Zdravstvena nega pacienta pri zavrnitvi presadka proti gostitelju po presaditvi krvotvornih matičnih celic : diplomsko delo

Majer, Andreja (author), Thaler, Darja (mentor), Ovijač, Darja (reviewer)

Uvod: Postopek presaditve krvotvornih matičnih celic se je razvil in je danes eden najbolj edinstvenih postopkov v medicini. Zavrnitev presadka proti gostitelju ostaja glavna ovira za uspešnost le-tega. Opisujemo ga kot reakcijo imunskih celic darovalca proti tkivom gostitelja. Zdravstvena nega pacientov z zavrnitvijo presadka proti gostitelju po transplantaciji krvotvornih matičnih celic zaradi svoje specifičnosti zahteva dodaten sklop znanja in spretnosti medicinskih sester. Namen: Namen diplomskega dela je predstaviti zahtevnost in posebnosti zdravstvene nege pacientov pri nastanku presadka proti gostitelju po presaditvi krvotvornih matičnih celic. Metode dela: V diplomskem delu je uporabljena deskriptivna metoda dela s pregledom tuje literature, iskane v podatkovnih bazah MedLine, SienceDirect, Taylor & Francis, Crossref, CINAHL in Webof science, s pomočjo iskalnikov Pubmed in EBSCOhost ter s spletnim brskalnikom Google Učenjak. Do podatkov smo dostopali na daljavo, preko knjižnice Zdravstvene fakultete. Iskanje literature je potekalo v obdobju od februarja do novembra 2021. V analizo je bilo vključenih 27 tujih člankov in 1 slovenski. Rezultati: Ugotovili smo, da incidenca zavrnitve presadka proti gostitelju narašča zaradi napredka razvoja zdravljenja z presaditvijo krvotvornih matičnih celic. Zavrnitev presadka proti gostitelju je najpogostejši pozni zaplet in pomembno vpliva na dolgoročno kakovost pacientovega življenja. Po svetu se za negovanje takšnih pacientov ustanavljajo specializirane klinike, medicinske sestre pa zaradi zahtevnosti in specifičnosti zdravstvene nege opravljajo specializacije. Zdravljenje s CAR-T celicami se je izkazalo kot učinkovito zdravilo v boju proti zavrnitvi presadka, proti gostitelju. Razprava in zaključek: Akutna in kronična zavrnitev presadka proti gostitelju sta zapleta, ki še naprej omejujeta življenje pacientov po presaditvi krvotvornih matičnih celic. Zdravstvena nega takšnega pacienta zahteva edinstveno znanje in spretnosti. S trenutnim razvojem zdravljenja s presaditvijo krvotvornih matičnih celic in novimi spoznanji bi zdravljenje s CAR-T celicami odpravilo potencial za nastanek zavrnitve presadka proti gostitelju pri alogenskih presaditvah.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, transplantacija, zavrnitev, kakovost življenja
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Majer]
• Year: 2022
• Number of pages: 27 str.
• PID: 20.500.12556/RUL-137021
• UDC: 616-083
• COBISS.SI-ID: 109555203
• Publication date in RUL: 29.05.2022

Secondary language

• Language: English
• Title: Nursing for patients with graft versus host disease after hematopoietic stem cell transplantation : diploma work

Abstract

Introduction: The process of hematopoietic stem cell transplantation has developed and is one of the most unique procedures in medicine today. Rejection of the graft against the host, however, remains a major obstacle to its success. It is described as a reaction of donor immune cells against host tissues. Nursing of patients with graft rejection against the host after hematopoietic stem cell transplantation, due to its specificity, requires an additional set of knowledge and skills of nurses. Purpose: The purpose of this thesis is to present the complexity and specifics of nursing patients in the formation of a graft against the host after transplantation of hematopoietic stem cells. Methods of work: The diploma thesis uses a descriptive method of work with a review of foreign literature, searched in databases MedLine, Sience Direct, Taylor & Francis, Crossref, CINAHL and Web of science using the search engines Pubmed and EBSCOhost and the web browser Google Scholar. Data were accessed remotely through the library of the Faculty of Medicine. The literature search took place in the period from February to November 2021. 27 foreign articles and 1 Slovenian article were included in the analysis. Results: We found that the incidence of graft rejection versus host was increasing due to progress treatment with hematopoietic stem cell transplantation. Graft rejection versus host it is the most common late complication and significantly affects the long-term quality of a patient’s life. Specialized clinics are being set up around the world to care for such patients, and nurses are specializing in the complexity and specificity of nursing. CAR-T cell therapy has been shown to be an effective drug in combating graft rejection against the host. Discussion and Conclusion: Acute and chronic graft rejection versus host are complications that continue to limit the lives of patients after hematopoietic stem cell transplantation. The nursing of such a patient requires unique knowledge and skills. However, with the current development of treatment and the findings of hematopoietic stem cell transplantation, CAR-T cell therapy would eliminate the potential for graft rejection against the host in allogeneic transplants.

• Keywords: diploma theses, nursing care, transplantation, rejection, quality of life