PŘEHLEDOVÉ ČLÁNKY Akutní infekce u pacientů po transplantaci ledviny | E17 / Vnitř Lék 2022;68(3):E12-E17 / VNITŘNÍ LÉKAŘSTVÍ www.casopisvnitrnilekarstvi.cz Závěr Imunosuprimovaní pacienti jsou ve zvýšeném riziku infekcí běžnými i oportunními původci s potencionálně závažným průběhem. V případě infekce vyžadující hospitalizaci, kromě odběru biologického materiálu ke kultivačnímu vyšetření, nasazení širokospektrých antibiotik při předpokladu bakteriální etiologie a podpůrné léčbě dané aktuálním stavem pacienta, redukujeme nebo vysazujeme imunosupresivní léčbu a jako minimum podáváme hydrocortison v dávce 200 mg/den a konzultujeme příslušné transplantační centrum. V diferenciální diagnostice febrilních stavů zvažujeme i neinfekční příčiny, jako je akutní rejekční epizoda, relaps systémového onemocnění nebo polékovou horečku. U pacientů v dialyzační léčbě po selhání funkce štěpu nezapomínáme na možný graft intolerance syndrom projevující se teplotami, bolestivostí v místě štěpu, anemizací, případně makroskopickou hematurií při zachovalé diuréze. V tomto případě je při vyloučení infekční etiologie po konzultaci transplantačního centra ke zvážení pulzní léčba kortikoidy. V případě jakýchkoli potíží u pacienta po transplantaci ledviny je konzultace příslušného transplantačního centra žádoucí. Podpořeno MZ ČR‑RVO‑FNOs/2018 LITERATURA 1. Obert R, Olfe AW, Alarie V et al. Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant. http://dx.doi.org/101056/NEJM199912023412303 [Internet]. 2008 Oct 21 [cited 2021 Dec 12];341(23):1725–30. Available from: https://www.nejm.org/doi/full/10.1056/ nejm199912023412303 2. Kostro JZ, Hellmann A, Kobiela J et al. Quality of Life After Kidney Transplantation: A Prospective Study. 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