Infekcije nakon transplantacije jetre

master's thesis

• Title (english): Infections after liver transplantation
• Author: Ana Mašić
• Mentor: Anna Mrzljak (mentor)
• Committee member: Neven Ljubičić (predsjednik povjerenstva)
• Committee member: Slavko Gašparov (član povjerenstva)
• Committee member: Anna Mrzljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Infekcije predstavljaju najznačajnije komplikacije nakon transplantacije jetre i značajno povisuju morbiditet i mortalitet bolesnika. Brojni faktori rizika utječu na razvitak i učestalost infekcija od kojih su najvažniji dugoročna imunosupresijia, infektivne i druge bolesti primatelja i darivatelja te sam kirurški postupak. Po vremenu nastanka infekcije se dijele na infekcije ranog, intermedijarnog i kasnog posttransplantacijskog razdoblja. Za svaki vremenski period vezani su najčešći uzročnici. U ranom razdoblju najučestalije su bakterijske nozokomijalne infekcije s visokom učestalošću multirezistentnih bakterija. Nakon toga smanjuje se broj nozokomijalnih, a raste broj oportunističkih infekcija s virusima kao glavnim uzročnicima te reaktivacija latentnih infekcija. U kasnom razdoblju javljaju se izvanbolničke infekcije, što ovisi o epidemiološkim svojstvima okoline u kojoj primatelj boravi. Infekcije mogu zahvatiti bilo koji organski sustav. Klinička slika je individualna, a simptomi su često skriveni zbog imunosuprimiranog stanja pacijenta. Jakost infektivnih zbivanja varira od blagih, samolimitirajućih upala do infektivnih septičkih komplikacija i zatajenja organa. Borba protiv infekcija uključuje pravilno korištenje farmakoterapije u imunosupresiji nakon transplantacije, pravilan odabir i doziranje antimikrobnih lijekova te visoku kvalitetu prevencije i profilakse za najčešće infektivne uzročnike. Cilj ovog preglednog rada je prikazati dosadašnja saznanja o infekcijama primatelja nakon transplantacije jetre, povezati pojavu infekcija s čimbenicima rizika te prikazati najznačajnije uzročnike i načine sprječavanja infektivnih zbivanja.

Abstract (english)

Infections represent the most significant complication after liver transplantation and significantly increase the morbidity and mortality of the patient. Numerous risk factors affect the development and frequency of infections, the most important being long-term immunosuppression, infectious and other diseases of recipients and donors, and the surgical procedure itself. Regarding the time of infection, they are divided into infections of early, intermediate and late posttransplantation period. The causal agents are related to the specific period. In the early period the most frequent are bacterial nosocomial infections, with a high frequency of multi-resistant bacteria. After that period the incidence of nosocomial infections decrease and a growing number of opportunistic infections is noted, with viruses as the main causal agents and the reactivation of latent infections as well. In the late period, outbreaks of infection may occur, and the etiology depends on the epidemiological setting of the environment in which the recipient resides. Infections may interfere with any organic system. The clinical presentation is individual and the symptoms are often hidden due to the immunosuppressed state of the patient. The strength of the infectious events varies from mild, self-limiting inflammation to severe infection with septic complications and organ failure. Combating infections involves proper use of immunosuppressive therapy after transplantation, proper selection and dosing of antimicrobial drugs and high quality of prevention and prophylactic measures. The aim of this review is to present the current knowledge on infections after liver transplantation, to associate the occurrence of infections with risk factors and to demonstrate the most important causes and ways of preventing infectious events.

• Keywords: infekcija; transplantacija jetre; imunosupresija; primatelj
• Keywords (english): infection; liver transplant; immunosuppression; recipient
• Language: croatian
• URN:NBN: urn:nbn:hr:105:940562
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-03-16 11:20:02