It is now recognized that the immune system plays an important role in preventing tumorigenesis, but its detailed defense mechanisms are unclear and may be early detection of abnormal cells in the body. And destroy them before they proliferate and become cancerous.
When the immune system was suppressed, the chance of developing some type of malignant tumor increased, the incidence of lymphoma in allograft patients was 100 times higher than that in the same age control population, and the more smoothly after transplantation. Less rejection, the more common occurrence of tumor, may be caused by excessive immunosuppressive reaction.
A wide variety of tumors can occur, but skin cancer, lymphoid neoplasms are the most common, accounting for about a third of all tumors. In Australia, skin cancer is a particular problem in New Zealand, with a high incidence of post-transplant skin cancer. Mainly basal cell carcinoma, squamous cell carcinoma, and melanoma, they have a strong tendency to metastasis, and prone to local recurrence. Treatment should be considered according to the patient's situation, such as lesions limited, can continue to use immunosuppressive drugs. If there is metastasis, we should consider stopping immunosuppressive therapy.
Immunosuppressive agents of cortisol play an important role in leading to a series of complications after transplantation. The low dose of cortisol or the administration of cortisol every other day can reduce the incidence of complications. A large dose of cortisol immunosuppressive drugs appear a lot of destruction of long bones, among which the femoral head is the most common lesion site, showing the avascular necrosis of the femoral head, patients difficult to walk. Pain. Hip arthroplasty and femoral head replacement are often required to restore the patient's walking function. Knee and shoulder joints are also often involved. However, the artificial replacement of these joints is not effective. Cortisol can also cause osteoporosis and vertebral compression fracture.
According to general statistics, about 1/4 of the transplant patients developed subcapsular cataract, but there are not many patients with severe visual impairment. A few serious consequences are retinitis, which can lead to blindness and the appearance of Ke Xing like face. Accompanied by acne, skin thinning and loss of elasticity, the skin is not easy to heal after creation. Especially the skin before shank, can form necrosis and chronic ulcer after trauma, so called transplantation leg. This not only prolongs the length of stay in hospital. And severe patients need skin graft treatment.
After transplantation, mental symptoms can have disorientation, hallucinations, paranoid delusions, but these symptoms can also be caused by metabolic factors, anesthesia, surgical or patient stress and environmental factors. When hormones are reduced to maintenance levels. The patient enters the normal environment, the mental symptom may subside.
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