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Blutungen in der Transplantationschirurgie

  • H. Riess

Zusammenfassung

Blutungskomplikationen in der Transplantationschirurgie resultieren einerseits aus der Komplexität des operativen Eingriffs und andererseits aus spezifischen Veränderungen der Hämostase aufgrund des zugrundeliegenden Organdefektes. So ist bei fehlenden sekundären Organschäden das Blutungsrisiko der Herztransplantation nicht wesentlich unterschiedlich von dem der koronaren Bypasschirurgie. Der infolge einer dekompensierenden Herzinsuffizienz mit konsekutivem Multiorganversagen resultierende Hämostasedefekt — unter Umständen agraviert durch den passageren kontinuierlichen Extrakorporalkreislauf eines Kunstherzens („bridging“) mit Antikoagulation — vervielfacht das Blutungsrisiko der folgenden Transplantation. Während hier das Verständnis der Pathophysiologie und die sich daraus ableitenden Möglichkeiten der therapeutischen Intervention in den Anfängen steckt, sind die Verhältnisse bei der Lebertransplantation weitgehend verstanden. Als weiteres Beispiel kann die Knochenmarktransplantation dienen, deren Grundlagen wesentlich von denen der Transplantation solider Organe abweicht.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

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  • H. Riess

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