RESUMO
Sickle-cell disease (SCD) leads to recurrent vaso-occlusive crises, chronic end-organ damage, and resultant physical, psychological, and social disabilities. Although hematopoietic stem-cell transplantation (HSCT) is potentially curative for SCD, this procedure is associated with well-recognized morbidity and mortality and thus is ideally offered only to patients at high risk of significant complications. However, it is difficult to identify patients at high risk before significant complications have occurred, and once patients experience significant organ damage, they are considered poor candidates for HSCT. In turn, patients who have experienced long-term organ toxicity from SCD such as renal or liver failure may be candidates for solid-organ transplantation (SOT); however, the transplanted organs are at risk of damage by the original disease. Thus, dual HSCT and organ transplantation could simultaneously replace the failing organ and eliminate the underlying disease process. Advances in HSCT conditioning such as reduced-intensity regimens and alternative donor selection may expand both the feasibility of and potential donor pool for transplantation. This review summarizes the current state of HSCT and organ transplantation in SCD and discusses future directions and the clinical feasibility of dual HSCT/SOT.
Assuntos
Anemia Falciforme/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Transplante de Órgãos/métodos , Transplante de Células-Tronco Hematopoéticas/tendências , Humanos , Transplante de Órgãos/tendências , Doadores de TecidosRESUMO
Resúmen ejecutivo que contiene información acerca del programa de asistencia técnica provisto por ACDI -VOCA para Servicios Multiples de Tecnologías Apropiadas - SEMTA. Programa orientado al establecimiento de asociaciones rurales de comercialización en las comunidades Comanche (Altiplano) y Achocalla (Valle Interandino), incentivando la participación eficiente y organizada de los pequeños productores de la zona en las diferentes actividades de comercialización consolidadas en función a la demanda del mercado, previa capacitación en cuanto a mejoras en la producción, aspectos administrativos y técnicas de comercialización aplicables