장기이식 환자에서 발생하는 위장관 합병증 |
김건민ㆍ정대영ㆍ김진일 |
가톨릭대학교 의과대학 내과학교실 |
Gastrointestinal Complication in Transplant Patients |
Gun Min Kim, M.D., Dae Young Cheung, M.D., Ph.D. and Jin Il Kim, M.D., Ph.D. |
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea |
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Abstract |
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The gastrointestinal tract is one of the major sites for complications after solid organ and hematopoietic stem cell transplantation, and gastrointestinal complications are the principle cause of morbidity and death. The major gastrointestinal complications after transplantation include mucositis, typhlitis, infectious enterocolitis by virus, bacteria or fungus, pseudomembranous colitis, gastric ulcer, graft- versus-host disease, pneumatosis cystoides intestinalis, thrombotic microangiopathy and post-transplantation lymphoproliferative disease. Symptoms and signs of gastrointestinal complications following transplantation are often non-specific and present with varying severity. Moreover, the suppressed immune state often prohibits invasive studies including endoscopy and blurs the serologic and hematologic results. Therefore, it is hard to reach accurate diagnoses even after thorough investigations. Almost all immunosuppressive drugs can lead to gastrointestinal complications and we need proper strategies to minimize their side effects. On the one hand, we can expect better organ and patient survival through the judicious use of a broad range of immunosuppressive drugs; on the other hand, we should try to not ruin survival through proper precautions and early treatment of gastrointestinal complications following successful transplantation. (Korean J Gastrointest Endosc 2010;41:65-71) |
Key Words:
Transplantation, Gastrointestinal diseases, Immunosuppression, Graft- Versus-Host Disease |
주요어:
이식, 위장관 질환, 면역억제제, 이식편대숙주병 |
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