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环孢素A和FK 506治疗的原位肝移植患者的神经毒性

Neurotoxicity after orthotopic liver transplantation in cyclosporin A- and FK 506-treated patients.

作者信息

Mueller A R, Platz K P, Schattenfroh N, Bechstein W O, Christe W, Neuhaus P

机构信息

Free University of Berlin, Univ.-Klinikum Rudolf Virchow, Department of Surgery, Germany.

出版信息

Transpl Int. 1994;7 Suppl 1:S37-42. doi: 10.1111/j.1432-2277.1994.tb01307.x.

Abstract

Neurotoxicity is a serious complication following orthotopic liver transplantation leading to increased morbidity and mortality. Neurotoxicity may be evoked by various perioperative factors, or may be due to drug-specific toxicity of immunosuppression. In the present study we evaluated the incidence of central nervous system (CNS) toxicity occurring within the early postoperative period of 121 patients, 61 randomly assigned to FK 506- and 60 to CsA-based immunosuppression as part of a multicentre study. The incidence of moderate or severe CNS toxicity was higher in patients treated with FK 506 (21.3%) than in patients receiving CsA (11.7%). The duration of symptoms was also greater in patients treated with FK 506 than in patients receiving CsA. The incidence of moderate or severe neurotoxicity after retransplantation was markedly greater in patients treated with FK 506 (100% of the patients).

摘要

神经毒性是原位肝移植术后一种严重的并发症,可导致发病率和死亡率升高。神经毒性可能由多种围手术期因素诱发,也可能是由于免疫抑制药物的特异性毒性。在本研究中,我们评估了121例患者术后早期发生中枢神经系统(CNS)毒性的发生率,其中61例随机分配接受基于FK 506的免疫抑制治疗,60例接受基于环孢素A(CsA)的免疫抑制治疗,这是一项多中心研究的一部分。接受FK 506治疗的患者中,中度或重度CNS毒性的发生率(21.3%)高于接受CsA治疗的患者(11.7%)。FK 506治疗的患者症状持续时间也比接受CsA治疗的患者更长。再次移植后,接受FK 506治疗的患者中,中度或重度神经毒性的发生率明显更高(100%的患者)。

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