Stratégia očkovania pri transplantácii pečene – držíme krok so svetovými trendmi?
Zuzana Podmanická1, Světlana Adamcová Selčanová2, Eliška Lovratová3, Zuzana Krištúfková4, Ľubomír Skladaný5
+ Pracoviště
Souhrn
Pacienti s pokročilým chronickým ochorením pečene (ACLD) a tí, ktorí čakajú na transplantáciu pečene (LT) alebo ju už podstúpili, sú vystavení vysokému riziku infekčných komplikácií v dôsledku oslabeného imunitného systému. Vakcinácia predstavuje kľúčovú stratégiu na prevenciu závažných infekcií v tejto vysoko rizikovej skupine. Účinnosť vakcín závisí od načasovania ich podania – optimálne je vakcinovať pacientov v raných štádiách ochorenia pred transplantáciou, keď je imunitná odpoveď najlepšia. Po transplantácii je vakcinácia možná, no vyžaduje stabilizáciu imunosupresívnej terapie. Podávanie živých vakcín po LT je kontroverzné, hoci nové výskumy naznačujú ich potenciálnu bezpečnosť v špecifických prípadoch. Tento článok sumarizuje odporúčané vakcinačné stratégie v Európe a vo svete, hodnotí účinnosť vakcinácie v tejto populácii a zdôrazňuje potrebu ďalšieho výskumu na optimalizáciu očkovacích postupov u pacientov s chronickými ochoreniami pečene a po transplantácii.
Klíčová slova
pokročilé chronické ochorenie pečene, transplantácia pečene, vakcinácia, imunitná dysfunkcia, infekčné komplikácie, imunosupresívna terapia
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