Common Infections In Organ Transplantation

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Ayşe Hande ARSLAN
Başkent Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji AD, Ankara, Türkiye
Article Language: TR
Değerli okuyucu,

Hepimizin bildiği gibi, ilk başarılı böbrek naklinin yapıldığı 1954 yılından bu yana bu tedavi yöntemi, son dönem organ yetmezliği olan birçok hastada başarı ile uygulanmaktadır. Günümüzde dünyada, başta böbrek, karaciğer, kalp, pankreas, ince bağırsak nakli olmak üzere yılda yüz elli binin üzerinde organ nakil gerçekleştirilmektedir. Ülkemizde ilk böbrek nakli 1975'te, ilk karaciğer nakli 1988'de Prof. Dr. Mehmet Haberal tarafından gerçekleştirilmiştir. Bugün ülkemiz nakil sıralamasında dünyanın ileri gelen ülkelerinden biridir. 2021 GODT (Global Observatory on Donation and Transplantation) raporuna göre Türkiye tüm nakillerde dünya genelinde on ikinci sırada, canlıdan alınan böbrek ve karaciğer nakillerinde ise ikinci sırada yer almaktadır.

İmmünsupresif ajanlardaki ve graft surviyindeki gelişmelere rağmen organ nakli başarısının önünde hâlihazırda iki engel bulunmaktadır; maligniteler ve enfeksiyonlar. Organ nakli sonrası rejeksiyonun engellenmesi için kullanılan immünsupresif tedaviler, organ alıcılarında daha fazla enfeksiyon gelişmesine neden olmaktadır. Solid organ nakli alıcılarında enfeksiyon etkenlerinin spektrumu çok geniştir. Etkenler toplum kökenli olabildiği gibi, sadece immün yetmezlikli hastalarda görülen fırsatçı enfeksiyon etkenleri veya donör kaynaklı beklenmeyen etkenler de olabilmektedir. Nakil alıcılarında enfeksiyonlar, sadece daha sık değil daha ağır da seyredebilmektedir.

Ülkemizde gittikçe artan sayıda gerçekleştirilen başarılı organ nakilleri sonucunda toplumda önemli bir sayıda organ alıcısı bulunmaktadır ve bu hastalarda gelişen enfeksiyonların hızlı değerlendirilmesi, erken tanınması ve etkin tedavi edilmesi iyi bir klinik yanıt için çok önemlidir.

Bu özellikli hasta grubunda gelişen enfeksiyonları değerlendirebilecek bilgi düzeyine sahip hekimlerin varlığı, organ nakli başarısının önemli bir basamağını oluşturmaktadır. Bu amaçla Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları (KLİMİK) Derneği bünyesinde kurmuş olduğumuz Nakil İlişkili İnfeksiyonlar Çalışma Grubu (NİÇG), bu hastalara hizmet verecek hekimlerin bilgi düzeyini arttırmak amaçlı çeşitli etkinliklerde bulunmaktadır. Türkiye Klinikleri'nin ''Organ Naklinde Sık Görülen Enfeksiyonlar'' adlı kitabı da bu etkinliklerden biridir. Bu kitap iki bölüm olarak düzenlenmiştir. Birinci bölümde organ nakli enfeksiyonları, ikinci bölümde ise bir diğer önemli tedavi yöntemi olan hematopoietik nakillerden sonra gelişen enfeksiyonlar irdelenecektir. Toplum sağlığına katkı sağlayacağını düşündüğümüz bu özel bölümleri okuyucuyla paylaşmamızı sağlayan Türkiye Klinikleri'ne çok içten teşekkürlerimizi sunarız.

Prof. Dr. Ayşe Hande ARSLAN
Editör
Başkent Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji AD, Ankara, Türkiye
Dear reader,

As you all know, since 1954, when the first successful kidney transplant was performed, this treatment method has been successfully applied to many patients with end-stage organ failure. Today, more than one hundred and fifty thousand organ transplantation are performed annually all over the world, including kidney, liver, heart, pancreas and small intestine transplants. In our country the first kidney transplantation (1975) and the first liver transplantation (1988) was performed by Prof. Mehmet Haberal MD. Today, our country is one of the leading countries in the world in terms of transplantation. According to the 2021 GODT (Global Organ Donation and Transplantation) report, Türkiye ranks twelfth worldwide in all transplants and second in kidney and liver transplants from living donors.

Despite advances in immunosuppressive agents and graft survival, there are currently two obstacles to organ transplantation success; malignancies and infections. Immunosuppressive treatments used to prevent rejection after organ transplantation cause more infections in organ recipients. The spectrum of infectious agents in solid organ transplant recipients is very broad. While the etiologic agents may be of community origin, they may be opportunistic microorganisms seen only in immunocompromised patients or unexpected ones originating from the donor. Infections in transplant recipients may not only be more frequent but also more severe.

As a result of the increasing number of successful organ transplantations in our country, there are a significant number of organ recipients in society, and rapid evaluation, early diagnosis and effective treatment of infections developing in these patients are very important for a good clinical response. The presence of physicians who have the knowledge to evaluate the infections that develop in this special patient group constitutes an important step in the success of organ transplantation.

For this purpose, the Transplantation-Related Infections Working Group (NIÇG), which we established within the Turkish Society of Clinical Microbiology and Infectious Diseases (KLİMİK), carries out various activities to increase the knowledge level of physicians who will serve these patients. Türkiye Klinikleri book titled ''Common Infections in Organ Transplantation'' is one of these events. This book is organized in two parts. In the first part, organ transplant infections, and in the second part, infections that develop after hematopoietic transplants, which is another important treatment method, will be discussed. We would like to express our sincere gratitude to the Türkiye Klinikleri for allowing us to share these special sections with the readers, which we think will contribute to public health.

Prof. Dr. Ayşe Hande ARSLAN
Editor
Başkent University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye

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