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Zentralbl Chir 2017; 142(02): 180-188
DOI: 10.1055/s-0035-1557918
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

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

Transplant Surgeon Meets Nephrologist: Important Nephrological Aspects Before and After Kidney or Liver Transplantation
F. W. R. Vondran
1   Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover, Deutschland
,
S. Wintterle
2   Nephrologie, Medizinische Hochschule Hannover, Deutschland
,
J. H. Bräsen
3   Pathologie, Medizinische Hochschule Hannover, Deutschland
,
H. Haller
2   Nephrologie, Medizinische Hochschule Hannover, Deutschland
,
J. Klempnauer
1   Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover, Deutschland
,
N. Richter
1   Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover, Deutschland
,
F. Lehner
1   Allgemein-, Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover, Deutschland
,
M. Schiffer
2   Nephrologie, Medizinische Hochschule Hannover, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
12 November 2015 (online)

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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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 3 Becker LE, Susal C, Morath C. Kidney transplantation across HLA and ABO antibody barriers. Curr Opin Organ Transplant 2013; 18: 445-454
    PubMedGoogle Scholar
  • 4 Ponticelli CE. The impact of cold ischemia time on renal transplant outcome. Kidney Int 2015; 87: 272-275
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 9 Page AJ, Ford ML, Kirk AD. Memory T-cell-specific therapeutics in organ transplantation. Curr Opin Organ Transplant 2009; 14: 643-649
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 15 Morath C, Opelz G, Zeier M. et al. Clinical relevance of HLA antibody monitoring after kidney transplantation. J Immunol Res 2014; 2014: 845040
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 18 Tyden G, Kumlien G, Genberg H. et al. The Stockholm experience with ABO-incompatible kidney transplantations without splenectomy. Xenotransplantation 2006; 13: 105-107
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 22 Lebranchu Y, Baan C, Biancone L. et al. Pretransplant identification of acute rejection risk following kidney transplantation. Transpl Int 2014; 27: 129-138
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 25 Gore JL, Pham PT, Danovitch GM. et al. Obesity and outcome following renal transplantation. Am J Transplant 2006; 6: 357-363
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 28 Laftavi MR, Sharma R, Feng L. et al. Induction therapy in renal transplant recipients: a review. Immunol Invest 2014; 43: 790-806
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 31 Delanaye P, Weekers L, Dubois BE. et al. Outcome of the living kidney donor. Nephrol Dial Transplant 2012; 27: 41-50
    CrossrefPubMedGoogle Scholar
  • 32 Muzaale AD, Massie AB, Wang MC. et al. Risk of end-stage renal disease following live kidney donation. JAMA 2014; 311: 579-586
    CrossrefPubMedGoogle Scholar
  • 33 Kher A, Mandelbrot DA. The living kidney donor evaluation: focus on renal issues. Clin J Am Soc Nephrol 2012; 7: 366-371
    CrossrefPubMedGoogle Scholar
  • 34 Schrem H, Kaltenborn A. Germany: Avoid more organ transplant scandals. Nature 2013; 498: 37
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 37 Siedlecki A, Irish W, Brennan DC. Delayed graft function in the kidney transplant. Am J Transplant 2011; 11: 2279-2296
    CrossrefPubMedGoogle Scholar
  • 38 Ponticelli C, Moia M, Montagnino G. Renal allograft thrombosis. Nephrol Dial Transplant 2009; 24: 1388-1393
    CrossrefPubMedGoogle Scholar
  • 39 Sprangers B, Kuypers DR. Recurrence of glomerulonephritis after renal transplantation. Transplant Rev (Orlando) 2013; 27: 126-134
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 42 Ponticelli C, Glassock RJ. Posttransplant recurrence of primary glomerulonephritis. Clin J Am Soc Nephrol 2010; 5: 2363-2372
    CrossrefPubMedGoogle Scholar
  • 43 Ponticelli C, Moroni G, Glassock RJ. Recurrence of secondary glomerular disease after renal transplantation. Clin J Am Soc Nephrol 2011; 6: 1214-1221
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 48 Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med 2013; 368: 2402-2414
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 50 Wadei HM, Mai ML, Ahsan N. et al. Hepatorenal syndrome: pathophysiology and management. Clin J Am Soc Nephrol 2006; 1: 1066-1079
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 53 Cabezuelo JB, Ramirez P, Rios A. et al. Risk factors of acute renal failure after liver transplantation. Kidney Int 2006; 69: 1073-1080
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 56 Nguyen C, Shapiro R. Renal failure and transplantation following nonrenal solid-organ transplantation. Curr Opin Organ Transplant 2012; 17: 525-530
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 63 Fogo AB. Causes and pathogenesis of focal segmental glomerulosclerosis. Nat Rev Nephrol 2015; 11: 76-87
    CrossrefPubMedGoogle Scholar
  • 64 Wei C, Möller CC, Altintas MM. et al. Modification of kidney barrier function by the urokinase receptor. Nat Med 2008; 14: 55-63
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 66 Beck jr. LH, Salant DJ. Membranous nephropathy: from models to man. J Clin Invest 2014; 124: 2307-2314
    CrossrefPubMedGoogle Scholar
  • 67 Sethi S, Fervenza FC. Membranoproliferative glomerulonephritis–a new look at an old entity. N Engl J Med 2012; 366: 1119-1131
    CrossrefPubMedGoogle Scholar
  • 68 Masani N, Jhaveri KD, Fishbane S. Update on membranoproliferative GN. Clin J Am Soc Nephrol 2014; 9: 600-608
    CrossrefPubMedGoogle Scholar
  • 69 George JN, Nester CM. Syndromes of thrombotic microangiopathy. N Engl J Med 2014; 371: 654-666
    CrossrefPubMedGoogle Scholar