 production. Transpl Immunol 1996; 4: 61-63
• 11 Tittelbach-Helmrich D, Pisarski P, Offermann G. et al. Impact of transplant nephrectomy on peak PRA levels and outcome after kidney re-transplantation. World J Transplant 2014; 4: 141-147
• 12 Scornik JC, Kriesche HU. Human leukocyte antigen sensitization after transplant loss: timing of antibody detection and implications for prevention. Hum Immunol 2011; 72: 398-401
• 13 Kidney Disease Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant 2009; 9 (Suppl. 03) S1-S155
• 14 Kousoulas L, Vondran FW, Syryca P. et al. Risk-adjusted analysis of relevant outcome drivers for patients after more than two kidney transplants. J Transplant 2015; 2015: 712049
• 15 Morath C, Opelz G, Zeier M. et al. Clinical relevance of HLA antibody monitoring after kidney transplantation. J Immunol Res 2014; 2014: 845040
• 16 Loupy A, Lefaucheur C, Vernerey D. et al. Complement-binding anti-HLA antibodies and kidney-allograft survival. N Engl J Med 2013; 369: 1215-1226
• 17 Schiffer M, Kielstein JT. ABO-incompatible renal transplantation: From saline flushes to antigen-specific immunoadsorption-Tools to overcome the barrier. Korean J Hematol 2011; 46: 164-168
• 18 Tyden G, Kumlien G, Genberg H. et al. The Stockholm experience with ABO-incompatible kidney transplantations without splenectomy. Xenotransplantation 2006; 13: 105-107
• 19 Heffron T, Welch D, Pillen T. et al. Successful ABO-incompatible pediatric liver transplantation utilizing standard immunosuppression with selective postoperative plasmapheresis. Liver Transpl 2006; 12: 972-978
• 20 Stewart ZA, Locke JE, Montgomery RA. et al. ABO-incompatible deceased donor liver transplantation in the United States: a national registry analysis. Liver Transpl 2009; 15: 883-893
• 21 Song GW, Lee SG, Hwang S. et al. Successful experiences of ABO-incompatible adult living donor liver transplantation in a single institute: no immunological failure in 10 consecutive cases. Transplant Proc 2013; 45: 272-275
• 22 Lebranchu Y, Baan C, Biancone L. et al. Pretransplant identification of acute rejection risk following kidney transplantation. Transpl Int 2014; 27: 129-138
• 23 Dunn TB, Noreen H, Gillingham K. et al. Revisiting traditional risk factors for rejection and graft loss after kidney transplantation. Am J Transplant 2011; 11: 2132-2143
• 24 Oien CM, Reisaeter AV, Leivestad T. et al. Living donor kidney transplantation: the effects of donor age and gender on short- and long-term outcomes. Transplantation 2007; 83: 600-606
• 25 Gore JL, Pham PT, Danovitch GM. et al. Obesity and outcome following renal transplantation. Am J Transplant 2006; 6: 357-363
• 26 Nyberg G, Karlberg I, Svalander C. et al. Renal transplantation in patients with systemic lupus erythematosus: increased risk of early graft loss. Scand J Urol Nephrol 1990; 24: 307-313
• 27 Cairoli E, Sanchez-Marcos C, Espinosa G. et al. Renal transplantation in systemic lupus erythematosus: outcome and prognostic factors in 50 cases from a single centre. Biomed Res Int 2014; 2014: 746192
• 28 Laftavi MR, Sharma R, Feng L. et al. Induction therapy in renal transplant recipients: a review. Immunol Invest 2014; 43: 790-806
• 29 Nguyen HD, Wong G, Howard K. et al. Modeling the benefits and costs of integrating an acceptable HLA mismatch allocation model for highly sensitized patients. Transplantation 2014; 97: 769-774
• 30 Chkhotua AB, Klein T, Shabtai E. et al. Kidney transplantation from living-unrelated donors: comparison of outcome with living-related and cadaveric transplants under current immunosuppressive protocols. Urology 2003; 62: 1002-1006
• 31 Delanaye P, Weekers L, Dubois BE. et al. Outcome of the living kidney donor. Nephrol Dial Transplant 2012; 27: 41-50
• 32 Muzaale AD, Massie AB, Wang MC. et al. Risk of end-stage renal disease following live kidney donation. JAMA 2014; 311: 579-586
• 33 Kher A, Mandelbrot DA. The living kidney donor evaluation: focus on renal issues. Clin J Am Soc Nephrol 2012; 7: 366-371
• 34 Schrem H, Kaltenborn A. Germany: Avoid more organ transplant scandals. Nature 2013; 498: 37
• 35 European Renal Best Practice Transplantation Guideline Development Group. ERBP Guideline on the Management and Evaluation of the Kidney Donor and Recipient. Nephrol Dial Transplant 2013; 28 (Suppl. 02) ii1-71
• 36 Yarlagadda SG, Coca SG, Garg AX. et al. Marked variation in the definition and diagnosis of delayed graft function: a systematic review. Nephrol Dial Transplant 2008; 23: 2995-3003
• 37 Siedlecki A, Irish W, Brennan DC. Delayed graft function in the kidney transplant. Am J Transplant 2011; 11: 2279-2296
• 38 Ponticelli C, Moia M, Montagnino G. Renal allograft thrombosis. Nephrol Dial Transplant 2009; 24: 1388-1393
• 39 Sprangers B, Kuypers DR. Recurrence of glomerulonephritis after renal transplantation. Transplant Rev (Orlando) 2013; 27: 126-134
