The key restriction of transplantation medicine globally, as well as in the Czech Republic, concerns the lack of organs. The number of deceased donors, and thus the availability of organ transplants, has been stagnating in our country. The paper describes current legal regulations governing the dia-gnosis of brain death and primary legal and medical criteria for the contraindication of the deceased for organ explantation, gives an overview of the number of liver transplants, age structure, and diagnosis resulting in brain death of the deceased liver donors in the Czech Republic.
- MeSH
- dárci tkání zásobování a distribuce MeSH
- lidé MeSH
- mozková smrt zákonodárství a právo MeSH
- nemoci jater chirurgie MeSH
- seznamy čekatelů MeSH
- transplantace jater * MeSH
- transplantáty zásobování a distribuce MeSH
- získávání tkání a orgánů zákonodárství a právo MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
The development of immunosuppression has significantly affected the development of liver transplantation and has helped to switch from the experimental method to a standard treatment of life threatening liver conditions. Tacrolimus is the basic immunosuppressant for patients after a liver transplant and thanks to its prolonged-release dosage form, which due to its simplicity and reliability of use, replaces tacrolimus twice daily early after the transplant and in the longterm administration, will apparently, for a while, defend its position. Other widely used medicines include mycophenolic acid and mTOR inhibitors, sirolimus and everolimus. The induction with antilymphocyte antibodies is used in less than 10% of liver recipients. Only a few new immunosuppresants in this century have passed later stages of clinical studies; the last 2 medicines registered for patients after liver transplantation include Advagraf (Astellas) and Certican (Novartis). Personalised immunosuppression should respect at least the following basic clinical situations: recipients renal function, hepatitis C virus infection, and hepatocellular carcinoma as the liver transplant indication. The results of immunotolerance bio-marker research are necessary for a more successful conduct of protocols minimising immunosuppression and leading to immunotolerance, especially under the efforts of complete withdrawal of immunosupression.
- MeSH
- antilymfocytární sérum imunologie terapeutické užití MeSH
- everolimus MeSH
- hepatocelulární karcinom chirurgie MeSH
- imunosupresiva terapeutické užití MeSH
- kyselina mykofenolová terapeutické užití MeSH
- lidé MeSH
- nádory jater chirurgie MeSH
- nemoci jater chirurgie MeSH
- rejekce štěpu prevence a kontrola MeSH
- reprodukovatelnost výsledků MeSH
- selhání jater chirurgie MeSH
- sirolimus analogy a deriváty terapeutické užití MeSH
- takrolimus terapeutické užití MeSH
- transplantace jater * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antilymfocytární sérum MeSH
- everolimus MeSH
- imunosupresiva MeSH
- kyselina mykofenolová MeSH
- sirolimus MeSH
- takrolimus MeSH
