Rothwell W S, Gloor J M, Morgenstern B Z, Milliner D S
Mayo Eugenio Litta Children's Hospital and the Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Transplantation. 1999 Jul 15;68(1):158-61. doi: 10.1097/00007890-199907150-00030.
Mycophenolate mofetil (MMF) is a new immune suppressive agent, effective in the prevention of acute rejection after renal transplantation.
The study was a retrospective review of records of pediatric renal transplant recipients from 1985 to the present.
Since October 1995, the immune suppression protocol for pediatric renal transplant recipients at Mayo Eugenio Litta Children's Hospital has included MMF, prednisone, and cyclosporine A. During that time, 19 children and adolescents have received renal allografts, 17 of whom were seropositive for varicella antibody before transplantation, while 2 were seronegative. Varicella infection occurred in 3 of 19 patients (15.8%), all 3 of whom had serologically documented immunity to varicella virus before transplantation. All episodes occurred within 12 months of transplantation. All had generalized vesicular lesions without dermatomal distribution. None of the patients developed fever, respiratory, mucocutaneous, or central nervous system manifestations. All were managed with oral acyclovir, and had an uncomplicated recovery without neuralgia. By contrast, of 74 consecutive patients transplanted before use of MMF, only 1 patient (1.4%) had varicella infection after transplantation (P=0.026).
The enhanced immunosuppression achieved with MMF appears to be associated with increased susceptibility to varicella infection.
霉酚酸酯（MMF）是一种新型免疫抑制剂，对预防肾移植术后急性排斥反应有效。
本研究是对1985年至今小儿肾移植受者记录的回顾性分析。
自1995年10月起，梅奥尤金尼奥·利塔儿童医院对小儿肾移植受者的免疫抑制方案包括MMF、泼尼松和环孢素A。在此期间，19名儿童和青少年接受了肾移植，其中17人移植前水痘抗体呈血清学阳性，2人呈血清学阴性。19例患者中有3例（15.8%）发生水痘感染，所有3例在移植前血清学检查均证明对水痘病毒有免疫力。所有感染均发生在移植后12个月内。所有患者均出现全身性水疱性皮疹，无皮节分布。所有患者均未出现发热、呼吸道、黏膜皮肤或中枢神经系统表现。所有患者均接受口服阿昔洛韦治疗，恢复顺利，无神经痛。相比之下，在使用MMF之前连续移植的74例患者中，只有1例（1.4%）在移植后发生水痘感染（P=0.026）。
MMF所致的免疫抑制增强似乎与水痘感染易感性增加有关。