• 40 Morozumi K, Takeda A, Otsuka Y. et al. Recurrent glomerular disease after kidney transplantation: an update of selected areas and the impact of protocol biopsy. Nephrology (Carlton) 2014; 19 (Suppl. 03) S6-S10
• 41 Briganti EM, Russ GR, McNeil JJ. et al. Risk of renal allograft loss from recurrent glomerulonephritis. N Engl J Med 2002; 347: 103-109
• 42 Ponticelli C, Glassock RJ. Posttransplant recurrence of primary glomerulonephritis. Clin J Am Soc Nephrol 2010; 5: 2363-2372
• 43 Ponticelli C, Moroni G, Glassock RJ. Recurrence of secondary glomerular disease after renal transplantation. Clin J Am Soc Nephrol 2011; 6: 1214-1221
• 44 Little MA, Hassan B, Jacques S. et al. Renal transplantation in systemic vasculitis: when is it safe?. Nephrol Dial Transplant 2009; 24: 3219-3225
• 45 Deegens JK, Artz MA, Hoitsma AJ. et al. Outcome of renal transplantation in patients with pauci-immune small vessel vasculitis or anti-GBM disease. Clin Nephrol 2003; 59: 1-9
• 46 Wang XP, Fogo AB, Colon S. et al. Distinct epitopes for anti-glomerular basement membrane alport alloantibodies and goodpasture autoantibodies within the noncollagenous domain of alpha3(IV) collagen: a janus-faced antigen. J Am Soc Nephrol 2005; 16: 3563-3571
• 47 Pinney JH, Lachmann HJ, Sattianayagam PT. et al. Renal transplantation in systemic amyloidosis-importance of amyloid fibril type and precursor protein abundance. Am J Transplant 2013; 13: 433-441
• 48 Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med 2013; 368: 2402-2414
• 49 European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol 2010; 53: 397-417
• 50 Wadei HM, Mai ML, Ahsan N. et al. Hepatorenal syndrome: pathophysiology and management. Clin J Am Soc Nephrol 2006; 1: 1066-1079
• 51 Schwarz A, Haller H, Schmitt R. et al. Biopsy-diagnosed renal disease in patients after transplantation of other organs and tissues. Am J Transplant 2010; 10: 2017-2025
• 52 Clajus C, Hanke N, Gottlieb J. et al. Renal comorbidity after solid organ and stem cell transplantation. Am J Transplant 2012; 12: 1691-1699
• 53 Cabezuelo JB, Ramirez P, Rios A. et al. Risk factors of acute renal failure after liver transplantation. Kidney Int 2006; 69: 1073-1080
• 54 Hilmi IA, Damian D, Al-Khafaji A. et al. Acute kidney injury following orthotopic liver transplantation: incidence, risk factors, and effects on patient and graft outcomes. Br J Anaesth 2015; 114: 919-926
• 55 Hilmi IA, Damian D, Al-Khafaji A. et al. Acute kidney injury after orthotopic liver transplantation using living donor versus deceased donor grafts: A propensity score-matched analysis. Liver Transpl 2015; 21: 1179-1185
• 56 Nguyen C, Shapiro R. Renal failure and transplantation following nonrenal solid-organ transplantation. Curr Opin Organ Transplant 2012; 17: 525-530
• 57 Sterneck M, Kaiser GM, Heyne N. et al. Everolimus and early calcineurin inhibitor withdrawal: 3-year results from a randomized trial in liver transplantation. Am J Transplant 2014; 14: 701-710
• 58 Schlitt HJ, Jonas S, Ganten TM. et al. Effects of mycophenolate mofetil introduction in liver transplant patients: results from an observational, non-interventional, multicenter study (LOBSTER). Clin Transplant 2013; 27: 368-378
• 59 Burra P, Senzolo M, Masier A. et al. Factors influencing renal function after liver transplantation. Results from the MOST, an international observational study. Dig Liver Dis 2009; 41: 350-356
• 60 Legendre CM, Licht C, Muus P. et al. Terminal complement inhibitor eculizumab in atypical hemolytic-uremic syndrome. N Engl J Med 2013; 368: 2169-2181
• 61 Weismüller TJ, Lerch C, Evangelidou E. et al. A pocket guide to identify patients at risk for chronic kidney disease after liver transplantation. Transpl Int 2015; 28: 519-528
• 62 Lufft V, Dannenberg B, Schlitt HJ. et al. Cardiovascular morbidity and mortality in patients with diabetes mellitus type I after kidney transplantation: a case-control study. Clin Nephrol 2004; 61: 238-245
• 63 Fogo AB. Causes and pathogenesis of focal segmental glomerulosclerosis. Nat Rev Nephrol 2015; 11: 76-87
• 64 Wei C, Möller CC, Altintas MM. et al. Modification of kidney barrier function by the urokinase receptor. Nat Med 2008; 14: 55-63
• 65 Murtas C, Bruschi M, Candiano G. et al. Coexistence of different circulating anti-podocyte antibodies in membranous nephropathy. Clin J Am Soc Nephrol 2012; 7: 1394-1400
• 66 Beck jr. LH, Salant DJ. Membranous nephropathy: from models to man. J Clin Invest 2014; 124: 2307-2314
• 67 Sethi S, Fervenza FC. Membranoproliferative glomerulonephritis–a new look at an old entity. N Engl J Med 2012; 366: 1119-1131
• 68 Masani N, Jhaveri KD, Fishbane S. Update on membranoproliferative GN. Clin J Am Soc Nephrol 2014; 9: 600-608
• 69 George JN, Nester CM. Syndromes of thrombotic microangiopathy. N Engl J Med 2014; 371: 654-666