Hondroliza nakon transplantacije jetre

master's thesis

• Title (english): Chondrolysis following liver transplantation
• Author: Mario Cvetko
• Mentor: Tomislav Smoljanović (mentor)
• Committee member: Domagoj Delimar (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Tomislav Smoljanović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2014-03-19, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Transplantacija jetre terapijski je postupak za sve bolesnike s ireverzibilnim akutnim ili
kroničnim zatajenjem jetre, čime im se pruža realna šansa ne samo za produljenje života nego
i za bitno poboljšanje kvalitete života. U bolesnika koji boluju od kroničnog zatajenja jetre,
kao i bolesnika liječenih ortotopnom transplantacijom jetre (eng. orthotopic liver
transplantation, OLT) postoji povećan rizik od nastanka koštano-zglobnih oboljenja. Jedno
od takvih oboljenja je i hondroliza. Hondroliza je bolest hijaline hrskavice sinovijalnog
zgloba, karakterizirana brzim propadanjem hondrocita i hrskavičnog izvanstaničnog matriksa.
Definitivan uzrok hondrolize u bolesnika nakon OLT još nije poznat. Incidencija bolesti
nakon OLT je niska (0,3%), a može biti zahvaćen jedan ili više zglobova. Najčešće zahvaćen
zglob je kuk, a potom po učestalosti lokalizacije hondrolize slijede redom koljeno, rame,
gležanj te lakat. Klinički se hondroliza očituje bolnošću i smanjenom pokretljivošću
zahvaćenog zgloba, a radiološki suženjem zglobne pukotine. Dijagnoza se postavlja na
temelju kliničke slike i radiološke obrade te u dvojbenim slučajevima artroskopskom
potvrdom. Zlatni standard u liječenju razvijene hondrolize je aloartroplastika zahvaćenog
zloba. U vremenu koje slijedi očekuje se porast broja bolesnika liječenih transplantacijom
jetre, a time i bolesnika s hondrolizom zbog čega je potrebno prikupljati saznanja o ovoj
rijetkoj bolesti kako bi se identificirali uzročni čimbenici te unaprijedila prevencija i liječenje
ove bolesti.

Abstract (english)

Liver transplantation is life saving medical procedure for patients with end-stage acute or
chronic liver failure, which provides patients greater life quality and longer life expectation.
Patients with chronic liver failure, so as patients treated with orthotopic liver transplantation
(OLT) have increased risk for bone and cartilage related maladies. One of the conditions is
joint chondrolysis. Joint chondrolysis is rapidly progressive deterioration of articular
cartilage. Definitive cause of chondrolysis in patients treated with OLT remains unclear.
Incidence of this disease is low (0.3%). Chondrolysis can affect one or more joints. Most
frequently involved joints are hip, then knee, shoulder and ankle. Clinically is presented with
great amount of pain and decreased joint motion and stiffness, with radiographs showing
narrowing of the joint space. Chondrolysis is diagnosed based upon clinical findings and
radiological confirmation, or arthroscopically in doubtful cases. Across all joints, total joint
arthroplasty remains golden standard for chondrolysis treatment. In years to follow, increase
in number of patients with liver transplantation is expected, so gathering knowledge about
chondrolysis is necessary, that the patients could get best treatment and chances to improve
their life quality.

• Keywords: hondroliza; zatajenje jetre; transplantacija; kuk; kvaliteta života
• Keywords (english): chondrolysis; liver failure; transplantation; hip; life quality
• Language: croatian
• URN:NBN: urn:nbn:hr:105:182577
• 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: Access restricted to students and staff of home institution
• Created on: 2015-12-15 12:50:29