医技学院（华盛顿医疗手册培训器官移植）PPT课件.ppt

Chronic Allograft Dysfunction accounts for the vast majority of late graft losses; mediated by immune and nonimmune factors slowly progressive, insidious; major obstacle to long-term graft survival Pathologic characterization：gradual vascular and ductal obliteration, parenchymal atrophy, and interstitial fibrosis Diagnosis: often difficult and generally requires a biopsy Treatment: if established, no effective therapy; require a second solid organ transplant; aimed at prevention Company Logo Graft Rejection General Principles Diagnosis Manifestations Treatment -----Chronic Allograft Dysfunction Accounts for the vast majority of late graft losses and is the major obstacle to long-term graft survival ?Difficult ?Require a biopsy ?Mediated by immune and nonimmune factors Unique ?No effective therapy ?A second solid organ transplant ?Prevention Complications Infections Renal Disease Malignancy CMV Hepatitis B Hepatitis C EBV Fungus Parasite Complications ●Skin cancer ●Lip Cancer ●Lymphoproliferative Disease ●Bronchogenic Carcinoma ●Kaposi Sarcoma ●Uterine/Cervical Carcinoma ●Renal Cell Carcinoma ●Anogenital Neoplasms Company Logo Complications----Infections Treatment Treatment Diagnosis Polymerase Chain Reaction (PCR) ---- Blood Sample ?Valganciclovir ?450 to 900 mg PO bid ?Ganciclovir ?2.5 to 5.0 mg/kg bid IV adjusted for Renal Function CMV ?Hyperimmune globulin+Ganciclovir ☆ Organ Involvement ?Foscarnet / Cidofovir ☆ Ganciclovir Resistant Complications----Infections Hepatitis Lamivudin Text Ribavirin Interferon Hepatitis B Hepatitis C Solid Organ Transplant Medicine Dr. Bai Xue-li The Department of HBP Surgery and Liver Transplantation Contents Solid Organ Transplant Basics 1 Graft Rejection 2 Complications 3 Special Considerations 4 In 1954, Prof. Joseph Murray achieved the first successful kidney transplantation from one identical twin to another without using anti-rejection drugs The first successful kidney tran