Maligne bolesti nakon transplantacije jetre

master's thesis

• Title (english): Malignant diseases after liver transplantation
• Author: Nikola Sršan
• Mentor: Tajana Filipec Kanižaj (mentor)
• Committee member: Slobodanka Ostojić-Kolonić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tajana Filipec Kanižaj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Transplantacije jetre u bolesnika sa teškim zatajenjem funkcija jetre jedini je oblik terapije koji može značajno produžiti život pacijenata. Razvoj znanosti na više područja doprinio je boljim rezultatima toga zahvata. Transplantacija jetre, kao i većina tako radikalnih zahvata, dovodi do niza komplikacija od čega je pojava malignih bolesti jedan od važnijih uzroka smrti među pacijentima. Maligne bolesti u pacijenata nakon transplantacije jetre nastaju zbog primjene imunosupresije, virusne infekcije, rezidualnih stanica tumora... Imunosupresija je važan dio terapije koji štiti alotransplantat od odbacivanja, no kao posljedicu ima smanjenu mogućnost organizma da se brani od infekcija i tumorskih stanica. Postoje dva oblika pojave malignih bolesti u pacijenata pod imunosupresijom ; novonastali tumori, te ponovna pojava tumora. ----- Novonastali tumori definiraju se kao tumori koji nastaju kod pacijenata u kojih nema podataka od prethodnim oboljenju od malignih bolesti. Oni se dijele na kožne, limfoproliferativne, kolorektalni tumor.
Ponovna pojava tumora definira se kao pojava tumorskih stanica koje su prije transplantacije bile prisutne. Može se razvijati u području transplantiranoga organa, peritonealnoj šupljini, zdijelici, regionalnim limfnim čvorovima i/ili udaljenim metastazama. Najčešći su hepatocelularni karcinomi, kolangiocelularni karcinomi, neuroendokrini tumori. ----- Zbog učestalije pojave tumora kod pacijenata sa imunosupresijom potrebna je redovita kontrola pacijenata čime se smanjuje smrtnost pravodobnim tretmanom i smanjuju troškovi liječenja pacijenata. U nekim slučajevima potrebna je ponovna transplantacija jetre. Liste čekanja su dugačke i zbog toga postoje zahvati koji povećavaju preživljenje pacijenata do pronalaska prikladnoga donora.

Abstract (english)

Liver transplantation in patients with severe renal disfunction of the liver is the only form of therapy that can significantly extend the life expectancy of patients. The development of science in several areas contributed to the better results of liver transplantation procedure. Liver transplantation, as well as most of such radical operations, is leading to a series of complications of which the occurrence of malignant disease is one of the major causes of death among the patients. Malignant tumors in patients after liver transplantation ocurre due to the application of immunosuppression, viral infections, residual tumor cells ... Immunosuppression is an important part in therapy by protecting the allograft from rejection. As consequence there is a reduced possibility of the body to defend against infections and tumor cells. There are two forms of malignant diseases in patients that undergo immunosuppression ; newly tumors, and recurrence of the tumor.
De novo tumors are defined as tumors arising in patients in whom there is no data from previous malignant diseases. They are divided into skin, lymphoproliferative, colorectal tumors. ----- Recurrence of the tumors is defined as the reocurrence of tumor cells that were present before transplantation. It can be developed in the transplanted organ, the peritoneal cavity, pelvic cavity, regional lymph nodes and /or distant metastases. The most common tumors are hepatocellular carcinomas, kolangiocelularni cancer, neuroendocrine tumors. ----- Due to the frequent incidence of tumors in patients with immunosuppression regular follow up in patients are required to reduce the mortality and reduce treatment costs of patients. In some cases retransplantation is required. Waiting lists are long, but there are interventions that increase the survival rates of patients while waiting a suitable donor.

• Keywords: maligne bolesti jetre; transplantacija jetre; ponovna pojava tumora; novonastali tumori
• Keywords (english): malignant diseases of the liver; liver transplantation; recurrence of the tumors; de novo tumors
• Language: croatian
• URN:NBN: urn:nbn:hr:105:287237
• 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: 2016-04-08 09:56:41