{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T16:20:05Z","timestamp":1705422005516},"reference-count":47,"publisher":"Akademiai Kiado Zrt.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,1,1]]},"abstract":"<jats:p>A t\u00fcd\u0151transzplant\u00e1ci\u00f3 napjainkban m\u00e1r rutinszer\u0171en v\u00e9gzett beavatkoz\u00e1ss\u00e1 v\u00e1lt a v\u00e9gst\u00e1dium\u00fa parenchym\u00e1s \u00e9s vascularis t\u00fcd\u0151betegs\u00e9gekben. Az elm\u00falt k\u00e9t \u00e9vtized sor\u00e1n t\u00f6bb mint 20 ezer t\u00fcd\u0151transzplant\u00e1ci\u00f3t v\u00e9geztek a vil\u00e1gon. Az immunszuppressz\u00edv szerek fejl\u0151d\u00e9s\u00e9nek eredm\u00e9nyek\u00e9nt az \u00e9letet vesz\u00e9lyeztet\u0151 akut rejekci\u00f3k sz\u00e1ma jelent\u0151sen cs\u00f6kkent, az els\u0151 \u00e9ven bel\u00fcli hal\u00e1loz\u00e1s csup\u00e1n 2%-\u00e1t okozza. A legnagyobb ar\u00e1nyban az infekci\u00f3k felel\u0151sek a korai \u00e9s a k\u00e9s\u0151i morbidit\u00e1s\u00e9rt \u00e9s mortalit\u00e1s\u00e9rt. A posztoperat\u00edv els\u0151 30 napon bel\u00fcli hal\u00e1loz\u00e1s 21,2%-a, az els\u0151 \u00e9ven bel\u00fcli hal\u00e1loz\u00e1s 40%-a infekci\u00f3s eredet\u0171. Az els\u0151 h\u00f3napban a betegek 35\u201370%-\u00e1n\u00e1l bakteri\u00e1lis pneum\u00f3nia alakul ki, amelynek kb. fel\u00e9t Gram-negat\u00edv p\u00e1lc\u00e1k okozz\u00e1k, domin\u00e1l\u00f3an Pseudomonas-t\u00f6rzsek. A betegek a m\u0171t\u00e9tet k\u00f6vet\u0151en antibiotikus profilaxisban r\u00e9szes\u00fclnek, amit azt\u00e1n a donort\u00fcd\u0151b\u0151l kimutatott t\u00f6rzs rezisztenciatesztje alapj\u00e1n m\u00f3dos\u00edthatunk. A korai posztoperat\u00edv id\u0151szakban az invaz\u00edv gomba- (Aspergillus-, Candida-) \u00e9s CMV-infekci\u00f3k a 100 napig tart\u00f3 inhalat\u00edv amphotericin \u00e9s sziszt\u00e9m\u00e1s valganciklovir-profilaxis hat\u00e1s\u00e1ra kevesebb mint 10\u201310%-ban l\u00e9pnek fel. Sz\u00e1muk a profilaxis befejezte ut\u00e1n emelkedik. A k\u00e9s\u0151bbiekben kialakul\u00f3 bronchiolitis obliterans szindr\u00f3ma (BOS) szint\u00e9n hajlamos\u00edt a fert\u0151z\u00e9sekre. Ennek jelent\u0151s\u00e9g\u00e9t az adja, hogy 5 \u00e9vvel a m\u0171t\u00e9t ut\u00e1n a betegek kb. 50%-\u00e1n\u00e1l detekt\u00e1lhat\u00f3 a BOS. Az infekci\u00f3k sikeres lek\u00fczd\u00e9s\u00e9nek alapja a rutinszer\u0171en, illetve a t\u00fcnetek fell\u00e9pte ut\u00e1n min\u00e9l hamarabb elv\u00e9gzett kontroll (laborat\u00f3riumi, radiol\u00f3giai, l\u00e9gz\u00e9sfunkci\u00f3s, k\u00f6pet- \u00e9s bronchoszk\u00f3pos vizsg\u00e1latok), majd a c\u00e9lzott ter\u00e1pia bevezet\u00e9se. A munka c\u00e9lja a t\u00fcd\u0151transzplant\u00e1ltakn\u00e1l jelentkez\u0151 leggyakoribb infekci\u00f3k klinikai manifeszt\u00e1ci\u00f3j\u00e1nak, diagnosztik\u00e1j\u00e1nak \u00e9s kezel\u00e9s\u00e9nek \u00e1ttekint\u00e9se.<\/jats:p>","DOI":"10.1556\/oh.2008.28233","type":"journal-article","created":{"date-parts":[[2008,1,16]],"date-time":"2008-01-16T08:19:04Z","timestamp":1200471544000},"page":"99-109","source":"Crossref","is-referenced-by-count":5,"title":["Pulmonary infections after lung transplantation"],"prefix":"10.1556","volume":"149","author":[{"given":"Krisztina","family":"Czebe","sequence":"first","affiliation":[{"name":"1 Orsz\u00e1gos Kor\u00e1nyi Tbc- \u00e9s Pulmonol\u00f3giai Int\u00e9zet III. T\u00fcd\u0151beloszt\u00e1ly Budapest Pihen\u0151 \u00fat 1. 1529"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal\u00e1zs","family":"Antus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Varga","sequence":"additional","affiliation":[{"name":"3 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Transzplant\u00e1ci\u00f3s \u00e9s Seb\u00e9szeti Klinika Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eszter","family":"Csisz\u00e9r","sequence":"additional","affiliation":[{"name":"1 Orsz\u00e1gos Kor\u00e1nyi Tbc- \u00e9s Pulmonol\u00f3giai Int\u00e9zet III. T\u00fcd\u0151beloszt\u00e1ly Budapest Pihen\u0151 \u00fat 1. 1529"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1016\/j.healun.2006.06.001","volume":"25","year":"2006","journal-title":"J. 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